Objective To evaluate the efficacy and technique of minimally invasive management for acute ureteral obstruction and severe infection caused by calculi.Methods A total of 51 patients with acute upper urinary tract obstruction and severe infection caused by calculi were enrolled in this study.When infection,sepsis,and electrolyte disorders were corrected,emergent drainage by retrograde ureteral catheterization using cystoscopy or B-ultrasonography-guided percutaneous nephrostomy were carried out.Ureteroscopic lithotripsy or extracorporeal shock wave lithotripsy(ESWL)were performed after the infection was controlled.Results Cystoscopic retrograde ureteral catheterization was completed in 8 cases,and the other 43 patients were treated successfully by B-ultrasonography-guided percutaneous nephrostomy.During the operations,purulent urine spurted out from the drainage tube.Ten patients had transient hematuria and lumbar pain postoperation.None of the patients developed pneumothorax,urinary extravasation,perirenal hematoma,or abdominal organ injuries,etc.In 3 cases,recauterization was done because the catheter dropped out.In all the patients,the body temperature and blood white blood cell counts returned to a normal range 3 to 7 days after the drainage.Among the cases,8 were treated with ESWL,35 received ureteroscopic lithotripsy,and 8 underwent ESWL after the ureteral stone being pushed upwards to the renal pelvis.No severe complications,such as ureteral perforation or tears,massive hemorrhage,or high fever occurred after lithotripsy.The stones were completely removed in all the cases in 3 weeks postoperation(in 1 week for 34 cases).The patients were followed up for 3 to 6 months,during which the renal function recovered to a normal level.Conclusions Retrograde ureteral catheterization using cystoscopy or B-ultrasonography-guided percutaneous nephrostomy combined with ureteroscopic lithotripsy or ESWL is efficient for patients with acute ureteral obstruction and severe infection caused by calculi.By using the method,ureteral infection can be controlled quickly without causing severe complications.

Objective:This study aimed to investigate the associations between single-nucleotide polymorphism (SNP) of IGF-1 and IGFBP-3 gene and risk of non-smoking female lung cancer in Chinese population. Methods:Genotyping was performed using the TaqMan method in 287 histologically confirmed non-smoking female lung cancer cases and 281 healthy controls. Results:The geno-type distributions of IGF-1 polymorphisms were significantly different between cases and controls (P<0.001). Analysis of multivariate logistic regression showed that the carriers of the CC genotype exhibited a significantly decreased risk of lung cancer in non-smoking female (adjusted OR=0.28, 95%CI:0.15-0.54). IGF-1 rs1520220 GG genotype may reduce the risk of advanced lung cancer incidence in nonsmoking female (adjusted OR=0.30, 95%CI:0.09-0.96). Log-rank test and Cox regression analyses revealed that variant geno-types of IGF-1 rs2946834 CT/TT had a significantly decreased lung cancer mortality risk compared with the homozygote CC in≥60 age group or patients with a lung tumor>3 cm. Conclusion:The IGF-1 polymorphism was associated with the risk of lung cancer and prognosis among non-smoking female. More rigorous laboratory studies of large sample population and functional studies are warrant-ed to confirm our findings.

Objective To determine the efficacy of retrovirus-mediated HSV-TK gene transfer and GCV in a BALB/c mice model with urinary bladder transitional cell carcinoma. Methods A replication defective retroviral vector containing HSV-TK gene was used. In vivo experimental animals were divided into 3 groups.In group A,7 tumors were induced in BALB/c mice by subcutaneous injection of MBT-2 transitional cell carcinoma (TCC);the virus was directly injected into the tumor and the animals received intraperitoneal GCV.In group B, 6 tumors were induced in BALB/c mice by subcutaneous injection of transferred HSV-TK gene TCC and the animals received intraperitoneal GCV.In group C,6 tumors were induced in BALB/c mice by subcutaneous injection of MBT-2 TCC and the animals received intraperitoneal normal saline.Tumor-volume measurement was performed in these 3 groups 10 d and 20 d after treatment, and the volume changes were compared among the 3 groups. Results In vivo experiment indicated that the mean tumor volume of group A [MBT-2 group, (55.37?4.52) mm3] and group B [MBT-2/HSV-TK group,(49.77?4.15)mm3] was reduced significantly compared with that of group C [control group,(146.27?10.46)mm3](P0.05).At 20 d after treatment, the mean tumor volume of group A [(186.75?8.14)mm3] and group B [(72.50?6.70)mm3] was also reduced compared with that of group C [(441.76?41.80)mm3] (P

