To evaluate the clinical value of NMP22 for the diagnosis of urothelial cancer. Urinary NMP22 was determined with enzyme linked immunoaorbent assay (ELISA) in 50 patients in whom 24 patients were suffering from cancer of urothelium, and 20 cases of cancer of other origins, and 6 cases of artificial bladder after total cystectomy for cancer. The median NMP22 value of urothelial cancer was 37 49U/ml, which was significantly higher than those of other patients (4 33U/ml, P

Objective To study the clinical characteristics of spinal hydatid disease and help to diagnozy and treat the disease. Methods 14 cases with spinal hydatid disease, admitted in our hospital between July 1994 and October 2003, were studied retrospectively. Besides routine examinations, plain X-ray films were performed in all 14 cases, CT in 8 cases and MRI in 13 cases, respectively. 8 cases sufferred serodiagnostic tests for human hydatidosis. All cases underwent operation and the histopathological examination. There were 5 males and 9 females with an average age of 25.8 years(range, 5-53 years) in this series. All 14 cases had the living history in endemic area and the average duration of symptom was 26.7 months(range, 4-120 months). The lesions most frequently involved the thoracic segments, accounting for 35.8%, and then 21.4% in the lumbar, and 28.6% in the lumbosacral segments, cervical segments were the least commonly involved. According to Dew'classification, spinal hydatid cysts located primarily at intradural extramedullary area in 1 case, extradural intraspinal in 2 cases, vertebral in 7 cases, paravertebral in 1 case and combination of various extradural tissues involved in other 3 cases. Results The clinical manifestations were localized back pain or radiating pain, mass and gradually progressive neurological dysfunction. Eight of 14 cases displayed abnormality in X-ray films which showed local, well-defined and irregular erosions with or without surrounding sclerosis or calcifications. CT scans presented multiloculated low density lesions. The MRI characteristics of the lesions were multiloculated cysts, signal intensities of the cyst content were similar to that of CSF. On T1W images the cyst wall appeared iso- or slightly more hypo-intense than the cyst content, T2W images demonstrated a low intensity rim and the hyper-intense cyst content resembling a bunch of grapes. Seven of 8 cases performed the 3-tests serodiagnosis were positive, and 3 cases with positive 3-tests serodiagnosis accepted 8-tests were positive. All the specimens were shown to be Echinococcus Granulosus. Conclusion MRI was the most sensitive diagnostic method and the best method to determinate the site and extent of the cystic lesions. CT and serological examination are useful for diagnosis. The key of avoiding misdiagnosis is to enhance understanding of the disease.

Objective To evaluate the clinical experience in the treatment of the bladder cancer with holmium laser. Methods From June 2001 to June 2002, a total of 34 cases of transitional cell bladder carcinoma, including 30 male and 4 female, with clinical stage T 1 to T 2a and grade I to Ⅱ, were treated with holmium laser. A 550um end firing fiber was delivered through 21 Fr cystoscopy and power(1 to 1.5 J) was delivered at 15 to 40 pulses per second. Results Bladder tumors were resected easily in 26 cases with holmium laser. In 7 cases it was supplemented with TURBT. Only in one case, holmium laser treatment was given up because of continuous bleeding. The patient was then treated with partial cystectomy. Laser operating time ranged form 5min to 60min, mean 20min. Side effects such as uncontrollable bleeding, perforation of bladder, and obturator nerve reflection were not found. 30 cases were followed up for 3 to 12 months, and tumor recurrence were found in 3 cases. Conclusion Holmium laser resection of bladder tumors is a safe, effective, simple method with less side effects. But the field of vision will be obscure unless continuous irrigation is given during operation.

Objective To calculate the maximum ability of the mobile medical team ( MMT) to treat the wounded in order to provide reference for wartime medical support .Methods The flow of casualties between the main units in an MTT is described,data on training is collected through video analysis and questionnaires , the workflow of each unit above is mod-eled by the method of operational research using WINQSB software , and the theoretical maximum value is obtained .Results The theoretical maximum ability of a typical MMT to deal with the wounded is 322 per day when all the function units are operating at full load .Conclusion Under new circumstances , data on an MMT are different from those in the past .Reason-able organization is needed to increase the efficiency while the amount of evacuation should be maximized .

