Objective To evaluate the efficacy and prognostic factors of combined medical thera-py with amitriptyline, cimetidine and intravesical resiniferatoxin post-hydrodistention for patients with painful bladder syndrome/interstitial cystitis (PBS/IC). Methods Twenty-nine patients with PBS/ IC according to NIDDK criteria were enrolled. There were 6 males and 23 females with average age of 52±14 years and average duration of symptoms of 3.7±1.9 years before diagnosis. The patients were divided into 2 groups. Non-concomitant disease group included 10 cases without concomitant disease and 7 cases with unrelated diseases such as hypertension and diabetes mellitus. Concomitant disease group included 5 cases with history of bladder neck incision, 3 cases with history of transurethral re-section of the prostate, 2 cases with history of gynecologic disease and 2 cases with history of gyneco-logic operation. Patients of concomitant disease group still had the painful bladder syndrome after 3 months when the primary disease had been cured. All patients were treated with amitriptyline (25 mg twice a day), cimetidine (800 mg per day) and intravesical resiniferatoxin (1-2 times) post-hydrodis-tention. The primary assessment index was O'Leary-Sant score. The secondary assessment index was pelvic pain score, mean voiding times per day and mean volume of each micturating. The data of pa-tients before treatment and after follow-up≥9 months were collected to evaluate the efficacy and prog-nostic factors of the combined treatment. Results The mean follow-up for all patients was 9.2±6.0 months. Patients were followed up at month 1 and month 6 after discharge. Then, patients would be followed up at each 6 months interval. The overall remission rate was 65.5% (19/29). Complete re-mission rate was 41.4% (12/29). Partial remission was 24. 1% (7/29). Non-remission rate was 34.5% (10/29). For all patients, the pre-treatment mean voiding times per day were 29±15, voiding volume each time was 64±36 ml, average O'Leary Sant score was 23. 8±4.8, and they were signifi-cantly improved post-treatment (17±12 times, 172±108 ml, 13. 3±10.4, respectively, P<0.001). O' Leary-Sant score of concomitant disease group was lower than that of non-concomitant disease group (21.5±4.7 vs 25.4±4.3, P=0.030). However, complete remission (8.3%, 1/12) of con-comitant disease group was lower than that(64. 7%, 11/17) of non-concomitant disease group (P= 0. 003). In independent variables of patients age, sex, duration of symptom, O'Leary Sant score pre-treatment, and whether or not with concomitant disease, according to the results of Logistic Regres-sion, patients with concomitant disease would have poor prognosis (P-0.008, partial regression coef-ficient was -3. 899, OR was 0. 020). Conclusions Treating PBS/IC patients with amitriptyline, ci-metidine and intravesical resiniferatoxin post-hydrodistention is effective. However, concomitant dis-eases such as gynecologic disease or urethra operation history can impair the effectiveness of these treatment.

Objective:To observe influence of trimetazidine on cardiac function in patients With chronic heart failure (CHF).Methods:According to number table method,a total of 70 CHF patients accorded With inclusion standards Were randomly and equally divided into trimetazidine group and routine treatment group.According to patient's condition,routine treatment group received digitalis,diuretics,angiotensin converting enzyme inhibitors etc CHF routine freatment.Trimetazidine group additionally received trimetazidine based on routine treatment.The treat-ment period Was four Weeks.Plasma brain natriuretic peptide (BNP)level Was measured and patients received 6min Walking test (6MWT)before and after treatment.Results:Compared With before treatment,there Was significant decrease in plasma BNP level in tWo groups after treatment (P<0.01),compared With routine treatment group, there Was significant increase in decreasing amplitude of BNP level [(655.89±135.61)pg/ml vs.(715.60±181.22) pg/ml,P<0.05]in trimetazidine group;compared With before treatment,there Was significant increase in 6min Walking distance (6MWD)in tWo groups after treatment (P<0.01),compared With routine treatment group,there Was significant increase in increasing amplitude of 6MWD [(181.46±51.16)m vs.(226.06±65.18)m,P<0.01] in trimetazidine group.Conclusion:Treatment trimetazidine can significantly reduce plasma brain natriuretic peptide level and improve heart function based on routine treatment in patients With heart failure.

