Percutaneous neprolithotomy (PCNL) is the preferred method for the treatment of the majority of urinary calculi, especially for the calculi lies in the renal and upper ureteral.Recently, a number of trials were applied into TPCNL, such as, decrease the nephrostomy and indwelling externally grooved ureteral stent, internal ureteral catheter and not aiming replace the preventive use of renal tube.TCNL has its advantages in postoperative pain, hospitalization time and postoperative recovery than standard percutaneous neprolithotomy.

Objective To explore the underlying clinical factors and precautionary measures of fluid extravasation in patients with calyceal calculi treated by ureteroscopic holmium laser lithotripsy.Methods A retrospective review was made on clinical records of 138 patients with calyceal calculi receiving retrograde ureteroscopic holmium laser lithotripsy from May 2005 to March 2009. The relevance was studied between the occurance of fluid extravasation complications and various clinical factors using x2 test and binary Logistic regression. The clinical factors included patients' sexes, age groups (＜30 years, 30-50 years, ＞50 years), history of treatment (ESWL or open surgery) for upper urinary tract calculi, preoperative upper urinary tract infection, intraoperative placement of ureteral catheter and the length of procedure duration (＜ 50 min, 50-80 min, ＞ 80 min). Results Fluid extravasation complications occurred in 24 patients. The sexes and age groups were irrelevant to the occurance of fluid extravasation complications; while history of ESWL or open surgery and preoperative infection in upper urinary tract, without intraoperative ureteral catheter placement and long duration of procedure were responsible for the higher rates of the fluid extravasation complications.Conclusion Reasonable selection of patients and timing of operation, regular intraoperative ureteral catheter placement and control the length of procedure duration help to reduce fluid extravasation during retrograde ureteroscopic lithotripsy.

Objective To detect the mouse testicular gene expression pattern differences be-tween spermatogonial stem cell (SSC) proliferative and differential stages and study the molecular reg-ulation mechanism in SSC proliferation and differentiation. Methods With the interval of 24 days, male Kunming mice were injected intraperitoneally with two doses of busulfan (10 mg/kg) to establish spermatogenesis regeneration models. 36 k Mouse Genome Array was used to detect the differential gene expression profiles between the stages of SSC proliferation and differentiation. Bioinforrnsties analysis was conducted in GO (gene ontology) and KEGG (Kyoto Encyclopedia of Genes and Ge-nomes) pathway to describe the potential roles that may play in spermatogonial stern cells behavior regulation. Results Nine hundred and eleven differential expression genes were identified by gene arrays in mice testes, consisting of 608 up-regulated and 303 down-regulated in SSC proliferation stage and SSC differentiation stage. The differential expression genes were classified by their biological process, molecular function and cellular component, respectively. Alterations with statistical signifi-cance (P<0.05)appeared in 84 KEG(;signal pathways, including Notch and Wnt signaling pathways which had been proved to be important for stem cell maintenance. Fifty-six differential expression genes were selected as genes related to stem cells, among which 40 genes were up-regulated, including some stem cell biomarkers(such as Cd9, StraS, hgbl-, Oct4 and Thyl)and some growth factors(such as Fgf2, Pdgfa and Csfl). Conclustion The regulation of SSC proliferation and differentiation involves inmany differentially expressed genes in various signal pathways. This study provides a molecular basis for the elucidation of the molecular mechanism behind self-renewal and differentiation of spermatogonial stem cells.

Objective To study the expression of urokinase-type plasminogen activator (uPA) and its relation with expression of receptor (urokinase-type plasminogen activator receptor uPAR) in epithelial ovari- an cancer (OEC) and with the clinic prognosis.Methods Expression of uPA and uPAR protein was detected by Streptavidin-biotin-HRP in 68 cases of epithelial ovarian cancer and compared with that in 10 cases of borderline tumor,10 cases of benign tumor and 10 cases of normal tissue,and correlation between them was analyzed.The different expression groups of uPA was correlated with the prognosis of ovarian epithelial can- cer.The expression of uPA showed a correlation with short survival time (P

