Flexible ureteroscopy techniques have experienced great developments in the past decade, as well as their expanding indications.However, this surgical procedure encountered some discouragement in clinical application for its long learning curve, poor ergonomics, high cost and attrition rate.In recent years, there were a group of advancements in flexible ureteroscopy, including robot-assisted ureteroscopy, dual working channels flexible ureteroscopy, disposable flexible ureteroscopy, rigid ureteroscopy with a deflectable tip and a series of accessory instruments development, which could all make surgery procedures more easily to be done and lower the expenses at the same time.These technical evolutions bring flexible ureteroscopy into a new level in urologic surgeries.

Objective To analyze the effect of inducible costmulator (ICOS)/inducible costmulator ligand (ICOSL) signaling pathway on hepatic fibrosis in mice infected with Schistosoma japonicum.Methods Seventy-eight ICOSL knockout (ICOSL-KO) mice and 77 wild type C57BL/6J mice were used as experimental schistosomiasis model infected with Schistosoma japonicum.The sera of mice were collected on the day before infection (0 week),and at 4,7,12,16 and 20 weeks post infection.Then,the concentrations of hyaluronic acid (HA) and hydroxyproline (HYP) in mice sera were measured by sandwich enzyme linked immunosorbent assay (ELISA) kits.The expressions of transforming growth factor β1 (TGF-β1),α-smooth muscle actin (a-SMA) and Collagen-Ⅰ in livers from ICOSL-KO/wild type mice were assessed by immunohistochemical staining.The granulomatous pathology and fibrosis level in mice liver were dynamically observed by hematoxylin and eosin (HE) staining and Masson's staining,respectively.The difference between groups was detected by t test or x2 test when appropriate.Results After infection with Schistosoma japonicum,the levels of HA and HYP were gradually increased.In ICOSL-KO mice,the levels of HA at 7,12,16 and 20 weeks post infection were all significantly lower than those in wild type mice [(161.32±15.44) vs (186.01±21.24) ng/mL,t=2.528 2,P＜0.05; (166.73±18.18) vs (231.39±20.12) ng/mL,t=4.342 4,P＜0.05; (193.58±21.06) vs (252.51±25.29) ng/mL,t=4.003 9,P＜0.05; (253.98±24.53) vs (310.88±23.86) ng/mL,t=3.718 0,P＜0.05].Similarly,HYP levels in ICOSL-KO mice at 12,16 and 20 weeks post infection were all significantly lower than those in wild type mice (all P＜0.05).Immunohistochemical staining showed that TGF-β1,α-SMA and Collagen-Ⅰ expressions in liver of ICOSL-KO mice from 7 to 20 weeks post infection were all significantly lower than those of wild type mice (all P＜0.05).HE staining showed,the volume of liver egg granulomas of ICOSL-KO mice was significantly smaller than that of wild type C57BL/6J mice (P＜0.01).Furthermore,Masson's staining showed that the level of hepatic fibrosis in ICOSL-KO mice was lower than that in wild type mice and the fibrosis scores were statistically different between two groups (all P＜0.05).The mortality rate of the wilde type C57BL/6J mice was higher than that of ICOSL-KO mice.After 20 weeks of infection,the difference was statistically significant (55.84 ％ vs 37.18 ％,x2 =5.427,P＜0.05).Conclusions The degree of hepatic fibrosis and related indicators are obviously down-regulated in ICOSL-KO mice infected with Schistosoma japonicum.These findings suggest that ICOS/ICOSL signaling pathway has an important impact on the process of hepatic fibrosis caused by Schistosoma japonicum.

Objective To investigated the significance of serum B7-H3 in differential diagnosis of patients with benign and malignant obstructive jaundice.Methods The B7-H3 levels in 60 patients with obstructive jaundice who were divided into benign (32 patients) and malignant (28 patients) obstructive jaundice group were tested by enzyme-linked immunosorbent assay before and after operation.Results The serum B7-H3 levels of malignant obstructive jaundice group were significantly higher than that of benign group (9334.57 ± 1009.57) pg/mL vs (4450.81 ± 406.92) pg/mL,(P ＜ 0.01).The B7-H3 levels of benign and malignant obstructive jaundice group after operation were significantly lower than those before operation (2531.03 ± 415.64) pg/mL vs (4450.81 ±406.92) pg/mL,(5833.00 ± 2190.87) pg/mL vs (9334.57±1009.57) pg/mL,(P＜0.01).Conclusion B7-H3 participate in the inflammatory immune and tumor immune response,The serum B7-H3 can be used as differential diagnosis index of benign and malignant obstructive jaundice.

Objective To describe the work experience and needs of enterostomal therapist in Shanghai.Methods Phenomenological methodology was adopted in this study.In-depth interview was conducted on 9 enterostomal therapists.Data were analyzed by inductive codes and coding methods.Results Five themes were extracted,including responsibility and mission,pride,accomplishment,helplessness,and satisfaction.When they began their new jobs,they confronted many challenges,but they conquered them with responsibility and mission.Finally,they felt growing up and harvested a lot during this time.Conclusions Hospital managers should pay attention to problems they encountered in their work and provide necessary supports for their training,work and development.

