AIM: To evaluate the efficacy and safety of multiple vitamin E, C, B facial mask for the patients with acne vulgaris. METHODS: One hundred and seventeen patients aged over 13 a, with acnes mainly sited on the face and an acne severity rating above grade 2 were enrolled in this study. The mask treatment was used once a day with 8 wk as a course.The primary endpoint included the number and the degree of acne lesions including comedoes, papules, pustules and cysts. The secondary endpoint was the overall efficacy evaluation by the physicians. RESULTS:After 8 wk of treatment with multiple vitamin E, C, B facial mask, the mean number of acne lesions:comedoes, papules, pustules and cysts decreased 13 + s 13,10 ± 12, 5 + 7 and 3 + 3, respectively. These changes were statistically significant (P ＜ 0.01 ). The results of overall efficacy evaluation showed that 7 patients '(6.0 % ) symptom was greatly improved, 44 patients '(37.6 % ) symptoms were moderately improved, 56patients'(47.9 % ) symptoms were slightly improved,and 10 patients' symptoms did not change. Among all 117 patients, 59 patients (50.4 % ) showed no adverse reactions, including swelling, redness, itching,burning or scaling. CONCLUSION: Multiple vitamin E, C, B facial mask is efficacious for the treatment of acne and more than half study subjects experienced in none adverse reaction. Multiple vitamin E, C, B facial mask possesses an alternate therapy in acne vulgaris.

Tumor tissue hypoxia is taken as an important biologic character of malignant tumors,it could reduce the therapeutic efficacy of radiotherapy and chemotherapy. Presenting a noninvasive approach in detecting hypoxic state in tumors,hypoxia imaging of nuclear medicine can be used in the differential diagnosis,prognosis evaluation and guiding therapy of malignant tumors.

Objective To investigate the clinical effect of ureteroscopic holmium laser lithotripsy for the treatment of ureteral calculus.Methods A total of 72 cases of ureteral calculus was treated with stone fragmentation from April to November 2004,by using the Lumenis VersaPulse PowerSuite 100W Holmium Laser system and the Circon ACMI Micro Ureteroscope.Under ureteroscopic visualization,the laser lithotrite was introduced to the stones,and holmium laser intraluminal stone fragmentation was carried out. Results The operation time was 14~83 min(mean,28 min).Three cases of fragmentation failure were due to upper ureteral stones migrating to the renal pelvis.The success rate of fragmentation on one session was 95.8%(69/72),which was 92.1%(35/38) for upper segment calculi and 100%(34/34) for middle-to-lower segment calculi.Intraoperative complications included 3 cases of ureteral perforation(4.2%),9 cases of stone migration(12.5%),and 72 cases of hematuria(100%).Postoperative complications included 45 cases of lumbago(62.5%),72 cases of hematuria(100%),and 5 cases of urinary tract infection(6.9%), without ureteral stricture.The kidney,ureter,and bladder(KUB) X-ray radiograph on the first postoperative day showed a stone-free rate of 86.1%(62/72),and the remaining residual stones were thoroughly expelled within following 2 weeks.The length of postoperative hospital stay was 2~5 d(mean,3 d).Re-examinations with B-ultrasonography or intravenous urography(IVU) at 3 months after operation in 46 cases revealed no ureteral stricture.Hydronephrosis subsided by 1.4?0.5 cm in 28 cases and completely disappeared in 21 cases.Conclusions Ureteroscopic holmium laser lithotripsy for treating ureteral calculus offers satisfactory clinical effects and low complication rates.

Objective To investigate the value of imaging diagnosis of endomyocardial fibrosis(EMF).Methods Imaging findings of 28 cases of EMF were restrospectively analyzed.Results There were three types:right ventricle type(n=21),left ventricle type(n=1),and dual ventricle type(n=6).The misdiagnostic rate of EMF by X-ray plain films was high(18/28). On angiography and MRI right ventricle type presented as shortened,deformed inflow-tract,obliteration of apex and dilated outflow-tract,marked tricuspid valve regurgitation(TR) and enlarged right atrium,even dilated superior vena cava,left ventricle type presented as narrowiug and deformed inflow-tract,small and deformed left ventride,even no markedly volume changes in relaxation or contraction,obtuse cardiac apex and mitral regurgitation.Dual ventricle type owned manifestations in the two types mentioned above,but predominated by right ventricle type. Conclusion In diagnosis of EMF X-ray plain films are of less value while MRI and cardioangiography are significant,MRI is a valuable non-invasive method,it can substitutd for cardioangiography as the first choice in diagnosing EMF.

