Objective To study the clinical significance of urinary hTERT in diagnosis and follow up of transitional cell carcinoma of urinary bladder.Methods Semi-quantitative RT-PCR was used to detected the expression of hTERT mRNA expression in 42 cases with bladder transitional carcinoma and 40 patients without carcinoma of bladder.Regular urine cytology results were compared with the expression of hTERT.Following-up observision of the changes of hTERT mRNA expression and its relation with recurrency in 36 cases of transitional cell carcinoma of urinary bladder was conducted.Results 30 0f 42 cases with bladder transcriptional carcinoma were found positive expression of hTERT.but only 3 in the control group of 40 cases presented the positive expression of hTERT.The overall sensitivity and specificity for hTERT were 71.43%and 92.50%.The sensitivities for hTERT were 50.00%,73.68%and 90.91%respectively in G1-G3 tumor.The urine hTERT expression level significantly increased with the tumor grade and clinical staging.The sensitivity and the specificity of urinary cytology were 19.05%and 100%.Compared with hTERT.the cytology had lower sensitivity and no difference in specificity.The recurrence of the tumor was found in 6 patients.8-16 weeks after positive expression of hTERT,cystoscope confirmed recurrence of bladder carcinoma.Conclusions hTERT is a tumor marker of transcriptional carcinoma of bladder.because of its relatively high sensitivity and specificity.Detection of hTERT in urine sediment is superior to traditional cytology.The urine hTERT rate significantly increases with the tumor grade and the clinical stage.hTERT can indicate recurrence of bladder carcinoma.so it is valuable to the monitoring of recurrence of transcriptional cell carcinoma of bladder.

OBJECTIVE:To observe the clinical efficacy and safety of tiotropium bromide combined with Salmeterol flutica-sone aerosol in the treatment of severe COPD in elderly patients. METHODS:A total of 90 elderly patients with severe COPD se-lected from May 2013 to May 2015 in our hospital as research objects were divided into control group and observation group ac-cording to random number table,with 45 cases in each group. Control group was given Salmeterol xinafonate and fluticasone propi-onate aerosol 1 press/time,bid;observation group was additionally given Tiotropium bromide powder for inhalation 18 μg,qd,on the basis of control group. Both groups were treated for 8 weeks. The short-term clinical efficacy,dyspnea score,pulmonary venti-lation function indexes [FVC,EFV1,EFV1%],blood gas analysis indexes [p(O2),p(CO2)] and QLI score before and after treat-ment were observed in 2 groups. The re-hospitalization time and the occurrence of ADR were compared between 2 groups. RE-SULTS:The total response rate of short-term treatment in observation group was 97.78%,which was significantly higher than 80.00% of control group,with statistical significance (P<0.05). There was no statistical significance in dyspnea scores,pulmo-nary ventilation function indexes,blood gas analysis indexes or QLI scores between 2 groups before treatment (P>0.05). After treatment,dyspnea scores and p(CO2) of 2 groups were decreased significantly,while pulmonary ventilation function indexes,p??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????(O2)and QLI scores were increased significantly;the observation group was significantly better than the control group,with statis-tical significance(P<0.05). The re-hospitalization time of observation group was significantly less than that of control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P<0.05). CON-CLUSIONS:Tiotropium bromide assisted with Salmeterol fluticasone aerosol show significant therapeutic efficacy for elderly se-vere COPD,and effectively relieve dyspnea symptom,improve pulmonary ventilation function and quality of daily life,reduce the re-hospitalization risk and do not increase the incidence of ADR.

Objective To investigate the clinical application of renal vessel angiography with 256-slice spiral CT in laparoscopic surgery for renals.Methods One hundred and fifty-five cases underwent computed tomograph angiography(CTA) who were all confirmed by operations.According to preoperative renal artery CTA case shown,the initial plan intraoperative renal artery was compared with the situation with the actual surgery.AIl axial images were reconstructed using technique.Results All patients underwent preoperative renal artery CTA operative findings correspond with the actual rate of 100％.CTA stereoscopic images were good at reflecting renal vascular anatomy and ectopic blood vessels line.Conclusion CTA can accurately evaluate out of shape and variation of the renal arteriesvariation.It has important significance of processing of renal arteries intraoperative rapid,dealing with the renal artery accurately and reducing blood loss or damage and other complications.