Objective To evaluate the values of DWI normalized ADC value in breast MRI in the differential diagnosis of benign and malignant breast lesions.Methods The absolute value of ADC,normalized ADC value and T1 WI dynamic contrast-enhanced TIC were analyzed in 49 patients with benign and malignant breast lesions;the efficiencies of single method diagnosis and combined diagnosis were assessed.Results When b=1 000 s/mm2 ,the absolute value of ADC <1.25×10 -3 mm2/s was taken as the thresh-old value for the diagnosis of malignant breast lesions,the area under the ROC curve was 0.818,the sensitivity was 73.9% and the specificity was 84.6%;the normalized ADC value <0.55 × 10 -3 mm2/s was taken as the diagnostic threshold,the area under the ROC curve was 0.901,the sensitivity was 87.0% and the specificity was 88.5%,there was a significant difference between both values.The lesions with a wash-out type of T1 WI dynamic contrast-enhanced TIC were diagnosed as malignant lesions,the sensitivi-ty was 89.5% and the specificity was 70.0%.The absolute value of ADC and T1 WI dynamic contrast-enhanced TIC were applied combinedly,the predicted percentage correct was 81.6% for the diagnosis of breast lesions,while the normalized ADC value and T1 WI dynamic contrast-enhanced TIC were applied combinedly,the predicted percentage correct was increased,which was 89.8%. Conclusion Normalized ADC value has a higher sensitivity and specificity in differentiating benign and malignant breast lesions,its combined application with T1 WI dynamic contrast-enhanced TIC can improve the diagnostic performance of breast lesions.

Objective To investigate the distribution and antibiotic resistance of gram-negative bacilli for better antimicrobial therapy in our hospital.Methods A retrospective analysis was conducted for the 1 060 strains of gram-negative bacilli isolated from clinical specimens during 2013.Results Of the 1 060 gram-negative bacterial strains isolated during 2013,E.coli,K . pneumoniae,P .aeruginosa and A.baumannii were the leading pathogens,accounting for 29.3%,22.8%,11.5% and 9.9%,respectively.The prevalence of extended spectrum-lactamases (ESBLs)positive strains was 63.7%,32.2% and 28.0% in E.coli,K .pneumoniae and P .mirabilis,respectively.The Enterobacteriaceae strains were highly sensitive to carbapenems.The percentage of the P .aeruginosa isolates resistant to meropenem,imipenem or amikacin was lower than 30%.The percentage of the Acinetobacter spp.(A.baumannii accounted for 70.9%)strains resistant to meropenem and imipenem were 25.0% and 26.2%.Conclusions Most of the gram-negative bacilli are resistant to multiple antimicrobial agents. We should strengthen the monitoring of the antibiotic resistance of gram-negative bacilli and optimize antimicrobial therapy.

Objective To estimate the prevalence of Glucose‐6‐phosphate dehydrogenase(G6PD) deficiency in Zhongshan area . Methods The activity of G6PD in red blood cells was determined by using ultra‐violet rate method for neonates ,couples of child‐bearing age and suspected patients who had clinical symptoms in Zhongshan area from 2012 to 2013 .Results The total detection rate of G6PD deficiency was 4 .37% (1 030/23 595);in male the detection rate was 9 .42% (513/5 447);in female the detection rate was 2 .85% (517/18 148) .Conclusion The incidence of G6PD deficiency were high in Zhongshan area .Therefore ,more attention should be paid to the screening of the disease in neonates and couples of childbearing age so as to reduce the incidence of G6PD defi‐ciency and prevent the complications caused by the disease .

