Objective To study the feasibility and safety of horseshoe kidney transplantation and avoid the waste of the donor kidney. Methods The horseshoe kidney was identified and confirmed during the organ procurement process. It was perfused in situ and procured en bloc. With an appropriate dissection and reconstruction on the beach table, the horseshoe kidney was carefully divided at the isthmus and transplanted into two separate recipients. The surgical strategies and postoperative outcomes of transplanting the cadaveric horseshoe kidneys were evaluated. Results Two recipients had a immediate return of renal function after the blood vessels were opened. One recipient had a normal renal function presented as lower post-transplant serum creatinine values with a follow-up of 12 months. There was no complications related to the horseshoe kidney. Another case died of infection 1.5 month later after the transplantation. Conclusions Cadaveric horseshoe kidney may be transplanted successfully using various individual technical strategies based on the specific renal anatomy. Considering the lack of donor horseshoe kidney transplantation is feasible and safe.

Objective To explore the efficacy of tigecycline combined with cefoperazone/sulbactam in the treatment of infections due to multiple drug resistant strains and pandrug-resistant acinetobacter baumannii, so as to guide the reasonable clinical medication.Methods A total of 16 cases of ventilator associated pneumonia caused by multiple drug resistant strains and pandrug-resistant acinetobacter baumannii treated in the First Hospital of Shijiazhuang from November 2012 to November 2014 were retrospectively analyzed, and the severity of the infection, clinical efficacy and mortality were observed.Results The multiple drug resistant strains and pandrugresistant acinetobacter baumannii were frequently detected in the 16 patients.Fifteen cases had been used other antibiotics before tigecycline, such as imipenem, cefoperazone/Shubatan, minocycline etc.The severity of underlying disease was assessed with the acute physiology and chronic health score(APACHE Ⅱ sore) within 24 h of admission, on the first day of tigecycline (TGC) therapy and after 7 days of TGC therapy.It showed that the average APACHE Ⅱ score were (25±6.0), (24.2±6.4) and (17.8±6.6) within 24 hours of admission(P＜0.01), on the first day of TGC therapy and after 7 days of TGC therapy.Thirty days after application of the TGC, the bacterial eradication rate was 56.25％ (9/16).The effective rate was 87.5％ (14/16).The failure rate was 12.5％ (2/16).Conclusion The effect of the tigecycline combined with cefoperazone/sulbactam on the clearance of the multiple drug resistant strains and pandrug-resistant acinetobacter baumanniiis is satisfied.

Objective To evaluate the surgical strategy and methods of kidney transplantation in patients with abnormal lower urinary tract. Methods Kidney transplantation was performed in 3 patients with abnormal lower urinary tract.Of them a 45 year old male recipient with tuberculous contracted bladder underwent cutaneous ureterostomy as kidney transplantation was conducted and then received immunosuppressive therapy of zenapax + tacrolimus (FK506) + mycophenolate mofetil (MMF) + steroid (Pred).The other 2 male patients with neurogenic bladder who were 24 and 34 years experienced kidney transplantation plus ileal conduit by one stage and by two stages,respectively.These 2 patients received immunosuppressive therapy of zenapax + FK506 + MMF + Pred and zenapax + CsA + MMF + Pred,respectively after transplantation. Results The patient who received ileal conduit by one stage experienced hematochezia and urinary fistula,which vanished after effective treatment.The rest 2 patients recovered smoothly.The functions of transplanted kidneys were satisfactory with no severe complications during follow up period. Conclusions The kidney transplantation and urinary diversion should be completed simultaneously or by stages depending on the conditions of the patients with abnormal lower urinary tract. The function of the transplanted kidney and the drainage of the ureter should be protected as much as possible.

Objective To analyze the epidemic characteristics of imported malaria in Liyang City,so as to provide the evi?dence for formulating appropriate control strategies and measures. Methods The malaria epidemic situation reports,case epi?demiological investigations and the follow?up materials of counterparts returned together with the cases were collected and ana?lyzed in Liyang City from 2007 to 2014. Results Totally 53 imported malaria cases were reported and they were all laboratory confirmed in Liyang City from 2007 to 2014. Forty ? nine cases(92.5%)were imported from African countries,37 cases (69.8%)were Plasmodium falciparum infection,and 37 cases(69.8%)had overseas incidence history. Forty cases(75.5%) were aged between 30 and 49 years,and 52 cases(98.1%)were male,42 cases(79.2%)were farmers. These cases were dis?tributed in all the 10 towns and there were no obvious seasonal variation for onset time. The median time from onset to seeing a doctor was 3 d,and the median time from seeing a doctor to being diagnosed was 0 d. The first visit health facilities by the pa?tients were various,and the diagnostic health facilities were all the medical institutions at the county level or above,and the standardized treatment rate was 100%. Conclusion During the last 5 consecutive years,there have been no local infected ma?laria cases in Liyang City,and the remarkable results have been achieved in malaria elimination. However,there are still many imported malaria cases,and the infected species are diverse. Therefore,the imported malaria is still the key of malaria preven?tion and control.