Objective To discuss three managements of bladder tumors under cystoscopy.Methods Of all the patients,1174 were injected compound aluminum sulphate in tumor pedicle,and 700 cases were treated with transurethral resection of bladder tumor (TURBT) and 34 cases were treated with holmium laser.Results The first management,without obturator nerve reflex and tumor recurrence in situ,was easy and economical but not fit for big tumors without pedicles.With the requirements for related techniques and equipments,TURBT might be accompanied by bleeding,obturator nerve reflex and tumor recurrence in situ.Of the 34 cases treated with holmium laser,there were 3 ones with ectopic recurrence and no one with recurrence in situ.With the requirement for holmium laser equipment,the third management was the most expensive one.Conclusion All of the three managements have their advantages and disadvantages.The doctor should select the right management or perform cross application according to the condition of the patient.

AIM: To study the in situ stimulation effect of compound aluminum sulfate injection after i.m. in rabbit quadriceps and dog bladder. The absorption of aluminum and the healing of the bladder wall were also studied to give an evaluation on the safety of the compound injection. METHODS: Compound aluminum sulfate injection was i.m. injected into quadriceps of the rabbits. The in situ stimulation effect was observed macrographically. Blood samples were collected at different time after i.m. injection. Aluminum concentrations were determined by ICP-MS assay and simulated with DAS software. Tissue necrosis as well as the healing of the bladder wall were observed macrographically or pathologically after the injection was given into dog bladder. RESULTS:Severe stimulation was observed after intra quadriceps injection, however, there was no obvious elevation of blood aluminum concentration. The average AUC0-24 was 2.93±1.82 mg·h·L-1 (n=5), corresponding to a relative bioavailability of about 2.77%. Injecting in bladder muscle necrotized the bladder wall in situ, but fibroblast generated and took place of the necrotized membrane and muscle four weeks after injection. There was no bleeding or perforation on the bladder wall. CONCLUSION:Caused compound aluminum sulfate injection in situ necrosis which healed up in 4 weeks. Aluminum absorption is very low after injection, giving a further explanation to the safety of the compound injection.

Objective To explore the morphology,cell phenotype and cell function in dendritic cells (DCs) derived from bone marrow after treatment with Sirolimus or Sirolimus combined with sTNFRI-IgGFc gene segment transfection.Method DCs were divided into 5 groups (imDCs,mDCs,Rapa-DCs,sTNFRI-DCs and Rapa-sTNFRI-DCs) according to different interventions.The expresson of MHC-Ⅱ,CD80 and CD86 was detected by flow cytometry.T cell proliferation of the mixed lymphocyte reaction was evaluated by MTT method.The levels of IL-12,IFN-γ and sTNFRI-IgGFc were determined by ELISA.Result On the day 10,the flow cytometry showed that the expression levels of MHC-Ⅱ,CD80 and CD86 on the cell surface in Sirolimus group were significantly higher than the other groups (P＜0.05).The expression level of CD86 in Rapa-sTNFRI group was significantly lower than in imDC group (P＜0.05).MTT results demonstrated that T cell proliferation ability in Sirolimus group,sTNFRI group and Rapa-sTNFRI group were reduced as compared with mDC group (P＜0.05).The ELISA results revealed that the levels of IL-12 and INF-γ in rnDC group were significantly higher than other groups (P＜0.05).The levels of IL-12 and INF-γ in Rapa-sTNFRI group were significantly lower than other groups (P＜0.05).Conclusion Sirolimus combined with modified sTNFRI-IgGFc gene could synergistically inhibit maturation of DCs more effectively than Sirolimus or modified sTNFRI-IgGFc gene used alone.

