Objective To investigate the treatment effect of retrograde holmium laser lithotripsy on treatment of impacted ureteral calculi.Methods One hundred and twenty-eight patients with ureteral calculi in the Second Affiliated Hospital of Xinjiang Medical University from Feb.2011 to Dec.2013 were divided into unimpacted ureteral calculi group (70 cases) and impacted ureteral calculi (58case).The treatment efficacy,operation complications of holmium laser lithotripsy and the causes of the failure of operation were recorded.Results The stone clearance rate,operative periods and postoperative incidence of gross hematuria in the un-impaction group were 91.4％ (64/70),(36.3 ± 10.7) min and 51.4％ (36/70) respectively,significant different from those in impacted ureteral calculi(74.1％ (43/58),(45.2 ± 13.9) min and 84.5％ (49/58) respectively;x2 =6.914,t =3.736,x2 =15.535 ;P ＜ 0.05).There were no significant difference between the un-impaction group and impaction group in terms of the postoperative hospital stay periods,analgesics utilization rate,urinary tract infection rates and ureteral perforation rate.In the un-impaction group,6 cases were surgical failure due to the movement of ureteral calculi during the operation.Fifteen cases were surgical failure in the impaction group,mainly due to the stone fragments move,the ureter excessive distortion and ureteral stricture.The success rate was 58.3％ (14/24) of the stones,which were above the level of L4 in the impaction group,while the success rate was 85.3％ (29/34) of the stones that was below the level of L4 in the impaction group (x2 =5.334,P ＜ 0.05).Conclusion Impacted ureteral calculi is more difficult to deal than unimpacted stone.The operation success rate of impacted stones above the level of L4 is less than below L4 due to stone fragments and ureter distorting.

This article summarized the application of PBL in psychiatric teaching practice.In PBL teaching practice,questions should be designed according to various aims of teaching,and questions should be asked in various stage of class and with various forms so as to inspire the students to explore new things and make them combine their self-study with mutual study

OBJECTIVE To investigate the factors that result in lower respiratory tract infection by Candida albicans and the situation of drug resistance in geriatric inpatients.METHODS Clinical samples were collected from the geriatric inpatients with lower respiratory tract infection in our hospital from Jan 2004 to Dec 2006,and among them,146 patients were found containing C.albicans in their sputum.Meanwhile retrospective analysis was made.RESULTS There were many factors resulting in lower respiratory tract nosocomial infection by C.albicans in geriatric inpatients,and the detection rates of C.albicans increased year by year in the past three years were 25.2%,36.9% and 39.9%,respectively.The drug resistance of C.albicans raised obviously at the same time was 20.6%,41.8% and 34.2%,respectively.CONCLUSIONS It is necessary for reducing lower respiratory tract infection rates to efficiently control the C.albicans infection factors and to properly use antibiotics.

This article was aimed to study the correlation between iron content inCornus officinalis leaves and its yield as well as quality. The method of microwave digestion atomic absorption spectrophotometer was used to determine the content of iron element inCornus officinalis leaves. HPLC was used to determine the content of loganin and ursolic acid in fruits. Correlation analysis was made among the content of iron element, yield of fruits, loganin and ursolic acid in fruits. The results showed that iron element in leaves of different yield level cornus officinalis was different. It also had some correlation with yield and quality of fruits. It was concluded that the research can improve relations of source-sink inCornus ofifcinalis, adjust source-sink balance, guide farmers to master the period of spraying iron fertilizer, and increase production and quality ofCornus ofifcinalis.

According to medicinal chemistry experiment characteristics,the teaching meth-ods and grading system were reformed,The main point of this course is improving students’ex-perimental technique and skill capability so as to effectively arouse the students’interest in study and improve their comprehensive experimental ability.

