Objective To evaluate the clinical efficacy of pneumatic lithotripsy under ureteroscope in the treatment of ureteral calculi. Methods A total of 110 cases of ureteral calculi were treated by using 8/9.8 F Wolf rigid ureteroscope and JUN-AIR pneumatic lithotripter. Results Successful lithotripsy under ureteroscope was achieved on one session in 105 cases, with a success rate of 955% (105/110). Calculi were entirely extracted within 1~6 weeks. Conversions to open surgery were required in 2 cases because of failed ureteroscope insertion. Upper ureteral stones moved into the kidney in 3 cases, 2 of which underwent the ESWL and 1 of which received medical treatment. Postoperatively, 5 cases were complicated with urinary infection with mild hematuria lasting for 1~3 days. Conclusions Pneumatic lithotripsy under ureteroscope is an effective method for treating mid-lower ureteral calculi, with advantages of high efficiency, safety, minimal invasion, less complications and simplicity of performance.

Objective To investigate the efficacy and safety of percutaneous nephrolithotomy (PCNL) combined with pneumatic lithotripsy for renal stones. Methods Clinical data of 95 cases of renal stones that were treated by PCNL from February 2007 to September 2008 were retrospectively analyzed. The operations were done by using ultrasonography and pneumatic lithotripter system (EMS Ⅲ). If the stones were easy to shatter,we used ultrasonic lithotripter,otherwise,pneumatic lithotripter or both of them were employed. Results The procedures were completed successfully in all of the 95 cases with the operation time ranged from 45-170 min (mean,85 min). No severe complications including pleural trauma and severe bleeding occurred during the operations. After the operation,9 patients had fever and 11 cases showed severe hemorrhage (9 of them were cured by conservative therapy and the other 2 recovered after nephrectomy). In the 95 patients,17 cases had residual stones,6 of them received a second operation. Conclusion PCNL combined with pneumatic lithotripsy is an effective and minimally invasive method for the treatment of renal stone.

Objective To explore the feasibility of DSCT dual-energy technique in pulmonary mass lesions.Methods A total of 100 patients with pulmonary masses underwent conventional plain CT scan and dual-energy enhanced CT scan.The virtual non-contrast (VNC) images were obtained at post-processing workstation.The mean CT value,enhancement value,signal to noise ratio (SNR),image quality and radiation dose of pulmonary masses were compared between the two scan techniques using F or t test and the detectability of lesions was compared using Wilcoxon test. Results There was no statistically significant difference among VNC ( A ) ( 32.89 ± 12.58 ) HU,VNC (S) ( 30.86 ± 9.60) HU and conventional plain images (35.89 ± 9.99 ) HU in mean CT value of mass ( F =2.08,P ＞ 0.05 ).There was statistically significant difference among VNC ( A ) ( 3.29 ± 1.45 ),VNC (S) ( 3.93 ± 1.49 ) and conventional plain image (4.61 ± 1.50) in SNR ( F =6.01,P ＜ 0.05 ),which of conventional plain scan was higher than that of VNC.The enhancement value of mass in conventional enhanced scan(60.74 ± 13.9)HU and distribution of iodine from VNC (A) ( 58.26 ± 31.99 ) HU was no statistically significant difference ( t =0.48,P ＞ 0.05 ),but there was a significant difference between conventional enhanced scan (56.51 ± 17.94 ) HU and distribution of iodine from VNC (S) (52.65 ± 16.78 ) HU (t =4.45,P ＜ 0.05 ).There was no statistically significant difference among conventional plain scan ( 4.69 ± 0.06 ) and VN C ( A ) ( 4.60 ± 0.09 ),VNC (S)(4.61 ±0.11 ) in image quality at mediastinal window ( F =3.014,P ＞ 0.05 ).The appearance,size,internal features of mass (such as necrosis,calcification and cavity) were showed the same in conventional plain scan,VNC (A) and VNC (S).Of 41 patients with hilar mass,18 patients were found to have lobular and segmental perfusion decrease or defect. Perfusion defect area was found in 59 patients with peripheral lung mass. The radiation dose of dual-energy enhanced scan was lower than that of conventional scan.Conclusion The virtual non-contrast,distribution of iodine and pulmonary virtual perfusion images can be obtained by DSCT dual-energy technique in one scan,which has a potential clinical value in the thorax.

PurposeTo analyze the urinary stone chemical composition using dual source CT (DSCT) dual energy imaging.Materials and MethodsNinety-seven stone samples with known chemical composition were placed in fresh swine kidneys and examined with DSCT dual energy scan, including 55 calcium oxalate stones, 13 hydroxyapatite stones, 9 uric acid stones, 4 cystine stones, 2 struvite stones and 14 mixed stones. The mean attenuation values and dual energy index (DEI) were measured at 80 kV and 140 kV. The stone composition was analyzed to determine the sensitivity, specificity and accuracy.ResultsDual energy analysis showed 59 calcium oxalate stones, 11 hydroxyapatite stones, 9 uric acid stones, 4 cystine stones and 14 mixed stones. 2 hydroxyapatite stones were erroneously marked as calcium oxalate stones and 2 struvite stones as calcium oxalate stones. The accuracy was 95.88% (93/97). The difference CT value at 80 kV and 140 kV and DEI value were statistically significant (P<0.05). The sensitivity for detecting calcium oxalate stones, hydroxyapatite stones, uric acid stones and cysteine stones were 100.00%, 84.60%, 100.00% and 100.00%, respectively; with specificity of 85.70%, 100.00%, 100.00% and 100.00%, respectively; and the accuracy were 95.18%, 97.59%, 100.00% and 100.00%, respectively.ConclusionDSCT dual energy imaging accurately analyzes the chemical composition of urinary stone in vitro, which provides important clinical value in analyzing the urinary stonesin vivo.

