Objective To investigate the clinical efficacy and safety of transurthral electrovaporization of the prostate(TUVP) for benign prostatic hyperplasia( BPH) at high risk.Methods Forty-eight patients with BPH at high risk were treated with transurthral electrovaporization of the prostate(TUVP).The clinical data and therapeutic results were measured.Results All patients went through the perioperiative period safely and had been followed up for 3 to 14 months.Postvoid residual ( PVR) , the International Prostate Symptom Score (IPSS) and quality of life (QOL) before operations were (97.5 ± 16.9) ml, ( 28.4 ± 2.3 ) score and (5.5 ±0.6) score respectively.Three months after operation ,PVR ,IPSS and QOL were( 30.2 ± 12.3 ) ml, (8.2 ± 1.3 ) score and( 1.9 ±0.5) score respectively,there was significant difference between them(t =22.31,53.16,31.94,all P<0.05).Conclusion TUVP is an effective and safe method in treating BPH patients at high risk.

Objective To evaluate the effects of anisodamine on apoptosis in cardiomyocytes and inflammatory response in overtrained rats. Methods Twenty-four male Wistar rats, weighing 200-220 g, were randomly divided into 3 groups ( n = 8 each) : control group (group C) , overtraining group (group O) , anisodamine group (group A) . The model of overtraining-induced acute heart injury was established by exhausting swimming. Anisodamine 10 mg/kg was given intraperitoneally 20 min before overtraining in group A. Blood samples were taken at 6 h after overtraining for measurement of serum CK-MB activity. The rats were then sacrificed and myocardial tissues taken for determination of TNF-α content and NF-κB activity (by immunohistochemistry) . The apoptosis rate was detected by flow cytometry. Results The CK-MB activity, apoptosis rate, TNF-α content and NF-κB activity were significantly higher at 6 h after overtraining in groups O and A than in group C, while lower at 6 h after overtraining in group A than in group O ( P < 0.05) . Conclusion Anisodamine can inhibit apoptosis in cardiomyocytes by reducing inflammatory response in overtrained rats.

Objective To analyze the medical undergraduates'employment intentions and determinants for policy recommendations on how to solve the contraction between the employment and human resources shortage working in the rural place.Methods Descriptive method was used for the employment recognition and unconditional logistic regression was employed for its factors analysis.Results 74.90% interviewees were not high for policy recognition,and only 21.16% undergraduates were willing to work in rural area.Logistic regression analysis found local culture and life environment (OR=2.668),institute performance(OR=0.630)and work challenge(OR=1.509)were key factors to affect their employment.Conclusion To give reform of primary institute performance mainly on pubic health service,take great importance on the medical service,improve work and life environment of rural workers and highly care health workers'career planning and development.

Objective To evaluate the diagnostic and prognostic value of serum CA19-9,CA125 and CP2 in mucinous ovarian tumors.Methods In this retrospective study,the serum CA19-9,CA125 and CP2 levels of 273 hospitalized patients with ovarian tumors of either mucinous or non-mucinous type were analyzed.Results(1)CA19-9 had the biggest area under chive(AUC)in mucinous tumors followed with CA125 while CA125 and CP2 had bigger AUC in non-mucinous tumor.(2)For the diagnosis of mucinous tumors,CA19-9 and CA125 combination showed a greatly increased sensitivity compared with CA19-9 or CA125 alone(93.8%versus 75.0%and 66.7%,P＜0.05)with no significant improvement of the specificity(P＞0.05).For the diagnosis of non-mucinous tumors,CA125 and CP2 combination showed an increased sensitivity compared with CA125 or CP2 alone(85.0%versus 80.7%,P＞0.05,85.0%versus 70.6%,P＜0.05)with no significant improvement of the specificity(P＞0.05).(3)Seventy percent of tumor marker-positive patients could undergo cytoreductive surgery.Compared with those who could not undergo cytoreductive surgery,they were more likely to have normal tumor marker two months after surgery (P＜0.05)and longer interval to re-elevation of tumor markers(P＞0.05),with lower reeurrence and death rate (P＜0.05).All of the 20 tumor marker-negative patients could have eytoreduetive surgery with only 10%recurrence.(4)CA19-9 inereased mainly in recurrent mucinous tumor,while CA125 increased dominantly in recurrent non-mueinous tumor.(5)The survival rate of CA125 and CP2 positive patients was much lower than CA125 and CP2 negative patients(P＜0.05),while the survival rate was similar between CA19-9 positive and CA19-9 negative patients.Conclusions CA19-9 is a sensitive index for diagnosis of mucinous ovarian tumors.Combination of CA19-9 with CA125 can improve the sensitivity of diagnosis and postoperative monitoring of mucinous ovarian tumors.Combination of CA125 with CP2 is more valuable in the diagnosis of non-mucinous ovarian tumors.

