Objective To evaluate the lithotripsy efficiency of a newly calculi anchoring forceps in vitro.Methods Compared the efficiency with or without calculi anchoring forceps in the circumstances imitate percutaneous nephrolithotomy.There are 24 calculus for each group in random selection.The lithotripsy was completed by one people.the time,energy and retained calculus were compared by T-test.Results When the energy expenditure reaches 2 kJ,the operating time was (4.7 ± 0.9) min in group 1 and (4.2 ± 0.9) min in group 2 (P ＞ 0.05).The removal calculus showed no differences between the two groups (P ＞ 0.05).After the energy used over 2 k J,the operating time of the remained calculus were (4.5 ± 1.2) min in group 1 and (9.2 ± 2.6) min in group 2 respectively (P ＜ 0.05),and the energy consumed (1.7 ± 0.5) kJ and (2.6 ± 0.4) kJ respectively (P ＜ 0.05).Total energy consumed in group 1 and group2 was (3.7±0.5) kJ and (4.6±0.5) kJ (P＜0.05).And the cumulate time used was (9.2±1.7) min and (13.4 ±2.7) min in group 1 and group 2 respectively (P ＜0.05).Conclusions The calculi anchoring forceps can improve the efficiency of lithotripsy in vitro.The improvement was significant for the calculus whose diameter was smaller than lcm.

Objective To detect the clinical characters and the classification of the congenital retinal vascular anomalies. Methods Nine cases (12 eyes) of congenital retinal vascular anomalies were exa- mined by ocular examination and fundus fluorescein angiography (FFA), in which 3 cases (4 eyes) were examined by indocyanine green angiography (ICGA) simultaneously. Results The congenital retinal vascular anomalies were located at the posterior pole in 8 cases (10 eyes), and extended to peripheral retina in 1 case (2 eyes). Congenital retinal vascular anomalies were classified as follows: congenital retinal macrovessel (1 case, 1 eye); congenital retinal arteriolar tortuosity (2 cases, 3 eyes); inherited retinal venous beading (1 case, 2 eyes); and congenital prepapillary vascular loops (5 cases, 6 eyes). Four cases (5 eyes) were associated with spontaneous hemorrhage induced by physical exertion (Valsalva maneuver). Conclusion Most of the congenital retinal anomalies are located at the posterior pole, involving arteries and veins, and can be associated with spontaneous hemorrhage induced by Valsalva maneuver.

Objective To explore and analyze the optimal timing of surgery and clinical efficacy of minimally invasive drilling drainage in the treatment of hypertensive cerebral hemorrhage .Methods 150 patients with hyperten-sive cerebral hemorrhage ,according to a random number table method ,were randomly divided into the three groups , 50 patients in each group.Patients in group A received minimally invasive drainage drilling within 6h after the onset of disease,patients in group B received minimally invasive surgery 6-24h after the onset,patients in group C were given elective minimally invasive surgery 24-72h after the onset.Another 50 patients with hypertensive cerebral hemorrhage who received craniotomy surgery over the same period ,were selected as the control group .The clinical effects were observed and compared in four groups .Results The total effective rate of group B was 88%,which was significantly higher than the other three groups (χ2 =4.00,6.38,12.70,all P<0.05).The early cure rate of the observation group was 40%,which was significantly higher than the control group (χ2 =8.57,P<0.05).After treatment,the number of cases whose activities of daily living degree recovered to grade I in the observation group was significantly higher than the other three groups (χ2 =4.11,5.00,8.32,all P<0.05).The excellent rate of group B was 88%(44/50),which was significantly higher than the other three groups (χ2 =6.83,5.83,15.43,all P<0.05).After treatment,the incidence rate of complications in group B was significantly lower than the other three groups ,the inci-dence rate of complications in the control group was the highest (χ2 =5.32,8.58,32.97,all P<0.05).Conclusion Minimally invasive drilling drainage in the treatment of hypertension cerebral hemorrhage can obtain significant effect , the optimal timing of surgery is 6-24h,minimally invasive treatment has advantages of less invasive ,faster recovery,fe-wer complications ,and less costs ,which is worthy of widely used in clinical practice .

