Objective To compare the efficacy of three procedures,extracorporeal shock wave lithotripsy(ESWL),ureteroscopic lithotripsy(URL) combined with ESWL,and minimally invasive percutaneous nephrolithotomy(MPCNL),for the treatment of complicated upper ureteral calculi.Methods Two hundred and thirty-four cases of complicated upper ureteral calculi were treated in this hospital from December 2002 to December 2003,including 76 cases of ESWL,78 cases of combined use of URL and ESWL,and 80 cases of MPCNL.Results In the ESWL cases,the stone fragmentation rate on one session was 56.6%((43/76),) the stone-free rate one month after operation was 46.1%(35/76),the mean hospitalization expenditure was 912 yuan,and the incidence of postoperative complications was 15.8%(12/76).In the URL combined with ESWL cases,the stone fragmentation rate on one session was 100%(78/78),the stone-free rate one month after operation was 83.3%(65/78),the mean hospitalization expenditure was 7 720 yuan,and the incidence of postoperative complications was 15.4%(12/78).In the MPCNL cases,the stone fragmentation rate on one session was 100%(80/80),the stone-free rate one month after operation was 100%(80/80),the mean hospitalization expenditure was 10 253 yuan,and the incidence of postoperative complications was 13.8%(11/80).The operation time,intraoperative blood loss,length of hospital stay,stone-free rate one month after operation,and hospitalization expenditure were significantly greater in the MPCNL cases than in the ESWL cases and the URL combined with ESWL cases.The stone fragmentation rate on one session was not significantly different between the MPCNL cases and the URL combined with ESWL cases,and was significantly higher in the MPCNL cases and the URL combined with ESWL cases than in the ESWL cases.The incidence of postoperative complications was not significantly different among the three groups.Conclusions Minimally invasive percutaneous nephrolithotomy should be used as the first choice for complicated upper ureteral calculi.

SWI/SNF is an ATP-dependent chromatin remodeling complex .ARID1 A gene is an important subunit of SWI/SNF complex and its dysfunction can cause abnormal chromatin remodeling , resulting in tumorigenesis .AR-ID1A occurs frequently low expression or deletion mutation in a variety of malignant tumors , such as ovarian canc-er, liver cancer, breast cancer, stomach cancer, lung cancer and so on, which indicates that ARID1A is an impor-tant tumor suppressor gene .

Objective To investigate the influence of topiramate(TPM) on quantitative pharmacoelectroencephalography (QPEEG) in normal subjects and epilepsy patients. Methods EEG were recorded in normal and epileptic subjects prior to and at 0.5,1,2,4,6,8,12,24 hours after the administration of single dose of TPM.The EEG power spectral activity including the absolute power,percent of power,total power in both occipital and total power of the whole scalp areas were calculated through 30 s epochs without artifacts after each recording.The statistical difference between baseline assessment and each post-drug time point was analyzed by the Wilcoxon matched-paired rank test. Results The power of sloe wave(peak value 66.76 ?V 2),?1-band (peak value 57.33 ?V 2)and total power (peak value 385.12 ?V 2)was increased after the administration of TPM and the total power of the whole scalp areas was also increased(peak value 2 500.75?V 2).The percent of power of ?-band(peak value 12.4%) and ?1-band(healthy control,peak value 17.5%) or ?-band(patient,peak value 13.94%)was increased,while ?3-band(healthy control,lowest value 10.4%) decreased. Conclusion TPM might change the background activity of EEG that was different from other antiepilepsy drugs.

Objective To evaluate mini-percutaneous nephrolithotomy in treating proximal ureteral calculi. Methods 109 patients underwent mini-percutaneous nephrolithotomy for proximal ureteral calculi from March 1998 to July 2001 were reviewed and evaluated. Results All the 109(100%) were rendered stone-free at 1 session.The average operation time was 60 munites,the estimated blood loss volume 25 ml and the average hospitalization 7 days.No major complications were noted. Conclusions Mini-percutaneous nephrolithotomy is safe and effective in treating proximal ureteral calculi and is less invasive for the patients.

