Abstract:Laparoscopic partial nephrectomy is gaining more and more popularity in treating patients with early renal carcinoma in recent years. Compared with radical nephrectomy, laparoscopic partial nephrectomy is a miniinvasive, safe method with satisfactory postoperative survival rate. However, there were still limited laboratory and clinical data about laparoscopic partial nephrectomy, and the experimental data of traditional laparoscopic surgery and open surgery were still used. Based on the existing data and the authors’ experience, this article proposes three hypotheses for the problems puzzling urologic surgeons; the authors hope to verify the hypotheses through basic or clinical research.

Abstract:Objective：To explore the procedures and clinical outcomes of retroperitoneal partial nephrectomy for early malignant renal tumors. Methods: A total of 21 patients (19 men and 2 women, with a mean age of 49 years) with early malignant renal tumors were subjected to retroperitoneal partial nephrectomy using ultrasound knife and electron microscopy. The 21 patients included 17 with clear cell renal carcinoma, 3 with granule cell renal carcinoma, and 1 with oxyphil cell renal carcinoma. The mean diameter of the tumors was (2.8±0.8) cm. Results: All the 21 cases underwent successful retroperitoneal partial nephrectomy without conversion to open operation. Mean surgical time was (105±15) min and mean blood loss was (120±22) ml. Four patients had a mean blood transfusion of 400 ml. One patient had urine leakage, with drainage volume of 200300 ml; the drainage was stopped 15 days after operation when the drainage was less than 20 ml. The mean postoperative hospital stay was (9±2) days (717 days). No patients had local recurrence during a mean follow up of (20±4) months. Conclusion: Laparoscopic partial nephrectomy is feasible and safe.

Abstract:Objective：To summarize our experience on retroperitoneal laparoscopic radical nephrectomy (RLRN) in treatment of patients with renal carcinoma．Methods: The clinical data of 180 patients with renal carcinoma, who received RLRN from Jan. 2001 to Jan. 2007, were retrospectively studied. The experience was summarized and the clinical outcomes of patients were assessed. Results: All the 180 patients were pathologically confirmed to have T1T2 phase renal carcinomas, with 87 cases had left side lesions and 93 had right ones．The diameter of tumors was 1.58 cm, with a mean of （4.8±1.3）cm. All the patients were subjected to RLRN and all underwent successful operation. The operation time was 5690 min, with a mean of (70±12) min; the blood loss was about 701 500 ml, with a mean of （122 ±36） ml. One patients had right renal venous injury (not converted to open surgery), 7 patients had pleural injury, 1 had diaphragmatic injury, 2 had subcutaneous emphysema, 1 had incision hernia, and 6 had delayed union of incision. The patients began oral intake of food 2448 h after operation and were discharged 79 days after operation. Fortyone patients were lost during the follow up (4 months to 6 years); 4 patients died due to other reasons and 2 had pulmonary metastasis. There was no puncture site metastasis in this group. Conclusion: RLRN has the advantages of less trauma, rapid recovery, and slight pain. It is a safe and effective method for treatment of renal carcinoma.

Abstract:Objective：To summarize our experience on laparoscopic adrenalectomy.Methods: From August 2001 to Jun 2007, a total of 203 patients (128 male and 75 female, aged 2174 years, with a mean of \[45±2\] years old) received laparoscopic adrenalectomy. Six patients had bilateral tumors. The diameters of the adrenal tumors or nodules were 0.418 cm. Results: The 203 patients received a total of 209 times of laparoscopic adrenalectomy: including 34 cases via transperitoneal approach, 166 via retroperitoneal approach and 3 via handassisted approach. The overall successful rate of laparoscopic adrenalectomy was 97.04% (197/203). Six persontimes (2.96%) were converted to open operation due to bleeding or adhesion. The mean operation time was 135±35 min and the estimated blood loss was 40250 ml (with a mean of 75±25 ml). The patients could get down the bed for activity 13 days after operation. The postoperative hospital stay was 710 days (with a mean of 7±2 days). The complications included vena caval injury (1 case), pleural injury (1 case), lumbar hematoma (4 cases), and fat liquefaction (1 case).Conclusion: Laparoscopic adrenalectomy has advantages for treating adrenal tumors. But different approaches should be chosen according to the size and pathological types of the tumors. Transperitoneal approach should be chosen for patients with larger tumors, for obese patients or for patients with bilateral lesions.

