Objective:To investigate changes of the stage,age of onset,and prostate specific antigen(PSA) level of prostate cancer with socioeconomic development and medicare promotion.Methods:The medical records of 784 inpatients with prostate cancer were analyzed retrospectively,who were diagnosed in Peking University First Hospital from 1997 to 2007.According to the time of diagnosis,all the patients were sorted into three groups:earlier group(1997-2001),intermediate group(2002-2004),and contemporary group(2005-2007).The tumor stages,ages,Gleason scores,and PSA levels of each group and of the three groups were compared to determine whether the discrepancies were significant.Results:The discrepancies of ages,Gleason scores,and stages between earlier and intermediate groups were not significant.The differences of ages and stages between intermediate and contemporary groups were not significant,but the change of Gleason scores was significant.The discrepancies of Gleason scores and stages between earlier and contemporary groups were meaningful,but the change of ages was not significant.Conclusion:As time passes,PSA levels and tumor stages of prostate cancer patients show a descending trend,but the discrepancy of ages between the three groups is meaningless.The weight of low risk and intermediate risk groups in localized prostate cancer is becoming heavy.

Objective The diagnosis and treatment of renal angiomyolipoma were studied. Methods A total of 72 cases of renal angiomyolipoma encountered and treated from Jan. 1983 to Dec. 1999 were reviewed. Results Of the 72 cases, 13 were misdiagnosed preoperatively.The positive diagnosis rate of ultrasonography was 73.6%(53/72) and that of CT 81.9%(59/72).10 cases( 13.9 %) had been misdiagnosed preoperatively with the combined use of ultrasonography and CT.Tumors smaller than 4 cm had a significantly higher misdiagnosis rate( P

Objective To evaluate the correlation between CYP3A4 enzyme and analgesia with fentanyl after gynecological operation. Methods One hundred and fifty-nine ASA Ⅰ or Ⅱ patients, aged 30-50 yr, scheduled for elective myomectomy or abdominal total hysterectomy, were enrolled in this study. Anesthesia was induced with midazolam, remifentanil, propofol and succinylcholine and maintained with iv infusion of propofol and remifentanil and intermitent iv injection of atracurium. Venous blood samples were obtained for determination of the plasma 1'-hydroxymidazolam and midazolam concentrations at 1 h after iv injection of midazolam. The ratio of the 1'-hydroxymidazolam concentration to the midazolam concentration was used to reflect the effect of CYP3A4 enzyme. Pain was assessed with visual analog scale (VAS) after consciousness was regained. When VAS score ＞ 4,the patients were given fentanyl 10 μg every 5 min until VAS score ≤ 4 and then PCIA with fentanyl was performed. VAS score was maintained ≤4. The times of successful delivery within 24 h after operation and during the period of 24-28 h after operation and fentanyl consumption within 48 h after operation were recorded. Pearson correlation was used to analyze the data. Results There was no correlation between the effect of CYP3 A4 enzyme and the times of successful delivery or fentanyl consumption, and the correlation coefficients were 0.16, 0.13 and 0.11 respectively ( P ＞ 0.05). Conclusion CYP3A4 enzyme is not the major enzyme metabolizing fentanyl.

Objective To evaluate the effect of dexmedetomidine on cognitive dysfunction after thoracic surgery in patients undergoing one-lung ventilation.Methods Sixty-two patients,aged 45-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index ranged from 17.5 to 25.5 kg/m2,scheduled for elective thoracic surgery,were randomly allocated into 2 groups (n =31 each) using a random number table:dexmedetomidine group (Dex group) and control group (C group).Dexmedetomidine 0.5 μg/kg was infused for 10 min starting from the time point before induction of anesthesia,followed by continuous infusion at a rate of 0.5 μg · kg-1 · h-1 until 30 min before the end of surgery in Dex group.The equal volume of normal saline was administered instead in group C.Before induction and at 24,48 and 72 h after surgery,venous blood samples were collected for determination of levels of S-100 beta protein and neuronspecific enolase in serum by ELISA.Cognitive function was assessed by Mini-Mental State Examination at 72 h after surgery.Results The levels of S-100 beta protein and neuron-specific enolase in serum were significantly increased after surgery than before induction in the two groups.Compared to C group,the levels of S-100 beta protein and neuron-specific enolase in serum were significantly decreased after surgery,and the incidence of postoperative cognitive dysfunction was decreased in Dex group (26％ vs 6％).Conclusion Dexmedetomidine can effectively reduce the nerve damage during one-lung ventilation and significantly inhibit the development of postoperative cognitive dysfunction in patients undergoing thoracic surgery,indicating that dexmedetomidine is suitable for thoracic surgery.