Objective To compare the outcomes of antegrade and retrograde approach ureteroscopy for impacted upper ureteric calculi and assess the safety and efficiency of the two types of minimally invasive technique. Methods A total of 106 patients with impacted upper ureteric calculi were treated with ureteroscopy. The procedure was performed via antegrade percutaneous nephrostomy tract in 50 patients (antegrade group) and via retrograde transurethral access in 56 patients (retrograde group). Results The success rate of retrograde group was 92.9% (52/56). Operating time was (45 ± 5 ) min, hospital stay was (6 ± 1) days. The stone free rate was 80.4%(45/56) at 1 month follow-up,7 patients with residual calculi required ESWL combination. Complication rate was 5.4% (3/56). The success rate of antegrade group was 100.0% (50/50). Operating time was (55 ± 8 ) min, hospital stay was (8 ± 2) days. The stone free rate was 100.0% (50/50) and no complication was noted. The stone free rate and the complication rate indicated significant difference between the two groups (P ＜ 0.05). Conclusions Antegrade and retrograde access ureteroscopy for impacted upper ureteric calculi are safe and effective. Success rate and stone free rate of antegrade approach are higher than those of retrograde approach.

Objective To discuss the medium-term follow-up of clinically insignificant residual fragments (CIRF) after minimally invasive percutaneous nephrolithotomy lithotripsy (MPCNL).Methods The clinical data of 72 patients with CIRF medium-term follow-up were analyzed retrospectively.Results Seventy-two patients with CIRF.The anatomical distribution of CIRF was 10 at upper pole,15 at middle,35 at lower,10 at renal ureteropelvie junction and 2 at upper and lower pole.Stone analysis showed that 41 cases of calcium oxalate calculi,16 of calcium oxalate calculi mixed with carbonate calculi,3 calcium oxalate calculi mixed with uric acid,4 calcium oxalate calculi mixed with struvite stone,3 struvite stone,2 uric acid stone and 3 carbonate apatite mixed with struvite stone.Fifteen cases had clinical symptoms,including 2 renal colic pain,8 hematuria,5 lower urinary tract symptoms,4 cases CIRF located in upper pole,1 case in middle pole,4 cases in lower pole,6 cases in ureteropelvic junction,the incidence of clinical symptoms in ureteropelvic junction was significantly higher than that in other locations (6/10 vs.4/12,1/15,4/37,P ＜0.05).Eight cases required surgical procedure,5 cases underwent extracorporeal shock wave lithotripsy,3 cases with ureteral CIRF were performed with ureteroscopic lithotripsy.CIRF were clear after surgery,7 patients with ureteral CIRF had renal colic pains.The stones were excluded after spasmolytic analgesic treatments.Conclusions CIRF can be located variously in the kidney and ureter.Most CIRF are calcium oxalate calculi and locate in the lower pole.Patients with the history of previous open surgery or extracorporeal shock wave lithotripsy are more likely to get CIRF.Medium-term follow-up of CIRF reveals that CIRF located in the renal ureteropelvis junction are more likely to have clinical symptoms.

Objective To evaluate the clinical effects and safety of percutaneous nephrolithotomy (PCNL) by middle renal calice used as the main target for the treatment of staghorn stones with the combination of pneumatic and ultrasonic lithotrite.Methods Clinical data of 73 patients underwent PCNL by middle renal calices as main access with 57 incomplete staghorn stones and 35 complete staghorn stones.To observe the situation calculus removal rate and complications.Results Seventy cases (88 sides) underwent one session PCNL by single access tract (middle caliees),3 cases (4 sides) underwent one session PCNL by double access tracts (2 cases by middle and low calices,1 case by up and middle caliees).After the first period of lithoclasty,17 patients (25 sides) residual stones and the stone removal rate 72.8％ (67/92),among these patients,1 case (1 side) had fragments of lateral renal calyeeal stones with no further treatment.Other 16 cases (24 sides)underwent second session PCNL,all were treated by single access tract (middle calices) and 2 cases (2 sides)had extracorporeal shock wave lithotripsy before the second PCNL.After the second period of lithoclasty,76 sides composed of 27 complete staghorn stones and 49 incomplete staghorn stones had no residual fragments with the stone removal rate 82.6％ (76/92).The operative time lasted 120-320 min.Hemoglobin dropped 1-4 g/L,11 cases in the operation procedure and 3 cases after operation needed blood transfusion respectively.One case of renal pelvic infection after operation and 1 case had split renal dysfunction with peri-parenchyma infection.The hospitalization time was 9-18 days.Conclusion It is effective and safe to perform PCNL for staghorn stone by middle calices as a main access.Combining pneumatic and ultrasonic lithotrite will be very useful with high stone clearance,short procedure time and less complications.