Objective To study interdialytic body weight gain(IBWG)in maintenance hemodialysis(MHD)patients,and to analyze the associated factors. Methods A total of 269 patients undergoing maintenance hemodialysis were enrolled in this cross-sectional study.The patients were divided into two groups according to the percentage of IBWG(PIBWG:interdialytic body weight gain/dry weight×100%):PIBWG＞3.50%(190 cases)and PIBWG≤3.50%(79 cases).Associated factors of IBWG were analyzed. Results The average IBWG of 269 MHD patients was(2.42±1.01)kg(0-6.33 kg),and PIBWG was(4.25±1.79)%.In male patients,IBWG was (2.45±1.09)kg,and PIBWG was(3.99±1.79)%.In female patients,IBWG was(2.39±0.85)kg,and PIBWG was(4.64±1.74)%which was significantly higher compared to males(P＜0.01).Patients with PIBWG＜3.00%accounted for 20%,with PIBWG≥3.00%to＜5.00%accounted for 50%,with PIBWG≥5.00%accounted for 30%.Compared to patients with PIBWG＞3.50%,those with PIBWG≤3.50%were characterized by elder age(year)(60.50 ±14.49 vs 54.07±13.78),more males(70.88%vs 54.74%),shorter dialysis duration(month)(41.03±41.92 vs 58.83±43.57),larger BMI(kg/m2)(22.67±3.36 vs 20.91±3.25)and less dry weight(kg)(56.69±10.94 vs 62.82±10.97),more residual urine(ml,In)(6.19±0.94 vs 5.48±0.8),lower predialysis serum β2MG(mmol/L)(31.61±9.82 vs 38.54±10.38)and phosphorus(mmol/L)(1.92±0.66 vs 2.15±0.58).Correlation analysis revealed that PIBWG was positively correlated with dialysis duration,Scr,BUN,β2-MG,phosphorus,decrease and decrease percentage of BP during hemodialysis,and negatively correlated with age,dry weight,BMI,residual urine,and pre-dialysis SBP,MAP. Conclusions PIBWG of about 70%of our patients was below 5%.Young.female.low BMI and dry body weight,long dialysis duration,low residual urine,chronic glomerulonephritis and diabetic nephropathy are associated with more IBWG,which may lead to greater intradialytic BP fluctuation.

Objective To explore the potential risk factors for aortic and mitral valve calcification in maintenance hemodialysis(MHD)patients. Methods Patients on MHD for at least 6 months.aged≥1 8 years without history of surgery or catheter for heart valve disease were enrolled in the study.Echocardiographic examination was performed to detect the calcification.The risk factors for aortic and mitral valve calcification were analyzed by Logistic regression. Results One hundred and eighty-one MHD patients(98 men and 83 women)were enrolled in the study.Of all the patients,aortic or mitral valve calcification was found in 94 patients(5 1.9%),aortic valve calcification in 90 patients(49.7%),mitral valve calcification in 30 patients(16.6%),aortic and valve calcification in 26 patients(14.4%).Multivariate Logistic regression showed that age(β=5.52,P=0.007),dialysis duration(β=6.99,P=0.039)and pre-albumin(β=-12.616,P=0.004)were independently correlated with aortic valve calcification.Mitral valve calcification was independently correlated with dialysis duration(β=6.057,P=0.002),history of primary hypertension(β=3.054,P=0.008),hemoglobin(β=-0.061,P=0.035)and β2 microglobulin(β=7.63,P=0.01).While the correlation between mitral valve calcification and age was borderline significant(β=0.085,P=0.05).Conclusions Valve calcification is prevalent in MHD patients,and aortic valve calcification is more common than mitral valve calcification.Age,dialysis duration and low serum pre-albumin are independent risk factors for aortic valve calcification.The risk factors for mitral valve calcification include age,dialysis duration,history of primary hypertension,anemia and high serum β2 microglobulin.

