Crohn's disease (CD) is a chronic nonspecific inflammatory disease.CD can affect any location in the digestive tract,and it also affect other organs,including the eyes,skin,liver and joints,which are termed extraintestinal manifestations (EIMs).The cutaneous manifestations of CD are common and occur in about one-third of patients.EIMs of CD have been divided into 3 categories.(1) Specific lesion,cutaneous manifestations of CD were the same as histopathologic findings of underlying gastrointestinal lesion.(2) Reactive lesion,it was also inflammatory lesion which was usually accompanied by underlying gastrointestinal disease while inflammatory injury was different from histopathologic findings of gastrointestinal lesion.(3) Associated lesion,it was caused by sequelae of human leucocyte antigen and chronic inflammation.In the current era of ever-expanding therapeutic options for CD,some investigators have proposed a fourth category of EIMs,namely those that are therapy-related lesion.The therapy-related lesion is closely related to disease-associated conditions in light of certain skin findings,and there is potential overlap between them.

Objective To evaluate the efficacy of preoperative and postoperative intravesical instillation of pirarubicin for the prevention of postoperative recurrence of non-muscle invasive bladder cancer (NMIBC). Methods From September 2012 to March 2014, 120 patients who were diagnosed as NMIBC and accepted trans-urethral resection of bladder tumor (TUR-Bt) were collected and randomly divided into two groups, including treatment group (60 cases) and control group (60 cases). 30 minutes before the operation, instillation of pirarubicin (40 mg) was performed in the treatment group, then pirarubicin perfusion was given within 24 h after operation, once a week for 8 weeks, and once a month for 10 months after operation. In control group, instillation of pirarubicin (40 mg) was given within 24 h after operation, and other treatments were the same as the treatment group. The differences of lesion detection probability, the 2-year recurrent rate and the adverse reaction rate were compared between the two groups. Results The lesion detection rates were 42.70 % (38/89) and 1.85 % (2/108) in the treatment group and control group, respectively (χ2=50.303, P<0.05). 119 patients were follow-up for 24 months. The 2-year recurrence rates were 8.47%(5/59), 21.67% (13/60) in treatment group and control group respectively (χ2= 4.033, P< 0.05). The adverse reactions mainly included hematuria (3 cases in treatment group, 3 cases in control group), urinary tract irritation (3 cases in treatment group, 2 cases in control group) and urethral stricture (1 case in treatment group, 1 case in control group). The difference of the adverse reaction incidence between the two groups was not significant statistically [11.86 % (7/59) vs. 10.00 (6/60), χ 2 = 0.106, P > 0.05]. Conclusions The preoperational intravesical instillation of pirarubicin can fix and diagnose malignant lesions in the bladder without adverse reactions, which will improve the rate of tumor resection and prevent postoperative recurrence of tumors.

Balance dysfunction in stroke was mainly caused by proprioception disorder, visual impairment, vestibular dysfunction, poor integration function in the central nervous system, core muscle strength decrease, and decrease in muscle coordination ability and cognitive dysfunction. This article described how to improve the balance function of patients from pathological factors, and systematically reviewed the latest research progress in the treatment of balance disorder after stroke. The clinical exercise therapy and the use of computers and other high-tech treatment can effectively improve the balance function of patients. These methods should be combined according to the pathologi-cal factors of patients with balance disorders.

