Objective To evaluate the therapeutic effect of ureteroscopy with holmium laser on ureteral stricture associated with calculi.Methods The clinical data of 36 cases of ureteral stricture associated with calculi undergoing ureteroscopy with holmium laser treatment were analyzed retrospectively with 26 cases of male patients and 10 cases of female patients.The age was 26-65 years.There were upper and middle ureteral stricture associated with calculi in 8 cases,and lower segment of ureteral stricture associated with calculi in 28 cases.All the patients were treated with ureteroscopy with holmium laser.All cases were followed up for 6-12 months.In the follow-up of 36 cases B ultrasound and urinary tract flat piece or intravenous urinary tract imaging were performed to evaluate the therapeutic effect.Results Thirty-six patients underwent ureteroscopy with holmium laser successfully.No conversion to open surgery occurred.Mean operating time was 30 (20-45) min.Mean hospital stay postoperatively was 3-5 d.Postoperative 8 cases with low thermal,alleviated by the anti-infection treatment,no ureteral avulsion,leakage and severe complications such as hemorrhage.Postoperative follow-up,32 cases (89％,32/36) were cured and 4 cases (11％,4/36) were improved.Conclusion Ureteroscopy with holmium laser in treatment of ureteral stricture associated with calculi is a simple and effective minimally invasive method.

Objective To explore the efficacy of four-step method for transurethral enucleation of the prostate . Methods A retrospective analysis was conducted on 120 cases of benign prostate hyperplasia ( BPH) treated with four-step method ( traction, enucleation, resection, and repair ) for transurethral plasmakinetic resection of the prostate in our hospital from January 2012 to February 2014. Results The average operation time was (91.4 ±35.3) min.The intraoperative blood loss was 78.8 ±34.1 ml. The resection of the prostate tissue weight was (32.1 ±15.7) g.The postoperative bladder infusion time was (1.5 ±0.5) days.The postoperative indwelling catheter time was 3.5 ±0.8 days.The postoperative hospital stay was (5.5 ±0.5) days.No death, blood transfusion, or TURS happened.Follow-up reviews at 3 months after surgery found postoperative international prostatic symptom score (IPSS) was significantly less than the preoperative level [4.5 ±2.2 vs.24.5 ±5.1, t=39.445, P=0.000], postoperative Qmax was significantly higher than preoperative level [(21.5 ±10.5) ml/s vs.(6.0 ±1.9) ml/s, t =15.912, P =0.000], and postoperative residual urine was significantly less than the preoperative level [(12.0 ±2.0) ml vs.(145.0 ±33.0) ml;t=44.069, P =0.000].No retrograde ejaculation, sexual dysfunction, or dysuria happened. Conclusion The four-step method for transurethral enucleation of the prostate is radical , safe, and simple.

Objective To investigate the risk factors for postoperative delirium in patients undergoing spine operation under total intravenous anesthesia. Methods Two hundred patients undergoing elective spine operation were included in this study. Patients' perioperative informations were recorded. The diagnosis of delirium was based on Confusion Assessment Method (CAM). The patients were divided into 2 groups according to the occurrence of delirium within 3 days after operation: postoperative delirium group and no postoperative delirium group. Multivariate logistic regression was used to analyze the risk factors for postoperative delirium. Results Postoperative delirium developed in 39 patients during the first three postoperative days. The incidence of postoperative delirium was 19.5%. The logistic stepwise regression analysis indicated that the risk factors for delirium included age, intraoperative blood loss and alcohol abuse. Conclusion Age, large amount of intraoperative blood loss and alcohol abuse are risk factors for postoperative delirium in patients undergoing spine operation under total intravenous anesthesia.

Objective To establish a method for simultaneously measuring L-citrulline and L-arginine concentration in plasma using reversed-phase high performance liquid chromatography (RP-HPLC)with ultraviolet detection,and the novel method is applied to the patients with digestive system tumor.Methods Plasma samples were deproteinized by trichloroacetic acid with heating method.Phenylisothiocyanate (PITC)was used as derivatization reagent and a gradient elution was adopted. The feasibility verification of method was carried out by detecting plasma L-citrulline and L-arginine acid concentration in 21 cases of advanced digestive tract malignant tumor patients,21 cases of non malignant tumor patients and 39 cases of healthy people.Results The linearity for L-citrulline and L-arginine ranged from 0 to at least 1 000 μmol/L.r=0.999 95 for both. The lower limits of quantification for L-citrulline and L-arginine were 0.240 μmol/L and 0.448 μmol/L respectively.The in-traday and interday coefficients of variation (CVs)were less than 3.4% and 7.2%,respectively.The average recovery rate was from 95.2% to 104.1%.The ratio of plasma L-citrulline/L-arginine in patients with digestive cancar was significantly higher than that in the healthy control group,t-test,P =0.009.The sensitivity and specificity of plasma L-citrulline/L-argi-nine ratio in the malignant tumor of digestive system were 81% and 71.4% respectively.Conclusion This method can pro-vide a reliable and efficient method for the clinical determination of the L-citrulline and L-arginine concentration in plasma. The ratio of plasma citrulline/arginine increased obviously in patients with digestive cancer,suggesting that this ratio is a more sensitive index than single concentration of L-citrulline or L-arginine when evaluating patients with digestive tumor.

