Objective To discuss the efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL) for residual or recurrent stones in the kidney or upper ureter after open surgery.Methods A total of 46 cases of residual or recurrent stones in the kidney or upper ureter after open surgery were included in the study.A pigtail catheter was inserted into the ureter transurethrally under ureteroscope to create an artificial hydronephrosis.Then a renal fistulization,usually on middle or upper calyx,was made.The stones were identified under ureteroscope,fragmented with a pneumatic ballistic lithotriptor,and extracted by using a grasping forceps.The renal fistulization tube was indwelled for drainage.Results The stones were completely removed on one session in 20 cases(43.4%),on two sessions in 15 cases(32.6%),and three in 8 cases(17.3%).Residual stones were seen in 3 cases(6.5%),with a size of 0.1 cm ? 0.1 cm ? 0.2 cm ～ 0.5 cm ? 0.5 cm ? 0.6 cm.Stones were removed through one working channel in 18 cases(39.1%),two channels in 20 cases(43.5%),and three channels in 8(17.4%).Conclusions The MPCNL is miuimally invasive and effective in the treatment of residual or recurrent stones after open surgery.

BACKGROUND:Gene-modified stem cel s can increase the secretion of peptides and ful-length proteins to protect spinal cord injury and promote recovery of neuronal function, which thus become a research hotspot in recent years. OBJECTIVE:To investigate the effect of nerve growth factor-modified adipose derived stem cel s in repairing spinal cord injury in rats. METHODS:Adipose derived stem cel s were primarily cultured by adherent culture method and cel surface markers were detected by immunofluorescence method, while spinal cord injury models were set by modified Al en method. Nerve growth factor plasmid was transfected into adipose derived stem cel s with Lipofectamine2000 and the expression of nerve growth factor was detected by real-time PCR and western blot. The modified adipose derived stem cel s intervened by nerve growth factor were injected into the injured part of spinal cord injury rat models. Basso-Beattie-Bresnahan score was used to evaluate the repairing effect. Models rats were sacrificed at 3 weeks after cel transplantation. Real-time PCR and western blot were used to testify nerve growth factor expression in the injured spinal segment after cel transplantation. RESULTS AND CONCLUSION:Adipose derived stem cel s were successful y cultured primarily, and positive for CD29 and CD44;the mRNA and protein expression of nerve growth factor was elevated after plasmid transfection. The Basso-Beattie-Bresnahan score was elevated after transplantation of adipose derived stem cel s intervened by nerve growth factor modification compared to control group;and the expression of nerve growth factor in the injured segment of the spinal cord was up-regulated detected by real-time PCR and western blot. These findings indicate that the nerve growth factor-modified adipose derived stem cel s have repairing effects on spinal cord injury in rats.

Objective To explore clinical treatment of postoperative hyponatremia of pituitary tumor. Meth-ods 32 cases of patients with postoperative hyponatremia of pituitary tumor were randomly divided into control group and treatment group. The control group(n = 15) was treated with routine western medicine, and the treatment group(n = 17) was treated with water limited and sodium supplemented based on the control group. The clinical effect was observed between control group and treatment group. Results The clinical effect in the treatment group was signifi-cantly higher than that of the control group(P <0.05). Conclusion The treatment of water limited and sodium sup-plemented on postoperative hyponatremia of pituitary tumor is better.

Background and purpose: The precise radiotherapy in patients with breast cancer consists of multiple procedures, such as simulation, treatment planning and delivery. We assessed the impact of treatment set-up errors on accuracy of post-operative radiotherapy (RT) in patients with breast cancer receiving tangential RT. Methods: Between November 2007 and August 2008, a total of 50 patients were enrolled an institutional review board-approved study. All patients received tangential RT for either right or left breast cancer. Read-out numbers of X, Y, Z directions shown on linear accelerator were recorded according to the sequence of before and after medial tangential field and after lateral tangential field.The impact of treatment set-up errors on post-operative radiotherapy (RT) in different subgroup patients was analyzed using stata 7.0 statistics software. Results:The mean set-up errors on Z, Y, X direction were 2.55, 3.96 and 0.58 cm, respectively. The largest set-up errors in all three directions were observed in the first week during treatment and the largest movement was observed in Z direction. Conclusion: The movements after medial tangential field treatment are much more than those after lateral treatment during RT.The movements in X direction arc substantially less than Y direction or Z direction intrafraction. As interfraction differences have been observed, the movements in the beginning two weeks are more than other treatment period.

