Objective To observe the effects of health promotion on tumor recurrence,quality of life and self feeling evaluation of patients with superficial bladder carcinoma.Methods 104 patients with superficial bladder carcinoma treated in our hospital from March 2002 to March 2005 were divided to two groups randomly.The patients in one group were treated by bladder irrigation with Bacille Calmette Guerin (BCG)simply,and those in the other group were treated by bladder irrigation and health promotion.Tumor recurrence,quality of life and self feeling evaluation between the two groups were compared.Results All patients were foUowed up for 7.3-36.0 months(mean 28.5 months).17 patients(15/51)in the simple BCG irrigation group had tumor recurrence in 0-12 months(2 patients),13-24 months(6)and 25- 36months(9)respectively.The recurrence rate in the first year was 3.9%.in the second year 11.8% and in the third year 17.6%.Eleven(11/53)patients had in the BCG irrigation and health promotion group.in 0-12 months(2),13-24 months(7),and 25-36 months(2)respectively.The recurrence rate in the first year was 3.8%.in the second year 13.2%.and in the third year 3.8%.There were no significant differences in the recurrence rates of the first and second year between the two groups(P>0.05).but there was significant difieFence in the recurrence rate of the third year between the two group(Y2=5.29,P< 0.05).There were no significant difierences in self feeling SCL-90 evaluation and quality evaluation of life after the first discharging between the two groups(P>0.05).After 3-year follow up,the life quality of the patients in the BCG irrigation and health promotion group was improved obviously compared with the simple BCG group(X2=6.47,P<0.05),and the bad negative emotion was diminished obviously compared with the simple BCG group(P<0.05).Conclusion Health promotion after operation on the patients with superficial bladder carcinoma can decrease the long-term tumor recurrence rate obviously,and improve the quality of life and self feeling significantly.

Objective To study the effect and the possible mechanism of delavirdine on muhidrng resist-ance-aasociated protein 2(MRAP2)-mediated multidrug resistance in LLC/cMOAT cells. Methods MTT assay was used to determine the effects of delavirdine on proliferation of LLC/CMV and LLC/cMOAT cells. The inhibitory effects of vincristine (VCR),cisplatin (DDP),adriamycin (ADM) and etoposide (VP-16) used alone or in combi-nation with delavirdine on the proliferation of LLC/CMV and LLC/cMOAT cells were evaluated by MTT assay. The cell cycle distribution, the apoptosis rate of the cells treated with different concentration of delavirdine and the intra-cellular concentration of ADM were determined by flow cytometry (FCM). Results Delavirdine at the concentration of 4 μmol/L and below showed no significant cytotoxicity to LLC/CMV and LLC/cMOAT cells. The resistance of LLC/cMOAT cells to VCB, VP-16, ADM and DDP were 9.58,1.11,2.98 and 3.96 folds of that of LLC/CMV cells. When 2 μmol/L delavirdine was added, the resistance was 5.21 and 2.55 folds respectively;when 4 μmol/L dela-virdine was edded,the resistance was 7.56 and 3.03 ,while 2,4 μmol/L delavirdine made no significant changes to the chemosensitivity of LLC/CMV cells to VCR and DDP(P>0.05). Cellular cycle analysis demonstrated that 0,6, 12,24 hours after co-cultured with delavirdine the amount of cells at G1 phase increased from(38.92±0.15)% to (56.87±2.23)%,(65.36±2.76)% and (74.77±5.06)%. The cell apoptosis rate increased from 1.77% to 17.45% and 28.52% when treated with delavirdine at 2,4 μmol/L and VCR for 24 h. When treated with 2,4 μmol/L delavirdine, ADM accumulation in LLC/cMOAT cells was enhanced significantly(P<0.05). Conclusion DLV can partially reverse the multidrng resistance of LLC/cMOAT cells, and the reverse effect correlates to the concentration. The possible mechanism may involve the growth arrest at G1, increasing of intracellular drug concen-tration and promoting apoptosis.

)(0.05);) the same was true when ≥1.0 cm,but with statistical significance (P0.05).Conclusion: COX-2 may be a stimulative factor in the progression of FAP and may participate in adenoma formation and cancerization.Selective inhibition of COX-2 may be an effective strategy for preventing FAP.

