Objective To compare the therapeutic effects of transureteroscope holmium laser lithotripsy ( URL) and retroperitoneal laparoscopic ureterolithotomy ( RLU) for unilateral upper ureteral calculi and evaluate the selection of indications and clinical value of URL and RLU .Methods 37 patients were enrolled into the study . 14 patients received URL ,23 patients received RUL .Double-J stent was routinely indwelled in both groups .The oper-ation time,hospitalization time,clearance rate of the stone and incidence of postoperative complications .Results The stone clearance rate after postoperation of RLU group was 100%, which was significantly higher than that of URL group 64.4%(χ2 =4.15,P<0.05).The mean operation time in RLU group was(132.0 ±7.8)min,which was sig-nificantly longer than URL group(46.5 ±7.2)min(t=6.23,P<0.05).The mean intraoperative blood loss of RLU group was(38.0 ±4.6)mL,which was significantly higher than URL group (10.0 ±3.2)mL(t=5.20,P<0.05). The postoperative complication rate of RLU group was 8.7%,which was significantly lower than URL group 21.5%(χ2 =4.06,P<0.05).There was no significant difference in hospitalization time and stone clearance rate between the two groups(P>0.05).Two cases converted to operation in URL group ,while only 1 case converted to operation in RLU group.Conclusion Laparoscopic ureterolithotomy has a higher stone clearance rate and shorter operation time compared with ureteroscopic lithotripsy .Laparoscopic ureterolithotomy is a safe and effective therapeutic method for unilateral upper ureteral stones .

Asingleparticle-inductivelycoupledplasmamassspectrometric(SP-ICP-MS)methodwas established to detect the size distribution and number concentrations of silver nanoparticle ( AgNPs) in dilute aqueous solution. The optimal dwell time was 3 ms to reduce possibility of two or more particles entering into detector simultaneously. An iterative algorithm was applied to distinguish AgNPs as outliers from baseline and dissolved metal ion signal if the measured intensity was beyond five time standard deviation of whole data. Size distribution and number concentration of three commercial silver nanoparticle dispersions ( nominal diameters of 30, 50, 100 nm) were determined using SP-ICP-MS. The result of SP-ICP-MS is accurately similar to the transmission electron microscopy ( TEM) , indicating that SP-ICP-MS is able to size silver nanoparticles. The particle size detection limit is 25 nm and the limit of number concentration is 8 × 104 particles/L in dilute solution. Tap water added with silver nanoparticle was tested to obtain a similar size distribution and number concentration. This method is simple, fast and highly sensitive, which can be used to investigate risk assessment of silver nanoparticle in aqueous environment and monitor silver nanoparticle in drinking water.

Objective To optimize the process parameters for the purification of the extract solution of Radix Astragali and Radix Puerariae in Huangqi Gegen Decoction prescription by ceramic membrane ultrafiltration. Methods With the extract solution of Radix Astragali and Radix Puerariae (in the proportion of 1 : 2) as the study object, and with solid content, puerarin transfer rate and characteristic peak area as indicators, the membrane pore size, ultrafiltrate temperature and ultrafiltration pressure were selected as the main factors, and single factor test and L9 (34) orthogonal test were used to optimize purification conditions. Results With comprehensive scores as the evaluation index, the optimized conditions for the extract solution were as follows:membrane pore size was 100 nm, ultrafiltration temperature was 35 ℃, and ultrafiltration pressure was 0.18 MPa. The main influence factors of ceramic membrane pore size and ultrafiltration pressure had obvious effects on the refined process(P<0.05).Conclusion The method of purification of the extract solution of Huangqi Gegen Decoction prescription by ceramic membrane ultrafiltration is feasible , and the results will provide reliable experimental evidence for the purification of Chinese herbal medicine extract with ceramic membrane.

Objective To explore the prognostic value of blood aspartate aminotransferase to platelet ratio index(APRI)in patients with hepatocellular carcinoma(HCC)after radical surgical resection. Methods A retro-spective cohort study was conducted to analyze 228 patients with HCC who underwent radical surgical resection. Patients were divided into low APRI group(APRI<1.62)and high APRI group(APRI≥1.62). Patients′clinical and demographic data and overall survival(OS)were statistically analyzed and multivariate analysis was performed to identify prognostic factors. Results APRI was closely related to preoperative serum ALT level,PLT level,the positivity of HBsAg,liver cirrhosis and portal vein tumor thrombus. OS of patients in low APRI group was signifi-cantly better when compared to those with an elevated APRI(P<0.01). Multivariate analysis indicated that preop-erative APRI,maximum size of tumor,number of tumor nodules,portal vein tumor thrombus,TNM and differenti-ation of tumors were independent prognostic factors for HCC(P<0.05). Conclusions Preoperative APRI≥1.62 is an independent prognostic factor of OS for patients with HCC after radical surgical resection.