Objective To find a safe and effective management for upper ureteral calculi after failure of extracorporeal shock wave lithotripsy(ESWL).Methods Under a F20.8 endoscope(EMS Ⅲ,Switzerland),percutaneous nephrolithotripsy was performed with pneumatic and ultrasonic power on 43 patients with upper ureteral calculi after having been treated by ESWL for 1 or 2 times.Results The procedure was completed in 42 of the patients with a mean operation time of 60 min(35 to 75 min),mean time for calculi removal of 12 min(5 to 20 min),and mean blood loss of 50 ml(20 to 150 ml).One patient was converted to open surgery because of failure of percutaneous renal puncture.One patient developed haematoma after the procedure and then was cured by conservative therapy without receiving blood transfusion.One patient had fever due to infection and was cured after antibiotic therapy.42 patients were followed up for 2 to 18 months(mean,6.4 months);none of them had massive hemorrhage,infection,hydronephrosis,or recurrence of the calculi during the period.Conclusions Percutaneous nephrolithotripsy with pneumatic and ultrasonic power is safe,minimally invasive,and effective for upper ureteral calculi after failure of ESWL.

or =70years of age) with advanced non-small-cell lung cancer. Single agent vinorelbine should be selective chemotherapy in elderly patients with advanced non-small-cell lung cancer.

Objective To investigate the characteristics of the ocular fundus of Chinese patients with polypoidal choroidal vasculopathy (PCV). Methods The photographs of ocular fundus of 42 Chinese patients (48 eyes) with PCV diagnosed by fundus photography, fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) were analyzed. Results In 48 eyes with PCV, 35 (72.9%) had subretinal hemorrhage, 13 (27.1%) had yellow-white exudation, 7 (14.6%) had subretinal tuberculum-like focus in tangerine peel at the posterior pole, and 26 (54.2%) had hemorrhagic or serous pigment epithelium detachment (PED). Thirty-six eyes (75.0%) had polypoidal dilations with branching vascular network, and the other 12 (25.0%) had scattered polypoidal dilations without identifiable continuous branching vascular network. The location for these lesions were at the macular region in 30 eyes (62 5%), arcade region in 6 (12.5%), peripapillary region in 3 (6.3%), and combination region in 9 (18.8%). Conclusions Most of the lesions in Chinese patients with PCV locate at the macular region and temporal vascular arcade. Most eyes are characterized by branching choroidal vessels with polyplike terminal aneurysmal dilations in ICGA.

Objective To observe the changes of disease course and the prognosis of visual acuity of Chinese patients with polypoidal choroidal vasculopathy (PCV). Methods Visual acuity and fundus photochromes of 20 eyes of 15 consecutive patients with PCV were followed up with a mean of 19.1 months (range from 2 to 64 months), in which the fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) of 14 eyes of 10 patients were followed up with a mean of 21.0 (range from 3 to 53) months. Results Among the 20 eyes, the visual acuity was more than 0.3 in 5 eyes (25.0%), between 0.1 and 0.2 in 6 (30 0%) and less than 0.1 in 9 (45.0%). During the follow-up, the visual acuity was improved in 2 (10.0%), stable in 10 (50.0%) and regressed in 8 (40.0%). Only 1 eye (5.0%) developed to macula scar. The result of ICGA revealed the polypoidal lesions that were unchanged in 4 eyes(28.6%), regressed in 2 (14.3%), grew in 6 (42.7%), repeatedly grew and spontaneously regressed in 6 (42.7%). Conclusions There is a large variation in the visual prognosis in Chinese patients with PCV. The polypoidal lesions can repeatedly grow and spontaneously regress in the natural course.

