Objective To analyze clinical and pathologic features of a rare vascular amyloid deposits of amyloid nephropathy ( VADAN) in 6 patients, so as to improve its diagnosis and treatment. Methods All patients received immunopathology, microscopy and electron microscopy examination, and amyloid types were analyzed. Results There were 3 males and 3 females with ages ranging from 52 to 73 years. Two patients suffered from multiple myeloma. Majority patients had slight albuminuria and hematuria. One patient combined with minimal change glomerular disease presented nephrotic syndrome. One patient combined with IgA nephropathy had albuminuria and hematuria. And one patient had myeloma cast nephropathy with acute renal failure. Kidney biopsy proved amyloid deposits along interlobular arterial wall only in all 6 patients. Two cases secondary from multiple myeloma were κ amyloid, and the rests were λ amyloid. Conclusions VADAN is a rare type of amyloid nephropathy. Its clinical manifestation is different from common amyloid nephropathy. Kidney biopsy will benefit its differential diagnosis.

Objective To study the effect of fast tract surgery (FTS) used in patients undergoing total knee arthroplasty (TKA). Methods For the experimental group, 341 inpatients with TKA in the Joint Surgery Department of Shandong Provincial Hospital from June 2014 to June 2015 were treated with FTS nursing measures. For the control group, 355 inpatients with TKA of the same department from January 2013 to May 2014 were treated with conventional nursing measures. The effects of FTS nursing measures, the parameters of patients′ postoperative complications, average hospitalization days and the function recovery of knee joint were evaluated respectively. Results After implementing the FTS nursing measures , the incidence of deep venous thrombosis of lower limbs reduced from 8.45%(30/355) to 2.35%(8/341) (χ2=2.340, P<0.05). The average hospitalization days treated without/with FTS nursing measures were:unilateral knee (14.49±3.62) days (without FTS) vs. (11.95±4.53) days (with FTS), bilateral knees (15.80± 3.01) days (without FTS) vs. (13.19±4.08) days (with FTS)(t=3.166, P<0.05). Two weeks after surgery, the HSS scores in the experimental group was 65.72 ± 5.54, while the HSS scores in the control group was 52.43 ± 7.32 (t=2.452, P < 0.05). Three months after surgery, the HSS scores in the experimental group was 88.72 ± 7.10, while the HSS scores in the control group was 72.14 ± 8.73 (t=2.528, P < 0.05). Conclusions FTS nursing measures could significantly reduce the incidence of deep venous thrombosis of lower limbs, shorten the hospitalization days of inpatients, and promote the functional recovery of knees.

Objective To evaluate the effect of early exercise intervention on deep venous thrombosis (DVT) after joint replacement.Methods 100 patients with joint replacement were divided into observation group including 50 cases and control group including 50 cases by random number table method.Early exercise intervention was used in observation group and usual nursing was used in control group.The hemodynamic index (femoral vein blood flow peak velocity and average velocity) and DVT incidence were compared between the two groups.Results After the intervention for 3 days,the femoral vein blood flow peak velocity and average velocity of observation group respectively were (43.5±4.1) cm/s and (27.3±3.2) cm/s,those of control group respectively were(36.6±3.7) cm/s and (20.2±2.8) cm/s.The difference between the two groups was statistically significant (t=2.987,2.895,P ＜ 0.05).After the intervention for 7 days,the femoral vein blood flow peak velocity and average velocity of observation group respectively were (56.1±4.7) cm/s and (32.1±3.9) cm/s,those of control group respectively were (41.3±3.9) cm/s and (22.4±4.3) cm/s.The femoral vein blood flow peak velocity and average velocity of observation group significantly higher than control group(t=3.675,2.929,P ＜ 0.05).The DVT incidence of control group and observation group respectively were 40.0％(20/50) and 14.0％(7/50),showed significant differences between the two groups(x2=8.574,P=0.003).Conclusions Using the early exercise intervention on patients with joint replacement can effectively improve the lower limb venous blood flow velocity and prevent DVT.