Abstract:Objective: To discuss the procedure and clinical effect of retroperitoneal laparoscopic nephropexy (RLN).Methods: From August 2001 to June 2006, RLN was performed on 28 female patients aged 2645 years old (mean, 34±2.5) with symptomatic nephroptosis, including 15 with the right kidney, 12 with the left, and 1 with both. The preoperative complaint of patients included subjective symptoms (constant and recurring pain in 28 patients) and objective symptoms (upper urinary infections in 16, hematuria in 12, and upper tract obstruction in 12). One patient underwent nephropexy via the transperitoneal approach and the others underwent nephropexy via the retroperitoneal approach. A retroperitoneoscopic procedure was performed after positioning the patients in the flank position. Digital preparation of the retroperitoneal space was made and standardized trocar was placed. The key step of the surgery was complete exposure of the kidney within Gerota’ fascia, which was aimed to separate the potential adhesions between the colon and kidney or between the inferior blood vessels of the kidney. Nephropexy was performed between the fibrous capsule at the lower pole of the kidney and the dissected psoas muscle, using three sutures placed by intracorporeal technique or the percutaneous needle both for introduction and removal of the suture; the sutures were separately tied over the sacrospinalis fascia. Results: The mean operative time was (125±9) min (ranging 115240 min); the mean postoperative hospital stay was (9±1.2) days, largely owing to the required 512 days’ bed rest. During a mean followup of (24±4.2) months(ranging 3 to 70 months), 3 patients had paresthesia, 5 had constant and recurrent ache, 20 were completely free of pain, and 4 had microhematuria. One patient had further episodes of pyelonephritis and upper tract obstruction after operation. Intravenous pyelogram(IVP) revealed that the ptosis incorporated into more than one vertebral body in 2 patients. Postoperative renal function test showed an improvement in renal function. Conclusion: RLN is miniinvasive and has less complication. The procedure should be considered as one of the optimal therapy for nephroptosis.

Abstract:Objective：To summarize our clinical experience on treating bladder transitional cell carcinoma with orthotopic ileal neobladder after radical cystectomy and to report the longterm followup results. Methods: From Jan. 1988 to Dec. 2006, 61 patients (49 male and 12 female) with a mean age of 64.0±5.6 years (range 54 to 78) were subjected to orthotopic ileal neobladder construction after cystectomy. The entire length of ileum was opened along the antimesenteric border, placed into a transverse “U” shape, and sutured with a running suture. The lateral borders of the “U” shape bottom were used to surround the urethra and were sutured with the interrupted suture from “inside” the neobladder for the ileourethral anastomosis. The ureters were implanted from inside the neobladder through a small incision into the ileum at a convenient site, and were embedded in a mucosal sulcus. The perioperation mortality, complications, urinary continence, renal function, image findings, and urodynamic examination were all retrospectively evaluated. Results: One patient (1.6%) died during perioperation period and all the others were followed up for 12168 months. Totally 13 patients (21.3%) died during followup. The complications included renal inadequacy (11 patients), ureteroileal obstruction (9 patients), ureteral reflux (6 patients), urine leakage (5 patients), bleeding (4 patients), incisional hernia (4 patients), urethral stricture (3 patients), and urethral recurrence (1 patient). After 60 months followup, 42 patients had a satisfactory urinary continence. Conclusion: After longterm followup, we conclude that the ileal neobladder is a satisfactory method for treatment of invasive bladder cancer after radical cystectomy; it has less complication and is clinically valuable.

Abstract:Objective：To investigate the methylation status of the promoters of RASSF1A and BLU genes in the renal carcinoma tissues and to assess their roles in the tumorigenesis of renal carcinoma. Methods: Methylation specific PCR (MSP) method was used to examine the methylation status of the promoters of RASSF1A and BLU genes in the renal carcinoma tissues of 26 patients with renal carcinoma and their corresponding adjacent normal tissues; and the results were analyzed. Results: We found that 17 （65.4%） of the renal carcinoma tissues had abnormal methylation of RASSF1A gene, and there was no abnormal methylation of RASSF1A in the adjacent normal tissues. Eleven(42.3％) of 26 renal cancer tissues had hypermethylation of BLU gene, and there was no hypermethylation of BLU gene in the corresponding adjacent tissues. Conclusion: Hypermethylation of RASSF1A and BLU genes is present in the renal carcinoma tissues, suggesting the hypermethylation of RASSF1A and BLU might be associated with the tumorigenesis of renal carcinoma.

