Objective To discuss the diagnosis and treatment of renal tuberculosis.Methods A retrospective study was made on 96 cases.Results Frequency (51.8%), urgency (37.2%),odynuria (33.4%),lumbodynia (41.0%),and hematuria(48.1%)were the most common symptoms. The diagnostic accuracy of IVU, B-type ultrasonography, CT and biopsy of mucous membrane of urinary bladder were 69.1%,12.5 %,37.5% and 33.3% respectively. 96 cases were given medicine (INH+RFP+PZA or PIA for 6-8 months).38 cases(39.6%)have been cured, while symptoms of 43 cases (44.8%) have been improved. Operation was performed on 15 cases that were ineffective treated by chemical therapy. Conclusions Urine routine, IVP, cystoscopy+biopsy of mucous membrane of urinary bladder provide important information for the diagnosis of renal tuberculosis. INH, REP and EMB or PIA combination therapy yields satisfactory outcome for early cases.

BACKGROUND:Thoracolumbar fracture often accompanies with the injury of adjacent intervertebral disc. Traditional posterior short-segment fixation does not deal with the injured intervertebral disc, which may be the main reason for kyphosis in patients after surgery.
OBJECTIVE:To investigate the effect of injured intervertebral disc on kyphosis angle in patients with single vertebral thoracolumbar fracture after treated with posterior short-segment fixation alone.
METHODS:From January 2009 to June 2014, 40 cases of thoracolumbar fractures were treated in Jinan Central Hospital. They were folowed-up at preoperation, 2 and 12 months after operation and 6 months after internal fixation removal. Data were obtained from X-ray and MRI scanning. According to the preoperative MRI images, cases were assigned to observation group (17 cases) and control group (23 cases) according to injury and non-injury intervertebral disc. Data of vertebral wedge angle, sagittal plane kyphosis, proximal intervertebral disc angle, sagittal index and degeneration classification of proximal intervertebral disc angle from two different groups were analyzed at each folow-up time point (18-30 months, averagely 23.6 months).
RESULTS AND CONCLUSION:(1) Imaging parameters: sagittal plane kyphosis was significantly severer at 6 months than that at 2 months in both groups (P < 0.05). Sagittal plane kyphosis, proximal intervertebral disc angle and sagittal index were greater in the observation group than in the control group at 12 months after surgery and 6 months after fixator removal (P < 0.05). (2) Degeneration classification of proximal intervertebral disc angle: Pearce degeneration grade of proximal intervertebral disc was significantly higher in the observation group than in the control group at 2 months after surgery and 6 months after internal fixation removal (P < 0.05). (3) Results suggested that kyphosis may appear in the patients with thoracolumbar fracture after a posterior short-segment fixation alone, and the injured disc may lead to more severe kyphosis.

BACKGROUND:Myocardial infarction leads to ischemic changes in the myocardium, triggering the emergence of ventricular remodeling, which is an important cause of death. Myocardial infarction is a common disease in the middle-aged and elderly population, but autologous bone marrow mesenchymal stem cells from these patients exhibit a weak ability of proliferation and differentiation. Therefore, a positive attempt of allogeneic stem cel transplantation is required in order to obtain better therapeutic outcomes. OBJECTIVE:To explore the effect of al ogeneic bone marrow mesenchymal stem cel s on ventricular remodeling after myocardial infarction. METHODS:Bone marrow mesenchymal stem cel s from 10 neonatal rats and 10 adult rats were isolated, cultured and identified. Another 40 rats were randomly assigned into four groups (n=10/group):model group, neonatal rat cel transplantation group, adult rat cel transplantation group, or sham group. Animal models of myocardial infarction were made in rats in the al groups except for the sham group in which the rats were given sham operation. Rats in the two cel transplantation groups were given the corresponding cel transplantation. Four weeks postoperatively, heart function of rats was detected in each group, and cardiac tissues were taken to detect changes in col agen formation and blood vessel density in the infarct area. RESULTS AND CONCLUSION:Four weeks after surgery, rats in the model group showed significant changes in cardiac function indexes as compared with the other groups (P<0.05), while compared with the model group, these cardiac function indexes improved in both two cel transplantation groups, but there was no significant difference between the two cell transplantation groups (P>0.05). Meanwhile, compared with the model group, significantly decreased collagen formation and increased blood vessel density were found in both two cell transplantation groups (P<0.05). Additionally, the vascular density of the infarct area was highest in the sham group (P<0.05). Experimental results show that both neonatal and adult rat bone marrow mesenchymal stem cel transplantation can improve cardiac function of rats, reduce the formation of collagen in the infarct area and delay ventricular remodeling after myocardial infarction.

