Objective To explore the safety and efficacy of minimally invasive percutaneous nephrolithotomy (MPCNL) for pediatric upper urinary tract calculi. Methods We retrospectively reviewed the clinical data of 35 pediatric patients with upper urinary tract stones treated by MPCNL in our hospital. The series consists of 29 boys and 6 girls with a mean age of 8.5 years (4 to 13 years). Among the 35 cases,7 children had proximal ureteral stones and 28 showed renal stones; 2 of the patients were complicated with ureteropelvic junction obstruction (UPJ). Results Totally 31 (88.6%) of the 35 cases were cured by MPCNL. The one-session success rate was 87.1% (27/31),and two-session success rate was 75% (3/4). Four patients were converted to open surgery because of UPJ-caused ureteral stenosis under the level of the calculi or failure in percutaneous renal puncture. Conclusion MPCNL is safe and effective for renal calculi and proximal ureteral calculi in children.

Objective To evaluate the influence of lesion size and depth on the diagnostic accuracy and the rate of pneumothorax in patients undergone CT-guided transthoracic aspiration biopsy for pulmonary lesions.Methods CT-guided percutaneous transthoracic biopsy was performed in 398 patients that had surgical resection or clinical follow-up.According to lesion size,lesions were divided into≤2 cm,2～4 cm and ≥4 cm.Lesion depth was measured from the pleura surface to the edge of the lesion.This depth was classified in three categories:≤1 cm,1～3 cm and ≥3 cm.Comparison of the diagnostic accuracy and the frequency of pneumothorax in different size and depth of lesion was performed.Results(1)The overall diagnostic accuracy of CT-guided percutaneous needle aspiration biopsy was 83.2%(331/398).Pneumothorax occurred in 58(14.6%)of 398 biopsy;(2)The diagnostic accurate rate in different size of lesion was 73.3%(44/60),81.5%(176/216)and 91.0%(111/122)respectively,?2=9.91,P0.05.The occurred rate of pneumothorax in different depth lesion was 2.8%(4/141),14.8%(21/142)and 28.7%(33/115),?2=34.03,P

OBJECTIVE:To investigate the situation of adverse drug reactions(ADR) in our hospital.METHODS:In this retrospective study,a total of 270 ADR cases reported between 2005 and 2007 in our hospital were analyzed statistically in respect of the age and sex of patients,drug categories and clinical manifestations etc.RESULTS:Of the 270 ADR cases,patients aged ≤18 years or ≥50 years took the highest proportion(51.1% for the two age groups).The ADR were chiefly manifested as lesion of skin and its accessories,followed by the reaction of digestive system.90.74% of the ADR cases were induced by injections,and 191 cases(70.74%) were induced by antibiotics.CONCLUSION:ADR worth the highest alert in the clinic.

Objective To investigate the factors influencing the diagnostic accuracy in CT-guided percutaneous transthoracic aspiration biopsy of lung lesions. Methods CT-guided percutaneous transthoracic biopsy was performed in 435 patients with surgical pathologic confirmation or clinical follow-up.Univariant statistical analysis and multivariant stepwise Logistic regression analysis were used to study the influence of lesion-related factors(benignancy or malignancy,size,location,depth,presence of cavity),procedure factors(laser-guidence,position of patient) and patient-related factors(sex,age,presence of emphysema);with the accuracy of the diagnosis. Results ① 289 lesions were diagnosed as malignant ones and 146 as benign ones.The accuracy of CT-guided biopsy was(83.4%)(363/435).Univariant analysis showed that the diagnostic accuracies for malignant and benign lesions were(88.9%)(257/289) and(72.6%)(106/146),respectively(?~2=(18.71),P=(0.00002)).Laser-group was superior to non-laser group((88.4%) versus(80.9%),respectively,?~2=(4.00),P=(0.0456)).Mean diameters of lesions in correct diagnostic group and non-correct diagnostic group were(3.78)?(1.64) cm and(3.02)?(1.26) cm,respectively((F=)(13.79),P=(0.0002)).②Multivariant stepwise Logistic regression analysis showed that among the various factors influencing the final benign or malignant diagnoses(Wald ?~2=(14.01),P=(0.0002)) and using laser-guidence(Wald ?~2=(3.92),P=(0.0477)) were significantly associated with the diagnostic accuracy. Conclusions Final correct diagnoses(benign,malignant) are closely related to the application of laser-guidence for determining the diagnostic accuracy in CT-guided transcutaneous thoracic needle aspiration biopsy.