Objective:To evaluate the short-and long-term outcomes of subtotal proctocolectomy for familial adenomatous polyposis(FAP).Methods: Twenty-one FAP patients who had undergone subtotal proctocolectomy during 1985-2000 in our department were followed up colonoscopically to observe whether there was any recurrence of polyps in postoperatively residual colon or/and rectum.Results: Adenomatous recurrence with variant degrees was detected in the residual colon or/and rectum in all 21 patients,the recurrence rate being 100%.Polypous growth was denser in the residual rectum than in the proximal residual colon.The adenomatous polyp in one patient cancerized 4 years after the initial operation.The cumulative occurrence of colorectal cancer was 4.8%.Conclusion: Subtotal proctocolectomy is a simple procedure for FAP with fewer complications,but there is a risk of polyps cancerization in the residual colon or/and rectum.

Familial adenomatous polyposis(FAP) is an autosomal dominantly inherited syndrome.It will inevitably(progress) to colorectal carcinoma if not handled properly.The extracolonic manifestations of FAP play important role in the clinical(diagnosis) and prognosis of FAP patients.This paper reviews the clinical characteristics of FAP and current progress in its research.

Objective To observe the clinical effect of procedure for prolaps and hemofrhoids (PPH) in treatment of mixed hemorrhoids combined with non-functional obstructed defecation syndromes (ODS).Methods The clinical data of 50 patients with mixed hemorrhoids combined with non-functional ODS treated by PPH were retrospectively analysed.All these patients were followed up for 12 months,the treatment outcome was observed.Results Eleven cases were basic cured,apparently effective in 12 cases,and effective in 12 cases,invalid in 15 cases,the total effective rate was 70％ (35/50),inefficacy patients were mainly combined with rectocele.None patients had serious complications such as death,anastomotic infection and pelvic sepsis.Conclusion PPH convenient operation,small trauma,for the treatment of mixed hemorrhoids combined with internal rectal prolapse is safe and effective,but the effective is poorer in treatment of mixed hemorrhoids combined with rectocele.

Objective To observe the expression and location of galactose β-1,4-glycosidic bonds (Gal β-1,4-GlcNAc) in keloid tissue,and to investigate the role of glycoprotein galactosylation in the formation of keloid.Methods This study included 10 keloid tissue specimens,7 hyperplastic scar tissue specimens,and 6 normal skin specimens.Lectin blot analysis was performed to measure the glycosylation level of glycoproteins,saturated picric acid-Sirius red staining followed by polarization microscopy to observe the type,expression and distribution of collagens in these specimens.The type Ⅰ/type Ⅲ collagen ratio was calculated.Immunofluorescence-based histochemistry was carried out by using Ricinus communis agglutinin I to analyze the expression and location of Gal β-1,4-GlcNAc in these skin samples,and double immunofluorescent staining to observe the colocalization of Gal β-1,4-GlcNAc and type Ⅰ procollagen α1.Results Compared with the normal skin tissue,the keloid tissue showed a significant increase in the expression of Gal β-1,4-GlcNAc in glycoproteins with a relative molecular mass of 30 000 to 40 000.Polarization microscopy revealed that there was a considerable expression of type Ⅰ collagen fibers,which amounted to (71.53 ± 4.03)％ in all the collagen fibers.The type Ⅰ/type Ⅲ collagen ratio was significantly higher in keloid tissue specimens than in normal tissue specimens (2.56 ± 0.53 vs.0.91 ± 0.11,P ＜0.05).Fluorescence microscopy showed that Gal β-1,4-GlcNAc was uniformly distributed in the membrane and cytoplasm of fibroblasts in keloid tissue,and the expression intensity of Gal β-1,4-GlcNAc in keloid tissue was notably stronger than that in normal skin tissue.There was a colocalization between Gal β-1,4-GlcNAc and type Ⅰ procollagen α1 in keloid tissue.Conclusions The expression of Gal β-1,4-GlcNAc,which is mainly observed in fibroblasts,is upregulated in keloid tissue,suggesting that Gal β-1,4-GlcNAc may be involved in the modulation of factors responsible for excessive fibre formation during the repair process of keloid.