Objective To determine the efficacy of berberine in the treatment of non-alcoholic steatohepatitis ( NASH) , and to investigate the regulating effect on macrophage phenotype transformation in hepatic tissue on methionine -choline deficiency (MCD) diet induced NASH mice.Methods Fourty male C57BL/6 mice were randomly divided into 4 groups (10 mice per group): the normal group (fed with normal diet), the NASH model group (fed with MCD diet), rosiglitazone treatment group (30mg/kg) and berberine treatment group (150mg/kg).Drugs were adopted in the preventive intervention method for 2 weeks.The hepatic histopathological method was adopted to evaluate the drug therapeutic effect.The serum levels of tumor necrosis factor-α(TNF-α), interleukin(IL)-6, and IL-10 were examined with ELISA method.M1 and M2 phenotype were detected by flow cytometry .Results The results showed berberine improved the degree of hepatic histopathology .Berberine not only reduced the level of TNF-α, but also increased the level of IL-10 in serum on NASH mice significantly ( P <0.05 ) . Flow cytometry data indicated that berberine decreased M 1 type macrophages and increased M 2 type macrophages in liver tissue .The ratio of M1/M2 was significantly decreased in berberine and rosiglitazone treated group ( P <0.01 ) .Conclusion Berberine may improve the hepatic pathological process in MCD diet induced NASH model possibly through modulating macrophage phenotype transformation , i.e.The ratio of M2 type is more than M1 type in hepatic tissue , and increasing anti-inflammatory cytokines .

ObjectiveTo discusses the MSCT multiplanar reconstruction manifestation (MPR) of localized fat collection adjaction to subdiaphragmatic inferior vena cava (IVCfat).MethodsThe thoracic and abdominal MSCT scan data of 8246 patients were browsed,45 patients with presumed IVCfat on axial CT scans were further studied prospectively with MSCT MPR.The predisposing position of IVCfat and its relationship with IVC were observed.It was divided into two kinds of intraluminal type and extraluminal type according to the angle of IVCfat with respect of the wall of IVC.The other 50 patients without IVCfat were randomly selected as the control group.The sagittal inclination angle (SIA) and diameter ratio (DR) between supra- and sub-diaphragmatic IVC between the two groups were compared by using t test.Results The detection rate was 0.55％ (45/8246).Of which hepatic vein lacuna 8 patients,subdiaphragmatic gap medial to IVC 28 patients and IVC groove 9 patients.The shape of IVCfat showed mainly for the round,oval and crescents on axial CT scans,of 15 patients intraluminal type,4 showed target signs .The shape of IVCfat showed mainly for half-moon at MPR.The SIA and DR at IVCfat group were 21.62° ± 8.42°and 2.01 ±0.84 respectively,at control group were 16.75° ±7.82°(t =1.594,P ＞0.05) and 1.31 ±0.28(t =2.341,P ＜ 0.05 ) respectively.ConclusionThe round,oval or half of limited fat density shadow adjaction to subdiaphragmatic inferior vena cava which similar to in the lumen is the characteristic performance of IVCfat,it may be an anatomical variation.