Objective To explore the clinical effect of Habib 4X bipolar radiofrequency ablation assisted laparoscopic partial nephrectomy without blockage of renal artery for treatment of renal cell carcinoma (RCC).MethodsBetween October 2010 and June 2011, 14 patients with exophytic RCC (T1N0M0) were treated with Laparoscopic Partial Nephrectomy with (LRA) or without (LPN) Habib 4X Bipolar Radiofrequency ablation assisted.The LRA group included 6 patients,and the maximum tumor diameter was 2.1 - 3.5 cm (mean,3.1 cm).The LPN group included 8 patients,and the maximum tumor diameter was 2.0 -3.7 cm (mean,3.0 cm).The operative time,average intra-operative blood loss,postoperative hospital stay and incidence of postoperative complications were recorded.Changes of hemoglobin (Hb),serum creatinine (SCr) and ipsilateral glomerular filtration rate (GFR) before and after operation were analyzed and compared. Results The 14 surgical procedures were successful without conversion to open operation.In LRA group,renal artery blocking was unnecessary,the Hb,SCr and GFR before and after operation were (127 ± 19) g/L vs.(124 ± 19) g/L、(96 ±39) μmol/L vs.(92 ±29) μmol/L and (42 ± 12) ml/min vs.(40 ± 13) ml/min,respectively,and the difference was not significant (P ＞0.05).In LPN group,the renal artery blocking time was 20-52 min (mean,32 min),the Hb,SCr and GFR before and after operations were (130±17) g/L vs.(112±15) g/L,(92 ±31) μ mol/L vs.(110±28)μmol/L and (43 ± 14) ml/min vs.(30 ± 11 ) ml/min respectively,and the difference was significant (P ＜0.05 ).The operative time was ( 86 ± 20) min and ( 112 ± 43 ) min,the estimated blood loss was (94 ± 18)ml and (256 ± 58) ml,and the postoperative hospital stay was (5.0 ± 0.8) d and (7.8 ± 1.2 ) d,respectively.The difference between the two groups was significant (P ＜ O.05).Complications such as bleeding,gross hematuria,and leakage of urine were noted in LRA group. Conclusions Habib 4X Bipolar Radiofrequency ablation assisted LPN without blockage of renal artery is a safe and effective intervention with a relatively low incidence of complications.And it is superior to LPN in operative time,intraoperative blood loss and postoperative recovery.

Hepatocellular carcinoma(HCC)is one of the most common malignancies worldwide.Due to the difficulty of diagnosis in the early stage of HCC, most HCCs are diagnosed in intermediate-advanced stage.Moreover, the high invasion, metastasis and recurrence rate of HCC result in the high mortality of HCC.MicroRNAs(miRNAs) are a class of highly conserved, endogenous, small, non-coding ,single stranded RNA with the length of 22 nucleotides.There are plentiful of miRNAs in liver.MiRNAs not only can regulate the growth and development of liver, but also are closely related to the formation of HCC.In the process of HCC formation, miRNAs could function as oncogenes or tumor suppressor genes to regulate multiple biological processes related to HCC, including cell differentiation,proliferation,tumorigenesis,angiogenesis,invasion,and metastasis.With the intensive study of molecular mechanisms of miRNAs in the process of HCC formation, increasingly studies have revealed that miRNAs could become sensitive biomarkers and effective therapeutic targets for HCC.

Background and purpose:Axillary lymph node metastasis of breast cancer has an important significance in prognosis and treatment of breast cancer. This study was to investigate the correlation between axillary lymph node metastasis and ultrasonographic characteristics of axillary lymph node combined with immunohistochemistry in breast cancer patients.Methods:A total number of 366 breast cancer patients were selected in this study. Seven hundred and twenty-eight axillary lymph nodes were collected. With ultrasonography, the maximum cortex thickness, the ratio of the height to the length, the ratio of the cortex to the medulla and blood lfow of axillary lymph nodes were observed, in order to study the correlation between these indicators and axillary lymph node metastasis combined with the postoperative immunohistochemical results.Results:According to univariate analysis, axillary lymph node maximum cortex thickness, the ratio of the height to the length, characteristics of blood flow and the positive expression rate of p53 were related to axillary lymph node metastasis (P<0.05). Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve showed that axillary lymph node maximum cortex thickness was the best indicator to determine axillary lymph node metastasis. The positive expression rate of p53 in patients with maximum cortex thickness >3 mm (42.78%) of axillary lymph node was signiifcantly higher than that in patients with maximum cortex thickness≤3 mm (25.82%) (P<0.01).Conclusion:Ultrasonographic characteristics of axillary lymph node and immunohistochemistry method are closely correlated with axillary lymph node metastasis in patients with breast cancer, which is important in diagnostic and treatment in clinic.