Objective To explore the efficacy of transurethral nephroscopic pneumatic lithotripsy combined with ultrasound lithotripsy for bladder calculus.MethodsBy using transurethral F20.8 nephroscope and EMS LithoCaster,we performed transurethral nephroscopic pneumatic lithotripsy and ultrasound lithotripsy on 69 patients with bladder calculus(63 men and 6 women)between October 2005 and May 2008.The diameter of the calculi was ranged from 1.5 to 6.0 cm.Among the patients,42 had one stone in the bladder,while 27 had multiple calculi.Fifty-five patients were complicated with BPH,14 had neurogenic bladder,and 4 showed bladder diverticulum with stones in situ.Pneumatic frequency was set at 8-12 Hz,and ultrasonic energy was 50%-60%.For the patients with BPH electrovaporization ablation was plused.ResultsAmong the 69 patients,68 were cured in one session.The mean operation time was 25 minutes(15 to 40 minutes).One patient was converted to open surgery because of rupture of the bladder during the procedure.No patient had urethral stricture,infection,or massive hemorrhage during the operation.Follow-up was available in 68 patients for 6 to 10 months(mean,9 months).During the period,no recurrent calculi was found by ultrasonography and X-ray.ConclusionTransurethral nephroscopic pneumatic lithotripsy combined with ultrasound lithotripsy is effective for bladder calculus.

Objective To investigate the calculi composition of patients with urinary calculi in Henan area and the clinical significance of preventing calculi recurrence with individualized method.Methods From August 2009 to July 2010,1050 patients in our hospital underwent extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy and percutaneous nephrolithotomy were set as the experimental group,all stone specimens were detected with the BRUKER TENSOR27 infrared spectroscopy for analysis of stone composition,and nurse on duty gave instructions according to the stone composition to prevent recurrence.From July 2008 to July 2009 1010 patients in our hospital underwent extracorporeal shock wave lithotripsy,ureteroscope and percutaneous nephrolithotomy were set as the control group,patients in the control group were not given calculi component analysis and these patients received general prevention guidance.The calculi recurrence was compared between two groups.Results Among 1050 cases in the experimental group,urinary calculi with single component accounted for 46.29％,of which calcium oxalate stones accounted for 44.95％.Calculi with mixed components accounted for 53.71％,mainly were calcium oxalate and carbonate apatite mixture components (30.48％).57 cases (5.43％) occurred urinary stone recurrence in the experimental group,while 177 cases(17.52％) in the control group.The difference had statistical significance.Conclusions Urinary calculi analysis has important clinical significance for understanding the causes and treatment of calculi as well as prevention of recurrence of calculi.

50.0%.CONCLUSION:The extensive use of antibacterials results in increased drug resistance,while rational use of antibiotics is the key of decreasing drug resistance and multidrug resistance.It is of great importance to analyze the variation of bacterial drug resistance in area hospital.

Objective The purpose of the study is to understand the epidemiology,distribution and molecular characteristics of oxacillin susceptible mecA positive Staphylococcus aureus (S.aureus).Methods Totally 1588 S.aureus isolates collected from 12 hospitals in 10 cities of China between 2010 and 2012 were retrospectively characterized.The isolates were characterized by antimicrobial susceptibility test of 20antimicrobial drugs.Three different methods (cefoxitin disc diffusion,agar dilution for oxacillin and cefoxitin) to detect oxacillin susceptible and mecA positive S.aureus were also compared.All the strains were confirmed to be S.aureus by detecting S.aureus specific genes by PCR (including nuc,femB,and mecA gene),which was viewed as the golden standard of MRSA.The molecular typing methods included SCCmec and spa typing.The statistical analyses were carried out in statistical product and service solutions (SPSS),Version 18.0.The significance level P was set at 0.05.Results According to the MICs of cefoxitin and oxacillin,a total of 60 isolates were oxacillin susceptible methicilin resistance Staphylococcus aureus (MRSA).Based on the differences of the specimen collection date,it is found that oxacillin susceptible MRSA have increased from 2010 to 2012 (P =0.05,95％ CI 0.045-0.056,X2 =6.099).These isolates were distributed in 9 major cities,and the highest prevalence is 30.0％ (18/60) in Guangzhou,followed by Beijing (18.3％,11/60),Wuhan (15.0％,9/60),Hangzhou (13.3％,8/60).Most of the isolates were from skin soft tissue infection (35％,21/60),blood stream infection (30％,18/60) and respiratory infection specimens (18.3％,11/60).The resistance rate to cefoxitin,erythromycin,clindamycin and tetracycline was 100％ (60/60),86.7％ (52/60),66.7％ (40/60) and 50％ (30/60),respectively.The molecular characterization showed that 21 spa and 5 SCCmec types were detected.The most predominant clone was spa t437-SCCmec Ⅳ (25.0％,15/60),followed by spa t437-SCCmecV (13.3％,8/60).Conclusions The detection rate of oxacillin susceptible MRSA is significantly higher from 2010 to 2012.The major clone is t437-SCCmec Ⅳ.The use of cefoxitin should replace oxacillin in detecting this type of MRSA.Further study is needed to confirm whether beta lactam antimicrobial agents should be used in the treatment of oxacillin susceptible mecA positive S.aureus.

