ObjectiveTo explore the application value of low pressure flushing in minimally invasive percutaneous nephrolithotomy lithotripsy.MethodsClinical data of 38 patients,who adopted the low pressure flushing therapy for curing the renal or upper ureteral calculi in the percutaneous nephrostolithotomy lithotripsy were retrospectively arakyzed.ResultsAming 38 patients after operation,stone-free rate of stage 1 was obtained in 25 cases and the stones were completely removed after secondary operation in 2 cases.5 patients had partial residual stones and two cases were most of the residual stones.The mean operation time was 1 ～ 2.5h.The average duration of hospitalization was 8d.There were no intraoperative and postoperative complications,such as the spread of infection due to the surgery.ConclusionThe low pressure flushing could improve clinical efficacy of percutaneous nephrostolithotomy lithotripsy and it had high security.

Objective To summarize the experience of ventriculo-peritoneal (V-P) shunt under micro-laparoscope for the treatment of hydrocephalus. Methods Twenty-eight patients with hydrocephalus were treated by V-P shunt under micro-laparoscope from November 2000 to May 2004. An infraumbilical trocar was placed through a 5 mm incision to introduce the operating laparoscope. Under laparoscopic visualization, a 3 mm trocar was introduced into the abdominal cavity along the right side of the ligamentum teres hepatis through an incision just to the right of the xiphoid process. A 1.5 mm subcutaneous incision at the corresponding site of the diaphragmatic surface of the liver on the right anterior axillary line was made and through it a sewing needle with 4-gauge unabsorbable silk suture was delivered into. A grasping forceps was inserted through the xiphoid port into the abdominal cavity to carry the two sides of the suture out. The V-P tubing was fixed in the interspace between the liver and the diaphragm by the ligation from the outside, and then was tunneled to the head. Results All the operations were successfully accomplished. The operation time for iutraabdominal tube placement was 5~10 min.All the patients experienced complete alleviation of symptoms of intracranial hypertension postoperatively. No surgical complications occurred.Follow-up check-ups for 6~36 months(mean,12 months) in 25 patients found no tube obstruction. Conclusions Ventriculo-peritoneal shunt under micro-laparoscope has the advantages of minimal invasion, precise positioning, excellent visualization and rapid recovery, being a safe and feasible method which is worthy of recommendation.

Objective To investigate the clinical characteristics and efficacy of acute myeloid leukemia (AML) with NPM1 and FLT3 mutations.Methods NPM1 and FLT3 mutations were detected in 67 patients with newly diagnosed AML by PCR-capillary electrophoresis.The relationship was analyzed between the mutations and efficacy.Results The incidence of NPM1 mutation was 10.4％ (7/67) in total AML patients and 26.1％ (6/23) in normal karyotypes AML patients.The incidence of FLT3-ITD mutation was 10.4％ (7/67) in total AML patients and 17.4％ (4/23) in normal karyotypes AML patients.The characteristics of 60 NPM1 wild type patients vs that of 7 NPMl mutation patients was as follow,platelet count (BPC) (54× 109/L vs.27.5 × 109/L,P ＜ 0.01),proportion of AML-M5 (57.1％ vs.27.3％,P ＜ 0.01),incidence of CD34+ (28.6％ vs.63.3％,P＜0.01),normal karyotypes (85.7％ vs.28.3％,P＜0.01),cases with particular fusion gene (0 vs.48.3％,P ＜ 0.01),incidence of FLt3-1TD-mutations positive (28.6％ vs.8.3％,P ＜ 0.01),and the differences were significant (P＜0.01).No statistic difference was found in white blood cell(WBC) counts,percentage of blasts in bone marrow,sex,median age and complete remission rate between the two groups (P ＞0.05).The WBC counts (26.9 × 109/L vs.8.1 × 109/L,P =0.013),percentage of blastsin in bone marrow (90％ vs.76％,P=0.014) in the FLT3-ITD mutationg positive patients were clearly higher than those in the FLT3-ITD negative patients.If not associated with FLT3-ITD mutations,mutant NPM1 appears to identify patients with improved response toward treatment.Conclusion It is necessary to detect NPM1 mutation and FLT3-ITD mutation in newly diagnosed AML patients,especially in patients with normal karyotype,which might help to molecular classification and treatment.

OBJECTIVE:To determine the concentration of valproic acid in serum.METHODS:Determination was performed with RP-HPLC with methanol:water(70∶30) as mobile phase,?-bromoacetophenone as deriving agent and cyclohexanecarboxylic acid as internal standard,and detected at wavelength 248nm.RESULTS:The calibrating curve of valproic acid was linear in the range of 14.47～248.0?g/ml.CONCLUSION:The method was convenient,rapid,accurate and suitable for TDM.

OBJECTIVE:To develop a RP-HPLC method for the determination of salicylic acid in serum and to apply this method to the pharmacokinetic and bioavailability study of salycylic acid in compound aspirin preparations.METHODS:Waters2690HPLC instrument was used with Diamonsil C 18 column(5?m,250mm?4.6mm)as stationary phase and methanol-ace?tonitrile-0.2%phosphoric acid(18∶32∶50)as mobile phase at a flow rate of1.0ml/min,and the detective wavelength was237nm.RESULTS:Calibration curve of salicylic acid was linear in the range of0.40～101.00?g/ml(r=0.9999).CONCLUS_ ION:The method is simple,sensitive,rapid and suitable for pharmacokinetic and bioavailability study of salicylic acid.

