Objective To investigate the effect of apoptosis with portal vein occlusion in various degrees or times and the following restoration portal vein flow on intestinal mucosal cells,to analyze its possible pathogenesis. Methods 40 healthy adults white Japanese rabbits were randomly divided into one controlled group and four experimental groups (according to portal vein half-clamping for 30 min, 45 min and portal vein full-clamping for 30 min, 45 min, divided into B1、C1、B2、C2 groups.).Each experimental group with portal vein occlusion on certain times then with restoration of portal vein flow for 2h. At choiced time rabbit guts were continuously cut to sections for HE、TUNEL staining and Bcl-2、Bax protein immunohistochemical staining,to observe the injury apoptosis in intestinal mucosa and the relationship between the expressions of Bcl-2 and Bax protein. Results Compared with control group A, down-regulation of Bcl-2 expression, up-regulation of Bax expression and the index of apoptotic cell increased were found in each experimental group. there exist significantly differences between each groups for Bcl-2 expression (P

Objective To investigate the inhibition of Jin’s hemorrhoid ointment extract on proliflation of human umbilical vein endothelial cell (ECV-304), then to study the mechanism of treating hemorroid. Methods MTT assay was used to observe the inhibition of various concentrations Jin’s hemorrhoid ointment extract and single Chinese Herbs of compound on human umbilical vein endothelial cell (ECV-304). Results Various concentrations Jin’s hemorrhoid ointment extracts inhibited proliflation of human umbilical vein endothelial cell, which depended on concentration. All of Rheum decoctions and high concetration Curcuma decoction inhibited ECV-304 proliflation. Conclusion Jin’s hemorrhoid ointment can inhibit proliflation of human umbilical vein endothelial cell, and Rheum maybe the main effective part of Jin’s hemorrhoid ointment, Curcuma also take part in it.

Objective To observe the clinical effects of open kinetic chain and closed kinetic chain exercise in the early period of anterior cruciate ligament reconstruction rehabilitation,provide the theoretical and clinical experiences for the early rehabilitation of the anterior cruciate ligament reconstructed knee.Methods From February 2009 to June 2010,60 patients undergoing single-bundle anterior cruciate ligament reconstructions by using hamstring tendon allograft were enrolled in the study,and were divided into two groups:open kinetic chain group(30 cases,30 knees)and closed kinetic chain group(30 cases,30 knees).In accordance with the rehabilitation procedures for six months,no statistically significant differences were found between the two groups in Lysholm scores,International Knee Documentation Committee(IKDC)scores and one-leg hop test preoperative.The active and passive range of notion,Lysholm scores,IKDC scores,one-leg hop test and KT-1000 were evaluated three and six months after surgery.Results Three months after surgery,no significant differences were found in passive range of motion,Lysholm scores,IKDC scores,but significant differences were found in active range of motion,one-leg hop test and KT-1000,and the closed kinetic chain group was significantly better than the open kinetic chain group.Six months after surgery,no significant differences were found in active range of motion,passive range of motion,one-leg hop test,Lysholm scores,IKDC scores,but significant difference in KT-1000,and the closed kinetic chain group was significantly better than the open kinetic chain group.Conclusion Closed kinetic chain exercise is benefit for recovery of muscles strength,proprioception and protect the graft in the early rehabilitation period after anterior cruciate liganent reconstruction.

