Objective To summarize the clinical experience of combined single-access minimally invasive percutaneous nephrolithotomy (MPCNL) and lithotripsy through flexible ureteroscope in the treatment of staghorn calculi.Methods Fifty-seven cases of renal staghom calculi underwent combined MPCNL and lithotripsy through flexible ureteroscope.The size of calculi was (2.7 cm×3.3 cm-3.8 cm × 5.2 cm),3.7 cm×4.1 cmon average.Results The success rate of stone fragmentation was 80.7% (46/57) after the first stage of operation,duration of which was 128 min on average.The average loss of blood was 80 mL (20 - 150 mL).Eleven patients with residual calculi in the middle and lower calyx were also underwent the second stage of operation after 5 - 7 days.The average operation duration of the second stage was 57 min and the total clearance rate was 93% (53/57).Four cases had a few of residual calculi with size of 0.4 - 0.8 cm and went on with the treatment of extracorporeal shock wave lithotripsy(ESWL).Two cases were stone-free in the follow-up for 3 months.Conclusion MPCNL combined with with lithotripsy through flexible ureteroscope on the treatment of staghom calculi can decrease the therapeutic risk and complication,increase the rate of stone-free and safety.

ObjectiveTo investigate the effects of ederavone on oxidative stress response during one-lung ventilation (OLV).MetihodsThirty ASAⅠ or Ⅱ patients of both sexes aged40-64 yr,weighing50-85 kg undergoing elective esophageal cancer resection were randomly divided into 2 groups ( n =15 each):control group (group C) and edaravone group (group E).In group E edavavone was infused immediately after tracheal intubation at 60.0 mg/h for 30 min.Then the infusion rate was reduced to7.5 mg/h and maintained until the end of operation.In group C equal volume of normal saline was infused instead of edaravone.Arterial and venous blood samplea were taken immediately before skin incision,at 30 min of OLV and 30 min after re-expansion of the collapsed lung for blood gas analysis and determination of serum MDA and 8-iso-PGF2a concentrations.PaO2/FiO2,PA-aDO2 and respiratory index (RI) (RI =PA-aDO2/PaO2 ) were calculated.ResultsPA-a DO2,RI and serum concentrations of MDA and 8-iso-PGF2a were significantly lower at 30 min after re-expansion of the collapsed lung in group E than in group C( P ＜ 0.05).ConclusionEdaravone can attenuate oxidative stress response during OLV.

To investigate the protective effects of Zuogui Pill (ZGP), a compound Chinese herbal medicine, on retina ganglion cells (RGCs) in rats after optical nerve clipping injury.

Objective To evaluate mini-percutaneous nephrolithotomy in treating superior segmental ureteral calculi. Methods Two Hundred and thirty-six patients underwent mini-percutaneous nephrolithotomy with holmium laser for superior segmental ureteral calculi from May 2005 to May 2008, 133 male and 103 female. Their age ranged from 17 to 76 years old with a mean of 47. 2 years. Of the 236 patients,141 compli-cated with calculi in the left side and 88 cases in the right side,7 in the both sides. The calculi diameter ranged from 0. 7 cm to 2.2 cm and the mean diameter was 1.4 cm. One hundred and ninety-three patients had undergone ESWL from 1～6 times. Results Of the 236 patients,217 were rendered stone-free at 1 pro-cedure. Residual calculi were found in 12 cases after operation and drugs were used for treatment. The resid-ual calculi were removed after 1 month. Seven cases with residual calculi were treated by ESWL and the cal-culi were removed. The total stone clearance was 91.9%. The mean operation time was 31.3 min(rang from 19～52 min), and the mean hospital stay was 9.5 days(rang from 6 to 12 days). The main complications following operation included: durative hematuria in 25 cases relieved by haemostasis and diuresis treatment within 24 to 48 hours,pnstoperative fever in 141 cases within 24 hours of which 103 were relieved by antiin-flammatory and fluid replacement treatment within 24 to 48 hours. Thirty-eight cases were relieved by anti-inflammatory treatwent depending on urine culture results within 3 to 7 days. The postoperative pain in all patients was light. Conclusion Minimally invasive percutaneous nephrolithotomy with holmium laser under ultrasound guidance is simple,safe and effective in treating proximal ureteral calculi.

Abstract A method for determination of trace mercury in water was established. The trace mercury in water was adsorbed quantitatively by activated carbon, and then determined by electrical pyrolysis atomic absorption spectrometry. In comparison with the detection methods of total mercury in water at present, the method avoids the steps of digestion, reduces the mercury pollution and the loss of the mercury, and is simple in operation. The effects of particle size of activated carbon, acid treatment method, acid medium and enrichment time on the enrichment efficiency were investigated. The effect of the pyrolysis temperature and the interfering ions on the determination results was investigated. Three standard addition procedures including activated carbon blank addition, solution blank addition and environmental water samples addition were studied. Regression correlation coefficients of three standard curves drawn by the three methods reached 0 . 9999 . The slope of the three standard curves had no difference by statistical test, indicating that the determination of mercury in environmental water samples under the experiment conditions was not interfered by the coexistent elements, which showed that the activated carbon blank addition method could be directly used for preparing standard curve of the method. The water samples containing 5 ng/L and 50 ng/L mercury were determined by the method, and the relative standard deviation were 7. 2% and 4. 2% (n=11), respectively, with a detection limit of 1. 2 ng/L. The recovery experiment was carried out after adding 10 ng/L mercury to the surface water and tap water samples, and the recoveries were between 92. 0% and 103. 0%. Analysis results were compared with ICP-MS as control and the deviation of the two methods were between 2 . 9% and 3 . 4%, indicating that the method was accurate and reliable, and had good precision.