BACKGROUND:Many studies have showed that neural stem cells therapy is a new strategy for hypoxic-ischemic encephalopathy.
OBJECTIVE:To review and analyze the status of research, transplantation strategies and mechanism of neural stem cells therapy for treatment of hypoxic-ischemic encephalopathy.
METHODS:A computer-based retrieval was performed in PubMed and CNKI database to search papers published from August 2000 to August 2013 using the key words of“hypoxic-ischemic encephalopathy, neural stem cells”in English and Chinese. The papers with objective-independent and repetitive contents were excluded, and final y 39 papers were included for final analysis.
RESULTS AND CONCLUSION:Neural stem celltransplantation can promote recovery of neurological function, which brings new hope to hypoxic-ischemic encephalopathy patients. But the study is at a primary stage and limited in laboratory. There are many critical factors that hinder the clinical transplantation, such as delivery path, transplantation time, single or combined transplantation, mechanisms of action. Application of neural stem cells requires further investigation.

Objective:To confirm the efficacy and safety of Tiankui antihypertension tablets combined with chemical drugs in the treatment of patients with hypertension whose blood pressure can 't reach the standard after the treatment only with chemical drugs. Methods:Randomized, double-blind, placebo control and multicenter clinical trials were performed on 240 subjects (160 in the ex-periment group and 80 in the control group) in 6 clinical trial centers. Tiankui antihypertension tablets and the placebo were respec-tively given with 4 tablets per time and 3 times a day. The efficacy and safety were observed. Results:For the blood pressure control, the significant efficiency of the experimental group was 63. 23%, while that of the control group was 31. 65%. The significant efficien-cy and effective rate of the traditional Chinese medicine (TCM) syndrome of the experimental group was 48. 39% and 20. 25%, re-spectively, while that of the control group was 20. 25% and 36. 71%, respectively. All of the studied clinical indicators showed signifi-cant differences between the two groups (P<0. 05). No severe adverse reaction was shown in the two groups. Conclusion:Tiankui an-tihypertension tablets combined with chemical drugs exhibits better curative effect and safety in the treatment of hypertension patients whose blood pressure can’ t reach the standard after the treatment only with chemical drugs.

Objective:To evaluate the tolerance and safety of Zhengbiguanjie tablets in healthy volunteers to provide the safe dose range for phase II clinical trial. Methods:Totally 36 healthy volunteers were randomly divided into five single dose groups at different doses ranging from 400 mg to 3200 mg per day and two multiple dose groups with 1600 mg and 2400 mg for continuous 7 days. The tol-erance and safety of the tablets were observed. Results: All vital signs were normal in all the volunteers in both single and multiple dose tests. Although some indicators turned into abnormal after the administration, it was not significant for clinical judgment. Neither drug combination nor serious adverse reactions were shown during the trial. However, two mild adverse events occurred and disap-peared later without any treatment. Conclusion:All the volunteers have good tolerance to Zhengbiguanjie tablets. The study proved the safety of Zhengbiguanjie tablets at single and multiple dose.

Objective To explore the clinical efficacy of lateral osteotomy via the supra-fibular-head approach combined with lateral locking plating for simple posterolateral tibial plateau fractures.Methods From January 2014 to February 2017,11 patients with simple posterolateral tibial plateau fracture were treated at Department of Orthopaedics,General Hospital of Middle Military Command of PLA.They were 8 males and 3 females,aged from 21 to 55 years (average 41.8 years).In all of them the supra-fibular-head approach was used for lateral osteotomy according to the size and orientation of the fracture block.After the fracture was reset,a full bone graft was implanted under direct visualization,followed by fixation of the posterolateral bone mass with a lateral locking plate which was placed as far as possible above the fibular head.The patients were encouraged 6 weeks after surgery to do knee functional exercise within 90°.The therapeutic efficacy was evaluated at the final follow-up according to the Rasmussen's criteria for knee functions.Results The average operative time was 74 minutes (from 55 to 90 minutes);the average intraoperative blood loss was 70 mL (from 40 to 120 mL).All the patients were followed up for 12 to 35 months (average,17.5 months).No neurovascular injury or incision infection was observed.Bony union was achieved in all patients after 10 to 15 weeks (average,12.5 weeks).Follow-ups found no implant loosening/breakage,genu valgum,genu varum,fracture redisplacement,or knee instability.According to the Rasmussen's function evaluation of the knee joint,10 cases were rated as excellent and one as good.Conclusion Lateral osteotomy via the supra-fibular-head approach combined with lateral locking plating is a preferred treatment for simple posterolateral tibial plateau fractures.