Abstract:Objective：To investigate the neuroendocrine properties of adrenalcortical tumors. Methods: We retrospectively reviewed the clinical data of 99 adrenalcortical tumor patients, who were treated in Changzheng Hospital form June 1999 to June 2005. Expression of neuron specific enolase (NSE), chromogranin A (CgA) and synaptophysin (Syn) proteins were examined by immunohistochemistry (SP method) using monoclonal antibodies. The general data of patients, including the age, symptoms, laboratory findings, and pathological types, were collected and subjected to statistical analysis with SAS v6.12 software. Results: The expression of all the above 3 proteins was found in adrenalcortical adenoma tissues, with the positive rate of NSE being 80%, the positive rate of CgA being 48.9%, and the positive rate of Syn being 75.6%; the positive rates in the adrenalcortical carcinoma tissues were 77.8%, 22.2%, and 77.8%, respectively; and those in the normal adrenal tissues was 20%, 0%, and 10%, respectively. The positive rates of 3 proteins in adrenalcortical tumors was significantly higher than those in the normal adrenal tissues (P<0.05); there was no significant difference between those of different adrenalcortical tumors. Conclusion: Both adrenalcortical adenomas and adrenalcortical carcinomas possess neuroendocrine properties, indicating that their development is associated with abnormal differential of nuroendocrine cells in adrenal cortex.

Abstract:Objective：To study the expression of MMP2, MMP9, vascular endothelial growth factor (VEGF) and RECK genes in bladder cancer tissues, so as to provide evidence for studying the molecular mechanism of bladder cancer metastasis. Methods: Reverse transcription polymerase chain reaction (RTPCR) was used to determine the expression of MMP2, MMP9, VEGF and RECK genes in 50 operative specimens of bladder cancer and their corresponding adjacent normal tissues; and the clinical significance of the expression was analyzed. Results: The positive rates of MMP2, MMP9, VEGF and RECK mRNA in the bladder cancer specimens were 80％, 56%, 78% and 64%, respectively. The expression levels of MMP2, MMP9 and VEGF mRNA in bladder cancer specimens were significantly higher than those in the paired adjacent normal bladder tissues（P<0.05）; the expression level of RECK genes in bladder cancer specimens was significantly lower than that in the normal tissue（P<0.05）. The expression levels of MMP2, MMP9 and VEGF was closely correlated with the clinical stages and grades of bladder cancer; there was no relation between the level of RECK expression and clinical stages and grades of the cancer. Conclusion: Abnormal expression of multigenes is present in bladder cancer tissues; the development, progression and metastasis of bladder cancer are associated with abnormal expression of multigenes.

Abstract:Objective：To analyze the activation mechanism of hepatic apoptosisrelated enzyme caspase3 during the early phase of liver regeneration in rats from the perspective of mitochondriamediated endogenous signal pathway.Methods: Thirtyfive male SD rats were randomly divided into 3 groups:model group \[70% partial hepatectomy (PH),n=15\],shamoperated group (n=15),and control group (n=5).The former 2 groups were further divided into 3 subgroups according to time after operation (3 h,6 h,and 24 h after operation,5 animals in each group).The animals in all groups were sacrificed and the liver homogenates were prepared.Using the fluorescence method,we determined the activities of hepatic caspase3 and caspase9 at 3 different time points after operation.The activity of glutathione peroxidase (GSHPx) and the content of NO were examined by enzyme immunoassay and nitrate reductase assay,respectively.Results: The activities of hepatic caspase3 and 9 both increased significantly compared with those of shamoperated group (P<0.01) at 3 h and 6 h after operation; the level of GSHPx was significantly decreased and the content of NO was significantly increased compared with those of the shamoperated group (P<0.01).Conclusion: Hepatic tissue is under oxidative stress during the early phase of liver regeneration,and the mitochondriamediated endogenous signal pathway is involved in the activation of caspase3.

Abstract:Objective：To assess the value of MRI and single photon emission computed tomography (SPECT) in detecting myocardial ischemia and necrosis. Methods: Coronary angiography (CAG), MRI and SPECT were performed in 28 patients with coronary artery disease one week before revascularization operation. The stenosis criterion was a more than 70% stenosis by CAG; the sensitivity，specificity and accuracy of both MRI and SPECT were calculated according to the criterion. Results: CAG revealed 39 positive arteries and 45 negative arteries. According to the CAG results, the sensitivity, specificity and accuracy of MRI for detecting myocardial ischemia were 92.31%, 80.00% and 85.71%, respectively; and for detecting myocardial necrosis were 66.67%, 91.11%, and 79.76%, respectively. The sensitivity, specificity and accuracy of SPECT for detecting myocardial ischemia were 94.87%, 82.22% and 88.10%, respectively; and for detecting myocardial necrosis were 61.54%, 86.67%, and 75.00%, respectively.Conclusion: MRI and SPECT have high accuracy in detecting myocardial ischemia and necrosis and the results of the 2 methods accord well with each other.

