Objective;To evaluate the endourethral surgery for urethrostenosis and urethratresia. Methods:68 patients with urethrosteno-sis or urethratresia were treated by endourethral surgery, such as internal urethrotomy, transurethral scar resection. Results: Of the 68 cases, the outcome was satisfactiory in 61 (89. 71% ). Endourethral surgery was carried out once for 55 patients and twice for 6,7 patients required open surgery. All patients had followed by urethral dilatation. 59 patients were followed - up for 3 months to 5 years. 54 cases can micture normally. Conclusions; Endourethral surgery is simple,safe,efficient treatment for urethrostenosis and urethratresia.

ObjectiveStudy on the effect of nasal decontamination hefor aerosol inhalation in elderly patients with general anesthesia postoperation.Methods130 elderly patients with general anesthesia postoperation were randomly divided into routine treatment group and nasal decontamination group.The time of first sputum,the time of postoperative sputum changing characters,respiratoty-related indicators,sputum cuhure positive rate of bacterial,the incidence of postoperative pulmonary complications was examined.ResultsCompared with routine group,nasal decontamination group obviously shorten sputum character changing time ( P ＜ 0.05 ).Postoperative nasal decontamination group and conventional group sputum Staphylococcus aureus positive rate were 7.7％ (5 cases) and 20.0％ ( 13 cases) respectively,the difference was significant(x2 =4.13,P ＜0.05).ConclusionGiven nasal decontamination before aerosol inhalation could improve character of sputum and reduce sputum bacterial culture positive rate,and had good efficacy and safety.

Objective To investigate and analyze the risk factors,morbidity and mortality rates of multiple organ dysfunction syndrome (MODS) after multiple trauma.Methods The clinical data of all 155 patients with multiple trauma admitted to our ICU from Sep 2008 to Jun 2011 were retrospectively analyzed,including treatment,injury severity score (ISS) and its relationship with MODS.Results The morbidity of MODS among all 155 patients was 18.7％ (29/155).There were 3,7 and 19 patients died due to multiple trauma in 39 ISS ＜ 16,58 ISS 16-25,and 58 ISS ≥25 cases respectively.The morbidity of MODS was significantly higher in patients with ISS ≥25 ( x2 =12.321,P =0.002) than in others.There were 15 cases with MODS and 28 cases without MODS died respectively in multiple trauma patients ( x2 =10.236,P =0.001 ).Conclusion MODS is the important reason for death in multiple trauma patients.It is pivotal to actively deal with primary trauma to avoid the second insult to the patients and support vital organs early in order to improve the prognosis of multiple trauma.

Objective To explore the characteristics of type 1 diabetic mice models induced by multiple low dcee streptozotoein(MLD-STZ).Methods Type 1 diabetic mice models was induced with intraperitoneally injection of STZ(40mg/kg body weight,daily)for 5 consecutive days and detected fasting blood glucose,urine glucose and histological ehange of panereata.Results The incidence of type 1 diabetes mdlitus was 65%;compared with normal control group,blood glucose and urine glucose levels increased significantly and histological analysis of pancreata showed marked insulitis in diabetic model group,and the hyperglycemia maintained from the fourth to the eighth week after the firml STZ injection.Conelnsion Type 1 diabetie mice models could be made successfully by MLDSTZ,and the hyperglycemia could maintain for a rather long time.

