Objective To explore the therapeutic efficacy of pneumatic lithotripsy combined with extracorporeal shock wave lithotripsy (ESWL) in patients with ureteral stones. Methods Pneumatic lithotripsy combined with ESWL was employed in the treatment of 365 cases of ureteral stones. Results Of the 365 cases,the operation succeeded in 360 cases and failed in 2 cases,and ureteral perforation occurred in 3 cases.ESWL was required in 80 cases after pneumatic lithotripsy. Conclusions Pneumatic lithotripsy combined with ESWL offers advantages of high efficacy,minimal invasion and broad indications.

Purpose:To study the efficiency and safety on vinorelbine combined with capecitabine in the treatment of metastatic breast cancer. Methods:Twenty-eight patients with measurable lesions of metestetic breast cancer received vinorelbine 6 mg/m 2 d 1-5 civ,cycles were repeated every 21 days. Patients received capecitabine for 2-4 cycles at the same time. All patients received more than one course of chemotherapy regimens and 19 patients had adriamycin and (or) paclitaxel treatment. Results:Thirteen patients received two cycles treatment and fifteen patients received four cycles of treatment. Complete response in one patient,partial response in six patients,minor response in seven patients,stable response in seven patients and progressive disease in seven patients were observed. Overall responsed rate was 50%.The common side effects were neutronpenia,hand-foot syndrome,skin pigmentation,fatigue. Conclusions:The combination of vinorelbine and capecitabine in the treatment of metastatic breast cancer was effective and the toxicities were tolerable. It is possible that this regimen is an ideal second line chemotherapy for metastatic breast cancer.

Objective To investigate the changes of B lymphocyte subsets ( naive B cells, memory B cells and plasmablasts) in peripheral blood of patients with rheumatoid arthritis ( RA) and their correla-tions with the clinical manifestation and laboratory indexes.Methods Sixty-six patients with RA were di-vided into two groups including the group with active RA and the group with inactive RA according to the dis-ease activity score in 28 Joints (DAS28).A control group with healthy subjects was set up accordingly.The distributions of B lymphocyte subsets in peripheral blood samples were detected with flow cytometry analysis and their correlations with clinical manifestations and laboratory indicators were analyzed.Results ( 1 ) Compared with healthy subjevts, the mean fluorescence intensities ( MFIs) of CD19 and the percentages of memory B cells in peripheral blood of the patients with RA were significantly decreased, while the percenta-ges of naive B cells were increased (P<0.05).The percentages of plasmablasts in the patients with active RA were significantly increased as compared with those of healthy subjects and the patients with inactive RA (P<0.05).(2) The percentages of plasmablasts in peripheral blood of the patients with RA were positively correlated with the joint tenderness count, joint swelling count and joint swelling index (P<0.05).(3) A positive correlation was found between the MFIs of CD19 and the erythrocyte sedimentation rates ( ESRs ) among the patients with RA.The percentages of plasmablasts were positively correlated with C reaction pro-tein (CRP) and anti-cyclic citrullinated peptide (anti-CCP) antibody (P<0.05).(4) The percentages of plasmablasts were also positively correlated with the DAS28 among the patients with RA ( R2=0.343, P<0.01).Conclusion The distributions of B lymphocyte subsets varied among the patients in different stages of RA, which were related to the patient′s clinical symptoms and laboratory indexes.The study suggested that different subsets of the B lymphocytes might play an important role in the pathological process of RA.

