Objective To compare the efficacy between ureteroscope with holmium laser lithotripsy (URS) and minimally invasive percutaneous nephrolithotomy (MPCNL) in oblique supine position for the proximal and middle ureteral calculi.Methods Ninety-six patients with proximal and middle ureteral calculi were divided into URS group (54 cases) and MPCNL group(42 cases) according to the treatment order.The operative duration,postoperative hospital stay,stone-free rate,intraoperative blood loss ＞ 400 ml rate,conversion to open surgery rate,complication rate including postoperative fever were observed,and stone composition was analyzed.Results The operative duration and postoperative hospital stay in URS group and MPCNL group were (55.3 ± 12.1),(49.6 ± 11.5) min and (1.7 ± 0.9),(4.4 ± 1.2) d,respectively,and there were significant differences (P ＜ 0.05 or ＜ 0.01).There were no significant differences in the stone-free rate,complication rate (Clavien degree Ⅱ),conversion to open surgery rate,intraoperative blood loss ＞ 400 ml rate,complication rate,postoperative fever rate (P ＞ 0.05).Stone composition analysis showed that the proportion of calcium oxalate stone was 51.0％(49/96).Conclusions URS and MPCNL in oblique supine position for the proximal and middle ureteral calculi are effective and safe therapeutic modalities.The operative duration of MPCNL in oblique supine position is shorter,and postoperative recovery of URS is fast.

Objective To establish a culture protocol for Th17 cells in vitro and evaluate the effect of curcumin on the differentiation and functions of Th17 cells and explore the related mechanisms. Methods Splenic CD4+CD25- T cells of C57BL/6 mice were isolated and purified with magnetic bead methods, and were co-cultured with plate-bound anti-CD3 and anti-CD28 antibodies and with transforming growth factor (TGF)-β, interleukin (IL)-6, IL-23, anti-interferon-γ antibody and anti-IL-2 antibody for Th17-polarization. The cultured Th17 cells were allocated into four groups: the control group, in which T cells were cultured on the basis of the above protocol; the low-concentration curcumin (CM-L, 5 μmol/L) and high-concentration (CM-H, 25 μmol/L) curcumin groups, and sirolimus (SRL, 100 ng/ml) group. The proportion of Th17 cells was detected with flow cytometry, and the mRNA expression of retinoic acid-related orphan receptor (ROR)γt, IL-17A, IL-21 was examined with real-time quantitative polymerase chain reaction. Finally, the protein expression of RORγt and the phosphorylation levels of signal transducer and activator of transcription (STAT) 3 were measured using western blotting analysis. Results The proportion of Th17 cells in the freshly isolated CD4+CD25- T cells was (3.1 ±0.4)%, whereas the proportion of the cells cultured with the protocol could get [(54.1±3.4)%, P<0.01]. As compared with the control group, the Th17 cells proportion in CM-L, CM-H and SRL groups was significantly decreased [CM-L (40.3±2.8)%, CM-H (25.8±2.3)%, SRL (25.0±2.0)%versus the control (54.1±3.4)%, t=6.15, 12.63, 12.97, P<0.01], and no marked difference was seen between CM-H group and SRL group (ft>0.05). Moreover, the mRNA levels of RORγt, IL-17A and IL-21, the protein expression of RORγt and the phosphorylation levels of STAT 3 in CM-L, CM-H and SRL groups were also lower than those in the control group (IL-17A mRNA: CM-L 0.81±0.05, CM-H 0.61±0.05, SRL 0.58±0.05, Control 1.01 ±0.11, t=4.81, 8.52, 8.89; IL-21 mRNA: CM-L 0.73±0.06, CM-H 0.49±0.03,SRL 0.59±0.03, Control 1.12±0.11, t=5.98, 9.22, 7.95, P<0.01). The mRNA level of IL-21 in the CM-H group was lower than that in the SRL group (P<0.05). Conclusion In vitro, curcumin can inhibit the differentiaton of splenic CD4+CD25- T cells into Th17 cells in the setting of Th 17-polarization and inhibit the expression of IL-17A and IL-21 mRNA, which is associated with the inhibitive effect of curcumin on RORγt expression and STAT 3 phosphorylation.