Objective To investigate the effect of simulated 400 m He-O2 saturation diving on the pulmonary oxidative-antioxidative system in rats.Methods SD rats were exposed to 4.1 MPa He-O2 mixture for 24 h in an animal chamber. Normal air pressure was used in the control group .The histopathology , contents of malondialdehyde ( MDA) , 8-hydroxy-2′-deoxyguanosine(8-OHdG),and glutathione(GSH) and activities of superoxide dismutase (SOD) and glutathione peroxi-dase( GSH-Px) in pulmonary tissues were determined .Results No difference was found during pathological examination or in MDA, 8-OHdG and SOD activity.GSH and GSH-Px activity were decreased significantly (P<0.05) after hyperbaric exposure.Conclusion Exposure to 4.1 MPa He-O2 for 24 h may promote oxidative stress and reduce antioxidative capacity rather than cause obvious oxidative damage in rat lungs .

Objective To explore the behavior characteristics in children with benign epilepsy combined with centro-temporal spikes(BECTS).Methods Eighty-two children with BECTS aged 2.5-3.0(2.65?2.31)years old,51 male,31 female,who were free of mental retardation assessed with Gesell developmental schedules,untreated with antiepileptic drugs,and were investigated 15 days after the latest seizure.Eighty-two healthy children with sex and age matched to the cases,53 male,29 female,aged 2.5-3.0(2.6?0.4)years old.The behavior characteristics of infants in BECTS group and control group were assessed with CBCL,including 6 behavior factors which were sleep problem,social flinches,depression,physical aspect,attacking,act of sabotage and the infants-middle school student social ability scale.Results The total scores of behavior characteristics and the scores of depression,sleep problem,attacking and act of sabotage in BECTS group were all higher than those in control group,the differences were statistically significant.However,scores of social flinches,and physical aspect in BECTS group had no significant differences compared with those of control group.There were no significant difference of social adaptive component between the BECTS and control group.Conclusions Children with BECTS have behavior disorders to some extent,but their social adaptive capacity are the same as normal children.

Objective To register the inpatients with stroke in Lasa plateau region,understand the clinical characteristics,risk factors and prognosis of patients with stroke in plateau region,and provide reference for prevention and treatment of stroke in plateau region.Methods Hospital-based stroke registration database was established,follow-up visits were paid to registered patients with stroke;the general sociological characteristics,clinical features,diagnosis and treatment situations of patients were collected and analyzed.Results Continuous registration in 464 patients with stroke in Tibet Autonomous Region People' s Hospital was made from July 1,2007 to March 30,2013,including 332 Tibetan patients and 132 Han patients,whose average age was (57.45 ± 16.14) years;326 male patients,138 female patients.Sixty-eight patients' age of onset was smaller than 40 years (14.22％).Among stroke subtypes,cerebral infarction was the most frequent syndrome (322 patients (69.40％)),followed by brain hemorrhage (129 patients (27.80％)),subarachnoid hemorrhage (13 patients (2.80％)).The difference between the male to female ratio of Tibetan patients (213:119) and Han patients(113:19) was statistically significant (x2 =20.795,P ＜0.001).The 4.5 h clinic visit rate of patients with stroke was 18.53％ (86/464),the 4.5 h clinic visit rate of patients with cerebral infarction was 13.35％ (43/322),including 1 patient who took intravenous thrombolytic therapy,accounting for 0.31％ of patients with cerebral infarction.The analysis indicated that the major risk factors of this group of patients with stroke were high blood pressure (249 patients (53.66％)),heart disease (102 patients (21.98％)),diabetes (67 patients (14.43％)) and chronic high altitude polycythemia (65 patients (14.00％)).Conclusions The patients with stroke in plateau regions tend to be younger,the clinic visit rate within 4.5 h is low,and the application of intravenous thrombolysis in patients with cerebral infarction is low.Chronic high altitude polycythemia becomes the special risk factor in plateau region.

