Objective To study effects of tethered spinal cord on functions of bladder and urethra. Methods Thirty six patients with tethered spinal cord were evaluated by video urodynamic studies. Filling phase function of bladder was evaluated by compliance of bladder and the presence of vesicoureteral reflux; voiding phase function of bladder was evaluated by maximal detrusor pressure; the synergy between detrusor and external urethral sphincter and continence of urethra were evaluated by voiding study with synchronous X ray image and pressure flow plot. Results 50% patients was diagnosed as detrusor areflexia with low compliance bladder, which was the main type of neurogenic bladder for patients with tethered spinal cord. And 22% was diagnosed as detrusor hyperreflexia. The incidence (83%)of damage of kidney function in patients with detrsusor areflexia and low compliance was significantly higher than patients with detrusor hyperreflexia ( P

0.05),(11.0?4.5)ml/s and (5.0?2.8)ml/s in urethral stricture group( P

Objective To evaluate the efficacy and tolerability of midodrine (Gutron) in female patients with stress incontinence. Methods A randomized,double-blind,parallel,placebo-controlled,multicentric study was carried out.136 female patients with stress incontinence.68 cases in study group received Gutron (2.5 mg,thrice daily) for a course of 4 weeks.68 cases in control group received placebo in the same manner. Results 129 cases completed the treatment.The mean quantity of incontinent urine decreased by 9.9 g in those receiving Gutron ( n =66) and by 3.1 g in placebo ( n =63),respectively ( P 0.05). Conclusions Midodrine hydrochloride at the dose of 2.5 mg thrice daily has greater efficacy on female patients with stress incontinence than placebo, and the tolerability of midodrine was equivalent to that of placebo.

Objective To analyse the therapeutic effect of methylprednisolone combined with anterior decompression and internal fixation in the treatment of cervical spine hyperextension injury. Methods 42 patients who were diagnosed with cervical hyperextension injury in orthopaedics department of the First Hospital of Jiaxing were collected.All patients were randomly divided into experimental group and control group, 21 cases in each group.Patients in control group received anterior cervical decompression and internal fixation only , patients in experimental group received methylprednisolone combined with anterior decompression and internal fixation, after treatment, the serum levels of TNF-α, SOD and American Spinal Injury Association (ASIA) score were detected in all patients.Results After treatment, compared with control group, the serum levels of TNF-αwas lower, SOD was higher and ASIA score was higher in experimental group, and the differences were statistically significant (P<0.05).Conclusion The methylprednisolone combined with anterior decompression and internal fixation could significantly reduce the serum level of TNF-α, and increase the serum level of SOD and ASIA score in patients with cervical spine hyperextension injury, could reduce the inflammatory damage, improve the antioxidant capacity, which has a good clinical effect.

Objective To investigate the expressions of transforming growth factor beta-1 (TGF-β1) and nuclear factor kappa B (NF-κB) in patients with chronic obstructive pulmonary disease (COPD),and to explore the mechanism of pathogenesis in COPD.Methods A total of 40 patients undergoing lung resections for pulmonary tumor were selected.Patients were divided into 2 groups according to COPD diagnostic criteria:the control group [patients without COPD,13 males,7 females,with an average age of (61.7±8.8) years] and the COPD group [patients with COPD,15 males,5 females,with an average age of (60.5 ± 9.4) years].Peripheral lung tissues from tumor lesions were detected in this study.The qualitative and quantitative expressions of NF-κB were determined by immunohistochemistry and Western blot,respectively.TGF-β31 mRNA level was determined by reverse transcription polymerase chain reaction (RT-PCR).Results The levels of TGF β1 mRNA and NF-κB protein and the NF-κB nucleus positive rate were significantly higher in the COPDgroup than in the control group [(0.42±0.11) vs.(0.34±0.13),(0.24±0.08) vs.(0.12±0.04),57.9％ vs.26.7％,respectively,all P＜0.05].The TGF-β31 mRNA level was positively correlated with the NF-κB protein expression in the 2 groups (r=0.497,0.618,both P＜0.01).The ratio of 1 second forced expiratory volume/forced vital capacity (FEV1/ FVC) was negatively correlated with TGF-β1 mRNA level and NF-κB protein expression (r=-0.624,r=-0.659,both P ＜0.01) in the COPD group.Conclusions The expression levels of NF-κB and TGF-β1 are significantly increased in patients with COPD,and there is a positive correlation between TGF-β1mRNA level and NF-κB protein expression.NF-κB may participate in regulating TGF-β1 mRNA expression and in contributing to the airway remodeling,thereby in effecting pulmonary function.

