Objective To observe the effect of atropine mydriasis, wearing myopia glasses for short or long distance, and massage on preventing and controlling myopia in teenagers and children. Methods A total of 198 myopia cases (involving 393 eyes) were randomized into control group and treatment group. The control group was given eyesight examination after mydriasis with atropine sulfate eye gel and wearing myopia glasses for long distance. The treatment group was given eyesight examination after mydriasis with atropine sulfate eye gel, wearing myopia glasses for short distance, and massage therapy. Eyesight examination was carried out once every 2 months and lasted for one continuous year. The changes of diopter were compared between the two groups. Results ( 1) Of 194 affected eyes from the treatment group, 96 eyes were effective, 68 were stabilized, and the effective rate was 45.5%and stabilizing rate was 35.1%. Of 199 affected eyes from the control group, 3 eyes were effective, 9 were stabilized, and the effective rate was 1.5%and stabilizing rate was 4.5%. The differences of effective and stabilizing rates were significant between the two groups ( P<0.01). ( 2) After treatment, the myopia diopter was increased in the control group ( P<0.01 compared with that before treatment) , and the myopia diopter in the treatment group maintained stable ( P>0.05). The difference of diopter was significant between the two groups (P<0.01). (3) The difference of astigmatism was insignificant in both groups before and after treatment and between the two groups after treatment (P>0.05). Conclusion Mydriasis with atropine sulfate eye gel, wearing myopia glasses for short or long distance, and focal massage therapy show certain preventive effect on myopia in teenagers and children by controlling the development of myopia diopter.

Objective To investigate effect of laparoscope anesthesia inducted by sevoflurane combined with different doses of propofol on vascular endothelial growth factor-C (VEGF-C) and prostaglandin E2(PGE2)in patients with hysteromyoma.Methods 77 cases of patients with uterine fibroids were selected and divided into two groups.40 cases in group A were anesthetized inducted by 2.0 mg/kg propofol combined with sevoflurane, 37cases in group A were anesthesia inducted by 1.0 mg/kg propofol combined with sevoflurane.VEGF-C and PGE2 in serum were compared before and 48h after the operation.Results Compared with preoperation, VEGF-C and PGE2in serum were lower (P<0.05), VAS score was lower (P<0.05);Compared with group B, VEGF-C and PGE2 in serum of the group A were lower (P<0.05), VAS score was higher (P<0.05).Conclusion Different doses of propofol on serum VEGF-C and PGE2 in patients with laparoscopic uterine fibroids have different effects, 1.0 mg/kg has a sedative effect, 2 0 mg/kg with anesthesia induction.

Objective To study the correlation between prognosis and vertigo and status of the vestibule functions with the patients of the sudden deafness (SD).Methods For 161 patients of the SD, the parameters of the hearing before treatment, vertigo and vestibule functions, were analyzed to establish a statistic model by means of Logistic regression with single factor analysis of variance, Logistic regression analysis and Chi square test.Results The single factor analysis of variance and Chi square revealed statistical differences between prognosis of the SD and hearing before treatment(P0.05).Conclusion If the patients with SD had more severe hearing loss, the prognosis would be less successful. The normal or abnormal caloric tests had influence for the prognosis of the SD, but vertigo showed influence on prognosis only when caloric test was abnormal. The degree of hearing loss was not related to that of vertigo or vestibule functions while the sudden deafness accompanied with vertigo was not due to the damage of vestibular functions.

Objective To investigate the clinical characters of posturographic test in patients with sudden hearing loss.Methods The postural map and correlative parameters value were examined by dynamic posturography in 100 cases of normal subjects and 120 cases of sudden hearing loss.According to state of the vestibule function,120 patients were divided into normal(67 cases) and abnormal(53cases) groups.The parameters of the length,velocity and Romberg of postural sway were compared between two groups.Results The postural map was most prominent centre patten(51%) in normal subjects,the patient's map was most prominent diffuse patten(60.83%).Length,velocity and Romberg of postural sway of the patients were significantly increased in comparison with normal subjects(P0.05).Conclusion The results of posturographic test indicate that the vestibular system in patients with sudden deafness is damaged.