Objective To study the relationship between angiogenesis and pathology and prognosis of cholangiocarcinoma. Methods Immunohistochemistry was used to determine micro-vessel density (MVD) and the expression of vascular endothelial growth factor(VEGF) and its receptor Flk-1/KDR in 50 cholangiocarcinoma cases. Results were compared with pathological and follow-up parameters. Results MVD in cholangiocarcinoma tissues and para-tumor tissues (34.04 ? 11.08, 32.80 ?9.28) were higher than normal bile duct tissues ( 11. 67 ? 4. 64) ( P

Objective To analyze the clinical feature of pediatric severe influenza A(H1N1)cases.Methods To summarize the clinical manifestation,diagnostic and therapeutic process of eight pediatric severe influenza A(H1N1)cases.Results All eight cases couldn't provide contact history.Four cases had fundamental diseases,which were nephrotic syndrome,congenital hypothyroidism,bronchial asthma and moderate anemia.All cases had cough and fever,which was productive cough and hyperpyrexia(5 cases).All cases had tachypnea,which presented at the course of 0.5～6 days and progressively aggravated to respiratory failure 3～24 hours later.Chest x-ray showed localized exudation,which was similar to mycoplasma pneumonia.Seven cases had increased percentages of neutrophil.Six cases had increased CRP.All cases had respiratory failure;two cases were complicated with toxic encephacopathy.Treatment included anti-virus and support therapy.All cases received immunoglobulin and some cases received glucocorticoid.Six patients received mechanicai ventilation.Time of mechanical ventilation was 3～6 days.No patients died.Conclusion Pediatric severe influenza A(H1N1)case is severe pneumonia with characteristic of severe hypoxemia.Acute respiratory distress syndrome and death can be prevented through effective and in-time therapy.

Objective: To investigate the incidence and morphology of C-shaped root canals in mandibular premolars by cone-beam computed tomography (CBCT) imaging, which provides a reference for clinical diagnosis and treatment. Methods : The CBCT scanning data of 964 mandibular first premolars and 907 mandibular second premolars in 508 cases were collected, and the root canal morphology, incidence of C-shaped root canals, bilateral symmetry and location of radicular grooves were analyzed. Results: The incidence of C-shaped root canals in mandibular first premolars was 4.1% and that in mandibular second premolars was 0.6%. The incidence of C-shaped root canals of mandibular first premolars was significantly higher than that of mandibular second premolars (χ2=25.775, P < 0.001). The symmetrical ratio of C-shaped root canals in the mandibular first premolars was 29%. There were no symmetrical C-shaped root canals in the mandibular second premolars. There were significant differences in the distribution of the C-shaped root canal configuration in the root canal (P < 0.001). The C-shaped configuration mainly existed in the middle axial and apical level of the mandibular premolars. The C2 type was more common. No C-shape was found in the coronal level of the mandibular premolars. Vertucci I single tube type was the most common type of root canal for the mandibular premolars included in this study; the incidences were 81.7% and 98.3% for the mandibular first and second premolars, respectively, and the difference was statistically significant (χ2=140.544, P < 0.001). The other root canal types of mandibular first premolars were more than those of mandibular second premolars. The incidences of Vertucci Ⅱ, Ⅲ, Ⅳ, and Ⅴ and C-shaped root canals in mandibular first premolars were significantly higher than those in mandibular second premolars. C-shaped root canal mandibular premolars had radicular grooves, and most of them were located at the mesiolingual side. Conclusion The morphology of the C-shaped root canal in mandibular premolars was complicated. CBCT can provide direct and accurate imaging evidence for clinical diagnosis and treatment.