Abstract:Objective：To evaluate the reliability of the digital marker tracing method combined with center-of-mass algorithm in measuring human pelvic displacement. Methods: Six cadaveric specimens of the third lumbar vertebra to the proximal 1/3 part of femur were used in present study. The specimens had no structural abnormality and all the soft tissues were dissected,reserving the hip joint capsules and the ligaments of the pelvic ring and floor. Markers with black dots against white background were used to mark the key points of the pelvis. Axial loadings from the proximal lumbar (simulating the two-legged stance) were applied by MTS in the gradient of 0 N to 500 N. Images of the front and lateral views were obtained using two CCD cameras. Using Image J software,we calculated the vertical displacement of S1 (the first sacral vertebrae) in the front view and the micro-angular rotation of sacroiliac joint in the lateral view by measuring the marker’s movement. Results: There was good correlation between the marked points before and after deformation of the pelvis,with the average correlation coefficient being 0.983. Based on the 768×576 pixels,pixel size (mm) 0.681 5×0.681 5 image,the accuracy of the displacement was about 0.018 pixels and the comparative error could reach 1.11‰. The load-displacement curves obtained in this study accorded well with the clinical results. The pelvic load-displacement curve exhibited approximately a linear behavior; the sacroiliac joint load-angular rotation curve in the sagittal plane exhibited a non-linear behavior. Under a vertical load of 500 N,the average vertical displacement of S1 of the pelvis was (0.835 6±0.283 0) mm and the average micro-angular rotation of sacroiliac joint in lateral view was (0.584±0.221)°. Conclusion: Digital marker tracing method combined with the center-of-mass algorithm is a simple,accurate method for measurement of pelvic displacement,which can be widely used in biomechanical research.

Abstract:Objective：To determine the effectiveness and validity of morphometric analysis made from dental panoramic tomograms (DPTs) for predicting mandibular bone mineral density (BMD) while taking the result of dual energy Xray absorptiometry (DXA) as gold standard. Methods: Twenty healthy subjects (8 male, 12 female) with intact dentition, aged from 1126 years old, were included in the present study. The BMD of each patient was measured at the lumbar spine (L1L4) by DXA; the results were obtained based on the density of surface (g/cm2). Dental panoramic radiography was carried out using dental panoramic tomography (RTG230/ENR, made in Italy). Mandibular cortical thickness (MCT) and panoramic mandibular index (PMI) values were calculated and their relationship with DXA measurements were subjected to correlation analysis. The validity of MCT and PMI measurements were assessed by sensitivity and specificity. Results: We found mandibular BMD was positively correlated with MCT (r=0.268, P<0.05) and PMI (r=0.251 3, P<0.05).The sensitivity,specificity and Youden index of MCT were 50%, 93.75%, and 0.437 5, respectively; the numbers of PMI were 50%, 87.50%, and 0.375, respectively.Conclusion: MCT and PMI might be potential indicators for mandibular BMD; they are simple and applicable in clinic.

Abstract:Objective：To observe the therapeutic effect of 153Smclodronate on nude mice orthotopically transplanted with human osteosarcoma. Methods: Severe combined immune deficiency (SCID) mice were subcutaneously inoculated with human osteosarcoma cell line HOS8603. The formed tumors were then transplanted into BALB/c nude mice at the tibia for passage; the tumors were harvested for establishing orthotopical mice model of human osteosarcoma. Mice treated with 153SmEDTMP and clodronate group served as controls. The distribution of 153Smclodronate was determined 24 h later. The appearance, tumor weights, Xray examination, histological observation, and survival of mice were compared between the 3 groups. Results: It showed that the distribution of 153Smclodronate in the lesion bone was much higher than that in other organs, with the radioactive ratio of lesion bone to blood being 4 627.11, lesion bone to normal bone being 10.81, and normal bone to liver being 8.41. 153Smclodronate treated mice had a slighter osteolytic reaction and a longer survival period, but the tumor mass was not significantly different compared with those of the control group. Conclusion: 153Smclodronate gathers at the lesion bone and it has good therapeutic effect on the mice model of human oseosarcoma, making it a promising agent for treatment of bone tumor.