OBJECTIVE:To determine Sarsasapogenin in Jujube seed concentrated pills by RP-HPLC-ELSD.METHODS:Separation of Sarsasapogenin was performed on Zorbax C18 column with methanol-water (90:10)as a mobile phase at a flow rate of 1.0mL?min-1.The temperature of the drift tube was 85℃and the air flow-rate was at 1.71mL?min-1.RESULTS:The linear range of Sarsasapogenin was 0.112 7～0.676 2mg?mL-1(r=0.998 3).The average recovery was 99.83%(RSD=0.93%).CONCLUSION:The method is simple,accurate and reproducible,and suitable for the quality control of Jujube seed concentrated pills.

Objective To evaluate the chnical value of intervention therapy combined with the foot plastic surgery in the treatment of diabetic foot.Methods 67 patients who accepted the intervention therapy combined with the plastic surgery for occlusive lesion of lower limbs arteries were selected.The clinical symptom,ankle brachial pressure index and hemodynamics were observed before and after treatment.All clinical indicators were compared between the therapeutic group and the control group.Results Among 67 patients,63 cases were successful in clinical treatment (the success rate:94.0％).One month,three months,six months after operation,the skin temperature,anklebrachial index,limp distance,clinical symptom,ankle brachial pressure index and hemodynamics were increased.Compared with preoperation,all above-mentioned indicators were improved obviously (P ＜ 0.05,P ＜ 0.01).Conclusion Intervention therapy for diabetic foot has the merits of less trauma,higher effectiveness of treating diabetic foot ulcers,defect repair,maximally reserved limbs and better shapes of limbs,which made both doctors and patients satisfied.It is a new direction for minimally invasive therapy.

AIM To study the effects of homoharringtonine(HHT) on inhibition of proliferation and induction of apoptosis of nasopharyngeal carcinoma cells CNE 2Z. METHODS The inhibitory rates of the proliferation and IC 50 were detected by MTT method. The apoptosis was analyzed by flow cytometry (FCM), agarose gel electrophoresis and Hoechst 33258/PI fluorescence staining. RESULTS After cells were treated with HHT of different concentrations for 24, 48 and 72 h,respectively,the inhibitory rates of the proliferation rised with concentration and time. The IC 50 values of 24, 48 and 72 h were (0 629?0 039), (0 483?0 011) and (0 389?0 027) mg?L -1 , respectively. The difference among IC 50 values was obvious ( P

Objective To design an approach above the fibular head for treating posterolateral tibial plateau fracture,and to investigate its feasibility,advantages and disadvantages in clinical application.Methods Ten frozen adult cadaveric knees were dissected to observe the correlation of the important lateral structures and effect of knee flexion on tensity of the lateral collateral ligament.The distance (OA) from superior border of facies articularis capitis fibulae to lateral edge of articular surface of tibial plateau and the distance (OB) from the cross point of lateral collateral ligament and facies articularis capitis fibulae level to lateral edge of articular surface of tibial plateau were measured.According to the anatomic measurement results,the approach above the fibular head was designed.Then 12 patients with posterolateral tibial plateau fracture were treated through this approach,and the short-term clinical results were evaluated.Results The value of OA ranged from 9.43 to 14.92 mm (average,12.97±1.83 mm).At 0° of genuflex,the lateral collateral ligament was tense and the average value of OB was 4.87±0.33 mm.During the course of genuflex,the lateral collateral ligament got loose following which the value of OB became larger.At 60° of genuflex,the lateral collateral ligament was most loose,and the posterolateral tibial plateau could be exposed completely by drawing posterolaterally lateral collateral ligament and rotating medially tibia.All patients were followed up for 6 to 24 months (average,18 months).The average bone healing time was 10.2 weeks (8 to 12 weeks).According to Rasmussen's knee functional score system,the results were excellent in 10 cases and good in 2 cases.No complications occurred,such as numbness of limbs,instability of the knee and internal fixation loosening.Conclusion The approach above the fibular head is feasible,simple and safe for treating posterolateral tibial plateau fracture.

