Objective:Both URL and MPCNL have been widely applied in the treatment of ureteral calculi.In this study,the safety,efficiency and degree of injury were compared between retrograde and antegrade access ureterolithotripsy for the calculi complicated with infection,in order to clarify the indications of the two types of minimally invasive techniques.Methods:A total of 192 patients with upper ureteral calculi complicated with infection were treated with ureterolithotripsy.The operation was performed via retrograde transurethral access in 72 patients and via antegrade percutaneous nephrostomy tract in 120 patients.Results:The success rate of retrograde approach was 93.1%.Mean operating time was 45.9?16.5min(20-90 min) with mean hospital stay of 5.1?1.8(2-6) days.The stone free rate was 84.7%(61/72) at 1 month follow-up.5 patients with residual calculi required combined ESWL.Complications were noted in 5.6%,CRP was 10.59?5.12 mg/L before operation,and was 38.63?4.61 mg/L 24h after the operation.The success rate of antegrade approach was 99.2%.Mean operating time was 62.4?17.6 min(40-120 min) with mean hospital stay of 8.57?2.57(5-15) days.The stone free rate was 100% and 1 complication was noted(0.01%).CRP was 11.29?5.38 mg/L before the operation,34.93?7.82 mg/L 24h after the operation.For the success rate and stone free rate,antegrade approach was higher than retrograde approach(P0.05)between the two groups before operation,but antegrade approach had lower CRP(P

Objective To review the relation between alpha fetoprotein(AFP) and gastric carcinoma as well as the advancement of literatures about the alpha fetoprotein-producing gastric carcinoma(AFPGC).Methods Domestic and foreign literatures on AFPGC were collected and reviewed.Results AFP is very useful to the diagnosis,pathological type and prognosis of the AFPGC as a specific tumor marker.Conclusion AFPGC is a special type of gastric cancer with high degree of malignancy and poor prognosis.

Objective To explore the regulatory roles of butorphanol on isolated rabbit pulmonary arteries by lipopolysaccharide(LPS)pre-incubation and assay the protective effect of ketamine on clinic sep tic shock patients.Methods Vascular ring tension detection technique was applied to observe the effect of butorphanol on the normal or lipopolysaccharide incubated pulmonaryvascular.Results In normal group, the final concentration of butorphanol(0.1 μmol,1μmol,10μmol,100μmol)were used to make pretreat ment- phenylephrine(PE)pulmonary artery relaxation.In LPS group,the effect of vasodilation of butor phanol was enhanced.Conclusions LPS can enhance the effect of butorphanol on pulmonary artery relaxa tion reaction.And the direct effect of butorphanol on pulmonary arteries was vasodilation.

Objective To investigate the regeneration and differentiation of HOCs in the 2-AAF/PHx rat models. To explore the expression of Cyr61and its mechanism in differentiation of HOCs in vitro. Methods In 2-AAF/PHx rats model,induction and expansion of HOCs were detected by immunochemistry and HE staining. West-ern blot was used for observing the expression of Cyr61. Furthermore,the expression of Cyr61 andβ-catenin were detected by Western blot in differentiation of WB-F344 cells in vitro. Results Cyr61 protein level increased as a re-sult of HOCs in rats livers after 2-AAF/PHx. In addition,the expression of Cyr61 and β-catenin significantly in-creased during WB-F344 cells differentiation in vitro. Conclusions Cyr61 might play an important role as a signal-ing mediator in HOCs response and closely correlate with Cyr61 andβ-catenin in proliferation and differentiation of HOCs.