Abstract:Objective：To compare the performance of mammography, magnetic resonance image and positron emission tomography/single photon emission computed tomography (PET/SPECT) in the diagnosis of breast cancer by Meta analysis. Methods: Based on the assessment standard of evidencebased diagnostic experiment, we searched PubMed, OVID, and Medline database (19862006) for the articles on the diagnosis of breast cancer with MG, MRI, PET and/or SPECT. The data and parameters of the 3 diagnostic methods were subjected to Meta analysis. Using software Excel 2003, SPSS13.0 and RevMan 4.2, we calculated the summary sensitivity and specificity, the pooled odds ratio (OR) and likelihood (LR). Summary receiver operating characteristic curve (SROC) was drawn to evaluate accuracy of the 3 methods. Results: We obtained 30 articles, which included 41 data sets: 14 on MG (2 941 lesions), 10 on MRI (1 428 lesions), and 17 on PET/SPECT (2 247 lesions). The pooled estimates for sensitivity of MG, MRI and PET/SPECT were 82%（95%CI：76%86%）, 86%（95%CI：83%88%）, and 87%（95%CI：83%90%）, respectively; for specificity were 69%（95%CI：62%75%）, 65%（95%CI：62%69%）, and 82%（95%CI：76%86%）, respectively. Their weighted AUC (area under curve) were 0.84, 0.89 and 0.90, respectively；Q* values were 0.77, 0.81 and 0.88, respectively. The sensitivities of the 3 methods were not significantly different. The specificity of PET/SPECT was higher than those of MG and MRI (P<0.05). The overall diagnostic efficacies of PET/SPECT and MRI were better than that of MG.Conclusion: MG remains to be a satisfactory method for initial diagnosis of breast cancer; MRI examination should first be considered for younger patients. PET/SPECT should be used when a diagnosis of breast cancer can not be confirmed.

Abstract:Objective：To prepare superparamagnetic iron oxide (SPIO) nanoparticles and to observe its acute toxicity on mice, so as to pave a way for further study on its longterm toxicity and on its role as a carrier in magnetic resonance gene imaging. Methods: The SPIO nanoparticle was obtained by means of coprecipitation, and its physical and chemical parameters were determined by transmission electron microscope, atomic force microscope, and 1.5 T super conduct MR, etc. According to the administration pathway and doses of SPIO, 90 mice were divided into oral administration (with a total dose of 2 104.8 mg/kg and a volume of 40 ml/kg, n=30), intravenous injection (a total dose of 438.5 mg/kg and a volume of 25 ml/kg, n=30) and intraperitoneal injection (with a total dose 1 578.6 mg/kg and a volume of 30 ml/kg, n=30) groups. Another 10 mice in each group receiving the same dose of normal saline via the same pathway served as the controls (n=10). The general condition, the major serologic parameters, and the pathological changes of major organs were observed 14 d after administration in each group. Results: We have successfully prepared SPIO, and its core component was Fe3O4 crystal, with a size of 2035 nm, a T2 relaxivity of 0.155×106 mol-1·sec-1, a specific saturated magnetization of 68.395 68 emu/g, and a retentivity of 21.463 74 Gs. There was no death of mice during the observation. There was no significant difference in serological parameters between mice of different groups and between each experiment group and their corresponding control group. No edema, degeneration and necrosis were seen in the liver, spleen, kidney, heart, and lungs by HE staining and marrow by Wright staining; only a few blue particles were observed in the liver and spleen in the administration groups by Prussian blue staining, none observed in the control groups. Conclusion: SPIO prepared in the present study meets the requirement of MR imaging, with no acute toxicity to mice, and warrants further study for future MR gene imaging.

Abstract:Objective：To study the inhibitory effects of an adenovirus (Ad)based short hairpin RNA (shRNA) expression system on expression of vascular endothelial growth factor receptor (VEGFR) and on growth of colon carcinoma cells in vitro and in vivo．Methods: RNA interference pAdEasy/VEGFR vector was used to transfect 293 cells via Lipofectamine 2000.The adenoviral vector carrying VEGFR was used to transfect CW2 cells and the transfection efficiency was determined by fluorescent microscope and flow cytometry.The expression of VEGFR was examined by RTPCR and Western blotting.The cell growth was observed with MTT method and the growth curve was plotted.Nude mouse was transplanted with CW2 cells to establish colon cancer tumor model and the growth of tumor was observed daily.Microvessel density (MVD) was detected by immunohistochemistry.Results: The recombinant pAdEasy carrying shRNA against VEGFR was verified by sequencing.Flow cytometry showed that the transfection efficiency of CW2 cells was 99.7%.RTPCR and Western blotting showed that the expression of VEGFR in pAdEasy/VEGFR group was obviously decreased.The growth curve showed that the cell growth in the pAdEasy/VEGFR group was obviously slowed down.We also found that the tumor growth in the nude mouse model was obviously inhibited and the MVD was also decreased.Conclusion: pAdEasy/VEGFRmediated VEGFR shRNA can effectively inhibit the expression of VEGFR in CW2 cells and suppress tumor growth in vivo.