Objective To evaluate the MRI features of neuropsychiatric abnormalities in systemic lupus erythematosus(NPSLE).Methods Brain MRI images of 21 cases with NPSLE confirmed by clinic were analyzed retrospectively.ADC values of the lesions and normal brain tissue were measured.Results Brain abnormal MRI findings in 20/21 cases were found(95%)including:(1)High signal intensity on DWI in 14 cases,11 were diffuse lesions,3 were focal lesions,4 of 14 combined with brain atrophy.The lesions mostly localized in white matter.The ADC values of the lesions in gray matter were decreased(t=2.513,P=0.019),while the ADC values of the lesions in white matter were increased(t=2.877,P=0.007).(2)2 cases only showed brain atrophy.(3)Leukoaraiosis presented in 2 cases.(4)Encephalomalacie presented in 2 cases,1 accompanied with brain atrophy.(5)No enhancement(3/5)and little patchy enhancement(2/5)were observed at contrast MRI study.Conclusion MRI plays an important role in displaying cerebral lesions and the location of it,progression and succession of NPSLE.

To investigate the effects of unpredictable chronic mild stress and Xiaotan Jieyu Recipe (XTJYR), a compound traditional Chinese herbal medicine, on the behaviors of Walker 256 tumor-bearing rats and to explore the mechanism.

To study action mechanism and time of administration of indomethacin in SMAO shock rabbits. Method:Thirty-two SMAO shock rabbits were randomly divided into four groups: control group A,indomethacin 5mg/kg I.V. at the occlusion of superior mesenteric artery (group B), indomethacin 5mg/kg L V. immediately after clamp being removed(group C) and the same dose 30min after clamp being removed(group D). Survival rate,hemodynamics, plasma calcium, myocardial calcium, TXB_2 and 6-keto-PGF_1. levels were observed in 4h shock period. Myocardial apecmen were examined with electronic microscope. Result: After indomethacin I.V,the survival rate was higher and bemodynamie better than those of controll. The plasma calcium level remained stable in indomethacin groups. Myocardial calcium content of group B and C was lower than that of group D and A. The TXB_2 and 6-ketoPGF_1. contents were similar in all groups. Under electronic microscope, the damages were slightest in group C and most serious in group D and A among the four groups. Conclusion:Indomethacin has a beneficial effect on the SMAO shock rabbits ,the mechanism of which can be related to improving myocardium contractivity as well as to blocking calcium channel,rather than the action through prostaglandins. The time of administration should be early as possible after shock.

Purpose Protein is the main influencing factors for diffusion weighted imaging (DWI) signals and apparent diffusion coefficient (ADC), it results in hyperintensity on DWI and low ADC, but not fully matched in clinic. This paper aims to investigate the effect of protein type and concentration on the signal intensity (SI) and ADC of DWI. Materials and Methods Different concentrations of albumin, globulin solution and the mixed solution were created in vitro. DWI was performed on GE 1.5T superconducting nuclear MRI system. Results ① There was a linear negative correlation between the ADC value and the concentrations of protein solution (at 37℃, ra= - 0.849, Pa<0.05; rg= - 0.843, Pg<0.05; at 40℃, ra= - 0.894, Pa<0.05; rg= - 0.819, Pg<0.05);there was a linear positive correlation between the SI of DWI and the concentrations of the albumin solution (at 37℃, r=0.753, P<0.05; at 40℃, r=0.845, P<0.05). There was no correlation between the SI of DWI and the concentrations of the globulin solution (at 37℃, r= - 0.222, P>0.05; at 40℃ , r= - 0.270, P>0.05). ② SI of the albumin solution was significantly higher than the globulin solution at the same concentration and temperature (t=3.96, P<0.001); the ADC values were not statistically different between the albumin and the globulin solution (t=0.61, P>0.05). Conclusion The nature of the cystic fluid can be understood preliminarily through quantitative analysis of the cystic fluid DWI and ADC values, so as to provide theoretical basis for the qualitative diagnosis of cystic lesions in vivo.

Objective To evaluate the activation of premotor area (PMA) in verb generation task, and to discuss the possible function of PMA in language expression. Methods Block-designed fMRI with verb generation task was performed on 23 subjects with GE 1.5T MR Scanner. During the test, the subjects were asked to generate a verb based on a given noun word. The white + appeared on the center of the black screen was used as control. The fMRI data were processed with SPM 2. Group analysis was performed with single sample t-test. Average mapping was obtained and overlapped onto standard MNI template. Activation of the PMA was analyzed. Results The fMRI data of eleven subjects were selected for group analysis after head motion effect was ruled out. Average mapping showed activation in the Broca's area, posterior part of the right inferior frontal gyrus, bilateral PMA and supplemental areas (SMA), left posterior parietal cortex, right thalamus, left basal ganglions, right cerebellum, and posterior part of the right temporal lobe. The area with the greatest activated intensity in the brain was the left PMA. Conclusion PMC is important in verb generation and may be responsible for voice processing, motor imagery, word extracting as well as advanced regulation of information.