0.05).There was significant difference in the 3-year survival rate between A and C group. Conclusions The 3-year survival rate was dramatically increased with combined therapy mainly by cisplatin, the dose of 60～80mg is tolerant for the elderly aged above seventy years, and perioperation complications can be cured.

OBJECTIVETo investigate the feasibility, effectiveness and practicability of transurethral enucleation plus pneumocystostomy rotary cut (TUE + PCRC) for large benign prostatic hyperplasia (BPH).

METHODSWe performed TUE + PCRC for 26 BPH patients aged 62 - 85 years with the prostate volume of 80 - 165 ml. We conducted transurethral enucleation of the hyperplastic prostate glands and pushed them into the bladder, followed by bladder puncture for pneumo-cystostomy rotary cut.

RESULTSAll the surgical procedures were successfully accomplished, with the mean surgical time of 41 (32 - 54) minutes and intraoperative blood loss < 60 ml in all the cases. Twenty-three of the patients were followed up for 2 - 8 months, which revealed no stricture of the urethra or any other severe complications. Compared with the preoperative baseline, significant improvement was achieved in the IPSS (6.5 +/- 2.2 vs 26.2 +/- 2.4), QOL (1.4 +/- 0.9 vs 4.6 +/- 1.2) and Qmax ([5.8 +/- 1.0 ] vs [19.6 +/- 2.8] ml/s) of the patients after surgery (P < 0.01).

CONCLUSIONTUE + PCRC, with its advantages of short operation time and less severe complications, is a safe and effective approach to the management of large BPH.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; surgery ; Transurethral Resection of Prostate ; methods

Objective To investigate the effects of intraperitoneal injection of valproic acid (VPA) combined with transplantation of bone marrow mesenchymal stem cells (BMSCs) on neurological function recovery after spinal cord injury (SCI) in rats.Methods BMSCs from 3-4 weeks old healthy male Sprague-Dawley (SD) rats were cultured in vitro.The third generation BMSCs were detected by flow cytometry.Spinal cord injury model was made by modified Allen's technique.Sixty adult male SD rats were randomly divided into five groups(n =12 in each group):Sham operation group and model group(received the same dose of normal saline at the same time point),VPA group(VPA,one time per q12 h with 300 mg· kg-1 · d-1).BMSCs group (1 × 106 cell· mL-1BMSCs 1 mL injected into the spinal cord of injured segment)and combined group(VPA + BMSCs).The BBB scale at the 14 d after injury was evaluated.The expression of Caspase-3 protein was detected by immunohistochemistry.Then the neuronal apoptosis rate was observed by TdT-mediated dUTP nick-end labeling(TUNEL) staining.Results BBB Rating:On the 14 d after SCI,the rate in sham operation group,model group,VPA group,BMSCs group and combined group were 21,(4.51 ± 0.41),(7.25 ± 0.95),(7.32 ± 0.55),(9.76 ± 0.95)point.The BBB score of the three treatment groups was significantly higher than that of model group with significantly (P ＜ 0.05).On the 14 d after SCI,the caspase-3 expression in sham operation group,model group,VPA group and BMSCs group and combined group were (1.64 ± 0.41) ％,(26.22 ± 4.81) ％,(21.21 ± 4.04) ％,(21.47 ± 3.32) ％,(16.15 ± 3.09) ％.The expression of Caspase-3 in three treatment groups was significantly lower than that model group with significantly(P ＜0.05).While the expression of caspase-3 in combined group was significantly lower than that in VPA group and BMSCs group with significantly(P ＜0.05).On the 14 d after SCI,the apoptosis rate in sham operation group,model group,VPA group and BMSCs group and combined group were (4.18 ± 0.39)％,(40.51 ± 3.81)％,(19.95 ± 2.04)％,(20.87 ±2.32)％,(12.83 ± 1.09)％.Compared with model group,the apoptosis rate of the three treatment groups was lower with significantly(P ＜ 0.05).The apoptosis rate of combined group was significantly lower than that of VPA group and BMSCs group with significantly (P ＜ 0.05).Conclusion It is very significant effects of intraperitoneal injection of VPA combined with BMSCs on neurological function recovery after spinal cord injury in rats.The mechanism may be related to down-regulation of Caspase-3 expression,leading to inhibition of apoptosis.

Objective To explore the cause of panic attack during body gamma-knife treatment in patients with cancer and the methods of psychological intervention,so as to improve the patients' confidence and ensure their gamma-knife treatment successfully.Methods Comprehensive psychological treatment was adopted,including cognitive therapy,relaxation therapy and psychological counseling,and 36 cases complicated with panic attack were received,before and after the intervention,they were evaluated by the self-rating anxiety scale (SAS).Results Thirty-three cases (91.7％) complicated with panic attack successfully completed gamma-knife treatment after psychological therapy.The SAS score was significantly decreased compared to that before therapy (t =3.878,P ＜ 0.05).Conclusions Comprehensive psychological therapy can effectively prevent and cure panic attack during gamma-knife treatment.

