【Objective】 To evaluate the efficacy and safety of different doses and frequencies of oral Sildenafil in the treatment of erectile dysfunction (ED). 【Methods】 The randomized,open clinical trial included 120 ED patients who met the inclusion and exclusion criteria. The patients were randomly divided into the following groups:on-schedule (25 mg/day),on-demand (50 mg,taken irregularly half an hour before each sexual life),new regular group (25 mg/day,50 mg more before each sexual life),regular group (100 mg/time,twice/week). All treatments lasted for 8 weeks. The follow-up indexes included the five-item International Index of Erectile Function (IIEF-5),Erection Hardness Scale (EHS) and Sexual Encounter Profile (SEP2/3). The adverse reactions were recorded. 【Results】 The IIEF-5 scores of the four groups were significantly higher than those after baseline treatment (P<0.001),but there was no significant difference among the four groups (P>0.05). In terms of effective rate,at the 16th week,there were significant differences between the on-demand group (10.7%) and new regular group (62.1%),and between the on-demand group (10.7%) and regular group (50.0%) (P<0.001). In terms of EHS, the percentage of grade 4 patients in regular group was significant higher than that in the on-demand group at the 8th week and 16th week (all P<0.05). In terms of positive rate of SEP-3,there was a significant difference between the on-demand group and regular group (P=0.042) at the 16th week. In the course of treatment,there were transient adverse reactions such as headache,blurred vision,stuffy nose and back pain,which did not affect the treatment. 【Conclusion】 All of the four treatment methods of oral sildenafil showed good efficacy. Both regular group and new regular group maintained good clinical efficacy during the follow-up,which is better than that of the on-demand group. The new regular scheme can be used as a new,safe and effective treatment option.

Objective To study the protein expression and gene amplification of human epidermal growth factor receptor-2(Her-2)in adenocarcinoma of the gastroesophageal junction and its association with the clinicopathological features .Methods Immunohistochemical method and fluorescence in situ hybridization ( FISH) were used to detect Her -2 expression and gene amplification in 80 surgically resected gastroesophageal junction cancer tissue .We further analyzed the relationship between the gastroesophageal junction cancer histolog -ical differentiation ,as well as depth of invasion ,clinical stage and lymph node metastasis .Results Her-2 am-plification of gastroesophageal junction carcinoma by FISH was 22.5%,while the overexpression by IHC was 15%.Her-2 gene amplification and protein overexpression were correlated with the differentiation ,clinical TNM stage,invasive depth and lymph node metastasis of the carcinoma (all P<0.05).Her-2 expression was not asso-ciated with the patients age,gender,invasive depth and lymph node metastasis(P<0.05).Conclusion Her -2 protein expression and gene amplification may be a prognostic indicator for the patients with gastroesophageal junction cancer .The joint detection of Her -2 protein expression level and the gene amplification can guide the prognosis and therapy for adenocarcinoma of the gastroesophageal junction .

ObjectiveTo investigate the ultrasonic clinical value of scalpel in abdominal surgery for D2 radical gastrectomy for gastric cancer.MethodsA retrospective analysis was made in Zhengzhou University Affiliated Luoyang Central Hospital from September 2008 to September 2010 gastric group.The patients were divided into ultrasound knife group and normal operative in 136,including 75 cases using ultrasonic scalpel,61 using cases electric knife.The lymph node dissection time,intraoperative blood loss,the drainage 72 h after were compared between the two groups.Results The average operation time ultrasound knife group was ( 114 ± 35 ) min,the surgery blood loss was ( 110.4 ± 32) mL.The drainage 72 h after operation was (180 ± 24) mL,which were significantly reduced compared with the normal operative group.The difference in detection rate between the two groups was not statric cancer can improve efficiency,reduce trauma,accelerate postoperative recovery,showing good application prospect in radical resection of gastri cancer.ConclusionsUltrasound knife used in D2 radical gastrectomy for gastric cancer can improve efficiency,reduce trauma,accelerate postoperative recovery,showing good application prospect in radical resection of gastric cancer.

