Objective To evaluate the efficacy and safety of holmium laser for treatment ureteric stones in patients with acute obstructive renal impairment.Methods Thirty-two patients were included in this study.None of the patients had a ureterie stent or nephrostomy tube before the ureteroseopy.All patients were treated with holmium laser.Results 30 patients with ureter stones in middle and inferior segment were free of stones by ureteroscopic lithotripsy.The success rate for treatment of ureteral stones lithotripsy and calculus removal was 93.7%.Ureter stones located in superior segment in two patients were sent back pelvis.Extracorporeal shock-wave lithotripsy were performed.The two patients were free of any stone fragmens a month later.In all patients, including the five with obstructive anuria,the renal impairment resolved or improved as evidenced by normalization or fall in blood urea and creatinine.100% of the patients were free of any stone fragments postoperatively.Conclusion A holmium laser was a safe and effective modality of ureteroscopic lithotripsy in patients with significant renal impairment or even obstructive anuria.It also had merits of small wound and fast postoperation recovery.Treatment of both-side ureteral stones could be handled at the same time.The use of holmium laser by ureteroacopy could be considered the first choice in patients with acute obstructive renal impairment.

Objective To analyze the causes,treatment and prevention of operation-related complications in liver malignancy patients after CT-guided percutaneous microwave coagulation therapy (PMCT).Methods A total of 68 patients with liver malignancy underwent CT-guided PMCT and their complications were analyzed retrospectively.Results The tumor diameter was 2.0-13.8 cm,mean 6.2 cm.Transcatheter arterial chemoembolization (TACE) was performed before PMCT in 64 patients,and 68 patients received 120 times of PMCT (1-8 times per patient).The main untoward reaction of PMCT was vagus nerve accentuation.Seven patients (7/120,5.83%) had complications including needle-tract implantation (n=2),liver abscess (n=2),pneumatothorax (n=1),cardiovascular accident (n=l) and enormous biloma with infection (n=l),6 were treated finally,and implanted tumor advanced in 1 patient.Conclusion CT-guided PMCT in liver malignancies is a safe therapeutic option with low rate of operation-related complications,which can be prevented and treated.Complications of PMCT are associated with the needle tract,frequency,coagulation range and perioperative management.

Objective To investigate the safety and clinical efficacy of uterime artery chemoembolization in postpartum hemorrhage (PPH) caused by abnormal placental implantation.Methods Between December 2006 and September 2009, there were 23 cases of abnormal placental implantation with PPH in our hospital, among which 9 presented with continuous small amount of vaginal bleeding and 14 with acute excessive bleeding.The average bleeding time was (8±6) d and the mean blood loss was (980±660) ml.Abnormal placental implantation was confirmed by color Doppler ultrasound (CD-US) in all cases, the internal lilac artery angiography was performed to identify the uterine artery and bilateral uterine artery chemoembolization (UACE) with methotrexate (MTX) and gelfoam particles to the distal end of uterine artery was conducted after.CD-US rechecked all patients within 48 h after UACE and those patients with blurred margins between placenta and uterus and abnormal blood flow (> 1 cm×1 cm) received ultrasonic-guided per vagina MTX multipoint injections.All cases were followed up for 3-26 months (average 12 months) to observe vaginal bleeding, placenta tissue discharge, serum human chorionic gonadotropin (hCG), uterine involution, menses, and side-effects or complications.Results (1) Curative effect: These 23 cases underwent 24 procedures of UACE successfully and vaginal bleeding ceased at an average of (3.5±1.3) min after UACE.Reduced blood flow in the placental implantation area was detected under CD-US after UACE.Among the 23 patients, wterine curettage was required in 16 cases due to retained placenta tissues with the mean blood loss of (40 ± 28) ml during the operation, 2 underwent subtotal hysterectomy and confirmed to be placenta percreta by pathology examination, and placenta tissues were spontaneously discharged completely in 5 cases.Totally, 91% of the patients (21/23) reserved their uterus.(2) Follow-up: the serum hCG reduced to normal within 1-13 d after the placenta tissue were evacuated.Regular menstruation returned within 2-3 months in those patients who reserved uterus and normal size uterus was found under sonography at 3 months.No severe complication was reported except for some post embolization syndrome, such as pelvic pain or fever.Conclusions UACE, combined with ultrasonic-guided transvaginal MTX injection, is a safe, minimal invasive and quick hemostatic procedure in treatment of abnormal placental implantation with PPH, and allows the preservation of uterus possible.CD-US is helpful in evaluation of the blood flow changes before and after UACE in abnormal placental implantation patients.