Objective To investigate the relationship between pulmonary arterial ( PA) enlargement and pulmonary function in patients with chronic obstructive pulmonary disease (COPD).Methods From December 2012 to June 2016,78 patients with acute exacerbation of COPD in the Eighth People＇s Hospital of Qingdao were selected. According to pulmonary CT findings,they were divided into two groups : PA enlargement group (38 cases) was PA＞3.0cm,normal PA group(40 cases) was PA≤3.0cm.FEV1and FVC of stable phase were compared.Results The FEV1of men in the A enlargement group was (1.08 ±0.44)L,that in the normal PA group was (1.44 ±0.66)L,the difference was statistically significant (t＝2.27,P＝0.028).The FEV1of women in the PA enlargement group was (0.90 ±0.41)L,which in the normal PA group was (1.35 ±0.58)L,the difference was statistically significant (t＝2.28,P＝0.026).Correlation analysis showed that the diameter of PA was negatively related with FEV 1/FVC(r＝-0.509,P＝0.001),PA enlargement was related with lung function decline.Conclusion COPD patients with PA enlargement are more associated with accelerated loss of lung function and should be treated early.

Objective To investigate the therapeutic effects of navigation-guided hollow screw fixation on the treatment of elderly patients with the sacroiliac complex injury.Methods Twentyone older patients with sacroiliac complex injury received the three-dimensional images-guided percutaneous hollow screw fixation from March 2015 to May 2016.There were 14 males and 7 females with age of 60-73 years[average(63.5 ± 3.7) years].Traffic accident injury was found in 15 cases,falling injury in 5 cases,others in one case.The pelvic fractures were classified by tile classification:type B2 in 2 cases,type B3 in 6 cases,type C1 in 5 cases,type C2 in 6 cases,type C3 in 2 cases.Intraoperative observation data,the injury of nerve and blood vessel during the screw insertion,postoperative fracture reposition and so on were recorded.The quality of fracture reposition was evaluated by Matta radiological criteria after surgery,and the pelvic function was assessed by Majeed scoring criteria at the last follow-up.Results A total of 30 hollow screws in 21 elderly patients were placed under three-dimensional images navigation,and each screw fixation time was 36-45 min,average (40.5±4.7)min with a small amount of bleeding (10-20)ml.Postoperative examinations showed that S1 vertebral cortical bone screw wear was found in one patient,and the end of the bolt washer was internalized into the outer table of the ilium without breaking the medial iliac plate in another patient.The above two patients had no postoperative complications.Other screws positions were good,without nerve or vascular injury and other complications.Postoperative reposition quality evaluated by the Matta radiological criteria showed that 14 cases had excellent quality,five with good quality,two with fair quality,and no case with poor quality.Therefore,the excellent and good rates were 90.5 ％.Moreover,19 elderly patients were followed up for 7-13 months average(10.3± 2.1)months,and only one patient showed the bilateral sacroiliac joint screws outside the lateral sacroiliac joint 5 mm.However,this patient had good function in the later follow-up without further prolapse.The remaining 18 patients assessed by the pelvic X-ray and CT at the end of the follow-up showed a good fracture healing,no screw breakage,loosening,and prolapse.Meanwhile,pelvic function findings evaluated by the Majeed standard demonstrated that nine cases were with excellent function,ten with good function,and the excellent and good rates were 90.5％.Conclusions Three-dimensional images-guided hollow screw fixation for the treatment of elderly patients with the sacroiliac complex injury is safe and effective with less trauma and high nailing accurateness.However,the placing process should be cautious in the elderly with osteoporosis.