ObjectiveTo assess the safety and efficacy of retrograde ureteroscopy lithotomy (URSL)assisted antegrade percutaneous nephrolithotomy (PCNL) for complex upper ureteral calculi in semisupine-lithotomy position.MethodsFrom March 2007 to December 2010,a total of 95 patients with complex upper ureteral calculi underwent retrograde URSL assisted antegrade PCNL in semisupine-lithotomy position.Ureteral calculi size was 12 mm × 6 mm to 38 mm × 15 mm,24 cases combined with renal calculus.Firstly retrograde URSL was performed,once the stone fragments moved up to renal pelvis,a 16-22 F PCNL working channel was established under the ultrasound guidance through which lithotripsy was performed using an ureteroscope.Finally a 6-7 F double-J tube was indwelled.ResultsOperations were successfullycompleted in 93 patients.However,in it 2 patients were converted to open surgery because of significantureteral distortion due to previous open surgery.Operative time was(42.7 ± 14.9) min; estimated blood loss was(34.5 ± 26.1 ) ml.The ureteral calculi clearance rate was 100.0％,and renal calculus clearance rate inthose combined with renal calculus was 95.8％ (23/24).There were no major intraoperative and postoperative complications excepted early urinary leakage in 2 cases and fever ≥39℃ in 3 cases.ConclusionsRetrograde URSL assisted antegrade PCNL in semisupine-lithotomy position is safe and feasible for complex upperureteral calculi,especially non-opaque calculi,combined with renal calculus,easily ascending ureteral calculi and large calculi burden which has low calculi clearance rate after URSL.The outcomes are encouraging with fewer complications.It also avoids intraoperative change of patient's position.

BACKGROUND:Smooth muscle cells and transitional epithelial cells were traditionally used to construct tissue-engineered bladder and to perform double-sided implantation of scaffold.However,double-sided implantation is difficult to perform,because smooth muscle cells are difficult to isolate or culture in vitro and passage is limited.OBJECTIVE:To verify the feasibility of tissue-engineered bladder reconstruction with bone marrow mesenchymal stem cells(BMSCs)and bladder acellular matrix(BAM).DESIGN:A basic empirical study.SETTING:Linbaixin Medical Research Center,Second Affiliated Hospital,Sun Yat-sen University.MATERIALS:Experiments were performed at the Linbaixin Medical Research Center,Second Affiliated Hospital,Sun Yat-sen University from March 2006 to Mav 2007.The laboratory was the Opening Laboratory of Hospital Affiliated to Health Department of China.One-month old SD rats of either sex,weighting 80-100 g were provided by Animal Experimental Center of Sun Yat-sen University.Fresh porcine bladders were offered by Animal Experimental Center of Southern Medical University.METHODS:Whole bone marrow culture and successive adherence method was used to culture rat BMSCs in vitro.Flow cytometry was employed to detect surface antigen.Eradicator washing method was applied to prepare porcine BAM and measure its purity and characteristies.Third passage of BMSCs were inoculated in BAM and cultured in a medium containing vascular endothelial growth factor(VEGF165)(25 ng/L)in vive and in vitro to test compatibility.Cells cultured alone were considered to be controls for the in vivo trial,and materials non-implanted with cells were considered to be controls for in vitro trial.Suitable microenvironment was simulated to induce the differentiation of BMSCs.Four weeks and eight weeks later,compound materials were respectively removed to perform tissue section test.Simultaneously,immunohistochemistry keratin staining was conducted to examine regeneration of epithelial cells.MAIN OUTCOME MEASURE:Biocompatibility of BMSCs and BAM.RESULTS:①BMSCs were cultured by whole bone marrow method.Flow cytometry demonstrated that third passage of cells were positive for CD29(99.43%).②BAM had good biological characteristics.Homogen matrix and byssoid collagen appeared under a microscope.Compatibility trials showed good compatibility of BMSCs and BAM and well-growth cells.③Four weeks later,histological section test confirmed inflammatory cell infiltration,closely-arranged collagen and elastic fiber.Immunohistochemistry keratin staining showed lamellar and discontinuous simple epithelium.Eight weeks later,no inflammatory cell infiltration was found,and closely-arranged collagen and elastic fiber were detected.Immunohistochemistry keratin staining showed lamellar and continuous multiple epitheliums.CONCLUSIoN:With good compatibility,BMSCs and BAM appear to be an ideal material for bladder tissue engineering.