Objective With various doses of lipopolysaccharide (LPS) intra-amniotic injection in pregnant rats to establish histologic chorioamnionitis (HCA) model,and to determine the effects of HCA on fetal lung maturation and development in preterm fetal rats.Methods Thirty pregnant Sprague-Dawley rats were randomly assigned to four groups.On 19 days of gestation,rats in three model groups (n=8) were given intra-amniotic injection of LPS 2,8,10 μg,respectively,and those in the only one control group (n=6)was given normal saline (NS) 40 μl.Fetal rats were taken out 48 hours after LPS injection.Placenta,fetal membrane,fetal lung and umbilical cord were collected for pathological examination.mRNAs of surfactant protein (SP)-A,B and C and keratinocyte growth factor (KGF) in lung were determined by quantitative real-time polymerase chain preaction.KGF protein expression in lung was measured by immunohistochemistry.Morphologic observation of lung was performed on postnatal day 3.R× C table Chi-square test,KruskalWallis test and analysis of variance were used as statistical methods.Results (1) Fetal rat mortality in control,LPS2,LPS8 and LPS10 group was 0.0％ (0/55),22.5％ (18/80),51.4％ (36/70) and 87.5％(35/40),respectively,which increased with increasing dose of LPS (x2=46.183,P＜0.005).(2) HCA,fetal lung inflammation and umbilical vasculitis were induced in LPS groups,and the severity was dosedependent (fetal lung inflammation:Hc=39.84,HCA:Hc=41.13,umbilical vasculitis:Hc=41.52,all P＜0.01).(3) The expression of SP-A,SP-B,SP-C and KGF mRNAs in the four groups (control,LPS2,8,10) had statistical differences (SP-A mRNA:0.99±0.28,2.48±0.34,1.09±0.31 and 0.09±0.09,F=78.051; SP-B mRNA:0.99±0.34,2.23±0.53,1.49±0.51 and 0.14±0.06,F=28.327; SP-C mRNA:1.20±0.39,2.00±0.20,1.04±0.37 and 0.12±0.16,F=39.546; KGF mRNA:0.97±0.19,2.18±0.61,0.93±0.09 and 0.21±0.11,F=37.544; all P＜0.01).All mRNA expressions in LPS2 group were higher than those in the control group and those in LPS10 group was lower (all P＜0.05).(4) The expression of KGF protein in LPS2 group was significantly higher than that in other groups (0.60±0.20 vs 0.28±0.12,0.37±0.22,0.24±0.12,F=17.280,all P＜0.01).(5) Alveolarization was significantly inhibited in LPS8 group on postnatal day 3,and less maturity of pulmonary tissue was observed.Conclusions Various doses of LPS intra-amniotic injection in rats could induce HCA,fetal lung inflammation and umbilical vasculitis with different degrees.Histological inflammation would be worse with increasing LPS dosage.Moderate inflammation could promote lung maturation without inducing bronchopulmonary dysplasia,and KGF may play a role in this process.

Objective To investigate the clinical efficacy and safety of the high-intensity focused ultrasound therapy in patients with colorectal liver metastases. Methods 28colorectal lesions in 16 patients with liver metastases after HIFU treatment lines observed patient vital signs,the main organ,imaging studies (CT or MRI,etc. ) ,complications and prognosis of cancer cases. Results All patients with stable vital signs after treatment, liver, kidney function was normal,6-month follow up, six more than 80% reduced lesion size,lesion size decreased in 18 of 30% to 50% ,4tumor volume did not change significantly; 16 patients, 1 patient was lost. 15 cases were followed uPfor 6 to 24 months,5 patients were transferred because of lesions disseminated in death within 6 months after surgery, calculated with the Kaplan-Meier median survival time was 13 months; 1 patient skin burning streak marks, healed after 1 week after treatment. 1 patient treatment areas of the chest skin, mild subcutaneous edema. Conclusion The treatment of patients with liver metastasis of colon cancer lesions was a non-invasive, safe and effective treatment.

Objective To provide guide for prevention and cure of peritonitis in peritoneal dialysis(PD) by comparing the causative organisms and clinical outcome of PD related peritonitis in younger and elderly patients in our center.Methods All patients who developed PD related peritonitis between January 2006 and December 2013 in Wuhan NO.1 hospital were included.According to their age,episodes were divided into younger patients group (＜ 65 years) and elderly patients group (≥65 years).The microbiology and clinical outcome of PD related peritonitis were compared,and the related risk factors of the treatment failure were analyzed.Results Three hundred and sixty-six episodes of peritonitis occurred in 258 patients during the study period.The overall rate of peritonitis was 1 episode in 76.8 patient-months.Elderly patients had higher incidence of peritonitis (1 episode every 56.4 months vs 1 episode every 88.7 months,P=0.001),higher incidence of fungus infection (9.6％ vs 3.9％,P=0.026) and higher mortality (46.2％ vs 14.0％,P=0.001) than that in younger patients.Cox regression analysis showed that longer duration of PD treatment and fungal peritonitis were both risk factors of the treatment failure.Conclusion Elderly patients had higher incidence of peritonitis,higher incidence of fungus infection and higher PD-related mortality than younger patients.