Objective To discuss the short-term currative effect of horizontal osteotomy across injured vertebral forⅤdegree old frac-ture-dislocations of thoracolumbar spine.Methods The data of 4 patients who received horizontal osteotomy across injured vertebral internal fixation in our hospital from April 2010 to October 2012 were retrospectively analyzed,of which 1 case with T8-9 fracture dislocation,2 cases with T10-11 fracture dislocation,1 case with T11-12 fracture dislocation.The Franke1 classification of all patients were grade A.Results All 4 cases were achieved completely fracture reduction and followed-up for 2-14 months(an average of 7.4 months),who could get sitting posi-tion with the support of brace 1 week after operation.The postoperative follow-up indicated that all 4 cases got fusion,but there was no improve-ment for Franke1 classification.Conclusion The method of horizontal osteotomy across injured vertebral forⅤdegree old fracture-dislocations of thoracolumbar spine has good short-term clinical effect,with the advantages of shorter operation time,less bleeding and good reduction effect.

Objective To explore the change of CD4+CD25+Foxp3+ regulatory T (Treg) cells during aging and the relation with lung tumor. Methods The Lewis lung cancer model was set up in C57BL/6 female mice, and the 36 mice were divided into young health group, middle-aged health group, elderly health group, young tumor group, middle-aged tumor group and elderly tumor group. The percentages of CD4+CD25+Foxp3+ Treg in CD4+ T cells in mice spleen cells were measured by flow cytometry, for reflecting the quantity of CD4+CD25+Foxp3+ Treg cells. And the level of Foxp3 mRNA in splenocyte was tested by real-time PCR method. Results The level of CD4+CD25+Foxp3+/CD4+ T cells and the quantity of Foxp3 mRNA were higher in tumor groups than in healthy groups(both P＜0.05 ). Besides, in the healthy groups, there were statistical differences in the level of CD4+CD25+Foxp3+/CD4+ T cells (F=47.70, P=0.000) and the quantity of Foxp3 mRNA among the different months groups. Accumulation of the CD4+CD25+Foxp3+ Treg cells was accompanied with aging, the elderly mice contained a significantly larger population of CD4+CD25+Foxp3+ Treg cells in their spleen when compared with the younger counterparts, and the highest was the elderly tumor group. So it was with the functional gene Foxp3 mRNA (F=6.56, P=0.009). Conclusions The results suggest a close relationship of the change of CD4+CD25+Foxp3+Treg cells with aging and the genesis and development of lung tumor.

Objective To observe the effects of short hairpin RNA (shRNA) targeting Her2 on its gene expression when the shRNA was stably transfected into human ovarian cell lines, SKOV3 and SKOV3. ipl, which have different extent of malignancy and investigate the changes of the biological characters of the two cell lines after the stable transfection. Methods The plasmids expressing shRNA targeting Her2 gene were transfected into SKOV3 and SKOV3. ipl cells. The stably transfected cells were gained by antibiotic screening. The expression of Her2 before and after the transfection was detected by RT- PCR and western blot. The transwell experiment was used to observe the invasion ability of the cancer cells before and after the transfection, and the parent and the transfected cells were injected into nude mice to observe the tumor growth. Results After the stable transfection with Her2 shRNA, mRNA and protein levels of Her2 gene in SKOV3 and SKOV3. ipl cells were remarkably reduced. The expression of mRNA were (68.0±3. 1) %, (40. 8±2. 0) %, (99. 9±1.3) %, (42. 4±2. 5) %. The expression of protein were (72. 1±3.4) %, (36. 4±1.5) %, (98.2±1.7) %, (40. 7±2. 1) %. The invasion ability into basilar membrane of the transfected cells was greatly reduced compared with the parent cells. The invasion cell numbers were 7.6±1.1, 1.8±0. 8, 36. 2±9.7, 15.7±7. 2. The growth rate of the planted tumors was lower in transfected groups than that of the parent groups. Conclusions (1) The expression of Her2 gene in SKOV3 and SKOV3. ipl cells was remarkably reduced by RNA interference targeting Her2. (2) The biological characters of SKOV3 and SKOV3. ipl cells are changed when the expression of Her2 gene is reduced by RNA interference.