AIM: To investigate the effects of hypoxia-inducible factor-1 (HIF-1) on cardioprotection of hypoxic preconditioning (HPC) and its mechanisms. METHODS: In the model of hypoxia/reoxygenation (H/R) of cardiomyocytes from neonatal Spargue-Dawley rats, delayed cardioprotective effects of HPC on lethal H/R were observed. Whole cell extracts were prepared for determining activities of extracellular signal-regulated protein kinases (ERKs) and HIF-1? phosphorylation. RESULTS: HPC significantly promoted survival and membrane integrity of cardiomyocytes subjected to sustained H/R. SDS-PAGE mobility shift experiments showed increased phophorylation level of HIF-1? in hypoxic preconditioned cardiomyocytes. ERK1/2 were activated at 10 min after HPC and returned to the control level at 60 min. CONCLUSION: HPC protects neonatal cardiomyocytes from H/B injury. HIF-1? phosphorylation induced by ERKs might contribute to the cardioprotection of HPC.

AIM: To investigate the effects of human urotensin II (hUII) on ischemia/reperfusion (I/R) injury in isolated rat hearts. METHODS: In the ischemia/reperfusion (I/R) model of isolated perfused rat hearts,the effects of hUII pretreatment on cardiac function was monitored with cardiac function software of MFL Lab200. ATP,total calcium,and malondialdehyde (MDA) content in myocardium were detected. The coronary perfusion flow (CPF) and lactate dehydrogenase (LDH) activity in coronary effluent were measured during reperfusion. RESULTS: In the hUII pretreated group,the release of LDH from myocardium was lower [(78.3?18.1)U/L] than I/R group [(109.3?23.9) U/L,P

Objective To investigate the effects of hyperbaric Oxygen (HBO)exposure on Caspase-3 and Bcl-2 mRNA ex-pressions in both internal carotid artery (ICA)and basal artery (BA)in rabbits.Methods Twenty-four healthy adult New Zealand rabbits were randomly divided into 2 groups:HBO group and the control group,with each group consisted of 12 animals.The rab-bits in the HBO group were exposed to HBO at 2.2 ATA for 60 minutes each day for 3 successive days.The rabbits in the control group were normally fed without any treatment.Real-time PCR was used to detect Caspase-3 and Bcl-2 mRNA expressions in both ICA and BA in 2 groups.Results HBO significantly decreased the Caspase-3 mRNA expression [(0.038 ±0.006 )vs .(1.000 ± 0.225)]and increased the Bcl-2 mRNA expression [(1.877 ±0.1 69)vs .(1.000 ±0.364)].In ICA,HBO similarly decreased the Caspase-3 mRNA expression [(0.41 9±0.091)vs .(1.000 ±0.1 75)]and increased the Bcl-2 mRNA expression [(1.269 ±0.270) vs .(1.000±0.1 1 7)]in BA.All the differences mentioned above were of statistical significance (P <0.01).Conclusion HBO ex-erts an inhibition effect on apoptosis in cerebral vascular endothelial cells.The mechanism may be related to inhibiting the expres-sion of Caspase-3 mRNA and promoting the expression of Bcl-2 mRNA.

Continuing medical education refers to the completion of basic medical education for inservice education,which is to guarantee the sustainable development of physicians in clinical and scientific research ability,and is the essential means to safeguard and improve the level of medical treatment.Traditional continuing medical education is given priority to the form of regularly organize workshops,so it has some limitations to oral and maxillofacial surgery.MOOC teaching is a kind of large-scale open new online teaching mode.This study provides an overview of the MOOC development,characteristics and development situation in the medical teaching.The necessity and feasibility of MOOC based teaching protocol in oral and maxillofacial surgery continuing medical education has been discussed.And curriculum transformation,construction of education model and possible challenges have also been analyzed and discussed in this paper.