Objective To evaluate the indications,complications and efficacy of permanent interstitial brachytherapy in the treatment of clinically localized prostate cancer. Methods Five patients (mean age,73 years;range,59~84 years) with clinically localized stage T 2b to T 3 adenocarcinoma of the prostate were treated with iodine-125 brachytherapy using the transrectal ultrasound guided transperineal implantation technique and Prowess 2.42 treatment planning system.The follow-up period ranged from 12 to 18 months. Results After implantation,the PSA levels of the 5 patients were decreased significantly and were all less than 0.5 ng/ml at 12th post-implant month;and the prostate volume shrunk from the third month. In the early period after the implantation all the patients complained of some voiding problems and had a noticed increase of International Prostate Symptom Score (IPSS),with the decrease of urinary flow rate.But the conditions improved gradually from the third month. No serious complications such as hematuria, bloody stool and rectal ulcer were found in this group. Conclusions Permanent interstitial brachytherapy has better efficacy,fewer complications and more radiation safety in the treatment of clinically localized prostate cancer.

Objective Abstract:Objective To explore the effects of arsernic trioxide(As2O3) on telomerase activity and cellular apoptosis of human colon cancer cell line CCL-187.Methods CCL-187 cells were divided into control group,1.0 ?mol?L-1As2O3 group and 2.5 ?mol?L-1As2O3 group,all groups were cultivated for 1 to 6 d.The inhitory rate of cell growth was detected by MTT assay.The morphologic changes of CCL-187 cells were observed under electron microscope.The expression of hTERT at mRNA level was analyzed by RT-PCR.Telomerase activity was determined by TRAP-PCR-ELISA.Results The differentiation of cells was found in 1.0 ?mol?L-1 As2O3 group,but apoptosis in 2.5 ?mol?L-1 As2O3 group,and at the same time,the telomerase activity was reduced and the hTERT-mRNA expression was downregulate in 1.0 ?mol?L-1 As2O3 group and 2.5 ?mol?L-1 As2O3 group in a time-dependent manner.There were significant differences compated with control group(P

Objective To assess the efficacy and safety of tolterodine on late-onset overactive bladder symptoms after prostate brachytherapy due to prostate carcinoma.Methods Twenty-six prostate cancer patients diagnosed by biopsy,who underwent prostate brachytherapy using iodine-125,were recrui(t)ed in this trial.All cascs complained of overactive bladder symptoms 6 months postoperatively.The 26 patients were divided into 2 groups:14 men in tolterodine group (TR group) who were given tolterodine 2 mg twice a day; 12 men in tamsulosin group (TS group) who were given tamsulosin 0.2 mg once a day.Efficacy was assessed by changes in IPSS,OABSS and nighttime voiding at 2 weeks and 4 weeks after medical treatment respectively.Safety was assessed by postvoid residual (PVR) and acute urinary retention (AUR),dry mouth,constipation and tachycardia at the fourth week after medical treatment.Results The age,tumor staging,GS,PSA,initial prostate volume,IPSS,OABSS,nighttime voiding,iodine-125 seeds implanted and needles punctured of both groups were comparable.IPSS,OABSS and nighttime voiding were significantly improved in TR group after 2 weeks of medical treatment and the above parameters were significantly improved than TS group (14.4 vs 18.3,5.9 vs8.4,1.4 vs2.5).OAB symptoms of TR group were also significantly improved than TS group after 4 weeks of therapy.There were no significant differences of PVR and AUR,dry mouth,constipation and tachycardia between both groups.Conclusions Tolterodine is effective and safe in treating late-onset OAB symptoms after prostate brachytherapy,although the occurence of dry mouth and tachycardia might be increased.