Objective: To standardize the bill management, protect the economic order of public institutions. Methods: According to the current status of bill management in public health institutions, the corrective measurements comparing to national stipulation were proposed. Results: It is an important measure to manage the economic environment. Conclusion: It needs to follow the National Law of Negotiable Instrument, so as to ensure the right of party. Implement the law of bill to ensunre the right of party.

Objective To observe any therapeutic effect of pulsed electromagnetic fields (PEMFs) on bone loss in spinal cord injury (SCI) patients.Methods Fifty-five patients with SCI were divided into two groups randomly.The twenty-six patients in the control group (group B) were given only routine rehabilitation treatment; the twenty-six patients in the treatment group (group A) received PEMF therapy in addition.Results After 12 weeks of treatment,the average bone mineral density (BMD) of the proximal femur (including total,neck,Wards,inter,troch) in group A was significantly higher than in group B.The levels of bone-gamma-carboxyglutamic acid containing protein (BGP) and 1,25 (OH)2D3 in group A increased significantly,while they decreased in group B.Urine-pyridinium/crealinine (U-Pyd/Cr) levels in group A decreased significantly,while in group B they were higher than before.There were statistically significant differences between the two groups.Conclusion PEMF treatment can effectively retard bone loss in SCI patients.It has good preventive and curative effects on osteoporosis after SCI.

Objective To investigate whether p53 expression is involved in human telomerase reverse trans-criptase (hTERT) regulation. Methods HepG2 cells and pPUR/U6/hTERT HepG2 cells were treated with the p53 antisense oligonucleotide respectively and p53 expression plasmid were introduced to HepG2 cells. The decreased or increased p53 level and the hTERT expression levels were analyzed by Western blotting. Results Down-regulation of p53 expression had no obvious effect on hTERT expression, but over-expression of p53 could significantly repress hTERT level. Conclusion p53 interacts with hTERT and inhibits hTERT expression in HepG2 cells.

Objective To observe the effect of tea polyphenols on proliferation, invasion and apoptosis of human thyroid papillary carcinoma cells (CGTH W-3) in vitro. Methods The effects of various concentrations of tea polyphenols on proliferation, invasion and apoptosis of CGTH W-3 cells were observed by MTT assay, plate scarification assay and flow cytometer, respectively. Results Tea polyphenols(50-400 mg/L) inhibited the proliferation of CGTH W-3 cells with dose-and time-dependent manners. The IC_50 of tea polyphenols to CGTH W-3 cells was 240 mg/L (1st day), 229 mg/L (3 rd day), 200 mg/L (5th day) and 118 mg/L (7th day). The cell free zoster which reflected the invasive ability was widened by tea polyphenols. The apoptosis percentage of CGTH W-3 cells incubated with tea polyphenols for 48 h was obviously increased, with 3.51% in control group, 12.61% with 100 mg/L tea polyphenols, 52.97% with 200 mg/L tea polyphenols and 70.79% with 400 mg/L tea polyphenols (all P

Background and purpose:Hypoxic cells in tumors are of chemoresistant and anti-apoptoic.Our study was focused on the effects of hypoxia on expression of P-glycoprotein(P-gp) and cell apoptosis in human lung adenocarcinoma A549 cell line(wtP53),in order to explore the probable mechanism of hypoxia in apoptic tumor cells.Methods:A549 cell line(human lung adenocarcinoma) was cultured under hypoxic atmosphere(2% O_2) for 24 h,the expression of hypoxia inducible factor-1?、P-gp and P53 protein was detected by immunohistochemistry,after cells under hypoxic atmosphere were exposed to Adriamycin for 24 h,the cell survival rate was detected by MTT,and apoptosis of by flow cytometer.Results:① The expression of hypoxia inducible factor-1?、P-gp and P53 protein in hypoxic cells were higher than the expression in anoxia ,and correlation between the expression of HIF-1? and P-gp or P53 protein was observed(P

Objective] To summarize the clinical experience of Professor Yu Ying’ao in treatment of epilepsy.[Method]Starting from Professor Yu Ying’ao epilepsy treatment of two typical cases, and discuss the treatment ideas and methods.[Results] Professor Yu Ying’ao is good at treating epilepsy, many cases, he believes that phlegm and distraught as the main disease epilepsy mechanism. Emphasizes the importance in the pathogenesis of phlegm, that Qianzhen Zhi Xian in the treatment of epilepsy through usage, and treatment based on syndrome differentiation. Treatment of multiple in Puji Benshi Fang Baijin pill on the basis of adding Huotan Kaiqiao, Zhenxin Pinggan Anshen, Xifeng Zhijing. Often the effect is very good.[Conclusion] Professor Yu Yingao’s experience in the treatment of epilepsy is unique, it is worth learning.