AIM To study the effect of alendronate sodium (Alen) on osteoclastic bone resorbing lacunae. METHOD Using the method of culturing osteoclasts on slices, the techniques of photomicrography microdensitometric scan and computer image analysis. RESULTS Alen(0 5,5 or 50 ?mol?L -1 )reduced the number and the surface area of osteoctastic bone resorbing lacunae dose dependently compared with model group there was significant defference ( P

Objective To observe the effects of Niupo Zhibao pellet, a compound traditional Chinese herbal medicine,on helper T cell(Th cell)expression in rats with endotoxin-induced rapid pulmonary fibrosis (RPF). Methods Two hundred and twenty-four Wistar rats were randomly divided into four groups:normal control,model,dexamethasone(DXM)and Niupo Zhibao pellet(NW)groups(each n=56). By using endotoxin three-hit regimen,the RPF model was established. Three days before and 7 days after the establishment of models in NW group,they were administered with the pellet by intragastric feeding,50 mg/100 g of distilled water twice a day,a total of 10 days medication. Rats in DXM group received DXM intraperitoneal injection,3.0 mg/kg once a day for consecutive 7 days. Rats in normal control group were administered with the same volume of distilled water by intragastric administration. On 1,3,7,9,14,21,28 days after the administration,blood and bronchoalveolar lavage fluid(BALF)specimens were collected. The contents of γ-interferon(IFN-γ)and interleukin-4(IL-4) in the serum and BALF were investigated by enzyme-linked immunosorbent assays(ELISA). The lung tissue was stained by hematoxylin-eosin(HE)and Van Gieson respectively. Morphological changes in lung tissue were observed under light microscope. Results HE staining showed that the pulmonary interstitial tissues of rats in model group were thickened,there was a large amount of inflammatory exudates,and micro thrombi were seem in alveolar space. The pulmonary interstitial tissues in rats of DXM group were thickened too,but the inflammatory exudate in alveolar space was much less. Compared to rats in DXM group,the rats in NW group had slightly more inflammatory exudate and their pulmonary interstitial tissues were basically normal. Van Gieson staining showed that the expression of collagen fiber in model group was obvious,that of DXM group less than the former one but not significant,while that in the NW group was reduced markedly. ELISA assays demonstrated that the levels of IFN-γin BALF and serum in model group were increased significantly,those in DXM group were lowered to the minimum on the 7th day,raised to the levels before treatment on the 14th day,and gradually declined on the 21st day. In the NW group,the IFN-γwas consistently at a high level,and then gradually declined at a slow rate. After 7 days of drug administration,the IFN-γ levels in BALF and serum at various time points in NW group were obviously higher than those in model and DXM groups〔BALF(ng/L):140.47±4.22 vs. 149.23±8.35,90.67±6.65;serum(ng/L):140.47±4.15 vs. 100.43±11.05,99.35±7.85,P<0.05 or P<0.01〕. The levels of IL-4 in BALF and serum in each group increased significantly,reached to their maximum on the 7th day,and then gradually decreased. After the drug administration for 28 days,those levels in NW group were obviously lower than those in model and DXM group〔BALF(ng/L):6.60±1.05 vs. 7.20±1.25,8.55±1.05,serum(ng/L):6.75±1.05 vs. 7.21±1.25,8.25±1.15,P<0.05 or P<0.01〕. Conclusion Niupo Zhibao pellet can suppress inflammation,ameliorate injury of lungs and inhibit lung fibrosis by promoting IFN-γsecretion,restraining IL-4 secretion and adjusting the imbalance of Th cells.

Objective To discuss the feasibility of percutaneous nephrolithotomy (PCNL) for treating upper urinary calculi under local anesthesia.Methods One thousand three hundred and sixty-three patients who suffered with upper urinary calculi were treated with PCNL, the puncture and tracts were created using local anesthesia and guided through ultrasound.Of the 1363 patients, 475 patients had complicated renal caluli, 520 patients had kidney pelvic calculi and 368 had upper uretere calculi.Results All of the patients successfully received PCNL under the local anesthesia.Of the 1363 patients five tracts were used in two patients, four tracts were used in four patients, three tracts were used in nine patients, double tracts were used in 25 patents and one tract was used in the remaining patients.The stone-free rate was 96.0% in the kidney pelvic calculi patients, 100.0% in the upper uretere calculi patients, and 90.1% in the complicated renal caluli patients.90.0% patients were find well throught the operation, 10.0% patients find a little pain and solved by another more 5 - 10 ml lidocaine local injection or 50 - 75 mg pethidine hydrochloride intramuscular injection.No case stop operation because of pain or position changed.All without any severe complications such as damaged of liver, spleen, thorax and intestine.Conclusion The PCNL handled under local anesthesia was simple safe and effective, deserved clinical popularizing use.

OBJECTIVETo construct three-dimensional (3D) models of renal stones and perform percutaneous nephrolithotomy (PCNL) virtual surgery simulation. Methods CT images were obtained from 8 patients with renal stones. Images segmentation and reconstruction were performed using MIMICS 10.0 software to construct the 3D model of the renal stones, which provided the anatomical relationships between the kidney and the adjacent organs. The optimal PCNL virtual surgery simulation for each individual case was performed using FreeForm Modeling System on the basis of the 3D model.

RESULTSEight 3D models of renal stone were constructed. The 3D model of the renal stones represented the interrelationships of the stones, intrarenal vessel, and the collecting system with the adjacent anatomical structures. Individualized PCNL virtual surgery simulations including percutaneous puncture, dilatation and pneumatic lithotripsy were performed successfully in all the 8 3D models.

CONCLUSIONDigital 3D model of renal stone provides the reliable and comprehensive imaging information for surgical design, and PCNL virtual surgery simulation has important clinical significance to improve the stone clearance rate and reduce the surgical complications.