Objective A retrospective review of the use of delayed sterna closure (DSC) after pediatric cardiac operations.The purpose of this study is to access the morbidity of DSC and to analyze the risk factors that may predict the need for DSC.Methods Between January 2008 and December 2011,5 546 infants (2 843 males,2 703 females) underwent cardiac operations through midterm sternotomy in Shanghai Children' s Medical Center.Median age was 5 months(1 day to 11 months) and mean weight was 6.1 kg(2.0-12.5 kg).The pathologies included transposition of great artery(TGA),corctation of aorta (CoA),interruption of aortic arch (IAA),pulmonary atresia (PA),truncus arteriosus (Truncus),complete atrioventricular septal defect(CAVSD),total anormalous pulmonary vein connection (TAPVC),double outlet of right ventricle(DORV),tetralogy of Fallot(TOF),and ventricular septal defect(VSD),et al.All hospital records were reviewed and clinical data were studied and analyzed.Results A total of 313 patients had DSC (5.6％).There were 191 males and 122 females.The reasons for DSC are hemodynamic instability in 296,bleeding in 11,and ECMO(or VAD) in 6 patients.Two hundred and fiftyone (80.2％) patients were less than 5 kg,84 (26.8 ％) patients were neonates,and 125 (39.9％) patients aged between one and three months old.The incidences of DSC for these patients were 13.9％,34.4％,and 18.4％ respectively.The diagnosis of complex congenital heart defects had a high risk of DSC.The incidences of DSC for TGA,CoA,IAA,PA,Truncus,CAVSD,TAPVC,and DORV were 28.8％,17.8％,43.1％,9.0％,30.4％,6.5％,and 10.8％ respectively.The DSC patients had longer duration of CPB time(147 min versus 72 min) and clamping time(81 min versus 40 min).In 282 patients the sternums were closed 1-11 days after the initial operation.In 3 cases the trial of closure failed for the first time and succeeded a second time until several days later.Fouty-six patients died ultimately including 15 patients died after the closure of sternum with a total mortality of 14.7 ％.Surgical site infection occurred in 17 patients (5.4％),and surgical intervention were needed in 4 severe cases(1.3％).Conclusion Neonates,an age less than 3 months,weight less than 5 kg,long CPB time and clamping time,and the diagnosis of complex congenital heart defects were risk factors of the need for delayed sterna closure after pediatric cardiac operations.

Objective To develop a chemiluminescence imaging DNA microarray method for simultaneous,fast and accurate detection of nine rash-and fever-causing pathogens,namely,Measles virus,Rubella virus,Enterovirus type 71, Varicella zoster virus,Dengue fever virus,Human small FDNA virus B19,Coxsackie virus type A16,A-βStreptococcus pyogenes (hemolytic streptococcus)and Salmonella typhi.Methods Primers and probes were designed based on the specific sequence in the conserved region of genomes of the nine pathogens.The nucleic acids of the nine pathogens were amplified and labelled by multiplex PCR method.The multiplex PCR amplification products were hybridized with specific probes of microarray that was scanned after washing and chemiluminescence coloration to identify the nine pathogens.After the optimization of the multiplex PCR system,hybridization and chemiluminescence imaging,the specificity,sensitivity and reproducibility of the chip were evaluated.The serial diluted nucleic acid of Enterovirus type 71 was detected using microarray and real-time PCR approach to compare the sensitivity of these two methods.Results Nine specific primers and eleven specific probes were selected.The microarray demonstrated high sensitivity and specificity.The minimum detection limit of plasmid DNA and in vitro transcribed RNAs was 3 ×103 copies per reaction.The detection sensitivity of this microarray was 10 percent of that by the real-time PCR method.The rate of sensitivity and specificity of clinical sample detection was 95% and 85.7% respectively,and the rate of accuracy was 93.2%.Conclusion A chemiluminescence imaging DNA microarray method for simultaneous,fast and accurate detection of nine pathogens that cause rash and fever illnesses is established successfully,which can serve as a new high throuthput screening method for clinical diagnosis and epidemiological investigation of rash and fever illnesses.