Objective:To know about the prevalence rates of depression and anxiety and its related factors a-mong human immunodeficiency virus (HIV)-infected men who have sex with men (MSM)in China.Methods:Under the help of MSM group,totally 600 HIV-infected MSM were recruited by snowballing sample among HIV-positive MSM,and 541 effective electronic questionnaire were received.Participants completed self-made question-naire of HIV-positive MSM healthy condition which included social demographic and health behavior et al.The Center for Epidemiologic Studies Depression Scale(CES-D)and Self-Rating Anxiety Scale (SAS)were used to survey the condition of depression (CES-D score ≥16)and anxiety (SAS score ≥50)respectively.Results:The percentage of having depression and anxiety symptoms was 44.7% (242 /541)and 25.1% (136 /541)respective-ly.Multiple unconditioned logistic regression analysis showed that the risk of having depressive symptoms included considered suicide in the past year (OR =3.31,95%CI:1.73 -5.34),nondisclosure their HIV infection to male primary sexual partners (OR =0.47,95%CI:0.30 -0.73),discrimination experience (OR =1.19,95%CI:1.11 -1.29).Compared with monthly income of 1500 yuan or less,participants who earned >5000 yuan monthly were less likely to have depressive symptoms (OR =0.34,95%CI:0.17 -0.71).Factors associated with anxiety symp-toms included considered suicide in the past year (OR =2.43,95%CI:1.40 -4.21),accepted antiviral therapy (OR=1.74,95%CI:1.06 ~2.84),discrimination experience (OR =1.12,95%CI:1.05 ~1.20).Participants earned >5000 yuan monthly (OR =0.44,95%CI:0.20 ~0.94)could decrease the risk of having anxiety symptom compared with whose monthly income of 1500 yuan or less.Conclusion:The prevalence rate of depression and anxiety symp-tom among HIV-infected MSM is high and need more attention.It may be helpful to call for the strategy of promo-ting mental health on decreasing social discrimination,communicating with sexual partners,and improving their eco-nomic status.

OBJECTIVE: To analyze the MR imaging findins of acinic cell carcinoma(ACC) in parotid gland and develop the diagnosis of this disease. METHOD: The MR imaging fearures of 11 patients with pathologically proved ACC were retrospectively analyzed. MR imagings were analyzed in relation to the follow:amount, location, size, shape, margin, pseudocapsule, MR signal intensity and enhanced pattern and the cervical lymphadenopathy. The clinical analysis on patients included age, sex, and follow-up. RESULT: There were 11 patients, 7 lesions was located in the right parotid gland and 4 lesions was located in the left parotid gland; the average maximum diameter was (2.66±0.99)cm; 7 lesions showed lobulated,and 4 lesions showed round; 8 lesions had no pseudocapsules and 3 lesions had incomplete pseudocapsule. All lesions showed homogeneous or heterogeneous isointense and slight hyperintense on T1 WI and T2WI. On post contrast images, the tumor parenchyma ingredients showed remarkable enhancement in all lesions. CONCLUSION The MR imaging of ACC in the parotid gland don't have specific features, but when the tumor of the parotid gland showed no pseudocapsule (or showed incomplete pseudocapsule), lobulate, small cysitc and remarkable enhancement, it may indicate ACC, and the correct diagnosis depends on clinical pathology.
Carcinoma, Acinar Cell ; pathology ; Contrast Media ; Humans ; Magnetic Resonance Imaging ; Parotid Gland ; Retrospective Studies ; Salivary Gland Neoplasms ; pathology

As early as the 20 th century, it has been observed that radiotherapy (RT), as a local therapy, can activate the adaptive immune system, resulting in spontaneous regression of tumors out of the radiation field, which is known as "abscopal effect". Although the occurrence of abscopal effect is still rare, with the gradual increase in the application of immunotherapy, more and more clinical cases of abscopal effect have been reported. Increasing attention has been paid to the therapeutic potential of RT in inducing systemic anti-tumor response. Especially, the combination of RT and immunotherapy enhances the research value of abscopal effect. However, its mechanism has not been fully elucidated, and the optimal timing, dose and fractionation of RT are also under study. How to classify the beneficiary groups is also a key issue. In this article, the history of abscopal effect, and the role of RT and immunotherapy in this phenomenon were briefly introduced, and the existing controversies in clinical application were illustrated, aiming to clarify the direction of current research and development and open a new chapter for tumor treatment in a short period of time.