Objective To compare the curative effects of CT-guided ethanol injection and lauromacrogol injection into the sac cavity in treating ovarian endometriosis cysts. Methods A total of 86 patients with ovarian endometriosis cyst were enrolled in this study. The patients were divided into ethanol group (n=44) and lauromacrogol group (n=42). Under CT guidance, injections of ethanol or lauromacrogol into the sac cavity of ovarian endometriosis cysts were respectively performed for the patients of both groups. The patients were followed up for six months, and the curative effects and the complications were analyzed. Results Six months after the treatment, the cure rates of ethanol group and lauromacrogol group were 95.50%and 92.86%respectively, and no statistically significant difference in cure rate existed between the two groups (P>0.05). The preoperative serum CA125 levels of the ethanol group and lauromacrogol group were (48.42±23.68)μg/L and(49.21±22.83) μg/L respectively, and the post operative ones were (23.56±5.89) μg/L and (25.49± 6.10) μg/L respectively; the differences between the preoperative data and the postoperative data were statistically significant in both groups (P<0.05), although the differences in serum CA125 levels between the two groups were not significant (P>0.05). The incidence of postoperative complications in the lauromacrogol group was obviously lower than that in the ethanol group (P<0.05). The cure time in the ethanol group was shorter than that in the lauromacrogol group, although the difference was not significant after six months. Conclusion For the treatment of ovarian endometriosis cysts, CT-guided lauromacrogol injection into the sac cavity has reliable curative effect. Compared to ethanol injection, injection of lauromacrogol is safer and has fewer adverse reactions. Therefore, this technique should be recommended in clinical practice. Serum CA125 can be used as an indicator for the evaluation of curative effect.

Objective To investigate the value of drug intervention for difficult weaning from mechanical ventilation. Methods A prospective single-blind randomized controlled trial was conducted. 120 patients with difficult weaning from mechanical ventilation encountered in Department of Critical Care Medicine of Peking University Third Hospital from January 2008 to December 2013 were included,and the patients were divided into treatment group and control group according to random number table,with 60 cases in each group. Patients received furosemide therapy in the treatment group 3 days before weaning up to 48 hours after weaning in order to control negative liquid balance. Enema was given the day before weaning to reduce abdominal pressure. On the weaning day,all of the patients received nitroglycerin and beta blocker or cedilanid to prevent or control elevation of blood pressure and heart rate in the process of weaning. All patients in treatment group received anisodamine in small dosage 2 hours before extubation.The patients in control group received conventional treatment without drug intervention. Baseline indexes of two groups were compared,including the heart rate,respiration rate(RR),mean arterial pressure(MAP),pulse blood oxygen saturation(SpO2),blood gas,hemoglobin(HG),albumin(ALB)and creatinine(Cr). The main reasons of difficulty in weaning,sedative and analgesic drug selection,presence of abdominal discomfort before weaning,interval between sputum suction before extubation,liquid balance at the beginning of the investigation and at time of weaning,24 hours and 48 hours after weaning,failures of spontaneous breathing test(SBT),length of mechanical ventilation,length of ICU stay,and total length of mechanical ventilation and total length of ICU stay during hospitalization. Results There was no statistically significant difference in the heart rate,RR,MAP,SpO2,blood gas,HG,ALB,Cr at the beginning of the investigation between the two groups. The main reasons for difficult weaning in both groups of patients were respiratory dysfunction,cardiac insufficiency,and central nervous system dysfunction. The use of propofol combined dexmedetomidine in the treatment group was more frequent than the control group〔16.7%(10/60)vs. 1.7%(1/60),χ2=8.107,P=0.004〕,and there was no statistically significant difference in the use of other combinations of sedative drugs between the two groups. Abdominal discomfort before weaning was milder in treatment group as compared with control group〔10.0%(6/60)vs. 25.0%(15/60),χ2=4.675,P=0.031〕. The interval between sputum suction before extubation in the treatment group was significantly longer than that of the control group〔hours:1(1,2)vs. 1(1,1),Z=-2.209,P= 0.027〕. SBT failure was less frequent in treatment group compared with control group〔times:0(0,1)vs. 1(1,2),Z=-6.561,P=0.000〕. Liquid balance was better in the treatment group than the control group at time of weaning,24 hours and 48 hours after weaning〔at time of weaning:-567.71 (-755.95,-226.41)vs. 1 256.76(472.48,1 796.63),Z=-9.038,P=0.000;24 hours after weaning:-5.03 (-530.28,245.09)vs. 342.28(125.36,613.25),Z=-4.711,P=0.000;48 hours after weaning:115.50(-450.26, 485.00)vs. 330.00(16.25,575.25),Z=-1.932,P=0.053〕. Compared with control group,length of mechanical ventilation〔days:1.0(1.0,2.0)vs. 2.0(2.0,3.0),Z=-6.545,P=0.000〕,ICU stay time〔days:3.0(3.0,4.0) vs. 4.0(4.0,5.0),Z=-6.545,P=0.000〕,and total length of mechanical ventilation〔days:8.0(6.0,12.0)vs. 11.0(8.0,15.0),Z=-4.091,P=0.000〕and total length of ICU stay during hospitalization〔days:12.5(9.2,19.0) vs. 17.0(12.0,29.5),Z=-2.722,P=0.000〕were all significantly shorter in the treatment group. Conclusions Adjuvant drugs therapy is helpful in patients weaning from the mechanical ventilation,and can shorten length of mechanical ventilation and ICU stay time. Propofol,combined dexmedetomidine,is helpful for weaning.

