Objective To explore the efficacy of four-step method for transurethral enucleation of the prostate . Methods A retrospective analysis was conducted on 120 cases of benign prostate hyperplasia ( BPH) treated with four-step method ( traction, enucleation, resection, and repair ) for transurethral plasmakinetic resection of the prostate in our hospital from January 2012 to February 2014. Results The average operation time was (91.4 ±35.3) min.The intraoperative blood loss was 78.8 ±34.1 ml. The resection of the prostate tissue weight was (32.1 ±15.7) g.The postoperative bladder infusion time was (1.5 ±0.5) days.The postoperative indwelling catheter time was 3.5 ±0.8 days.The postoperative hospital stay was (5.5 ±0.5) days.No death, blood transfusion, or TURS happened.Follow-up reviews at 3 months after surgery found postoperative international prostatic symptom score (IPSS) was significantly less than the preoperative level [4.5 ±2.2 vs.24.5 ±5.1, t=39.445, P=0.000], postoperative Qmax was significantly higher than preoperative level [(21.5 ±10.5) ml/s vs.(6.0 ±1.9) ml/s, t =15.912, P =0.000], and postoperative residual urine was significantly less than the preoperative level [(12.0 ±2.0) ml vs.(145.0 ±33.0) ml;t=44.069, P =0.000].No retrograde ejaculation, sexual dysfunction, or dysuria happened. Conclusion The four-step method for transurethral enucleation of the prostate is radical , safe, and simple.

Objective:To investigate the expression of CD55 in triple-negative breast cancer (TNBC) and its correlations with prognosis.Methods: The expressions of CD55 was detected by immunohistochemistry Streptavidin-Peroxidase method in 100 cases of triple-negative breast cancer and 50 cases of adjacent-carcinoma tissues, with clinical and pathological features and follow-up data, the Cox model analysis was established and to analyze the prognostic factors. Results: The positive expression of CD55 was 56.0% in the tissues from triple-negative breast cancer, whereas its positive rate was 8.0% in the corresponding adjacent breast tissues, with statistical significance (x2=32.0,P<0.05). The expression of CD55 was significantly related with tumor size, clinical stage and axillary lymph node metastases (x2=7.404,x2=8.688,x2=4.802;P<0.05); the expression of CD55 did not show correlation to age, and histologic grade. Multivariate analysis showed that the age, clinical stage, CD55 protein expression and axillary lymph node metastasis were the independent risk factors affecting the 5-year disease-free rate of patients and that clinical stage and axillary lymph node metastasis were the independent risk factors affecting the 5-year overall rate of patients.Conclusion: The expression of CD55 might be related to the development and prognosis of triple-negative breast cancer. The expression of CD55 may be used as one of the indicators in determining the progress and prognosis of TNBC.

Objective To investigate the correlation of hypoxia-inducible factors (HIF),P53 level and liver cancer infiltration in the microenvironment of the liver cancer pathological.Methods Flow cytometry was used to determine the P53 expression.Immunohistochemical method was applied to detect the expression of HIF characteristics,the correlation between Liver function (alanine amiotransferase (ALT),albumin (ALB),alpha fetoprotein(AFP))and HIF,P53.Results HIP positive rate in patients with encapsulated with incomplete,tumor diameter ≤ 5 cm and＞ 5 cm,tumor stage Ⅰ+Ⅱ and Ⅲ were 50.0％ (14/28) and 33.3％ (14/42),43.6 ％ (17/39)and 22.6％ (7/31),29.7％ (11/37)and 18.2％ (6/33)respectively.The HIF positive rate decrease in patients with capsular damage,tumor diameter increases (＞ 5 cm),Ⅲ patients,and differences between groups were statistically significant (P =0.040,0.030,0.030,respectively).P53 positive expression rate were 42.9％ (12/28) vs.83.3％ (35/42),51.3％ (20/39) vs.93.5％ (29/31),35.1％ (13/37) vs.69.7％ (23/33).The P53 positive expression in patients with capsular damage,tumor diameter increases (＞ 5 cm),Ⅲ patients with were relatively higher,the difference between groups was statistically significant (P =0.030,0.030,0.040,respectively).HIP positive rate in patient with past suffering from chronic hepatitis,cirrhosis and chronic AFP ＞ 35 ng/L,ALT ＞ 80 U/L were 36.2％ (21/58),27.9％ (17/61),27.1％ (14/51),28.2％ (11/39),lower than that of 58.3％ (7/12) in non-chronic hepatitis,non-cirrhotic 55.0％ (5/9),AFP ＜35 ng/L 58.0％ (11/19),ALT ＜ 80 U/L 51.6％ (16/31) of patients,the differences were statistically significant (P =0.046,0.047,0.037,0.045,respectively).P53 positive rate in patient with past sufering from chronic cirrhosis,AFP ＞ 35 ng/L,ALT ＞ 80 U/L,albumin ＜ 35 g/L were 82.0％ (50/61),74.5％ (38/51),69.2％ (27/39),73.7％ (42/57),respectively,higher than that of patient without chronic cirrhosis 44.4％ (4/9),or with AFP ＜ 35 ng/L 31.6％ (6/19),ALT ＜ 80 U/L 22.6％ (7/31),albumin ＞ 35 g/L 46.2％ (6/13).Tthe differences were statistically significant (P =0.037,0.040,0.032,0.041,respectively).Conclusion HIF and P53 might be the important factor in monitoring the development of hepatocellular carcinoma invasion.

