55 consecutive anatrophic nephrolithotomies on 53 patients performed between July, 1983 and June, 1990 were reviewed. The patients (36 male and 19 female) ranged in age from 3 to 72 years. The operation time averaged 219.8 minutes with a range of 120-330 minutes, and the ischemic time ranged between 20 and 90 minutes, with a mean of 43.5 minutes. Postoperative complications developed in 18 patients, which were such as persistent urinary tract infection in 5cases (9.4%), atelectasis in 4 (7.5%), transient urine leak in 2 (3.8%), delayed bleeding in 2 (3.8%) and urinary retention in 2 (3.8%). Postoperative residual stones were identified in 15 (27.3%), but in 8 of these 15patients stones were delivered spontaneously and thus 48 of 55 cases (87.3%) became stone free. The recurrence of stone was noted in 2 out of 48 patients during the short follow up period. Anatrophic nephrolithotomy seems to be an effective method compared to other procedure because of decreasing recurrence of stone by complete stone removal and reconstruction of abnormal collecting system.
Follow-Up Studies ; Hemorrhage ; Humans ; Male ; Methods ; Postoperative Complications ; Pulmonary Atelectasis ; Recurrence ; Urinary Retention ; Urinary Tract Infections

Objective To investigate the relationship between the p27~(kip1) expression and the change of radiosensitivity of esophageal cancer cells.Methods Radio-resistant cells (EC9706R) were gradually isolated by means of repeated gamma-ray irradiation (6 000 cGy in total) upon human squamous esophageal carcinoma cells (EC9706).The radiosensitivity of these two types of cells was measured by standard colony formation assays,their cell cycle distribution analyzed by flow cytometry respectively,and the p27~(kip1) expression detected by immunocytochemistry.Results As compared with their parent cells,the isolated human squamous esophageal carcinoma cells(EC9706) showed clearly greater radio-resistance(for EC9706R,SF_2=65.71%,D_0=2.20 Gy,D_q=1.61 Gy,N=2.07,and for EC9706,SF_2=46.72％,D_0=1.61 Gy,D_q=0.99 Gy,N=1.85;SF_2,D_0,Dq and N were all higher).As to the cell cycle distribution,the population of G_1 phase cells in EC9706R cells was significantly decreased,but the proportion of S phase cells was significantly increased as compared with the parent cells.Immunocytochemistry revealed that the p27~(kip1) expression of EC9706R cells was clearly lower than that of EC9706 cells.Conclusion Cell phase change due to the decrease of p27~(kip1) expression may be one of the mechanisms of the generation of radio-resistance in esophageal cancer cells.

Objective To explore the changes in secondary lesions to motor neurons caudal to a damage site on the spinal cord of rats.MethodsForty female adult Sprague-Dawley rats were given incomplete spinal cord injuries (SCIs) at the T10 level using a modification of Allen's method. Locomotor function was evaluated using an inclined plane test, modified Tarlov scores and the Basso-Beattie-Bresnahan (BBB) scale before the operation and 1,2, 3,4 and 5 weeks post surgery. Histomorphological changes at T10 and L5 were observed under a light microscope.Results①Morphology of the distal spinal cord: 1 week after SCI, neurites and Nissl bodies of the motor neurons had decreased. By the 2nd week the decrease had become more obvious. At the 3rd week after SCI, neurites and Nissl bodies had not decreased further, but neuron atrophy and apoptosis were found. At the 4th to the 5th week after SCI, neurites and Nissl bodies had increased significantly. ②Morphology of the damage site: At the 1 st week after SCI, hemorrhage and inflammation as well as nerve fiber necrosis were observed. By the 2nd week astrocytes had-increased and a few nerve fibers had grown at the damage site. At the 3rd week, regeneration of nerve fibers and astrocytes were found. At the 4th to the 5th week after SCI astrocytes and nerve fibers had not increased further. ③Locomotion function: The angles of the inclined plane test, Tarlov scores and BBB scores had decreased significantly at the 1st, 2nd, 3rd, 4th and 5th week post injury compared with those before the SCI. The values at the 2nd, 3rd, 4th and 5th week were all significantly better than those at the 1st week after SCI. There was an increasing trend in scores from the 3rd week to the 5th week, but without significant differences compared with the 2nd week after the operation.ConclusionsSecondary degeneration and damage, including decreases in neurites and Nissl bodies, neuron atrophy and apoptosis may occur in the motor neurons distal to the damage site in the early stage after SCI. This correlates with changes in the pathology of local damage.