Objective To investigate the impact of graft position shift on anterior cruciate ligament reconstruction induced by femoral fixation of interference screw. Methods Nineteen fresh cadaveric knees were used and assigned to three groups. 1) Study of graft position shift: 5 knees were randomly selected, interference screws of 7 mm, 8 mm and 9 mm were used in autologous tendon fixation, then the graft position shift were measured. 2) Study of isometry: 7 knees were randomly divided into the isometric reconstruction group (D group). In the D group, Retrobutton, interference screw and interference screw in location-corrected bone tunnel were used respectively as fixation. The isometry of grafts was evaluated. 3) Study of tibia anterior translation: 7 knees were randomly divided into the anatomic reconstruction group (J group). In the J group,the tibia anterior translation was measured in four different conditions in the same joint: intact knee joint,knee joint without ACL, ACL anatomic reconstruction by interference screw fixation, and ACL anatomic reconstruction by interference screw fixation with corrected bone tunnel location. Results 1) With 7 mm, 8mm and 9 mm interference screw fixation, graft position shift were (2.36±0.11) mm, (2.72±0.06) mm and (3.00±0.06) mm respectively. 2) Graft length change: graft length change in Retrobutton group and corrected bone tunnel group were less than 3 mm, while graft length change in those fixed with interference screw were stretched in more than 3 mm. 3) Study of tibia anterior translation: there was no difference among the intact group, the anatomic group and the corrected group at 0° and 15°. However, the difference was found between the intact group and other groups at 30°、60° and 90° of flexion, as well as between these two reconstructed methods at 20° joint flexion (P＜0.05). Conclusion In both isometric and anatomic ACL reconstruction with interference screw, the graft is pushed tightly toward the femoral tunnel wall, which shifts the graft away from the desired position. In our study we find out that the corrected location of the femoral bone tunnel significantly improves the isometry of ACL reconstruction and anatomic reconstruction.

Vagus nerve reflex is a rare complication of percutaneous renal decompression. It is often induced by excessively rapid decompression of severe hydronephrosis and traction of the main nerves innervating the kidney. The clinical manifestations are irritability, sweating, clammy skin, hiccups, slow heart rate. It is easy to misdiagnose. In this study, 4 patients with vagus nerve excitement after percutaneous renal decompression were treated. After monitoring the patient’s vital signs and giving treatment such as expanding blood volume and raising blood pressure, the symptoms gradually disappeared.

A rapid resolution liquid chromatography quadruple time-of-flight mass spectrometric ( RRLC-Q-TOF/MS) method combined with multivariate statistical analysis was applied to investigate the changes of endogenous metabolites in murine urine before and after ultraviolet B ( UVB ) irradiation for the purpose of discussing the physiological mechanism of acute injury caused by UVB radiation. A narrow-band UVB ( NB-UVB) (TL-01, peak value 312nm) was used to establish the acute light damage model. The urine samples were centrifuged before four times dilution treatment, subsequently the diluted urine samples were separated on a Supelco Ascentis Express C18 column using water (0. 1% formic acid) and acetonitrile as mobile phase by gradient elution. The differences metabolites with major contribution for grouping were found out based on the metabolic profiling analysis of principal component analysis ( PCA) and cluster analysis ( CA) , which could illustrate their possible mechanism of actions by means of relevant pathways. A prediction model was built to investigate the forecasting ability of the acute photo damage induced by UVB irradiation through the partial least square discriminant analysis ( PLS-DA ) . The results of multivariate statistical analysis showed that the blank control group was separated from UVB model group quite well, 11 endogenous metabolites were identified as the potential biomarkers through comparison with the database, tandem mass spectrum data and standard substance, which indicated the UVB radiation may affect the sphingolipid metabolism, nucleic acid metabolism, linoleic acid metabolism and amino acid metabolism pathways. These different metabolites could be helpful for diagnosing the light damage induced by UVB radiation

