Objective To investigate the application effect of stone basket in ureteroscopic holmium laser lithotripsy for treatment of upper ureteral calculi. Methods The clinical data of 96 patients with upper ureteral calculi were retrospectively analyzed, all patients underwent ureteroscopic holmium laser lithotripsy. Forty-eight cases used the stone basket in the operation process (observation group), and 48 cases did not use the stone basket in the operation process (control group). The operation time, length of stay, success rate of lithotripsy, stone residual rate and incidence of postoperative complication were compared between 2 groups. Results The patients of 2 groups successfully completed surgery. There were no statistical differences in operation time, length of stay and incidence of postoperative complication between 2 groups (P>0.05). The success rate of lithotripsy in observation group was significantly higher than that in control group: 97.92% (47/48) vs. 75.00% (36/48), and the stone residual rate was significantly lower than that in control group:4.17%(2/48) vs. 18.75%(9/48), and there were statistical differences (P<0.05). Conclusions The stone basket in ureteroscopic holmium laser lithotripsy for treatment of upper ureteral calculi can thoroughly remove stones. It reduces the incidence of residual stones, does not affect the safety of the operation, and has good clinical value.

Objective To explore the relationship between corticospinal tract (CST) repairment and motor function recovery after rehabilitation in stroke patients by diffusion tensor imaging (DTI). Methods 15 stroke patients with internal capsule lesions and injured CST, 4-8 weeks after onset were included. They were scanned with DTI and assessed with the simple Fugl-Meyer Assessment (FMA) before and after 3-month rehabilitation. The fractional anisotropy (FA), FA ratio (rFA) and FA asymmetry (FAasy) in cerebral peduncle, posterior limb of internal capsule (PLIC) and corona radiate were obtained. The correlation of differences of FA, rFA and FAasy of CST with FMA was analyzed. Results The scores of FMA increased after treatment (P<0.01). The FA of the ipsilesional CST were significantly less than that of contralesional ones before and after rehabilitation. There was statistical differences in FA, rFA and FAasy in the corona radiate section of CST after treatment (P<0.05), but was not in the cerebral peduncle and PLIC section. However, there was no significant correlation of FA, rFA and FAasy of corona radiate section to scores of FMA. Conclusion DTI can respond to the repairment of corticospinal tract after stroke, especially in the corona radiate section.

Objective To explore brain plasticity of upper extremities motor function recovery after stroke with diffusion tensor imaging (DTI). Methods 25 stroke patients with internal capsule lesions and affected corticospinal tract (CST), 4-8 weeks after onset, were divided randomly into rehabilitation group (n=13) and control group (n=12). Both groups received routine medication and the rehabilitation group also received rehabilitation. All the patients were scanned with DTI and assessed with upper extremity Fugl-Myer Assessment (UE-FMA) before and 3 months after treatment. The fractional anisotropy (FA), FA ratio (rFA) and FA asymmetry (FAasy) in cerebral peduncle, posterior limb of internal capsule (PLIC) and corona radiate were obtained. The bilateral corticospinal tracts were reconstructed with diffusion tensor tractography. Results The scores of UE-FMA increased in both groups after treatment (P<0.05), and increased more in the rehabilitation group than in the control group (P<0.05). There was significant difference in FA, rFA and FAasy in the corona radiate section of CST after treatment in the rehabilitation group (P<0.05), but was not in the cerebral peduncle and PLIC section. However, there was no significant differences in FA, rFA and FAasy in the control group. The ipsilesional CST fibers were more compact after treatment in the rehabilitation group. Conclusion Rehabilitation can improve the upper extremities function recovery after stroke, which may associated with the repairment of CST in the corona radiate section.

OBJECTIVETo explore the clinical and function efficacy of the treatment of Herbert B2-type scaphoid fracture through volar approach with double screws prograde internal fixation.

METHODSFrom December 2005 to June 2010,18 patients with Herbert B2-type scaphoid fracture were treated with double screws prograde internal fixation through volar approach, including 14 males and 4 females with an average age of 33.11 years (ranged from 21 to 52 years). The fracture healing situation was evaluated by X-ray examination. Functional outcome was assessed by using Modified Mayo wrist score.

RESULTSAll patients were followed up with a mean time of (25.06 +/- 4.00) months. The bone healing time was (3.55 +/- 0.65) months. The pain,passive range of motion, grip of wrist were improved at 4 months after operation (P < 0.05). The Mayo wrist score were improved from preoperative 42.78 +/- 7.32 at 4 months after operation (93.89 +/- 5.83) (P < 0.05), the results were excellent in 9 cases and good in 9 cases.