Objective To evaluate the cost-effectiveness of the aneurysm intra-artery GDC embolization and the aneurysm clapping of intracranial aneurysm, and to give the instruction for the clinical practice. Methods A case control study (1 vs. 1) was developed to evaluate the cost in hospital, the cost for return visit and the Quality-adusted Life-Year (QALY) and lifetime costs of the intra-artery GDC embolization and the aneurysm clapping of intracranial aneurysm, under the matching of the age, sex, living place, the size and place of the aneurysm, and the Hunt & Hess score. Clinically effectiveness dates were derived from the medical records. Cost dates were derived from follow-up by telephones or letters. The correlation analysis was done with the SPSS 13. 0. Results The cost in hospital in AC group was (54 945±16 946) RMBs,which washigher than the ones in AE group(63 768±12 665) RMBs, (t = 1.71, P <0. 05). The cost of missed working in AE group was 200 RMBs(the median), which was lower than the ones in AC group 650 RMBs (z =2. 57,P < 0. 01). The cost of return visit in AE group was 1200 RMBs, which was lower than the ones in AC group1950 RMBs (z = 1.82, P < 0. 05). The cost-effectiveness of the intra-artery GDC emhalization and the aneurysm clapping had no difference 3805 RMBs/year vs. 3028 RMBs/year(z =0. 42,P >0. 05). Conclusion The results suggest that the two therapies have no difference in cost effective rate. Considering the physical and mental loss, the aneurysm intra-artery GDC embolization was better than the aneurysm clapping for the patients with aneurysm that diameter less than 25 mm.

Objective To analyse the X-ray characteristics of the intraductal papilloma and to improve the diagnostic accuracy.Methods The mammographic data of 80 cases of intraductal papilloma of breast by pathology were analysed.Results 24 cases showed circular filling defect, 12 cases showed stringy filling defect,ductal blocked in 30 cases, ductal dilation in 48 cases. Conclusion Galactography is a effective method for diagnosing intraductal papilloma of the breast.

Objective To study the prognostic factors of primary ureteral carcinoma,and to analyze the risk factors of the occurrence of subsequent bladder cancer. Methods This series included 160 cases of primary ureteral carcinoma (93 men and 67 women;mean age,63.7 years).Of them,81 cases had the tumors on the left and 79 on the right;the tumors were located at the upper and middle parts of the ureter in 51 cases,and at the lower part in 96.Pathological staging showed T a (9 cases),T 1(58),T 2(46),T 3(41) and T 4(6);the grading showed G 1(4),G 2(119) and G 3(37).All the 160 cases underwent surgery.Among them,renal and full length of ureter resection plus sleeve resection of bladder were performed on 124 cases (77.5%).All the cases were followed up and the results were statistically analyzed. Results The overall 5-year survival rate was 53.0%.The 5-year survival rates of T a,T 1 and T 2 cases (83.3%,71.9%,59.1%,respectively) were significantly higher than those of T 3 and T 4 cases (37.5% and 16.7%,P

ObjectiveTo investigate the role and its mechanism of the NOD-like receptor 3 (NLRP3) inflammasome in alveolar macrophages in ventilator-induced lung injury (VILI) in rats.Methods Thirty adult male Sprague-Dawley (SD) rats were randomly divided into three groups, with 10 rats in each group: spontaneous breathing control group, normal tidal volume (VT) group (VT 8 mL/kg) and high VT group (VT 40 mL/kg). All of the rats underwent tracheotomy. Then rats in spontaneous breathing control group were kept to have spontaneous breathing, while rats in normal VT group and high VT group received mechanical ventilation. After 4 hours, the rats were sacrificed by carotid artery bleeding, and the bronchoalveolar lavage fluid (BALF), blood serum and lung tissue were collected. Lung wet/dry ratios (W/D) were measured. Light microscopy and electron microscopy were performed to observe the pathological changes in lung tissue, and the ultrastructural changes in alveolar macrophages. Enzyme linked immunosorbent assay (ELISA) was performed to measure the total protein content in the BALF and the interleukins (IL-1β and IL-18) in the serum and BALF. The mRNA expressions and protein levels of NLRP3, apoptosis-associated speck-like protein containing CARD (ASC), caspase-1, and nuclear factor-κB (NF-κB) in alveolar macrophages were assayed by real-time fluorescent quantization reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot.Results The structure of lung tissue and alveolar macrophages of rats in spontaneous breathing control group and normal VT group appeared normal, while obvious inflammatory changes were found in high VT group. Compared with spontaneous breathing control group and normal VT group, the ratio of W/D (8.89±0.90 vs. 5.18±0.86, 5.71±0.82, bothP< 0.05), contents of total protein, IL-1β, IL-18 in BALF were significantly increased [total protein (g/L):2.34±0.41 vs. 1.77±0.14, 1.81±0.06, IL-1β (ng/L): 133.48±10.48 vs. 81.54±3.12, 83.80±5.22, IL-18 (μg/L):4.57±0.45 vs. 3.04±0.51, 3.43±0.43, allP< 0.05], and IL-1β and IL-18 in serum were also increased [IL-1β(ng/L): 105.06±10.18 vs. 65.11±8.58, 75.30±10.62, IL-18 (μg/L): 2.27±0.09 vs. 1.18±0.34, 1.43±0.15, all P< 0.05]. The mRNA and protein expressions of NLRP3, ASC, caspase-1 and NF-κB in alveolar macrophages of high VT group were significantly increased compared with that of spontaneous breathing control group and normal VT group. The mRNA expressions of NLRP3, ASC, caspase-1 and NF-κB in high VT group were (8.53±2.21), (5.75±1.17), (7.47±1.23) and (10.86±2.38) folds of those in spontaneous breathing control group, and the protein expressions of NLRP3, ASC, caspase-1 and NF-κB were (1.50±0.14), (1.49±0.04), (1.53±0.15) and (1.51±0.11) folds of those in spontaneous breathing control group (allP< 0.01). There were no significant differences in all the indexes between normal VT group and spontaneous breathing control group.ConclusionNLRP3 inflammasome in alveolar macrophages may be involved in the mechanism of occurrence of VILI.

