Objective To evaluate the clinical effect of pneumatic lithotripsy under ureterorenoscope in the treatment of ureteral calculi. Methods One hundred and eighty-nine cases of ureteral calculi were treated by ureterorenoscopic pneumatic lithotripsy between November 1999 and February 2003. Results Lithotripsy was performed successfully on one session in 183 cases,with a success rate of 96.8% (183 of 189).Conversions to open surgery were required in the remaining 6 cases because of unsuccessful entry of the ureterorenoscope (ureteral perforation in 1 case).Follow-up period ranged from 10 days to 3 months (mean, 1.3 months). Stones were entirely expelled in 182 cases of the 183 cases (99.4%) within 2 months after the procedures. Conclusions With minimal invasion and pain, this procedure is safe and effective for ureteral calculi, being probably the treatment of first choice.

OBJECTIVE: To determine the contents of the related substances in Aosaibos crude drug by HPLC.METHODS: The determination was carried out on a SunFireTM RP C18 column with mobile phase consisted of phosphate buffer solution(pH 3.05)-acetonitrile(8∶2) at a flow rate of 1 mL?min-1.The detection wavelength was set at 220 nm;The sample size was 20 ?L and column temperature was set at room temperature.RESULTS: The main peak and the impurity peaks of 3 batchs of Aosaibos crude drug were well-separated.The contents of the related substances were all lower than 1.19%.CONCLUSION: The determination method is simple,sensitive and applicable for the content determination of the related substances of Aosaibos.

Objective To investigate MRI signal features and MRI appearances of patients with advanced stage in polyacrylamide hydrophilic gel injection for facial plasty.Methods In this study,MRI of 11 cases with 23 polyacrylamide hydrophilic gel injection of facial plasty for 6 to 10 years were retrospectively reviewed.All images were acquired with GE 3.0T MR imaging unit.MR sequences,including FSE T1WI,FSE FS T2WI,and STIR were applied with 8-channel brain coil.MRIs sliced through the maxillofacial region in the transverse,coronal and sagittal planes.Results In 11 cases of 23 polyacrylamide hydrophilic gel injection,there were different degrees of capsule rupture and induration in 6 polyacrylamide hydrophilic gel injection,and the images showed sporadic callosities such as subcutaneous nodules and nodules in glands or muscles ; hydrogel migration in 8 polyacrylamide hydrophilic gel injection.Secondary deformity occured in 80 ％ cases,in which the most cases were induced by hydrogel migration.Conclusions Magnetic resonance imaging can make clear of the type of rupture and the distribution leakage of polyacrylamide hydrophilic gel for facial plasty and it is an ideal approach for advanced patients with polyacrylamide hydrophilic gel injection for follow-up.

Objective To investigate the invasion,internalization and the organelles damage of the cultured dendritic cells ( DC2.4 strain) during Vibrio vulnificus (Vv) infection.Methods The study model was the cultured DCs infected by Vv 1.1758 strain.Electron microscopy was used to observe the localization of bacteria in different time point of infection,cell morphology and the process of organelles changes.The cytoskeleton structure including the microfilaments and the microtubules rearrangement was examined by the fluorescence microscope.Results The Vv were pinocytosed into the DC cells through double-sides,and localized at 1-2 μm of the inner side membrane.It cost 1.27,1.87,3.43 hours reaching the infection ratio of 25％,50％,75％,respectively.Using electron microscopy,the DCs had been observed the phagosome formation within 1h,chromatin activation within 2 h,chromatin aggregation 4 h,and the significant cytoskeleton structure disruption within 6 h.Endoplasmic reticulum,mitochondria and lysosomes became swollen.In DCs,the protruding filaments gradually reduced,and their shape changed from the point-like to the linearlike aggregation at the inner side of the plasma membrane,extended microtubules disappeared,the microtubules at the outside nuclear membrane striking rearranged.Conclusion After DC was infected by Vv,the bacteria were pinocytosed into the inner side of DC membrane,and the microfilaments were observed to move from the cytoplasm to cell membrane.In addition,the microtubules moved from the synapse and the cell membrane to the nuclear membrane.The high lethality of Vv could provoke to the DCs cytoskeleton rearrangements.