Objective To studiy the surgical outcomes of children with congenital aortic stenosis (AS),and summarized the experience of surgical procedures.Methods From February 2006 to November 2011,a total of 49 consecutive children with AS underwent surgical treatments.Twenty-nine patients were male and 20 patients were female.The median age was 17 months (1 month to 14 years),and median weight was 15.6 kg (3.2-47.0 kg).Peak AS gradients was (74.9 ±20.4)mmHg (45-123 mm Hg) before surgery.Fourteen patients had isolated congenital AS,4 had combined moderate-to-severe aortic insufficiency (AI).Thirty-Three patients had associated cardiac anomalies,including ventricular septal defect,atrial septal defect,patent ductus ateriosus,coarctation of aorta,subaortic stenosis,and supravalvular mitral stenosis.Thirty-one patients underwent aortic valvotomy,9 valvuloplasty,2 Aortic valve replacement (AVR),1 Ross procedure,2 Ross-Konno procedure,and 4 Konno/AVR.Median follow-up was 20 months (2-55 months).Clinical and echocardiographic follow-up data were analyzed.Results There was 1 postoperative death who died of heart failure due to severe mitral valve insuffciency.Latest follow-up data showed that the survivals performed in satisfactory cardiac function.Left ventricular ejection fraction (LVEF)was 0.69 ±0.10,and fraction shortening (FS) was 0.38 ±0.09.Peak AS gradients decreased significantly after surgery to (38.6 ± 15.8) mm Hg (20-73 mm Hg),P ＜ 0.001.One patient needed reintervention because of severe recurrence of adhesion in the commissure 3 months after the previous surgery.Totally 31 patients underwent simple valvotomy procedure.Postoperative AI was none or trace in 5,mild in 20,and moderate in 6.Two surgical techniques were used to repair the aortic valve according to the anatomy of the valve and the cause of insufficiency,including commissuroplasty in 6 and pericarial casp extension in 3.Nine patients underwent valvuloplasty procedure,post-operative AI was none or trace in 3,mild in 5,and moderate in 1.We put more attention to the 7 patients who had moderate AI valvotomy or valvuloplasty,and the latest follow-up showed that these patients were in good condition and there was no deterioration the degree of AI.Conclusion Long-term outcomes show that aortic valvotomy and valvuloplasty are reliable and effective approaches for congenital AS in children.When moderate-to-severe AI exists,other procedures such as Ross,Ross-Konno,AVR,or Konno/AVR are preferred.

Objective To improve and establish an RP-HPLC method for the determination of related substances of piracetam and its injection. Methods Using thermo syncronis C18(4.6 mm ×250 mm,5μm)chromatographic column, mobile phase was acetonitrile-phosphate buffer (adjust pH of 1.0 g/L potassium hydrogen phosphate solution to 6.0 with phosphoric acid), gradient elution with initial mobile phase 5% acetonitrile.The flow rate was 1 mL/min, detected at 205 nm.Five calibration factors of the known impurities were separately measured.the related substances were determined using main component self-compare with calibration factor.Results Piracetam and their related substances were well separated.The calibration curves of five known impurity A~E were linear within the concentration range measured.The average recoveries were 99.46%,98.21%,97.22%,100.23% and 97.58%, respectively(n=9), RSDs of the average recoveries were lower than 2.0%.The calibration factors of five known impurity A ~E were 1.1, 1.4,1.5,0.8, 1.4, respectively.Conclusion The method can be used to determine the related substances in piracetam and its injection.The related substances can be determined accurately using main component self-compare with calibration factor.