Objective To evaluate the effects and complications of percutaneous nephrolithotomy (PCNL) in the treatment of renal stone after repeated extracorporeal shockwave lithotripsy (ESWL).Methods Forty-four patients who had a history of repeated ESWL (treatment group) and 50 patients with-out surgical intervention (control group) were submited to PCNL,and clinical data was documented in details and analyzed.Results The time to establish access in treatment group and control group was (11.8 ± 4.1) min and (10.9 ± 2.5) min,respectively,and there was no significant difference (t =1.308,P =0.194).The time to extract stone in both groups was (92.0 ± 13.5) min and (66.6 ± 17.6) min,respectively,and there was significant difference (t =7.776,P =0.000).The operative time in treatment group was (113.9 ± 12.0) min,which was longer than that in control group with (87.6 ± 13.6) min (t =8.354,P =0.000).The clearance in both groups was 81.8％ and 94.0％,and there was no significant difference (x2 =3.361,P =0.067).The was no death or other severe complication in both groups.Conclusions The operation time in treatment group was longer than that in control group,and there was no significant difference in clearance and complication rate.Thus it was safe and effctive to perform PCNL in these patients with a history of failed repeated ESWL.

The action mechanism of matrix metalloproteinases-2 (MMP-2) and tissue inhibitor of metalloproteinases-2 (TIMP-2) in the genesis, development and degeneration of haemangioma was investigated by detecting their expression in the tissue of haemangioma in different phases by using the immunohistochemistry. Fifty paraffin-embedded specimens of skin capillary haemangioma were collected, which were documented in the Department of Pathology, Renmin Hospital of Wuhan University from 2000 to 2006. All samples were stained by regular HE method, and proliferative cell nuclear antigen (PCNA) was tested by immunohistochemical S-P method. The samples were classified according to the Mulliken criteria and the expression pattern of PCNA. Immunohistochemical S-P method was applied to detect the expression of MMP-2 and TIMP-2 in proliferative and degenerative phases of cutaneous capillary haemangioma, and in normal skin tissues. In combination with the detection of the expression of factor VIII-related antigen, it was verified that in haemangioma tissues, the cells expressing MMP-2 and TIMP-2 were vascular endothelial cells. The MMP-2 and TIMP-2 expression was quantitatively analyzed by image analysis system (HPIAS-1000), and one-way ANOVA(107) and SNK(q) test were done to analyze average absorbance (A) and positive area rate of immunohistochemically positive particles by using SPSS11.5. The results showed: (1) Among 50 samples of haemangioma, there were 26 proliferative haemangiomas, and 24 degenerative haemangiomas, respectively; (2) The expression of MMP-2 was weak in normal vascular endothelial cells, cytoplasm of connective tissues and extracellular matrix around blood vessels. The expression of MMP-2 in proliferative group was significantly higher than in degenerative group and control group (normal skin) (P<0.05), but there was no statistically significant difference between the latter two groups; (3) TIMP-2 was highly expressed in normal tissues, degenerative vascular endothelial cells, cytoplasm of connective tissues and extracellular matrix around blood vessels. The expression level of TIMP-2 in proliferative phase was significantly lower than in degenerative phase (P<0.05), and the expression of TIMP-2 in proliferative phase was significantly different from that in degenerative phase and normal tissues (P<0.05). It was concluded that in proliferative phase of haemangioma, MMP-2 may promote over-proliferation of endothelial cells of haemangioma, and in degenerative phase, TIMP-2 can inhibit the proliferation of endothelial cells of haemangioma. The two substances play important roles in the genesis, development and degeneration of haemangiomas.

Mesenchymal stem cells(MSCs)have a unique role in immune regulation and focus to T-cells.In the mixed lymphocyte reactions,MSCs inhibit T-cells proliferation by cycle arrest,but they do not increase T-cell apoptosis and the suppress T-cell activation.In addition,MSCs can reduce CD8~+T cells and Thl cells,and simultaneously increase Th2 cells in the reaction system to suppress the inflammatory response,which may play a therapeutic effect on the T-cells mediated autoimmune diseases.