Objective To compare the effect of octreotide combined with omeprazole and omeprazole alone in the treament of upper gastrointestinal bleeding.Methods Clinical data of 101 patients with gastrointesinal bleeding were retrospectively analyzed.According to the treatment,the patients were divided into the observation group(56 cases) and control group(45 cases).The patients in observation group were given octreotide and omeprazole,and patients in control group were given omeprazol alone.Then the results of the two groups were analyzed.Results The total effective rate of observation group was 91.07％,and was higher than that of the control group(73.33％) (x2 =5.61,P ＜0.05) ;The average hemostasis time of observation group was (15.9 ±3.9)h,and was shorter than that of the control group [(23.5 ± 4.7) h] (t =1.937,P ＜ 0.05) ; The hemoglobin level of the observation group was (116.7 ± 12.4) g/h after 72 hours treatment,and was higher than that of the control group [(91.5 ± 17.3) g/h] (t =2.013,P ＜ 0.05) ;The pH of observation group was higher than that of control group after 12h,24h,48h and 72h treatment(all P ＜ 0.05).Conclusion Octreotide combined with omeprazole is effective for upper gastrointesinal bleeding,and it can shorten the bleeding time and improve the cure rate.

Objective To observe the process of Vibrio vulnificus inducing dendritic cell strain apoptosis.Methods We established the mixed culture model of mouse dendritic cell ( DC 2.4 strain) and Vibrio vulnificus( Vv1.1758 strain ),analyzed morphological characteristics of cell apoptosis by DAPI fluorescence staining,detect DNA fragmentation level of apoptosis cells by DNA Ladder assay,analyze DC2.4 apoptosis rate by Annexin V FITC/PI staining,determine activities of caspase-3 and caspase-8 by means of spectrophotometric method and detect changes of mitochondrial transmembrane potential ( △ Ψm ) by JC-1 fluorescence labeling.Results After Vv1.1758 strain and DC2.4 cell were mixed and cultured for 4 h,DAPI fluorescence staining showed typical apoptosis characteristics-chromatin condensation and marginalization; DNA agarose gel electrophoresis showed apoptosis band; apoptosis rates at 2,4 and 6 h were respectively (37.8±9.8) ％,(54.3 ± 12.7 ) ％ and ( 68.2± 14.6 ) ％ ; Mitochondrial transmembrane potentials (△Ψm) at 1 h,2 h and 4 h reduced by 7.1％,16.1％ and 46.7％ respectively; caspase-8 activity increased at 1.5 h and reached the peak at 2 h [ (2.48±0.19) U/μg],while caspase-3 activity started to increase at 3h and reached the peak at 4 h [ ( 1.91 ±0.16) U/μg ].Conclusion Vibrio vulnificus could induce dendritic cells by two pathways: reducing mitochondrial transmembrane potential and activating caspase-8 promoter and finally activate effector caspase-3 to promote apoptosis.

Objective To observe the changes of serum levels of inflammatory cytokines in the elder patients with clopidogrel resistance (CLR) after coronary stenting. Methods A total of 93 patients with unstable angina pectoris received coronary stenting were enrolled, and peripheral blood samples were taken before and 24 hours, 1 week and 1 month after surgery. The platelet aggregation (PAG) induced by adenosine diphosphate (ADP) were detected, and all patients were divided into CLR group (n=33) and normal response group (n=60) according to PAG response. At the same time, the levels of C-reactive protein (CRP), soluble fragment of CD40 ligand (sCD40L) and P-selectin were detected by enzyme-linked immunosorbent assay. Results The incidences of CLR were 35. 5% (33/93), 26. 9%(25/93) and 20. 4%(19/93) respectively 24 hours, 1 week and 1 month after surgery. The levels of CRP C(8. 8 ± 2. 5) mg/L at 24 hours, (5. 3 ± 2. 5) mg/L at 1 week], P-selectin [(73. 8±34)×10~(-3) ng/L at 24 hours, (70. 5±31. 6)×10~(-3) ng/L at 1 week, (66. 4±22. 3) ×10~(-3) ng/L at 1 month] and sCD40L C(7. 7 ±2. 3)×10~(-3) ng/L at 24 hours] after surgery in CLR group showed significant differences comparing with pre-surgery and normal response group (all P< 0.05). The CLR at 30 days after coronary stenting was significantly correlated with the level of P-selectin (r=1.334) and smoking (r= 1.053). Conclusions The levels of CRP, P-selectin and sCD40L in some elder patients after coronary stenting are increased and may be correlated with CLR. The levels of P-selectin and smoking are the predictors for CLR.