Objective To investigate the role of c-Jun N-terminal kinase (JNK) signal transduction pathway in IL-8 and TNF-α secretion from alveolar macrophages induced by mechanical ventilation with large-tidal volume in rabbits. Methods Thirty male New Zealand white rabbits weighing 210-260 g were randomly divided into 330-40 bpm, PEEP 0), and SB203580 group (group S). The animals were anesthetized with iv pentobarbital sodium 40 mg/kg, traeheostomized and mechanically ventilated. Group C received no mechanical ventilation. The animals were mechanically ventilated for 3 days in group V. The animals were mechanically ventilated for 3 days and SB203580 (a specific JNK inhibitor) 6 mg/kg was injected via the ear vein every day during ventilation (the ventilation parameters were the same as those in group V). The animals were then sacrificed by exsanguination. The concentrations of IL-8 and TNF-α in bronchoalveolar lavage fluid (BALF) were determined by ELISA and the alveolar macrophages were collected. After the macrophages were cultured for 2 h in vitro, the expression of IL-8 mRNA and TNF-α mRNA was determined by RT-PCR. Results Compared with group C, the levels of IL-8 , TNF-α,IL-8 mRNA and TNF-α mRNA were significantly increased in group V (P＜0.05). Compared with group V, the levels of TNF-α and TNF-α mRNA were significantly decreased ( P ＜ 0.01 ), but no significant change was found in the levels of IL-8 and IL-8 mRNA in group S ( P ＞ 0.05). Conclusion JNK signal transduction pathway plays an important role in TNF-α secretion from alveolar macrophages induced by mechanical ventilation with large-tidal volume in rabbits, but is not involved the secretion of TNF-α.

Objective To investigate the attitude of medical students towards standardized resident training in Shanghai and to provide references for policy adjustment.Methods Self-made questionnaire was used to investigate the attitude of 267 clinical medical students towards standardized resident training in Shanghai.Reference reviewing and expert consultation were also performed.Results Nearly eighty percent of students believed that they had basic knowledge of the training.Two thirds of students hold objective attitude towards the policy.Conclusions Income and pressure in finding jobs are the main reasons why students object the policy.Standardized resident training program need to improve in aspects of advertisement,incoming,quality of teaching staff,connection between medical education and training.

Objective To better understand the pathogenicity and evolution of Yersinia pestis, we carried out the whole genome sequencing of human-avirulent Yersinia pestis strain 91001, which was isolated from a species of rodent-Microtus brandti. Methods We utilized “whole genome shotgun” approach to get the genome sequence of 91001. Based on the finished and annotated genome sequence of 91001, as well as the previously published genome sequences of CO92 and KIM, we performed detailed comparative genomics analysis on their chromosomes and plasmids. Results The genome of 91001 consisted of one chromosome and four plasmids (pPCP1, pCD1, pMT1 and pCRY). The pPCP1 plasmid of 9 609bp was almost identical with its counterparts from reference strains, which possessed 10 CDS. Plasmid pCD1 was found to be a plasmid of the type III secretory apparatus, and its length was 70 159bp. Although its CDS are quite similar to those of the reference plasmids, there were obvious rearrangements which produced certain differences in structure among them. Another plasmid was pMT1, a 106 642bp plasmid, which showed slightly different architecture compared with the reference ones. There was no mutation in virulent-related genes of pMT1 and pMT1 of 91001, which seemed to have retained more fragments of an ancestor plasmid. pCRY was a novel plasmid discovered in this work. It was 21 742bp long and harbored a group of gene encoding type IV secretory system. pCRY seemed to be able to replicate. The length of chromosome of 91001 was 4 595 065bp, and among its 4 037 predicted CDS (coding sequences), 141 were possibly pseudogenes. There were many IS in the chromosome. Due to the rearrangments mediated by IS, the structure of 91001 chromosome showed significant differences compared with CO92 and KIM. According to the results of comparative genomics analysis, we deduced the genetic mechanisms of nitrate reduction, glycerol fermentation, arabinose and milibiose utilization in 91001. Conclusion According to the analysis of plasmids structure, pseudogenes distribution, nitrate reduction negative mechanism, gene comparison and chromosome architecture, we conclude that 91001 and other strains isolated from Microtus brandti and Microtus fuscus evolved from ancestor Y. pestis and then developed into a different lineage. The deletion of large genome fragments from 91001 chromosome and pseuogenes might contribute to its unqiue pathogenicity and host-specificity.