Objective To study the changes of the symptoms and quality of life (QOL) in patients after the Transvaginal tape-obturator (TVT-O) treatment and weather would this treatment lead to bladder outlet obstruction (BOO) and bladder function change. Methods A total of 82 stress urinary incontinence (SUI) women who had underwent TVT-O were included, age from 39-82 years, 3-60 months after operation. All patients were divided into 5 groups by the time post-operation. The ICI-Q-SF scores were collected to study the change of the symptoms and QOL of each group perioperation. Qmax, PVR, bladder weight, wall thickness of each group were collected to study whether would TVT-O lead to BOO and bladder function change. Results Forty-five (55%) patients were cured and 33(40 %) improved after TVT-O. Total cure rate was 95 %. There was a significant improvement of average symptom and QOL in all of the 5 groups (3-month, 6-month, 1-year, 2-year, above-2-year) (P＜0. 05). Qmax changed from (32. 17±10.74), (25.64±6.05), (25.68±11.36), (25.70±10. 28), (25.29±15. 10)ml/s pre-operation to (28.30±15.21), (25.64±10. 48), (24. 49±7.96),(25.43±11.92), (25. 92± 10. 17)ml/s post-operation in 5 groups(P＞0. 05). PVR changed from (0.04±0.20), (0. 00±0.00), (0. 17±0. 39), (2.70±6.01), (1. 96±5.10)ml pre-operation to (1. 79±6.16), (0.00±0.00), (12. 50±29.89), (5.00±15. 54), (33. 70±92.10)ml post-operation in 5 groups(P＞0.05). The bladder weight changed from (43. 62±7.81), (41. 57±8. 63), (46.11±8.12), (42. 50±3. 85), (44. 52±4. 38)g pre-operation to (45. 62±5.32), (47.21±5. 47),(44.89±4. 65), (45. 14±4. 13), (46. 70±5.84)g post-operation, which differed significantly in 6-month, 2-year, above-2-year groups (P＜0. 05). The bladder wall thickness changed from (2.23±0.51), (2.22±0.47), (2.04±0.38), (2. 19±0. 43), (2. 19±0. 38)mm pre-operation to (2.25±0. 40), (2. 18±0.47), (2. 07±0.47), (2.22±0. 47), (2. 20±0. 44)mm post-operation(P＞0. 05).Conclusions TVT-O has a high cure rate for SUI and there was a significant improvement of average symptom and QOL of all patients after the treatment. But TVT-O may lead to BOO and bladder function change since bladder weight increases significantly in some patients.

Objective To study the influence of overactive bladder (OAB) on the symptoms and quality of life (QoL) in patients after Transvaginal Tape-Obturator (TVT-O) treatment for stress urinary incontinence (SUI).Methods Eighty-two SUI women underwent TVT-O were included in this study.The perioperative ICI-Q-SF scores,including frequency of leakage,volume of leakage,and QOL scores,were collected to study the perioperative OAB prevalence and the influence of OAB on the improvement on the symptoms and QOL after TVT-O.Results The total efficacy of TVT-O was 95%.The average symptom and QOL scores in all patients decrease from (8.17±2.29)and (7.95±2.16)to (1.84±2.34)and(1.32±2.24)after TVT-O,P＜0.05.The prevalence of OAB decreased from 46% to 24% after TVT-O,P＜0.05.The average post-operation symptom and QOL scores of the pre-operation non-OAB group were (1.09±1.60)and(0.82±1.45),while those of the OAB group were (2.71±2.75) and (1.89±2.82),P＜0.05.The average post-operation symptom and QOL scores of the post-operation non-OAB group were (1.06±1.68) and (0.56±1.15),while those of the OAB group were (4.25±2.49) and (3.65±3.10),P＜0.05.Conclusions TVT-O is effective for female stress urinary incontinence and contributes to the significant improvement of symptoms and QOL in patients with OAB.The treatment will not raise the prevalence of OAB in itself.

Objective To assess the clinical effect of tumor-type prosthesis replacement for treatment of giant cell tumors of bone near the joints. Methods Thirty-seven patients with giant cell tumors of bone near the joints from January 1998 to January 2008 were reviewed. 18 were males and 19 were females. The ages ranged from 19 to 64 and the median age was 32 years old. The anatomic site of the lesions spreaded at distal femur(23 cases) , proximal tibia(10 cases),proximal humerus(3 cases) and proximal femur(1 case). According to Companacci's staging system: 9 patients were classified as grade II and 28 as grade Ⅲ. All patients had been treated with block excision and reconstruction with prosthesis. The functional outcomes were evaluated by MSTS 93 score. Results According to the follow-up for 2 -9 years,1 patient (4. 3% ) had local recurrence and underwent amputation of the diseased limb. As for the complications, periprosthesis infection occurred in 1 patient, prosthesis loosening in 2 patients. The average MSTS 93 score was 22. 49 ±5. 16 in 3 years after surgery. The evaluated functional result revealed excellent or good performance in 89. 2% of the patients. Conclusions Tumor-type prosthesis replacement is an effective procedure to reduce the local recurrence,and to restore joint function.