Objective To compare the efficacy and complications of percutaneous nephroscope decortication of cystic renal disease with transureteroscopic decompression of cystic renal disease.Methods Retrospectively analyze the clinical data of 42 simple renal cyst cases,who under treatment of surgical in Zhongnan Hospital of Wuhan University from Sep.2010 to Sep.2014 via percutaneous nephrolithotomy as well as ureteroscope.There were 21 patients in each group.Comparisons were made between the two groups on operation time,peripheral tissue injury,blood loss,postoperative infection,hospitalzation time.Postoperative recurrence were followed up.Results For the percutaneous nephroscope decortication of cystic renal disease group and transureteroscopic decompression of cystic renal disease group,the operation time were (38.43 ± 9.76) minutes,(28.95 ± 8.67) minutes,the number of tissue injury were 8,6;the blood loss were (28.62 ± 9.82) mL,(23.48 ± 7.65) mL;the number of postoperative infection was 4,10;the postoperative recurrence were 2,5;the hospitalzation time were 2 days and 8 days.Compared with the transureteroscopic decompression group,the percutaneous nephroscope decortication group had a less postoperative infection and fewer postoperative recurrence (P ＜ 0.05).But the operation time was longer in the percutaneous nephroscope decortication group (P ＜ 0.05).Conclusions The therapeutic effect of percutaneous nephroscope decortication is much better than that of transureteroscopic decompression,but also has a little disadvantage.

Purpose To investigate the serum prostate specific antigen( PSA)feature of high grade prostatic intraepithe1ia1 neop1asia ( HGPIN)patients,and the association of the number of cores positive for HGPIN on initia1 biopsy and the risk of cancer deve1opment in second biopsy. Methods 492 cases of patients with suspicious prostate cancer were schedu1ed for transrecta1 u1trasound prostatic biopsy with an 8-core temp1ate. In the first biopsy,186 cases of patients with PCa,34 cases of patients with iso1ated HGPIN( on1y one core invo1ved with HGPIN)and 13 cases of patients with extensive HGPIN( two or more cores invo1ved with HGPIN),64 cases of pa-tients with LGPIN,195 cases of patients with BPH. The va1ues of PSA were ana1yzed and compared within these groups. In patients with extensive HGPIN or iso1ated HGPIN we proposed a repeat 8-core biopsy after 6 months independent of serum PSA 1eve1. The same measure was app1ied for patients diagnosed as LGPIN or BPH in the first biopsy with accompanying increase or persistent e1evation of serum PSA 1eve1. The incidence of PCa was ana1yzed and compared within these groups. Results The serum PSA 1eve1s were no sig-nificant1y different between LGPIN and BPH(P>0. 05),between iso1ated HGPIN and LGPIN(P>0. 05),and between iso1ated HG-PIN and BPH(P>0. 05). The serum PSA 1eve1s were significant1y different between extensive HGPIN and LGPIN(P<0. 05),be-tween extensive HGPIN and BPH(P<0. 05),and between extensive HGPIN and iso1ated HGPIN(P<0. 05). In the second biopsy, the incidence of PCa in patients with extensive HGPIN was 38. 48%,that in patients with iso1ated HGPIN was 9. 68%,that in patients with LGPIN was 12. 50%,and that in patients with BPH was 12. 20%. Conclusions The features of PSA in patients with iso1ated HGPIN are simi1ar to BPH,PSA 1eve1 in patients with extensive HGPIN were between PCa and BPH,and patients with extensive HG-PIN have a higher incidence of PCa in second biopsy than iso1ated HGPIN and BPH.

OBJECTIVE: To study the relationship of purple tongue and its regional blood flow. METHODS: Laser-Doppler flow meter was employed to test the volume and velocity of blood flow at different sites of purple tongue (56 cases) and normal tongue (54 cases), and the test results were analyzed. RESULTS: The volume of blood flow of purple tongue was significantly lower than that of the normal tongue (P<0.01), while the velocity was significantly higher (P<0.01). The volume and velocity of blood flow at different sites of the tongue were similar without significant difference. CONCLUSION: The volume of blood flow of purple tongue is decreased and the velocity increased. Purple tongue may be caused by dysfunction of the microcirculation of the tongue.