Purpose To investigate the second generation dual source CT low tube voltage (100 kV) combined with sonogram-affirmed iterative reconstruction (SAFIRE) in assessing coronary artery stents. Materials and Methods One hundred and fifty-six patients underwent CT coronary angiography after implanted coronary artery stents. Among all the patients, 86 cases were performed with 100 kV combined with SAFIRE, and 70 cases with 120 kV combined with filtered back projection reconstruction (FBP). Mean CT values, image noise, SNR, SAIR, image quality scores, stents detecting and radiation dose of aortic root, inner-stent, and the coronary artery proximal to the stent were compared. Results The mean CT value of aortic root, inner-stent, and the coronary artery proximal to the stent of 100 kV group was higher than that of 120 kV group (t=2.75, 11.77 and 3.19, P<0.05), while image noise and SAIR of 100 kV group were lower than those of 120 kV group (t=-2.53 and -9.51, P<0.05). SNR of aortic root, inner-stent, and the coronary artery proximal to the stent was not statistically different between the two groups (t= -1.34, -0.95 and 1.67, P>0.05). There was no statistic difference of image quality score between the two groups (t= -0.203, P>0.05). Totally there were 243 stents detected, including 67 of right coronary artery, 123 of left anterior descending, 36 of left circumflex, and 17 of other branches. Stent length ranged 3.8 to 98.7 mm and averaged (27.5±16.4) mm. The CTDIvol, DLP and ED of 100 kV group were lower than those of 120 kV group (t= -11.03, -9.41 and -9.41, P<0.05). The effective dosage reduced about 51.5% in 100 kV group when compared with that of 120 kV group. Conclusion The second generation dual source CT low tube voltage (100 kV) combined with SAFIRE in assessing coronary artery stent could meet the diagnostic requirement and reduce the radiation dosage, without increasing image noise and beam hardening artifacts.

Adult ; Antiphospholipid Syndrome ; complications ; Humans ; Male ; Myocardial Infarction ; complications

Objective To observe the prophylactic effects of a HSV-2gD2DNA vaccine in guinea pigs challenged with HSV-2strains.Methods Female guinea pigs were divided into3groups with10each,which was immunized intramuscularly with100?g of pc-gD plasmids(recombinant HSV-2DNA vac-cine),or with pcDNA3blank plasmids,with normal saline as control,respectively.Two booster injections were given on day7and day21.Sera were collected for virus neutralization test on day0,day28,and day56.The animals were challenged with HSV-2strain sav intravaginally,and lesions induced on the external genital skin were scored between day1and day21after challenge.Results The titer of neutralizing anti-body to HSV-2was much higher in the sera from animals immunized by pc-gD plasmids than that from ani-mals immunized by pcDNA3blank plasmids or normal saline.Furthermore,the lesion scores on external genital skin were significantly decreased in pc-gD group than those in other two groups with either primary or recurrent infections.Conclusion The constructed gD2vaccine can efficiently protect guinea pigs from genital infection and reduce recurrent infection induced by latent herpes simplex virus.

10.3969/j.issn.1007-3969.2013.05.002

Objective To study effect of bufalin on invasion and metastasis of gastric cancer cells and related mechanism.Methods AGS human gastric cancer cell line was used for in vitro experiments.Cultured cells were treated by negative control group,bufalin group and oxaliplatin group.Cell proliferation was determined by MTT.Invasion and metastasis were observed by Wound-Healing Assay and Transwell Assay.Expression levels of E-cadherin,matrix metalloproteinases (MMP)-2,MMP-9 were detected by Western blotting.Results Bufalin was found to significantly inhibit the proliferation of AGS cells in a dose and time dependent manner.Wound-Healing Assay and Transwell Assay showed that as compared with the blank control group,bufalin inhibited invasion and metastasis of AGS cells (P＜ 0.05),but there was no statistically significant difference between bufalin group and oxaliplatin group (P＞0.05).Western blotting showed the expression of E-cadherin was increased in bufalin group as compared with the blank control group while the expression levels of MMP-9 and MMP-2 were down-regulated (P＜0.05),but there was no statistically significant difference between bufalin group and oxaliplatin group (P＞ 0.05).Conclusion Bufalin has anti-cancer activity on gastric cancer cells,and it has the ability of inhibiting cancer cell invasion and metastasis,and regulating the expression of some related gene.

Objective To assess the application of echocardiography in mini-invasive surgical device closure of ventricular septal defect (VSD). Methods 73 VSD patients including 35 with aneurysm formation and among them 21 with multi-defects in the aneurysm were treated by mini-invasive device closure. A closure device was positioned to the defect through parastemal mini-incision in all patients. TEE was used to monitor the whole procedure, to guide the device positioning and to evaluate the curative effect instantly after operation. All patients were evaluated by TTE one year postoperatively. Results All patients were successfully positioned closure devices by TEE guiding. 9 cases were found with trace to small amount residual shunt instantly after operation. 7 cases still had small amount residual shunt at the time of 48 hours after the operation. In the one year follow-up, 4 cases had residual shunt, but the size and volume of left ventricle were significantly reduced than those before operation, and the pulmonary artery systolic pressure was also reduced. Conclusion Echocardiography possesses an important role in preoperative indication screening, intraoperation monitoring and evaluating the curative effect postoperatively.