Objective To investigate the relationship beween bladder relaxation characters and 3-adrenergic receptor level in DM rats. Methods The studying subjects consist of induced diabetes and normal control rats,30 rats in each group,to detect bladder relaxation charaters in 2 groups and its relationship with 3-adrenergic receptor,cAMP contents.Western blot was performed to probe 3-adrenergic receptor.cAMP products of bladder was studied with radioimmunoassay. Results Bladder relaxation in response to isoproterenal stimulation was observed. Bladder pressure of streptozotocin induced diabetes rats at week 2,4,12 were (11.8?2.3),(11.9?2.2),(11.5?3.0)cm H_2O respectively,and (32.8?7.6),(33.9? 5.2 ),(34.7?2.7)cm H_2O in control group.3-adrenergic receptor level in diabetes group were (104?7),(105?11),(126?14)?m at week 2,4,12,and in control group (151?11),(151?10),(152?13)?m.cAMP products were detected at the same time points,namely,(0.195?0.026),(0.198?0.030),( 0.109? 0.031)pmol/L in diabetes group,and (0.349?0.051),(0.350?0.052),(0.353?0.051)pmol/L in control group. Conclusions Relaxation abilities is impaired in diabetes bladder.Though 3-adrenergic receptor level was up-regulated,cAMP products is donw-regulated,which is responsible for detrusor relaxation.3-adrenergic receptor pathway is impaired via donw-regulating cAMP products in diabetes cystopathy.

Objective of this study is to re-compute the national hospitalization rate in China using the second-hand data and explore the practical use of systematic review in health policy research field.Methods Domestic literatures on hospitalization rate in the last six years were collected and quality assessment was done.Merging analysis was used based upon systematic review approach.Results 25 reported literatures on hospitalization rate of urban and rural residents were included into the study.After merging analysis,the hospitalization rates were 4.70% for the country,5.31% for the urban and 4.26% for the rural.They are higher than the reported hospitalization rate in National Health Services Survey (NHSS)in 2003.After merging with the NHSS data,the hospitalization rate were 4.12%,4.85% and 3.82% respectively.Conclusions Systematic review can be applied in health service and policy research field.Data merging and information processing methods are diversified and could be selected upon research purpose and data attribute.Computation methods in systematic review in health policy research still need to be developed.

Objective To observe the changes in the level of serum cystatin C and the expression of matrix metalloproteinase-9 (MMP-9) in the kidney after the development of diabetic nephropathy in streptozotocin (STZ) induced diabetic rats, and to study their correlation. Methods Sixteen female Wistar rats were used to reproduce diabetes by interperitoneal injection of STZ (60mg/kg). Immunohistochemical staining was employed to detect the expressions of MMP-9 in kidneys with image analysis system, and ELISA was used to determine serum cystatin C after 4 or 8 weeks. The correlation between MMP-9 and cystatin C was analyzed by SPSS 10.0. Results The expressions of MMP-9 in diabetic kidneys both at the 4th and the 8th week (8.180?0.905 and 3.948?0.623, respectively) were significantly lower than that of normal control rats (15.620?3.444 and 16.185?3.120, respectively. P

Objective By analyzing the effect of adopting the responsibility system for entrusted asset management targets in some public hospitals the paper aims to explore the feasibility of doing so as to provide lessons for the reform of public hospitals in China. Methods Interviews of focus groups and surveys through questionnaires were conducted to find out about reform in the management of public hospitals in Wuxi City of Jiangsu Province, including successes and problems. Results Some problems remain to be solved while effects have been achieved in the entrusted management of public hospitals. Conclusion Reform of hospitals through entrusted management is currently a way of deepening the reform of public hospitals. Some preliminary conditions are already in place for reform in the system of public hospitals, yet support is stili needed in terms of sound policy and environment. In future reform should go a step further in personnel and distribution systems, supervised asset management, and the estabh'shment and perfection of the Corporation management structure. More efforts need to be made by the state in encouraging explorations and strengthening guidance.

