AIM: To access the difference of the efficacy between terbinafine and itraconazole in the treatment of dermatophyte onychomycosis. METHODS: The Medline, Science Direct On Site (SDOS), and Springer database were searched in detail on the data of the mycological cure rates of the two antifungal agents for treatment of dermaphyte onychomycosis occourring in patients aged from 18 a to 60 a with the published double blind randomized clinical trials and then pooled. The odds ratio (OR) and its 95 % confidence interval (CI) were calculated. RESULTS: Six treatises of double blind randomized clinical trials were selected for this analysis according to the screening criteria. The mycological cure rate of continuous terbinafine 250 mg per day was higher than that of either therapeutic effect of itraconazole pulse 400 mg per day (OR = 5.01, 95 % CI (3.42 - 7.33)) or continuous itraconazole 200 mg per day (OR = 2.58, 95 % CI (1.91 - 3.49)) . CONCLUSION: Terbinafine is more effective than itraconazole in the treatment of dermatophyte onychomycosis.

ObjectiveTo investigate the possible mechanism of common bile duct ligation (CBDL) preconditioning alleviating subsequent renal ischemia/reperfusion injury.MethodsC57BL/6 mice was divided into 3 groups.In CBDL group,the common bile duct was transiently ligated at day 0 (d0),and recanalized after two days (d2) and two days later (d4). Unilateral renal ischemia/reperfusion injury was performed.Sham operation was done in Sham group at d0,then unilateral renal I/R was performed at d4. Control group was set as normal contrast. Total bilirubin (TB) was monitored.24 h after I/R (d5),we collected blood to detect creatinine (Cr),and the expression of heat-shock protein 27 (HSP-27) and endothelial nitric oxide synthase (eNOS) was monitored by Western blotting at d0,d2,d4,d5 four time points.ResultsAfter CBDL,TB fell to normal at d4.Cr levels in CBDL group were lower than in Sham group (P＜0.05),the protein expression levels of HSP-27 and eNOS were increased from d2 and sustained to d5 in CBDL group as compared with Sham group ( P ＜ 0.05 ).Conclusion CBDL preconditioning can obviously alleviate renal ischemia/reoerfusion injury in mice probably by up-regulating the expression of HSP-27 and eNOS.

Objective To analyze of pathogenic bacteria of pulmonary infection in patients with terminal cancer.Methods The clinical data were retrospectively analyzed including the general cultivation of pathogenic bac-teria in sputum and the results of drug sensitivity of hospitalization of patients with lung cancer from July 2013 to May 2014.Results 132 strains of pathogenic bacteria were cultured from120 cases of patients with pulmonary infection, including gram-negative bacilli accounted for the vast majority of 27.3%,accounted for 59.8% of Gram-positive coc-ci,Ranked in the top 5 pathogenic bacteria were Streptococcus pneumoniae,Staphylococcus aureus,Candida albicans, Klebsiella pneumoniae,there arevarying degrees of resistance to commonly used antibiotics in bacteria.Conclusion Selecting and using the antimicrobial agents according to the results of pathogen detection in patients,could improve the effectiveness of antibiotic treatment and reduce bacterial resistance.

Objective To study the influences of the length of sexual abstinence on sperm parameters and seminal plasma biochemical indicator.Methods Sperm concentration and motility were detected by computer assisted sperm analysis(CASA).The sperm morphology was analyzed using semiautomatic sperm morphology analyzer.Seminal plasma fructose concentration,neutral a-glycosidase,zinc,and acid phosphates concentration were measured by spectrophotometer.Improved DTNB was conducted for detection of the content of seminal plasma novain.Prostatespecific antigen(PSA)was measured with commercial kit.Three groups were defined according to the days of sexual abstinence:G1(1-3 days),G2(4-5 days)and G3(＞6 days).Results Sperm concentration of G2 was significantly higher than that of G1(P＜0.01),and of G3 than that of G1 and G2(P＜0.01).Sperm motility and per centage of morphologically normal sperm of G3 were significantly lower than that of G1(P＜0.01).Seminal plasma fructose concentration of G3 was significantly lower than that of G1 and G2(P＜0.01,P＜0.05).Seminal plasma neutral a-glycosidase,carnutine,zinc concentration of G3 was significantly higher than that of G1 and G2(P＜0.01,P＜0.05).Conclusion The length of sexual abstinence can influence sperm parameters and seminal plasma biochemical indicator.

Objective To evaluate the diagnosis and treatment of urinary tract endometriosis.Methods Retrospective review of 10 female cases of urinary tract endometriosis was carried out. All cases age was from 28-49, and the average age was 39-year-old. The course of this disease was from 6 months to 3 years. Four of 10 cases were bladder endometriosis. The clinical presentations included the urgency, frequency, pain at micturition and lower abdomen pain during menstruation, gross hematuria coinciding with menstruation 1 case. B-ultrasound and CT showed the mass of bladder from 2. 0 -3.5 cm but were not specific. Four of 6 cases ureteral endometriosis were the left side and 2 cases were the right side. This clinical presentation included non-specific flank or abdomenal discomfort in 4 cases, intermittent gross hematuria in 1 case and 1 case renal hydronephrosis was found incidentally by B-ultrasound. B-ultrasound indicated unilateral upper urinary tract dilation and hydrops in all cases,with pyelic separation from 2.0-4.5 cm and ureteral separation from 1-2 cm. CT indicated stenosis of the lower ureter in 5 cases, ureter tumor in 1 case. Results All cases were treated surgically.Partial cystectomy were performed in 4 cases of bladder endometriosis, of which, 1 case bilateral oophorectomy and hysterectomy. Five cases were performed ureteral segmental resection, of which, 3 ureterocystostomy and 2 terminoterminal anastomosis. 1 case was performed radical nephrectomy and ureterectomy. Postoperative pathological findings confirmed the diagnosis of endometriosis. Postoperative oral hormone therapy was given to 9 cases for 6-12 months. All cases were followed for 12-60months. 2 cases ureteral endometriosis had recurrent hydronephrosis in 18-24 months. The 2 cases received ureteral stent and cured by oral hormone therapy or goserelin subcutaneous injection for 3 months. Conclusions Urinary tract endometriosis usually shows non-specific symptoms. The diagnosis can be missed on both clinical examination and preoperative work-up. Surgical treatment is effective and adjuvant hormone therapy is often recommended to prevent the recurrence.

