Objective;To evaluate the endourethral surgery for urethrostenosis and urethratresia. Methods:68 patients with urethrosteno-sis or urethratresia were treated by endourethral surgery, such as internal urethrotomy, transurethral scar resection. Results: Of the 68 cases, the outcome was satisfactiory in 61 (89. 71% ). Endourethral surgery was carried out once for 55 patients and twice for 6,7 patients required open surgery. All patients had followed by urethral dilatation. 59 patients were followed - up for 3 months to 5 years. 54 cases can micture normally. Conclusions; Endourethral surgery is simple,safe,efficient treatment for urethrostenosis and urethratresia.

Objective To observe the effect of HBO in the treatment of artery complications after liver transplantation.Method Five cases were treat by HBO(202.65 kpa,once every day,oxygen inhalation 60 min) and other therapies after operation.Result After HBO,the whole-body situations were obviously improved,liver functions were ameliorated,no new necrotic focuses were found,and the primary necrotic focuses were reduced or vanished.Conclusion HBO was an effective way to treat and prevent the artery complications after liver transplantation and protect the ischemic liver cells.

Objective To explore the association between rheumatoid arthritis (RA) with HLA-DRB1 in China. Method The reported articles about HLA-DRB1 RA in China were searched and Meta-analysis was performed. Result Fourteen studies enroll 1118 RA patients and 1301 controls, the associated gene was HLA-DR4 (OR=4.05, P

Objective To investigate the clinical features,treatment and prognosis of paraneoplastic pemphigus (PNP).Methods A retrospective study was performed on 11 patients with PNP hospitalized in the Department of Dermatology,Ruijin Hospital.Clinical characteristics of these patients were analyzed.Results Of the 11 patients,10 had oral or labial erosions or ulcers,and 6 had obstructive bronchiolitis.Computed tomography (CT)showed solitary internal tumors in all the patients after appearance of skin lesions,and 8 of them were diagnosed with Castleman's disease.All the patients had been treated with corticosteroids before operation,but achieved no obvious improvement.After 2-7 months of postoperative treatment with low-dose prednisone and thalidomide,both cutaneous and mucosal lesions healed with the relief of pulmonary symptoms in 5 patients.Conclusions Oral erosions or ulcers appear to be the most common initial manifestation of PNP with Castleman's disease as the most frequent accompanying tumor.Early detection and timely resection of tumors are keys to successful treatment of PNP,and postoperative treatment with glucocorticoids and thalidomide proves to be effective for PNP.

Objective To observe the effect of intranasal dexmedetomidine on total intravenous anesthesia for thyroid surgery postoperative analgesia.Methods Sixty female patients who were undergoing elective thyroid surgery were enrolled.Patients by total intravenous anesthesia were randomized in mechanical sampling method to receive intranasal dexmedetomidine 1 μ g/kg (group Ⅰ,30 cases),or the same volume sodium chloride (group Ⅱ,30 cases) before anesthesia induction,then flurbiprofen 100 mg intravenous 10 min before surgery.The postoperative surgical pain was assessed utilizing visual analogue scale (VAS),and the postoperative pain of cough was assessed by comfort score (BCS) at 1,2,4,6,8,12,24 h after surgery,in addition,the adverse reactions were recorded.Results The VAS scores at 1,2,4,6,8,12 h in group Ⅰ were lower than those in group Ⅱ,and there were statistically significant (P ＜ 0.05).The BCS scores at 1,2,4,6,8 h in group Ⅰ were higher than those in group Ⅱ,and there were statistically significant (P ＜ 0.05).The nausea and dizziness morbidity in group Ⅰ were lower than those in group Ⅱ (8 cases vs.14 cases,6 cases vs.14 cases),and there were statistically significant (P ＜ 0.05).Eight patients were required supplemental analgesic within 12 h after surgery in group Ⅱ,which was more than that in group Ⅰ (0 case),and there was statistically significant (P ＜ 0.05).Conclusion Receive total intravenous anesthesia for thyroid surgery,the patients who are given intranasal dexmedetomidine 1 μ g/kg combined with flurbipmfen can reach satisfactory postoperative analgesia,decrease the nausea and dizziness morbidity,increase the comfortable degree.

Oxidative stress and inflammation are two main factors in the progress of diabetic nephropathy(DN) and its complications. NF‐E2 p45‐related factor (Nrf2) is a crucial transcriptional factor which manipulates downstream genes that encode some antioxidant enzymes and phase Ⅱ detoxifying enzymes ,to maintain the redox homeostasis and cellular detoxification response. Therefore ,more and more researchers are focusing on the role of Nrf2 in DN. In this review ,the detailed role of Nrf2 in DN will be discussed. Hopefully ,our work can epitomize recent research progress and provide novel clues for diabetic nephropathy prevention and treatment.