Objective To discuss the prognosis of the metastatic prostatic carcinoma and analyze the relative factors. Methods From 2001 to 2002, 32 cases of matastatic prostatic carcinoma were admitted to our hospital, the ages ranging from 54 to 87, with the mean age of 71 years. All the diagnosis was proved by the six cores transrectal biopsy of the prostate. The serum PSA ranged from 63 to 2000 ng/ml. Two cases had the Gleason score of 2 - 6, 19 cases had the Gleason score of 7 and 11 cases had the Gleason score of 8 - 10. Preoperative routine examinations included serum testosterone, pelvic CT or MRI scan, CXR and bone scan. Twenty-seven cases were found to have osseous metastasis, among them 8 cases combined with lymph nodes metastasis, and 5 cases with lymph nodes metastasis only. All of them were treated with gonadectomy and the blockade of the androgen receptor (with Bicalutamide 50 mg/d or Flutamide 250 mg/d). It lasted 7 - 48 months with first endocrine therapy,and mid last time 23 months. After first line endocrine therapy failure, Diethylstilbestrol and Estramustine were used in the androgen-independent stage. Thirteen cases were not effective, and second therapy had effect to 19 cases and it lasted for 3 - 15 months. Results The follow-up periods ranged from 13 to 98 months, with the mean period of 33 months. Twenty-eight cases died, 4 cases survived. The median survial period was 37 months, 1-year survival rate was 100% (32/32), 3-year survival rate was 53%(17/32) , 5-year survival rate was 19%(6/23). As to the survival period, there were negative correlaions between survival and the level of PSA (r= -0. 262, P=0. 045) and the Gl-eason score (r=- 0. 624, P=0. 001). There were positive correlations between survival and the level of testosterone (r=0. 514, P=0. 008) and the age (r=0. 311, P = 0. 032). And there was no correlation between survival and the number of the positive cores of the biopsy (r=0. 211, F = 0. 158) and the clinical stage (r=0. 211, P = 0. 352). Conclusions As to the metastatic prostatic carcinoma, there are correlations between the survival and the levels of testosterone before treatment, age, the Gl-eason score and the level of PSA. There is no relationship between the survival period of the metastatic prostatic carcinoma and the number of the positive cores of the biopsy and the clinical stage.

Objective To investigate the expressions of Livin protein and VEGF protein in bladder urothelial carcinoma(BUC) ,and theirs relationships with the clinicopathologic parameters of bladder urothelial carcinoma. Methods The expression of Livin and VEGF protein in 69 samples of BUC tissue and 10 samples of normal bladder epithelium tissue were detected by immunohistochemical SP method. Their relationships with clinicopathologic data were statistically analyzed. Results The positive expression rate of Livin and VEGF in BUC tissues were 65.2% (45/69) and 46.4% ( 32/69), but negative in normal bladder epithelium tissues, which showed significant differences in the comparison (Ps ＜ 0. 05 ). We found significant difference in the comparison of Livin positive rate between groups with or without recurrence ( 78. 8 % vs 48. 1%, χ2 = 6. 13, P ＜ 0. 05 ); but no differences in pathological grade,TNM stage and tumor number( Gl 55.6% ,G2 64. 3% ,G3 73.9% ;Ta ～ T1 61.9% ,T2 ～ T4 70. 4%; Single-tumor 59. 6%, multi-tumor 77.3%; χ2 = 1.52,0. 52,2.07, Ps ＞ 0. 05 ). For BUC,the expression of VEGF was correlated with the pathological grade,TNM stage( Gl 16. 7% ,G2 53.6% ,G3 60. 9%, χ2 = 8. 91; Ta ～ T1 33.3%, T2 ～ T4 66. 7%; χ2 = 7. 34; Ps ＜ 0. 05 ), but not the tumor number and recurrence( Single-tumor 57.4% , multi-tumor 59. 1%, χ2 = 0. 01; with recurrence 51.5% , without recurrence 40. 7% ,χ2= 0. 69; Ps ＞ 0. 05 ). We found no relationship between the expression of Livin and VEGF (r =0. 056,P ＞ 0. 05 ). Conclusion The overexpressions of Livin and VEGF protein may play an important role in the occurrence and development of BUC. Combind detection of these two protein can be used in the diagnosis and prognosis of BUC.

