Objective To investigate the relationship of urinary vascular endothelial growth factor (VEGF) and occurrence and invasiveness of bladder cancer. Method The expression of urinary VEGF in 48 patients with bladder cancer (bladder cancer group) and 45 normal cases (control group) were examined by ELISA immunohistochemical staining. Results VEGF levels in urine in bladder cancer group [(174.77±83.41) μg/L] were higher statistically than those in control group [(63.53 ±22.62) μg/L] (P < 0.01), and related to the staging and grading of tumors. VEGF levels were significant higher in invasive lesions [(223.00 ± 83.13) μg/L] than those in superficial ones [(130.40 ± 54.86) μg/L] (P < 0.01). VEGF levels of G3 [(259.23 ± 75.82) μg/L] were significant higher compared with G1 [(138.00± 85.60) μ g/L] and G2 [(146.22 ±47.53) μ g/L] (P < 0.01). Conclusion The concentration of urinary VEGF relates to the clinical staging and pathological grading, and it is a labeling index of the biological behavior of bladder cancer.

Objective To analyze the psychometric properties of the Fine Motor Function Measure Scale (FMFM) with cerebral palsied children less than 3 years old. Methods Three hundred and seventy-five children less than 3 years old with cerebral palsy were involved. The test-retest reliability, inter-tester reliability, correlation validity and structural validity of the FMFM were analyzed, as well as the responsiveness. Results The test-retest reliability (ICC = 0. 983 3 ) and the inter-tester reliability (ICC = 0. 992 4) of the FMFM were satisfactory. The correlation index between the raw FMFM scores and scores on the Peabody Developmental Motor Scale——Fine Motor was 0.919 9. The FMFM could clearly distinguish differences in fine motor function between the affected side and the intact side in children with hemiplegia. The differences in fine motor function between children with diplegia and quadriplegia could also be distinguished by the FMFM. The effect size of this scale was also good. Conclusion The reliability, validity and responsiveness of the FMFM were satisfying. The fine motor functioning of children with cerebral palsy could be effectively measured using the FMFM scale.

Objective To study the value and clinical significance of diffusion tensor imaging(DTI)in differentiating high-grade astrocytomas and solitary metastatic tumors of brain.Methods 16 patients with intracranial solitary metastasis and 25 patients with high-grade astrocytoma confirmed pathologically were examined with MR DTI.Mean diffusivity(MD)and fractional anisotropy(FA)were measured in the regions of interest(ROI)of peritumor and cerebral parenchyma of the normal side on DTL Fiber tractography was reconstructed and the encountered patterns of tumor-related alteration to cerebral white matter were observed.Results The peritumor were all depicted as hyperintense or isointense signals on DTI.The FA values were 0.227±0.05 and 0.169±0.07 in the peritumor of high-grade astrocytoma and metastasis respectively,which was of significant difference(P＜0.05).Furthermore,fiber tractography could display the course of white matter tracts in three-dimensional space.Conclusion DTI may be help to differential diagnosis of solitary metastasis and high-grade astrocytoma in clinical practice.

The cost to U.S.consumers of specialty drugs is too high,and cost-sharing obligations are reducing patient access to affordable and life-changing medications.While accounting only for approximately two percent of prescriptions filled,specialty drugs accounted for nearly 45 percent of the U.S.drug spend in 2018,and this rate continues to rise.This review analyzes the current state of the U.S.specialty drug market and recommends six policy options for decreasing out-of-pocket costs to consumers.A systematic review was conducted,gathering articles from peer-reviewed and government resources published from January 2014 to May 2019 using databases such as PubMed,OVID,and the Congressional Research Service (CRS).Articles were reviewed for unique and relevant information relating to cost specialty drugs,industry trends,underlying legislation and policy challenges,and viable policy options.The findings show that,while the cost of specialty drug prices is growing,the rate of growth is projected to slow to a compound annual growth rate (CAGR) of 4 to 7 percent between 2019 to 2023,as compared to a CAGR of 7.2 percent from 2014 to 2018,largely due to the Food and Drug Administration's approval of 10 new biosimilars in 2018 and early 2019.However,specialty drug spending as a percentage of total spending continues to rise and can cost payers and patients more than USD 3,500 on average per month.We recommend six policy options for reducing consumers' out-of-pocket cost obligations:(1) discourage "pay-for-delay" agreements and patent evergreening;(2) align incentives across the specialty drug supply chain with value-based pricing;(3) tighten orphan drug eligibility or impose a sales tax on drugs if the sales tax exceeds a specified threshold until federal subsidies are recouped;(4) increase transparency in transactions between specialty drug supply chain stakeholders;(5) tax the direct-to-consumer advertising of specialty drugs and use the proceeds to fund public research;and (6) support copay cards and patient assistance programs.While the consensus across the industry is that the out-of-pocket costs of specialty drugs to patients are too high,industry stakeholders must agree about which set of policy options to implement.Lawmakers must explore options for reducing the out-of-pocket costs of specialty medications and gather public input on how to best align stakeholder incentives across the specialty drug supply chain.