Objective To investigate the therapeutics of solitary kidney complicated with complexcalculi,and improve the effect and safety of treatment.Methods Experiences in the treatment of 32 patients with solitary kidney complicated with complex calculi were summarized.Congenital solitary kidney was 6 cases (18.8%),postnatal reason was 26 cases(81.2%),left was 12 cases(37.5%),right was 20 cases (62.5%).All patients were with mould or multiple calculi,9 cases were complicated with ureter calculi,and 8 cases were hospitalized because of obstructive anuria.The patients with mould calculi received extracorporeal shock-wave lithotripsy (ESWL) prior to percutaneous nephrolithotomy(PCNL).While the patients with multiple calculi received PCNL prior to ESWL. Some cases were treated by lithedialysis.Results Twenty-nine cases (90.6%)were cured by ESWL combined with PCNL 12 cases received lithodialysis during PCNL. Eight cases with obstructive anuria recovered in 12 hours after emergent ESWL or lithodialysis,3 cases(9.4%)underwent open operation because of deformity or obstruction in renal pelvis and ureter,1 case had to keep nephrostomy because of repeated infection.Followed up 4-36 months,29 cases (90.6%)kept good kidney function,3 cases(9.4%)had renal insufficiency,2 cases(6.2%)reoccurred calculi.Conclusions The therapeutics of ESWL combined with PCNL may clear complex calculi of solitary kidney effectively and safely.It is necessary to take emergent ESWL in renal obstructive calculi cases.And the patients with lower ureter obstructive calculi may take lithodialysis first.It is proper to choose open operation on the patients with deformity of renal pelvis or obstruction of ureter.

Objective To observe the effect of bone marrow-derived mesenchymal stem cells (bMSCs) on graft healing within a bone tunnel after anterior cruciate ligament (ACL) reconstruction in rabbits.Methods The study involved 24 New Zealand white rabbits undergone ACL reconstruction with an autologous ipsilateral gastrocnemius tendon graft.Both hindlimbs were included.In one hindlimb,graft coated with fibrin glue compound by bMSCs was employed (bMSCs group).Whereas in the contralateral hindlimb,graft coated with fibrin glue without cells was employed (control group).At postoperative 2,4,6 and 8 weeks,specimens were harvested to have a biomechanical test of tensile strength and stiffness of tendon-bone interface.Results Tensile strength and stiffness of tendon-bone interface in both experiment and control groups presented a rising trend with the prolong of repair time.In contrast,significantly higher tensile strength and stiffness of tendon-bone interface were observed in experiment group since the 6 weeks (P ＜ 0.05).Conclusion bMSCs transplantation significantly enhances the early tensile strength and stiffness at tendon-bone interface after ACL reconstruction in rabbits and improves the graft healing within a bone tunnel.

Objective To explore the correlation of anticardiolipin antibody (ACL) and lupus nephritis (LN) glomerular microthrombi (GMT) in patients with systemic lupus erythematosus (SLE) and to analyze their clinical manifestations and renal pathological characteristics.Methods The clinical data of 126 LN patients treated at our hospital between January 2005 and October 2010 were retrospectively reviewed.The factors,including age,gender,the clinical manifestations in and outside of kidney were evaluated by multivariate Logistic regression analysis.Enzyme-linked immunosorbent assay (ELISA) was used to test the serum levels of ACL in all patients.Statistical analysis was conducted using x2 test and Logistic regression.Results ① All 126 patients were investigated.Thirty-eight LN patients had GMT.When compared with the LN-non-GMT group,the SLE disease activity index (SLEDAI),urinary protein quantity (24 h),serum creatinine,serum urea nitrogen,anti-dsDNA antibody (+),the incidence of severe hypertension,anemia,thrombocytopenia,arthritis were higher in the LN-GMT group (P＜0.01).Logistic regression analysis showed that SLEDAI (OR=2.486,95％CI 1.678-3.684,P=0.000),anemia (OR=4.628,95％CI 1.045～20.496,P=0.044) were correlated with GMT; ② The pathologic results of renal biopsy showed that GMT had an incidence of 30.2％ (n=38) in LN.As compared with the LN-non-GMT group,Wilcoxon test showed that the LN-GMT group suffered more severe greater renal pathological injuries (P=0.012).The pathological types of LN-non-GMT and LN-GMT groups were as follows:type Ⅳ (38％ vs 76％) and type Ⅲ (31％ vs 8％); ③ The positive rate of ACL was higher in the LN-GMT group than that in the LN-non-GMT group (n=23,61％ vs n=15,36％).The differences were statistically significant (P=0.018).Conclusion GMT is not rare in LN.SLEDAI,anemia and positive ACL are correlated with GMT,LN patients with concurrent GMT have more severe renal pathological changes.