Objective To investigate the safety and feasibility of barbed absorbable suture line in retroperitoneoscopic partial nephrectomy. Methods 45 patients who were suitable for retroperitoneoscopic partial nephrectomy from February 2013 to February 2014 were collected and randomly divided into V-Loc group and the control group. 23 cases of V-Loc barbed absorbable suture line were chosen by suture kidney in V-Loc group.There were 22 cases of coated vicryl plus antibacterial suture and Hem-o-lok clip in the control group. The differences of operative time, blood loss, warm ischemia time, suture time, hospital stay and suture material costs were compared respectively between the two groups. Results All 45 cases of retroperitoneoscopic partial nephrectomy were successfully performed, without conversion to open surgery and important intraoperative complications. Postoperative pathology report showed that there were 37 cases with renal clear cell carcinoma, 3 cases with papillary renal cell carcinoma, 2 cases with chromophobe renal cell carcinoma with negative surgical margin, 3 cases with renal angiomyolipomas. In the V-Loc group and the control group, the average operative time were (90.8±9.6) and (96.9±9.1) min (P>0.05), the mean blood loss were (80.4±24.2) and (99.5±24.8) ml (P>0.05), the mean warm ischemia time were (21.5±3.4) and (25.3±1.9) min (P<0.05), suture time were (10.8±1.7) and (16.8±3.1) min (P<0.05), respectively, postoperative hospital stay were (5.7±1.7) and (7.1±1.9) d (P>0.05), the average cost of renal parenchymal suture material were (1 215.5±101.4) and (2 073.5±301.8) yuan (P<0.05). The warm ischemia time,suture time and suture material costs in the V-Loc group were significantly lower than those in the control group (all P<0.05). Conclusion The application of barbed absorbable suture line in retroperitoneoscopic partial nephrectomy can shorten warm ischemia time and suture time, and save hospitalization costs, with favorable safety and feasibility.

Objective To evaluate the efficacy and feasibility of 125I radioactive seed interstitial implantation for the local advanced urinary tract epithelial carcinoma without total resection.Methods The clinical data of 21 patients with local advanced urothelial carcinoma without completely surgical resection who were treated by 125I radioactive particles implantation were retrospectively analyzed.The patients were divided into two groups and received preoperative plan.In group A, 14 patients received implants during operations, including 7 bladder transitional cell carcinoma patients who underwent a transurethral resection surgery or partial bladder resection and another 7 ureteral carcinoma cases who underwent semi urine road resection.After these operations, all of patients had tumor residues.After furthest resection of the tumor, the 125I seeds were implanted at the residual suspicious tumors and their surroundings.In group B, 7 patients were implanted under the guidance of color ultrasound or CT.According to the evaluation criteria of solid tumor in 2009, the tumor remission rate, survival rate, distribution and the mobile information of the particles were observed.Results The operations were successfully completed in all of 21 patients, and serious complications did not appear during the operation.Particle distribution and lesions were basic coincidence.A total of 2 particles displaced, but every patient had no adverse reactions.There were 2 patients with local fever after operation within 4 months, while the rest of patients had no adverse reactions.After median follow-up for 36 months (3-75 months) , the 1-year survival rate was 100.0 ％ (21/21), the 2-year survival rate was 90.5 ％ (19/21), and the 3-year survival rate was 61.9 ％ (13/21).The tumor remission rate of group A was 85.7 ％ (12/14) after 6-9 months, and was 42.9 ％ (6/14) after 12 months.The bladder was preserved in 7 cases with bladder tumors with the 2-year survival rate of 100.0 ％ (7/7) and the 5-year survival rate of 71.4 ％ (5/7).The tumor remission rate of group B after 6-9 months was 71.4 ％ (5/7), and was 42.9 ％ (3/7) after 12 months.Conclusion 125I seed implantation is a good choice for locally advanced urothelial carcinoma with high local tumor control rate, which is expected to be applied in the individual treatment of advanced urothelial cancer.

Objective To generate high purity and maturity DC from human peripheral blood monocytes in vitro.Methods PBMC were isolated directly from whole blood by density gradient centrifugation and purified by collecting the attached cell,DC were then generated by induction and culturing PBMC for five days with RPMI1640 medium containing rhGM-CSF and rhIL-4 in vitro,and under the condition of 37 ℃,5% CO2.On the fifth day,rhTNF-α was added into DCs cultures,which were then incubated for three additional days.The morphology was monitored by light microscopy,and the phenotypes were determined by FCM.Results After eight days of culture,the cells developed typical and significant dendritic morphology and plenty of cells expressed CD1a, CD80 and CD83,features of DC.Including(78.07±9.43)%CD1a,(60.11±20.50)% CD80 and(46.82±14.15)% CD83 were expressed.About (3.12±1.30)x106 DC cells were derived from 40ml human peripheral blood.Conclusion The way to generate DCs is simple and easy.The DCs produced by this method acquired high purity and maturity antigenic characteristics of DCs.

