Objective To investigate the effect of percutaneous nephrostolithotomy (PCNL) on patients with different body mass index.Methods The clinical data of 84 patients with kidney stones who were treated with PCNL surgical treatment were enrolled in this study,and they were divided into different groups according to body mass index (BMI),including 16 cases of BMI ＜ 18.5 kg/m2(low BMI group),36 cases of 18.5 kg/m2≤BMI ＜24.0 kg/m2 (normal BMI group),32 cases of BMI≥24.0 kg/m2 (high BMI group),and the curative effect was evaluated.Results Three groups' operation time,multichannel gravel rate,stones clearance,length of hospital stay,blood transfusion rate had no significant difference (P ＞0.05),the incidence of complications in low BMI group [31.25％ (5/16)] was obviously higher than that in normal BMI group [5.56％(2/36)] and high BMI group [9.38％(3/32)],there was significant difference (P ＜ 0.05).Conclusion BMI of PCNL surgery influences on certain effect,low BMI will affect patients with surgery tolerance,cause complications increase,obesity wifl increase the difficulty of the operation.

Henoch-Sch(o)nlein purpura(HSP) is one of the most common vasculitides in children with many manifestations including skin purpura,arthritis,abdominal pain and renal involvement.The renal involvement(Henoch-Sch(o)nlein purpura nephritis,HSPN) is the principal cause of morbidity and major risk factor for prognosis in HSP.The paper reviewed the updated treatment strategy for HSPN.Accordingly,steroids,cyclophosphamide,mycophenolate mofetil,mizoribine,cyclosporine,triptolide,angiotensin converting enzyme inhibitors (ACEI) / angiotensin receptor blockers(ARB),plasma apheresis and tonsillectomy are possible indicator for the further therapy of HSPN.Furthermore,prospective randomized controlled treatment studies on children with severe HSPN would be needed.

Objective:To analyze the efficiency and influencing factors of Chinese medical and health resources. Methods:Based on the panel data of 31 mainland provinces from 2003 to 2011 in China, use the two-stage Malmquist-Tobit model to analyze. Results:The efficiency of Chinese medical and health resources shows an increasing trend, which is dual driven by improvement of technical efficiency and technological progress. The efficiency varies among different areas, and the descending order of efficiency value is east, west and center. The level of economic development, population density, the proportion of profitable hospitals, the levels of urbanization and education can promote Chinese medical and health efficiency with different extent. Conclusion:To improve the efficiency of Chinese medical and health resources, it needs to promote economic development level, allocating health resources reasonably, and advancing urbanization and education levels orderly.

Objective To investigate the relationship between plasma homocysteine levels and lipids in aged patients with acute cerebral infarction(ACI).Methods Fourty-eight cases(observation group),who had been inpatients with cerebral infarction during May 2006 to May 2007,thirty healthy people(control group)contrasted and analyzed.Results The mean plasma homocysteine level and cholesterol(TC),triglycerides(TG),low density lipoprotein(LDL)of aged patients with acute cereral infarction were significantly,higher than those of the control group,but high density lipoprotein(HDL)was lower(P＜0.01).No significant correlation between Hcy level and TC,TG,HDL-C,LDL-C level in serum.Conclusion Plasma homocysteine lexrel and lipids all siginificantly increased in aged patients with acute cereral infarction,and homocysteinemia is not related with lipids,but is an independent risk factor for cerebral infarction.

Objective To investigate the changes of CRP in diagnosis of the acute exacerbation of COPD and its significance.Method CRP and WBC were measured both when the patients just before and after the treatment with effective antibiotics to compare their change.Results The positive rate of CRP is 85.40%.and the difference Was obvious(P＜0.01).At the same time,the CRP's difference between before and after the use of antibiotics was also obvious(P＜0.01).Conclusion CRP is a sensitive and specific index to the acute exacerbation of COPD,and is helpful to discover this acute disease early as well as a good guide to estimate the serious of pneumonia sand to respond the efficacy of antibiotics.

