Background and purpose:To investigate the clinico- pathological characteristics, prognosis and diagnosis of primary renal sarcoma that is a rare, highly malignant tumor with poor prognosis and survival. Methods:9 cases of renal sarcoma in our hospital were reviewed and analyzed. Nephrectomy was the main treatment for the patients. All the specimens were stained with histochemicial and immunohistochemical method, correlated literatures were also reviewed.Results:The distributions of pathology were malignant fibrous histiocytoma leiomyosarcoma, liposarcoma, myxosarcoma synoviosarcoma. Immunohistiochemical test was essential for the diagnosis of renal sarcoma.Conclusions:Pain and palpable mass were the common symptoms. Early radical surgery remains the optimal treatment, the role of chemotherapy and radiotherapy in the treatment modalities of the disease is still controversial.

Objective:To introduce the experience and clinical efficacy of a new type of negative pressure suction ureteroscope in the treatment of upper ureteral calculi, and compare it with traditional rigid ureteroscope and flexible ureteroscope lithotripsy.Methods:From January 2018 to January 2020, 160 patients with upper ureteral incarcerated calculi who were treated in Shengjing Hospital Affiliated to China Medical University were included in this study, and their clinical data were retrospectively analyzed.There were 50 cases in the rigid ureteroscope group, 54 cases in the flexible ureteroscope group and 56 cases in the new negative pressure combined ureteroscope group.The differences of operation time, hospital stay, stone free rate and postoperative complications were observed and compared among the three groups.According to whether the maximum diameter of the stone is more than 1.5 cm, the subgroups were analyzed to further compare the curative effect of the three groups.Results:All the 160 operations were completed successfully and none of them were converted to open surgery.The stone free rate of the new negative pressure suction ureteroscope Group (90.0% (18/20))was higher than that of the flexible ureteroscope Group (61.9% (13/21)) and the rigid ureteroscope Group (55.6% (10/18)), χ 2=8.49, P<0.001). The stone free rate in the first month after operation was also superior (96.4% (54/56), 77.7% (42/54), 74.0% (37/50), χ 2=5.48, P=0.01). The stone subgroup analysis showed that when the stone diameter increased (>1.5 cm), the net stone rate of the new negative pressure suction ureteroscope Group [91.6% (22 / 24)] was better than that of the flexible ureteroscope Group (62.5% (15/24)) and the rigid ureteroscope Group (50.0 (8/16))(χ 2=6.480, P=0.001). Conclusion:Compared with the traditional ureteroscopic lithotripsy, the new negative pressure suction ureteroscopic lithotripsy has higher initial and overall stone free rate, and higher safety factor.For the patients with stone diameter>1.5 cm, the new negative pressure suction ureteroscope lithotripsy has more advantages.

We have achieved good effects in realizing the dynamic management of probity -risk, positively preventing the unhealthy tendencies in the medicine purchases and sales and medical services from the sources , and promoting implementation of combating corruption and upholding integrity by exploring the prevention and control mechanism including prevention , monitoring and disposition and strengthening the education , institution, supervi-sion, accountability and so on .

AlM: To investigate the effect of endocapsular phacoemulsification cataract extraction and intraocular lens (lOL) implantation with a 1. 8mm or 3. 0mm clear corneal incision on total root mean square ( RMS ) value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film.
METHODS:ln a prospective study, 156 age- related patients ( 196 eyes ) were randomly distributed into two groups. 1. 8mm-group comprised 94 eyes that had a silicone lOL inserted through a 1. 8mm sutureless clear corneal incision, while, 3. 0mm- group comprised 102 eyes through a 3. 0mm clear corneal incision. Postoperatively, the changes in the total RMS value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film at 1wk, 1 and 3mo were determined respectively.
RESULTS:ln both groups, postoperatively at 1wk,there were statistically significant differences ( P<0. 05 ) in the total RMS value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film, while, there were statistically minimal differences ( P< 0. 05 ) between 1. 8mm-group and 3. 0mm-group at 1mo, but were not statistically significantly different ( P > 0. 05 ) between two groups at 3mo postoperative.
CONCLUSlON:This study confirms that incision size has strong impact on the corneal higher-order aberrations, especially, 3. 0mm incision caused significant differences in the total RMS value of cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film compared with 1. 8mm micro-incision, therefore, micro-incision is very beneficial for clinical use in phacoemulsification.