Objective To explore the significance on expression of mdr-1, P-gp and DNA heteroploidy in invasive bladder carcinoma. Methods The expressions of mdr-1 and P-gp were detected by RT-PCR and immunohistochemistry(SP) method, and DNA ploidy by flow cytometry method in 26 cases of invasive bladder carcinoma tissues, which were compared with those in 10 normal bladder tissues. At the same time, the flow cytometry was used to determine DNA heteroploidy. Results A of mdr-1 in the neoadjuvant chemotherapy CR, PR, non-respond and control group were (0.61±0.75), (0.71±0.11), (1.68±0.28) and (0.745±0.13),respectively (P＜0.05). Positive rates of P-gp had significant differences between CR, PR and non-respondgroup and control group (P ＜0.05). Positive rates of DNA heteroploid in the above groups were 50 %, 45 %,69 % and 10 %, respectively (P ＜0.05). Conclusion The detections of mdr-1, P-gp and of DNA heteroploid contribute to evaluate neo-adjuvant chemotherapy effects of invasive bladder carcinoma.

BACKGROUND:Due to different pathogenesis of degenerative and isthmic lumbar spondylolisthesis, the differences in sagittal spino-pelvic morphology and life quality between them are stil unclear.
OBJECTIVE:To investigate the differences in sagittal spino-pelvic morphology and life quality between degenerative and adult isthmic lumbar spondylolisis patients.
METHODS:From May 2012 to February 2015, 169 lumbar spondylolisthesis patients with complete imaging data were included in the study. Degenerative group contained 83 patients, and isthmic group contained 86 patients. The folowing radiographical parameters were measured on standard standing lateral radiographs of the entire spine, including thoracic kyphosis, lumbar lordosis, sagittal vertical axis, pelvic incidence, pelvic tilt and sacral slope. Meanwhile, slippage angle, slippage percentage and slippage distance ofal patients were also measured. SF-36 scale was employed to evaluate life quality, which was compared between groups.
RESULTS AND CONCLUSION:(1)Lumbar lordosis, thoracic kyphosis and slippage angle were significantly lower in the degenerative group than those in the isthmic group (P< 0.05-0.01). The sagittal vertical axis in degenerative group was higher than that in isthmic group (P< 0.01). (2) With respect to the domains of SF-36 scale, degenerative group had lower physical functioning score and social functioning score compared with the isthmic group (P< 0.01). (3) Pelvic incidence, pelvic tilt, sacral slope, slippage percentage and slippage distance showed no significant difference between two groups (P> 0.05). (4) Results suggested that pelvicmorphology between the degenerative and isthmic lumbar spondylolisthesis was similar. Compared with degenerative lumbar spondylolisthesis, isthmic spondylolisthesis patients have higher thoracic kyphosis, lumbar lordosis and slippage angle. In addition, notable limitations of physical functioning and social functioning were found in degenerative lumbar spondylolisthesis patients.

BACKGROUND:In recent years, studies have shown that mesenchymal stem cells can secrete various growth factors, and has certain application prospect in the treatment of liver fibrosis.
OBJECTIVE:To explore the different sources of mesenchymal stem cells in the treatment of liver fibrosis in rats. METHODS:Fifty Sprague-Dawley rats were given intraperitoneal injection of carbon tetrachloride to construct the model of liver fibrosis. Another 10 normal Sprague-Dawley rats were used as normal controls. Model rats were randomly divided into five groups, 10 rats in each group, including model control group, normal saline group, bone marrow mesenchymal stem cellgroup, umbilical cord mesenchymal stem cellgroup, and umbilical cord blood mesenchymal stem cellgroup. After 8 weeks of modeling, different sources of mesenchymal stem cells at a density of 2×106 were injected via tail vein into model rats. After 12 weeks, the rats were kil ed, and serum alanine aminotransferase, aspartate aminotransferase and albumin levels were detected as wel as the expression of type I col agen and glial fibril ary acidic protein in liver tissue was detected by fluorescence quantitative PCR method.
RESULTS AND CONCLUSION:We have successful y established the SD rat model of hepatic fibrosis. Bone marrow mesenchymal stem cells aggravated hepatic fibrosis, umbilical cord blood and umbilical cord mesenchymal stem cells could reduce the level of hepatic fibrosis in rats. Umbilical cord mesenchymal stem cells had the most obvious effect that significantly reduced expressions of alanine aminotransferase, aspartate aminotransferase and type I col agen and glial fibril ary acidic protein. The results showed different sources of mesenchymal stem cells have different effects on rat fibrosis. Bone marrow mesenchymal stem cells aggravate hepatic fibrosis, and umbilical cord and umbilical cord blood stem cells can al eviate hepatic fibrosis in rats.

