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 investigate a new method for the reconstruction of the urethra using peritoneal free grafts in phalloplasty in a rabbit model. Methods Animal models were established in 24 adult male New Zealand white rabbits, which were randomly divided into the peritoneal graft group (n=12) and peritoneum-skin graft group (n=12). In the former group the peritoneal tube grafts with the mesothelial surface inward were used as the urethral substitutes. And a circumferential 1 cm rim of scrotal skin was inserted at the tip of the tubularized peritoneal graft for urethroplasty in the latter group. Subsequently, a superficial epigastric fasciovascular pedicle flap for phalloplasty was harvested and tubed over the reconstructed urethra. The process of growth was observed grossly. Results The reconstructed penis survived well without urethral stricture, and the peritoneal-lined grafts survived in all rabbits with a smooth, moist quality and without ulceration and fibrosis. Gross examination showed 8 meatal occlusions with fistulas simultaneously in the peritoneal graft group, and 3 fistulas in the peritoneum-skin graft group. Conclusion The authors have successfully designed the rabbit model of the urethroplasty using the tubularized peritoneal free grafts in the penile reconstruction and demonstrated the possibility of the new method for phalloplasty brings a light to clinical study.

Objective To investigate the effect of comb interferon( comb interferon CITF) uniting virazole to cure recurring or non-responding chronic hepatitis C.Methods Hypodermic comb "interferon 15μg,3 times every week,subcutaneously injected,24 weeks course of treatment was adminstered to 74 patients of recurring or non-responding chronic hepatitis C.Clinical symptom,physical sign,ALT,hepatovirus continual response rate and the condition of adverse effect were observed during treatment,chron-culminate,follow to 6 months' withdrawl.Results 72 patients accomplished treatment,HCV-RNA of recurring group and non-responding group to continual negative change rate were 73% and 37% (P＜0.05)after treatment termination,without severity adverse reaction being found.Condusion Comb interferon 15 μg/d combining virazole 900mg/d have better curative effect in curing recurring or nonresponding chronic hepatitis C.

Objective To analyze the clinical effect of community comprehensive intervention in the prevention and treatment of hypertension.Methods A total of 160 cases of patients were randomly divided into two groups,the control group (80 cases)were treated with conventional antihypertensive drug treatment;the observation group 80 cases of patients were treated with comprehensive community intervention on the basis of treatment of the control group.Two groups of patients before and after the intervention of blood pressure changes were observed and recorded,treatment effect and medication compliance were comparative analysized.Results The total effective rate of patients in the observation group was 86.25%,which was significantly higher than that in the control group (57.5%),the difference was statistically significant (χ2 =20.44,P <0.05).DBP,SBP after intervention of patients in the observation group were significantly lower than those before intervention and in the control group after the intervention,the differences were statistically significant (t =18.48,6.06,all P <0.05).Conclusion The effect of community comprehensive intervention on hypertension patients is significant,it can effectively control the patient's blood pressure level,improve the quality of life of patients,which is worth promoting.

Objective To investigate the effects of Huaier Granule combined with TAC chemotherapy on immunologic function and prognosis in triple negative breast cancer patients after operation.Methods Ninty-two cases of Ⅰ-ⅢA stage triple negative breast cancer patients entered the study.They were randomly divided into control group and research group.Only TAC chemotherapy was affected in control group of 42 cases, while Huaier Granule combined with TAC chemotherapy was applied in research group of 50 cases.And we gave Huaier Granule to patients in the first day of chemotherapy.The changes of T cell subset, NK cell were detected in the patients respectively in the first day before therapy and after therapy.The five-year disease-free survival rate and overall survival rate were also observed in two groups.Results Compared with control group, the changes of T cell subset, NK cell had no significant differences in research group in the first day before therapy(P ＞0.05).In the first day after therapy, the level of CD4 + (38.16 ± 5.71) ％ in control group was significantly lower than that (44.67 ± 6.47) ％ in research group(P ＜ 0.05).However, the percentage of CD8 + T cells (28.68 ± 4.06) ％ in control group was markedly higher than that (22.85 ± 3.22) ％ in research group (P ＜ 0.05).The level of NK cell (15.75 ± 3.47) ％ in control group was obviously lower than that (19.46 ± 4.22) ％ in research group(P ＜ 0.05).The five-year disease-free survival rate is 28.6％ in control group, however the five-year disease-free survival rate is 42.0％ in research group, there were significant differences between two groups(P ＜ 0.05).Furthermore, the five-year overall survival rate in research group was obviously higher than that in control group(P ＜ 0.01).Conclusions Huaier Granule combined with TAC chemotherapy not only enhances immune function but also improves prognosis and quality of life in triple negative breast cancer patients after operation.It provides a positive exploration for anti-cancer research by integration of traditional and western medicine.