Abstract:Objective：To study the influence of different ages on expression of Bcl2 and Bax protein in the contusive brain tissues after traumatic brain injury (TBI), so as to probe into the molecular mechanism of the age influence on the prognosis of TBI patients. Methods: The expression of Bcl2 and Bax protein in contusive and lacerated brain tissue ( within 3 h to 9 h after trauma) in aged group (≥ 60 years), adult group (1959 years) and nonadult group (≤18 years) was analyzed and compared by immunohistochemistry method and computer micrograph analysis. The temporal lobe samples of 15 patients with temporal epilepsy or vascular deformity were taken as control. Results: The expression of NGF, Bcl2 and Bax protein in the contusive and lacerated brain tissue was higher in the 3 TBI groups than that in the control group. The ratio of Bcl2/Bax expression in aged group was significantly lower than those in the adult and nonadult groups (P<0.05); and the ratio of Bcl2/Bax expression in the adult group was significantly lower than that in the nonadult group (P<0.05). Conclusion: The expression of Bcl2 and Bax protein after TBI is influenced by the age of sufferers; the decrease of Bcl2/Bax ratio might be associated with the neurological deficits after TBI in aged patients and the higher ratio of Bcl2/Bax might be associated with the better prognosis of TBI in nonadult patients.

Abstract:Objective：To strengthen the research on theory and method of early warning for emergent public health event, so as to obtain timely information, correctly analyze the situation, and apply effective measures when the event happens. Methods: The definition of vulnerability of emergent public health event and the vulnerability factors were discussed. The indicator system and the evaluating method for public health vulnerability were systematically studied. The extenics theory and the theory of vulnerability evaluation were used for warning exercise. Results: We constructed an extenics model for early warning of emergent public health event; the model was used to evaluate the public health of a population. Conclusion: The theory of vulnerability evaluation is introduced in emergent public health event to construct an extenics model for early warning of emergent public health event; the model can be used to evaluate the public health of certain population.

Abstract:The morbidity of colorectal cancer has been increasing year by year in China.Screening test of colorectal cancer can effectively decrease the morbidity and mortality of it.However, the current screening technique has obvious defect.Screening of exfoliated colonocytes isolated from human stool for early detection of colorectal cancer is noninvasive and well tolerated by patients; it has a potential for colorectal cancer screening.

Abstract:Objective：To search for a new method for establishing high precision 3D finite element model of maxillary anterior dentition segment. Methods: Spiral CT (SCT) scanning was used to obtain the data of digital imaging and communications in medicine (DICOM) of teeth and the periodontal tissues; the data were used to construct the iges NURBS model by combining converse engineering software Geomagic and computeraided design (CAD). The 3D finite element analysis model was created after the unit lattice was meshed and checked by Hypermesh preprocessors. Results and Conclusion: We have successfully established the high quality 3D model of maxillary anterior dentition segment and the periodontal tissues (including periodontal ligament and alveolar bone); the model contained 640 396 tetrahedrons and 117 889 nodes. The present method is easytouse and is suitable for establishing the model for complex tissues like teeth and periodontal tissues. The established model has a high comparability and provides a good basis for studying the biomechanic behavior of maxillary anterior dentition segment under different orthodontic force systems

Abstract:目的：观察消痰解郁方对慢性强迫游泳应激后小鼠行为学及其海马组织5HT1A受体mRNA表达的影响，探讨其可能的抗抑郁效果及机制。方法：40只昆明种小鼠随机分为消痰解郁组、氟西汀组、生理盐水对照组和正常组（n=10），前3组小鼠连续7 d行强迫游泳应激后分别给予消痰解郁方（3.92 g/ml、0.4 ml/d）、氟西汀（0.13 mg/ml、0.4 ml/d）和生理盐水（0.4 ml/d）,正常组小鼠正常饲养。观察前3组小鼠7 d内强迫游泳不动时间的变化；应激结束取所有小鼠海马组织，RTPCR半定量法比较各组小鼠5HT1A受体mRNA的表达。结果：与正常组相比，慢性强迫游泳应激后小鼠海马区5HT1A受体的mRNA表达明显下降（P＜0.05）；与生理盐水对照组相比，消痰解郁方和氟西汀均能明显缩短小鼠的强迫游泳不动时间，提高小鼠海马区5HT1A受体mRNA的表达，且消痰解郁组优于氟西汀组（P均＜0.05）。结论：消痰解郁方可能通过上调慢性强迫游泳应激后小鼠海马区5HT1A受体mRNA的表达，缩短小鼠强迫游泳不动时间，这可能是其发挥抗抑郁作用的机制之一。