Resveratrol, isorhapontigenin and pinosylvin, isolated from Gnetum parvifolium, and their analogues have been synthesized and tested for their inhibitory activity of HIV-1. Natural product 12a and analogues (12d, 12e, 12g) display significant inhibitory activity of HIV-1 replication. Among them, compound 12d (trans-3, 4, 5, 4'-tetrahydroxystilbene) exhibits the most potent anti-HIV-1 activity with an IC50 value of 1.84 micromol x L(-1).

Objective:To describe our diagnostic and therapeutic experience of patients with urinary tract endometriosis.Methods:We performed a retrospective analysis of 22 cases of urinary tract endometriosis with histopathological results from 2001 to 2007.Results:The mean patient age was 36.0 years.Of the 22 patients,4 had bladder involvement and 18 ureteral involvement.In those with bladder endometriosis,the diagnosis was made by cystoscopy and biopsy in 4 patients.The treatments consisted of partial cystectomy in 3 patients and transurethral resection of the bladder in 1 patient.One of the patients who underwent transurethral resection of the bladder experienced 1 relapse.The relapse was treated with partial cystectomy.In the patients with ureteral endometriosis,the diagnosis was mainly established by ultrasound(18 cases),intravenous urography(11 cases),retrograde pyelography(7 cases),CT(14 cases) and MRI(5 cases).The treatments consisted of ureterolysis in 1 patient,ureteroneocystostomy in 4,and ureteral resection and end-to-end anastomosis in 13 of them.All the patients pathologic results were of endome-triosis.Conclusion:Urinary tract endometriosis is an uncommon disease.Partial cystectomy should be considered as the therapeutic option for bladder endometriosis.For cases of ureteral endome-triosis,the first technique depends on the location,extent and depth of the lesion.

Objective To compare the clinical pharmacodynamics of domestic and imported propofol by target-controlled infusion. Methods This was a prospective,randomized,double-blind,cross-over study. Eighteen ASA Ⅰ or Ⅱ patients aged 45-55 yr undergoing substitute valve operation for severe deep venous were randomly divided into sequential Ⅰ and Ⅱ , in sequence Ⅰ , the imported propofol was applied in the first stage of surgery and then domestic propofol in the second stage surgery, while in sequence Ⅱ the order was reversed. The target plasma concentration of propofol was initially set at 0.5 μg/ml, followed by increments of 0.5 μg/ml when the effect-site concentration and plasma concentrations was balanced, until the predicted effect-site concentrations reached 3.5 μg/ml. BIS value, RR, SpO2 and hemodynamics were recorded at 0,0.5, 1.0,1.5,2.0,2.5,3.0 and 3.5 μg/ml effect-site concentration level, the predicted effect-site concentrations and the BIS value at loss of consciousness in 5%, 50% and 95% of the patients were calculated. Adverse reactions were recorded during the trial period.Results Under the same effect-site concentration,there was no significant difference in BIS value,RR, SpO2 and hemodynamic monitoring indicators between the two drugs( P ＞ 0.05). There was no significant difference in predicted effect-site concentrations of propofol, the BIS value at loss of consciousness in 5%, 50% and 95% of the patients and the incidence of adverse reaction between the two drugs ( P ＞ 0.05). Conclusion The domestic propofol and imported propofol have clinical bioequivalence.

AIM: To investigate the expression of midkine in bladder transitional cell carcinoma and to analyze its relationship with the features of clinical pathology and prognosis.METHODS: The expressions of midkine protein in 50 cases of bladder transitional cell carcinoma samples were detected by SP immunohistochemical method using polyclonal antibodies against human midkine.Survival time of 40 cases was recorded.RESULTS: The protein expression of midkine was found in cytoplasm of tumor cells.The overall positive rate of midkine in 50 cases of bladder carcinoma was 90%(45/50).The positive degree of midkine showed a trend of increasing in grade and stage.There was statistically significant difference among them(P0.05).Patients with high expression of MK predicted a poor clinical outcome.CONCLUSION: Midkine is overexpressed in bladder transitional cell carcinoma than that in normal bladder.MK expression in bladder cancer is higher in less differentiated and deeper invaded cases,but it has no correlation with age,sex,treatment,tumor number and size.Patients with higher MK expression have shorter survival time than those with lower MK expression.

