With the aim of further understanding of the nerve supply of the Iumbodorsal region,and its relation to the pathogenesis of lumbago and lumbocrural pain,the superior chnial nerves of lilty adult Chinese cadavers were dissected. In the present study,it was shown that the superior clunial nerve consists of lateral branches of the posterior rami of spinal nerves rarying from T_(12)L_(1～5)and S_1 segments. The contribution of these branches to this nerve is as follows,T_(12):40 cases,L_1 and L_2: 100 cases each,L_3:96 cases,L_4:48 cases,L_5:11 cases,and S_1:4 cases.Our observation revealed the fact that the posterior rami of L_(4,s)spinal nerves consist of a lot of lateral cutaneous branches,which is not in accordance with embroyological descriptions cited in literature which deny their existence. Basing on our data,we classify the superior clunial nerve into 4 types,Viz:one- branched:1 case;two-branched:15 cases;three-branched:66 cases;and four-branched:18 cases. More than one half of the medial and the most medial branches of the superior clunial nerves perforate through the deep surface of the attachment of the posterior layer of the lumbodorsal fascia on to the iliac crest,and enter the superficial fascia of the buttock.During acute wriggle of the loin,the firm fixation and tight stretching of the perforating branches by this attachment may cause partly the injury of the branches. The crossing point of the lateral margin of the sacrospinalis muscle and iliac crest or the area slightly medial to this point is the site where the perforating superior clun- ial nerve could be localized supeficialiy.

Objective To study the clinical features of complicated upper urinary tract infection in children,aiming to provide a reference for clinical diagnosis and treatment of the disease.Methods The clinical data of 68 cases with complicated upper urinary tract infection hospitalized at the Department of Urinary Surgery NO.1,Children's Hospital of Shenzhen between January 2013 and August 2015 were retrospectively analyzed.Results A total of 68 cases,in which 44 were male,24 were female,and repeated infections were found in 15 cases.Fever was the most common clinical manifestation(48 cases,70.59％),while frequent urination and odynuria were rare(9 cases,13.24％).A total of 57 strains had been cultured form the submitted specimens which were obtained from the 68 cases,including 41 strains of gram-negative bacteria,15 strains of gram-positive bacteria and 1 strain of fungus.Two different strains were cultured in 3 children.Fourteen strains of Escherichia coli had 11 extended spectrum beta lactamases (ESBLs)-positive strains.In the 11 strains of klebsiella pneumoniae,8 trains were ESBLs-positive.The drug resistant rates of gram-negative bacteria to Ampicillin and Cefuroxime sodium were both more than 90％.The sensitive rates to Piperacillin/Tazobactam was more than 90％.Thirty-one cases of complicated upper urinary tract infection were cured by administering Piperacillin/Tazobactam,while 15 cases were cured by changing Cefuroxime sodium to Piperacillin/Tazobactam according to the drug sensitivity results.Conclusions Clinical manifestations of complicated upper urinary tract infection are untypical,and fever is the most common symptom.Repeated infection is common.The gram-negative bacteria is the dominant pathogen causing the complicated upper urinary tract infection.ESBLs-positive bacteria accounts for high proportion.The drug resistance rate to penicillin and the first,second generation of the cephalosporin is high.The drug sensitive rate of piperacillin tazobactam is high,with good prognosis.

Objective To investigate the causes and managements of capsular perforation in transurethral resection of prostate(TURP) for benign prostatic hyperplasia (BPH). Methods Clinical data of 893 cases who received TURP from February 2002 to February 2011 were analyzed retrospectively.Results In 893 cases, capsular perforation in 16 cases, among them, tissue covered perforation in 10 cases, dissociative perforation in 3 cases, perforation under bladder trignne in 3 cases. Six cases occurred with obviously extravasation, 10 cases with transurethral resection syndrome (TURS) or omen of TURS. Two cases were ceased operation and received TURP again after 2 weeks, 2 cases transferred to open surgery suprapubic prostatectomy, 12 cases kept up operation with lower bladder douche pressure. Two cases with postoperatire bleeding underwent open surgery hemostasis cured. All cases were discharged from hospital after recovery. Conclusions The type and extent of capsule perforation must be judged correctly,corresponding treatment must be given, prevention and treatment of TURS must be taken notice of, if capsule perforation occurs when TURP operation in progress. Less haematoma, clearview and normal anatomic structures can decrease the incidence of perforation.

