Objective To explore the feasibility,efficent and safety of transuretheral enucleation of prostate combined with extraction of gland pieces from small lower mid-line incision(LMI).Methods One hundred and twelve patients with large benign prostatic hyperplasia were treated by modified transurethral nucleation of prostate,during the operation,the gland was divided into 2-3 parts which were extracted from a small LMI.Results In this method the operation time was 60-120 min with an average time of(70 ± 10)min and blood loss during operation was 60-400 ml with an average of(150 ± 15)ml.There was no severe complication during and after operation.At the 3 month after surgery,the urine flow rate(Qmax)increased from (7.5 ±2.4)ml/s to(16.0 ±2.5)ml/s,and urine residual volume(RUV)decreased from(75 ± 15)ml to (25 ± 10)ml,international prostate symptom score(IPSS)decreased from 25.5±:4.5 to 8.4 ± 1.3,and the quality of life(QOL)decreased from 5.5 ± 0.4 to 1.2 ± 0.3.All these changes were statistically significant (t =28.53,36.19,37.16 and 59.53,Ps ＜ 0.05).At the 6 month,no complications,e.g.,permenant uroclepsia,urethrostenosis or erection disfounction occurred.Conclusion Transurethral enucleation of prostate combined with gland extraction from LMI for large benign prostatic hyperplasia is safe and effective and it is worthy of generalization in clinical practice.

ObjectiveTo investigate the clinical significance of posterior spinal cord shifting after two different types of laminoplasty for multilevel cervical myelopathy.Methods From June 2004 to September 2007,65 patients with cervical spondylotic myelopathy were reviewed in this study,including 41 males and 24 females with an average age was 56.3 years(range,39-75).Among them,33 patients underwent selective laminoplasty and 32 patients underwent open-door laminoplasty.There were no significant differences of preoperative JOA scores and cervical curvature index between two groups.After one year follow -up,the posterior shifting of spinal cord,Japanese Orthopaedics Association (JOA) recovery rate,loss of curvature index and axial symptom for each patient were calculated.ResultsAll cases were followed up for average 34 months(range,26-47).There was significant difference of the postoperative posterior shifting between the two groups,which was(1.4±0.6) mm in selective laminoplasty group and(3.3±1.2) mm in opendoor laminoplasty group,respectively.The average JOA recovery rate was 60.5％±21.3％ and 61.1％±17.9％ in selective laminoplasty and open-door laminoplasty group,respectively.There was no significant difference of JOA recovery rate between the two groups.Loss of cervical curvature indices was 3.3％±1.7％ and 3.1％± 2.4％ in selective laminoplasty and open-door laminoplasty group,respectively,with no significant difference between the two groups.The rate of patients with evident axial symptoms was 18.2％ and 33.3％ in selective laminoplasty group and open-door laminoplasty group,and the difference of the scores of cervical axial symptom was statistically significant.ConclusionThe degree of the postoperative posterior shifting of the spinal cord in open-door laminoplasty group was greater than that in selective laminoplasty group.The posterior shifting of the spinal is correlated with cord,axial symptom but not the recovery rate and curvature index.

Objective To observe the efficacy of liposomal doxorubicin combined with cyclophosphamide, vincristine and prednisone in the treatment of refractory Non-Hodgkin’s lymphoma.Methods Liposomal doxorubicin (40mg/m2) was given by intravenous drip in the 1st day. Cyclophosphamide (750mg/m2) was given by intravenous injection in the 1st day. Vincristine (2mg) was given by intravenous injection in the 1st day. Prednisone (100mg/m2) was given orally from the 1st to the 5th day. A cycle was repeated every 3 to 4 weeks. Every patient took at least 2 cycles of the regimen.Results A total of 13 patients were assessed in the group. Among them, 7 were completely release (53.8), 4 were partially release (30.67) and 2 remained the same (15.35). The B symptom of 7 patients in the 9 with that disappeared, and that of the other 2 patients was improved obviously. The most common adverse effects were slight gastrointestinal reactions and the grade Ⅲ bone marrow suppression in a few patients. Conclusion The regimen of liposomal doxorubicin combined with cyclophosphamide, vincristine and prednisone is effective in the treatment of refractory Non-Hodgkin’s lymphoma with tolerable toxicity. It may be a salvage chemotherapeutic regimen deserving further study.