Objective To establish in vitro metabolism of fentanyl by human liver microsomes in Chinese population.Methods Thirty patients undergoing elective operation on liver were enrolled in the study.Normal liver specimens were obtained during removal of liver and gall for preparation of liver microsomes (by calcium precipitation) which were used for establishment of the liver microsomal incubation system for fentanyl.Fentanyl served as the metabolic substrate in the incubation reaction.The concentration of fentanyl in the incubation medium was detected at 0,5,10,15,20 and 30 min of incubation using HPLC-UV.Sufentanil served as the interior label element.The n-hexane-ethanol absolute was used to extract the sample.The chromatographic column used in this method was Grace C18 (4.6 mm × 250.0 mm,5 μm).The mobile phase was methyl cyanide-KH2PO4 buffer solution with the flow rate of 1.0 ml/min,detection wavelength of 205 nm and sample size of 20 μl.Linear regression analysis was performed by using the least-squares method.The specimens of the blank incubation system with the final concentration of fentanyl 0.6,2.4 and 10.0 μg/ml were obtained to determine the recovery,precision and stability.The metabolic rate of fentanyl in human hepatic microsomes was calculated.Results Fentanyl and the interior label element sufentanil were separated completely,and the retention time were 5.730 and 9.336 min,respectively.Endogenous matrix of microsomes did not interfere with the analysis.Regression equation was C =0.945 8A-0.140 4,R2 =0.999 2.C was the concentration of fentanyl,and A was the peak area ratio of fentanyl versus sufentanil.The recovery of incubation system with low,medium and high concentrations of fentanyl was 85％-115％,and relative standard deviation (RSD) was less than 10％.The RSD of intra-and inter-day precision and stability was less than 10％.The method was proved to meet the requirements of biological sample analysis.The metabolic rate of fentanyl was (1.6 + 0.8) nmol/min per milligram protein in human hepatic microsomes of 30 cases.Conclusion The in vitro metabolism of fentanyl by human liver microsomes is convenient,and the detectability is high,so it can be used for the research on the in vitro metabolism of fentanyl in Chinese population.

Objective To investigate the effect of paclitaxel and gemcitabine on the expression of nucleosomal binding protein 1(NSBP1) in bladder cancer cell line T24 and its significance. Methods Reverse transcription PCR(RT-PCR) and western blotting were used to detect the expression of NSBP1 in bladder cancer cell T24 treated by different concentration(10% ,40% ,80% IC50) of paclitaxel and gemcitabine for 48 hours. Results RT-PCR showed that relative optical density (OD) of NSBP1 in bladder cancer cell T24 treated by 0%, 10%,40% and 80% IC50 paclitaxel were 0.392 ±0.024, 0.227±0.037, 0.135±0. 063 and 0.091 ±0.017, respectively (P＜0.05). Relative OD of NSBP1 in bladder cancer cell T24 treated by 0%, 10%, 40% and 80% IC50 gemcitabine were 0.492±0.044, 0.262±0.031, 0.151±0.014 and 0.089±0.011, respectively. Western blotting showed that relative OD of NSBP1 in bladder cancer cell T24 treated by 0%, 10%,40% and 80% IC50 paclitaxel were 0.473±0.017, 0.252±0.041, 0.194±0.023 and 0.118±0.016, respectively. Relative OD of NSBP1 in bladder cancer cell T24 treated by 0, 10%, 40% and 80% IC50 gemcitabine were 0.581±0.014, 0.201±0.033, 0.135±0.021 and 0.114±0.011, respectively(P＜0.05). Conclusion Paclitaxel and gemcitabine can decrease the expression level of NSBP1 in bladder cancer cell line T24 both in mRNA and protein levels, so NSBP1 may be one of the targets of chemotherapy.