Abstract:目的：探讨辛伐他汀在裸鼠体内引起的K562细胞NFκB信号通路的分子变化，以说明辛伐他汀是否依赖NFκB信号通路参与K562细胞凋亡发生。方法:体外培养慢性粒细胞白血病细胞株K562细胞，接种于18只BALB/cnu/nu裸小鼠皮下，构建移植瘤模型。随机分为3组，每组6只。对照组腹腔注射生理盐水0.2 ml，两个处理组分别注射0.2 g/L的辛伐他汀0.25 ml（0.05 mg）和0.4 ml（0.08 mg）。均隔日注射，连续6次。采用TUNEL法检测K562细胞早期凋亡的变化，RTPCR检测K562细胞中NFκB信号通路IKKβ、IκBα、NFκB1 mRNA的差异表达。结果:不同剂量的辛伐他汀能够诱导裸鼠体内K562细胞发生明显的凋亡，且高剂量组凋亡率高于低剂量组（P<0.01）;不同剂量的辛伐他汀能够引起 IKKβ、IκBα、NFκB1 mRNA的表达下调（P<0.01）。结论:辛伐他汀可诱导K562细胞凋亡，可能与NFκB通路基因的表达下调有关。

Abstract:目的：评价单侧声带麻痹自体脂肪注射的疗效。方法:单侧声带麻痹29例，病程6个月至12年。以自体腹壁脂肪2～5 ml注入患侧声带内。治疗前后以电子喉镜、频闪喉镜、声音评估、嗓音声学参数分析等评价治疗效果。结果:声带自体脂肪注射术后即刻，术侧声带内移、肿胀、体积明显增大。1周后肿胀消退，声带维持较大的体积，声门膜部裂隙明显缩小，但声门后裂隙仍较明显。术后即刻嗓音恢复不明显，2～5 d后迅速好转。术后2个月及6个月时声嘶恢复正常、明显好转、好转、无改善分别为13、11、5、0例及4、11、9、5例。术后2个月及6个月，声学参数频率微扰（jitter）、振幅微扰（shimmer）、标化噪声能量（NNE）平均值均明显小于术前，最长声时（MPT）明显长于术前，差异均有统计学意义（P＜0.05）。注射6个月后全部病例嗓音质量不同程度降低，jitter、shimmer、NNE平均值均明显大于术后2个月，MPT明显短于术后2个月，差异均有显著性意义（P＜0.05）。为维持疗效，术后6个月，9例接受2次注射，4例作3次注射。结论:自体脂肪注射术治疗声带麻痹简单、方便、微创，但往往须多次注射方能维持较好效果。

Abstract:目的：在中耳手术中，分别应用普鲁泊福异氟烷芬太尼(PI组)和异氟烷芬太尼(I组)维持全麻，比较患者全麻后的恢复。方法:34位患者在诱导插管后随机分为两组，I组(N=17)始终维持异氟烷呼出浓度在1%；PI组(N=17)在插管后即启动3 mg·kg-1·h-1的普鲁泊福输注，同时维持异氟烷呼出浓度在0.5%。手术结束后记录患者呼唤睁眼时间(T1)，拔管时间(T2)，离开麻醉恢复室（PACU）时间(T3)，完全清醒不再嗜睡时间(T4)，下地活动时间(T5)和进食时间(T6)。术后24 h询问患者在麻醉过程中是否有知晓及麻醉后有无眩晕和恶心呕吐。结果:T1和T2时间在I组\[分别为(9.2±3.2) min和(10.7±3.5) min\]略低于PI组\[分别为(11.0±4.7) min和(11.7±4.2) min\]，但差异无显著性统计学意义（P＞0.05），而T3-T2(PACU停留时间)、T4、 T5和T6在PI组显著少于I组(P<0.05)。结论:应用普鲁泊福异氟烷芬太尼维持全麻不延长患者苏醒与拔管时间，而其他恢复指标较优。