Objective To analyze the surface-electromyography (sEMG) signals of patients with lumbar disc herniation before and after core stability exercise therapy.Methods Thirty-eight cases diagnosed with lumbar disc herniation were randomly divided into a control group (n =19) and an experimental group (n =19) using a random number table.The former was given two weeks' conventional traction physiotherapy,while the latter was given another two weeks of core stability exercise of lumbar and dorsal muscles after the conventional treatment.All of the patients were assessed using a visual analogue scale (VAS) and each was given a Japanese orthopedic association (JOA) score,sEMGs were recorded before and after 4 weeks of treatment.Results After treatment,average VAS scores[(1.11 ±0.74) and (0.95 ±0.62) respectively] and JOA scores[(21.05 ±3.08) and (23.47 ±2.04) respectively] in the control and experimental group both had improved significantly compared to that before treatment (P ＜ 0.01).The average JOA score in the experimental group was significantly higher than that in the control group (P ＜ 0.01) after the treatment.After treatment of 4 weeks,erector spinae median frequency (MF) values(84.84 ± 12.78) and erector spinae average amplitude (AEMG) value (108.94 ± 24.70) in the experimental group were significantly improved(P ＜ 0.05),so did the multifidus muscles MF value(95.63 ± 16.35) of affected side.There was no significant difference between the affected and unaffected side (P ＞ 0.05).Moreover,the MF values of the experimental group were significantly higher than that the control group (P ＜ 0.05) after treatment.There was significant difference between the average AEMG values of erector spinae of affected side before and after treatment (P ＜ 0.05).Conclusions Core stability exercise can further alleviate the symptoms of lumbar disc herniation after conventional traction physiotherapy.It improves the fatigue tolerance of the back's core muscles and relieves functional imbalance of the multifidus muscles.However,the time of therapy should be lengthened to study its effect on strengthening lumbar muscles.

Most military hospitals lack sufficient support from medical universities and therefore are confronted with a bottle -neck in graduate education. Based on the real conditions of military hospitals, this article introduces the practice and achievement in graduate education in our hospital by expanding the enrollment access, promoting the admission publicity, stressing the disciplinary balance, improving the supervisors′abilities, and enhancing teaching quality. With considerations on the four aspects of supporting strength of scientific research, stratified design of disciplines, construction of teaching quality, and innovation of training modes, it pro-vides some experience in graduate education with a view of giving reference for other military hospitals.

Glioma is the most common type among the malignant brain tumors ,and it accounts for almost half of central nervous system tumors .In addition,one of characters of glioma is easy to relapse .The key to pro-long the patients′survival time is how to choose appropriate treatments after surgical resection .With the develop-ment of medical technology ,precise approaches to treat these tumors are applied ,including radioactive particle im-plantation in brachytherapy and gene therapy .In this paper ,we discuss the status of the two therapies respective-ly,analyzing their superiority and inferiority ,and explore the prospects for the development of combined therapy in order to improve the prognosis of glioma better .

Background and purpose:The majority of patients with gastric cancer are in advanced stage with either extensive invasion of tumor into the adjacent organs,lymph nodes or distant metastases when diagnosed.As a new anticancer drug of Taxanes,docetaxel has shown considerable promise in advanced gastric cancer through clinical study in these years.We conducted a clinical trial to compare the response and toxic reaction of weekly and 3-weeks'docetaxel /cisplatin/5-Fu treatment in advanced gastric cancer.Methods:80 patients were deviede into two groups.Ggroup A:Docetaxel 25 mg/m2 iv d 1,8,15,cisplatin 25 mg/m2 iv d 1-3,5-FU 500 mg/m2 iv d 1-5 q4w.Group B:Docetaxel 75 mg/m2 iv d 1,cisplatin 25 mg/m2 iv d 1-3,5-FU 500 mg/m2 iv d 1-5 q3w;The clinical responses were assessed after two cycles.Toxicity was assessed every cycle.Results:There was 1 CR in 40 cases,16 with PR,14 with SD in group A;there was 1 CR in 40 cases,17 with PR,14 with SD in group B.The overall response rates were 42.4% and 45.0% in group A and B,respectively.Grade Ⅲ/Ⅳ neatropenia were 32.5% and 77.5% in group A and B.The major non-hematologic toxicity was weakness.Grade Ⅲ/Ⅳ weakness were 22.5% and 42.5% in group A and B.Conclusions:The response rates were similar between groups A and B.The occurrence of hematological toxicity and weakness were lower in weekly treatment group.

Expression of gamma interferon (IFN-?)-like substance in adrenal pheochromocytoma was investigated with immunohistochemical technique. In 15 out of the 16 cases of adrenal pheochromocytoma positive IFN-@-like immunoreactive substance was detected in the cytoplasm of the tumor cells, whereas in adrenal tissues adjacent to adrenal tumors in 26 cases (pheochromocytoma 12, adrenal corti-col tumors 12, others 2) only two with pheochromocytoma showed positive IFN-?-like immunoreactive substance in the cytoplasm of zona reticularis cells. The results suggest that IFN-? may be a kind of antigen associated with differentiation of cell.