Objective To investigate the efficacy and safety of treatment of urethral complete broken injury with double ureteroscopic urethral realignment.Methods A clinical data of 26 cases of urethral complete broken injury who had underwent double ureteroscopic urethral realignment were retrospectively analyzed.Results The patients were confirmed by urinary tract imaging for urethral complete broken injury.The catheters were inserted successfully into bladders and removed at 6 weeks after operations.The operative time was 25-53 (39.0 ± 12.4) min.Twenty patients gained fluent urination after removal of catheter,with maximum urine flow 17-28 ml/s after 6 weeks.Six cases had urethral stricture.Among them,2 cases received urethral expansion,3 cases received transurethral cold knife incision,and 1 case received urethral anastomosis.All of them gained fluent urination.Conclusion Treatment of urethral complete broken injury with double ureteroscopic urethral realignment is feasible,superior and reproducible.

Objective To discuss the main causes, necessity and strategy of reoperation in patients with differentiated thyroid cancer. Methods The clinical data of 124 patients with thyroid cancer who needed reoperation from 2000 to 2010 were analyzed retrospectively. Results In the 124 patients with thyroid cancer required for reoperation, 75 cases were misdiagnosed as benign thyroid tumor and previously received local nodulectomy or subtotal lobectomy, in which the extent of resection was not enough; in 39 cases, the first time surgical modality were unsuitable, of which 27 cases with cervical lymph node metastasis were not performed cervical lymph node dissection, and 12 cases with cervical lymph node metastasis cancer were only performed lymph node biopsy, and the diagnosis of thyroid cancer was ignored. 10 cases suffered reoperation because of failure to diagnosis thyroid cancer by quick pathologic diagnosis. The rate of residual cancer was 50% (62/124) by final pathologic diagnosis,and the rate of complication was 4.03% (5/124). Conclusion Misdiagnosis of thyroid cancer as benign thyroid tumor is the main cause of reoperation. Reoperation is necessary for those patients who received nonstandardized operation. The key points of avoiding reoperation are to improve cognitive level of operator for thyroid cancer, to emphasize the routine application of quick pathologic diagnosis during operation of thyroid and select the best suitable surgical modality.

To establish a method for the simultaneous determination of the active ingredients ( codeine phosphate, brompheniramine maleate, chlorpheniramine maleate, ephedrine hydrochloride and guaifenesin) in compound codeine phosphate oral preparations by capillary electrophoresis ( CE) . Methods:The method employed an uncoated capillary column ( eCAPTM ) from Beck-mann company (50 cm × 75 μm);the electrophoresis voltage was at 10 kV;20 mmol·L-1 phosphate buffer solution (pH 7. 5) was used;the UV measurement was at the wavelength of 214 nm. Results: The studied components had good linear ranges (r≥0. 995) within the range of the investigated concentrations. The recovery was no less than 96%. Conclusion:The presented method can be ap-plied in the content determination of active ingredients in compound codeine phosphate oral preparations from different enterprises. It is simple, efficient and universal, which facilitates the market supervision in a fast and valid manner.

It has been well-documented that ICAM-1 implicates in pathophysiology of ischemic-reperfusion injury of the kidney.Renal injury after ischemia appears to be a consequence of tissue hypoxia not only from interrupted blood supply but also from the process of reperfusion which leads to an active inflammatory process.Infiltrating leukocytes are potential source of reactive oxygen species.Proteolytic enzymes and cytokines,which during reperfusion may play a detrimental role.It has been suggested that ICAM-1 plays a key role during leukocyte adhesion and recruitment to inflamed tissue.The goal of the review is to explore the effect and significance of ICAM-1 as well as its mechanism in renal ischemia-reperfunsion.