The purpose of this study is to investigate the applicability of a natural swelling matrix derived from boat-fruited sterculia seed (SMS) as the propellant of osmotic pump tablets. The sugar components, static swelling, water uptake and viscosity of SMS were determined and compared with that of polythylene oxide (WSR-N10 and WSR-303). Both ribavirin and glipizide were used as water-soluble and water-insoluble model drugs. Then, the monolayer osmotic pump tablets of ribavirin and the bilayer osmotic pump tablets of glipizide were prepared using SMS as the osmotically active substance and propellant. SMS was mainly composed of rhamnose, arabinose, xylose and galactose and exhibited relatively high swelling ability. The area of the disintegrated matrix tablet was 20.1 times as that at initial after swelling for 600 s. SMS swelled rapidly and was fully swelled (0.5%) in aqueous solution with relative low viscosity (3.66 +/- 0.03) mPa x s at 25 degrees C. The monolayer osmotic pump tablets of ribavirin and the bilayer osmotic pump tablets of glipizide using SMS as propellant exhibited typical drug release features of osmotic pumps. In conclusion, the swelling matrix derived from boat-fruited sterculia seed, with low viscosity and high swelling, is a potential propellant in the application of osmotic pump tablets.

Objective To explore the relationship between plasma homocysteine levels and diabetic retinopathy (DR).MethodIn 40 DR patients and 63 non-DR patients,the indexes including plasma homocysteine concentrations,duration of diabetes,ages,blood pressure,preprandial blood glucose(PBG),plasma GHbA,e,plasma lipids,serum folie acid and semm vitamin B12 were analyzed.ResultsPlasma homocysteine level was significantly higher in DR patients (12.9μmol/L) than that in non-DR patients (7.8μ.mol/L) (P＜0.01),and the relationship remained significant correlation after adjusted for duration of diabetes,GHbA1c,ages,serum folic acid and serum vitamin B12(OR = 1.23,P＜0.05).ConclusionHyperhomocysteinimia is a risk factor and an independent predieator of DR.

Objective To investigate the the operative time of two stage soft ureteroscope lithotripsy for hemorrhagic embolism after percutaneous nephrolithotomy(PCNL).Methods The clinical data of 1 patient with massive hemorrhage after PCNL who treated with superselective renal artery embolization and ureteral soft lens were analyzed.Results The patient with postoperative bleeding after PCNL was treated with superselective renal artery branch embolization,after 30d embolization,the holmium laser lithotripsy under the soft ureteroscope for ureteral calculi was performed,and the renal pelvis mucosa smooth,no bleeding and scar formation were intraoperative visible.After operation,the stone was removed basically,and the double J tube was removed 2 weeks after operation.The patient had no special discomfort and the renal function was normal.Conclusion Postoperative 14-30d is a relatively safe time to perform flexible ureteroscopic lithotripsy for super selective renal artery embolization in the treatment of patient with massive hemorrhage after PCNL.

Objective To investigate the associations between the single nucleotide polymorphisms of TERT rs2736098, CLK3 rs11543198 and bladder cancer. Methods 201 bladder cancer cases and 200 healthy controls were included in the research, and the genotypes of TERT rs2736098 and CLK3 rs11543198 were determined using the PCR-RFLP method. Relationship between genotypes and bladder cancer risks was investigated. Results There were statistical significance in the rs2736098 genotype frequencies and allele frequencies between cases and controls (χ2= 6.973, P = 0.031; χ2= 7.412, P = 0.006). Compared with the individuals with the GG genotype , the risk of bladder cancer increased 2.069 times with the AA genotype (OR = 2.069, 95%CI: 1.181-3.624, P = 0.011). And there were no significant associations between the rs11543198 genotype frequencies and allele frequencies between cases and controls (χ2 = 0.202, P = 0.904; χ2 = 0.188, P = 0.665). Rs2736098 and rs11543198 genotype distribution in bladder cancer pathologic grade and stage had no statistical significance (P > 0.05). Conclusion Rs2736098 polymorphism is associated with risk of bladder cancer and rs11543198 polymorphism was not associated with risk of bladder cancer.