Objective To evaluate the efficacy and advantages of the technique by combined PCNL and retrograde intrarenal surgery (RIRS) in a second stage to treat the complex renal stones in solitary kidney cases.Methods PCNL most with a single 18-24 F tract was performed first and RIRS was carried out at a second stage in solitary kidneys of 21 patients,of which congenital in 14.3％ (3 cases),contralateral nephrectomy in 42.8％ (9 cases),and functional solitry kidneys in 42.8％ (9 cases).Of the 21 patients,the average age was 45 years with 15 males and 6 females.The stones were 8 multiple,6 partial staghorn,and 7 complete staghorn with a mean size of 4.6 (3.8-6.8) cm.Results Of the 21 PCNL cases,a single tract,double,triple tracts were established in 18 (85.7％),2 (9.5％),1 (4.8％) cases,respectively.Mean operation time of PCNL was 95 (45-175) min.After 1 day of PCNL,all case had residual stones with a mean size of 1.9 (1.0-3.5) cm.Two case occurred fever after PCNL and one case presented bleeding resolved by selective renal artery embolization.The mean operation time of RIRS was 72 (35-95) min.Stone-free rate after RIRS was 85.7％ (18/21).The final stone free rate increased to 95.2％ (20/21) after one case received a second-look PCNL and two cases accepted ESWL.Two cases occurred fever and steinstrasses after RIRS resolved by rigid ureteroscopy.At the 3 months follow-up,renal function became stable,improved and worse in 71.4％ (n=15),23.8％ (n=5),and 4.8％ (n=l) of patients.Conclusions PCNL combined with RIRS could be an effective and safe option for complex stones in solitary kidneys with less bleeding,reduced tracts,minor complications and good renal function preservation.

Objective To compare the efficiency between mini-percutaneous nephrolithotomy (MPCNL) and extracorporeal shock wave lithotripsy (ESWL) for monotherapy of renal calculi in infants less than 3 years.Methods Forty-six infants were treated with either SWL (22 infants) or MPCNL monotherapy (24 infants).The mean age was (22.6 ± 8.7) months vs (23.5 ± 6.6) months and the stone size was (21.4 ± 3.5) mm vs (21.7 ± 1.7) mm,and there were no significant difference.Results For MPCNL,mean operating time was (76.2 ± 23.4) min and mean hospital stay was (14.13 ± 5.8) d.The stone-free rates were 84.0％ (21/25) after first session and 96.0％ (24/25) after second-look procedure.Postoperative fever happened in 4 (16.0％) cases.Hemoglobin drop was (8.5 ± 4.4) g/L and no one needed blood transfusion.For ESWL,the stone-free rate were 31.8％ (7/22) after first session and 86.3％ (19/22) after second session for 11 infants (50.0％).Mean hospital stay was (6.6 ± 2.3) d and 10 cases (45.5％)had complications.Hemoglobin drop was (10.6 ± 12.7) g/L.MPCNL was lower than ESWL in complications rate and re-treatment rate,and the stone-free rate was higher,but the hospital stay and operation time was longer (P ＜ 0.05).GFR revealed improve or stable after operation in both groups.Conclusions For a higher success rate,lower complication rate and re-treatment rate,MPCNL was an effective option for the management of relatively larger stones in children (even in infants).

Objective To investigate the treatment of urinary tract obstruction after kidney transplantation, and to introduce the novel ‘antegrade percutaneous urinary tract throughout guidance technique’ with guide wire in selected patients. Methods 43 cases of renal transplantation patients due to urinary tract obstruction (ureteral stenosis and hydronephrosis in 24 cases, urinary calculi with or not ureteral stenosis in 19 cases) received endourological treatment. Retrograde pathway was tried firstly, if failed, antegrade pathway was adopted with‘antegrade percutaneous urinary tract throughout guidance technique’, 18 Fr percutaneous tract was established if necessary, endoscopy was needed in antegrade or combine with retrograde pathway. Results Of the 43 patients, 9 (20.9 %) patients were managed directly through the retrograde ureteroscopy, 28 (65.1 %) patients were managed with anterograde percutaneous technique in 18 Fr tract, 6 (14.0 %) patients were treated with ‘antegrade percutaneous urinary tract throughout guidance technique’. Operation time was (72.0 ± 16.0) (45 ~ 95) minutes. Postoperative stone clearance rate of 89.5 % (17/19). Of 32 cases with ureteral stricture, 6 (6/32, 18.8 %) cases were cured after one time of dilation and JJ stent indwelling for 2 months, 18 (56.3%) cases with stable hydronephrosis after 2-3 times of dilation and JJ stent indwelling, 5 cases (15.6 %) needed long-term repeated stent indwelling for drainage, 3 (9.4%) cases required nephrostomy tube drainage. Conclusion Minimally invasive treatment of urinary tract obstruction after renal transplantation is effective. Antegrade percutaneous urinary tract throughout guidance technique provided a powerful guarantee for retrograde operation and avoided the bleeding risk following percutaneous renal surgery, when combined with flexible ureteroscopy, urinary calculi in patients with kidney transplantation can be effectively managed with little trauma.