Adult ; Female ; Humans ; Imaging, Three-Dimensional ; Kidney Calculi ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Nephrostomy, Percutaneous ; methods ; Software ; Tomography, Spiral Computed ; User-Computer Interface

OBJECTIVE[corrected] To evaluate the method and technique of single-port laparoscopic radical nephrectomy.

METHODSForm January 2009 to September 2011, 22 patients with renal carcinoma were treated with single-port laparoscopic radical nephrectomy. An incision about 5 cm in length was made through the umbilicus or in the postaxillary line under the 12th rib to establish the peritoneal or retroperitoneal working space. A single-port cannulation was deployed and the operation was carried out using standard and crooked laparoscopic equipment.

RESULTSThe operations were completed successfully in all the 22 cases without conversion to open surgery, but additional trocar was needed in 5 cases. The mean operative time of radical nephrectomy was 150 min (90-240 min). The mean postoperative hospital stay was 7.6 days (3-15 days). The operation left a roughly 5-cm-long scar in all the cases.

CONCLUSIONSingle-port laparoscopic radical nephrectomy is safe and feasible with good cosmetic effect and shows much potential in radical resection of renal carcinoma.

Adult ; Aged ; Female ; Humans ; Kidney Neoplasms ; surgery ; Laparoscopy ; methods ; Male ; Middle Aged ; Nephrectomy ; methods ; Young Adult

The access negotiations of National Reimbursement Drug List (NRDL) in China from 2017 to 2019 effectively improved the availability and affordability of high-value innovative drugs. However,the actual outpatient reimbursement of most negotiated drugs is lower,which affects the patients" health insurance funds. In this paper,97 negotiated drugs in 337 overall planning cities were selected as samples to analyze the outpatient reimbursement for negotiated drugs. The results showed that the reimbursement level of 40 negotiated drugs was less than 50% in over 70% cities,which can be mainly interpreted as absence or imperfection of outpatient reimbursement policies for special diseases. Finally,this paper puts forward suggestions and protocols for improving the outpatient medical insurance through realizing outpatient overall planning,improving outpatient reimbursement policies for special diseases,and exploring innovative payment,ensuring the achievement of the access to NRDL.

Objective:In order to improve the understanding of the clinical, endoscopic and pathological characteristics of occult primary intestinal lymphangiectasia in infants, and to reduce misdiagnosis and missed diagnosis, we analyzed the clinical manifestations and diagnosis and treatment related data of a case of primary intestinal lymphangitis in Xiamen Children′s Hospital.The patient was admitted to the hospital with bronchopneumonia, mild diarrhea and edema, without decreasing in the number of peripheral blood lymphocytes, showing hypoproteinemia.Albumin infusion failed to alleviate hypoalbuminemia, and then gastroscopy showed that the duodenal segment had white millet like granular protrusion with different sizes and dense density, and the mucosa had extensive leukoplakia like lesions.Pathological examination showed that the small intestinal lymphadenectasia was obvious, and then the small intestinal lymphadenectasia was confirmed.After diagnosis, albumin was infused every two days for two consecutive courses and portagen medium chain fatty acid milk powder was fed.After treatment, the total protein and albumin in the plasma basically rose to the normal level, and the color Doppler ultrasonography of abdomen and chest showed that both pleural effusion and bilateral pulmonary effusion had been absorbed.The retrospective analysis of this case shows that for infants with dropsy caused by the decrease of plasma albumin and globulin, the possibility of excessive protein consumption caused by liver and kidney disease, tumor, tuberculosis and other chronic diseases should be excluded, and small intestinal lymphadenopathy should be considered, gastroscopy should be performed as soon as possible, pathological biopsy should be further improved, early diagnosis and treatment should be carried out as soon as possible And diet intervention treatment to avoid serious consequences caused by not timely handling.

Heart failure with high prevalence is the endpoint of many cardiovascular diseases. Once diagnosed， patients usually need lifelong medication， which seriously affects their quality of life. The drugs commonly used to treat heart failure include angiotensin-converting enzyme inhibitors， beta-blockers， aldosterone receptor antagonists， and diuretics. However， the long-term use of those drugs can lead to side effects such as hypotension， depletion of body fluid， and electrolyte imbalance and even increase mortality. According to the theory of traditional Chinese medicine （TCM）， Qi deficiency and blood stagnation is the major cause of heart failure and when Qi is not moving， blood is not flowing. Therefore， the TCM clinical treatment of heart failure uses the Chinese medicinal materials which replenish Qi， activate blood， and dispell stasis to treat both internal cause and external symptoms. Recent studies have demonstrated that Chinese herbal medicines such as Astragali Radix， Ginseng Radix et Rhizoma， Notoginseng Radix et Rhizoma， Salviae Miltiorrhizae Radix et Rhizoma， Angelicae Sinensis Radix， as well as the compound formulas such as Buyang Huanwutang， Simiao Yongantang， Qili Qiangxin capsules， and Qishen Yiqi drops， play a significant role in the prevention and treatment of heart failure via replenishing Qi， activating blood， and dispelling stasis. Inhibition of oxidative stress and inflammatory responses， mitigation of myocardial fibrosis， improvement of calcium cycling， and protection of mitochondrial function represent the key mechanisms for the treatment of heart failure with Chinese medicinal materials. Focusing on the pathogenic mechanisms and signaling pathways of heart failure， this paper systematically describes the pharmacological effects， molecular mechanisms， and research progress in the clinical application of Chinese medicinal herbs with effects of replenishing Qi， activating blood， and dispelling stasis and their compound formulas in the prevention and treatment of heart failure， aiming to provide scientific evidence for the development and clinical use of anti-heart failure Chinese medicinal materials.