Objective To investigate the effect of urotensin Ⅱ on myocardial fibrosis in rats.Methods The pressure overload animal model was established in rats by abdominal aorta coarctation.The rats were divided into sham operation group,modeled for 4,8 and 12 weeks group.The expression of U Ⅱ,GPR14,col-Ⅰ,col-Ⅲ,and PKA in cardiac tissues was detected by Western blot.Isolated and cultured cardiac myofibroblasts (CFs) from new-born SD rats were treated with U Ⅱ,KT5720 or SB-611812,and then the proliferation of CFs was observed by micro scope and CKK-8.Results The expression of U Ⅱ,GPR14,col-Ⅰ,col-Ⅲand PKA increased markedly in cardiac tissues of model rat,which were time-dependent.U Ⅱ promoted the proliferation of CFs (P＜0.05),which could be inhibited by KT5720 or SB-611812.Conclusions U Ⅱ/UT system promotes the occurring and development of myocardial fibrosis.

Objective To investigate the roles of five scoring systems including model for endstage liver disease (MELD), Child-Turcotte-Pugh (CTP), Mayo, MESO and MELD-Na scoring systems, in predicting the prognosis of patients with chronic severe hepatitis. Methods The clinical data of 213 patients with chronic severe hepatitis were retrospectively studied. The five scoring systems were applied respectively to evaluate the scores in survival group and death group. The capability of these five scoring systems to predict the prognosis of severe hepatitis were compared by the receiver operating characteristic (ROC) curve, area under curve (AUC) and cut-off value.Measurement data were compared by group t test. The comparisons of AUC among scoring systems were done using MEDCLAC software. Results The scores of death group evaluated by MELD, CTP,Mayo, MESO or MELD-Na scoring systems (30.6 ± 9.5, 11.3 ± 1.5, 10.4 ± 1.3, 2.3 ± 0.8 and 39.0 ± 11.8, respectively) were consistently higher than those of survival group (21.1± 6.8, 10.6 ±1.6, 9.0±1.5, 1.6±0.5 and 22.6±8.2, respectively) (P＜0.01). The values of AUC of these five systems were 0.810, 0.623, 0.749, 0.829 and 0.885, respectively. The Youden's indexes of these five systems were 0.507, 0.175, 0.389, 0.528 and 0.650, respectively. Conclusions The CTP scoring systems can not predict the prognosis of chronic severe hepatitis very well. The Mayo scoring systems can partially predict the prognosis. On the contrary, MELD, MESO and MELD-Na systems can successfully predict the disease prognosis, and the score of MELD-Na system shows the best correlation with the prognosis.

Objective To study the methods and effect of the surgical treatment for intrahepaticolithiasis(IHL). Methods In recent 12 years, in our hospital,230 cases of IHL were treated by different operations companied with biliary fibrescopy to remove the residnal stones of biliary tract. Results (1) Hepatolobectomy combined with Y-type hepatocholangiojejunostomy was done in 103 cases,the success rate was 91.8%.(2)Y-type hepatocholangiojejunostomy was performed on 45 cases,the success rate was 81.2%.(3)Hepaticolithotomy combined with T-tube drainage was done in 72 cases,the success rate was 69.3%. Conclusions For intrahepaticolithiasis,combination of hepatolobectomy with other operation and with biliary fibrescopy during or after the operation shoul be done, which can effectively improve the curative effect.

Objective To investigate the distribution situation of human papillomavirus (HPV) genotypes profile in cervical cells among women in Xuzhou area and its clinical significance .Methods 23 kinds of HPV DNA were extracted in cervical cell samples from 8 010 women in Xiuzhou area .The gene‐chips technique of PCR combined with reverse dot blot was adopted to detect the HPV genotypes .Results Among 8010 cervical cell samples ,there were 1 852 HPV infected cases ,the total HPV infection rate was 23 .12% ,the HPV infection rates of single type accounted for 17 .17% and its predominant types were 16 type (4 .35% ) ,followed by 58 type (2 .12% ) and 52 type (1 .82% ) ,The detection rate of multiple HPV infection was 5 .96% ,in which the predominant types were HPV16+58(4 .40% ) ,16+52(2 .94% ) ,11+16(2 .52% ) .Conclusion The single HPV infection of HPV16 ,58 ,52 and the multiple HPV infection of HPV16+58 ,16+52 ,11+16 are the main genotypes of cervical cells among women in Xuzhou area , this gene chip technique is suitable for the cervical cell sample ,its once detection can detect 23 kinds of HPV genotypes with high specificity and high sensitivity ,which has an important significance for the molecular epidemiologic survey study of HPV genotypes distribution among women in our country .