ObjectiveTo investigate the role and its mechanism of the NOD-like receptor 3 (NLRP3) inflammasome in alveolar macrophages in ventilator-induced lung injury (VILI) in rats.Methods Thirty adult male Sprague-Dawley (SD) rats were randomly divided into three groups, with 10 rats in each group: spontaneous breathing control group, normal tidal volume (VT) group (VT 8 mL/kg) and high VT group (VT 40 mL/kg). All of the rats underwent tracheotomy. Then rats in spontaneous breathing control group were kept to have spontaneous breathing, while rats in normal VT group and high VT group received mechanical ventilation. After 4 hours, the rats were sacrificed by carotid artery bleeding, and the bronchoalveolar lavage fluid (BALF), blood serum and lung tissue were collected. Lung wet/dry ratios (W/D) were measured. Light microscopy and electron microscopy were performed to observe the pathological changes in lung tissue, and the ultrastructural changes in alveolar macrophages. Enzyme linked immunosorbent assay (ELISA) was performed to measure the total protein content in the BALF and the interleukins (IL-1β and IL-18) in the serum and BALF. The mRNA expressions and protein levels of NLRP3, apoptosis-associated speck-like protein containing CARD (ASC), caspase-1, and nuclear factor-κB (NF-κB) in alveolar macrophages were assayed by real-time fluorescent quantization reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot.Results The structure of lung tissue and alveolar macrophages of rats in spontaneous breathing control group and normal VT group appeared normal, while obvious inflammatory changes were found in high VT group. Compared with spontaneous breathing control group and normal VT group, the ratio of W/D (8.89±0.90 vs. 5.18±0.86, 5.71±0.82, bothP< 0.05), contents of total protein, IL-1β, IL-18 in BALF were significantly increased [total protein (g/L):2.34±0.41 vs. 1.77±0.14, 1.81±0.06, IL-1β (ng/L): 133.48±10.48 vs. 81.54±3.12, 83.80±5.22, IL-18 (μg/L):4.57±0.45 vs. 3.04±0.51, 3.43±0.43, allP< 0.05], and IL-1β and IL-18 in serum were also increased [IL-1β(ng/L): 105.06±10.18 vs. 65.11±8.58, 75.30±10.62, IL-18 (μg/L): 2.27±0.09 vs. 1.18±0.34, 1.43±0.15, all P< 0.05]. The mRNA and protein expressions of NLRP3, ASC, caspase-1 and NF-κB in alveolar macrophages of high VT group were significantly increased compared with that of spontaneous breathing control group and normal VT group. The mRNA expressions of NLRP3, ASC, caspase-1 and NF-κB in high VT group were (8.53±2.21), (5.75±1.17), (7.47±1.23) and (10.86±2.38) folds of those in spontaneous breathing control group, and the protein expressions of NLRP3, ASC, caspase-1 and NF-κB were (1.50±0.14), (1.49±0.04), (1.53±0.15) and (1.51±0.11) folds of those in spontaneous breathing control group (allP< 0.01). There were no significant differences in all the indexes between normal VT group and spontaneous breathing control group.ConclusionNLRP3 inflammasome in alveolar macrophages may be involved in the mechanism of occurrence of VILI.

Great advances have been made in understanding the genesis,diagnosis,risk stratification and the targeted therapy of myeloproliferative neoplasms (MPNs) in the past decade.This article reviews the current situation in the genesis,diagnosis and risk stratification of these classic bcr-abl-negative MPNs presented in the 56th American Society of Hematology (ASH) annual meeting.

Primary myelofibrosis is a kind of chronic myeloproliferative neoplasms.The discovery of the JAK2V617F mutation as well as other molecular abnormlities underly the pathogenesis of Philadelphia negative myeloproliferative neoplasms (MPN).The initial description of JAK2V617F mutation in 2005,the reporting of calreticulin (CALR) mutations last year and the clinical application of JAK inhibitors,showed the gradually deepening understanding with regard to the pathogenesis and the development of therapeutic strategies for primary myelofibrosis (PMF).This article reviewed the progress in diagnosis,risk stratification of of PMF,the benefits and potential side effect of JAK inhibitors,which reported on the 2014 European Hematology Association annual congress.

This is a review on the new progress in the study of regulation mechanism of Plasmodium falciparum Var gene family. The mutually exclusive expression system caused expression only one in 60 var genes while others were silenced. It was regulated on the transcriptional level mainly through three pathways:non-coding DNA elements,chromatin structure and perinuclear localization.