Prostate cancer is one of the common malignant tumors of the urinary system and mostly found in elderly men. Like most tumors, prostate cancer involves a variety of molecules in its occurrence and progression. More studies on the development of prostate cancer focus on the tumor markers, DNA damage repair related genes, and tumor invasion and metastasis related factors. This article presents an overview on the research progress in these three aspects.
Biomarkers, Tumor ; Biomedical Research ; DNA Repair ; Disease Progression ; Humans ; Male ; Neoplasm Invasiveness ; Prostatic Neoplasms ; genetics ; pathology

Objective We summarized the clinical experience of modified ileal ureter substitution for treating long segment ureteral defection.Methods We retrospectively analyze the clinical data of 2 patients with long segment ureteral defect who treated with Yang-Monti ileal ureter substitution between March 2015 and November 2015.One 75 years old male patient was diagnosed as upper ureteral malignance and solitary kidney.The length of defection from renal pelvis to bladder was 22 em.His serum creatinine was 100 μmol/L,blood urea nitrogen was 5.7 mmol/L,serum chloride was 98 mmol/L.Another one 41 years old female patient was diagnosed as middle and lower ureteral iatrogenic injury.The traumatic length was 15 cm.Her serum creatinine was 70 μmol/L,blood urea nitrogen was 5.1 mmol/L,serum chloride was 100 mmol/L.they were both treated by Yang-Monti ileal ureter substitution.The ileal intestinal segment was used for the ureteral replacement,which were more than 15 cm to the ilealcecum.The length of intestine was 10.0 cm and 7.5 cm,respectively.The ileal mesentery was preserved.After closing the mesangial hiatus,the ileal segment was pull into the retroperitoneal space and pulling out via descending colonic mesangial window.The ileal segment was divided into three parts,which was 2.5 to 3.0 cm in each part.Each part was opened via long axis and then rotated 90 degree.The 4-0 absorable suture was used to suture the edge of each intestinal part continuously.The sutured intestine was re-tubularized,using 4-0 absorable suture and the F16 catheter was used as the tube model.The length of reconstructed ureter was 22 cm and 18 cm,respectively.The neo-ureter was re-anastomosed with renal pelvis and bladder wall.Two F6 double J stents were placed in the neo-ureter.Results The operative time was 160 min and blood loss was 200 ml in the first case.In the second case,the operative time was 180 min and blood loss was 220 ml.No significant complications were noticed intra-operation and post-operation.Six months after operation,the male patient's serum creatinine was 112 pmol/L,blood urea nitrogen was 6.1 mmol/L,serum chloride was 106.0 mmol/L and electrolytes were normal.In another patient,serum creatinine was 79 μmol/L,blood urea nitrogen was 5.9 mmol/L and serum chloride was 103.0 mmol/L.The GFR was 24.9 ml/min and 22.1 m]/min 3 and 6 months after operation,respectively.Ureteral obstruction wasn't detected on IVU images 3 months after operation.Conclusions For patient with long ureteral defect,which cannot be replaced by other urinary tissue,YangMonti ileal ureter substitution is one of the optional modalities.As a new technique of ureteral substitution,Yang-Monti ileal ureter substitution is simple and fewer complications and can improve the quality of life in patient compared with traditional ureteral substitution.

Acupuncture Therapy ; methods ; Adult ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Tennis Elbow ; therapy

Objective To observe the clinical effects after implantation of an aspherical intraocular lens Acrysof IQ.Design Prospective,randomized concurrent-controlled study.Participants 64 patients(64 eyes)with bilateral senile cataracts.Methods Pa- tients were operated with phacoemulsification and IOL implantation.They were divided randomly into 2 groups according to the table of random number:one group with Aerysof IQ(aspherical IOL)implantation and the other with Acrysof SN60AT(spherical IOL).Thor- ough ophthalmic examinations,including visual acuity,slit lamp examinations,fundoseopy,wavefront aberrometry,contrast sensitivity, were performed 1 week,1 month and 3 months after surgery.Main Outcome Measures Visual acuity,the best corrected visual acuity, spherical aberration(C 12),the root mean square of the total higher-order aberration(RMSh),and contrast sensitivity at 4 kinds of light backgrounds.Results At 1 postoperative month,RMSh(0.30?0.68?m)and C12(0.07,?0.04?m)in aspherical IOL group were signifi- cantly lower than those of the spherical IOL group(0.49?0.14?m,0.36?0.06?m)(P=0.00)with a 6.0 mm aperture.At 3 postoperative months the RMSh(0.30?0.07?m)and C12(0.06?0.06?m)in aspherical IOL group were significantly lower than those of the spherical IOL group(0.47?0.14?m,0.34?0.06?m)(P=0.00)with a 6.0 mm aperture.The asphefieal IOL(Acrysof IQ)provided statistically sig- nificant better contrast sensitivity at all spatial frequencies under mesopic conditions(3 cd/m~2)with and without glare(P