Objective To evaluate the capability of multilocus variable-number tandem-repeat ( VNTR) analysis ( MLVA) and pulsed-field gel electrophoresis ( PFGE) for genotyping Salmonella enterica serovar Typhi (S.Typhi) isolates.Methods Five polymorphic VNTRs (SAL02,SAL11,SAL16,SAL20, and TR4699 ) that were observed in S.Typhi strains from previous studies were selected to establish MLVA . Twenty-one epidemiologically unrelated S.Typhi strains that were isolated from Shenzhen ,China from 2002 to 2007 were genotyped by the established MLVA , and the results were compared with those by PFGE . Results The Simpson′s index of diversity ( D value ) for all five different VNTRs ranged from 0.838 to 0.943 .A total of 19 MLVA profiles and 19 PFGE profiles were found , respectively .The D value for both MLVA and PFGE were 0.99 and the test results from two analyses were identical .Conclusion The five polymorphic VNTRs analysis could be used as an alternative typing scheme for epidemiologic investigation of S.Typhi infection .

Objective To investigate the prevalence and molecular characteristics of the extended -spectrum β-lactamase ( ESBL) and AmpC enzyme-producing Proteus mirabilis ( P.mirabilis) strains isola-ted in Shenzhen People′s Hospital.Methods The production of ESBLs and AmpC enzymes by P.mirabilis isolates were detected by a screening and confirmatory test for ESBLs and AmpC disk test , respectively .The PCR assays followed by DNA sequencing of the products were employed to analyze the multiple genes inclu -ding the ESBLs genes, AmpC genes, insertion sequences (ISs) upstream of the ESBLs or AmpC genes, plasmid -mediated quinolone resistance ( PMQR ) determinants , quinolone resistance-determining region (QRDR) genes , the integrase genes, and class1 integron cassette.The epidemiological analysis of the iso-lates was performed by pulsed field gel electrophoresis .Results There were 130 P.mirabilis clinical iso-lates collected from Shenzhen People′s Hospital in China during the year 2004 to 2010.Among them, 13 isolates (10%) produced ESBLs, that accounted for 0%-9.1%in the year 2004-2009 and up to 29.4%in 2010, and 3 isolates (2.3%) produced AmpC enzymes.The predominant genotype of ESBLs -producing isolateswas b al CTX-M-14(n=7), followed by blaCTX-M-65(n=3), blaCTX-M-55(n=1), blaCTX-M-24(n=1) and blaPER-1 (n =1).The clinical isolate of PER-1-producing P.mirabilis was reported for the first time in China.Twoisolates carried an AmpC β-lactamase gene of blaCMY-2 and one isolate carried an unidentified AmpC gene .ISEcp1 located upstream of blaCTX-M and blaCMY-2 were detected in 91.7% (11/12) of CTX-M-producing isolatesand one CMY-2-producing isolate, respectively.ISPa12 was present upstream of blaPER-1 in one studiedisolate.Approximately 66.7% (10/15) of ESBL and /or AmpC-producing isolates harbored PMQR genes including2 carrying qnrD, 5 carrying aac-Ib-cr and 3 carrying both qnrD and aac-Ib-cr.Twelve ESBL and /orAmpC-producers with high level of resistance to ciprofloxacin carried the similar mutation profiles of S 83I inGyrA, S80I or S80R in ParC and among them, six strains showed E466D mutation in GyrB.Approximately86.7% (13/15) of ESBL and/or AmpC-producing isolates carried class 1 integron.Fourteen PFGE typeswere observed among 15 ESBL and/or AmpC-producers.Conclusion The prevalence of CTX-M β-lactamasesin P.mirabilis isolates contributed to the increased resistance to extended -spectrum cephalosporins.The qnrD and/or aac-Ib-cr genes were detected among the most of ESBL and /or AmpC-producing P.mirabilis clinical isolates.

Objective To explore the efficacy and safety of HAA regimen (homoharringtonine,cytarabine and aclarubicin) in the treatment of 150 newly diagnosed adult acute myeloid leukemia (AML).Methods All patients entered the study from May 1999 to June 2008 were treated with HAA regimen. Coxsurvival analysis was used to estimate the survival rate and differences between M1/M2 and M4/M5 were compared with 2-sided log-rank test. Results Out of the 150 patients, 121 (81%) achieved complete remission (CR). After the first course, CR rate was 68%. The CR rates of 97%, 84% and 38% were achieved in patients with favorable, intermediate and unfavorable cytogenetics, respectively. For the patients with CR, the median follow-up time was 16.5 ( 1.5-100.5 ) months, and the estimated 3-year survival rate was 45%. The estimated 3-year relapse free survival rate was 52% for the 121 patients with CR.Conclusions HAA regimen may be an efficacious and safe regimen with a good toleration in the induction therapy for newly diagnosed AML, and a high CR rate could be achieved with only one or two courses.