Objective To summarize clinical experience of reconstructive operation with transpositional colon behind the sternum after corrosive esophageal burns and to explore the treatment for its complications.Methods Clinical data of 65 cases with esophageal scarred stricture after corrosive burns receiving reconstructive operation with transpositional colon behind the sternum were reviewed,56 of them by end-to-end anastomosis between transpositional anterograde peristaltic colon and esophagus,seven by end-to- end anastomosis between transpositional anterograde peristaltic colon and pharyngeal fundus,and two by end- to-end anastomosis between transpositional reversed peristaltic colon and esophagus,to summarize treatment experiences in pre-operation,operation and post-operation.Results Fifty-one of this group of patients recovered and discharged form the hospital smoothly,12 with cervical anastomotic leakage after operation including two cured by re-operation and ten cured by conservative treatment,and two with necrosis of transpositional colon including one died during operation and the other cured.Conclusions Corrosive burns of esophagus can be cured by leaving scarred stricture esophagus open without resection,and the effectiveness of reconstructive operation with transpositional colon behind the sternum is satisfactory with good pre-operative preparation,correct surgical operation,and correct post-operative treatment.

Homocysteine ; analogs & derivatives ; blood ; Humans ; Infant ; Infant Nutrition Disorders ; complications ; Male ; Methylmalonic Acid ; urine ; Skin Diseases ; etiology ; Vitamin B 12 ; administration & dosage

Objective To compare the advantages and disadvantages of three different fixation methods via muscle-splitting approach for the treatment of single segmental lumbar vertebral diseases.Methods All of 90 patients with the single segmental lumbar vertebral diseases were treated from June 2012 to June 2013,including 34 males and 56 females,at the age of 27-76 years old,averagely (53.37± 15.41) years.Twenty-seven patients were treated with unilateral pedicle screws via unilateral muscle-splitting approach (unilateral fixation group).Thirty-three patients were treated with unilateral pedicle screws and contralateral translaminar facet screw via unilateral muscle-splitting approach (combined fixation group).Thirty patients were treated with unilateral pedicle screws via bilateral muscle-splitting approach (bilateral fixation group).Observe and compare the imaging and clinical results of these three groups.Results There were no significant difference in incision length and postoperative wound drainage between these three groups.The operation time was shortest in unilateral fixation group,while longest in bilateral fixation group.In the intraoperative blood loss,the unilateral fixation group was the same as the combined fixation group,while less than the bilateral fixation group.No infection was found after operations.Seven patients experienced epidermal necrosis of the incision,including 1 patient of unilateral fixation group,4 patients of combined fixation group and 2 patients of bilateral fixation group.Three patients suffered from nerve injury,including 2 patients of combined fixation group and 1 patients of bilateral fixation group.The follow-up time was from 12 to 36 months,averagely 25.5 months.The intervertebral height of lesion segments was apparently recovered after surgery,and maintained during the follow-up in these three groups.No significant changes of area and grade of multifidus muscle were detected at 1 year after surgery compared with preoperative.Seven patients experienced endplate cutting and cage partially embedded into vertebral body,including 3 patients of unilateral fixation group,3 patients of combined fixation group and 1 patient of bilateral fixation group.There was no loosening,displacement,breakage or cage shifting.Except 5 patients (2 patients of unilateral fixation group,2 patients of combined fixation group and 1 patient of bilateral fixation group),the remaining cases had well interbody fusion.At the final follow-up time,the JOA score significantly increased compared with preoperative.Besides,unilateral fixation group and combined fixation group were superior to bilateral fixation group.Conclusion Three different fixation methods via muscle-splitting approach for the treatment of single segmental lumbar vertebral diseases had well clinical results.The unilateral fixation and combined fixation via muscle-splitting approach had more advantages.The combined fixation via muscle-splitting approach is an innovation in approach,exposure and fixation aspects.