Objective To observe the effect and safety of the treatment of urethral stricture with guide wires leading a balloon dilatation catheter.Methods The clinical date of 25 cases of male patients suffering traumatic posterior urethral stricture were analyzed retrospectively,was treated with a balloon dilation catheter led by guide wires.Results All our patients were cured successfully with a guide-wire-leading balloon dilatation catheter expanding only once and there were no complications such as urethral perforation,rectal injury etc.Although 2 cases had not been ohviously improved risht after dilatation,but improved furtherly six months later.The follow-up was six to twelve months.23 cases were cured.2 osses were improved.The recovery rate was 92%.The effective rate was 100%.Conclusion It was safe and effective to treat urethral stricture with balloon dilation catheter led by guide wires.

The fibronectin was purified from human plasma by Gelatin-Sepharose 4B affinity chromatography. The rabbits were immunized with the fibronectin. the raw anti-fibronectin sera were absorbed bythe solid phase of the fibronectin free human serum. Then the specific anti-fibronectin sera were obtained. The fibronectins deposited on human bullet wounds, incised wounds as well as on blunt forceinJuries were demonst.ated by PAP immunohistochemical study using diluted anti-fibronectin serum.The results were quite sati factory.

Objective To explore the feasibility and effectiveness of aesthetic restoration of caries of mandibular deciduous incisors with strip crown form of maxillary deciduous incisors.Methods A total of 64 patients (202 teeth) with symmetrical caries of bilateral mandibular central incisors or lateral incisors were randomly selected.The opposite maxillary incisors were restored with strip crowns form and the opposite incisors were restored with resin composite.The effects of the two methods and the incidence of complications were compared three months,six months and twelve months after treatment.Results Three months after treatment,there was no significant difference in the success rate between the two groups.Six months after treatment,there was significant differencein the marginal adaptation between the two groups (x2 =3.919,P =0.048);12 months after treatment,there was significant difference in the restoration integrity of the two groups and the incidence of secondary caries (x2 =5.027,P =0.025;secondary caries x2 =4.369,P =0.037).Conclusions The strip crown form of maxillary primary incisors can be used for aesthetic restoration of caries of mandibular primary incisors,and its effect is better than that of direct resin filling.The strip crown form for mandibular primary incisors needs to be developed and produced urgently.

OBJECTIVE: To investigate the effects of autophagy on osteogenic differentiation of stem cells from the apical papilla (SCAPs) in the presence of tumor necrosis factor- (TNF-) stimulation . METHODS: SCAPs treated with TNF- (0, 5, and 10 ng/mL) with or without 5 mmol/L 3-MA were examined for the expression of autophagy marker LC3-Ⅱ using Western blotting. The cells were transfected with GFP-LC3 plasmid and fluorescence microscopy was used for quantitative analysis of intracellular GFP-LC3; AO staining was used to detect the acidic vesicles in the cells. The cell viability was assessed with CCK-8 assays and the cell apoptosis rate was analyzed using flow cytometry. The cells treated with TNF- or with TNF- and 3-MA were cultured in osteogenic differentiation medium for 3 to 14 days, and real- time PCR was used to detect the mRNA expressions of osteogenesis-related genes (ALP, BSP, and OCN) for evaluating the cell differentiation. RESULTS: TNF- induced activation of autophagy in cultured SCAPs. Pharmacological inhibition of TNF--induced autophagy by 3-MA significantly decreased the cell viability and increased the apoptosis rate of SCAPs ( < 0.05). Compared with the cells treated with TNF- alone, the cells treated with both TNF- and 3-MA exhibited decreased expressions of the ALP and BSP mRNA on days 3, 7 and 14 during osteogenic induction ( < 0.05) and decreased expression of OCN mRNA on days 3 and 7 during the induction ( < 0.05). CONCLUSIONS Autophagy may play an important role during the osteogenic differentiation of SCAPs in the presence of TNF- stimulation.
Autophagy ; drug effects ; physiology ; Cell Differentiation ; drug effects ; physiology ; Cell Survival ; drug effects ; Cells, Cultured ; Dental Papilla ; cytology ; Green Fluorescent Proteins ; Humans ; Osteogenesis ; physiology ; Stem Cells ; drug effects ; physiology ; Transfection ; Tumor Necrosis Factor-alpha ; administration & dosage ; antagonists & inhibitors ; pharmacology