Objective To identify the therapeutic effect and safety of mini -percutaneous nephrolithotomy combined with antegrade modular flexible ureteroscope for the treatment of staghorn stone.Methods The clinical data of 116 patients with staghorn calculi who underwent mini -percutaneous nephrolithotomy combined with antegrade modular flexible ureteroscope were retrospectively analyzed.Of the 116 patients,63 cases were men,53 cases were women .Age ranged from 2 5 to 6 7 years .The diameter ofcalculi ranged from 4 6 to 9 8 (mean =4 6 )mm .There were 63 large complete staghorn renal calculi in these patients.Results All procedures were performed successfully using a single lithotripsy tract.The mean surgical time was (125.4 ±30.0)minutes.The initial stone -free rate was 81.03%(94 /116).Twenty -two cases had several residual calculi from 12 to 25mm.Post -procedure complications included hemorrhage in 9 patients,fever(>38.5 ℃)in four patients,and reactive pleural effusion in one patient. Blood loss requiring transfusion,sepsis,adjacent organ injury and kidney loss were not observed.Conclusion Mini -percutaneous nephrolithotomy combined with antegrade modular flexible ureteroscope has good therapeutic effect in treating renal staghorn calculi,since the technique in treating the renal staghorn calculi makes the operation period shorter,the rate of stone -free higher,the operation wounds smaller,the rate of complication lower,the rate of surrounding organ injury less.

Objective To construct the conditionally replicative adenovirus vector pAd-Egr1-TRAIL-hTERT-E1A-E1Bp-E1B55K carrying early growth response gene-1 (Egr1)promoter and tumor necrosis factor related apoptosis inducing ligand (TRAIL)gene, and to observe the effects of the vector combined with 2 Gy irradiation on the TRAIL expression in MDA-MB-231 cells.Methods Egr-1 promotor sequence was cloned from pMD18 T-Egr1, TRAIL was constructed the downstream of Egr1 promoter, pShuttle-Egr1-TRAIL-hTERT-E1A-E1Bp-E1B55K (CRAd.pEgr1-TRAIL)was constructed,after the adenovirus vector was packaged successfully,MDA-MB-231 cells were infected with them and irradiated with X-rays.Real time PCR method and ELISA were used to detect the expression levels of TRAIL mRNA and protein, respectively. Six groups in the experiment were set up:control, 2 Gy,CRAd.p,CRAd.pEgr1-TRAIL,CRAd.p + 2 Gy and CRAd.pEgr1-TRAIL + 2 Gy. Results The recombinant adenovirus vector pAd-Egr1-TRAIL-hTERT-E1A-E1Bp-E1B55K was constructed and packaged successfully.The expression level of TRAIL mRNA in MDA-MB-231 cells transfected with the vector of 5 MOI for 24 h following 2.0 Gy X-rays irradiation began to increase and arrived to the top 8 h later in various groups,then declined.The expression level of TRAIL protein in MDA-MB-231 cells began to increase 6 h after irradiation and reached to the peak 24 h later,then declined 48 h later.There were significant differences in the expression levels of TRAIL protein between CRAd.pEgr1-TRAIL + 2.0 Gy and other groups at the same time point (P<0.01). Conclusion The recombinant adenovirus vector is obtained successfully, and the TRAIL mRNA and protein expression levels in MDA-MB-231 cells can be increased significantly by the vector combined with 2.0 Gy X-rays irradiation.

Objective To validate the hypothesis that the phenotype reversion occurs in the smooth muscle cells in the corpus cavernosum of hypertensive rats with selenium food and explore selenium′s impact on erectile function. Methods 25 14-week-old male spontaneously hypertensive rates (SHR) were divided into 2 groups (SHR-ED-Se group n = 8 and SHR-ED-N group n = 9). SHR-ED-Se rats were fed with selenium diet, SHR-ED-N rats and WKY rats with normal diet. And 10 syngeneic normotensive rats (WKY) were used as control group. All rats were killed after 4-week feeding. Immunohistochemical staining and color image analysis system were used to observe expression of α-actin, desmin and osteopontin (OPN) in rats corpus cavernosum of different group. Results 2 SHR-ED-N rats died. Expression of α-actin of smooth muscle in corpus cavernosum in SHR-ED-N group was the lowest in all groups (P = 0.000), so did erection frequency (P < 0.05). Expression of OPN in SHR-ED-N is the highest (P = 0.000). No significant difference existed in expression of desmin in all group (P > 0.05). Conclusions Phenotype modulation of smooth muscle in corpus cavernosum of SHR rats can be reversed by selenium which means the smooth cells can transform from synthetic phenotype into the contractile phenotype, resulting ultimately in improving erectile function.

Objective To investigate the clinical, pathology, diagnosis and treatment of the lower urinary system dysfunction among chronic recreational ketamine abusers. Methods From 2000-2008, 20 ketamine abusers(14 men and 6 women; mean age, 22.3 years), from 3 hospitals in Guangzhou and Hongkong, and suffering from lower urinary tract dysfunction was reported. All of them had abused ketamine for 1 to 4 years, and presented with severe lower urinary tract symptoms. Complaint of severe frequency, urgency, urge incontinence, and painful haematuria was common. Urine cultures were negative. Six men suffered from severe dysuria. B ultrasound examination of 16 cases demonstrated the presence of bilateral hydronephrosis. Fourteen IVU and 10 CT investigations demonstrated the presence of bilateral hydronephrosis, bladder contraction, and 1 case showed papillary necrosis of the kidney. Different levels of abnormal liver function and chronic/acute renal failure were observed. All of the patients were required to withdraw the narcotics and the experimental medicine were given. Results The biopsies of 6 cases demonstrated the cystitis. Twelve cases' symptoms were reversible after these patients stopped or reduced the frequency and amount of ketamine abuse. Pentosan polysulfate sodium and sodium hyaluronate solution relieved the symptoms of 6 patients. Conclusions "Street ketamine" associated urinary system dysfunction might be a kind of in flammatory process involving the upper and lower urinary tract. Underlying aetiology and treatment methods necessitate further study.