ObjectiveTo investigate the clinical value of CEA, CA19-9, CA242 and CA72-4 four serum tumor markers in colorectal cancer diagnosis, surgery and postoperative evaluation of their. Methods Immunohistochemical assay was used in 80 patients with colorectal cancer and 50 cases of colorectal benign diseases to detect the CEA, CA19-9, CA242 and CA72-4 and other four serum tumor markers, with 2-year follow- up. ResultsFour kinds of serum tumor markers CEA, CA19-9, CA242 and CA72-4 levels in colorectal cancer group were significantly higher than the control group ( P ＜ 0.05 ) ; levels of the four serum tumor markers in patients in Dukes stages C, D were significantly higher than those in Dukes stages A, B;four serum tumor markers were significantly increased in patients with recurrence of metastasis. Conclusion Combined detection of serum CEA, CA19-9, CA242 and CA72-4 has clinical value in diagnosis, surgical treatment evaluation and monitoring of metastasis and recurrence after surgery of colorectal cancer can improve detection sensitivity and specificity.

Objective To explore the efficacy of transurethral resection of bladder neck(female)and urinary sphincter(male)to treat neurogenic urinary dysfunction. Methods Forty-one patients(28 women and 13 men)with neurogenic urinary dysfunction(dysuria)were retrospectively analyzed.All patients had sacral neurological damage.The mean patient age was 27(12-43)years.All patients had urinary retention and ureter dilation.Twenty-nine patients had renal function damage.Residual urine volume was 151-700 ml(mean 420 m1).MFR was 4-14 ml/s.After local anesthesia,bladder neck(female)was incised at 5,6,7 o'clock to the circle fiber.Urinary sphincter(male) was cut off at 11,1 o'clock and was dilated using sound(F24-F27).The catheterization time was 1-2 weeks. Results All 41 patients were followed up,from 2 months to 252 months,average 85 months.Thirty-six patients(88%)were completely recovered with no residual urine,no dilation of ureter and pelvis,no renal function damage.of these 36 cases,surgery was carried out once for 1 patient,twice for 20 and 3 times for 15.Five patients(12%)were not improved. Conclusion Transurethral resection of bladder neck(female)and urinary sphincter(reale)to treat neurogenic urinary dysfunction could be an effective method.

Objective To study the macrophage immune response after the percutaneous microwave coagulation therapy (PMCT) under the ultrasound guide. Methods Eighty-nine cases of primary hepatic carcinoma patients were treated by PMCT. At the time of the fourth week after PMCT and before PMCT, the patients were given percutaneous biopsy under ultrasound guide. And the samples were stained by immunohistochemical methods. Then the infiltration of macrophage on local treatment areas were compared before and after the treatment. Moreover the function of immunocytes were observed by electronic microscope. Results The infiltration of macrophage increased significantly in post-PMCT as compared with that in pre-PMCT. And there were more protuberance from the macrophage and much more lysosome and endoplasmic reticulum and mitochondrium observed by electronic microscope. Conclusion The local macrophage cellular immunity can be more improved after the primary hepatic carcinoma treated by PMCT.

Objective To assess the value of contrast-enhanced ultrasound(US)in differential diagnosis of hyperechoic hepatic lesions when compared to conventional US.Methods Eighty-four hyperechoic liver lesions in 66 patients were examined using both conventional and contrast-enhanced US techniques.Results Receiver operating characteristic analysis revealed a significant improvement in the discrimination of malignant versus benign hyperechoic hepatic lesions (area under the receiver operating characteristic curve,0.867±0.045 at conventional US,0.997±0.003 with contrast-enhanced US(P＜0.0001).For correct diagnoses types of hyperechoic liver lesions,contrast-enhanced US improved from 64.3% to 92.9%,comic)ared with conventional US (P＜0.001).Conclusions Contrast-enhanced US showed a significant improvement in characterization and differentiation of hyperechoic hepatic lesions when compared to conventional US.