Objective To study the classification, management and outcome of the fracture of ulna coronoid process. Methods Retrospective analysis was carried out in 31 patients with fracture of ulna coronoid process. There were 19 males and 12 females with an average age of 29.8 years old (range, 18-52 years old). The fractures of ulna coronoid process were classified into 4 major groups based on the condition of the injury of ulna coronoid process, the anterior bundle of the ulnar collateral ligaments(UCL) and the elbow stability. The fracture of coronoid process within half of the height was defined as type Ⅰ. The half of coronoid process fracture with the injury of UCL was defined as type Ⅱ. The base of coronoid process fracture with the dislocation of elbow joint was defined as type Ⅲ, sometimes with the injury of UCL. The severe comminute fracture of coronoid process with elbow instability was defined as type Ⅳ. There were 11 cases in typeⅠ, 9 typeⅡ, 6 type Ⅲ and 5 type Ⅳ in our group. According to the type of injury we choose correlative treatment. Results The follow-up was 18-72 months(average 28.6 months). All the patients got fracture union, and without inflammation, neural injuries and elbow instability. 1 type Ⅲ and 2 type Ⅳ had traumatic osteoarthritis, and 2 type Ⅲ and 2 type Ⅳ occurred heterotopic ossification. There was a statistical significance when the motion range of two-side joints was compared in type Ⅳ. Conclusion We choose conservative treatment in the fracture of typeⅠ. But if the piece of bone affected motion of elbow joint, we can choose operative treatment, and elbow stability is not affected. The fracture of type Ⅱ and type Ⅲ with elbow instability should be reduced internal fixation and the ligament must be repaired or reconstructed. In cases of type Ⅳ, bone reconstruction is necessary to recover of elbow stability. Proper post-operative rehabilitation can decrease the rate of traumatic osteoarthritis.

Objective To investigate the effects of losartan on aortic elasticity and remodeling in spontaneously hypertensive rats (spontaneously hypertensive rats SHR). Methods WKY (Wistar - Kyoto ) rats with normal blood pressure and 16 weeks spontaneously hypertensive rats were randomly divided into WKY control group, SHR control group, high dose losartan group (SHR + HL), low doses losartan group (SHR + LL). Each group has six animals which were given normal diet for 24 weeks. Losartan which was dissolved in 10 ml physiological saline was filling in stomach, other groups were filling with physiological saline. Tail arterial blood pressure, kidney tissues calcium concentration, renal small artery hydroxyproline content was measured and small arteries wall thickness of Glomerularwas detected, and the ratio of thickness and inner diameter (MT/LR) in kidney pathological were observed. Results The calcium concentration of SHR group in kidney tissues was [(18.42±2.34)μmol/g], kidney small artery hydroxyproline content was [(8.26±2.02)mg/g], which were greater than WKY group [(11.83±1.98)μmol/g,(5.16±0.98)mg/g] (t＝3.116,3.258,P＜0.05), but the two treatment groups were less than SHR group (t＝2.946,P＜0.05), the difference was significant. Small arteries wall thickness of Glomerular was [(5.25±1.13)μm], the ratio of thickness and inner diameter (MT/LR) was [(9.57±1.78)%], which were greater than WKY group[(4.03±0.16)μm ,(7.12±1.35)%](t＝2.836,3.425,P＜0.05), but the wall thickness of two treatment groups were [(7.64±1.29)%,(7.85±1.32)%], the two treatment groups were less than SHR group (t＝3.512,3.648,P＜0.05). Conclusions Losartanmay inhibit intracellular calcium overload, reduce fibrosis degree and improve renal arteriole resistance and reverse the renal arteriole reconstruction of SHR rats.

ObjectiveTo investigate the inhibitory effects and related toxicity of all-trans-retinoic acid(ATRA) combined with arsenic trioxide(As2O3) on transplanted human bladder neoplasms in nude mice.MethodsThe subcutaneously transplanted tumor models of human bladder neoplasms in nude mice were established and then it was randomly divided into four teams: Saline group, ATRA group, As2 O3 group and the combination of ATRA and As2 O3 group.Each group composed of 10 nude mice and received intratumor injection in the following 14 d.The tumor growth inhibitory rate was calculated.The pathological changes of tumor,cardiac, liver, and kidney were observed after H.E.staining.The expression of MVD (Marked with CD43) and VEGF were detected by SP of immunohistochemistry.Blood routine examination and hepatic and nephritic functional examination was carried out to evaluate the side-effects.Results The tumor growth was significantly suppressed in ATRA group(inhibitory rate was 41.82％) and As2O3 group (inhibitory rate was 43.77％) compared with saline group.When ATRA combined with As2O3 ,inhibitory effects were improved(inhibitory rate was 68.55％).The difference of growth inhibitory rate between each group was obviously significant(x2 =26.81, P ＜0.01).There was less expression of MVD (Marked with CD43) and VEGF in ATRA group and As2 O3 group and the combination group compared with saline group (ODVEGF = 19.23 + 2.32,20.72 + 2.01,17.16 ± 1.59,27.33 ± 2.17, respectively; ODMVD = 44.77 + 8.25,43.39 + 7.41, 30.56 + 7.71,141.12 + 8.38, respectively), and the suppressed effect in the combination group was most significant (t = 3.16,3.08,3.37, P ＜ 0.01).WBC inhibition was seen in ATRA group and As2O3 group and the combination group, but no significantly difference among them(P ＞0.05).Hepatic and nephritic toxicity were not found.ConclusionsCombination of ATRA and .As2O3 had obvious synergistic effects on transplantéd tumor of human bladder neoplasm in nude mice, and moderate white blood cell inhibition and no hepatic or nephritic toxicity.