Objective To verify the authors' previous cDNA micro-array results and to further investigate the moleculer mechanisms of gastric cancer. Methods Quantitative real-time RT-PCR was employed to detect the expressions of three S100A calcium-binding genes in 22 fresh surgical samples of gastric tumor tissue and non-cancerous mucosa from the same patients. Results The transcription level of S100A2 in primary cancer lesion was elevated in 80% of samples when compared with matching non-neoplastic mucosa (P=0.018) and the average up-regulation level was 10.78 fold. 55% of cancer lesions showed higher transcription level of S100A4 than their adjacent non-neoplastic mucosa, the average up-regulation level was 2.31 fold. S100A6 transcription level was higher in 74% (P=0.01) of primary cancer lesion with an 2.25 fold up-regulation than the adjacent non-neoplastic mucosa. After rectified by ?_2-microglobulin, the relative expression levels of S100A2, S100A4 and S100A6 were 2.83?10~ -4 , 6.44?10~ -2 and 0.41, respectively. According to the Spearman correlation coefficient analysis there were significant positive correlations between S100A2 and S100A4, and S100A2 and S1006 (P value were 0.00 and 0.017, respectively). Conclusion The changes in S100A2 and S100A6 genes may be an early event in a majority of gastric cancer patients, while S100A4 may be associated with the infiltration of gastric cancer. Further study on the three genes might be helpful for understanding the nature of gastric carcinoma.

Carbonic anhydrase(CA) is one of a group of enzyme that contains zinc. They exist widely in the mammals. CA has at least 14 species of isoenzyme. Among them,CAIX is located at the downstream of VHL tumor suppressor gene,and it can be activated through HIF-1 pathway. CAIX primarily exists in the mucous membrane of gastrointestinal tract in normal human tissues and its expression is low. However,higher expression of CAIX can be detected in renal cell carcinoma,cervical carcinoma and lung cancer,it may be closely related with the occurrence and development of the tumor. In addition,we can predict the prognosis of tumor patients by analysis of the expression of CAIX,thus,it is considered that CAIX is a tumor specifi c antigen. Due to its highly specifi c expression in renal cell carcinoma,CAIX will become the potential target antigen of tumor vaccine as well as the target gene for the treatment of RCC. The application of CAIX shows high promise in RCC target therapy. Hence,it is defi nitely important for us to investigate the expression and regulation of the CAIX.

The activities of acid phosphatase and ?-1,4 glucosidase and the concentration of citric acid in the semen of 51 cases of chronic prostatitis were determined.The mean value was 694.33?346.61 Bodansky units for acid phosphatase,43.84?24.70mIU/ml for ?-1,4 glucosidase,and 3.26 ?2.37 mg/ml for citric acid.The activity of acid phospohatase and the concentration of citric acid were significantly lower in the patients with chronic prostatitis than in the normal subjicts while the activity of ?-1,4 glucosidase showed little changes.The findings suggest that the functions of the prostate was severely imparired and that of the epididymis remained normal in patients with chronic prostatitis.

Objective To determine the ESBLs of Klebsiella pneumoniae and ESBL typing by molecular genetic procedures. Methods MIC test and ESBLs confirmation test were taken by agar dilution method in 80 strains of Klebsiella pneumoniae isolated in Beijing area from July 1999 to December 1999. To the 20 ESBLs positive conjugates isoelectric focusing was given. And nucleotide sequencing was analysed to conjugate strain CK23. Results 28 (35%) of the 80 strains of Klebsiella pneumoniae produced ESBLs. In the 28 strains, 20 were successfully done with conjugation of resistant plasmid. Isoelectric focusing results revealed that 13 (65%) of the 20 strains produced an ESBLs protein with a pI of 8.8 with or without additional pI 7.6 and pI 5.4. These ? lactamases were all inhibited by clavulanite acid. The strains with pI=8.8 protein were highly resistant to cefotaxime and ceftriaxone but were susceptible or intermediate to ceftazidime. We picked CK23 strain out from 13 conjugates for gene cloning by the primers designed for bla CTX M and nucleotide sequencing. The results showed that the ESBLs gene in CK23 was CTX M, highly similar to CTX M 3 but had 3 amino acids, which were Glu39Gly, Leu122Pro, Asp278His. Conclusions 28 (35%) of the 80 strains of Klebsiella pneumoniae produced ESBLs. Resistant plasmid successfully conjugated in 20 of the 28 ESBLs producing strains. 13 of the 20 (65%) conjugates pruduced a pI =8.8 ESBLs,which was CTX M ESBLs,with only 3 amino acids different from CTX M 3. This paper indicated that a type of CTX M ESBLs existed in Klebsiella pneumoniae in Beijing, which specifically confers resistance to cefotaxime.

Objective To explore the temporal expressions of interleukin-10(IL-10)and interleukin-4(IL-4)and their relationship with the wound age during skin incised wound healing in mice.Methods Immunohistochemical and image-analysis techniques were employed in vital skin wounds 0.5h～168h after incision and postmortem incision 0.5h～6h after death.Results Weak expression of IL-10 was detected at 0.5h after incision,which increased subsequently,and peaked at 3h post-injury.Then decreased to the pre-incision level at 24h,but peaked again at 72h after injury.Immunostaining revealed that epidermal cells and infiltrating mononuclear cells were the major source of IL-10.IL-4-positive cells were observed in the dermis at 24h,and reached the maximum level at 96h,which maintained until 168h post-injury.IL-4 was mainly expressed in the fibroblast-like cells of the granulation tissue and dermis.In addition,faint IL-10-positive cells were merely identified in the epidermal cells in the postmortem incision skin within 1～3h after incision.No IL-4-postitive cells were found in the postmortem incision skin.Conclusion The time-dependent expressions of IL-10 and IL-4 during cutaneous wound healing may be used for the estimation of wound age.