Objective To investigate the expression of insulin-like growth factor Ⅱ mRNA-binding protein 3( IMP3 ) in transitional cell carcinoma of bladder( TCCB ) and its clinical significance. Methods The IMP3 expressions in 6 normal bladder tissues and 48 TCCB tissues were determined by immunohistochemistry staining, and the relationships between IMP3 expression and gender, age, pathological grading and staging were analyzed statistically. Results The positive expression rate of IMP3 was 62.5% ( 30/48 ) in bladder cancer,which were significantly higher than that in normal control ( 0/6 ) ( P ＜ 0. 05 ). The positive rate of IMP3 expression were significantly lower in superficial TCCB ( 46. 15%, 12/22 ) or early TCCB [ Grade Ⅰ 12. 5%(1/8) ,Grade Ⅱ 60. 0% (12/20) ] than that in invasive TCCB [T2 or above,81.8% (18/22) ] or advanced TCCB [ Grade Ⅲ ,85% ( 17/20 ) ] ( Ps ＜ 0. 05 ). Conclusion IMP3 is a promising biomarker for eraly detection and assessment of the malignancy degree in TCCB.

ObjectiveTo determine the correlation of human leukocyte antigen-G (HLA-G)expression with CMV active infection after kidney transplantation. MethodsA total of 215 first-time kidney transplantation recipients in one transplantation center were divided into CMV ( + ) group and CMV ( - ) group according to whether they had active CMV infection. mhla-g1 expression on leukocytes was analyzed by flow cytometry. The concentrations of soluble HLA-G5 were detected by using ELISA. The sHLA-G5 cutoff levels by ROC curve was employed to predict the active CMV infection. The expression of sHLA-G5 mRNA and protein in leukocytes was analyzed by using RTPCR and Western blotting respectively. Immunohistochemical staining was used to detect the HLA-G expression in kidney biopsies of 12 cases. ResultsThe expression of mHLA-G1 in peripheral blood was low in both CMV ( + ) group and CMV ( - ) group. Also when CMV-PP65 was positive, there was no significant change in mHLA-G1. In CMV ( + ) group, the proportion of CD14+ mHLA-G1 +cells[(45. 53 ± 17.32)％]in peripheral blood was increased as compared with that in CMV (-)group[(10. 22 ± 5.78)％]. The expression of sHLA-G5 was increased significantly in CMV ( + )group. The optimal cutoff value of sHLA-G5 predicting the active CMV infection was 202. 9 μg/L,with high diagnostic accuracy. HLA-G was positive in the kidney tissue of 10 patients out of 12 patients with active CMV infection. Both RT-PCR and Western blot analysis showed that sHLA-G5 was significantly higher in CMV ( + ) group than that in CMV ( - ) group. ConclusionROC curve analysis of sHLA-G5 with the cutoff value of 202. 9 μg/L can be used to predict the active CMV infection. The HLA-G levels in peripheral blood were significantly increased and HLA-G expression in the tubular epithelial cells of the graft could be a protection mechanism of the kidney function.