Objective To summarize the experience of ES WL and PCNL management for pediatric renal calculi. Methods We retrospectively reviewed the clinical data 105 cases.The series consists of 33 girls and 72 boys.The average age was 8.7 years.Of the 105 children,21(20. 0%) had urinarytract abnormality.68 cases were treated with ESWL,33 with mini-P CNL,and 4 cases with residual stone fragments were treated with min-PCNL and ES WL.Four children underwent open procedures. Results 92 s essions of ESWL were performed in 68 children,57(83.8%)became stone-free.Among them 47 cases ( 69.1 %) were cured by one ESWL session,18 cases(26.5%)had two sessions,three children had three sessions.Two cases who had ureteral steinstras se were rendered stone-free by ureteroscopy.Among 33 children managed by mini- PCNL,24 (72.7%) were cured by one PCNL session,9(27.3%) by two sessions,three pa tients with UPJ obstruction underwent antegrade pyeloureterotomy at the same tim e.Stones were cleared using one PCNL session in 24(72.7%),2 sessions in 29(87.9% ),4 patients were cured with ESWL and mini-PCNL.The overall success rate was 97 .0%.2 of 4 cases in open procedures were performed by means of pyeloplasty,one p atient had residual stone fragments after open surgery. Conclusions ESWL is the first-line treatment for renal calculi in children.PCN L is a option but based on stones status,instrumental and technical conditions. Combining PCNL with ESWL had better outcome.

Objective To evaluate the treament of central retinal artery occlusion by thrombolysis infusion via super selective ophthalmic artery catheterization.Design Retrospective,observational case series.Participants 21 eyes of 21 patients with CRAO. Methods 21 patients with CRAO were diagnosed by stereoscopic color fundus photography and flouorescein fundus angiography, and were treated by urokinase infusion via super select ophthalmic artery catheterization seldinger technique.Main Outcome Measures Visual acuity and the postoperative complications.Results In the 21 patients,10 had showed the occlusion of ophthalmic arterial trunk by super selective internal carotid artery angiography,the others can be found the appearance of ophthalmic arterial trunk and all patients had undergone thrombolysis therapy successfully.Imaging times of central retinal artery before and after thrombolysis infusion treatment are 38.18?10.86 seconds,12.65?3.30 seconds(t=-11.89,P=0.000).Mean foflow-up time is 3.23?1.26 months.After the treatment,the visual acuity was more than 0.25 in 4 patients,improved to different extent in 9 and remained unchanged in 8. Conclusions Super selective arterial catheterization with thrombolysis for CRAO can improve the visual acuity of the patients,a speedy execution of all internal,neurological,and ophthalmology diagnostic measures;and a prompt therapy are necessary.

Objective The quantitative pharmacoelectroencephalography ( QPEEG ) of many antiepileptic drugs (AEDs), such as carbamazepine, valproic acid, phenobarbital and topiramate but not levetiracetam (LEV), have been studied. This study is to investigate the effect of LEV on QPEEG. Methods One dose of LEV at l g was administrated to 12 healthy adults (6 males, average age at 26 years, average height at l.67 m). The EEG samples (of 180 seconds each) were obtained prior to and at regular intervals ( 1, 1.5, 2, 3, 4, 6, 7, 8, 12, 24 hours) after administration of LEV. The EEG activity was processed with the power spectral analysis and separated into different frequency bands. The absolute powers of both occipital and frontal lobes were calculated through 30 seconds epochs without artifacts for each recording. The statistical difference between baseline pre-drug control and each post-drug assessment was evaluated by the Wilcoxon matched-paired rank test. Results The power of α1-band and β-band increased bilaterally over both frontal and occipital lobes after the administration of LEV. There was no change of α2-band over bilateral frontal lobes, but increased in double peaks shape with the low point at the 6 hours after the administration. The power of α1-band showed the significant change after the administration at the 1.5 hours (18.8950, Z= -3.059, P=0.002) in the left front, 3 hours (18.6150, Z= -2.981, P =0.003)in the right front, 1.5, 2, 3 and 4 hours (61.0233, 53.9425, 47.6192 and 51.8250 respectively, Z =-3.059, -3.059, -2.903 and -3.059, all P ＜ 0.01 ) in the left occipital, and 1, 1.5, 2 and 3 hours (53.5358, 56.8092, 50.3500 and 47.1733 respectively, Z = -2.903, -3.059, -3.059 and -2.981,all P ＜ 0.01 ) in the right occipital. The power of α2-band showed the significant change after the administration at the 3 hours (73.5450, Z = - 3.059, P = 0.002) in the left occipital, and 1, 3 hours (80. 6808 and 87. 1750, Z = -2.903 and - 3.059, P = 0.004 and 0.002 respectively ) in the right occipital. The power of β-band showed the significant change after the administration at the 3 hours (3.8000, Z = -3.059, P = 0.002) in the left front, 1.5, 2 and 3 hours (4.0408, 4.3217 and 4. 1050,Z= -2.903, -3.059 and -3.061, all P＜0.01) in the right frontal, 3 hours (9.1408, Z= -3.059,P =0.002) in the left occipital, and 1.5, 3 hours (8.9267 and 9.3033, Z = -2.981 and -2.981, both P = 0.003) in the right occipital. Conclusions LEV can change the background activity of QPEEG. The changes are different from those of the other AEDs.