OBJECTIVE:To establish a GC-MS assay for determination of the contents of phenol and menthol in calamine and menthol lotion.METHODS:Using DM-5elastic quartz capillary as separation column,I-octanol as internal standard,phenol and menthol were detected separately under the70℃～150℃step-up hyperthermic condition to select the ion fragment peaks with M/Z of94and71.RESULTS:Phenol and menthol were good linear within1.092～21.840?g/ml(r=0.9998)and1.194～9.552?g/ml(r=0.9999).Recoveries were100.2%(RSD=1.34%)and100.4%(RSD=0.74%)respective?ly.CONCLUSION:The method is quick and accurate with highly repeatability and specificity and it is adequate for contents determination and quality control for this preparation.

Objective To evaluate the feasibility, safety, and efficacy of CT-guided permanent iodine-125 implantation for malignant tumors.Methods Thirteen lesions in 10 consecutive patients with malignant tumor were treated with CT-guided iodine-125 permanent implantation brachytherapy, of which four cases were primary unresectable carcinoma and six cases were metastases. There were 4 males and (6 females,) the mean age was 56.9 years (range 54 to 62 years). Based on the CT imaging within two weeks before the implantation of the seeds, a computer-based treatment planning system was used to determine the optimal seed distribution. Subsequent CT-guided needle placement and seed implantation were carried out. Post-implant CT scans were performed immediately and five to ten months after the implantation in all cases to assess seed distribution, complication, and curative effect. Results CT-guided iodine-125 permanent implantation was accomplished smoothly in all cases. This technique offered a better seed placement. The number of seeds implanted in one lesion was 1 to 44 (mean 18.6). No acute complications and late toxicity related to the implantation were observed. Pain relief was obtained in all four patients (100%) presenting with pain. Follow-up CT demonstrated that 3 of 13 lesions disappeared completely, eight lesions diminished, and the remaining 2 lesions had no significant change in size. Mean lesion size of pre-implant and post-implant were 3.15 cm and 2.06 cm, respectively (t=5.127, P

ObjectiveTo explore the effect of glucocorticoid inhaled on bone metabolism, bone density and adrenal function in children with asthma.Methods60 children were randomly divided into the treatment group and control group with 30 cases in each group, and having 30 pneumonia children as another control. Children of the treatment group were treated with budesonide (200～600 μg/d) inhaled, asthma cases in the control group without budesonide inhaled. Bone metabolism, bone density and adrenal function of children in three groups were compared.ResultsAfter 18 months treatment, there were no significantly differences of bone metabolism, bone density and adrenal function among children of three groups (P>0.05).ConclusionThe treatment of glucocorticoid inhaled is safe to asthma children.

Objective To explore the possibility that rat bone mesenchymal cells (BMSCs) can differentiate into hepatocytes under the affection of fetal liver filtrate. Methods PAS and green indigo dye were used to detect glycogen and differential level of hepatocytes, respectively. The concentration of ALT, AST, ALP in the culture supernatant were served as markers of hepaocyte function. Results Fourteen days after induced by the fetal liver filtrate, BMSCs changed their shapes into polygon, oval or round. Some of BMSCs were positive for AFP and ALB at 7 days after induction, then the number of positive cells increased, and most of BMSCs expressed AFP and ALB till 21days. The PAS reaction and indocyanine green(ICG) intaking also appeared at 7days. Enzyme in supernatant such as ALT, AST, ALP were fristly detected at 7days and peaked at 14days,then the level declined. Conclusion The fetal rat liver filtrate was able to induce BMSCs into cells with function and characteristics of hepatocytes.

Objective To investigate certain risk factors for and their impact on abnormal liver function in middle-aged and elderly adults.Methods A case-control study was constructed based on the SAGE cohort of 8642 registered residents aged 50 years or over in Shanghai.Of them,137 individuals with abnormal liver function,defined as aspartate transaminase (AST)＞ 40 U/L or alanine aminotransferase (ALT)＞ 40 U/L,were randomly selected as the observation group,while 411 healthy controls were 3 ∶ 1 matched with the cases in the observation group by gender and age (1 year).Face-to-face administered questionnaires and physical examinations were conducted and serum samples were tested for ALT,AST,glucose (GLU),total cholesterol (TC),triglycreide (TG),hepatitis B surface antigen (HbsAg) and anti-hepatitis C virus antibody (anti-HCV Ab).Chi square test and rank sum test were used for single factor analysis,and logistic regression analysis was used for multiple factors.Results The prevalence of HBsAg positive patients was 12.4 ％ (68/548) Univariate analysis showed that hepatitis virus infection and body mass index (BMI) were associated with abnormal liver function (both P＜0.000).Multivariate logistic regression analysis showed that hepatitis virus infection (OR=1.85,95％ CI:1.04 3.29,P-0.036) and obesity (OR=3.60,95％CI:1.92-6.73,P＜0.001) increased the risk of abnormal liver function,whereas chronic medication (OR=0.51,95％ CI:0.32-0.80,P =0.004) decreased the risk of abnormal liver function.Conclusions Among the study population,hepatitis virus infection and obesity are risk factors for abnormal liver function in middle-aged and elderly people.After adjustment for potential confounders,chronic medication is negatively correlated with abnormal liver function and may be a protective factor for liver function.