BACKGROUND:Corticosteroid-induced osteonecrosis of femoral head is one of the major causes of the loss of hip joint function. More and more studies have shown that corticosteroid-induced osteonecrosis of femoral head may be associated with proliferation ability of bone marrow mesenchymal stem cells.
OBJECTIVE:To detect the proliferation and differentiation ability of bone marrow mesenchymal stem cells isolated from patients with steroid-induced osteonecrosis of femoral head, providing rational evidences for treatment of corticosteroid-induced osteonecrosis of femoral head with the transplantation of autologous bone marrow containing bone marrow mesenchymal stem cells into the necrotic area of femoral head.
METHODS:Bone marrow mesenchymal stem cells from the femoral heads were col ected from patients with corticosteroid-induced osteonecrosis of femoral head, and new femoral neck fractures without osteonecrosis who were scheduled for total hip arthroplasty. In another group, bone marrow mesenchymal stem cells were col ected from ilium bone marrow of the same steroid-induced osteonecrosis of femoral head patients. The femoral neck fracture was defined as fracture without preceding trauma or in response to minimal trauma. Cases with corticoid treatment were excluded from the femur neck fracture patients. Al bone marrow mesenchymal stem cells were divided three groups:femoral neck fracture group;femoral head group of corticosteroid-induced osteonecrosis of femoral head;ilium group of corticosteroid-induced osteonecrosis of femoral head. The bone marrow mesenchymal stem cells were isolated by enzyme digestion or density gradient centrifugation from bone marrow blood of the three detecting area, and then selected by the adhesive method. Passage 3 bone marrow mesenchymal stem cells were selected for experiments.
RESULTS AND CONCLUSION:The results of methyl-thiazolyl-tetrazolium assay indicated that the bone marrow mesenchymal stem cells obtained from the femoral head group showed reduced proliferation ability compared with those obtained from the other two groups. The percentage of bone marrow mesenchymal stem cells was increased at G 0/G 1 , but decreased significantly at S+G 2/M in the femoral head group (P<0.05). The bone marrow mesenchymal stem cells obtained from the ilium group were proliferated best. The decreased proliferation ability of bone marrow mesenchymal stem cells may play a role in the low repair capacity of corticosteroid-induced osteonecrosis of femoral head, and bone marrow mesenchymal stem cells from the ilium of patients with corticosteroid-induced osteonecrosis of femoral head have a better proliferative ability.

