Objective To investigate the clinical manifestations,diagnosis and treatment of renal tuberculosis(TB). Methods This series included 52 patients with renal TB.Of them 36 cases (69%) presented with irritative symptoms.10 cases (19%) had lumbago accompanied by hematuria.6 cases (11%) had renal angina and 6(11%) painless hematuria.B-ultrasonography suggested renal TB in 20 cases and unilateral hydronephrosis in 22 cases;renogram showed that the diseased kidneys had no function in 31 cases.Urinal AFB and tuberculosis PCR(Tb-PCR) were performed in 38 cases,the results were positive in 13(34%)and 21(55%),respectively.27 cases were misdiagnosed to have calculi or inflammation.Treatments consisted of antituberculous chemotherapy in 12 cases (23%)and surgery in 40(77%). Results All of the 12 cases who received medications recovered completely.40 cases undergoing surgery were pathologically diagnosed to have renal TB;of them 5 cases developed ureteral stump syndrome. Conclusions Urine AFB and Tb-PCR remain the primary diagnostic methods before operation.When the non-functioning kidney is resected,the involved ureter should be concomitantly resected as much as possible.

To discuss treatment of wide-necked aneurysms.Methods Guglielmi detachable coil(GDC)after stent Pacement treat wide-necked aneurysm.Results Aneurysm was complete embolized,parent artery was intact.Conclusions Endovascular treatment of wide-necked aneurysms using and GDC is technically feasible.

Objective:To explorethe the clinical manifestations, treatment and prognosis of anastomotic pseudoaneurysm after renal transplantation caused by infection.Methods:Clinical data of 1 recipient with pseudoaneurysm after renal transplantation due to Pseudomonas aeruginosa infection were retrospectively analysed and combined with a literature review. Results:At Month 2 post-transplantation, the recipient developed right lower abdominal pain, and contrast-enhanced ultrasound examination showed a pseudoaneurysm at the artery anastomosis. Anti-infection and anti-rejection therapy had no obvious effect, and therefore next surgical exploration was performed. A size4.0 cm×3.5cm pseudoaneurysm was found intraoperatively at the graft renal artery anastomosis.After graft was evaluated as having no preservation value, the transplanted kidney and pseudoaneurysm were resected. Bacterial culture indicated Pseudomonas aeruginosa infection.The recipient recovered well and waited for next transplantation. Conclusions:Pseudoaneurysm of transplanted kidney is a very rare complication after renal transplantation, and caused by infection of Pseudomonas aeruginosa is more rarer, It has not been reported in mainland China.This type of recipient has the characteristics of high graft inactivation rate and high mortality rate. Timely surgical resection can effectively prevent the deterioration of disease.

Objective To systematically evaluate the effect of routine insertion of double-J stents to prevent major urological complications(MUCs)in kidney transplant recipients.Methods Medline,Embase,Cochrane Library,and Chinese Biomedicine database were searched to locate relevant randomized controlled trials(RCT).Data extraction and assessment of methodologic quality were performed independently by two reviewers.Meta-analysis was performed by Revman 5.0 software.Results Ten RCT(including 1616 patients)were identified.By comparing the routine stent group with the no stent group,the meta-analysis showed:(1)incidence of urine leak,urinary obstruction and UTI was 4 times lower,6 times lower,increased by 52 % respectively(P＜0.0001);(2)Patient and graft survival,rate of acute rejection,delayed graft function and hematuria were of no significant difference.In subgroup analysis,it was found:(1)Compared with the no stent group,the group in which stent duration was≤ 4 weeks had a lower incidence of MUCs and a higher incidence of UTI;meanwhile,the group in which stent duration was ＞ 4 weeks had a much lower incidence of MUCs and the rate of UTI was increased without significant difference;(2)In the RCT of which urethral catheter duration was ＜ 5 days,there were no significant differences between the two groups in MUCs and UTI.In the RCT of which urethral catheter duration was ≥5 days,the stent group had a lower incidence of MUCs and a higher incidence of UTI.Conclusion Routine stenting reduces the incidence of MUCs.Although the double-J stent increases the risk of UTI,it seems that UTI doesn't affect the outcome of transplantation.The stent duration should be within 4 weeks.For the stent recipients,the longer duration of urethral catheter,the lower incidence of MUCs,the higher incidence of UTI;thus,it is up to clinicians to decide the optimal duration of urethral catheter.Long term prescription of 480 mg cotrimoxazole once daily,from the operation day till after stent removal,effectively reduces the risk of UTI associated with stent placement.

Objective To study the expression of hypoxia inducible factor-1alpha (HIF-1α) mRNA in re-nal tissue after renal ischemia-reperfusion injury (IRI), and to investigate the effect of hyperbaric oxygen (HBO) on renal IRI and its mechanism. Methods Forty-two Wistar rats were randomly divided into a normal control group(n =6), a renal IRI group (n=18) and an HBO treatment group (n=18). Renal IRI models were established in all the rats. The plasma levels of Cr in the experimental groups were then measured after 1, 3 and 5 hours. The expres-sion of HIF-1α mRNA was also detected using real-time PCR and immunohistochemistry. Kidney tissue sections were preserved for ultrastructure examination. Results (1) The average levels of plasma Cr in the renal IRI group were significantly higher than those in the control group. Compared with the renal IRI group, plasma Cr was significantly lower in the HBO treatment group. (2) The average expression of HIF-1α mRNA was significantly lower an hour after reperfusion, but significantly higher after 3 hours than in the control group. There was no significant difference by the 5th hour after reperfusion. In the HBO treatment group, HIF-1α mRNA was up-regulated significantly at the 1st and 3rd hour after reperfusion compared with the renal IRI group, but it was reduced significantly by the 5th hour after reperfusion. (3) The severity of the kidney injury increased gradually with time in the renal IRI group. After HBO treatment, however, the damage to the renal tissues decreased significantly. Conclusions HIF-1α mRNA plays an important role in the development of renal IRI. The damage to renal tissues and renal function improves significantly after reperfusion and HBO treatment through earlier priming and up-regulating of HIF-1α mRNA expression. HBO should be applied early to help prevent renal IRI.

