Intravesical instillation after transurethral resection of bladder tumor (TURBT) has been considered as the most important and effective method for the prevention and treatment of non-muscle invasive bladder cancer (NMIBC).Nowadays, the main choices of intravesical instillation are chemical drugs and Bacillus Calmette-Guerin (BCG).For all pa-tients with NMIBC, intravesical instillation should be admistered as soon as possible after TURBT.For patients of G_(1-2)T, an immediate single postoperative instillation of chemotherapy as standard therapy for low-risk disease is enough.For interme-diate-risk patients, it is recommended to use an immediate single postoperative instillation of chemotherapy plus an induc-tion course or maintenance treatment, but the scheme of intravesical instillation should be based on the specific circum-stances of the patients.For high-risk patients, maintenance therapy with BCG should be the first chioce.The combination of intravesical BCG and chemotherapy has certain advantages in treating NMIBC, but its efficacy needs further verifica-tion.Although there is a long history of intravesical instillation after TURBT, the choice of drugs, the time of instillation, and the corresponding dosages are still inconclusive.This article summarizes the strategies of the treatment for NMIBC after TURBT.

Objective To investigate the clinical values of dexmedetomidine in general anesthetic for laparo-scopic cholecystectomy.Methods One hundred patients admitted to our center with cholelithes were prospectively studied.According to the principle of completely random digital table,all patients were randomly signed to dexmedeto-midine group or control group.The primary outcomes were hemodynamic changes and postoperative complications. Results There was no significant differences at t0,t1,t2,t3,t4 and t5 in mean arterial pressure (P >0.05).There was no significant difference in heart rate at t0 (P =0.503),however,compared with the control group,patients in the dexmedetomidine group got a significant reduction in t1,t2,t3,t4 and t5 in heart rate(all P <0.05).Compared with the control group,the operation time of the dexmedetomidine group was significantly shorten[(1 18.52 ±15.42)min vs.(127.24 ±19.14)min,t = -5.673,P =0.021 ],the rate of movement of the center of the operation was significantly decreased (36% vs.64%,χ2 =7.840,P <0.001),the incidence rate decreased significantly (0% vs. 10%,χ2 =5.263,P =0.022).There was no difference between the two groups in intra -operative bleeding volume, hypertension,hypotension,tachycardia,postoperative drainage volume,postoperative bleeding,infection and vomiting (all P >0.05 ).Conclusion Dexmedetomidine contributed to maintaining the hemodynamic stable in general anesthetic for laparoscopic cholecystectomy,and reducing the rate of shivering.

The centrosome plays a crucial role in the maintaining of cell conformation,mitosis and chromosome seg-regation.It responds to the DNA damage and keeps the genome stability via cross-talking with the intranuclear DNA damage repair system.The apoptosis of tumor cells can be induced through inhibition of the duplication of centro-some.So the inhibitors of centrosomal proteins will be a potential anti-tumor therapy.

[Objective] To evaluate the curative effect of anterior cruciate ligament(ACL)reconstruction for remaining anteromedial or posterolateral bundle and ruptured fiber.[Method]Among 89 cases of ACL rupture,there were 32 cases of sports injury,24 cases training injury,23 cases traffic accidents and 10 cases sprained in daily life.ACL ruptured at the notch of the femur in 24 cases,and at the intercondyle of the tibial in 28 cases.Thirty-two cases were reconstructed with quadri-bundle Hamstring tendon knot press-fit technique and 20 cases were reconstructed with quadriceps tendon press-fit technique with autogenetic patellar bone.ACL anteromedial bundle(AMB)ruptured in 14 cases and posterolateral bundle(PLB)ruptured in 23 cases.The intact bundle and the remnants of ACL were preserved.AMB and PLB were reconstructed with double-bundle Hamstring tendon knot press-fit technique in 37 cases.Absorbable interference screws were used at the tibial tunnel and sutured tendon was knotted across the tibial bone bridge.[Result]The average duration of follow-up were 25 months(14-37 months).Lysholm knee function score increased by 27.7 scores,from average 67.5 scores of pre-operation to average 95.2 scores at the end of the follow-up.Rulermetr examination tibial translation was 4 mm?2 mm in 72 cases and 6 mm?3 mm in 17 cases.Lachman test was negative in 79 case,weakly positive in 8 cases and positive in 2 cases.The function of the knees were improved and the stabilization was strengthened after operation.According to knee therapeutic effect evaluation criterion,76 cases were excellent and 13 cases were good.[Conclusion]To keep the remaining of anteromedial or posterolateral bundle and ruptured fiber for ACL reconstruction is beneficial for the graft revascularization or healing,and is helpful for the position sense or rehabilitation.

As a method of financial management and control,the implementation of cost accounting has a significant influence on management of sicentific research projects.The model patterns of cost accounting in the United Kingdom,the United States and European Union,respectively can be served as practical frameworks to guide Chinese scientific research project funds in terms of accounting forms,methods and contents.Based on the understanding of current domestic development and problrms of cost accounting experiences learned from internation practices are signifcant for improving cost accounting system in scientific research projects of China.

BACKGROUND:The rise of tissue engineering has opened up new ways for tissue repair and reconstruction of the urinary tract, and the bladder acellular matrix is a better alternative material for urinary tissue engineering.
OBJECTIVE:To construct the compound of hair fol icle stem cells with heterologous bladder acellular scaffold, and to observe the growth of hair fol icle stem cells on the scaffold.
METHODS:Bladder acellular matrix from New Zealand rabbits were prepared and detected using scanning electron microscopy and Masson staining. Passage 3 hair fol icle stem cells were statical y inoculated into the surface of bladder acellular matrix using secondary sedimentation method. Under inverted microscope, cellgrowth was observed, and cellgrowth curves were drawn. cellgrowth on the scaffold surface was observed through histological detection and scanning electron microscope observation.
RESULTS AND CONCLUSION:Prepared bladder acellular matrix was a white translucent film with fiber mesh structure, and no residual cells were seen. Masson staining results indicated that the bladder acellular matrix had col agen structure, and no obvious residual cells. After culture for 48 hours, hair fol icle stem cells grew wel around the bladder acellular matrix under inverted microscope;1 week later, hair fol icle stem cells extended and adhered to the scaffold surface. These findings indicate that hair fol icle stem cells have a good biocompatibility with the bladder acellular matrix through in vitro culture.

Objective To evaluate the clinical outcomes of arthroscopically assisted combined anterior and posterior cruciate ligament reconstruction, with an implant fixation of combined press-fit technique of hamstrings tendon knot and bone bolt. Methods 15 cases of combined injury of anterior and posterior cruciate ligament were reconstructed under arthroscopy. There were 10 males and 5 females, and the average age of patients was 23 years ranging from 19 to 31 years. 9 left knees and 6 right knees were involved. A hamstring was taken by standard procedure with a stripper, and pretension was performed on the harvested tendons; a bone bolt was inserted into the tendon to form a tendon knot. The bottle-neck shaped tunnel was prepared by stepping drill at the femoral side, the tendon knot and bone bolt was pulled inside of femoral tunnel, and then out of the tibial tunnel. Repeating the full extension and flexion of the knee joint for 20 times, and then the weaving suture of tendons was brought to pass underneath of tibial bridge and tightened together. Results The patients were evaluated by Lysholm knee functional scales, the average knee score were 61.5?4.6 and 92.5?3.7 respectively before and after operation, and the difference was of statistical significance(P

[Objective]To analyze the characteristics of articular cartilage lesions in knees and evaluate the therapeutic efficacy of microfracture technique under arthroscopy for articular carrtilage lesions.[Method]A total of seventy-nine patients with articular cartilage lesions were treated with the microfracture technique.Thirty-eight patients were males and forty-one were female,with the mean age of 38.3 years(15~57years).The averaged preoperative duration of symptoms was 11 months(3~23 months).After preparation of the lesion,used an arthroscopic awl to make multiple holes,results in microfracture holes approximately 3mm apart and the depth approximately 3 mm.[Result]A total of 131 articular cartilage lesions were found in Seventy-nine patients,for an average of 1.6 lesions per case.The main lesion was found on the medial femoral condyle in 33.6% and the patella in 22.1%;60.3% of lesions were grade Ⅳ according to Modified Outerbridge Scale;In 43.5% of the lesions the total area was from 1~2 cm2.Seventy-three patients were followed up for 17 months in average(10~33 months).At the time of the latest follow-up,79.7% of patients were satisfied with the results.According to Lysholm knee evaluation system,the mean scores was improved from 43 points preoperative to 88 points postoperative.[Conclusion]Arthroscopic microfrature is simple and effective to repair of articular cartilage lesions of knee joint.This method can release pain and improve joint function.

Background Neovascular glaucoma (NVG) is a serious eye disease with a variety of causes.It results from the secretion of growth factors by hypoxic retinal tissue,such as vascular endothelial growth factor (VEGF),but anti-VEGF treatment alone dose not completely inhibit neovascularization.Our previous study found that platelet-derived growth factor-c (PDGF-C) is also an important factor in pathological angiogenesis.However,the role of PDGF-C in the development of NVG remains unknown.Objective This study was to quantitatively detect the levels of VEGF and PDGF-C in the aqueous humor of patients with NVG and provide a basis for the anti-angiogenesis therapy.Methods A prospective cohort study was carried out.Sixty-two eyes of 62 patients with advanced NVG and 11 control subjects with age related cataract were included in Xijing Hospital of the Fourth Military Medical University from January 2014 to August 2015.Ten of 62 NVG eyes received retinal photocoagulation and/or cryotherapy,and 16 eyes resulted from central retinal vein occlusion,20 eyes from diabetic retinopathy,5 eyes from postopeartion of retinal detachment,4 eyes from Eales disease and 7 eyes from unknown cause.Iris neovascularization of grade Ⅱ was found in 13 eyes,grade Ⅲ in 29 eyes and grade Ⅳ in 10 eyes.Aqueous humor specimen was collected for 0.1-0.2 ml during the surgery,and the contents of VEGF and PDGF-C in the aqueous humor were detected by ELISA assay.Written informed consent was obtained from each subject prior to any medical procedure.Results The VEGF and PDGF-C concentrations in the aqueous humor were (1 138.17±69.31) ng/L and (29.80±1.64) ng/L in the NVG group,respectively,which were significantly higher than (679.54±49.81) ng/L and (18.60±1.85)ng/L in the control subjects (t=20.95,20.49,both at P＜0.01).The VEGF and PDGF-C concentrations in aqueous humor were (1 095.99±52.71) ng/L and (28.55±0.94) ng/L in the retinal photocoagulation group,showing significantly decreases in comparison with (1 146.28±69.57) ng/L and (30.04± 1.64) ng/L in the untreatment group (t =-2.160,P =0.034;t =-2.760,P =0.008).The VEGF content in aqueous humor was positively correlated with PDGF-C content in the patients with NVG (r=0.346,P=0.006).However,the aqueous levels of VEGF and PDGF-C were not significantly different among various primary disease groups and different iris neovascularitation gradings (all at P＞0.05).Conclusions Both VEGF and PDGF-C contents in the aqueous humour are considerably elevated in NVG patients.Retinal photocoagulation and/or cryotherapy can inhibit the release of VEGF and PDGF-C in the aqueous humor.PDGF-C may be a target for the treatment of NVG.

Objective:To investigate the feasibility,effectiveness and safety in the treatment of symptomatic middle cerebral artery stenosis with stenting.Methods:Twelve patients with middle cerebral artery stenosis were treated with stenting from August 2005 to December 2006.Among these patients,9 were male and 3 were female.The meam(SD)age was 69(5.3)years(range 56 to 81 years).The mean(SD)stenosis degree was 84.2%(3.7)(range 50% to 99%).All patients were successfully treated with balloon-expanded stents.and there was not any severe complications.Results:The rate of residual stenosis after the procedures was≤20%.No cerebral ischemic symptoms recurred in the patients over a 6-to 18-month follow-up period.Conclusions:Endovascular stenting is a safe and effective approach in the treatment of symptomatic middle cerebral artery stenosis,and its short-term effect is significant.