Objective To study the correlation of HLA-G levels with acute rejection and CMV active infection post-kidney transplantation.Methods A total of 132 initial kidney transplantation recipients were divided into kidney function stable group (F),acute rejection group (AR),CMV group according to whether they had active CMV infection and acute rejection.Forty-one healthy donors served as control group (H).HLA-G levels and mRNA expression were analyzed by using flow cytometry,ELISA,RT-PCR and Western blotting.Immunohistochemical staining was used to detect the HLA-G expression in kidney biopsies.Results The expression levels of mHLA-G1 were low in all 4 groups pre-transplantation.Only CMV group had significantly more CD14+ mHLA-G1+ cells post-transplantation (P＜0.05).sHLA-G5 levels were higher in F group than in H group (P＜0.05),but there was no significant difference among other groups pre-transplantation (P＞0.05).sHLA-G5 levels were increased significantly in CMV group as compared with F group (P＜0.05),and those in F group were higher than in H and AR groups (P＜0.05).Renal tissue biopsies from 21 renal transplantation recipients with AR indicated that HLA-G5 was expressed negatively in 17 patients,positively in 3 patients and 1 weakly positively.HLA-G was positive in the kidney tissue of 9 patients out of 9 patients with active CMV infection.In total 132 recipients,AR incidence was significantly lower in CMV ( + ) group (7.1 ％,2/28) than that in CMV ( - ) group (24.0 ％,25/104).Conclusion The sHLA-G5 may contribute to predict AR and CMV active infection; AR and CMV active infection may be correlation with immune balance in kidney transplantation recipients.

Objective To evaluate the diagnosis and surgical treatment of parathyroid carcinoma (PTC). Methods Clinical data of 8 PTC cases were analyzed retrospectively. Results PTC accounted for 5. 7% of patients with primary hyperparathyroidism (PHPT) in our hospital. There were 4 men and 4 women. Male patients had younger mean onset age compared with female patients. The disease history of PTC was shorter than PHPT of benign causes. Six patients were admitted for acute hypercalcemia. Seven patients complained of palpable neck mass. Calcium level was 3.75?0.34 mmol/L,and PTH level was 1429.47?841.75 pg/ml. Frozen section established diagnosis in only one case. Four patients underwent radical en bloc resection. Other 4 cases received routine simple parathyroidectomy, 3 patients developed recurrence in 12 - 18 months postoperatively. Conclusions Acute hypercalcemia is common in PTC. Frozen biopsy diagnosis is not satisfactory. An initial en bloc resection of tumor and adjacent structures contributes most to the prognosis.

Objective To investigate the molecular epidemiology of Staphylococcus aureus in Yanbian area .Methods From March 2011 to June 2012 ,a total of 101 consecutive and non-duplicate strains of Staphylococcus aureus were collected from Yanbian Hospital .Genotypes of SCCmec ,spa,and multilocus sequence typing (MLST) were determined by PCR combined with DNA sequencing analysis .The pvl gene was detected by PCR .Results The most prevalent SCCmec type was type II (65 .0% ,39/60) ,followed by SCCmec type III (26 .7% ,16/60) .A total of 11 Spa types were identified for the MRSA strains ,including t2460 (55 .0% ,33/60) ,t030 (18 .3% ,11/60) ,t002 ,t324 ,and t632 (5 .0% ,3/60 each) .A total of 29 Spa types were identified for MSSA strains ,including t796 (14 .6% ,6/41) ,t309 (9 .8% ,4/41) ,and t126 (7 .3% ,3/41) . The pvl gene was identified in 5 stains .MRSA strains were classified into three types based on multilocus sequence typing (MLST) ,namely ST5 ,ST239 and ST72 .MLST-based MSSA types were more diverse ,including ST5 ,ST 25 ,ST 15 ,ST 59 ,ST 1 ,ST 7 ,ST 45 ,ST 22 ,and ST 188 .Conclusions ST5-MRSA-SCCmecII-t2460 and ST239-MRSA-SCCmecIII-t030 are the most prevalent MRSA clones in Yanbian area .Multiple prevalent MSSA clones are identified.

OBJECTIVE: To analyze the relationship between traditional Chinese medical syndromes and fungal pneumonia for moderate and advanced lung cancer patients. METHODS: We retrospected 115 moderate and advanced lung cancer patients with different syndromes in traditional Chinese medicine (qi deficiency, yin deficiency, blood deficiency, yang deficiency, blood stasis, phlegm dampness, phlegm heat, damp heat, cold dampness, qi stagnation, heat toxin), who had the concurrent fungal pneumonia, and used regression analysis method to analyze the data. RESULTS: When the patients had the phlegm heat syndrome, they got a significantly higher risk of having fungal pneumonia (P < 0.01); and when they had the heat toxin syndrome, they also had a high risk of having fungal pneumonia (P < 0.05). CONCLUSION: The phlegm heat and heat toxin syndromes are the risk factors for moderate and advanced lung cancer patients having concurrent fungal pneumonia.