Objective To prospectively assess the therapeutic procedure and outcome of MR-guided percutaneous sclerotherapy in patients with venous vascular malformations of the extremities. Methods Fifty-seven percutaneous sclerotherapy treatments were performed under MR guidance in 28 patients with venous vascular malformation. Assessment was conducted to analyze (1) individual success of therapy, (2) improvement of clinical symptoms, ( 3 ) occurrence of complications, (4) volume changes at follow-up examinations, (5) contrast-to -noise ration (CNR) changes. Paired-t test was used to compare the volume and CNR of pre- and postintervention. Results All MR-guided percutaneous sclerotherapy were performed successfully and without serious complications. Individual predominant symptoms were improved, especially about the pain and functional impairment. The mean lesion volumes of pre- and post-intervention were (56. 8 ± 11.7 ) cm3 and ( 27.0 ± 7.2 ) cm3 respectively, which showed significant difference ( t = 8. 90, P < 0. 01 ). The percentage of volume shrinkage ranged from 28. 5% to 74. 4% [ mean ( 54. 4 ± 5. 3 ) % ]. The CNR of the pre and post-interventional images were 21.9 ± 2. 0 and 8.4 ± 0. 9 respectively. There was significant difference(t = 21.76, P < 0.01 ) between them, and the percentages of CNR decrease were 40.0% to 78. 0% [ the mean(61.0 ± 3.6)%]. Conclusion MR-guided sclerotherapy of venous vascular malformations of the extremities is a safe and efficient technique.

Objective To evaluate CT-guided pereutaneous biopsy and fine needle aspiration in diagnosing malignant musculoskeletal tumors. Methods CT-guided percutaneous biopsy and fine needle aspiration was performed in 106 cases with suspected musculoskeletal tumor. The pathological results obtained from biopsy specimens were compared with clinical final pathological diagnoses. Results All 106 cases were finally diagnosed as suffering from malignant musculoskeletal tumors, which were proved by operation and incisional biopsy. Of 106 cases receiving CT-guided percutaneous biopsy and needle aspiration, the pathologic diagnosis obtained from this procedure was consistent with the clinical final pathological diagnosis in 89 and was "negative" in 17, with an accuracy rate of 84.0%. Conclusion CT-guided percutaneous biopsy and fine needle aspiration is a safe, simple and effective technique for the diagnosis of malignant musculoskeletal tumors, Incisional biopsy may be necessary when this procedure gives "negative" result.

Objective To explore the immunomodulatory mechanism of 2-(-2-benzofuranyl )-2-imidazoline(2-BFI) in rat model of experimental autoimmune encephalomyelitis (EAE).Methods Fifty fe-male Sprague-Dawley(SD) rats were randomly divided into five groups by random digit table , including con-trol group(n=10), EAE model group(n=10), low dose 2-BFI group(1.5 mg/kg, n=10), median dose 2-BFI group (3 mg/kg, n=10) and high dose 2-BFI group (6 mg/kg, n=10).The SD rat model of EAE was induced by immunizing with a guinea pigs′spinal cord homogenate ( GPSCH ) .The severity of EAE was scored according to the signs and symptoms .Pathological changes were observed through Hematoxylin-eosin staining, and then the degrees of inflammatory infiltration were evaluated .The number of activated neuroglia that expressed GFAP and iba 1 in lumbar cords was counted by immunohistochemistry .The expressions of IL-1β, IFN-γ, IL-4 and IL-10 in cervical cords were measured by ELISA .Results Compared with EAE group, rats in the low, median and high dose 2-BFI treatment group had lower incidence of EAE , prolonged latency and decreased CNS inflammation , but only the median dose group showed significant alleviation in clinical symptoms and decrease in CNS inflammatory cell infiltration (P<0.05).Immunohistochemical re-sults showed that the numbers of activated microglia were significantly inhibited ,but the numbers of activated astroglia were increased in the rats treated with median dose of 2-BFI in comparison with the EAE group ( P<0.05).Results of ELISA demonstrated that expressions of IL-1βand IFN-γin 3 mg/kg 2-BFI treated group were significantly decreased compared with that in the EAE group (P<0.05), but expressions of IL-4 and IL-10 were remarkably increased(P<0.05).Conclusion 2-BFI at median dose of 3 mg/kg has a benefi-cial neuroprotective effect on rats with EAE , and its mechanism might be related to immunodulation .