Objective:To investigate the effect of sorafenib on the proliferation of human oral cancer TCA8113 cells and to explore the underlying mechanisms.Methods:Mter treated with sorafenib at 2.5,5,10,20 μg/ml respectively for48 h,TCA8113 cell proliferation was examined by MTT and colony formation assay.Western blotting was employed to examine the p38MAPK expression in the cells.TCA8113 cells were pretreated with 10 μmol/L of SB203580 (a specific inhibitor of p38MAPK) for 30 min,and then by different concentrations of sorafenib for 48 h,cell proliferation was tested by MTT assay.Results:Sorafenib significantly inhibited the proliferation of TCA8113 cells in a concentration dependent fashion.Sorafenib also remarkably promoted the activation of p38MAPK of the cells.SB203580 significantly alleviated soiafenib induced TCA8113 cell viability decrease.Conclusion:Sorafenib can inhibit the proliferation of TCA8113 cells,which may be related to the activation of p38MAPK.

Objective To investigate the factors influencing basic rehabilitation service needs of people with disability at Zhabei District in Shanghai .Methods Primary rehabilitation demands and services of 10 311 disabled persons in Zhabei District were surveyed.Results The screening rate of persons with disability having primary rehabilitation demands was 83.5%. And the gender, age, type of disability, disability level, education, employment might be the factors affecting the primary rehabilitation demands of people with disability.Conclusion The primary rehabilitation service demands vary in deferent types of people with disability. The various services based on the extensive rehabilitation services should be provided to deferent categories of people with disability.

Objective To understand the status of special rehabilitation service demands of people with disability at Zhabei District in Shanghai and to provide the basis for the policy development.Methods Screen rate (SR) was used to indicate the level of demand of rehabilitation service, the data were analyzed with SPSS 13.0 statistical software.Results There were 4 349 persons with disability who demanded the special rehabilitation service; the SR of “on-site rehabilitation service” demands was the highest among the whole persons with disability; the SR of “personalized allotment of supplies and appliances” demands of the intellectual disability and mental disability was lower than the other types; the SR of special rehabilitation service demands of the female, the elderly, the low cultural level, the unemployed and the people with severe disability were relatively higher.Conclusion The form of “on-site rehabilitation services” needs to improve based on the demand of the disabilities; “personalized supplies and appliances” for the intellectual disability and mental disability needs to further develop; the rehabilitation services targeted to the female, the elderly, the low cultural level, the unemployed and the people with severe disability need to improve.

Objective To provide the advice on how to optimize the allocation of resources and make other policy through the analysis factors affecting rehabilitation services needs of people with disability at Zhabei district in Shanghai.Methods The factors affecting rehabilitation services needs such as types of disability, disability levels, education, employment, marital status, age and sex were analyzed with Logistic analysis.Results The factors affecting primary rehabilitation services were types of disability, education, employment situation, marital status and sex. And people with disability had the characters of female, hearing disability, retired returned to more primary rehabilitation services, with OR values being 1.219, 1.544 and 1.533 respectively compared with itself controls. And the high educational disable people' will, returning to primary rehabilitation services, was weaker compared with low educational disable people. The factors affecting special rehabilitation services were types of disability and employment situation. And people with disability had the characters of hearing disability, unemployment returned to more special rehabilitation services, with OR values being 2.380 and 1.310 respectively compared with itself controls.Conclusion The rehabilitation needs are different among different groups people with disability, so the factors affecting rehabilitation services needs such as types of disability, education, employment situation, marital status and sex should be taken into consideration while activating primary rehabilitation services, while the types of disability and employment situation should be taken into more consideration while activating special rehabilitation services.

Objective To evaluate the efficacy of modified arytenoid adduction in the management of patients with unilateral vocal fold paralysis(UVFP).Methods A retrospective review was performed on 22 patients who underwent modified arytenoid adduction for UVFP between February 2001 and December 2007.Pre-,and 3 months postoperative aspiration,perceptual(GRBAS),acoustic data(fundamental frequency,F_0,fundamental frequency perturbation,jitter,amplitude perturbation,shimmer,normalized noise energy,NNE)and aerodynamic(maximal phonatory time,MPT,mean airflow rate,MFR)were analyzed statistically.Results The ratings of postoperative aspiration were significantly decreased than that of the preoperation(P<0.0001).There was a significant decrease in GRBAS scales postoperatively versus preoperatively(P<0.0001).The mean values of voice acoustics parameters (F_0,jitter,shimmer,NNE)were significantly decreased,the maximum phonation time were significantly longer,and the mean airflow rate were significantly decreased after operation than that of the preoperation(P<0.001).Conclusion Modified arytenoid adduction is an effective medialization technique that can restore satisfactory speech and prevent aspiration in patients with UVFP.