Objective To compare the effects between propofol and sevoflurane on NK cells and B lymphocytes in patients undergoing radical operation for tongue cancer.Methods Forty patients (male 25 cases,femal 1 5 cases,aged 44-67 years,ASA Ⅰ or Ⅱ)undergoing elective radical operation for tongue cancer were randomized into 2 groups:group P received 2.0-2.5 mg/kg propo-fol,1-2 μg/kg remifentanil,0.1 5 mg/kg cis-atracurium for induction and 4-6 mg · kg- 1 · h- 1 propofol, 0.2-0.3 μg · kg- 1 · min- 1 remifentanil for maintenance; group S received 8 %sevoflurane with 5 L/min fresh gas flow,1-2 μg/kg remifentanil,0.1 5 mg/kg cis-atracurium for in-duction and 2 %-3 % sevoflurane, 0.2-0.3 μg · kg- 1 · min- 1 remifentanil for maintenance. Peripheral venous blood samples were taken at 3 0 min before (T0 )and 1 h (T1 ),3 h (T2 )and 5 h (T3 )after induction of anesthesia,the end of operation (T4 )and at 2 4 h (T5 ),4 8 h (T6 )and 7 2 h (T7 )after operation for determination of the percentages of NK cells (CD3 - CD1 6 + 5 6 + )and B lymphocytes(CD3 - CD1 9 + )by the flow cytometer.Results Compared with T0 ,the percentages of CD3 - CD1 6 + 5 6 + and CD3 - CD1 9 + in two groups were significantly decreased at T1-T5 (P <0.0 5 ),and the percentage of CD3 - CD1 6 + 5 6 + in group S was significantly decreased at T6 (P <0.0 5 ).The percentage of CD3 - CD1 6 + 5 6 + in group S were significantly lower than that in group P at T2-T6 (P < 0.0 5 ).There were no significant difference in the percentages of CD3 - CD1 9 +between two groups at the same time points.Conclusion Compared with sevoflurane,propofol can maintain a higher percentage of NK cells,and was helpful to maintain the immune function in patients undergoing radical operation for tongue cancer.

Eurycoma longifolia,also known as Tongkat Ali in Malaysia,as one of traditional herbal medicines,is used for centuries in South-East Asia.With the discovery of anticancer and anti-HIV properties,this herbal medicine has attracted great attention recently.In this review,the following information on E.longifolia,including chemistry,bioactivities,pharmacokinetics,clinical studies,and side effects and safety,was introduced.Our results,to a certain extent,will provide scientific base for commercial utilization and clearance of the Tongkat Ali products with regard to consumers' safety.

Objective In order to choose the best surgical approach for minimally trauma varicocelectomy color Doppler ultrasound(CDU) was used to detect the anatomic relationships of spermatic vein in groin. Methods Sixty varicocele patients were randomly selected. Their spermatic veins were examined by CDU which beginning from superficial inguinal ring,passing the crossing point of spermatic vein and femoral artery ,and ending at the 3cm above the deep inguinal ring. The depths from skin to spennatic vein were measured and the relationships between spermatic vein and femoral artery were recorded. Results The average length of incision is 2.1cm and the average duration of operation is 22 minutes. The average depth from skin to spermatic vein was 1.1cm,1.55cm and 3.56cm respectively at the site of the superficial inguinal ring,the crossing point of spermatic vein and femoral artery,and the deep ingui-nal ring. Conclusion The best approach for minimally trauma varicocelectomy is at the crossing point of spermatic vein and femoral artery because here the spermatic vein is relative superficial and has merged into two or three vessels and the femoral artery can be easily touched by fingers.

Objective To evaluate the therapeutic effect of modified dual plating and less invasive stabilization system(LISS) in the complex fractures of tibial plateau.Methods One hundred and sixty-eight patients with complex fractures of tibial plateau were divided into two groups by the therapeutic methods,89 patients were in modified dual plating group while 79 patients were in LISS group.The advantages and curative effect of two groups were retrospectively analyzed.Results The excellent and good rate in modified dual plating group was slightly higher than that in LISS group [89.9％ (80/89) vs.86.1％ (68/79)],and there was no significant difference (P ＞ 0.05).No patient occurred deep site infection,severe nerve damage,phlebothrombosis in two groups.In modified dual plating group,the operation time and bleeding volume was (89.2 ± 13.6) min and (188.4 ± 45.6) ml,the hospital stay and healing time was (16.5 ± 1.8) d and (13.3 ±2.1) months.In LISS group,the operation time and bleeding volume was (74.3 ± 12.5) min and (236.5 ±65.5) ml,the hospital stay and healing time was (16.7 ± 2.1) d and (11.4 ± 1.5) months.There was no significant difference (P ＞ 0.05).Conclusion The therapeutic effect of modified dual plating and LISS have no significant difference for complex tibial plateau fractures.