Objective To observe the effect of a triptolide-eluting stent(TES)on neointimal hyperplasia in response to vascular injury,inflammation and safety to prevent restenosis after angioplasty.Method Twelve pigs were randomly divided into three groups and received either a bare metal stent(BMS),a sirolimus-eluting stent (SES)or a TES.Each pig was treated with antiplatelet drugs after angioplasty.Biochemistry,vascular morphometry,histopathology and immunohistochemistry were analyzed at 12 weeks after angioplasty.Results The injury scores of the blood vessel were similar in all three groups.There were no differences in minimal lumen diameter or lumen area between the TES[(5.13 ±0.46)mm2;(2.65 ± 0.21)mm]and SES[(5.01±0.54)mm2;(2.65±0.25)mm]groups,but they were significantly(P＜0.01)larger than those in the BMS group[(3.76±0.61)mm2;(2.15 ±0.18)mm].The neointimal area in the TES group was smaller than that in the BMS group,but was similar to that in the SES group.The expression of VEGF,ICAM-1 and α-actinin were significantly lower in the TES group than in the BMS group.In all groups,the proliferation on both edges of the stents was insignificant.No toxicity was found in the TES group.Conclusions TES inhibits neointimal proliferation and the expression of inflammatory factors in pigs.In this study,TES safely and effectively prevented restenosis for 12 weeks.

Objective To evaluate the clinical effects of two different revascularization approaches,one via percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and the other via coronary artery bypass graft (CABG),on short-and long-term prognosis in elderly patients with diabetes and multi-vessel coronary artery disease.Methods A retrospective analysis was conducted on 254 elderly patients with diabetes and multi-vessel coronary artery disease.Based on the revascularization approach,patients were divided into the PCI group (n=93) and the CABG group (n =161).The incidence of major cardiovascular events (MACE) were observed during hospitalization and 1-year after follow-up.Results All-cause mortality and the incidence of non-fatal myocardial infarction were higher in the CABG group than in the PCI group during hospitalization [4.9％ (8 cases) vs.1.1％ (1 cases),5.6％ (9 cases) vs.2.2％ (2 cases),each P＜0.05],while there was no significant difference in the incidence of MACE between the two groups1-year after follow-up (P＞ 0.05).The incidence of cerebrovascular events was lower in the PCI group than in the CABG group [2.2 ％ (2 cases) vs.6.2％ (10 cases),P＜0.05],while the rate of revascularization was higher in thePCI group than in the CABG group [6.5％ (6 cases) vs.1.9％ (3 cases),P＜0.05].Cox regression analysis showed that diabetes (OR =1.65,95％ CI:1.013-1.926,P =0.024) and left ventricular ejection fraction (OR =1.30,95 ％ CI:1.018-1.652,P =0.027) were independent risk factors for revascularization and cerebrovascular events.Conclusions MACEs during hospitalization are fewer in elderly patients with diabetes and multi-vessel coronary artery heart disease who received PCI than in those who received CABG.PCI has a similar mid-and long-term effect as CABG,bur PCI has a higher revascularization rate and lower risk of MACEs than CABG.

Objective To study the correlation between the risk factors of coronary slow flow phenomenon ( CSF) and the level of plasma D-dimer in patients with ACS ( acute coronary syndrome) after emergency percutaneous coronary intervention ( PCI) .Methods A total of 297 patients with ACS after PCI were enrolled for retrospective analysis.All patients were divided into CSF group and control group in the light of corrected thrombolysis in myocardial infarction (TIMI) frame count method (cTFC).Multivariate analysis for evaluating clinical predictors of CSF was carried out using Logistic regression test and Pearson analysis to find the correlation between plasma D-dimer and cTFC.The predictive value of D-dimer level in the occurrence of coronary slow flow was determined by using receiver operating characteristic ( POC) curve analysis.Results CSF was observed in 59 cases (19.8%).The plasma D-dimer was significantly higher in the coronary slow flow group compared with the control group ( P <0.05 ) .Multivariate regression analysis and Logistic regression test showed that the level of plasma D-dimer ( OR =1.276, 95%CI:1.132-3.224, P=0.012), thrombus score (OR =1.108, 95%CI: 1.085-2.103, P =0.018) and target lesion length of culprit vessel ( OR =1.436, 95%CI: 0.635-1.382, P =0.037 ) were the risk factors of CSF.Correlation analysis showed that plasma D-dimer were positively associated with CSF. Receiver operating characteristic ( ROC ) curve analysis showed that D-dimer cutoff point at 515.3 ng/ml had a good judgment significance ( AUC 0.783, OR =1.502, 95%CI: 1.324-2.531, P =0.005). Conclusions The increased D-dimer level is a risk factor and plays an important role in the ACS patients with the CSF phenomenon, thereby predicting no-reflow phenomenon after primary PCI in these patients.