Objective To compare the effect of intravenous resuscitation with sodium pyruvate (Pyr) Ringer solution against lactated Ringer solution on hemodynamic and organ functions during shock stage in dogs with burn.Methods 28 Beagle dogs were subjected to 50％ total body surface area (TBSA) burn,and they were divided into three groups:burn injury without fluid resuscitation (N R,n =8),Ringer lactate solution(RL,n =10),and Pyr Ringer solution (RP,n =10).They were given intravenous fluid resuscitation according to Parkland formula 30 minutes after burn.The hemodynamics,organ functions and mortality were observed in conscious state before burn injury,and 2,6,8,12,24 hours after burn injury.Results Within 24 hours after burn,all the dogs in NR group died,and those in RL and RP groups were all alive.At 2 hours after burn,the mean arterial pressure (MAP),cardiac index (CI),dp/dt max of left ventricular contractility were significantly reduced in NR,RL and RP groups compared with those before injury [MAP(mmHg,1 mmHg =0.133 kPa):45.33 ± 7.78 vs.141.67 ± 5.98,91.33 ± 10.25 vs.142.33 ± 6.16,98.67 ± 9.54 vs.142.83 ±5.47; CI (mL·s-1·m-2):8.17 ±0.83 vs.48.34 ±3.33,16.84 ±2.17 vs.47.34 ± 1.67,19.00 ± 1.50 vs.47.34 ± 1.33; dp/dt max (mmHg/s):426.83 ± 51.91 vs.1 372.50 ± 39.61,594.00 ± 88.23 vs.1 363.83 ± 44.92,645.00 ±66.82 vs.1 395.83 ± 19.49,all P＜0.05],and the systemic vascular resistance (SVR) and alanine transaminase (ALT),creatinine (Cr),serum MB isoenzyme of creatine kinase (CK-MB),diamine oxidase (DAO) were significantly higher [SVR (kPa·s ·L-1):1 322.50 ±36.37 vs.281.45 ± 8.84,777.50 ±41.84 vs.289.72 ± 6.70,571.40 ±40.01 vs.286.27 ±8.66; ALT (U/L):89.50 ±4.11 vs.40.57 ±3.63,89.25 ±4.88 vs.37.92 ± 2.62,86.30 ±5.61 vs.38.47 ±3.50; Cr (μmol/L):75.62 ±4.61 vs.41.58 ±2.78,77.00 ±5.92 vs.46.55 ± 3.17,74.13 ±2.56 vs.45.65 ± 1.83; CK-MB (kU/L):13.122 ±0.282 vs.1.557 ±0.009,8.885 ±0.272 vs.1.497 ± 0.009,8.692 ± 0.180 vs.1.490 ± 0.005; DAO (kU/L):2.26 ± 0.14 vs.0.25 ± 0.02,1.50 ± 0.07 vs.0.25 ± 0.01,1.37 ± 0.07 vs.0.25 ± 0.02,all P＜0.05].All parameters in NR group kept on worsening till death,while hemodynamic and organ functions of two intravenous resuscitation groups were gradually improved,CI,SVR and DAO in RP group were significantly superior to those of RL group from 2 hours on after burn (all P＜0.05),and dp/dt max and CK-MB in RP group were significantly better than those of RL group from 6 hours on after burn [dp/dt max (mmHg/s):1 082.33 ± 63.59 vs.1 018.60 ± 47.36,CK-MB (U/L):7 898.70 ± 255.74 vs.8 438.70 ± 442.00,all P＜0.05],and MAP (mmHg) was significantly better than that of RL group at 6 hours (124.67 ± 9.39 vs.114.33 ± 9.16,P＜0.05),and Cr (tμmol/L) was significantly better than that of RL group from 24 hours on after burn (53.42 ± 4.99 vs.60.77 ± 3.11,P＜0.05).Conclusion The Pyr Ringer solution was superior to the Ringer lactate solution in improving hemodynamic and organ functions for intravenous resuscitation in dogs with 50％TBSA full thickness burn.

Objective To enhance the rapid response capability of urgent medical unit to satisfy the requirements of natural and manmade disasters for medical service.Methods Modularization principle and system approach were applied.Results Modularized design and management of urgent medical equipments were realized.Conclusion It's very important to realize modularized management of urgent medical equipments.

Gallbladder carcinoma is a common malignancy of biliary system which associated with dismal outcomes.It is difficult to resect because of its various etiologic factors,difficulties of early diagnosis,high malignancy grade and early metastasis.A review is presented here to discuss the progress of extended radical operation for gallbladder carcinoma,and focused on the scope and complications of the resection.