Hydrogel is a kind of material with high water content,good biocompatibility and extracellular matrix-like property,among which polypyrrole(PPy)conductive hydrogels have both physical characteristics and excellent conductivity of hydrogels themselves.Its conductivity can be used to detect electrical signals generated in biological systems and provide electrical stimulation to regulate the activities and functions of cells and tissues.These characteristics make it widely used in the biomedical field.The recent progress of PPy conductive hydrogels in biomedical field was reviewed in this paper.In terms of classification,according to the cross-linking mechanism of PPy and hydrogel matrix,the non-covalent cross-linked PPy conductive hydrogels and covalent cross-linked PPy conductive hydrogels were divided.The applications of PPy conductive hydrogels in the biomedical field(Skin damage repair,nerve repair,myocardial repair and flexible sensing,etc.)were mainly introduced,and the development trend and challenges of PPy conductive hydrogels in the biomedical field were discussed.

BACKGROUNDPeople with metabolic syndrome are at higher risk for developing coronary artery disease (CAD). The effect of the metabolic syndrome on outcomes in patients with preexisting CAD has not been well studied. This study was conducted to assess the prevalence, characteristics, in hospital and long term prognosis of CAD with metabolic syndrome and to determine the factors influencing the prognosis of the disease.

METHODSThe DESIRE registry contains data of 3696 patients with CAD between 2001 and 2004. Mean long term followup was (829 +/- 373) days. Diagnosis of metabolic syndrome was based on modified International Diabetes Federation (IDF) Worldwide Definition of the Metabolic Syndrome, using body mass index (BMI) instead of waist circumference.

RESULTSOf 2596 patients with complete records of height, weight, and so on, 1280 (49.3%) were identified with metabolic syndrome. The patients with metabolic syndrome had higher level of body mass index, systolic blood pressure, diastolic blood pressure, fasting glucose and disordered blood lipid (all P < 0.0001), with higher creatinine [(10.5 +/- 4.3) mg/L vs (9.9 +/- 2.9) mg/L, P < 0.0001] and the number of white blood cells [(7.49 +/- 2.86) x 10(9)/L vs (7.19 +/- 2.62) x 10(9)/L, P = 0.008) compared with those without metabolic syndrome. The patients with metabolic syndrome showed severer coronary angiographic alterations (left main artery and/or > or = 2-vessel) (73.6% vs 69.6%, P = 0.031). There were no significant differences of major adverse cardiac and cerebral events (MACCE) or mortality in hospital between the two groups. During followup, the ratio of MACCE in CAD with metabolic syndrome patients increased significantly (11.8% vs 10.0%, P = 0.044). Fasting blood glucose (> or = 1000 mg/L) and triglyceride (TG, > or = 1500 mg/L) were responsible for most of the increased risk associated with the metabolic syndrome (adjusted OR 1.465, 95% CI 1.037 - 1.874, P = 0.032; OR 1.378, 95% CI 1.014 - 1.768, P = 0.044).

CONCLUSIONSThe prevalence of metabolic syndrome was very high in CAD patients. The metabolic syndrome confers a higher risk of long term MACCE in patients with CAD, and dysglycaemia and hypertriglycaemia appear to be responsible for most of the associated risk.

Adult ; Aged ; Blood Glucose ; analysis ; Coronary Artery Disease ; complications ; physiopathology ; therapy ; Female ; Humans ; Lipids ; blood ; Male ; Metabolic Syndrome ; complications ; epidemiology ; Middle Aged ; Myocardial Revascularization ; Prognosis

BACKGROUNDAdenosine phosphate-mediated platelet aggregation is a prognostic factor for major adverse cardiac events in patients who have undergone selective percutaneous coronary interventions. This study aimed to assess whether an adjusted loading dose of clopidogrel could more effectively inhibit platelet aggregation in patients undergoing selected percutaneous coronary intervention.

METHODSA total of 205 patients undergoing selected percutaneous coronary intervention were enrolled in this multicenter, prospective, randomized study. Patients receiving domestic clopidogrel (n = 104) served as the Talcom (Taijia) group; others (n = 101) received Plavix, the Plavix group. Patients received up to 3 additional 300-mg loading doses of clopidogrel to decrease the adenosine phosphate-mediated platelet aggregation index by more than 50% (the primary endpoint) compared with the baseline. The secondary endpoint was major adverse cardiovascular events at 12 months.

RESULTSCompared with the rational loading dosage, the tailored loading dosage better inhibited platelet aggregation based on a > 50% decrease in adenosine phosphate-mediated platelet aggregation (rational loading dosage vs. tailored loading dosage, 48% vs. 73%, P = 0.028). There was no significant difference in the eligible index between the Talcom and Plavix groups (47% vs. 49% at 300 mg; 62% vs. 59% at 600 mg; 74% vs. 72% at 900 mg; P > 0.05) based on a standard adenosine diphosphate-mediated platelet aggregation decrease of > 50%. After 12 months of follow-up, there were no significant differences in major adverse cardiac events (2.5% vs. 2.9%, P = 5.43). No acute or subacute stent thrombosis events occurred.