OBJECTIVE:To observe analgesia,sedation effects and safety of flurbiprofen axetil combined with hydromorphone for postoperative patient-controlled intravenous analgesia (PCIA) after orthopedics surgery. METHODS:Totally 90 patients with combined spinal epidural anesthesia underwent lower limb surgery were selected from anesthesology department in the Affiliated Hospital of Chengde Medical College during May 2016-Jan. 2018. They were divided into SF group,H group and KH group according random number table,with 30 cases in each group. The postoperative PCIA pump drug liquid formula of SF group included Sufentanil citrate injection 2-3 μ g/kg+Tropisetron hydrochloride for injection 10 mg+0.9% Sodium chloride injection diluted to 100 mL;that of H group included Hydromorphone hydrochloride injection 0.12 mg/kg+Tropisetron hydrochloride for injection 10 mg+0.9% Sodium chloride injection diluted to 100 mL;that of KH group included Hydromorphone hydrochloride injection 0.12 mg/kg+Flurbiprofen axetil injection 50 mg+Tropisetron hydrochloride for injection 10 mg+0.9% Sodium chloride injection diluted to 100 mL. The operation time, intraoperative medication (epidural application frequency of additional ropivacaine,frequency of ephedrine and atropine),effective pressing times of analgesic pump and the analgesic effect of PCIA were observed in 3 groups. VAS score and Ramsay sedation score were observed 2,6,12,24,48 h after surgery. The hospital anxiety and depression scale (HAD) score,profile of mood states (POMS) score and the occurrence of ADR were observed before and after surgery. RESULTS:There was no statistical significance in operation time,epidural application frequency of additional ropivacaine or frequency of ephedrine and atropine among 3 groups (P＞0.05). The effective pressing times of analgesic pump in KH group were significantly lower than SF group and H group. The proportion of patients with excellent and good anesthesia effect in KH group was significantly higher than SF group and H group (P＜0.05);there was no statistical significance between SF group and H group(P＞0.05). VAS score of 3 groups 48 h after surgery were significantly lower than 6, 12,24 h after surgery;that of KH group was significantly lower than SF group and H group(P＜0.05);there was no statistical significance between SF group and H group(P＞0.05). There was no statistical significance in Ramsay score among 3 groups at different time points(P＞0.05). Before surgery,there was no statistical significance in HAD score or POMS score among 3 groups (P＞0.05). After surgery,HAD score and POMS score of KH group and H group were significantly lower than before surgery and SF group(P＜0.05);there was no statistical significance in KH group and H group,before and after surgery in SF group(P＞0.05). No vomiting,respiratory depression,pruritus and digestive tract bleeding were observed in 3 groups. The incidence of dizziness and nausea in H group and KH group were significantly lower than SF group (P＜0.05);there was no statistical significance between KH group and H group(P＞0.05). CONCLUSIONS:The flurbiprofen axetil combined with hydromorphone show good analgesic and sedative effect for PCIA after orthopedics operation,and can significantly improve emotion and mood of patients with good safety.

With the increasing emphasis on the bio-psycho-social medical model, significant progress has been made in patient-reported outcomes. Now, through a comprehensive analysis and synthesis of literature within the field, this study explores the advancements in the application of patient-reported outcomes in clinical research on lymphoma. The intention is to provide valuable references for future related studies.

Objective To investigate the clinical features of aortic dissection (AD) and emergency treatments. Methods Data from 784 patients with aortic dissection were collected in the Department of Emergency from January 2000 through December 2009. A retrospective analysis was carried out to determine the survival rate, mortality rate and treatment efficiency. Results Pain was the most common onset symptom (77.7% , 609/784). The majority of patients (86.5%) had essential hypertension (678/784). All the patients with preoperative diagnosis of aortic dissection underwent emergency medical intervention by internists resulting in 81.5% survival rate (639/784) and 18.5% mortality rate (145/784). There were 157 patients without improvement (20.0% ) and the total efficiency rate was (83. 1% ). The efficiency rate of conventional treatment was 76.4% , while the efficiency rate of triple four-procedure treatment was 89. 8% (P<0.05). Of them, 139 patients (17. 7% ) died in the hospital. Among them,. 26 patients died within 24 hours (18.4% ) and 47 cases died within 48 hours (33. 8% ) and 66 patients died within 72 hours (47.2% ). There were 92 patients who refused treatments after diagnosis, and among them, 81 patients died within 72 hours (88.04% ). The difference in mortality rate between two groups was significant (P<0.05). Conclusions The diagnosis of aortic dissection depends on detailed history, physical examination and CT or MRI imaging. Analgesia, sedation and control of blood pressure are essential for emergency treatments. Early diagnosis and effective emergency treatments are the critical strategy for the early surgical intervention and time window for further treatment to improve the survival rate of AD.