Objective After acute craniocerebral trauma , to a certain extent , arterial blood lactate and lactate clearance rate reflect the illness severity .We aimed to investigate the prognosis value of arterial blood lactate and lactate clearance rate in patients with craniocerebral trauma . Methods 94 cases with craniocerebral trauma treated in the Department of Emergency of Nanjing General Hospital of Nanjing Military Regionfrom February 2015 to November 2015 were retrospecively analysed .GCS ( Glasgow Coma Scale ) score, arterial blood lactate , blood pressureand heart rate were measured once patients admitted to hospital and 6 hours later ,arterial blood lactate was measured again to calculated the arterial blood lac-tate clearance rate .Based on the GCS score , we divided the patients into mild group (13-15), medium group (9-12) and severe group (3-8).We also divided the patients into death group and survival group according toprognosis .We compared arterial blood lactate and lactate clearance rate betweeeneach group respectively . Results There were significant differences in arterial blood lactate (F=19.99,P<0.01) and 6h lactate clearance rate(F=6.21,P<0.01)be-tween lighter group , medium group and severe group .The initial arterial blood lactate of death group was significantly higher than sur-vival group[(4.20 ±1.36)mmol/L vs (1.58 ±0.93)mmol/L], the difference was statistically significant (t=-9.78,P<0.01). The 6 h lactate clearance rate of death group was significantly lower than survival group [(31.73 ±12.84)%vs (46.25 ±12.01)%], the difference was statistically significant (t=4.55,P<0.01). Conclusion Arterial blood lactate and 6 h lactate clearance rate can evaluate the severity and prognosisof illnessin patients with craniocerebral traumaand have important application value in clinical work .

The metastasis of renal cell carcinoma to the ureter is a rare phenomenon, and synchronal detection of metastasis to the contralateral ureter is a rarer phenomenon. A 62-year-old male patient with painless hematuria was examined and detected a renal cell carcinoma on the right kidney and bleeding from the left ureter. Ureteroscopy revealed a tumor in the left upper ureter, and biopsy suggested clear cell carcinoma. Laparoscopic radical nephrectomy was performed to resect the right renal cell carcinoma, and the pathology revealed a clear cell carcinoma, with Fuhrman nuclear grade 2 class. The ureteral tumor was resected 3 months later and the pathology revealed renal clear cell carcinoma. Sunitinib was used for 37 months, and there was no tumor recurrence or metastasis so far.

Objective:To explore risk factors for the efficacy and complications of surgery for infectious kidney stones.Methods:The clinical data of 75 patients with infection kidney stones from January 2015 to May 2022 were retrospectively analyzed. This group of 75 patients, were 23 to 74 of age, with mean of (49.3±10.4) years old. Among them, 25 were male and 50 were female. The mean diameter of the stones was (5.4±2.7)cm. There were 29 cases of staghorn stones, 25 cases of multiple kidney stones, and 21 cases of single kidney stones. Preoperative renal function measuring by creatinine was 68 (51, 68)μmol/L. Twenty-five patients (33.3%) were combined with comorbidities, including diabetes mellitus, neurogenic bladder, spinal cord injury, cerebrovascular disease, or urinary anatomical malformation. All the patients underwent surgical treatment, including percutaneous nephrolithotomy, flexible ureteroscopy, and combined endoscopy. Postoperatively, urosepsis was diagnosed according to the SOFA score. One month after the operation, CT or KUB were re-examined to evaluate the efficacy of the operation. Multivariate logistic regression was used to analyze the risk factors for surgical efficacy, complications and sepsis.Results:All 75 patients undewent successful surgery. The overall stone clearance rate was 64%, and the single-factor analysis showed that the stone diameter ( P=0.001) and stone type ( P=0.002) were the impacting factors of the surgical efficacy of infectious kidney stone. Multivariate analysis showed that stone type ( OR=2.55, 95% CI 1.00-6.51, P=0.049) was an independent risk factor influencing the efficacy of surgery for infectious kidney stones. A total of 24 cases experienced surgical complications after surgery, including 18 cases of infection, 3 cases of bleeding, and 3 cases of subcapsular hemorrhage, and the complication rate was 32.0%(24/75). Univariate analysis showed that hydronephrosis ( P=0.039), comorbidities ( P=0.009), and preoperative renal function ( P=0.008) were risk factors for postoperative complications of infectious nephrolithiasis, and multivariate analysis showed that comorbidities ( OR=0.21, 95% CI 0.05-0.90, P=0.029) were independent risk factors for postoperative complications. The incidence of postoperative urosepsis was 6.7%, and univariate analysis did not find any risk factors for sepsis. Conclusions:Stone type is a factor that affects the efficacy of surgery for infectious kidney stones, and comorbidities are factors that affect surgical complications.