Objective To investigate the operative technique and efficacy of PPH for severe hemorrhoids. Methods The clinical data of 153 cases of severe hemorrhoids treated by PPH, individualized according to size and nature of the piles, concomitant morbidities and conditions at the dentate line, and analysis of the relevance between operative technique and clinical efficacy as well as postoperative complications, were revieuled retropectively. Results All of the prolapsed tissue retracted immediately. Bleeding at the anastomotic site occurred in 49 cases, pulsatile bleeding in 12 cases, all of which were sutured under direct vision with cessation of bleeding. The width of excised-tissue was 2.1~4.6cm(average 3.5cm). The main symptoms of patients on the 1st post-operation day were abdominal distention caused by dysuria, pain, and tenesmus and burning sensation. At followup of 1-40 months, there was no stenosis of stoma, anal incontinence or recurrence of prolapse. After operation, a very satistactory result was achieved in 87 cases, satisfactory in 63 cases and mostly satisfactory in 3 cases. Conclusions In order to achieve ideal results with good retraction of tissues, avoidance of complications and improve patient satisfactory rate, the use of PPH for severe hemorrhords must be individualized and technical skill during operation are important.

Objective To evaluate the value and the expression of Axl receptor tyrosine kinase (AxlTK) in renal pathology of lupus nephritis (LN) patients. Methods The expression of AxlTK were detected in 29 LN and 10 primary nephritic syndrome (NS) patients using immunohistochemistry in renal tissue. The correlations between the levels of AxlTK on glomeruli and clinical manifestations, laboratory parameters, disease activity, and renal pathology in LN patients were investigated. T test and single factor analysis of variance were used tp compare between groups, and Pearson or Spearman test was used for correlation analysis. Results AxlTK was extensively expressed on surface of mesangial cells, endothelial cells in glomeruli. There was more expression of AxlTK on mesangial cells in LN patients [(7.0 ±2.2)×10-2] than that in primary NS patients [(3.1 ±1.2) ×10-2] (t=5.382, P<0.01). The expression of AxlTK in the glomeruli of LN patients with oral ulcers is higher than that in patients without of ulcers (t=2.259, P=0.032), and it was positively correlated with the anti-nucleosome antibody (AnuA) level in patients (r=0.488, P=0.017). The expression of AxlTK on glomeruli were higher in class Ⅳ and classⅢ of LN patients than that of class Ⅴ, but there was no statistically significant difference between them (P>0.05). Conclusion The expression of Axl TK in glomerular is significantly increased in glomeruli in LN patients. The expression level of AxlTK on glomeruli is correlated with the occurrence of oral ulcers and AnuA. The level of AxlTK expression is related to pathological categories of kidney in LN patients. The results of this study suggest that AxlTK might participate in the pathogenesis of LN.

Objective To explore the possibility and reliability of mutual recognition of renal indexs among 20 clinical labora-tories entitled with state key clinical laboratory,and to supply reference for future national mutual recognition of laboratory examination results.Methods Determined the concentrations of TP,ALB,TC,TG and Roche multiple calibrators and sub-mitted the results.The results were analyzed for robust Z score,percentage difference after calibration,bias at medical deci-sion level to observe the possibility and reliability.Results The bias of TG was out of the least allowable bias,thus they were not appropriate to mutual recognition.Conclusion It remains immature in the mutual recognition of lipids’determina-tions and much work needs to be done in field of internal quality control of the laboratory.