Objective To investigate the feasibility of dose verification of intensity modulated planning of helical tomotherapy (HT) using three-dimensional semiconductor array (Delta4) and find a more time-consuming and accurate method to validate the delivery dose.Methods Delta4 detector array was used to verify the HT plan dose distribution of 10 patients.The precise setup of detector array was guided and registered by MVCT imaging.After the implementation of delivery,the measured dose distributions on the corresponding planes were compared with those calculated by the treatment planning system (TPS).According to the different acceptance criteria combination of dose difference or distance to agreement at different threshold level including 3％/2 mm,3％/3 mm,3％/4 mm,3％/5 mm at TH5,TH10,TH20,TH30,TH70,TH90,the γ analysis method was utilized to evaluate the dose verification.Results The dose distribution measured by the Delta4 was well consistent with that calculated by the TPS.The mean γpassing rates were all above 94.89％.Conclusions Delta4 detector array can get satisfying results when used in HT plan dose verification and is a viable tool to replace traditional film dosimetry system in clinical quality assurance work.

Objective To study the safety and feasibility of tubeless percutaneous nephrostolithotomy by hemostasis gel closure of mini-percutaneous renal-channel.Methods Eighty patients after conventional percutaneous nephrostolithotomy are selected and divided into two groups according to the principle of randomization.Control group adopts conventional percutaneous nephrostolithotomy calculi lithotripsy with renal pelvis drainage tube placement whereas the experimental group adopts tubeless percutaneous nephrostolithotomy by hemostasis gel closure of mini-percutaneous renal channel.Both experimental group and control group will be scientifically and statistically analyzed via the incidence and the dose of using sedative for alleviating pain after operation,hospital stay,level of hemoglobin,and the occurrence of complications such as continuate hemorrhage,infection,urinary extravasation,etc.Results The operation of both groups are successful in phrase Ⅰ.The incidence and the dose of using sedative in control group are obviously higher than that in experimental group(45％ vs 20％).However,the incidence of postoperative complications like infection and hemorrhage and hospital stay between two groups are undifferentiated in statistics(P ＞ 0.05).Neither the experimental group nor the control group has perinephric hematoma,and seven cases of control group have urinary leakage after remove of fistula.Conclusion Tubeless percutaneous nephrostolithotomy by hemostasis gel closure of mini-percutaneous renal-channel is safe and feasible and it can reduce the incidence of postoperative pain and avoid urinary leakage.

Objective: To investigate the changes and significance of microvessel density(MVD) in bone marrow of patients with aplastic anemia. Methods: 30 aplastic anemia cases,20 hyperplastic anemia cases,and 20 normal individuals′ paraffin-embedded bone marrow biopsys were stained with HE and CD34 by immunohistochemistry method respectively;and the vol% of hematopoietic tissue area in bone marrows were detected accordingly. Results:The difference between the MVD of HE and CD34 was not significant in aplastic anemia cases ,and the difference between the MVD of HE and CD34 was not significant in normal individuals either. While the MVD of HE was significantly lower than that of CD34 in hyperplastic anemia cases. The difference of the MVD between light and heavy pathogenetic condition in aplastic anemia cases was significant.The MVD of CD34 were significantly different among the cases of aplastic anemia, hyperplastic anemia,and normal individuals.The MVD showed significant linear correlation with the vol% of hematopoietic tissue area (r=0.74,P

Objective To explore the immunophenotype features and folate receptor expression of blasts in patients with myelodysplastic syndromes(MDS).Methods Four-color flow cytometry using conventional and secondary gating strategies was used into analysis the immunophenotype features and folate receptor(FR) expression of blasts and CD+34 cells in bone marrow nucleated cells with MDS.The patients with acute myeloid leukemia-M2(AML-M2) were as positive control.Results with progression of MDS from RA/RAS,RAEB to RAEB-T,using conventional gating strategy,the proportion of CD+34 cells were gradually increased(P＜0.05).Moreover,the expression of HLA-DR,CDll7,CD13,CD33 were also gradually increased and the expression of CDl5 was gradually decreased(P＜0.05).Using secondary gating strategy,the expression of HLA-DR,CD117,CD13,CD33 on blasts were higher than those by conventional gating(P＜0.05).However,there was no significant difference(P＞0.05) in the expression of above mentioned antigens on CD+34 cells among different MDS subtypes.On the other hand,there were no expression of FR on blasts and cD+34 cells with different MDS subtypes.Conclusion With progression of MDS,the antigens of blasts surface change into more immature immunophenotype of medullary system.But these antigens abnormal expression only illustrates the increase of ascendant malignant clone quantity,it can not reflect the nature of the disease.Using flow cytometry technique can not detect whether or not FR expression on the blasts with MDS.

Objective To investigate the imaging manifestations, clinical features and treatment of primary aggressive osteoblastoma (PAO)of the calcaneus.Methods The clinical data,imaging findings and treatment of PAO of the calcaneus in a young man retrospectively analyzed with literature review.The lesion was confirmed by pathology one and half years ago,and recurred after operation 10 months follow-up.Results X-ray and CT revealed expansive destruction of right calcaneus with little calcification or ossification,the bone destruction in the medial part of the calcaneus was obvious,the bone cortex was thin and incontinuous,there was no soft tissue mass or periosteal reaction.The talocalcaneal joint was not involved by the tumor.Neither other bones nor the root of Achilles' tendon showed direct tumor invasion or metastasis but neighboring swelling existed.Conclusion There are no significant differences about imaging manifestations, clinical features and laboratory analyses between primary aggressive and benign osteoblastoma of the calcaneus.The accurate diagnosis of PAO is only depending on pathology.The therapeutic effect with pure curettage and bone grafting for the lesion is not fine and tends to recur and malignant change.