Objective To approach the effect of Shenfu injection (SFI) and conventional early goal-directed therapy (EGDT) on organ functions and outcomes of septic shock patients. Methods Eighty-four cases conformed to the criteria for the diagnosis of septic shock admitted to Department of Critical Care Medicine of Xuzhou Central Hospital were randomly divided into conventional treatment group (42 cases), and SFI treatment group (42 cases). Conventional treatment was given in the two groups;in SFI treatment group, SFI 100 mL was additionally given by trace continuous intravenous pump 20 mL/h, twice daily for 7 days. Before and after treatment for 1, 6, 12, 24, 48, 72 hours, the levels of hemodynamic status, lactic acid and dosage of vasoactive drugs used, organ function, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score, the time of weaning from ventilator, the length of stay in intensive care unit (ICU), time without organ failure and 28-day mortality rate were observed. Results Compared with those before treatment, after treatment in the two groups, the mean arterial pressure (MAP), cardiac index (CI) and systemic vascular resistance index (SVRI) were increased, while the levels of heart rate (HR) and lactate were decreased (all P<0.05). Compared with conventional treatment group, in SFI treatment group, after treatment for 24 hours, the MAP level was increased significantly [mmHg (1 mmHg=0.133 kPa):75.40±9.75 vs. 71.80±11.08, P < 0.05], that continued to 48 hours; after treatment for 6 hours, the CI level was increased obviously (mL·s-1·m-2: 75.18±34.84 vs. 67.35±39.34, P < 0.05) , that continued to 48 hours; after treatment for 6 hours, the lactic acid level was decreased markedly (mmol/L: 2.03±0.82 vs. 2.24±0.97, P < 0.05);in the comparison of dosage of vasoactive drugs used between two groups, the difference was not significant (all P >0.05). Compared with that before treatment, in the conventional treatment group after treatment for 1 and 3 days, gamma glutamyl transpeptidase (GGT) was increased, on the 5th day it began to decrease, reaching its minimum on the 7th day (U/L:26.75±16.74 vs. 46.96±25.85);while in SFI treatment group, GGT was increased after treatment for 1 day, on 3rd day it began to decrease, reaching its lowest level on the 7th day (U/L:22.41±17.87 vs. 51.23±27.74);aspartate aminotransferase (AST), total bilirubin (TBil), oxygenation index (PaO2/FiO2) were increased after the treatment for 1, 3, 5, 7 days, and blood urea nitrogen (BUN), creatinine (Cr) were decreased at different time points after treatment. In the conventional treatment group, the precursor protein (PA) was decreased after treatment for 1, 3, 5 days, on the 7th day it was increased (mg/L:134.20±63.44 vs. 115.70±45.96);while in SFI treatment group, after the treatment for 1 days and 3 days, it was decreased, on the 5th day it was increased, reaching its highest level on the 7th day (mg/L:145.40±59.75 vs. 108.20±54.34). Compared with those before treatment, after treatment for 1, 3, 5, 7 days, APACHEⅡscore and SOFA score were decreased in the two groups, but there was no statistically significant difference in APACHEⅡscore between the two groups, in SFI treatment group after treatment for 3 days, SOFA score was significantly lower than that of the conventional treatment group (6.31±3.86 vs. 7.14±4.03, P<0.05), that continued to the 7th day after treatment. In SFI treatment group, the time for weaning from ventilator (days:7.5±3.5 vs. 9.1±3.2) and the length of stay in ICU (days: 16.1±9.2 vs. 18.7±8.3) were significantly shorter than those in conventional treatment group (both P<0.05). There were no significant differences in time without organ failure (days:14.5±4.2 vs. 15.3±3.1) and 28-day mortality rate [28.6%(12/42) vs. 31.0%(13/42)] between SFI group and conventional group (both P>0.05). Conclusion The combined use of SFI and EGDT can improve hemodynamics, reduce damage to vital organs, and shorten the times for ventilation and stay in ICU in septic shock patients.

Objective To study the mechanism of some vegetables inhibiting human platelet aggregation function.Methods Some vegetable juice was mixed(tomato juice as positive control)with platelet-rich plasma(PRP),and maximum ratio of platelet aggregation was measured after induction by agonists on the aggregometer.The expression levels of platelet activation marker were detected,including fibrinogen receptor(Fib-R),P-selectin(CD62P),and the combination amount of fibrinogen on the surface of platelet by flow cytometry to validate the inhibitory effect of platelet aggregation by animal tests.Ordinary white rabbits were randomly divided into five groups,each group was fed with saline,cooked tomato juice,blanched garlic leaves juice,Chinese cabbage juice or spinach juice,respectively.And the maximum ratio of rabbit platelet aggregation in different time were observed.Results Cooked vegetable juice couldn't inhibit human platelet aggregation induced by AA,but blanched garlic leaves juice,Chinese cabbage juice and spinach juice could inhibit human platelet aggregation obviously induced by ADP.collagen or epinephrine.The inhibition intensity of platelet aggregation increased markedly along with the increase of the concentration of the cooked vegetables juice.Cooked juice of blanched garlic leaves,Chinese cabbage,spinach could not inhibit the expression of Fib-R and CD62P,Whereas they were able to significantly decrease the amount of Fib-R and fibrinogen binding. ADP-induced rabbit platelet aggregation ratios in the group fed with cooked juice of blanched garlic leaves,Chinese cabbage or spinach were significantly lower than control group after 3,5,8 weeks,respectively.The inhibition ratios of the platelet aggregation in cooked Chinese cabbage juice group were 45.7%,53.6%,48.5% after 3,5,8 weeks,respectively.Cooked juice of blanched garlic leaves group were 10.7%,66.7%,46.3%,respectively. Cooked spinach juice group were 8.7%,21.0%,42.6%,respectively.The collagen-induced rabbit platelet aggregation ratios in the groups fed with cooked juice of blanched garlic leaves or Chinese cabbage were significantly lower than control group after 5 and 8 weeks respectively. The inhibition ratios of the platelet aggregation in cooked Chinese cabbage juice group were 54.9%,56.3%after 5 and 8 weeks,respectively. Cooked juice of blanched garlic leaves group were 28.4%and 86.7%,respectively. Cooked tomato juice could not inhibit rabbit platelet aggregation in 8 weeks. Conclusions After induced by ADP or collagen,cooked juice of blanched garlic leaves,Chinese cabbage and spinach could significantly decrease the amount of Fib-R and fibrinogen binding,and inhibit platelet aggregation function significantly.It may have potential application of therapy or prlevention of thrombotic diseases.