CONCLUSIONVolar approach with double screws prograde internal fixation is an efficacy and safety surgical technique for Herbert B2-type scaphoid fracture.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Palmar Plate ; surgery ; Range of Motion, Articular ; Scaphoid Bone ; injuries ; surgery ; Wrist Injuries ; physiopathology ; surgery ; Young Adult

Objective To investigate the causative mutations of CYP27A1 gene in a sporadic cerebrotendinous xanthomatosis patient. Methods Genomic DNA was extracted from peripheral blood of the patient and her parents. All exons and splice sites of CYP27A1 gene were amplified by polymerase chain reaction (PCR) followed by Sanger sequenc-ing. 105 healthy unrelated subjects were also sequenced for the novel mutation in CYP27A1. Results A novel splice site mutation c.446+1G>T, a novel missense mutation c.877A>T(p.Met293Leu) and a known missense mutation c.1016C>T (p.Thr339Met) of CYP27A1 gene were identified in the patient. The mother carriers the two novel mutations and the fa-ther the c.1016C>T(p.Thr339Met) mutation. The two novel mutations were absent in 105 control subjects, respectively. Conclusions Our study detected two novel mutations, c.446+1G>T and c.877A>T, as well as a known mutation c.1016C>T, of CYP27A1 in a sporadic cerebrotendinous xanthomatosis patient. Our data provide novel information for the mutational spectrum of the gene, which is applicable in the genetic testing and diagnosis. The data also provide in-sight into the pathogenesis of the disease.

OBJECTIVETo evaluate the contribution of platelet and leukocyte activation in pathogenesis primary pulmonary hypertension (PPH).

METHODSPulmonary hypertension was induced by subcutaneous injection of 2% monocrotaline (MCT) in male Prague-Dawley (SD) rats. Blood samples were collected at the third week after MCT injection, and flow cytometry was used to determine the fibrinogen-binding platelet, CD11b expression on leukocyte and platelet-leukocyte aggregation.

RESULTThree weeks after MCT injection, rats exhibited higher right ventricular systolic pressure (RVSP) and mean pulmonary artery pressure(mPAP), as compared with controls. MCT induced vascular remodeling characterized by vascular medial wall thickening in pulmonary muscular arteries. The ratio of platelets fibrinogen binding was increased in rats 3 weeks after MCT injection than that of control group[(4.08 +/-1.59)% compared with (1.45 +/- 0.61)%, P<0.01]. CD11b expression in monocytes and neutrophils, but not in lymphocytes was increased significantly 3 weeks after MCT injection (P <0.01). Platelet-neutrophil aggregations increased in MCT injected rats as compared with controls (P <0.01).

CONCLUSIONRats of PPH model demonstrate enhanced circulating platelet and leukocyte activation, which may contribute to the pathogenesis of PPH.

Animals ; Blood Platelets ; metabolism ; Fibrinogen ; metabolism ; Hypertension, Pulmonary ; blood ; chemically induced ; Leukocytes ; physiology ; Male ; Monocrotaline ; Platelet Aggregation ; Platelet Count ; Random Allocation ; Rats ; Rats, Sprague-Dawley

Objective To observe the significance of rehabilitation integrated system for stroke patients. Methods From October, 2013 to June, 2015, 95 stroke patients were divided randomly into experimental group (n=48) and control group (n=47). The experimental group received rehabilitation under the guide of rehabilitation integrated system, while the control group in the routine process. They were assessed with simplified Fugl-Meyer Assessment (FMA) and Barthel Index (BI) before and 3 months after treatment. The satisfaction was also inves-tigated. Results There was no significant difference between groups in the differences of scores of FMA and BI before and after treatment (t<1.044, P>0.05), while the satisfaction was higher in the experimental group (t=4.287, P<0.01). Conclusion The application of rehabilitation integrated system may improve the process of treatment and the efficiency of management, and result in more satisfaction of the stroke pa-tients.

OBJECTIVETo evaluate the clinical efficacy and efficacy sustainable time of acupuncture in knee osteoarthritis (KOA).