OBJECTIVETo evaluate the clinical effects of iliolumbar fixation for the sacrum fractures of Denis type II.

METHODSThe clinical data of 86 patients with sacrum fracture of Denis type II treated by iliolumbar fixation from January 2008 to January 2012 were retrospectively analyzed. There were 55 males and 31 females, aged from 17 to 55 years old with an average of 39.1 years. Among them, 73 cases complicated with pelvis fracture and 13 cases with acetabular fracture; 37 cases with sacral neurological symptoms and 49 cases without sacral neurological symptoms. Fracture healing time, nerve function, clinical function and complications were observed in the patients.

RESULTSIn 86 cases, 6 cases were out of followed-up and 80 cases were followed up from 24 to 71 months with an average of 36 months. The mean fracture healing time was 13 weeks (ranged, 10 to 38 weeks). According to Gibbons scoring to evaluate the neurological function, preoperative nerve rehabilitation, lower limbs feeling, lower limbs activity,bladder and rectum function,total score respectively were 0.62 +/- 0.04, 1.54 +/- 0.35, 1.12 +/- 0.18, 0.23 +/- 0.01, 3.46 +/- 0.47 and postoperative respectively were 0.82 +/- 0.12, 0.36 +/- 0.04, 0.05 +/- 0.01, 0.03 +/- 0.01, 1.25 +/- 0.22, there were statistically significant differences between preoperative and postoperative (P < 0.05). According to Majeed scoring to evaluate the clinical function, postoperative pain, standing, sitting, sexual life, work ability, total score respectively were 22.54 +/- 4.02, 27.93 +/- 5.46, 8.47 +/- 3.61, 2.54 +/- 1.33, 16.46 +/- 4.34, 81.32 +/- 8.73, 60 cases got excellent results, 17 good, 3 fair. The main complications including fracture nonunion of 5 cases,deep incision infection of 1 case, and screw prominence resulting uncomfortable of 8 cases.

CONCLUSIONIliolumbar fixation has the advantages of stable fixation, satisfactory functional rehabilitation, less complications, and is a good method in treating sacrum fracture of Denis type II.

Adolescent ; Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sacrum ; injuries ; surgery ; Spinal Fractures ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVE: To investigate the quantification and significance of Msx2, topoII-α; HPV16 and VEGF in sinonasal inverted papilloma(SNIP), to study the correlation among the four factors,and to discover the relationship between Msx2 and topoII-α in the process of SNIP malignant transfomation. METHOD: Real-time quantitative Polymerase Chain Reaction (RT-qPCR) was used to detect the expression of Msx2, topoII-α, HPV16 and VEGF in 13 cases of sinonasal inverted papilloma (SNIP), 10 cases of sinonasal squamous cell carcinoma(NSCC) and 10 cases of inflammatory nasal polyp paraffin (INP)tissues. According to the pathology results SNIP were divided into mild dysplasia, moderate dysplasia and severe dysplasia. All the data were analysised by SPSS17. 0, P<0. 05 was refered to statistically significant difference. RESULT: The mRNA level of Msx2, topoII-α, VEGF and HPV16 in SNIP, NSCC tissues were significantly higher than in the INP tissues (P<0. 05). The expression differences of Msx2, topoII-α, HPV16 and VEGF mRNA level in SNIP tissues which were divided into three groups according to their pathological results,were all statistically significantly different between any two of the three groups (P< 0. 05). Using Pearson correlation coefficient analysis,we found positive correlation between any two of the mRNA level of Msx2, topoII-α, VEGF and HPV16 (P<0. 05). CONCLUSION Msx2 and topoII-α may play an important role in the process of SNIP Malignant transformation,which may be new targets for gene therapy of SNIP and NSCC.
Antigens, Neoplasm ; physiology ; Carcinoma, Squamous Cell ; genetics ; Cell Transformation, Neoplastic ; genetics ; DNA Topoisomerases, Type II ; physiology ; DNA-Binding Proteins ; physiology ; Genes, Homeobox ; Homeodomain Proteins ; physiology ; Human papillomavirus 16 ; Humans ; Nose Neoplasms ; genetics ; Papilloma, Inverted ; genetics ; RNA, Messenger ; Vascular Endothelial Growth Factor A ; physiology