Objective To analyze the patterns of amino acid changes in liver failure patients treated with non-bioartificial liver support system (ALSS), and to explore the efficacy of ALSS in liver failure treatment. Methods A total of 146 liver failure patients treated with ALSS from June 2009 to August 2010 were recruited in this study. Paired blood samples were collected from every patient and serum amino acids and ammonia were tested by automatic amino acid analyzer. The changes of amino acids in patients with different prognoses, different types/phases of liver failure were evaluated.Measurement data were compared by paired t test. Results After ALSS treatment, liver failure patients experienced a significant decrease in serum glutamic acid and lysine [(395.62±200.24)μmol/Lvs (260. 05±169.56) μmol/L and (436. 73±326. 18)μmol/L vs (407. 12±292.01) μmol/L,respectively; t= 8. 611 and 2. 659, respectively; both P＜0.01)], while experienced greatly increases in threonine and branched-chain amino acids/aromatic amino acid ratio [( 1302. 90 ±1288.70) μmol/L vs (1406.70 ±1272. 34) μmol/L and 1. 23 ± 0. 53 vs 1. 36 ± 0.57, respectively; t = 2. 895 and 1. 061,respectively; both P＜0. 01)]. The changes of glutamic acid, tyrosine, arginine and methionine before and after ALSS treatment in patients with different prognoses, different types/phases of liver failure were all significantly different. Conclusions ALSS treatment could improve the serum amino acid disorder in liver failure patients. The amino acids in patients with different types/phases or different prognoses of liver failure change significantly after ALSS treatment.

Objective To explore the role of brief ischemia pretreatment in the induction of renal ischemic tolerance,and investigate its effects on tubular cell necrosis,apoptosis and proliferation. Methods Male Sprague-Dawley rats were randomly divided into three groups,including sham-operated group (Sham),ischemia/reperfusion injured group subjected to theocclusion of both renal pedicles for 40 min followed by reperfusion(I/R),and preconditioned group with 20-min ischemia pretreatment induced 4 days before I/R(IPC).Histological changes were evaluated by PAS staining.The ultra-structure of tubular cells was observed by transmission electron microscopy(TEM).Apoptosis was confirmed by terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-biotin nick end labeling (TUNEL).The proliferation of tubular cells was evaluated with proliferating cell nuclear antigen(PCNA). Results Twenty-minites ischemia pretreatment offered both promising functional and histological protection against 40-min ischemia/reperfusion injury (P<0.01).The mortality rate wag reduced from 33%in I/R group to 0 in IPC group.The renopmtection offered by 20-min ischemia pretreatment was accompanied with reduced postischemic tubular cell apoptosis and necrosis (P<0.05), and increased cell proliferation (PCNA positive) (P< 0.01). Conclusions Brief and sublethal prior ischemia can render the kidney more tolerant to subsequent prolonged I/R injury. Its ability to tilt the balance of tubular cell fate toward survival, reducing postischemic cell death and enhancing cell proliferation, may play an important role in renal protection of ischemic preconditioning.

Objective To study interdialytic body weight gain(IBWG)in maintenance hemodialysis(MHD)patients,and to analyze the associated factors. Methods A total of 269 patients undergoing maintenance hemodialysis were enrolled in this cross-sectional study.The patients were divided into two groups according to the percentage of IBWG(PIBWG:interdialytic body weight gain/dry weight×100%):PIBWG＞3.50%(190 cases)and PIBWG≤3.50%(79 cases).Associated factors of IBWG were analyzed. Results The average IBWG of 269 MHD patients was(2.42±1.01)kg(0-6.33 kg),and PIBWG was(4.25±1.79)%.In male patients,IBWG was (2.45±1.09)kg,and PIBWG was(3.99±1.79)%.In female patients,IBWG was(2.39±0.85)kg,and PIBWG was(4.64±1.74)%which was significantly higher compared to males(P＜0.01).Patients with PIBWG＜3.00%accounted for 20%,with PIBWG≥3.00%to＜5.00%accounted for 50%,with PIBWG≥5.00%accounted for 30%.Compared to patients with PIBWG＞3.50%,those with PIBWG≤3.50%were characterized by elder age(year)(60.50 ±14.49 vs 54.07±13.78),more males(70.88%vs 54.74%),shorter dialysis duration(month)(41.03±41.92 vs 58.83±43.57),larger BMI(kg/m2)(22.67±3.36 vs 20.91±3.25)and less dry weight(kg)(56.69±10.94 vs 62.82±10.97),more residual urine(ml,In)(6.19±0.94 vs 5.48±0.8),lower predialysis serum β2MG(mmol/L)(31.61±9.82 vs 38.54±10.38)and phosphorus(mmol/L)(1.92±0.66 vs 2.15±0.58).Correlation analysis revealed that PIBWG was positively correlated with dialysis duration,Scr,BUN,β2-MG,phosphorus,decrease and decrease percentage of BP during hemodialysis,and negatively correlated with age,dry weight,BMI,residual urine,and pre-dialysis SBP,MAP. Conclusions PIBWG of about 70%of our patients was below 5%.Young.female.low BMI and dry body weight,long dialysis duration,low residual urine,chronic glomerulonephritis and diabetic nephropathy are associated with more IBWG,which may lead to greater intradialytic BP fluctuation.