Objective To investigate expression of CXCR4 and CXCR7 protein and mRNA, which are the receptors of stromal cell derived factor-1α(SDF-1α), in the bone marrow mesenchymal stem cells (BMSCs);to explore the role of SDF-1α/CXCR4/CXCR7 axis in migration of BMSCs in vitro and the possible mechanism .Method BMSCs were isolated from rats and cultured in vitro.CD29, CD44 and CD34 of the cells were identified by flow cytometry .CXCR4-selective antagonist AMD 3100 and CXCR7-specific neutralizing antibody were applied to block CXCR 4 and CXCR7 respectively.The expressions of CXCR4 and CXCR7 mRNA and protein on BMSCs were detected with RT-PCR and Western blotting .Transwells chamber test was used to observe the migration of BMSCs .The BMSCs were divided into the BMSCs group ( A ) , the AMD3100 pretreated BMSCs group ( B ) , the CXCR7-specific neutralizing antibody pretreated BMSCs group(C), the AMD3100 +CXCR7-specific neutralizing antibody pretreated BMSCs group ( D).Result Flow cytometry showed that the expressions of CD 44 and CD29 were positive, while the expression of CD34 was negative in the third passage of BMSCs (P3-BMSCs).CXCR4 and CXCR7 protein and mRNA were both expressed in P3-BMSCs. Compared with the A group, the expression of CXCR4 and CXCR7 protein declined significantly in the B group and the D group;the protein expression of CXCR7 in the C group was lower compared with the A group (P<0.05).However, the expression of CXCR4 mRNA and CXCR7 mRNA had no significant difference between groups .SDF-1αfactor promoted migration of BMSCs ( P <0.05 ).Compared with the 0μg/L group, the numbers of migrated cells were increased significantly in both of the 10μg/L group and the 100μg/L group ( P<0.01 ) .The number of migration of BMSCs was significantly higher in the 100μg/L group than that of the 10μg/L group ( P <0.01 ) .AMD3100 and CXCR7-specific neutralizing antibody both inhibited significantly the migration of BMSCs ( P<0.05 ) , and the attenuate effect was more significant when they worked together ( P<0.05 ) .Conclusion CXCR4 and CXCR7 receptors are co-expressed in P3-BMSCs;the SDF-1αfactor can promote the migration of BMSCs in the concentration dependent manner ;SDF-1α/CXCR4/CXCR7 axis is involved in the migration of BMSCs , and both of the CXCR4 and CXCR7 receptors have a synergistic promoting effect to the BMSCs migration .

Objective To compare the efficacy between arthroscopic assisted reduction and traditional opera-tion approach for the treatment of tibial plateau fractures.Methods 75 patients with tibial plateau fracture(SchatzkerⅠ -Ⅳ type)were recruited,which were randomly divided into the arthroscopic and traditional operation group according to different treatment methods.The clinical efficacy and value of arthroscopically assisted reduction was ana-lyzed and compared according to the incidence of postoperative complications,the operative time,incision length,blood loss,hospital stay,and clinical efficacy between the two groups.Results Compared with the data in the traditional operation group,the incidence of postoperative complications (2.70% vs.21.3%)was significantly lower(χ2 =5.980,P =0.014).The operative time[(88.1 ±15.2)min vs.(103.8 ±22.1)min]was significantly shorter(t =3.575,P =0.001).And the incision length[(6.7 ±2.3)cm vs.(10.8 ±2.7)cm)]declined greatly(t =5.745,P =0.000).The hospital stay time and blood loss were significantly lower than that of the traditional operation group[(4.5 ± 2.3)d vs.(6.5 ±3.1)d;(145.2 ±43.0)mL vs.(294.4 ±90.2)mL,respectively],and the differences were statisti-cally significant(t =3.166,P =0.003;t =7.829,P =0.000,respectively).The excellent rate of clinical features in arthroscopic group(86.49%)was higher than that of traditional operation group(71.05%),and the difference was statistically significant(χ2 =3.723,P =0.039).Conclusion Arthroscopic -assisted reduction has many features for the tibial plateau fractures (SchatzkerⅠ -Ⅳ type),such as lower incidence of postoperative complications,less trau-ma,shorter operative time,and better postoperative knee function and so on,so it is worthy of clinical application.