Objective To explore the clinical effect of stomach-tonifying decoction combined with western medicine on the treatment of patients with yin deficiency syndrome of stomach of chronic atrophic gastritis.Methods Totally 68 patients with yin deficiency syndrome of stomach of chronic atrophic gastritis were randomly divided into control group (n =33) and treatment group (n =35).The control group was treated with western medicines such as amoxicillin capsules,clarithromycin sustained release tablets,omeprazole enteric-coated capsules and bismuth potassium citrate capsules.The treatment group was treated with stomach-tonifying decoction on the basis of the control group.Both groups were treated for 6 weeks.The clinical efficacy,score of TCM syndromes,gastric mucosa pathological score and gastric mucosal inflammation indexes [interleukin-11 (IL-11),interleukin-12 (IL-12),C reactive protein (CRP) and tumor necrosis factor-α (TNF-α)] and gastric mucosal immune function indexes (CD4 +,CD8 + and CD4 +/CD8 +).Results The total effective rate of the treatment group was 94.29％,which was significantly higher than 75.76％ of the control group (P ＜0.05).After treatment of 6 weeks,the scores of TCM syndromes in both groups were significantly lower than those before treatment (P ＜ 0.05),and the scores of main TCM symptom such as epigastric pain,abdominal nausea after eating,loss of appetite and score of minor TCM symptom such as nausea and vomiting and total score in the treatment group were significantly lower than those in the control group (P ＜ 0.05).After 6 weeks of treatment,the gastric mucosa pathological score in both groups was significantly lower than that before treatment (P ＜ 0.05),and the score of the treatment group was significantly lower than that of the control group (P ＜ 0.05).After treatment of 6 weeks,the gastric mucosal inflammation indexes and gastric mucosal immune function indexes in both groups were significantly lower than those before treatment (P ＜ 0.05),and these indexes in the treatment group were significantly lower than those in the control group (P ＜ 0.05).Conclusion Stomach-tonifying decoction combined with western medicine is effective in treating patients with yin deficiency syndrome of stomach of chronic atrophic gastritis,which can significantly improve the clinical symptoms and reduce the degree of inflammatory reactions of gastric mucosa,so it is worthy of clinical application.

Objective To explore the clinical effect of stomach-tonifying decoction combined with western medicine on the treatment of patients with yin deficiency syndrome of stomach of chronic atrophic gastritis.Methods Totally 68 patients with yin deficiency syndrome of stomach of chronic atrophic gastritis were randomly divided into control group (n =33) and treatment group (n =35).The control group was treated with western medicines such as amoxicillin capsules,clarithromycin sustained release tablets,omeprazole enteric-coated capsules and bismuth potassium citrate capsules.The treatment group was treated with stomach-tonifying decoction on the basis of the control group.Both groups were treated for 6 weeks.The clinical efficacy,score of TCM syndromes,gastric mucosa pathological score and gastric mucosal inflammation indexes [interleukin-11 (IL-11),interleukin-12 (IL-12),C reactive protein (CRP) and tumor necrosis factor-α (TNF-α)] and gastric mucosal immune function indexes (CD4 +,CD8 + and CD4 +/CD8 +).Results The total effective rate of the treatment group was 94.29％,which was significantly higher than 75.76％ of the control group (P ＜0.05).After treatment of 6 weeks,the scores of TCM syndromes in both groups were significantly lower than those before treatment (P ＜ 0.05),and the scores of main TCM symptom such as epigastric pain,abdominal nausea after eating,loss of appetite and score of minor TCM symptom such as nausea and vomiting and total score in the treatment group were significantly lower than those in the control group (P ＜ 0.05).After 6 weeks of treatment,the gastric mucosa pathological score in both groups was significantly lower than that before treatment (P ＜ 0.05),and the score of the treatment group was significantly lower than that of the control group (P ＜ 0.05).After treatment of 6 weeks,the gastric mucosal inflammation indexes and gastric mucosal immune function indexes in both groups were significantly lower than those before treatment (P ＜ 0.05),and these indexes in the treatment group were significantly lower than those in the control group (P ＜ 0.05).Conclusion Stomach-tonifying decoction combined with western medicine is effective in treating patients with yin deficiency syndrome of stomach of chronic atrophic gastritis,which can significantly improve the clinical symptoms and reduce the degree of inflammatory reactions of gastric mucosa,so it is worthy of clinical application.

Objective To study the calcium metabolism in tacrolimus(FK506)induced rats nephrotoxicity and the preventive effect of calcium channel blocker.Methods Twenty-four Spragueinduced or FK506-induced nephropathy model.Blood creatinine,blood electrolytes,renal tissue histopathology(HE stain)and the change of ultrastructural organization in renal cells by transmission electron microscope were observed.Results The blood creatinine levels of both CsA and FK506 groups [(36.00±2.61)and(34.17±4.54)μmol/L] were significantly higher than those of the FK506+Dilgroup and control group(all P＜0.05).The blood calcium levels of both CsA and FK506 groups (2.00±0.04 and 2.05±0.04 mmol/L) were significantly lower than those of the FK506+Dil group and control group(all P＜0.05).The blood creatinine and calcium levels of FK506+Dil group were not significantly different with those of control group(P＞O.05).Histopathology examination showed cloudy swelling and vacuolization of the renal tubular epithelial cells and intra-cellular mitochondria swelling and vacuolization in the CsA and FK506 groups.However,the pathological changes of the FK506+Dil group were remarkably milder in comparison with the CsA and FK506 groups.Concluum channel blocker,Dil,could prevent the FK506-induced nephrotoxicity.