Objective To research the thickness of adults frontal bones in many parts and analyze the mean-ing. Methods We chose 130 dry skulls of the Chinese people including 70 male skulls and 60 female skulls and ver-tically devided the frontal bones according the devidement of the superciliary arch into 4 parts on average. Then we measured the thickness of the frontal squama,the frontal tuber,the forehead and temple,the superciliary arch,the or-bital surface and the frontal sinus using the ruler, vernier caliper and protractor. Results We got the thickness of the frontal squama,the frontal tuber,the forehead and temple,the superciliary arch,the orbital surface and the frontal si-nus and calculated the average datas. What's more,besides the thickness of the frontal tuber,forehead and temple,the superciliary arch had statistical significance(P < 0.05) between males and females, other parts of the frontal bones had no statistical significance(P>0. 05). Conclusion We measured the thickness of the frontal squama,the frontal tu-ber,the forehead and temple,the superciliary arch,the orbital surface and the frontal sinus and the datas will had good guiding roles to our department's work.

To study the effects of different pH HEPES-KH reperfusate solution on immature myocardial protection, isolated perfused Langendorff model from immature rabbit hearts were developed formed. Control group (C) was perfused only with pH 7.4 HEPES-KH solution for 90 min. Ischemia/reperfusion group (group I/R) was perfused with pH 7.4 HEPES-KH solution before ischemia or after ischemia. Experimental group (group E), after ischemia, was perfused with pH 6.8, pH 7.1 and pH 7.4 HEPES-KH solutions for 5 min, 5 min, and 20 min, respectively. The left ventricular function recovery, MWC, LDH and CK leakage, MDA, ATP content, and SOD activity were determined. Our results showed that the left ventricular function recovery, ATP content and SOD activity in group E were higher than those of group I/R (P < 0.05). MWC, MDA content, LDH and CK leakage in group E were lower than those of group I/R (P < 0.05). These findings suggested that pH paradox might be one of important mechanisms for immature myocardial ischemia-reperfusion injury, and acidic perfusate, at the beginning of reperfusion, might attenuate pH paradox and ameliorate functional recovery in isolated perfused immature rabbit hearts.
Myocardium/metabolism ; Random Allocation ; Superoxide Dismutase/metabolism

Objective To explore and evaluate the effects of participatory teaching approach in the teaching of medical research methods. Methods The students of clinical medicine of Grade 2007 who took the elective course of medical scientific research method were taken as traditional teaching group, taught by teachers only, while the students of clinical medicine of Grade 2008 and 2009 as participatory teaching group, adopting the way of teachers' lectures and students' participation. At the end of the course, the questionnalre survey method combining interviews was used to investigate the teaching effectiveness, using descriptive analysis and chi-square test to compare the effectiveness between the traditional teaching methods and the participatory teaching methods. Results Compared with the traditional 'teachers centered' method, the 'participatory teaching approach' had better teach-ing results. Through the study of this course, 54 students (42.9%) learned how to conduct scientific research topics, 44 students (34.9%) mastered the design of the questionnalre, 59 students (46.8%) enhanced their ability of data analysis. Students' learning motivation and satisfaction were higher, and 117 student's participation (92.8%) were satisfied with the curriculum setting. Conclusion In medical research method teaching, the effect of participatory teaching method teaching is superior to the tradi-tional teaching method, and students' motivation and satisfaction are higher.