Objective To establish reliable proteomics analysis models for Yersinia pestis and obtain the basic proteomics data of this pathogen. Methods The human-avirulent Y. pestis strain 91001 was cultured as an experimental strain, and the proteins of which were extracted and divided into three parts fractionally according to their solubility. Then three different methods (Shotgun-LC-MS-MS, 1D-LC-MS-MS and 2D-MS) were used to analyze the extracted proteins. The obtained data were compared with the theoretical protein database of strain 91001 so as to identify the expressed protein of Y.pestis strain 91001 in this study. Results 971 proteins were identified by shotgun-LC-MS-MS method, accounting for 23.4% of the predicted proteins of strain 91001 (971/4 143). 915 proteins were identified by 1D-LC-MS-MS method, accounting for 22.1% of the predicted proteins of strain 91001 (915/4 143). However, with 2D-MS only 5.62% of the predicted proteins (233/4 143) were identified. Altogether 1 193 proteins were identified when the results of the 3 methods added together, accounting for 28.7% of all the predicted CDS in 91001. Conclusion The kind and quantity of proteins identified by various proteomics methods differ from each other dramatically, therefore it is necessary to utilize multiple methods to get more reliable protein profiles of Y. pestis.

Objective To investigate the efficacy of ganciclovir in viral keratitis and its influence on serum related indicators.Methods Patients with viral keratitis from May 2012 to December 2013 in our hospital were randomly divided into control and observation groups, each group had 62 cases.Patients in control group were treated with acyclovir eye drops, and those in observation group were treated with ganci-clovir ophthalmic gel.The difference in efficacy of two groups was compared.The levels of serum inflamma-tory cytokines of interleukin-2 (IL-2), IL-4, IL-6, IL-8, tumor necrosis factor-α(TNF-α), and interferon-γ( IFN-γ) of two groups before and after treatment were compared, the serum levels of nitric oxide ( NO) , super oxide dismutase (SOD), malondialdehyde (MDA), C3, and C-reactive protein (CRP) were been compared.Results The pain relief time and corneal healing time of observation group [(3.41 ±0.89)d and (4.02 ±1.11)d] were all shorter than control group [(4.52 ±1.21)d and (6.30 ±1.45)d].The cure rate and total effective rate of observation group were 58.06%and 90.32%, respectively.It was sig-nificantly higher than control group ( P <0.05).After 3 and 7 days of treatment, the serum levels of IL-4, IL-6, and IL-8 were lower than control group, and IL-2, and IFN-γwere higher than control group (33.87%and 82.26%) ( P <0.05).After 3 and 7 days of treatment, the serum levels of NO and MDA were lower than control group, and SOD, C3, and CRP were higher than control group ( P <0.05).Con-clusions Ganciclovir has a better efficacy than acyclovir for viral keratitis, and can effectively adjust the serum levels of related indicators.

Objective To investigate the diagnostic and prognostic value of serum miR-155 for pancreatic cancer.Methods A total of 110 pancreatic cancer patients,70 chronic pancreatitis and 58 healthy individuals who admitted to the First People's Hospital of Hefei between January 2009 and August 2013 were prospectively enrolled.Their serum miR-155 levels were detected by real-time PCR.The receiver operating characteristic curve was employed to estimate the diagnostic accuracy of miR-155 for pancreatic cancer.Correlations between miR-155,carbohydrate antigen 19-9 (CA 19-9) and TNM stages were analyzed.The Kap1an-Meier approach and the Cox model were used to assess the prognostic value of miR-155 for pancreatic cancer.Results Pancreatic cancer patients had significantly higher serum miR-155 when compared either with chronic pancreatitis patients or healthy individuals (P ＜ 0.05 for both).The areas under the receiver operating characteristic curve were 0.82 (95％ CI:0.75 ～ 0.88) for miR-155,and 0.88 (95％ CI:0.82 ～0.93) for miR-155 combined with CA19-9.MiR-155 increased as the TNM stages advanced,and it was positively correlated with CA 19-9 (R2 =0.22,P ＜ 0.05).MiR-155 ≥ 1.46 △CT was independently associated with pancreatic cancer mortality,with a hazard ration of 2.88 (95％ CI:1.26 ～ 6.58).Conclusion Serum miR-155 is a useful biomarker for diagnosis and prognosis of pancreatic cancer.