Objective To analyze how is the elastography of renal tissue correlated to clinical biochemical indexes and pathological changes in patients with chronic kidney disease (CKD), and toexplore the potential of renal elastography to become a new noninvasive method available for the dynamic monitoring of renal disease progression, as well as its efficacy assessment and prognosis evaluation. Methods Patients admitted to the department of nephrology of the First Affiliated Hospital of China Medical University and received renal biopsy from August 2014 to January 2015 were selected. One hundred and thirteen cases of CKD patients, 61 males and 52 females were enrolled, including 23 cases of IgA nephropathy, 39 cases of membranous nephropathy, 15 cases of minimal change nephropathy and 7 cases of focal segmental glomerulosclerosis. The Young modulus of renal cortex and medulla (YMcortex and YMmedul a) were detected by Aix Plorer type full digital color Doppler ultrasound. The correlations between the YMs and clinical biochemical indicators in blood and urine, and the difference of YMs among different pathological changes in patients with CKD were analyzed by statistics. Results The YMcortex and YMmedul a in CKD patients were higher than those in the control group (all P<0.05); and with the progression of CKD, the YMcortex and YMmedul a gradually increased. The YMcortex in CKD G5 patients was higher than that in CKD G1?3 patients (all P<0.05). The YMmedul a in CKD G3?5 patients was higher than that in CKD G1?2 patients (all P<0.05). The YMcortex was correlated with systolic pressure, serum creatinine, cystatin C, serum albumin, serum phosphorus, calcium and phosphorus product, uric acid, intact parathyroid hormone (iPTH), urinary NAG, estimate glomerular filtration rate (eGFR) and hemoglobin (all P<0.05). The YMmedul a was correlated with systolic pressure, serum creatinine, serum albumin, uric acid, iPTH, urine microalbumin (MA), urinary NAG and hemoglobin (all P<0.05). Serum cystatin C (β=0.485, P=0.018) and uric acid (β=0.418, P=0.039) were independently correlated with the YMcortex. Serum creatinine (β=0.380, P=0.019), uric acid (β=0.482, P=0.004) and smoking (β=0.337, P=0.009) were independently correlated with YMmedul a. The YMcortex and YMmedul a in different pathological types were statistically significant (P<0.001, P=0.003). The YMcortex and YMmedul a in patients with membranous nephropathy and IgA nephropathy were higher than those in the patients with minimal change nephropathy (all P<0.05). The YMmedul a in patients with focal segmental glomerulosclerosis was higher than that in the patients with minimal change nephropathy (P<0.05). The YMcortex in the patients with phases Ⅳ and Ⅴ based on the Lee grading system of IgA nephropathy was higher than that in the patients with phases Ⅱ andⅢ (P<0.05). According the Oxford classification for IgA nephropathy, the YMcortex and YMmedul a in the T1 and T2 patients were higher than those in the T0 patients (P<0.05). The YMcortex and YMmedul a showed no statistically significant differences among different stages of membranous nephropathy. Conclusions The YMcortex and YMmedul a are associated with the progress of renal insufficiency, which may become new indicators for determining CKD progression. The renal ultrasound elastography may become a new non?invasive method for early diagnosing CKD, dynamic monitoring disease progression, and assessing efficacy and prognosis.