Objective To investigate the expression and clinical significance of α-actinin-1 protein (ACTN1) in prostate cancer (PCa) and prostatic hyperplasia (BPH). Methods The clinical data of patients with PCa or BPH treated in our school affiliated hospital were collected between January 2007—October 2014, according to certain criteria. Immunohistochemistry method was used to detect the expression of ACTN1 in 30 samples of PCa and 30 samples of BPH tissues. Western blot assay was used to detect the relative expression of ACTN1 in 18 samples of PCa and 20 samples of BPH tissues in two groups. Results The result of immunohistochemistry showed that the positive expression rates of ACTN1 were 76.7%and 20%in PCa and BPH groups respectively. The difference was statistically significant (P<0.01). Western blot assay showed that the relative expression of ACTN1was significantly higher in PCa group (0.591±0.182) than that in BPH group (0.037 ± 0.052, P < 0.05). There was no significant difference in expression level of ACTN1 between different age groups. There was no significant difference in serum prostate specific antigen (PSA) level between patients with or without bone metastasis, and patients with or without lymph node metastasis (P > 0.05). There were significant differences in ACTN1 levels between different Gleason score and T staging groups (P<0.05). Conclusion The expression ofα-actinin-1 is significantly higher in PCa tissues than that in BPH tissues. There is the relationship between expression of ACTN1, Gleason scores and T staging.

Objective To investigate the association between peripheral white blood cell count including its subtypes and cardiovascular disease (CVD) incidence and one-year all-cause mortality in maintenance hemodialysis (MHD) patients.Methods A total of 371 MHD patients at Zhongshan Hospital,Fudan University between March 2009 and February,2011 were enrolled.Demographic,hematological,nutritional and inflammatory markers were obtained.All patients were followed for one year to investigate the risks for CVD event and mortality.Spearman correlation and linear regression were used to assess the relationship between white blood cell count and other laboratory parameters.Difference in categorical factors between two groups were determined with Chi-square test,Difference in continuous values between two groups were assessed with t test.Kaplan-Meier analysis and Cox proportional hazards model were applied to assess one-year mortality predictors.Results Patients with CVD event had lower lymphocyte count level (1.17±0.38 vs 1.34±0.51,P＜ 0.05) and higher monocyte count level (0.44 ± 0.15 vs 0.37 ± 0.15,P＜0.01) than those without CVD event.Cox proportional hazard regression showed that an increased lymphocyte count was associated with reduced mortality risk,95％CI:0.136-0.719,P ＜ 0.01) and that an increased monocyte count was associated with increased mortality risk,95％ CI:2.657-74.396,P＜0.01) after adjustment for hsCRP.Conclusion Decreased lymphocyte level and increased monocyte level are significantly related to CVD event and are independent predictors of increased one-year all-cause mortality risk in MHD patients.

Hemodynamic situation is an important factor of recurrence of postoperative carotid artery aneurysm. In order to investigate the hemodynamic factors of postoperative carotid artery aneurysm affect carotid artery aneurysm recurrence, we established a 3D finite element carotid artery aneurysm for the preoperative and postoperative periods using the three-dimensional reconstruction techniques. And then we measured the hemodynamic factors of carotid artery aneurysm of preoperative and postoperative by the finite element method. The carotid artery aneurysm model has an accurate and realistic shape; the pressure of the recurrence of aneurysm was reduced significantly after surgery,wall shear stress increased significantly at residual neck, and blood flow velocity increased significantly, which will increase the risk of recurrence. The hemodynamic analysis provides a reference for development of aneurysm clinical treatment programs and prevention of recurrence.
Aneurysm ; pathology ; surgery ; Blood Flow Velocity ; Carotid Arteries ; pathology ; surgery ; Computer Simulation ; Hemodynamics ; Humans ; Stress, Mechanical