Objective To compare the therapeutic effect of laparoscopic radical cystectomy with orthotopic ileal neobladder (LRC-INB) vs open radical cystectomy (ORC-INB). Methods A total of 81 patients were evaluated including 33 undergoing LRC-INB (group A) and 48,ORC-INB (group B) from June 1994 to September 2004 at our institution.The parameters for analysis included operative time,surgical method,blood loss,therapeutic effect,complications and hospital stay.Statistics included t-test and chi-square analysis (P

Objective To present the initial experience and results of the laparoscopic radical cystectomy (LRC) with orthotopic ileal neobladder. Methods Fifteen patients (14 men and 1 women) with invasive bladder carcinoma underwent LRC with orthotopic ileal neobladder.The mean age was 59.5 years(range,39 to 71 years).The LRC with orthotopic ileal neobladder consists of 3 major steps,namely laparoscopic cystectomy,extracorporeal formation of ileal pouch and laparoscopic urethra-pouch anastomosis.With 5 trocars,the surgeon conducted the procedure through the 2 ports on the left side,and the assistants did so on the right side and hold the laparoscope.The bilateral pelvic lymphadenectomy were performed first.The ureters were dissected just outside the bladder.The radical cystoprostatectomy was performed for the male patients.The total bladder, uterus and appendage were removed for the female patient.A 4 to 5 cm median incision in lower abdomen was made to remove the surgical specimens and construct the ileal pouch.A 50 cm ileal loop was taken from the abdominal cavity,isolated,detubularized and reconfigured into “M” shaped pouch with running suture.The anti-refluxing ureter implantation was performed by inserting the 1 cm of ureter into the pouch and suturing them.For the first 4 cases,the urethra-neobaldder anastomosis was completed through the abdominal incision;while for the other 11 cases,the anastomosis was done under the laparoscope. Results The mean duration of surgery was 5 to 10 h with a mean of 6.5 h;the blood loss was 200 to 1000 ml with a mean of 387 ml.During a follow-up of 1 to 11 months,all patients were alive and asymptomatic with normal upper tracts and had no evidence of local recurrence or metastasis.4 to 6 weeks after surgery,all the patients with orthotopic ileal bladder had complete daytime continence,and nocturnal continence was achieved with 2 to 3 times voiding at night. Conclusions This procedure combines the advantages of minimally invasive laparoscopy with the speediness of open surgery.The laparoscopic cystoprostactomy has a magnified clear vision,which makes meticulous manipulation possible,and reduces bleeding,sphincter injury and nerve bundle injury.Shorter time of intestine exposure during the procedure is good for recovery of intestinal function and for reducing postoperative intestinal adhesion.External construction of ileal pouch shortens operation time remarkably.Ileal segment has long and mobile mesentery,thereby can be easily taken out through a small abdomen incision and anastomosed with urethra stump without tension,so it is more suitable for construction of a pouch.

Objective To evaluate the outcomes of M-shaped orthotopic ileal neobladder. Methods A total of 42 male patients with malignant bladder tumors underwent M-shaped orthotopic ileal neobladder after extraperitoneal total cystoprostatectomy.A segment of 45 to 50cm ileal loop was isolated,detubularized,and reconfigured in “M”- shape to form a pouch.Bilateral ureters were reimplanted by means of inserting the 1 cm distal segment into the pouch.The bottom of pouch was opened and anastomosed with the urethra. Results The 42 patients were followed up for 12 to 96 months with a mean of 44 months.38 cases(90.5%) were well continent during daytime,and 36 cases(85.7%) were continent at night.The volume of the pouch was (361?48)ml at 12 months postoperatively. Urodynamic examination showed that the peak voiding pressure was (86.8?21.4)cm H 2O(1 cm H 2O=0.098 kPa).The maximum flow rate (Q max ) was(18.4?6.1)ml/s.No remarkable ureter reflux and obstruction were found.No patient was detected to develop recurrent urethral carcinoma. Conclusions Extraperitoneal cystectomy can prevent the abdomen from tumor contamination and protect the operative field from intestine interference.The ureter-inserting reimplantation technique is a simple anti-reflux anastomosis with lower rate of ureteral stenosis.Isolating the neobladder and ureters from the peritoneal cavity can reduce the postoperative complications of adhesive ileus,internal hernia,and urine leakage to peritoneal cavity.The neobladder is similar to original bladder in position,volume,shape,and anti-reflux of ureter connection.

