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 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

Objective To observe the effects of bone marrow mesenchymal stem cells(BMMSCs) conditioned-medium (B-CM) on apoptosis in cultured cortical neurons after hypoxia-reoxygenation in vitro in rats.Methods BMMSCs were isolated,cultured and expanded,the culture me-dium was substituted by new medium that contain no serum when cells grew to 90% confluence.After cultured for 24 hours,the medium was collected as B-CM.Cortical neurons of mouse cultured for 8 days were divided into three groups:normal control groups,hypoxic group,B-CM disposed groups.Cell viability were detected by 3-(4,5-dimethlthiazd-2-yl)-2,5-diphenyltetra-zoliu bromidel (MTT) methods and the apoptosis of neurons was examined by flow cytometry and telemicroscopy on hypoxia for 0,6 hours and hypoxia-reoxygenation for 24 hours,respectively.Results Compared with control group,hypoxia for 6 hours could decrease cell viability,hypoxia-reoxygenation for 24 hours increased the cell apoptosis ratio remarkably(P

Objective To perform APACHEⅡand SOFA in assessmentof EICU patients with sepsis ,and analyze the risk factors. Methods A retrospective analysis from January 2014 to October 2015 in EICU of our hos-pital ,a total of 83 patients suffered from sepsis ,including sepsis group(30 cases)and septic shock(53 cases). PCT,PT,APTT,lactic acid,mechanical ventilation time and APACHE Ⅱ and SOFA score were collected, through the receiver-operating characteristic curve(ROC)index to predict the prognosis of patients with sepsis.Re-sults The mortality of the patients in the septic shock group,PT,APTT,APACHEⅡ,SOFA score,mechanical ventilation time and PCT were significantly higher than thosein the sepsis group(P<0.001). APTT,APACHEⅡ, SOFA score and mechanical ventilation time had significant difference (P ≤ 0.001) between survival and dead. The lactic acid level of the dead group was significantly higher than that in the survival group(P=0.038). The ar-ea under curve(AUC=0.806)of APACHEⅡscore was better than the SOFA score(AUC=0.765).The outcome of sepsis had correlation with APACHEⅡ,SOFA score,lactic acid,and mechanical ventilation time(P<0.05). Conclusion APACHE II and SOFA scores can accurately predict mortalityoutcome in emergency intensive care units patients with sepsis,especially the APACHEⅡscore.We can measure blood coagulation function,APACHEⅡ,SOFA score,PCT,lactic acid and mechanical ventilation time to assess the severity of patients with sepsis.

Nowadays,medical students have high pressure in hunting job.We analyzed the background of hunting job for medical students and discussed the corresponding psychological problems.Finally,we provided the countermeasures to solve these problems for medical students to find a job.

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 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 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.