Objective To investigate the expression of c-FLIPL in leukemia and explore its clinical significance. Methods The expression level of c-FLIPL mRNA in bone marrow mononuclear cells was determined by real-time polymerase chain reaction(PCR)in 103 leukemia patients with different types of leukemia,including 54 cases of acute lymphocytic leukemia(ALL)with 37 newly diagnosed,5 relapsed,and 12 complete remis-sion,38 cases of acute myeloid leukemia(AML)with 24 newly diagnosed,6 relapsed,and 8 complete remission,newly diagnosed 2 cases of acute undifferentiated leukemia(AUL),6 cases of chronic myelocytic leukemia(CML),and 3 cases of chronic myelomonocytic leukemia(CM-ML). The immunophenotype of patients were detected by flow cytometry. Results Expression level of c-FLIPL mRNA was higher in newly diag-nosed and relapsed leukemia patients. There was no significant difference between newly diagnosed and relapsed leukemia patients(P>0.05). Ex-pression level of c-FLIPL mRNA of AUL and CML was higher than that in other patients ,but there was no significant difference(P>0.05). Ex-pression level of c-FLIPL mRNA of all newly diagnosed and relapsed leukemia patients was significantly higher than that in control group and com-plete remission group(P<0.05). The expression level of c-FLIPL mRNA was correlated with risk stratification ,white blood cell(WBC),lactate dehydrogenase(LDH),hydroxybutyrate dehydrogenase(HBDH),CD45 and TEL-AML1,but was not associated with age,sex,fibrinogen and chromosome abnormality. Conclusion c-FLIPL mRNA is highly expressed in leukemia patients ,and is closely related with risk stratification , WBC,LDH,HBDH and prognosis.

Objective To discuss the establishment,implementation and clinical effect of appraisal system of self-injection of insulin.Methods 100 type 2 diabetes patients were chosen as the objects.The appraisal system of self-injection of insulin for diabetes patients was established to quantify the level of related knowledge and self-injection level.Selective health education was given to patients and plan-imple-mentation-appraisal-processing(PDCA)method was adopted in the quality control management of health education.Results After the implementation of the appraisal system,the patients'grades of the related knowledge and skill on self-injection of insulin were enhanced.Fasting blood glucose and 2 h postprandial Mood glucose was stably controlled,which was statistically different from that before the implementation of the appraisal system.Conclusions The implementation of the appraisal system can sharpen the patients'self-control ability of disease and avoid the blindness,low efficiency and duplication of health education workers.

Objective To evaluate the protective effects and mechanism of levocarnitine preconditioning (LCN) on myocardial is-chemia-reperfusion injury in patients undergoing cardiopulmonary bypass .Methods 60 cases of ASA Ⅱ or Ⅲ degree and NYHAⅡ or Ⅲ degree patients who aged 25 ~ 57 years old ,undergoing cardiopulmonary bypass with elective cardiac valve replacement were randomly divided into 2 groups (n = 30 each) :group C (treated with 0 .9% sodium chloride) and group L (treated with LCN) .Group L was infused levocarnitine 50 mg/kg per 1 day at the beginning of 7 days before operation ,group C was given the same amount of 0 .9% sodium chloride .Blood samples were taken from central vein at 5 min after the induction the level of anesthe-sia (T0 ,baseline) ,5 min before aortic cross-clamping (T1) ,30 min after release of the aortic cross-clamp (T2) and at 6 (T3) ,12 (T4) and 24 h (T5) after operation for determination .The level of plasma cardiac troponin I (cTnI) ,creatine kinase-MB (CK-MB) and tumor necrosis factor-α (TNF-α) .Myocardial specimens were obtained from right auricle before aortic cross-clamping and after release of aortic cross-clamp to observe the pathologic changes ,the protein expression of p38 MAPK and phosphorylational-p38 MAPK that analyzed by western blotting .Cardiac index (CI) and left ventricular ejection fraction (LVEF) were measured at 1st day before operation and 7th day after operation by using heart color ultrasonography .Results The levels of cTnI ,CK-MB and TNF-α were significantly lower at all time points in group L than in group C (P< 0 .05) .Myocardial mitochondrion impairment was lighter ,the expression of p38 MAPK and phosphorylational-p38 MAPK were significantly attenuated in group L than in group C (P< 0 .05) .CI and LVEF were significantly higher at 7th day after operation in group L than in group C(P< 0 .05) .Conclusion Le-vocarnitine preconditioning can attenuate myocardial ischemia-reperfusion injury and recover cardiac function in patients undergoing cardiopulmonary bypass ,the mechanism may be related to keep the integrity of the mitochondrial membrane and space structures , inhibit the expression of p38 MAPK and phosphorylational-p38 MAPK and decrease the inflammatory response .