Objective To identify the therapeutic effect and safety of anterograde flexibleureteroscopy on the treatment of upper -middle ureteral calculi.Methods The clinical data of 47 patients who underwent anterograde flexible ureteroscopy for the treatment of upper -middle ureteral calculi in our center were retrospectively reviewed. During the 47 patients,28 cases were men,19 cases were women.Age ranged from 20 to 68 years.The diameter of calculi ranged from 8 to 22mm(mean =14 mm).Results The flexible ureteroscopic lithotripsy procedure were successful in all the cases.The mean operative time was (65.3 ±8.5)min.The mean hospital stay was 8 days.The average blood loss was less than 50mL.The initial stone -free rate was 93.62%(44 /47).No severe complications occurred intraoperative and postoperative.Conclusion Anterograde flexible ureteroscope has good therapeutic effect in treating upper -middle ureteral calculi.It is safe and effective procedure,with less complication and a high calculus removing rate.The surgical methods is worthy of clinical application.

OBJECTIVETo track and analyze two false positive cases from non-invasive prenatal testing for potential fetal aneuploidy.

METHODSThe two cases, respectively reported to have XO (+++) and T18 (1/20) XO(+), were analyzed with conventional karyotyping, fluorescence in situ hybridization (FISH) and massively parallel genomic sequencing (MPS).

RESULTSThe first fetus, who was suspected for XO(+++), was verified to have super female syndrome (47,XXX/46,XX) due to confined placental mosaicism by karyotyping of amniotic fluid cells, FISH analysis of placenta and massively parallel sequencing (MPS) of fetal tissue. The second fetus, suspected to have trisomy 18 (1/20) XO(+), was verified to have Turner syndrome by karyotyping, FISH and MPS analyses of umbilical cord blood cells. And the karyotype was 45,X[48]/46, X, der(X) del(X) (p11.21) del(X) (q13.3)[62].

CONCLUSIONNon-invasive prenatal testing carries a risk for false positive diagnosis of fetal sex chromosome and trisomy 18. Combined cytogenetic and molecular techniques are required to ensure an accurate diagnosis.

Adult ; Aneuploidy ; Chromosome Aberrations ; Diagnostic Errors ; False Positive Reactions ; Female ; Fetal Diseases ; diagnosis ; genetics ; Humans ; Pregnancy ; Prenatal Diagnosis ; Young Adult

Objective To discuss the experience of medical treatment and rescue of the ‘SHENZHOU' astronauts in the landing place in the past 10 years,and to establish more effective mobile ICU in medical helicopters to ensure ‘SHENJIU' astronauts safety.Methods The data collected from foreign nations and our country was reviewed.Formerly experience in first-aid and rescue astronauts of our team was summerized.The important reasons of accidental injuries of astronaut during aerospace flight were listed.More effective and reasonable prophylactic measurements and clinical treatments of the accidental injuries of astronauts were brought forward.Results we established three effective mobile ICU that could ensure the safety of the astronauts.The carriers of the ICU were helicopters,and damage control surgery can be performed there.Fine armature made us more effective.Conclusions Reasonable and effective prophylactic measurements and clinical treatments were the important aspect of the successful manned aerospace flight.The first-aid system in helicopters could realize the destination of swift response and first-aid.

Objective To summarize the medical security experience in first-aid and resuscitation for astronauts at the exit of capsule after the spacecraft returns to the main landing site in the process of human spaceflight in China,and thus to provide a powerful security measures for Chinese aerospace medicine.Methods The medical support experiences were summarized in human spaceflight from "Shenzhou V" to "Shenzhou X",relevant reports on emergency rescue and resuscitation were consulted in in-orbit process and after emergency return and landing for domestic and foreign astronauts,astronauts' physiological changes in cardiopulmonary resuscitation were analyzed during emergency return,and then,corresponding strategies were proposed and tested in practice (actual combat) by combining with the flight characteristics of the spacecraft "Shenzhou XI".Results On the basis of the original emergency treatment,the countermeasures for the cardiopulmonary resuscitation were proposed after the spacecraft returned to the main landing site in human spaceflight,the emergency equipment was adjusted,the emergency procedures were optimized,and anti-fog glidescopes were added,laryngeal masks were introduced to perform supraglottic ventilation as the quickest and most effective airway opening measure on site.In addition,ultrasound examination was applied in practice as an important treatment and assessment method for basic life support and advanced life support.All these could ensure the rescuing ability on cardiopulmonary resuscitation during their stay in space for the medium-term and after their return to the main landing site.Conclusions During the return of the astronauts of the spacecraft "Shenzhou XI" to the main landing site,the first aid and support program had been improved specifically and the process had been optimized to ensure the successful completion of medical security mission of China's human spaceflight.