ObjectiveTo investigate the effects of topiramate (TPM) on complexity of electroencephalography (EEG) by means of quantitative pharmacoelectroencephalography (QPEEG) and nonlinear analysis methods.MethodsOne dose of TPM was administrated to epileptics and healthy adults. The EEG samples were obtained prior to and at regular intervals (at 0.5, 1, 2, 4, 6, 8, 12, 24 hours after the administration) within 24 hours following the administration of TPM. The EEG activity was processed with the nonlinear analysis methods. The complexity measure, approximate entropy, Lyapunov exponent and fractional dimension of the whole scalp areas were calculated through 60 seconds epochs without artifacts after each recording. The statistical difference between baseline predrug assessment and each postdrug control was described by analysis of variance.ResultsThe Lyapunov exponent was increased first, then decreased, and then increased finally (the maximum value was 0.44 in both centrals in the healthy people). The approximate entropy and fractional dimension showed the tendency of descent, the complexity measure decreased in healthy adults (the least value was 0.34 on right parietal), but increased in patients (the maximum value was 0.34 in right posterior temporal).ConclusionTPM might change the complexity of EEG.

Objective To reveal the cerebral activation areas related to semantic processing of language functions in patients with temporal lobe epilepsy(TLE).Methods 6 patients with left-TLE,6 patients with right-TLE,and 6 controls,all right-handed,were studied using functional magnetic resonance imaging(fMRI)during a reversible words decision task.Their responses were recorded by key-press.The image data was analyzed by statistical parametric mapping 2(SPM2)including the individual statistical analysis and group analysis.Results There was no difference between the right-TLE patients and controls in cerebral activation,which included left inferior frontal gyrus,left middle frontal gyrus,left superior temporal gyrus,left middle temporal gyrus and bilateral cingulate gyrus,bilateral fusiform gyrus,bilateral basal ganglia,bilateral cerebellum(especially right).The activation in patients with left-TLE was atypically distributed relative to the controls,there were more activation in right inferior frontal gyrus,right precentral gyrus and left cuneus,left precuneus.Conclusion There is atypical distribution of the cerebral activation area related to semantic processing of language functions in patients with left-TLE,and enantiomorphous transformation is found in the contrelateral side of cerebrum.

Objective To report our experience with minimally invasive percutaneous nephrolithotomy (MPCNL) in treatment of renal calculi in solitary kidneys. Methods From August 2000 to August 2010, 242 patients with renal calculi in solitary kidneys were treated by MPCNL, the data were reviewed retrospectively. Results The mean operative time was 68 min, the clearance rates were 79.3% (192/242) after first session and 88. 0% (213/242) after second-look MPCNL and ESWL, respectively. Postoperative fever happened in 18 cases. