Objective To evaluate the late complications of continent ileocolic reservoir with an unaltered in situ appendix conduit and the management. Methods Thirty patients with bladder cancer who had undergone the surgery of continent ileocolic diversion with an unaltered in situ appendix conduit were followed up for 108 to 126 months (mean 118 months).The long-term post-operative complications were documented. Results The complications occurred as follows:urinary pouch superdistention in 5 cases,calculus formation in the urinary pouch in 6,difficulty with catheterization in 4,uerteral obstruction in 3,hemorrhage of the pouch in 1 and mild hyperchloremic acidosis in 1.These complications were managed accordingly and good results achieved. Conclusions Although continent ileocolic diversion with an unaltered in situ appendix conduit has a long-term efficacy,the complications occur frequently.The procedure needs further improvement.

Objective To study the cellular apoptosis and telomerase activity in bladder cancer before and after treatment with cell wall skeleton of bacillus Calmett Guerin(BCG CWS) and interleukin 2(IL 2). Methods The cellular apoptosis and telomerase activity of 33 cases of bladder cancer tissues were detected by terminal deoxynucleotidyl transferase mediated dUTP biotin nick end labeling(TUNEL) and telomeric repeat amplification protocol(TRAP) assay both before and after treated with BCG CWS and IL 2. Results The apoptosis index for bladder cancers before and after treatment with BCG CWS and IL 2 was (35.6?12.7)% and (79.1?11.3)% respectively, the apoptosis index being obviously increased after the treatments, P

Objective To explore surgical methods of removing polyacrylamide hydrogel (PAHG) and the right time of repairing the deformity of breast after removing PAHG.Methods We operated with endoscopy to remove PAHG through the lower mammary areolar incision.According to injection influence,we made the dicision whether to put the silicon gel prosthesis (hereafter referred to as prosthesis) simultaneously,and to fix the porsthesis,and to rebuild the imframammary fold of breast using biological repair membrane (hereafter referred to as membrane).Results In all 46 patients,39 patients' injection and their envelope were removed entirely.7 patients left part of the envelope because of its thin and wide characters.14 of them accepted prosthesis augmentation mammaplasty simultaneously and 5 of these accepted membrane repair.4 patients received prosthesis augmentation in stage Ⅱ.All patients' incision were primary healing.The incision scars were not obvious.1 patient with breast cancer suffered breast excision; 1 patient who received prosthesis and membrane simultaneously appeared prosthesis displacement after 3 months and fixed again.1 patient who received membrane appeared hydrops in residual cavity,and the membrane was removed finally.Conclusions This method with endoscopy through mammary areolae is necessary for cleaning PAHG entirely.We can use prosthesis to repair the deformity of breast after removing PAHG,and if necessary use membrane to fix the implant and rebuild the inframammary fold of the breast.

Objective:To construct bispecific minibody by using anti HBsAg and anti RBC single chain Fv(ScFv).Methods:A “knob” variant T366W was first obtained by replacement of a small amino acid with a larger one in the human IgG1 CH 3 domain.The knob was designed to insert into a “hole” in another CH 3 domain which was created by replacement of three large residues with three smaller residues:T366S:L368A:Y407V.The “knob into hole” mutation:S354C:T366W/Y349C:T366S:L368A:Y407V.Then a disulfide bond was engineered in combination with previously designed “knob” or “hole” CH 3 was connected to anti HBsAg or anti RBC ScFv genes respectively.Then the two genes were combined together to form a bispecific minibody expression vector.The bispecific minibodies were expressed in E.coli.Results:Three different form of anti HBsAg and anti RBC minibody expression vectors were constructed.They contained wild type CH 3,“knob into hole”CH 3 or “knob into hole” plus disulfide bond CH 3 respectively.The results indicated that these three different types of bacterially expressed minibodies had similar HBsAg and RBC binding activities.The second and third type of minibody could cause agglutination of human RBC when HBsAg was present,which demonstrated bispecific function.Conclusion:Engineered interface of CH 3 can promote formation of heterodimers of different antibodies and faciliates the formation of bispecific antibodies(bispecific minibody) in E.coli expression system.

Objective To study the prevalence of food intolerance and to explore its related factors among adult health check-up receivers.Methods A total of 863 adults who took physical examinations in our hospital from April to October 2011 were enrolled in this investigation.Height,body weight and blood pressure were measured,and serum IgG level was measured by enzyme-linked immunosorbent assay (ELISA).Results The total positive rate of food intolerance was 73％,and the leading intolerance items were crab (40.1％ ),egg (29.8％ ),cod fish ( 21.6％ ),milk ( 20.0％ ) and soybean ( 14.4％ ).Females showed significantly higher prevalence of food intolerance than males.Various positive rate of milk or soybean intolerance was found in different age groups.No correlations of serum specific IgG with body mass index and systolic or diastolic blood pressure were observed.In logistic regression analysis,the odds ratio of food intolerance of women was 1.67 ( 95 ％ confidence interval 1.190 to 2.607 ).ConclusionsThe prevalence rate of food intolerance was high.The risk for food intolerance was significantly increased in women.Specific IgG antibody detection may help to early prevent and diagnose food intolerance-related diseases.

ObjectiveTo estimate the value of transthoracic coronary flow Doppler imaging to detect coronary flow reserve (CFR) changes in patient with obstructive sleep apnea syndrome (OSA). Methods Fifty patients with OSA who hospitalized or were outpatient in Aerospace 731 Hospital during the period of 2010 March to 2013 December were enrolled in this study and were divided into three groups according to apnea hypopnea index (AHI). Eighteen cases of patients which AHI was greater than 5 and less than 20 were defi ned as mild group, 16 cases of patients which AHI was more than 20 and less than 40 were defi ned as middle group, 16 cases of patients which AHI was greater than 40 were defi ned as severe group. The diastolic peak velocity (PDV) and meanfl ow velocity (MDV) of the distance segment of left anterior descending coronary (LAD) were measured by transthoracic echocardiography at rest and after intravenous infusion of adenosine triphosphate (ATP). Meanwhile, CFR was calculated. Forty healthy persons were chosen as control group. Thettest was used to compare the difference of PDV, MDV and CFR between OSA group and healthy controls. The single factor analysis of variance was used to compare the difference of PDV, MDV and CFR in patients with different AHI. SNK -q test was used to compare in different OSA groups. Thet test was used to compare the difference of PDV, MDV among OSA group, healthy control and OSA groups with different AHI at rest and after intravenous infusion of ATP.ResultsCoronaryfl ow velocity Doppler signals were successfully obtained in all the groups. PDV ([92.78±7.68] cm/s) and MDV ([85.93±6.98] cm/s) after intravenous infusion of ATP in control group were significant higher than those at rest ([28.09±4.55] cm/s and [21.76±5.09] cm/s) (t=49.687 and 58.259, bothP<0.001). PDV ([82.73±6.91] cm/s) and MDV ([77.39±6.73] cm/s) after intravenous infusion of ATP in OSA group were signifi cant higher than those at rest ([29.93±3.66] cm/s and [22.28±4.15] cm/s) (t=55.381 and 47.700, bothP<0.001). There was no statistically signifi cant difference between PDV and MDV at rest in OSA group and control group. The difference of PDV and MDV between OSA group and normal group was statistically signifi cant after intravenous infusion of ATP (t=6.524 and 5.884, bothP<0.01). There was no statistically signifi cant difference between OSA groups with different AHI at rest. There were statistically signifi cant difference between OSA groups with different AHI after intravenous infusion of ATP (5≤AHI<20:t=-32.903 and-32.771, both P=0.000; 20≤AHI<40:t=-37.122 and-32.623, bothP=0.000; AHI>40:t=-28.197 and-20.184, both P=0.000). PDV and MDV of patients with AHI>40 were less than those of patients with 5≤AHI <20 and 20≤AHI<40 and the differences were statistically signifi cant (PDV:q=21.048 and 15.667, bothP<0.05; MDV:q=12.958 and 18.182, bothP<0.05). However, the differences of PDV and MDV was not statistically signifi cant between patients with 5≤AHI<20 and patients with 20≤AHI<40.The CFRmax and CFRmean in OSA group were lower than those in control group (t=5.310 and 6.430, bothP=0.000). There were statistically signifi cant difference for CFRmax and CFRmean in patients with different AHI and the difference decreased with severity of OSA increased. The CFRmax and CFRmean in patients with 5≤AHI<20 were higher than those in patients with 20≤AHI<40 and AHI>40 (CFRmax:q=2.889 and 4.142, bothP<0.05; CFRmean:q=3.080 and 4.204, bothP<0.05). There was no statistical signifi cant difference for CFRmax and CFRmean between patients with 20≤AHI<40 and patients with AHI>40.ConclusionsIn patients with obstructive sleep apnea syndrome, transthoracic coronaryfl ow imaging combined with intravenous infusion of adenosine triphosphate shows impaired in CFR. It means the patients with OSA have a coronary artery microcirculation impairment in early stage. Assessing CFR in the patients with OSA is of important clinical value for the evaluation of treatment effective of medicine and surgery and follow-up.

Objective To study the expressions of keratin 10, 14 and 17 (KI0, K14, K17) in psoriatic lesions before and after the treatment with acitretin. Methods Thirty patients with moderate or severe plaque psoriasis were included in this study. The cohort consisted of 19 males and 11 females with an average age of 33.9 years, and disease course of 4 months to 30 years. Patients were treated with acitretin for 8 weeks which started with an initial dose of 20 mg per day for 1 week, then switched to 0.5-0.75 mg per kilogramme of body weight per day until symptom improvement, finally maintained at a dose of 10-30 mg per day. The expression of K10, K14 and K17 was detected by immunohistochemical technique before and after treatment with acitretin. The relationship between the disease severity and levels of keratins was evaluated. Results Prior to the treatment, increased expression of K14 and K17 was observed in lesions of patients along with the decreased expression of K10 compared with the normal controls. After treatment, the expression of K14 and KI7 significantly decreased (both P < 0.01), while that of K10 increased (P < 0.01), and there was still a statistical difference between the patients and normal controls (P < 0.01). A significant decrease was observed in the PASI score of patients (P < 0.01). The changes in the expression levels of K10, K14 and KI7 before and after treatment were somewhat correlated with the clinical course and severity of psoriasis. Conclusions Systemic aeitretin can affect the expression of K10, K14 and K17 in psoriatic lesions, but the extent of changes in their expression is not always consistent with the improvement of clinical manifestations.

ObjectiveTo investigate the clinical characteristics,diagnosis,treatment and prognosis of limited stage primary esophageal small cell carcinoma (PESC).MethodsClinical data was retrospectively analyzed for 42 patients with pathologically confirmed PESCs who underwent transthoracic esophagectomy with lymphadenectomy from Nov.1990 to Dec.2010 at the Cancer Hospital of Shantou University Medical College.The survival analysis was performed using Kaplan-Meier method.ResultsThe clinical symptoms,imaging and endoscopic features of PESC were similar to those of esophageal squamous cell carcinoma (ESCC).Of the 26 cases that received pre-operative endoscopic biopsy,only five cases were diagnosed as PESC,while the other 21 cases were misdiagnosed as ESCC.The mean follow-up time of this series was 25.3 months (0-123 months).34 patients died of the disease during the follow-up;7 were still alive and 1 was lost.The median survival time (MST) of the 41 patients was 13.0 months (95 ％ confidence interval 6.3-19.7),and the 6-,12-,24-,36-,and 60-month overall survival rates (OS) were 78.6 ％,57.5 ％,30.8 ％,23.7 ％,10.5 ％,respectively.ConclusionPESC is a rare disease with poor prognosis,and is prone to be misdiagnosed by endoscopic biopsy.Currently no standard treatment has been established.

Objective To explore the expression of nestin and Ki-67 in malignant peripheral nerve sheath tumors (MPNST) and its significance in the differential diagnosis. Methods Immunohistochemical technique (SP) was used to detect the expression of nestin and Ki-67 in 42 cases of MPNST and 24 cases of benign peripheral nerve tumor.Results Total expression of nestin was found in 95.2 ％(40/42) of MPNST.Strong expression of nestin was detected more frequent in MPNST compared to benign peripheral nerve tumors [40.5 ％(17/42) versus 4.2 ％(1/24),x2 =8.403,P =0.004].Ki-67 labeling index in MPNST varied from 1％-70 ％.However,greater than 3 ％ labeling index of Ki-67 staining was observed in 64.3 ％(27 / 42) of MPNST while none of the 24 benign tumors had nuclear staining exceeding 3 ％. The higher Ki-67 labeling index showed significant differences between the two groups (x2 =23.518,P =0.000).Conclusion Nestin and Ki-67 are useful markers in distinguishing MPNST from benign tumors.

To analyse the relationship between tumor necrosis factor (TNF)-α and interleukin-6 with hyperuricemia in ethnic Uygur,Kazak,and Han in Xinjiang province.1 200 cases of Uygur,Han,and Kazak populations were randomly enrolled.Serum uric acid,triglyceride,total cholesterol,high density lipoprotein-cholesterol,low density lipoprotein-cholesterol,fasting plasma glucose,body weigh and height,waist circumference,and hip circumference were measured.Waist-to-hip ratio and body mass index were calculated,and TNF-α,interleukin-6 were determined.The differences between uric acid and inflammatory factors were statistically significant; The differences in TNF-α was statistically significant between high uric acid group and control group in Uygur and Han,and the differences in interleukin-6 was statistically significant between high uric acid group and control group in Uygur,Kazak,and Han(P＜0.01).TNF-α and interleukin-6 were positively correlated with serum uric acid in Uygur,but in Kazak only interleukin-6 was negatively correlated with serum uric acid,in Han only interleukin-6 was positively correlated with serum uric acid(P ＜ 0.01).Hyperuricemia was associated with inflammatory factors,TNF-α,interleukin-6,but there were ethnic differences among Uygur,Kazak,and Han,thus it may provide people of new ideas for prevention and treatment of hyperuricemia and other related metabolic disorders.