Objective To evaluate the long-term effe ct of the continent urinary reservoir of ileocecum-colon with the appendix as out let. Methods Continent urinary reservoir of ileocecum-c olon with the appendix as outlet was performed in 46 patients with bladder tumor .Of them,21 patients (15 men and 6 women;mean age,57 years) were followed up by urodynamics for over 5 years.Pathologic grading showed G 2 in 12 cases and G 3 in 9;TNM staging showed T 3aN 0M 0 in 11 cases,T 3bN 0M 0 in 5,T 3bN 1M 0 in 3 and T 3bN 0M 1 in 2. Results Of the 21 cases,19 (95%) were of urinary continence.Catheterization was perfor med 4～5 times at daytime and 1～2 times at night; the volume was about 250～400 ml each time.On average the initial pressure of the reservoir was 28 cm H 2O (1 c m H 2O=0.098 kPa),and the maximal filling pressure was 36 cm H 2O;the correspo nding average capacity of the reservoir was 265 ml and 450 ml,respectively.The c losing pressure of the appendix outlet was 45 cm H 2O.One case developed lung m etastasis and underwent resection; 1 developed liver metastasis and died later.N o evidence of ureteral reflux and no hyperchloremic acidosis were observed. Conclusions Continent ileocecum-appendix pouch can be consi dered as an ideal form of urinary diversion characterized by lower internal pres sure and larger capacity of the urinary reservoir, and satisfactory continence.

ObjectiveTo investigate the clinical effects of androgen blockade combined treatment for the elderly with middle and late prostate cancer.Methods 63 patients (average age of 69.3 years) with middle and late prostate cancer (above stage T3 ) were studied retrospectively from June 2001 to August 2009.21 cases were treated by operation of bilateral orchidectomy independently.15 cases were treated by castration independently (enantone 3.75 mg or zoladex 3.6 mg/month,hypodermic injection for one year).27 cases were treated by bilateral orchidectomy plus maximum androgen blockade (MAB) (bicalutamide 50 mg,qd,fulutimad 250 mg,rid,po.)Results The survival rates of 1,2,3 years were 100.0％,90.0％,75.0％ in operation group,100.0％,86.7 ％,73.3％ in drug group,and 100.0％,96.2％,84.6％ in MAB group,respectively.The survival rates of 3 years was higher in MAB group than the other groups(x2 =4.460,P＜0.05).The levels of PSA within 3 months decreased and urinary flow rates in three groups increased after treatment than before treatment (t =2.641,3.074,6.703,P ＜ 0.01 ) with no differences among the groups.The relieve period of validity was longer in MAB group than in other groups (F=16.57,P＜0.01 ).Conclusions MAB may be more effective for the elderly with middle and late prostate cancer than castration therapy independently.

Objective To evaluate the long term outcome of the continent urinary reservoir constructed with ileocecum appendix. Methods From 1985 to 1992,continent urinary reservoir was constructed by using ileocecum appendix after radical cystectomy for 56 patients,of which 11 have been followed up for over ten years. Results The daytime continence rate was 90% and the night continence rate 80%.The average capacity of the urinary pouch has been 388 ml,and the mean pressure 28 cm H 2O.The average urine flow rate is 9.6 ml/s.No evidence of ureteral reflux and no hyperchloremic acidosis have been observed.Stone formation in the pouch occurred in 1 patient,pseudo valve in the posterior urethra in 2 and stricture of the posterior urethra in 1. Conclusions Continent ileocecum appendix pouch might be considered as an ideal form of urinary diversion,characterized by low pressure,large capacity,continent and in situ urination.

Objective To study the clinical effects of intra internal iliac arterial chemotherapy for invasive bladder cancer after operation. Methods From February 1997 to June 2000,32 cases of invasive bladder cancer underwent partial cystectomy and arterial infusion pump implanted into the intra internal iliac artery, for postoperative chemotherapy. Results The patients have been followed up for 5～42 months, with a mean of 26 months,27 of the 32 patients have been free from the tumor,metastasis to lung and liver was noted in 2.Recurrence occurred in 3?10?16?30 months after operation respectively.Few side effects were noted. Conclusions Intra arterial chemotherapy might serve as an adjuvant therapy for invasive bladder cancer after operation.