Objective To compare the safety and efficacy of flexible ureteroscopic lithotripsy (F-URS) and mini-percutaneous nephrolithotomy(MPCNL) for treating upper ureteral calculi by the randomized controlled clinical trial .Methods 120 cases of up-per ureteral calculi treated in this hospital from May to September 2013 were randomized into the F-URS group and the MPCNL group with 60 cases in each group .The postoperative clinical curative effects were compared between the two groups .Results The initial stone clearance rates of the F-URS group and the MPCNL group were 68 .33% and 95 .00% respectively ,and the difference was statistically significant (P< 0 .05) .The clearance rate of the two groups after postoperative 3 months were 96 .67% and 98 .33% respectively ,and the difference between the two groups had no statistical significance (P>0 .05) .The operating time of the F-URS group and the MPCNL group was (35 .33 ± 11 .57)min and (53 .75 ± 17 .31)min respectively ,the average hospital stay after operation was(3 .05 ± 0 .62)d and (5 .43 ± 1 .84)d respectively ,and the average visual analogue scale(VAS) score on first postoper-ative day was 1 .70 ± 1 .37 and 3 .68 ± 1 .57 respectively .These indicators had statistically significant differences between the two groups(P<0 .05) .The average dropped amount of hemoglobin and the occurrence rate of complications after operation had no sta-tistically significant differences between the F-URS group and the MPCNL group(P>0 .05) .Conclusion For upper ureteral calculi with surgical indication ,the effect of F-URS is equivalence to MPCNL in the aspect of the stone clearance rate ,but F-URS has high-er security and shorter postoperative hospital stay .In the department with the condition to conduct F-URS ,F-URS should be ranked as the preferred treatment method for upper ureteral calculi .

Objective To explore the application of allergen detection in children with recurrent asthma and its clinical signifi‐cance .Methods The clinical data of 524 cases of children with recurrent asthma in this hospital ,from February 2013 to February 2015 ,were retrospectively analysed .According to age ,these children with recurrent asthma were divided into three groups:250 ca‐ses were enrolled into infants group(0- <1 years old) ,150 cases enrolled into cheepers group(1- <3 years old) ,124 cases were enrolled in children group (≥3 years old) .Children in the three groups were treated with allergen detection ,and positive rates and distribution of allergens were compared among three groups .Results The total positive rate of allergen detection was 39 .69%(208/524) .The positive rate of allergen detection was the highest in children group(66 .13% ) ,and the lowest in infants group (24 .00% ) ,and there were statistically significant differences in the positive rates among the three groups(P<0 .05) .The top 3 common allergens were milk ,household dust mite and cat dander .The positive rates of household dust mite and house dust were the highest in children group ,but lowest in infants group ,there were statistically significant differences in the positive rate among the three groups(P<0 .05) .Conclusion Allergen detection is particularly important for children with recurrent asthma ,which not only could quickly find the etiology of asthma and identify children who are susceptible to asthma ,but also provide references for early intervention in childhood asthma .

AIM: To investigate the effects of glioma cells on aquaporin expression in blood-brain barrier and their importance in pathophysiology. METHODS: A blood-brain barrier model was established by coculture of ECV304 and astrocytes in vitro . HPLC was used to determine the change of water transport of in vitro blood-brain barrier model after the influence of glioma cells. The expression levels of AQP1 and AQP4 were analyzed by semiquatitative RT-PCR. RESULTS: Glioma cells decreased expression level of AQP4 of astrocytes and induced abnormal expression of aquaporin-1 in endothelial cell line. The water transport of in vitro blood-brain barrier model from luminal side to abluminal side was increased after coculture with glioma cells. CONCLUSION: The vasogenic brain edema induced by glioma cells may not be the result of hyperpermeability of blood-brain barrier to macromolecules in plasma. The changes of aquaporin expression may be the molecular basis of brain edema induced by glioma cells.

Objective To explore the safety and clinical efficacy of Ginkgo biloba lactone injection combined with Alteplase intravenous thrombolysis in treatment of acute ischemic stroke.Methods Totally 87 patients were recruited and divided into control group and test group.The,patients in control group (39 cases) were given Alteplase 0.9 mg/kg for injection,intravenous bolus total dose 10％ was given within 1 min,then intravenous infusion of the remaining 90％ was given in 1 h,and given basic therapy after 24 h.The 48 cases in test group,which were immediately iv Ginkgo biloba lactone injection after intravenous thrombolysis,6 mL added into 250 mL saline,once daily for 14 d,and also were given basic therapy after 24 h.All NIHSS scores were recorded before treatment,14 d and 90 d after treatment,and the adverse events were recorded.The modified Rankin scale (mRS) score and BI index were performed at 14 and 90 d after admission.Patients in two groups were classified according to the TOAST classification,and the patients with large-arteryatherosclerosis and small-artery occlusion were analyzed.Results No intracranial hemorrhage occurred in the two groups.The NIHSS score and mRS score of test group were significantly lower than that of control group,and BI index was significantly increased 90 d after treatment.The NIHSS score and mRS score of test group were significantly lower than that of control group,and BI index was significantly increased90 d after treatment of patients with large-artery atherosclerosis.But there was no significant difference between test group and control group of patients with small-artery occlusion.Conclusion Ginkgo biloba lactone injection combined with rt-PA intravenous thrombolysis in the treatment of acute ischemic stroke has high safety,and can improve the prognosis of patients.