CONCLUSIONAn adjusted loading dose of clopidogrel could have significant effects on antiplatelet aggregation compared with a rational dose, decreasing 1-year major adverse cardiac events in patients undergoing percutaneous coronary interventions based on adenosine phosphate-mediated platelet aggregation with no increase in bleeding.

Adenosine Diphosphate ; pharmacology ; Aged ; Angioplasty, Balloon, Coronary ; Female ; Humans ; Male ; Middle Aged ; Platelet Aggregation ; drug effects ; Platelet Aggregation Inhibitors ; administration & dosage ; Prospective Studies ; Ticlopidine ; administration & dosage ; adverse effects ; analogs & derivatives

OBJECTIVETo prepare the anticolon carcinoma vaccine with rich chaperone peptide and to examine its anticancer immunological efficacy.

METHODSCT26 colon carcinoma cells were cultured in 1 mg/L Trichosanthin 1640 medium at different temperatures to induce the chaperone expression and promote the synthesis of antigen peptides. Groups of these cells treated under the different condition were lysed by the sonic disintegration, and the lysates were centrifuged. The rawpurified proteins were obtained from the supernatants by precipitating with saturated ammonium sulfate and removing the molecules below 50,000 and above 300,000 in molecular weight via dialysis. Furthermore, the proteins with the molecular weights in 70,000, 90,000, 95,000, 110,000 and 170,000 were collected through gel filtration and SDS-PAGE. The purified proteins were analysed by Western blotting, and inspected on the anticancer immunological effects including lymphocyte proliferation and the activities of NK and CTL.

RESULTSMajor of the chaperone peptides of anticancer effects in CT26 cells, including antigen peptides joining with HSP70, HSP90, gp96, HSP110 and HSP170, was satisfactorily extracted and condensed, and rich chaperone peptide composites were successfully obtained. The composites prepared under various condition could all enhance lymphocyte proliferation and the activities of CTL and NK(P<0.01).

CONCLUSIONSThe rich chaperone peptide composites are successfully prepared via dialysis, salt fractionation and gel filtration combined with SDS-PAGE. Both the heat stress and Trichosanthin can increase the composites, which treated by 42 centi-degree heat stress and Trichosanthin are found to possess the strongest anticancer efficacy.

Animals ; Cancer Vaccines ; immunology ; Cells, Cultured ; Heat Stress Disorders ; metabolism ; Heat-Shock Proteins ; metabolism ; Mice ; Mice, Inbred BALB C ; Molecular Chaperones ; immunology ; Trichosanthin ; pharmacology

OBJECTIVETo evaluate endourethral surgery for urethratresia under the X-ray guide.

METHODSWe performed transurethral urethroplasty for 11 patients with urethratresia using the PlasmaKinetic electrodes under the guidance of C arm xanthippe.

RESULTSIn the 11 cases, operations were all successful, 9 achieved smooth urination and 2 needed regular urethral dilation.

CONCLUSIONX-ray guided internal urethroplasty with PlasmaKinetic electrodes is a simple and efficient treatment for urethratresia.

Adult ; Aged ; Electrodes ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Urethra ; injuries ; Urethral Obstruction ; surgery ; X-Rays

BACKGROUNDThe epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) maybe changed by strict infection control measures, and the impact of empirical antibiotic therapy on the outcomes of MRSA infection was not clear. We aimed to investigate the present epidemiological status of MRSA infection and empirical antibiotic therapy for MRSA infection in university teaching hospitals in mainland China.

METHODSThe present study was a multicenter prospective observational study conducted in five university teaching hospitals. Patients who were consecutively admitted to the intensive care unit and signed a consent form from March 3, 2011 to May 31, 2011 were included. Patients with age <18 years or with a length of hospital stay <48 hours were excluded from this study. The following variables were collected or recorded: demographic data, general status, APACHE II score of the patient at the time of admission, infections, and the use of antibiotics during a stay. Primary outcomes and prognostic indicators included length of hospital stay and 28-day and 90-day mortality. The differences between the patients with appropriate empirical therapy and patients with inappropriate therapy were analyzed to detect the influences of antibiotic therapy on the prognosis of MRSA infection.

RESULTSA total of 682 cases were enrolled. Thirty (66.2%) of 88 MRSA cases were treated with effective antibiotics for MRSA infection; only 20% received appropriate empirical antibiotic treatment. The empirical therapy group compared with the target therapy group had a shorter length of stay, but there were no significant differences in mortality rates. There were no significant differences in the length of hospital stay, length of stay, and 28-day and 90-day mortality between MRSA-infected patients who received or not received effective antibiotics. Two hundred and eighteen cases received sensitive antibiotics for MRSA.

CONCLUSIONSThe MRSA infection rates are at relatively low levels in university teaching hospitals in China. The empirical use of sensitive antibiotics for MRSA infection was at relatively high rate, and there is a tendency of overusing in patients without MRSA infection. On the other hand, the rate of appropriate empirical antibiotic therapy for patients with MRSA infection is relatively low.

Anti-Bacterial Agents ; therapeutic use ; China ; epidemiology ; Female ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Methicillin-Resistant Staphylococcus aureus ; Middle Aged ; Prospective Studies ; Staphylococcal Infections ; drug therapy ; epidemiology