Objective To establish a mouse model of systemic C. albicans infection by oral inoculation of the pathogen and observe the proliferation and distribution of C. albicans in vivo tissues. Methods Male ICR mice(n=46) were used as the experiment group(n=40) and blank group (n=6). Cotton swabs with C. albicans were used to infect the mice (7 × 106 CFU/mL), and the blank group with saline. The mice of the experiment group were randomly divided into two groups:model group A for clinical assessment (n=20) and model group B for tissue fungal burden detection (n=20). Clinical score, survival and autopsy were carried out among the model group A. Five mice were randomly killed from the model group B at 3 d, 5 d and7 d after infection, respectively ( blank group killed 2 mice each time) . Microbial load tablet method was used to detect the tissue fungal burdens in different tissues, meanwhile samples of tongue, esophagus, stomach, liver, kidney, lung of infected mice were taken for pathological examination. Results White spot appeared on the surface of tongue since 3 d postinfection and increased with time and finally caused death. The mortality reached over 50% at 5 d. C. albicans was not only detected from the tongue (87?5%), stomach (87?5%), liver (54?5%), kidney (50?5%), lung (20%) and heart (4%), but also was microscopically seen mycelia proliferation in the tongue, stomach, liver, and kidney , yet not seen in the control group, showing that C. albicans caused disseminated systemic infection through mucosal infection in mice. Conclusions C. albicans can induce opportunistic systemic infection by breakthrough the mucosal immune barrier, so as to increase the infection to death.

BACKGROUND:Culture condition,isolation method and efficiency are different in reported human umbilical cord-derived mesenchymal stem cells,which lack of unified identification standards.Therefore,it is necessary to establish a high-efficiency and economical culture system for human umbilical cord-derived mesenchymal stem calls(hUCMSCs).OBJECTIVE:To isolate hUCMSCs and induced differentiate into adipocytes and osteblasts.METHODS:The hUCMSCs were isolated form human umbilical cord by tissue adherence and digested with collagenase.The morphology,proliferation and immunophenotype of the 3rd passage cells were analyzed,and then cells were induced to osteogenic and adipogenic differentiation in vitro.RESULTS AND CONCLUSION:The hUCMSCs isolated from human umbilical cord by tissue adherence and digested with collagenase could be cultured and proliferated in vitro.Flow cytometry analysis revealed that the hUCMSCs were positive for CD29 CD44,CD59,CD105,but were negative for CD40,CD86 and HLA-DR.These calls could be induced to differentiate into adipocytes and osteblasts under proper inducing conditions.The hUCMSCs retained the appearance and phenotype even after being expanded more than 40 passages in vitro.This confirmed that the existence of MSCs in human umbilical cord and they had the capacity of differentiating into adipocytes and osteblasts.

Objective: To evaluate the occupational health risk of decorative coating manufacturing enterprises and to explore the applicability of occupational hazard risk index model in the health risk assessment, so as to provide basis for the health management of enterprises. Methods: A decorative coating manufacturing enterprise in Hebei Province was chosen as research object, following the types of occupational hazards and contact patterns, the occupational hazard risk index model was used to evaluate occupational health risk factors of occupational hazards in the key positions of the decorative coating manufacturing enterprise, and measured with workplace test results and occupational health examination. Results: The positions of oily painters, water-borne painters, filling workers and packers who contacted noise were moderate harm. And positions of color workers who contacted chromic acid salts, oily painters who contacted butyl acetate were mild harm. Other positions were harmless. The abnormal rate of contacting noise in physical examination results was 6.25%, and the abnormality was not checked by other risk factors. Conclusion The occupational hazard risk index model can be used in the occupational health risk assessment of decorative coating manufacturing enterprises, and noise was the key harzard among occupational harzards in this enterprise.

Major depressive disorder (MDD) is a common affective disorder.With its unique characteristics and advantages,traditional Chinese medicine (TCM) has played an important role in the treatment of MDD.Recent researches have revealed that the neuroinflammation-induced neurogenesis reduction were the key pathology of MDD.This analysis indicated that salvia was frequently used for treatment of MDD from the prescriptions reported in literatures.Salvianolic acid (SalB),one of main active compounds of salvia,had showed anti-inflammation and neuroprotection effects in previous studies.In this review,we summarized the antidepressant effects of SalB through regulating microglial activation,inhibiting neuroinflammation and promoting neurogenesis.According to the theory of removing blood stasis for promoting tissue regeneration,it was suggested that the novel antidepressant strategies for antiinflammatory and neuroprotective activities were through microglia-modulating pathway with TCM.