Objective To evaluate the various patterns of hepatic perfusion disorders with multi-slice spiral CT and to emphasize the significance of recognition for them . Methods In a period of 1 year, the all CT images of 1568 patients received multi-slice spiral CT examination of upper abdomen were analyzed retrospectively. The CT findings, etiologies and mechanisms of different pattens of hepatic perfusion disorders were investigated. Results 103 cases were demonstrated to have hepatic perfusion disorders. 69 cases were associated with tumors and the other 34 cases were non-tumor associated. The etiologies of various hepatic perfusion disorders were classified as (1)arterioportal fistulae(41.7%), (2) portal venous inflow obstruction(23.3%), (3) inflammartory hyperemic changes(17.5%), (4) steal phenomenon by hypervascular tumors(6.8%), (5) hepatic venous outflow obstruction(4.9%), (6) aberrant hepatic blood supply (3.9%) and (7) uncertain causes(1.9%). There was significant correlation between the CT images of perfusion disorders in shape and distribution and the causes of them. Conclusion Multi-slice spiral CT provides a new effective technique for demonstrating and understanding various hepatic perfusion disorders. Familiarity with the spiral CT appearances of these perfusion disorders will result in more accurate evaluation for various pathologic or physiologic states reflected by them.

Objective Prostate cancer is one of the most common cancer in males .The article was to investigate the expres-sion and clinicopathological significance of VEGF-C mRNA in prostate cancer , finding the molecular marker for early diagnosis and prognosis assessment of prostate cancer . Methods TaqMan real-time polymerase chain reaction ( PCR) analysis was used to detect the expression of VEGF-C mRNA in 3 prostate cancer cell lines(PC-3, DU145 and LNCap), 32 cases of prostate cancer (Pca) sam-ples and 15 cases of benign prostatic hyperplasia (BPH).Analysis was also made on the correlations of VEGF-C mRNA expression, clinicopathological features and prognosis . Results High levels of VEGF-C mRNA were detected in PC-3 ( 153 .31 ±26 .24 ) and DU145(194.62 ±41.36)compared to LNcap(1.00 ±0.00).The expression of VEGF-C mRNA in prostate cancer tissues was 3.43 folds higher than that in the benign prostatic hyperplasia tissues ([13.67 ±1.95] vs [11.89 ±1.63], P=0.004).The high expres-sion of VEGF-C mRNA in prostate cancer was associated with high Gleason score ( P =0.004 ) and lymph node metastasis ( P =0.015).In patients with high expression and low expression of VEGF-C mRNA, the 3-year survival rate was 12.5%and 40.0%re-spectively(P=0.033). Conclusion The VEGF-C mRNA expression may be related to the biological behavior of prostate cancer .It is suggested that VEGF-C mRNA can be used as a prognostic marker for prostate cancer .

Objective To study the technique of modified multi-slice spiral CT aniography(MSCTA) for displaying the whole length of the carotid arteries and the origin of the vertebral arteries,and to evaluate its clinical value.Methods A total of 152 patients underwent modified MSCTA of extracranial carotid artery which scanned from skull base to aortic arch with contrast medium injected from the femoral vein, the image quality and the detection of lesions were assessed in comparison with that of DSA in a few of cases. Results (1) The jugular vein was displayed in 4 cases, only accounting for 2.63%. (2) The carotid segments including the proximal common carotid artery(CCA), the middle CCA, the carotid bifurcation, the internal carotid artery(ICA) bulb and the distal ICA could be visualized adequately by MSCTA,the showing rates were 97.69%,97.69%,97.69%,95.62% and 97.64%,respectively. Furthermore, moderate or severe stenosis detected by MSCTA in 17 cases was closely corresponding with the results of DSA. Conclusion Modified MSCTA of extracranial carotid artery can display the whole length of extracranial carotid artery and the origin of the vertebral arteries satisfactorily without the interference of the jugular, subclavian and innominate veins, and can improve its clinical application.

objective To investigate the method of securing donors and recipients during the initial procedure of adult-to-aduh living donor liver transplantation(ALDLT).Methods The clinical data,preoperative assessment,surgical strategies and complications of 71 adult donors and recipients who underwent ALDLT from April 2007 to November 2007 were retrospectively analyzed.Results Sixty-three right lobes without middle hepatic vein(MHV),1 extended right lobe,4 right lobes with MHV and 3 left lobes with MHV were obtained.Two donors suffered from postoperative complications including 1 with bile leakage and 1 with abdominal bleeding.No donor mortality occurred.Eighteen recipients had postoperative complications including 12 with biliary complications,3 with vascular complications and 3 with small-for-size syndrome.The perioperative mortality rate of recipients was 10%(7/71).Conclusions Strict donor and recipient assessment,optimal surgical strategy and postoperative care are extremely helpful to secure donors and recipients during the initial procedure of ALDLT.