To describe the clinical,radiological and pathological characteristics of idiopathic pulmonary alveolar proteinosis(I-PAP)and to evaluate the methods of diagnosis and treatment.Three patients were successfully diagnosed and treated in our hospital and the literature on the subject was reviewed.Three patients,two males and one female(mean age 46 years),were diagnosed averagely in 4 months.Two severe patients presented with progressive dyspnea and type I respiratory failure,and one mild patient only with dry cough and hypoxemia.Chest X-ray radiographs all showed perihilar "butterfly" shadow and chest CT scans showed diffused ground-glass opacities(GGO),typically with "map" changes and "crazy paving" patterns.All the patients underwent bronchoscope,branchoalveolar lavage fluid(BALF)had grossly opaque and/or milky appearance and its sediment was periodic acid-Schiff stain positive.Transbronchoscopic lung biopsy(TBLB)specimens were obtained and under light microscopy alveoli and some of the small bronchioles were filled with eosinophilic proteinaceous material with needle-like clefts.By electron microscopy numerous cellular debris and extracellular multilamellated bodies were found.Two severe patients were successfully treated with sequential whole-lung lavage and one required repeated lavages.I-PAP is rare and prone to be misdiagnosed.The radiological features may indicate the diagnosis and examinations of TBLB and BALF can make the accurate diagnosis.Whole-lung lavage is the most effective therapy by now and granulocyte-macrophage colony-stimulating factor(GM-CSF)may be beneficial in some patients.

Tibia shaft fracture is the most common long bone fractures clinically and intramedullary nail fixation is the best choice due to superior biomechanical characteristics for unstable tibia shaft fractures.At present,the common approaches for intramedullary nail insertion are divided into supra-patellar approach and infra-patellar approach.The semi-extended position of supra-patellar approach contributes to better fracture reduction but lead to potential patella-femoral cartilage injury.In contrast,flexion or hyper-flexion position of infra-patellar approach might result in unsatisfactory fracture reduction,then have an impact on clinical outcome.Therefore,the clinical outcome might be different because of approach choice.However,there is no consensus about the optimal surgical approach for intramedullary nailing.Thus,we performed the review to discuss the approaches for tibia intramedullary nailing and compare their strengths and weaknesses.

OBJECTIVETo summarize the experiences of applying three-dimensional (3D) technique in scarless endoscopic thyroidectomy (SET) via anterior chest approach.

METHODSMedical records of patients who undenvent SET using 3D technique from December 2013 to May 2014 were retrospectively reviewed. A total of 32 patients who had a preoperative ultrasound-guided fine-needle aspiration cytology diagnosis of unilateral papillary thyroid carcinoma and underwent lobectomy associated with central lymph node dissection were included in this study. All patients were female with a mean age of (37 ± 10) years at diagnosis. In addition, 45 female patients who underwent traditional endoscopic thyroidectomy at the same period were randomly selected as control.

RESULTSAll surgical procedures were successfully finished. The mean surgical time in 3D group was (91. 7 ± 11. 4) minutes, and mean hospitalization time was (3. 2 ± 0. 5) days. Contemporary hoarseness was observed in one patient, and no bleeding, infection, hypocalcemia and other postsurgical complications were observed. Compared to the traditional endoscopic surgery group, 3 D group had significantly shorter surgical time of lobectomy ((23. 2 ± 5. 1) minutes vs. (28. 0 ± 5. 0) minutes, t = 4. 156, P = 0. 000). Negative results were seen in the time taking of creating surgical space ((14. 6 ± 3. 3) minutes vs. (15. 6 ± 2. 5) minutes), central lymph node dissection ((25. 1 ± 5. 4) minutes vs. (24. 4 ± 6. 3) minutes) and total surgical time ((91.7 ± 11. 4) minutes vs. (96. 1 ± 13. 0) minutes).

CONCLUSIONApplication of 3D technique in endoscopic surgery can offer 3D vision of the surgical field, thus significantly shorten lobectomy time and more easily to achieve fine dissection and functional protection of recurrent laryngeal nerves, parathyroids and other vital anatomic structures.

Adult ; Biopsy, Fine-Needle ; Carcinoma ; diagnosis ; surgery ; Carcinoma, Papillary ; Endoscopy ; methods ; Female ; Humans ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Operative Time ; Retrospective Studies ; Thyroid Neoplasms ; diagnosis ; surgery ; Thyroidectomy ; methods