Actins ; analysis ; Animals ; Dimethylnitrosamine ; Immunohistochemistry ; Liver ; metabolism ; pathology ; Male ; Necrosis ; chemically induced ; pathology ; Rats ; Rats, Wistar ; Reticulin ; analysis ; Silver Staining

Objective To investigate the influence of preoperative arterial chemoembolization on expression of Ki-67,and clinical significance in bladder cancer. Methods Before and after chemoembolizafion of therapy,the expression of Ki-67 in 30 patients of bladder cancer tissue were examined by immunohistochemical staining.The rehtion of its expression to the pathological grade and clinical stage was evaluated clinically.Results Positive rate of Ki-67 expression in the bladder cancer tissue was 70.00% and 26.67% respectively.There was significant difference between the before and after therapy (P＜0.01). Follow-up for mean 24.6 months recurrence rate in 30 cases was 16.67%.The expression of Ki-67 correhted to the pathological grade, clinical stage and patient recurrence rates of bladder cancer.Conclusions Preoperative arterial chemeembelization can reduce the expression of Ki-67,adjust malignancy of bladder cancer,could downgrade and downstage the tumors,and cut down the postoperative metastasis,improve survival rate and reduce recurrence rate.Both of the Ki-67 labeling index are predictive factor for recurrence of superficial bladder cancer.

Objective To study the influence of transeatheter bladder arterial chemoembolization on neovascularization and vascular endothelial growth factor (VEGF) expression in bladder cancer treatment. Methods Thirty bladder cancer patients (Tis =1, Ta =2, T1 =6, T2 =11, T3 =9, T4 = 1; G1 = 9, G2=13, G3 = 8) were treated with transcatheter arterial chemotherapy with Mitomycin (20 mg) or Hydroxycamptothecin (10 nag) adding cisplatin (60 rag) and embolization with gelatine sponge particle gelform 1 week before surgery. Before and after the chemoembolization, the expression of VEGF and microvessel density (MVD) count in cancer tissue were examined by SP immunohistochemical staining. Tumor samples after chemoembolization were taken and sent for pathological examination. The over all survival rates were recorded and analyzed as well. Results Before and after the chemoembolization, positive rates of VEGF expression in bladder cancer tissue were 73. 3% and 43.3%, respectively and MVD were 69.8±3.4 and 56. 4±3.3, respectively. There were significant differences between the parameters before and after the treatment (P<0.05). After the intervention, tumor diameter decreased from 2.2±0.9 cm to 1.6±0. 9 cm (P<0.05) and tumor tissues were in severe necrosis and degeneration. During the follow-up of 24. 6 months (ranging from 12 to 36 months),there were 5 recurrent cases (G1 T1 =1, G2 T1=1, G2T3=1, G3T3 = 1, G3 T4 =1, primary transitional cell carcinoma= 4, admixture carcinoma= 1). In the recurrent group, VEGF expression were positive in 5 cases (100% strong positive) and 4 cases (80%, 3 positive, 1 strong positive) (P>0. 05) before and after the chemoembolization. However, it had significant difference in strong positive expression (P<0.05); MVD were 87.4±3.0 and 72.4±4.1 (P<0.05) before and after the treatment. The MVD in no recurrent group was 53.2±3. 5 after chemoembolization, and it had statistical significance comparing with the recurrent group (P<0. 05). Conclusions The chemoembolization can decrease the expression of tumor VEGF and MVD. Thus, it can adjust bladder cancer malignancy, downgrade and downstage the tumors and decrease the risk of postoperative metastasis. For the long-term, this treatment will improve the survival rate and reduce recurrence rate.

Objective To investigate the effect of transcatheter bladder arterial chemoembolization on microvessel density(MVD)change in bladder cancer. Methods The MVD count of bladder cancer tissue of 30 patients before and after chemoembolization were examined by SP immunohistochemical staining.Cancer tissues were examined pathology after chemoembolization.All the cases were followed up for 12 to 36 months(mean 24.6 months),the 3 years survival rate was evaluated clinically. Results MVD counts were 69.8±3.4 and 56.4±3.3 before and after therapy respectively(P<0.05).Cancer tissues were severely damaged ultramicroscopically after interventional chemotherapy.The recurrent rate was 16.67%in 30 cases. Conclusions The chemoembolization could decrease MVD,improve survival rate and reduce the recurrence rate.

OBJECTIVE To overcome shortcomings in use of bed sheet,and to improve it for examining bed.METHODS Based on the working principle of the reel toilet paper and industrial drive belt,a reel device for(disposable) whole bed sheet was designed,and used on the bed examining more than 300 times.(RESULTS) The new designed reel aevice with disposable whole bed sheet was operated easy and safely,with decreased cost and(contamination) in use.It could alleviate infection opportunity in favor of control againt hospital infection and(environmental) protection.(CONCLUSIONS) The device can mount on any size of examining bed and widely accept for use.

ABSTRACT:Objective To explore the expression of chemokine receptor CX3CR1 in severe acute pancreatitis (SAP)rats model and to estimate whether it can be a potential predictor of SAP.Methods Forty Sprague-Dawley rats were randomly divided into sham-operation (SO)group (n =20)and SAP group (n =20).Rats were killed at 6 h,12 h,24 h and 48 h after model induction.The serum level of CX3CR1 was measured by enzyme-linked immunosorbent assay (ELISA).The expression of CX3CR1 protein in the pancreas,lung and kidney were detected by immunohistochemistry.Results The serum level of CX3CR1 in SAP rats increased gradually after model induction and reached the peak at 24 h (542.4 pg/mL),which were significantly higher than those in SO group (P <0.05).The expression of CX3CR1 was found in the pancreas,lung and kidney tissues of SAP rats and higher than that in SO group.Meanwhile,the expression of CX3CR1 reached the peak at 24 h in the pancreas and lung and at 48 h in the kidney.Conclusion This study suggests that the chemokine receptor CX3CR1 may be one effective index for predicting the severity of acute pancreatitis and deserves further research.