Objective:To evaluate the quantity and function changes of dendritic cells ( DC) in peripheral blood of patients with repeated implantation failure ( RIF).Methods:30 patients with RIF and 15 normal controls were enrolled in this study,and the peripheral blood was collected during the mid-luteal phase.The percentage of DC subsets and the expression levels of functional molecules were assessed by flow cytometric analysis.Results:Compared with normal controls,the percentage of lin-HLA-DR+DC cells accounting for leukocytes in patients with RIF was not significantly different ( P>0.05).There were also no significant differences in the expression levels of co-stimulatory molecules ( CD80 and CD86) and immune tolerant molecules CD200 on DC cells surfaces between patients with RIF and normal controls ( all P>0.05).In addition,the percentage of CD11c+CD123-mDC accounting for DC cells was significantly increased in patients with RIF (P<0.05),however,the percentage of CD11c-CD123+pDC was similar (P>0.05). Conclusion:The percentage of mDC accounting for DC cells was significantly increased in patients with RIF, which may be one of factors affecting pregnancy outcomes.

Objective To study the feasibility and safety of hand-assisted laparoscopic hepatectomy for huge left hepatoma.Methods Nine patients with huge left hepatoma underwent hand- assisted laparoscopic hepatectomy including hepatocellular carcinoma(4 cases),intrahepatic cholangioearcinoma(1 case),hepatic metastatic squamous carcinoma(1 case),hepatic cavernous hemangioma(2 cases),and hepatic spindle cell tumor(1 case).The mean age was 45.3 years.AFP was positive in 3 cases and CEA was positive in 1 case.The preoperative liver function was Child-Pugh A in all patients.The procedure included dissection of left hepatic ligaments and portal triad clamping with Pringle's maneuver and hepatectomy.Results The laparoscopic procedures were completed safely in all patients including 6 left lateral segmentectomies and 3 left hemihepatectomies.There was no conversion to laparotomy.Mean surgical time was 111.7 minutes.Mean blood loss was 97.8 ml.Portal triad clamping was used in 8 cases and mean clamping time was 13.4 minutes.Neither formidable bleeding nor gas embolism occurred.There were no serious postoperative complications such as postoperative bleeding or bile leak or liver failure.Liver function recovered within 7 to 10 days.Preoperatively positive AFP and CEA turned negative after operation.The mean postoperative hospital stay was 8.4 days.Four patients with HCC underwent postoperative prophylactic hepatic arterial chemoembolization within the first postoperative month. All patients were tumor-free as evaluated by postoperative follow-up of 4～11 months.Conclusions Hand-assisted laparoscopic hepatectomy for huge left hepatoma is feasible and safe in appropriately selected patients.

Objective To investigate the efficiency of Trichostatin A (TSA) in inducing cell apoptosis and altering the Notch pathway genes expression in PANC-1 cells line.Methods The survival rate and apoptosis of PANC-1 cells were measured by MTT assay and Hoechst 33258 staining,respectively.mRNA expression levels of the genes,numb,gcn512,dll3,hes6,eaf2,cytohesins,in PANC-1 cells were assessed by real-time quantitive PCR.Western blot was used to measure the expression of bcl-2,bax,actived caspase-3 and NICD protein which was the biologically active form of Notch-1.Results After culturing with 0.1,0.2,and 0.4 μmol/L TSA for 24 hours,the cellular survival rate of PANC-1 cells significantly decreased to 72％,58％ and 39％,respectively.The survival rate of PANC-1 was negatively correlated to time length of culture with TSA.Increased apoptosis of PANC-1 cells after 12,24 and 36 h culture with TSA was detected by Hoechst 33258 staining.Western blotting showed that the expression of bax,actived caspase-3 and NICD protein increased while the bcl-2 protein decreased after culture with TSA.In real time quantitive PCR assessment,the mRNA expression of numb and hes6 in PANC-1 cells were upregulated by TSA (P ＜ 0.05),while the mRNA expression of gcn512 and dll3 were down-regulated by TSA (P ＜ 0.05).While mRNA expressions of eaf2 and cytohesin1,2,3,4 were not affected by TSA.Conclusions TSA induces apoptosis of pancreatic cancer cell line PANC-1.The Notch signal pathway may be involved in inducing cellular apoptosis of PANC-1 when cultured with TSA.