Objective To evaluate the clinical features and treatment of pelvi-ureteric junction obstruction (PUJO) in a duplex kidney. Methods From 1993 to 2010, 752 patients were diagnosed as PUJO in our hospital and 18 patients (2.4%) with PUJO in duplex kidneys. Three patients had obstruction in the complete duplicated systems and 15 in the incomplete duplicated systems. Five patients had obstruction of the upper moiety and 13 of the lower moiety. All of the 18 patients underwent B-ultrasonography, with 15 enhanced CT scan, 11 intravenous urography and 10 retrograde pyelography.All patients had serum creatinine test after admission and during the follow-up. Results Sixteen patients underwent operations and 2 patients were treated conservatively. Nine patients underwent pyeloplasty and 7 patients underwent heminephroureterectomy. Pathology shows derangement of the lamina muscularis at pelvi-ureteric junction and infiltration of inflammatory cells in mesenchymal. They were followed up from 6 months to 3 years with a mean of 24 months. The clinical symptoms of patients who underwent surgery were cured in all cases. B-ultrasound and IVU showed that hydronephrosis was obviously relieved and the levels of serum creatinine remained the same or decreased. The hydronephrosis and serum creatinine of patients who underwent conservative treatment remained stabilized. Conclusions PUJO in duplicated system is a rare condition. Careful preoperative evaluation is needed to reach the final diagnosis and retrograde pyelography has high specificity. Treatment should be individualized according to split and partial renal function.

Objective To evaluate clinical and CT features of the 4 th lumbar vertebral spondylolisthesis (L 4DS ) as well as CT value in its diagnosis. Methods CT features of 36 cases of L 4DS were observed and interarticular distance (IAD) and facet joint angle (FJA) were measured and compared with control group.Results Patients with L 4DS mostly were over 40 years old. CT features included degenaration, spondylolisthesis and spinal canal stenosis. IAD and FJA were significantly narrowed. Conclusion CT axial scans combined with plain films,CTM and MPR clearly shows basic changes of L 4DS , providing useful details for clinical management. Narrow posterior vertebral part are important factors leading to L 4DS.

Aim To study the inflammatory mechanism of herniatedcervical intervertebral discs from patients with cervical spondyloticmyelopathy, and the roles of the inflammation in the cervical disc degenera-tion and cervical spondylosis. Methods 35 herniated cervical discs wereobtained fron 31 patients with cervical spondylotic myeloyathy during theanterior cervical surgery. 7 normal, nondegenerated cervical discs(controlgroup) were obtained from three fresh cadavers. All discs were divided intotwo samples, one of which was used as histological examination, and theother was used to detect contents of IL-1α. IL-6 and TNF-α biochemi-cally. Results In 35 herniated cervical discs, 18(51% ) were shownabundant inflammatory cell infiltrates in margin of herniated discs; 17(49%) no inflammatory cell infiltrates; normal discs also no any inflam-matory cell infiltrates. Biochemical assay indicated IL-1 α, IL-6 and TNF-αin cervical spondylotic myelopathy was (10.4 ± 1.9), (7.7 ± 2. 1 ) and(7.5 ± 1.7) pg/g respectively and those in noninflammatory infiltrates groupwas (10.2 ± 1.6), (6.7 ± 2.6) and (7.0 ± 1.8) pg/g respectively and thosein the control group was (2.0±0.9), (1.2±1.0) and (1.3±0.8)pg/g.The contents of cytokine IL-1α, IL-6 and TNF-α were obviously higher thanthat of normal discs( P =0. 000 1, t = 11. 359 1, 7. 951 0, 9. 372 8), andthere were no differences in the contents of cytokines between discs withinflammatory cell infiltrates and discs with no inflammatory cell infiltrates(P＞ 0.05, t=0.6120, 2.6204, 1.7394).Conelusion Herniatedcervical disc from the cervical spondylotic myelopathy was inflammatory, andinflammation may play an important role in cervical disc degeneration and inpathogenesis of cervical spondylosis.

Objective To evaluate the value of ~(99m)Tc-MIBI tumoraffin imaging,computed tomography(CT)and magnetic resonance imaging(MRI)in the diagnosis of recurrent nasopharyngeal carcinoma(NPC) after radiotherapy.Methods The ~(99m)Tc-MIBI tumoraffin imaging,CT and MRI were performed in 78 NPC postradiotherapy patients,including 38 patients with local recurrence and 40 patients with radiofibrosis confirmed by pathology and follow-up.Results The sensitivity of ~(99m)Tc-MIBI tumoraffin imaging(73.7%) was lower than that of CT(94.7%) and MRI(92.1%).The specificity of ~(99m)Tc-MIBI tumoraffin imaging(92.5%) was obviously higher than that of CT(62.5%) and MRI(67.5%).There was no significant difference in the accuracy between three imaging examination methods.The sensitivity, specificity and accuracy of the combination of three imaging examination methods in the diagnosis of recurrent NPC after radiotherapy were 97.4%,95% and 96.2%,respectively.Conclusion The ~(99m)Tc-MIBI tumoraffin imaging has higher specificity in the diagnosis of recurrent NPC after radiotherapy.The diagnostic accuracy may be further improved with the combination of three methods.

In the process of teaching southern Asia students in medical biochemistry,teaching mode has been actively explored.Sufficient preparation before class,applying nimble teaching style,emphasis on communication with foreign students and searching for effective review and examination system will receive the satisfactory results.