Objective To investigate nontraumatic avascular necrotic of the femoral head with different etiology whether or not having similar MRI and pathologic findings.Methods MRI features of nontraumatic avascular necrosis of the femoral head caused by differant etiology in 98 patients(152 hips) were retrospectively analysed.The causes of osteonecrosis of the femoral head included steroid-induced in 49 patients(86 hips),alcoholic in 18 patients(25 hips) and idiopathic cause in 31 patients(41hips).Gross section and pathologic examinations were performed on 34 femoral heads obtained after total hip replacement from 25 patients.Results Osteonecrosis of the femoral head with different etiology occurred at the anterior superior part of femoral head.The necrotic zones both on pathological gross section and MRI were consisted of cartilage,necrotic focus,proliferative zone and normal bony zones along the lesions.The proliferative zone surrounded necrotic area was low signal intensity on both T1WI and T2WI.There was correlations between localized MRI signal behavior and specific histopathologic features of femoral head osteonecrosis.Conclusion Nontraumatic osteonecrosis of the femoral heads associated with different etiology have similar characteristics on both MRI and pathology

Objective To evaluate CT-guided percutaneous biopsy and fine needle aspiration in diagnosing malignant musculoskeletal tumors.Methods CT-guided percutaneous biopsy and fine needle aspiration was performed in 106 cases with suspected musculoskeletal tumor.The pathological results obtained from biopsy specimens were compared with clinical final pathological diagnoses.Results All 106 cases were finally diagnosed as suffering from malignant musculoskeletal tumors,which were proved by operation and incisional biopsy.Of 106 cases receiving CT-guided percutaneous biopsy and needle aspiration,the pathologic diagnosis obtained from this procedure was consistent with the clinical final pathological diagnosis in 89 and was "negative" in 17,with an accuracy rate of 84.0%.Conclusion CT-guided percutaneous biopsy and fine needle aspiration is a safe,simple and effective technique for the diagnosis of malignant musculoskeletal tumors.Incisional biopsy may be necessary when this procedure gives "negative" result.

Objective To investigate the clinical effects of Compound Biejia Ruangan Tablet (CBRT) combined with entecavir in patients with chronic hepatitis B with hepatic fibrosis.Methods Totally 92 cases of patients with hepatic fibrosis of chronic hepatitis B in Ankang people's hospital from January 2013 to May 2016 were divided into observation group (n =45) and control group (n =47),patients in observation group were treated with CBRT combined with entecavir,and patients in the control group were treated with entecavir.Treatment was for 48 weeks.The liver function,liver fibrosis,serum inflammatory factors,and adverse reactions were compared between two groups.Results After treatment,the ALT,AST,TBIL,and ALB/GLB levels of two group were significantly lower than those before treatment (P ＜ 0.05),but there was no significant difference between two groups after treatment.After treatment,the PCⅢ,IV-C,HA,LN,IL-6,IL-4,IL-10,and TNF-α levels of two group were significantly lower than those before treatment (P ＜ 0.05),and the PCⅢ,IV-C,HA,LN,IL-6,IL-4,IL-10,and TNF-α levels of observation group were significantly lower than those of control group (P ＜ 0.05);there was no statistically significant difference in the incidence of adverse reactions between two groups (P ＜ 0.05).Conclusion CBRT combined with entecavir is safe and effective to treat liver fibrosis of chronic hepatitis b,and it could significantly improve liver function,improve the degree of liver fibrosis,and reduce the level of serum inflammatory factors.