Objective To explore the role of Tbx3 gene in the occurrence and development of breast cancer. Methods 44 cases of the fresh breast carcinoma tissues and peritumor tissues were collected individually, the gene expression of Tbx3 was detected by RT PCR and the relationship between the changes of Tbx3 gene expression and the related clinicopathological factors of breast carcinoma was investigated. Results Obviously, the expression level of Tbx3 gene in breast carcinoma tissues was higher than that in the peritumor tissues. Furthermore, Tbx3 gene expression level in breast carcinoma tissues was not associated with the tumor size and ages of patients. However, the histological grading of breast carcinoma, tumor infiltrating degree, TNM stagings, and axillary lymph node metastasis were positively correlated with the expression level of Tbx3 gene. Conclusion Tbx3 gene with high expression may promote the occurrence and development of breast cancer and it is also likely a symbol of crucial changes in the development of breast cancer

Objective To understand the effect of circumcision in reducing high-risk human papilloma virus (HPV) infection in male adults. Methods One hundred and twenty-eight married adults with phimosis who underwent circumcision enrolled in the case group and high-risk HPV of urethral discharge specimens were detected before and 2 years after operation. A total of 128 cases of phimosis without circumcision were recruited in the control group. High-risk HPV infection rates were compared between the two groups. Results The highrisk HPV infection rates in the two groups were comparable at baseline. In the circumcision group, high-risk HPV infection rate was 27. 3% preoperative and it significantly decreased to 12.5% two years after operation( x2 =8. 839 ,P =0. 005). In the control group,high risk HPV infection rate was 28. 1% at baseline and it was 25.0%two years later, with no significant difference (x2 =0.320,P = 0.671).Conclusion Circumcision can significantly reduce high-risk HPV infection. Promoting circumcision actively in our country may have an important role in preventing high-risk HPV infection.

Objective To explore the effect of angiotensin Ⅱ antagonist on left ventricular hypertrophy(LVH) and insulin resistance in elderly patients with diabetes mellitus and hypertension. Methods One hundred and twenty elderly patients with diabetes mellitus and essential hypertension with LVH by echocardiography entered the study. Patients were randomized into the telmisartan (80～160 mg/d) group or perindopril (4～8 mg /d) group. After treatment of telmisartan or perindopril,patients were followed-up for 8 months.Plasma sample was collected from each patient before and after treatment of telmisartan or perindopril,respectively.Then plasma levels of cholesterol,fasting plasma glucose(FPG), insulin and Homeostasis Model Assessment Insulin Resistance (HOMA-IR) were investigated.The echocardiography before and after 8 months of treatment with telmisartan or perindopril were also examined. Results Data were analyzed and showed that: (1)After 8 months of treatment with telmisartan or perindopril, blood pressure was reduced from 159/101 to 142/89 mm Hg(P