Objective To observe the effect of intranasal dexmedetomidine on total intravenous anesthesia for thyroid surgery postoperative analgesia.Methods Sixty female patients who were undergoing elective thyroid surgery were enrolled.Patients by total intravenous anesthesia were randomized in mechanical sampling method to receive intranasal dexmedetomidine 1 μ g/kg (group Ⅰ,30 cases),or the same volume sodium chloride (group Ⅱ,30 cases) before anesthesia induction,then flurbiprofen 100 mg intravenous 10 min before surgery.The postoperative surgical pain was assessed utilizing visual analogue scale (VAS),and the postoperative pain of cough was assessed by comfort score (BCS) at 1,2,4,6,8,12,24 h after surgery,in addition,the adverse reactions were recorded.Results The VAS scores at 1,2,4,6,8,12 h in group Ⅰ were lower than those in group Ⅱ,and there were statistically significant (P ＜ 0.05).The BCS scores at 1,2,4,6,8 h in group Ⅰ were higher than those in group Ⅱ,and there were statistically significant (P ＜ 0.05).The nausea and dizziness morbidity in group Ⅰ were lower than those in group Ⅱ (8 cases vs.14 cases,6 cases vs.14 cases),and there were statistically significant (P ＜ 0.05).Eight patients were required supplemental analgesic within 12 h after surgery in group Ⅱ,which was more than that in group Ⅰ (0 case),and there was statistically significant (P ＜ 0.05).Conclusion Receive total intravenous anesthesia for thyroid surgery,the patients who are given intranasal dexmedetomidine 1 μ g/kg combined with flurbipmfen can reach satisfactory postoperative analgesia,decrease the nausea and dizziness morbidity,increase the comfortable degree.

Object To develop a method for the quantitative determination of salvianolic acid A in rat plasma. Methods HPLC method and Hypersil ODS column (4 6 mm?200 mm, 10 ?m) were used, the mobile phase was acetontrile water (1∶2 65, adjusted pH to 2 5 with formic acid), at a flow rate of 0 9 mL/min, the UV detection wavelength was 285 nm. Cinnamic acid was used as internal standard. Results The recovery of the method was in the range of 98 9%～106 9%, the recovery of the extraction was over 83%. The within day precision and the day to day precision were both lower than 8 4%. Conclusion The method is appropriate for the determination of salvianolic acid A when pharmacokinetics of salvianolic acid A is studied in rat plasma.