Objective Fecal biomarkers have emerged as an important tool for assessing and monitoring disease activity in patients with inflammatory bowel disease ( IBD) .We aimed to investigate the diagnostic value of fecal neopterin and calprotectin in pa-tients with active inflammatory bowel disease and made comparison with that of serum C-reactive protein ( CRP) . Methods A total of 151 consecutive patients with IBD (84 CD and 67 UC) provided 2 gram fecal samples for the measurement of fecal neopterin( FNP) and calprotectin( FCP) concentrations and 2 milliliter blood samples for the serum C-reactive protein measurement before undergoing a colonoscopy.ELISA was applied in the measurement.Clinical disease activities were scored independently according to the Best Crohn′s Disease Activity Index(CDAI) in patients with CD, while the Modi-fied Mayo Scores in patients with UC.Comaprison was made in the relativity of each fecal marker and IBD activity score, the optimum value of diagnosing IBD acitivity as to each fecal marker, as well as sensitivity, specificity, moreover, receiver operating characteristic curve ( ROC) was drawn.50 healthy volunteers who received a normal colonoscopy were also enrolled as the control group and asked to give a 2 gram fresh stool sample. Results The FNP and FCP concentrations in patients with IBD were significantly higher than those in healthy control group(P<0.05).Both FNP and FCP concentrations differed significantly in clinically active IBD when compared with those in patients with inactive disease( P<0.001) .In CD patients, the correlation coefficients of FNP and FCP with CDAI were 0.55 and 0.59, respectively(P<0.001).In UC patients, the correlation coefficients of FNP and FCP with Mayo scores were 0.74 and 0.77, respectively( P<0.001) .The correlation coefficients of serum CRP in CD and UC patients with clinical scores were 0.49 and 0.60, respectively(P<0.001).The area under the ROC curve(AUC) of FNP and FCP for the diagnosis of clinical activity in pa-tients with CD were 0.75 and 0.80, respectively.The AUC of FNP and FCP in UC patients were 0.85 and 0.90, respectively.The AUC of serum CRP in patients with CD and UC were 0.65 and 0.74, respectively.When combined FNP with FCP, the AUC in pa-tients with CD and UC were 0.85 and 0.92, respectively. Conclusion FNP is a novel reliable and non-invasive biomarker to evalu-ate clinical disease activity in patients with IBD as accurate as FCP, It is advisable to combine FNP with FCP to evaluate disease activi-ty in patients with IBD.

Background:Peroral endoscopic myotomy(POEM)is a novel minimally invasive endoscopic technique for treatment of esophageal achalasia(EA). It has been demonstrated to be safe and effective in several short-term clinical studies, however,studies focusing on its mid- and long-term outcome are rare. Aims:To investigate the mid-and-long term efficacy of POEM in EA patients. Methods:A retrospective analysis was performed in 41 EA patients who underwent POEM in the Department of Gastroenterology and Hepatology of Nanjing General Hospital of Nanjing Military Region from Jul. 2012 to Dec. 2013. All these patients were followed up periodically for clinical symptoms(Eckardt score),maximum esophageal diameter and lower esophageal sphincter pressure(LESP),and the intra- and post-operative complications and recurrence were recorded. Results:POEM was successfully completed in all 41 EA patients,the mean operative time was(69. 5 ± 20. 6)min(range 35-125 min),and the mean length of hospital stay was 3. 5 days. Compared with the pre-operative data,the post-operative Eckardt score,maximum esophageal diameter and LESP during follow-up(mean 26. 3 months, range 19-36 months)were significantly decreased(P all < 0. 05). Procedure-related complications were seen in 6 patients (14. 6% );the clinical success rate was 95. 1%(39 / 41)and the recurrence rate was 2. 4%(1 / 41). Conclusions:POEM is safe and effective in mid-and-long term follow-up with low recurrence rate. It might become the first-line therapy for EA,and the long-term efficacy and complications need further follow-up study.

Objective To compare different beginning time of acid simulation to reduce the acute damage of salivary glands after high-dose of iodine-131 treatment for the post-surgery patient with differentiated thyroid cancer (DTC) and screen out the optimal beginning time of acid simulation .Methods Total 309 cases of post-surgery DTC patients accept high-does ioding-131 treatment (average dose of ioding-131 :4 .28 ± 0 .43 GBq) ,and all patients was divided into three group randomly ,the beginning time of acid stimulation(vitamin C :10 mg per time ,three time a day ,lemonade:50 mL per 2 h) for each group is 2 ,12 and 24 h .Then observe the incidence and time of acute damage of salivary glands for each group .At same time ,we analyses the relation between acute dam-age of salivary glands with sex and age .Results The incidence of acute damage of salivary glands is 13 .21% (2 h) ,24 .51% (12 h) , 26 .73% (24 h)respectively ,the incidence of 2 h is lower than those of 12 h and 24 h obviously(P<0 .05) ,and there is no difference between 12 h and 24 h(P>0 .05) .The occurrence time of acute damage of salivary glands for 84 .85% patients is between 10-24 h .And there is no difference of incidence of acute damage of salivary glands between different sex and age group .Conclusion 2 h maybe the optimal beginning time of acid simulation to reduce the acute damage salivary glands for the post-surgery DTC patients after high-dose iodine-131 treatment in this study .Sex and age are no influence to the occurrence of acute damage of salivary glands .

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