Objective To evaluate the effect of the urinary reservoir constructed with ileocecum-appendix in the elderly with bladder cancer. Methods From March 2002 to June 2008, 12 cases were treated using ileocecum-appendix as the reservoir after radical cystectomy. They all received the imaging urodynamics examination and were followed up for 1 year. Results The 11 of 12 patients had urinary continence completely. Only 1 case had incontinence and 3 cases had incontinentia urinae at night. Times of uresis were 8-10/day and 3-5/night within 3 months after surgery, and 4-6/day and 0-2/night 6 months after surgery. The urinary output was 150-350 ml/time. Urodynamics showed that mean urinary flow rate was 10.5 ml/s, mean initial bladder pressure was 27 cm H2O, the maximum filling pressure was 35 cm H2O. The average reservoir capacity was 152 ml and 420 ml, respectively. The out let pressure of posterior urethra was 52 cm H2O. The volume of residual urine was 0-65 ml. No evidence of ureteral reflux occurred, no hyperchloremic acidosis was observed. Conclusions Orthotopic bladder reconstruction is considered as an ideal form of urinary diversion characterized by low pressure, larger capacity and continence.

AIM: To study the inducing effect of human mutant p27 gene on apoptosis of the colorectal cancer cells. METHODS: The recombinant adenovirus Ad-p27mt was constructed to infect the colorectal cancer cell SW480. The inducing effect of Ad-p27mt on apoptosis in colorectal cancer cells was measured by flow cytometry, DNA fragment analysis and TUNEL method. RESULTS: Ad-p27mt was successfully constructed. When the multiplicity of infection (MOI) was ≥50, the infection efficiency reached 100%. After 24 h of infection, there was an apoptotic hypodiploid peak observed by flow cytometry before G_1 and there were apoptotic characteristic bands in the DNA electrophoresis. The apoptotic index detected by TUNEL method was 82.6?3.2 (Ad-p27mt group) and 5.0?3.5 (control group), respectively, the difference of which was significant (P

Objective To explore the effects of premature atrial contractions on hemodynamics combined with coronary heart disease and hypertension .Methods According to the advance rate ,62 patients with premature atrial contractions were invided into 3 groups :< 20% group(n= 18) ,20% - 40% group(n= 20) and > 40% group(n= 24) .All of the patients were performed imped‐ance cardiography .The hemodynamics indexes at different times were compared ,and the variation rates in hemodynamics of the three groups combined with basic diseases were analyzed .Results Stroke volume(SV) ,stroke index(SI) ,aortic compliance(AC) , stroke work(SW) ,stroke work index(SWI) ,and heather index(HI) were smallest when premature atrial contractions ,which were middle when the first sinus beats before premature atrial contractions ,and largest when the first sinus beats after premature atrial contractions(P< 0 .05) .The variation rates in hemodynamics were smallest in < 20% group ,which were middle in 20% - 40%group ,and largest in > 40% group(P< 0 .05) .The percentage of patients with basic heart diseases was lowest in < 20% group , which was middle in 20% - 40% group ,and highest in > 40% group(P< 0 .05) .Conclusion The advance rate is relatively large in patients with basic cardiovascular disease .Premature atrial contractions has certain effects on hemodynamics ,and the effects are positively correlated with advance rate .

BACKGROUND: The incidence rate of colon cancer is on an obvious increase. Previous treatments are primarily surgical therapy; radiotherapy and chemotherapy. Gene therapy has been applied in the clinical practice for treating colon cancer.OBJECTIVE: To construct replication deficient hp27mt recombinant adenovirus and detect its expression in SW480 cell in order to investigate the viability of gene therapy based on adenovirus and study the anti-tumor characteristic of mutant p27.DESIGN: A non-randomized controlled trial.SETTING: Department of Gastroenterology, Affiliated People' s Hospital of Yunyang Medical College, Institute of Clinical Medical Science of Yunyang Medical College; Department of Gastroenterology, Zhongnan Hospital of Wuhan University.MATERIALS: The experiment was conducted in the Institute of Clinical Medicine, Yunyang Medical College from January 2002 to September 2003. Restriction endo-nucleases Age Ⅰ, Nhe Ⅰ, Kpn Ⅰ, Pac Ⅰ and Pme Ⅰ;Taq polymerase; T4 DNA ligase; Western blot kit; mouse anti-human p27kipl polyclonal antibody, horseradish-peroxidase conjugated goat anti mouse second IgG monoclonal antibody; pORF9-hp27mt plasmid, adenovirus framework plasmid pAdeasy-1, shuttle plasmid pShuttle-CMV, LacZ recombinant adenovirus Ad-LacZ, liposome, colon cancer cell line SW480.METHODS: hp27mt was excised from vector pORF9-hp27mt by restriction endonucleases, and inserted into shuttle plasmid pShuttle-CMV after two cycles of subclone, forming plasmid pShuttle-CMV-hp27mt. Then it was transformed by linear terminus(cut by PmeI) plasmid pShuttle-CMV-hp27mt into competent E. coli BJ5183 which contained adenovirus framework plasmid pAdeasy-1 to ensure that homologous recombination occurred. After correct identification of the transformant, it was digested by PacⅠ and transfected Ad293 cells, and packed into recombinant adenovirus Ad-hp27mt. Recombinant adenovirus was identified by polymerase chain reColon cancer cell line SW480 was infected with recombinant adenovirus Ad-p27mt, and expression of p27 protein was detected by Western blot.of expressed p27 protein after Ad-p27mt transfected colon cancer cell.novirus framework plasmid pAdeasy-1 with pShuttle-CMV-hp27mt, 30%combinant adenovirus DNA contained the target gene. Virus titer of the recancer cells, p27 was highly expressed in SW480 cells, as compared to low expression in non-transfected cells and Ad-LacZ transfected cells.CONCLUSION: Adenovirus, a type of gene transferring vector, can efficiently mediate p27 expression in tumor cells, which provides effective gene transfecting carrier for treating colorectal cancer with mutation p27 gene.