Abstract:目的：测定112例输尿管结石患者24 h尿枸橼酸、尿钙含量，并分析两者相关性。方法:收集2006年7月至2007年6月112例输尿管结石患者及48例对照者的24 h尿液，测定其24 h尿枸橼酸值及尿钙含量，分析二者相关性。结果:输尿管结石患者24 h尿枸橼酸含量（mg）明显低于对照人群（289.48±147.66 vs 485.49±133.77,P<0.001），且低枸橼酸尿症(<320 mg/24 h)者明显多于对照人群（66.1% vs 9.8%,P<0.001），性别对尿枸橼酸影响不大。输尿管结石患者24 h尿钙(mmol) 高于对照组 (8.52±2.79 vs 6.28±1.83,P<0.001),而高钙尿(>7.5 mol/24 h)人数明显多于对照组(51.7% vs 19.5%，P<0.001)，性别对尿钙影响不大。尿枸橼酸、尿钙水平之间未发现线性相关。结论:输尿管结石患者常常伴有低枸橼酸尿症和高钙尿症，但尿枸橼酸水平和尿钙含量无明显相关，性别对患低枸橼酸尿症或高钙尿症无明显影响。

Abstract:目的：评价经输尿管镜下气压弹道碎石治疗双侧输尿管结石并急性肾功能衰竭疗效。方法:对42例双侧输尿管结石患者进行经输尿管镜气压弹道碎石和取石治疗。结果:42例患者经输尿管镜成功解除梗阻，肾功能有效恢复，术后患者进入多尿期，患者都出现不同程度的血尿，肾绞痛5例。均在保守治疗或留置双“J”管后缓解消失。多尿期持续3~14 d（平均6 d），急性梗阻38例血 BUN、Cr恢复正常范围，最快1 d，最慢7 d；慢性梗阻4例肾功能完全恢复，平均时间1.5个月。结论:输尿管镜气压弹道碎石术能迅速消除上尿路结石梗阻所致的急性肾功能衰竭，具有安全、高效、创伤小、术后恢复快的特点，术后留置输尿管导管或双“J”管，同时加强术中及术后并发症的处理，可提高碎石成功率，减少并发症的发生。

Abstract:目的：探讨高龄高危前列腺增生症的临床特点及生理盐水中的前列腺电切术（TURIS）的安全性和有效性。方法:在内科、麻醉科的协助下，术前积极处理并发症和合并症，将手术风险降低至最低限度后再行PKRP。结果:本组50例安全实施TURIS，随访1～10个月，排尿通畅，国际前列腺症状评分(IPSS)由30．5分降到9.5分；生活质量评分(QOL)由6分降到2.5分；剩余尿由186 ml降至30 ml，无水中毒、尿失禁及继发性出血。尿道狭窄2例。治疗后IPSS、QOL、PVR差异有统计学意义。结论:TURIS是治疗高龄高危BPH安全有效的方法。

Abstract:目的：探讨乳腺原发性印戒细胞癌的临床病理特点以及鉴别诊断要点。方法:观察1例乳腺原发性印戒细胞癌的特殊乳腺炎性表现以及病理和免疫组化特点，并回顾和讨论文献报道的62例病例。结果:乳腺原发性印戒细胞癌起病时间短，淋巴结转移率高，5年生存率低于乳腺黏液癌。黏液分布上的病理学特点可资与黏液癌鉴别，免疫组化MUC1+/MUC4-可与转移性印戒细胞癌鉴别。结论:乳腺原发性印戒细胞癌虽少见，但生物学行为恶性度高，需通过其独特的病理特征鉴别，一经诊断应重视早期全身治疗包括采取极积的综合治疗。

Abstract:目的：探讨前列腺癌（PCa）中前列腺上皮源性Ets转录因子（prostate epitheliumspecific Ets transcription factor, PDEF）mRNA的表达及临床意义。方法:应用核酸原位分子杂交技术（ISH）半定量法观察23例前列腺增生（BPH）、41例前列腺癌组织中PDEF mRNA的表达，并对检测结果进行分析。结果: BPH组织PDEF mRNA中等阳性及强阳性表达率为34.8%(8/23)，明显低于PCa组织（73.2%，30/41，P<0.01）。A＋B期PCa组织中PDEF mRNA中等阳性及强阳性表达率为57.1%（12/21），明显低于C＋D期（90%，18/20，P<0.05）；高分化PCa组织PDEF mRNA强阳性表达率（8.3%，1/12），明显低于中等分化（64.3%，9/14）及低分化组织（73.3%，11/15，P<0.05）,中等分化与低分化组织无显著差异。PDEF mRNA的表达与PSA表达存在相关性（P<0.05）。结论:PDEF基因可能参与了PCa的发生、发展和演变过程。

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