BACKGROUND: Studies demonstrated that vertebral endplate can be remodeled during intervertebral disc degeneration.However,the relationship between morphology of the vertebral endplate and intervertebral disc degeneration remains poorly understood.OBJECTIVE: To explore the relationship between the morphology of the vertebral endplate and the lumbar disc herniation.METHODS: Forty cases without previous spine disorder and sixty-two cases symptomatic lumbar disc herinations lumbar vertebral were scanned by using spiral CT.Scan range was from superior L4 to superior S2.Scan protocols as below: 140 kV,345 mAs,FOV 160 mm,layer of thick 1 mm,pitch 1.0.Original images were carried through three-dimensional reconstructions using O2 image work station,W300,C80,ZOOM=1.5,Expand 1.Intervertebral disc maximum anteroposterior,transverse diameter,circumference,area and shape were measured based on curve planar reconstruction.RESULTS AND CONCLUSION: Endplate shape was strongly related to disc herniation(all the P value < 0.01).Endplate area was a less significant factor L4/5 in men and L5/S1 in men and females(P < 0.05).The shape of the intervertebral body endplate margin is an important factor contributing to the development of disc herniation at L4/5 and L5/S1.

Objective To explore the association between gene polymorphism of interleukin(IL)-4 C590T and serum level of IL-4 and atherothrombotic cerebral infarction(ATCI).Methods The gene polymorphisms of IL-4 C590T in 159 patients with ATCI and 151 normal control subjects were carried out by polymerase chain reaction(PCR)-restriction fragment length polymorphism(RFLP).The serum level of IL-4 in normal control group was determined with enzyme linked immunosorbent assay(ELISA) method.Results In the normal control group,the serum level of IL-4 in TT genotype[(31.85?5.68) pg/ml] was higher significantly than those in TC[(28.67?6.00) pg/ml] and CC genotypes[(20.98?0.99) pg/ml],TC genotype was higher significantly than CC genotype(all P0.05).Conclusions IL-4 590T allele is associated with higher level of serum IL-4.The C590T polymorphism is not associated with the incidence of ATCI.

Objective To compare the therapeutic effects of minimally invasive percutaneous nephrolithotomy(MPCNL) and retroperitoneal laparoscopic ureterolithotomy(RLUL) in the management of impacted upper ureteral calculi.Methods A total of 72 patients with unilateral impacted upper ureteral calculi were treated with MPCNL(n=45) or RLUL(n=27).The operation time,clearance rate of the stone,and the incidence of postoperative hyperpyrexia were statistically analyzed.Results All the operations were completed.As compared to the RLUL group,the MPCNL group had a significant shorter operation time [(43?9) minutes vs(69?17) minutes,t=-11.564,P=0.000].On the day after the operation,both the groups showed a stone clearance rate of 100%.No significant difference was detected in the rate of postoperative hyperpyrexia between the two groups [13.3%(6/45) vs 11.1%(3/27),?2=0.000,P=1.000).The patients were followed up for 1 to 24 months(mean,8 months),none of them developed ureteral stricture or recurrent stones during the period.Conclusion Both MPCNL and RLUL are safe,effective,and feasible for impacted upper ureteral calculi.