METHODSThe non-randomized concurrent control trial was adopted. One hundred and ninety-three cases of KOA were divided into an immediate acupuncture group (group A, 97 cases) and a delayed acupunc-weeks at the end of treatment. In group B, the same acupuncture therapy was applied after waiting 4 weeks. The acupoints in the two groups were Liangqiu (ST 34), Dubi (ST 35), Zusanli (ST 36), Yanglingquan (GB 34), Yinlingquan (SP 9), Xuehai (SP 10), Xiyan (EX-LE 4), Xiyangguan (GB 33). WOMAC (Western Ontario and McMasters Universities Osteoarthritis) was used for the assessment of the primary index and VAS (visual analogue scale) was for the secondary index. The evaluation was accomplished by the patients at the beginning of trial, on the 4th and 8th weeks. In each group, 72 patients finished the trial and the data of the lost cases were included in the final data analysis.

RESULTSIn the 4th week of trial, WOMAC score was (25. 8+/-22.0) in group A difference (P<0. 001). VAS scorewas (31. 8+/-24. and was (43.8+/-22.2) in group B, indicating the significant 6) in group A and was (56. 6 +/-25. 8) in group B, indicating very significant difference (P<0. 001). In the 8th week, the efficacy was reduced slightly in the follow-up of group A, but it was improved apparently as compared Acupuncture relieves joint pain and improves joint function obviously.by th patiĩeffr,a Mtaetfti-?an tf ri-with that before treatment.

CONCLUSIONAcupuncture relieves joint pain and improves joint function obviously.The effect of acupuncture is still sustainable in 4 weeks after terminating the treatment.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Arthralgia ; therapy ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; therapy ; Treatment Outcome

OBJECTIVETo explore the influence of the DNA repair gene ERCC2 single nucleotide polymorphisms (SNPs) rs13181, rs1618536, and rs1799793 on male idiopathic infertility in Ningxia, China.

METHODSUsing MassArray, we conducted a case-control study and genotyped three ERCC2 SNPs rs13181, rs1618536, and rs1799793 for 351 males (aged 31.0 +/- 4.2 years) with idiopathic infertility and another 327 normal fertile men (aged 33.0 +/- 5.9 years) as controls.

RESULTSThe ERCC2 AnyG-anyA-anyA genotypes were significantly associated with an increased risk of idiopathic infertility (OR 0.414, 95% CI 0.176 - 0.970), while the three single ERCC2 SNPs rs13181, rs1618536, and rs1799793 showed no significant differences between the cases and controls (P > 0.05).

CONCLUSIONThe ERCC2 SNPs rs13181, rs1618536, and rs1799793 play a role of interaction in male idiopathic infertility in Ningxia, contributing to the risk of the disease.

Adult ; Case-Control Studies ; China ; DNA Repair ; Genotype ; Humans ; Infertility, Male ; genetics ; Male ; Polymorphism, Single Nucleotide ; Xeroderma Pigmentosum Group D Protein ; genetics

OBJECTIVETo improve the differential diagnosis of tuberculous meningitis (TBM) and reduced potential misdiagnosis of TBM.

METHODSThe clinical data of 47 misdiagnosed cases of TBM between January, 1994 and June, 2009 were investigated retrospectively. The clinical presentations and causes for the misdiagnoses were analyzed.

RESULTSThe 47 patients with misdiagnosed TBM included 28 male and 19 female patients with a mean age of 36.84∓16.41 years. Eight patients had an acute onset, 10 had a subacute onset, and 29 had chronic disease. The initial symptoms, in the descending order of their frequencies, included fever and headache (87.2%), anergia and dyskinesia (27.7%), cerebral nerve damage (23.4%), decreased level of consciousness (14.9%), and urinary and fecal incontinence (2%). Meningeal irritation was present in 25 cases and positive Babinksi sign was found in 19 cases. Elevated intracranial pressure occurred in 51.1% of the cases, and 16 cases showed papilloedema. Non-purulent CSF with elevated protein was found in 86.7%, decreased glucose in 50%, and decreased chlorinate in 53.3% of the cases. Eight out of 23 cases showed a positive result of PPD test. MRI identified abnormitis with meningeal enhancement in 15 cases, hydrocephalus in 7 cases and infarction in 14 cases. Tuberculoma was found in 2 cases, and spinal cord lesions were found 4 cases. All the patients received anti-tuberculosis therapy, which resulted in symptomatic improvement in 39 cases, fluctuated condition in 2 cases; 5 patients discontinued the treatment and 1 died.

CONCLUSIONEarly TBM often presents with atypical features and its differential diagnosis can be difficult. CSF monitoring and careful inspection of the radiographic data can be helpful in the diagnosis of suspected cases, for which early anti-TB treatment is an important means to reduce misdiagnosis.

Adult ; Diagnosis, Differential ; Diagnostic Errors ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tuberculosis, Meningeal ; cerebrospinal fluid ; diagnosis ; Young Adult