Objective:To investigate the difference of 24h urinary metabolic abnormalities in patients with different subtypes of calcium oxalate stones.Methods:The clinical data of 120 patients with simple calcium oxalate stones admitted to the Second Affiliated Hospital of Zhengzhou University from March 2018 to May 2020 were retrospectively analyzed.There were 90 males (75.0%) and 30 females (25.0%), with the age of (49.1 ±13.5) years old, and body mass index (BMI) of (24.6 ±3.0) kg/m 2. There were 23 cases of diabetes mellitus (19.2%), 8 cases of coronary heart disease (7.0%), 36 cases of hypertension (30.0%) and 45 cases of gastrointestinal diseases (37.5%). There were 11 cases (9.2%) of low pH, 54 cases (45.0%) of hyperoxaluria, 19 cases (15.8%) of hypercalcemia, 72 cases (60.0%) of hypocitrouria, 3 cases (2.5%) of hyperuricuria, and 18 cases (15.0%) of hyperuricemia. In the 120 patients, 79 underwent ureteral soft lithotripsy, 28 underwent percutaneous nephrolithotomy, and 13 underwent extracorporeal shock wave lithotripsy. The patients were divided into calcium oxalate monohydrate stone group (COM group) and calcium oxalate dihydrate stone group (COD group). The general clinical data and urinary metabolic data of the two groups were compared. Independent risk factors for stone formation of the two groups were analyzed. Results:There were 120 cases in this study, with 90 cases in COM group and 30 cases in COD group. Urinary oxalic acid in COM group and COD group was 41.3 (30.1, 54.2) mg and 34.1 (26.6, 39.9) mg, respectively, and the difference was statistically significant ( P=0.01). The incidence of hyperoxaluria was 52.2% (47 cases) and 23.3% (7 cases), respectively, and the difference was statistically significant ( P<0.01). Urinary calcium in COD group and COM group was 6.8 (6.1, 8.8) mmol and 4.0 (2.3, 5.2) mmol, respectively, and the difference was statistically significant ( P<0.01). The incidence of hypercalcemia was 43.3% (13 cases) and 6.7% (6 cases), respectively, the difference was statistically significant ( P<0.01). The urinary phosphate in COM group and COD group was 2 063.5 (1 688.8, 2 803.2) mg and 1 231.7 (766.7, 1 740.9) mg, respectively, and the difference was statistically significant ( P<0.01). The serum uric acid level in COM group and COD group was (343.0±111.7)μmol/L and (297.6±77.6)μmol/L, respectively, and the difference was statistically significant ( P<0.05). There were no significant differences in term of age, gender, body mass index, diabetes mellitus, coronary heart disease, hypertension, gastrointestinal disease, parathyroid hormone (PTH), hemoglobin, serum creatinine, serum potassium, serum phosphorus, serum calcium, serum sodium, stone load and side between the two groups ( P>0.05). There were no significant differences in urinary sodium, urinary phosphorus, urinary magnesium, urinary citric acid and urinary uric acid levels between the two groups ( P>0.05). Binary Logistic regression analysis showed that hyperoxaluria was an independent risk factor for COM patients ( OR=4.859, P<0.01). Increased urinary phosphoric acid level was an independent risk factor for COM patients ( OR=1.001, P<0.01). Hypercalcemia was an independent risk factor for COD patients ( OR=27.856, P<0.01). Conclusions:COM calculus patients have higher urinary oxalic acid and urinary phosphoric acid levels, and are more likely to have hyperoxaluria. COD calculus patients have higher urinary calcium levels and are more likely to develop hypercalcemia.