Objective To observe the expression of cyclooxygenase(COX)-2 in different malignancy astrocytoma by immunohistochemistry,so as to judge the invasive action of COX-2 in astrocytoma.Methods A total of 55 cases with astrocytoma underwent 63 times operation including 8 recurrent cases were selected,and 9 cases with severe brain injury who needed decompression surgery were selected as control group.The astrocytoma tissues and decompression surgery to remove tissues removed immediately fixed in 10％ formalin buffer solution.The expression of COX-2 was determined by immunohistochemistry.Results The positive expression rate of COX-2 in astrocytoma tissues was higher than that in decompression surgery to remove tissues[69.84％ (44/63) vs.1/9],and there was significant difference (x2 =11.589,P ＜ 0.01).The positive expression rate of COX-2 in recurrent astrocytoma tissues was higher than that in primmy astrocytoma tissues [8/8 vs.65.45％ (36/55)],and there was significant difference (x2 =3.957,P ＜ 0.05).With increased astrocytoma malignancy,the positive expression rate of COX-2 also increased,and there was significant difference (P ＜ 0.05).Conclusion COX-2 may have some relationship with the invasion of astrocytoma,leading to increase tumor grade,and relapse.

Objective To analyze the popular characteristic and drug resistance of Pseudomonas aeruginosa in a hospital of Guiy-ang from January 201 1 to December 2013.Methods The distribution characteristic and drug resistance of Pseudomonas aeruginosa isolated from clinical samples from January 201 1 to December 2013 were analyzed retrospectively.Results A total of 642 strains of Pseudomonas aeruginosa were isolated for three years in our hospital from January 201 1 to December 2013,there was 57.0% isola-ted from sputum specimens,and 27.9% isolated from excreta of wound.The infected endemic area distribution was made up of Or-thopedic Surgery,ICU,Geriatrics Department and Respiratory Department accounting for 22.9%,20.1%,18.8% and 1 5.9% re-spectively.Pseudomonas aeruginosa was most sensitive to polymyxin bacillosporin.The drug resistance rates to Trimethoprim,Am-picillin and Cefazolin were all 100.0%.The drug resistance rates to Ampicillin/sulbactam and Ceftriaxone were 90.0%. Conclusion Pseudomonas aeruginosa is the main cause of lower respiratory tract infections in patients and wound infection and show serious multi-drug resistant,so it is necessary to use drugs reasonably according to the drug susceptibility results.

Objective To analyze the genetic characteristics and the evolution of the influenza A (H3N2) virus strains circulating in Jiangsu province between 2013 and 2014.Methods This study analyzed thirty-one representative strains of influenza A (H3N2) virus, which were isolated in different regions of Jiangsu province and during different time periods from 2013 to 2014.Results Genetic distances in nucleic acid and amino acid between a strain used for vaccine production (A/Texas/50/2012) and the 31 strains were 0.010 5 and 0.012 4.Similarities between them in nucleic acid and amino acid sequences were 97.9%-99.6% and 97.2%-99.3%.Phylogenetic analysis showed that the hemagglutinin (HA) genes of the 31 strains were divided into three different groups.Three strains isolated in 2013 and three strains isolated in 2014 belonged to Group 1 and Group 2, respectively, while the others belonged to Group 3.Three positive selection sites (237, 366 and 367) in HA protein were observed by REL model.Compared with the strain used for vaccine production, the 31 strains were characterized by amino acid substitutions (N128A/T and P198S/A) in HA protein and all of the mutations located in B-cell epitopes.The total number of mutation sites reached 24.Compared with the A/Texas/50/2012 strain, seven strains presented the glycosylation site 126NWT, and three strains showed disappeared glycosylation sites of 45NSS and 144NNS.Evaluation of vaccine efficacy for A(H3N2) virus strains showed that the vaccine efficacy was not very well.Conclusion The HA gene of A(H3N2) virus had undergone a greater variation and the vaccine efficacy was not very well in Jiangsu province during 2013 to 2014, which made the influenza A(H3N2) virus become the circulating strain.