BACKGROUND:With the rapid development and wide application of proteomics techniques,effective tools are available for exploring specific biomarkers for early detection and diagnosis of liver diseases.Recent years,many novel and promising biomarkers have been discovered and evaluated.OBJECTIVE:To review the advances and applications of proteomics in liver development,regeneration and diseases.RETRIEVAL STRATEGY:A computer-based online search of Medline database was undertaken for the English literatures about liver diseases and proteomics published from January 1995 to July 2007 with the keywords "proteomics,liver".Meanwhile,Chinese articles published from January 1995 to July 2007 were searched in CNKI database,with the same keywords in Chinese.The retrieved articles were screened firstly,and those about proteomics and liver diseases were selected and searched for full texts.Repetitive studies and Meta analysis were excluded.156 articles about the proteomics and liver diseases were collected,and finally 32 articles were included.LITERATURE EVALUATION:Of the 32 articles,3 were about the research background of proteomics,6 about proteomics under healthy status,and 23 about proteomics research in liver diseases.DATA SYNTHESIS:Proteomics is a novel science to study protecome using various techniques.The study of the proteome,called proteomics,now evokes all the proteins coded by gene in any given organism,tissue,cell,and even organelle.The researches of proteomics help us to find and understand the life as a whole.Nowadays,there lacks of effective strategy in diagnosis,stages,and treatment in liver diseases.Proteomics is promising in alertness,diagnosis,treatment and prognosis in liver diseases.CONCLUSION:With the deepened study of proteomics in liver diseases,there will be a revolution in the diagnosis and treatment of liver diseases.

OBJECTIVE To investigate the isolation and antimicrobial resistance of nonfermentative Gram-negative bacilli(NFGNB) in order to provide laboratory evidence for clinically selecting antibiotics.METHODS All isolates were identified by routine procedure and DADE BEHRING MicroScan auto-system,and K-B paper disk diffusion in accordance with NCCLS standards was employed for drug sensitivity tests.RESULTS There were 273 strains of NFGNB isolated from Feb 2005 to Aug 2006,mainly from sputum,middle urine and secretion. The main NFGNB were Pseudomonas aeruginosa,Acinetobacter baumannii and Stenotrophomonas maltophilia.The resistance rates of P.aeruginosa and A.baumannii to imipenem/cilastatin,cefoperazone/sulbactam and cefepime were less than 13.6%,11.9% and 25.4%;to amikacin and piperacillin/tazobactam were 31.1% to 37.8%.The resistance rate of S.maltophilia was the highest among the NFGNB.Its resistance rates to imipenem/cilastatin showed 100%,to cefoperazone/sulbactam,levofloxacin and compound sulfamethoxazole were less than 14.3%.CONCLUSIONS The NFGNB are the important pathogens causing clinical infection,especially P.aeruginosa,A.baumannii and S.maltophilia.There are significant differences in antimicrobial resistance among different NFGNB.

Objective To investigate the stabilization and clinical feasibility of 915MHz implanted microwave ablation equipment through experiential study on the ablation of vitro porcine livers.Methods Equipment of KY-2000 microwave ablation was used,which is produced by Kangyou microwave energy institution in Nanjing.Microwave frequency was 915MHz(?1%).Rigid implanted microwave antennae with internal sodium chloride cooling were directly implanted into vitro porcine livers,and ablations were performed in differential irradiation powers.Continuous and pulsed wave irradiation patterns can be selected,and lasted 600s and 1200s respectively.Results This equipment is safe and stable.The shapes of ablation lesions are all elliptical.Conclusion The ablation lesions can be effectively enlarged by implanted 915MHz microwave.After further experiences in vivo animal,it will be applied in ablation treatment of large liver tumors.