Objective To observe the clinical effect of thrombus removal of external hemorrhoid combined with procedure for prolapse and hemorrhoids(PPH) in the treatment of circumferential mixed hemorrhoid with incarceration.Methods A total of 118 cases of circumferential mixed hemorrhoid with incarceration were divided into two groups:experimental group of 60 cases was treated by thrombus removal combined with PPH;control group of 58 cases was treated by Milligan-Morgan.We observed the differences of postoperative visual analogue scale (VAS)score,edema,bleeding,residual skin tag,wound healing time,anal stenosis,fecal incontinence,anorectal manometry and satisfaction in the two groups.Results There was significant difference between the experimental group and the control group in postoperative edema,bleeding and residual skin tag(χ2=6.63,4.19,6.64,P<0.05),but postoperative anal stenosis and fecal incontinence weren′t statistically significant different(χ2=0.38,1.11,P>0.05).Postoperative VAS score,wound healing time,satisfaction,anal resting and anal maximal squeeze pressure between the two groups were all statistically different(P<0.01).Conclusion The operation of thrombus removal of external hemorrhoid combined with PPH can effectively reduce the postoperative complications and promote recovery.

Objective To investigate the effects of simvastatin (SV) on the proliferation,differentiation and apoptosis of human promyelocytic leukemia cell line NB4.Methods NB4 cells were incubated with SV at different concentration with or without all-trans retinoic acid (ATRA),and NB4 cells without any treatment were taken as normal control.Cells of different groups were collected at 24 h,48 h and 72 h after incubation for further detection.Morphological changes by Wright stain were performed.MTT method was used to assay the growth inhibition rate and flow cytometry was used to detect the surface CD11b expression levels,the early stage apoptosis ratio and cell necrosis ratio.Results Treated with 15 μ mol/L SV,10 μ mol/L SV and 5 μ mol/L SV respectively,with the NB4 cells growth,the cell inhibition rates gradually increased (F =7.15,P =0.000),as well as CD11b expression levels (F =3.41,P =0.014) and AnnexinVexpression levels (F =43.38,P =0.000).Furthermore the NB4 cells treated with 15 μ mol/L SV exhibited the most significant changes with cell inhibition rate of 0.96±0.02,CD11b expression level increased to (62.41±6.37) ％ and AnnexinV expression level increased to (87.38±2.94) ％ after 72 h incubation.Combination of 15 μmol/L SV with 0.5 μmol/L ATRA displayed obvious interaction for increasing CD11b expression levels (F =4.093,P =0.025),while no significant interaction for cell inhibition rates and Annexin V expression levels were observed.After 72 h incubation,the CD11b expression levels (89.46±9.13) ％ in NB4 cells treated with 15 μ mol/L SV in combination with 0.5 μ mol/L ATRA were significantly higher than those treated with ATRA (71.27±7.27) ％ and SV (62.41±6.37) ％ (t =2.71,P =0.054; t =4.37,P =0.017)' solely.Conclusion Simvastatin in vitro inhibits NB4 cell proliferation,promotes cell apoptosis,and synergistically induces cell differentiation with ATRA dose-dependently in vitro,which indicates that SV may have the effect of synergistic anti-promyelocytic potency with ATRA.

Objective To investigate the effect of simvastatin (SV) in combination with cytosine arabinoside (ARA-C) on the proliferation and apoptosis of K562 cells. Methods Human K562 cells were incubated with SV and cytosine arabinoside alone or in combination and K562 cells without any treatment were taken as normal control. Cells in different groups were collected at 24, 48 and 72 h after incubation for further detections. Morphological changes by Wright stain were performed. MTT method was used to assay the growth inhibition rate and cytoflowmetry was used to detect the early stage apoptosis ratio and cell necrosis ratio. Results Compared with Ara-C group and SV group, cells in the group treated with SV combined with Ara-C showed obvious karyopyknosis,apoptosis bodies formation and significant cell growth inhibition, which were positively correlated with culture time. Combination of 15 μmol/L SV and Ara-C showed the most significant cell growth inhibition with a inhibition rate of (72±1) % at 72 h of culture, as was significantly higher than that of 15 μmol/L SV group (45±2) % and 20 μmol/L Ara-C group (44±0) % (P ＜0.01),furthermore, combination of 15 μmol/L simvastatin and Ara-C showed synergistic inhibition with Q value of 1.24 and 1.19 at 24 h and 48 h in each. The apoptosis rates at early stage (AnnexinV) detected by flow cytometry in 20 μmol/L, 15 μmol/L and 10 μmol/L SV treated K562 cells were significantly higher than that in normal K562 cells (P ＜0.01), as were positively correlated with culture time and SV dose (P ＜0.05). There were no significant difference of early apoptosis rate between the 20 μmol/L SV and 15 μmol/L SV groups (P ＞0.05), yet the very two were both higher than that of 10 μmol/L SV group (P ＜0.05). There were no statistic differences of late apoptosis rate (PI) amongdifferent treated groups (P ＞0.05). Conclusion SV inhibited K562 cell proliferation and induced cell apoptosis in vitro, and combination of SV and Ara-C exhibited obvious synergistic inhibition and apoptosis, which may increase the sensitivity of K562 cell to chemotherapy. SV at 15 μmol/L may be the best concentration for K562 cells in vitro.