The risk of early acute rejection after kidney transplantation is relatively high, which severely affects the quality of life of the recipients. In 2009, Kidney Disease: Improving Global Outcomes (KDIGO) recommended that immune inducers should be included in the immune-inducing regime before kidney transplantation, aiming to provide certain strength of immunosuppression during this critical phase and effectively reduce the incidence of acute rejection following kidney transplantation. At present, the selection, efficacy and safety of immune inducers remain controversial among transplantation centers around the world. In this article, clinical efficacy of monoclonal antibodies including interleukin-2 receptor antagonist, alemtuzumab, rituximab and polyclonal antibody antithymocyte globulin in immune induction therapy before kidney transplantation were compared and literature review was performed at home and abroad, aiming to provide reference for promoting the individualized selection of immune inducers for kidney transplantation and improving the quality of life of recipients.

Objective Definition Chiasm of crus penis and discuss its possible role in penile erection. Methods Penile samples were acquired from 15 formalin preserved corpses.The structure located among crus penises were observed.The information about the structure located in crus penises with the nerve and blood vessel structure were recorded and analyzed. Results There was a structure of muscle fiber of ischiocavernosus among the crus penises.These muscle fiber through muscle bundle and tendon reach albuginea of cavernous body of the penis.There was long muscle fiber in the lateral surface of crus penises.While the muscle bundles were interlaced with each other with opposite side homonymous muscle and were encased with connective tissue when it reach to the back side of cavernous body of the penis.There were nerves and blood vessels observed in and out of the cavernous body of the penis and through the above structure in the crus penises. Conclusions Chiasm of crus penis was named as a structure of muscle fiber coming from two sides of the ischiocavernosus in crus penises.The structure of Chiasm of crus penis may provide an internal connection for the role of controlling the erection of the penis.

Objective:To investigate the effect of Sirtuin 1 (SIRT1) on subarachnoid hemorrhage (SAH) and its possible mechanism.Methods:A mouse model of SAH was constructed by internal carotid artery puncture. The protein and mRNA expression levels of SIRT1 at 0, 3, 6, 12, 24, 48, and 72 h were detected by Western Blot and qRT-PCR. A Western Blot assay was used to examine SIRT1 and the expression levels of endoplasmic reticulum stress-related markers GRP78, p-PERK/PERK, p-eIF2α/eIF2α, and CHOP after administration of a SIRT1 inhibitor or SIRT1 si-RNA. At 24 h after SAH, subarachnoid hemorrhage volume, neurological function score, brain water content, and blood-brain barrier integrity were measured.Results:The highest expression of SIRT1 protein and mRNA was observed at 24 h compared with other time points, and the differences were statistically significant (all P < 0.001). Inhibition of SIRT1 expression leads to increased expression of endoplasmic reticulum stress-related proteins GRP78, p-PERK/PERK, p-eIF2α/eIF2α, and CHOP, exacerbating hemorrhage and brain water content, disrupting blood-brain barrier integrity, and significantly reducing neurological function scores. Conclusions:Inhibition of SIRT1 expression significantly increased the endoplasmic reticulum response to excitation and exacerbated early brain injury after SAH.

Objective Age and sex of the population with suspected pulmonary tuberculosis (PTB) symptoms in Yuexiu District of Guangzhou were analyzed , to find out the prevalence and important risk factors responsible for tuberculosis in this district. Methods New PTB suspects domiciling in Guangzhou Yuexiu District during 2010-2015 were of interests. Data from Guangzhou Tuberculosis Control Project registration book and biobank of Guangzhou Tuberculosis Translational Medicine Center were applied to analyzed the frequency distribution of age and sex of the population. Results 6 154 cases of PTB suspects were included in this study. As to sex,ratio of male to female was 1.70 and there was no obvious fluctuation from 2010 to 2015. Frequency distribution among PTB suspects under 40 had no difference between male and female , but the ratio of male to female was nearly 1.70 for study objects aged above 40.As to age , there was a minor peak in the age group of 25~ while the greater peak was in the age group of 50~ after the age group of 35~. Conclusion In Yuexiu District of Guangzhou ,male were more likely to be the PTB suspects than female , and the peak age of prevalence was between 50 and 60.

Objective To study the level of clinical diagnosis of pulmonary tuberculosis and implementa-tion of tuberculosis prevention and control policy. Methods Frequencies and percentages of pulmonary tuberculosis, other lung diseases and health among 3315 cases with pulmonary tuberculosis suspicious symptoms ,transferred by non-tuberculosis control institutions during 2010-2015,were calculated and analyzed. Results Among the 3315 suspected cases of pulmonary tuberculosis ,cases of pulmonary tuberculosis ,tuberculosis ,other lung diseases and healthy group were 2068,598 and 649 based on final diagnosis and their percentages were 62.38%,18.04% and 19.58% respectively. As to groups of elder than fifteen years ,the proportion of patients with pulmonary tubercu-losis accounts for 72.62%,61.00%and 48.58% of the total of young group(15~44 years old ),middle age group (45 ~ 64 years old)and elderly group(≥ 65 years old )respectively. Conclusions Compared with pulmonary tuberculosis suspicious symptomscases from tuberculosis control institution during the same period ,the proportion of tuberculosis patients from transferred groups is roughly the same.It indicate high levels of tuberculosis diagnosis and implementation to tuberculosis control policy.