Objective To evaluate stone retention time coefficient (RTC) times stone size value (RTC × S) as the indication of extracorporeal shockwave lithotripsy (ESWL) efficacy in the treatment of upper ureteral calculi.Methods From January 2009 to May 2011,180 consecutive patients including 109males and 71 females who underwent ESWL for a single radiopaque upper ureteral stone with the mean stone size (0.9 ± 0.2) cm and the mean stone retention time (12.6 ± 9.7) d were retrospectively analyzed.The mean patient age was 39 years (range from 21 to 65 years).The base of RTC was set as 1 and each 0.1 was added on it if the stone stayed one more week in upper ureter.Patients were classified into 2 groups by stone size.105 patients were in group ＜ 1 cm and 75 patients were in group≥ 1 cm.According to RTC × S value,79 patients were in group ＜ 1 and 101 patients were in group≥ 1.Stone-free rate between these two groups in the same grouping indication and between two matched groups in the different grouping indication were compared respectively.The chi-square test compared categorical variables between the two groups and all statistical analyses were 2-sided with P ＜ 0.05 defined as statistically significant.Results The overall stone-free rate of group ＜ 1 cm was significantly higher than that of group≥ 1 cm (81.9％ vs.68.0％,P ＜0.05).The overall stone-free rate of group RTC × S value ＜ 1 was significantly higher than that of group RTC × S value ≥1 (96.2 ％ vs.60.4％,P ＜ 0.05).Comparison between two matched groups showed that the stone-free rate of group RTC S value ＜ 1 was significantly higher than that of group ＜ 1 cm (96.2％ vs.81.9 ％,P＜0.05),but group RTC×Svalue≥1 was comparable to group≥l cm (60.4％ vs.68.0％,P ＞ 0.05).26 patients with ＜ 1 cm stones were enrolled in group ≥ 1 for long stone retention time and larger RTC × S value.The overall stone-free rate of them was 38.5％ (10/26) which was significantly lower than that of group≥ 1 cm (P ＜ 0.05).Conclusions The stone retention time is an important factor in efficacy of ESWL for upper ureteral calculi.Use RTC × S as a new indication of ESWL,not only the stone size but stone retention time is taken into account as well.ESWL is highly efficacious in patients with RTC × S values ＜ 1.

Objective To compare the clinical effects and side events between simple synchronal radiochemotherapy(group A) and cervical local implantation chemotherapy combined with synchronal radiochemotherapy(group B) in advanced cervical cancer.Methods Sixty patients with primary cervical cancer,admitted to our hospital from January 2009 to December 2009,were enrolled into the study.The clinical staging of these patients ranged from Ⅱb to Ⅲb.The patients were randomly divided into two different therapy groups.In group A,patients received external irradiation by X-rays and intracavitary by 192 Ir and PT chemotherapy(n=30).In group B,patients received cervical local implantation of fluorouracil palliative 400-500 mg in addition of external irradiation by X-rays and intracavitary by 192 Ir and PT chemotherapy(n=30).The short-term effect and complications were compared between the two groups.Results The effective rate of group A was significantly higher than the second group(97% vs.80%,x2=4.706,P＜ 0.05).The most common complication was myelosuppression.In group A we observed 8 cases had grade Ⅰ,10 cases had grade II,9 cases had grade Ⅲ,3 cases had grade Ⅳ myelosuppression.In group B we observed 8 cases had grade Ⅰ,12 cases had grade Ⅱ,7 cases had grade Ⅲ,3 cases had grade Ⅳ myelosuppression.There were no significantly differences in the comparisons of this complication between the two groups(x2=0.432,P＞0.05).Conclusion The cervical local implantation chemotherapy combined with synchronal radiochemotherapy might improve the prognosis in advanced cervical cancer patients without increasing toxic side effects.