BACKGROUND:Clinical physicians should pay attention on how to reduce ankle fracture healing wounds, reduce bleeding, improve operating technique, and improve repair effect, especialy for comminuted fracture. It is necessary to understand how to develop a detailed plan before repair, observe specific circumstances of the fracture from multiple angles, and establish three-dimensional images using two-dimensional X-ray films or CT scan. These raise a chalenge for each physician. OBJECTIVE:To explore the application effect of three-dimensional print, minimaly invasive percutaneous screw and locking plate fixation in the repair of ankle fractures. METHODS: A total of 26 cases of fracture of ankle joint were treated from January 2012 to June 2014. There were 9 cases of double ankle fracture, 12 cases of three ankle fractures, and 5 cases of three ankle fractures involved PILON fracture on the lower tibia. They received spiral CT scanning on the ankle joint, and stored in the format of di.com. After processing with minics software, data were converted into STL format, and then input into the three-dimensional printer. Thus, models of ankle joint were made at the ratio of 1:1. The repair scheme was made. After discharge, X-ray films were checked every month to observe the healing condition of fractures. According to Mazur ankle score standard, ankle joint function was assessed. RESULTS AND CONCLUSION: Al 26 cases were folowed up for 6-12 months. The fractures were healed. The healing time was 4-6 months, averagely 5.5 months. The healing was good, without vascular and nerve damage, or plate breakage. In accordance with the Mazur ankle score standard, there were excelent in 11 cases, good in 13 cases with an excelent and good rate of 92%. The operation time was (64±15) minutes, and intraoperative blood loss was (100±15) mL. The incision was healed in stage one. These findings confirm that the simulation training and operation in fracture models of three-dimensional print have smal injuries to patients with ankle fracture. The bleeding was less, the operation was simple, the healing time was short, and the functional recovery was rapid, especialy for comminuted fracture.

Objective To investigate the expression of Phosphorylated-signal transduction and activators of transcription 3 (P-STAT3) proteins in human prostate tissue from patients received re-peated biopsies. And consider the usefulness of detecting expression of P-STAT3 in early diagnosis of prostate cancer (PCA). Methods Fifty-eight patients (29 cases of PCA, and 29 cases of benign prostatic hyperplasia (BPH)) who had received repeated biopsies were involved in this study. Immu-nolabelling has been carried out on PCa patients' samples of cores from initially negative biopsies, typ-ical cores from cancer field, and other cores of the same batch biopsies showing no sign of prostate cancer. BPH patients' samples of cores from initial biopsies were set as control. All specimens were done immunohistochemistry stain with anti-P-STAT3 monoclonai antibody. The association of P-STAT3 expression in prostate tissues with the pathology result was evaluated. Results Compared with 10.3% in specimens of patients free of prostate cancer, the positive rate of anti-P-STAT3 stained in typical cores from cancer field, other cores of the same batch biopsies showing no sign of prostate cancer, and cores from initially negative biopsies, was 93.1 % (27/29), 82.8 % (24/29) and 86.2 % (25/29), respectively. There were significant differences of these values between former and laters' (X2=60.123,P=0.000). If P-STAT3 positive in tissue of initially biopsies was considered as the di-agnostic standard of prostate cancer, then it would show a relatively high sensitivity (86.2%) and specificity (89.7%). Conclusion IHC stain for P-STAT3 in prostate biopsy samples could be served as an adjunct to the current diagnostic approach to prostate biopsy for early diagnosis of pros-tate cancer.

Objective To determine the prognosis and staging non small cell lung cancer (NSCLC) that extends across the fissure into adjacent lobe after surgery.Methods 3752 patients with histopathologically confirmed non small cell lung cancer (NSCLC) received surgical reeessetion from January,1997 to April,2007.Among them,163 patients have a tumor invasion beyond fissure.After matching by pathologic TNM staging (7th),326 patients whose tumor defined in a single lobe were eligible for analysis.Results Histopatholngic staging of matched patients was I a:10 patiens(6.1％ ),I b:79 patients (48.5％),Ⅱa:5 patients (3.1％ ),111:44 patients (27.0％) and Ⅲa:25 patients( 15.3％ ).5 years survival in patients with stage 1 tumors crossing the interlobar fissure was 51％,while in patients not cross the interlobar fissure was 63％ ( P ＜0.05 ).There was no difference in survival for tumors stage Ⅱa and above with regard to importance of interlobar extension.The T2 tumor extending across a lung fissure had a reduction in survival compared with T2 tumor not cross the lung fissure and similar to the T3 tumor without the fissure invasion.Conclusion Our results suggest that TNM staging should be modified for tumor extends the fissure into adjacent lobe.