Objective:To generate monoclonal antibodies against ciprofloxacin (CIP) and to analyze its immunological traits for establishing a determination method for ciprofloxacin residues in food tissues.Methods:BALB/c mice were immunized by the conjugation of CIP-BSA successfully.The splenic cells of BALB/c mice and the oncocyte were fused and screened in HAT culture medium.Cell strains of 1C9,3F6,6H2,6A7,6G11 and 8F5 were cloned,which could secret the monoclonal antibody (Mab) for ciprofloxacin.Results:By ELISA method,the haplotype of Mabs were identified.The antibody secreted by 1C9,3F6 and 6A7 were classified to the IgG2a.Those of 6H2 and 8F5 were classified to the IgG1 while 6G11 to IgG3.The results of SDS-PAGE showed that the Mab protein was made up of the weight chain and the light chain whose molecular weight were 50 kD and 25 kD,respectively.All of those Mabs had fine specificity and sensibility.The indirect ELISA titer of 1C9 was 1:6.4?102 in supernatant and 1:5.6?105 in ascites.The affinity of 1C9 was 2.85?109 L/mol and the value of IC50 reached to 245.86 ng/ml.The protein secreted by 1C9 was screened for establishing the ELISA method and the detective limitation reached to 45.25 ng/ml.There were no cross reactions to Ofloxacin,Difloxacin,Sarafloxacin,Malachite green,Chloramphenicol and Furacilin while the rate of cross reaction to Enrofloxacin could reach to 84.6%.Conclusion:The Mabs are sensitive and specific,which are suitable to be applied in establishing immunoassay of CIP residues.

Objective To investigate the effect of blood-flow-activating and blood-stasis-removing herbal medicine on the vision of primary glaucoma patients.Methods A retrospective study was carried out in 60 eyes of primary glaucoma from 32 cases.The cases were allocated to Group A and Group B.Group A(n=33 eyes)was treated with routine drugs of lowering intraocular pressure and operation and Group B(n=27 eyes)with blood-flow-activating and blood-stasis-removing herbal medicine additionally.Results After treatment,the vision of 8 eyes( 24.24%)in Group A and 16 eyes ( 59.26%)in Group B was improved,and the difference was significant(P 0.05).Conclusion Blood-flow-activating and blood-stasis-removing herbal medicine combined with routine treatment is helpful for the increase of vision of primary glaucoma.

This experiment was designed to investigate the expression profile of miRNAs (microRNA) in human gastric cancer tissues.Methods The expression profiles of miRNAs were compared between 3 pairs of GC and adjacent normal tissues using an Exiqon miRNA array,following which quantitative PCR (qPCR) was employed to confirm the results of the miRNA array,and 10 miRNAs were selected.Bioinformatics was used to analyze the biological function of the differentially expressed miRNAs and its target genes in gastric cancer.Results Compared with adjacent mucosal tissues,95 miRNAs were up-regulated and 16 miRNAs were down-regulated in GC (＞ 2 folds,P ＜ 0.05).The qPCR results were consistent with microarray-based expression analysis (P =0.049).Furthermore,the online GO and pathway analysis revealed that miRNAs might involve RNA transcription,RNA metabolism,gene expression,gene silencing,and other biological functions in GC.Conclusion There is abnormal expression of miRNAs in gastric cancer,and the abnormal expression of miRNAs may be related to GC tumorigenesis.

Aim To construct a subtracted cDNA library o f differentially expressed genes in human gastric carcinoma induced by diallyl dis ulfide(DADS). Methods Differentially expressed cDNA species induc ed by DADS in MGC 803 human gastric carcinoma cell line was determined by using suppression subtractive hybridization (SSH). Then these cDNA species were direct ly inserted into T/A cloning vector to set up the subtractive library. Amplification of th e library was carried out with transformation of E.coli by high voltage electrop erforation. One hundred positive bacteria clones were randomly picked and identi fied using PCR method. Results The amplified library contained more than 1,000 positive bacteria clones. Random analysis of 100 clones with PCR m ethod showed that all clones contained 100～600 bp inserts.Conclusions A subtracted cDNA library of differentially expressed genes in MGC 803 hum an gastric carcinoma cell line induced by DADS is constructed successfully with SSH and T/A cloning techniques. The library is efficient and lays solid foundati on for screening and cloning new and specific tumor correlative genes of human g astric carcinoma, and provides a new idea for further exploring the mechanism of DADS effects on carcinoma cells.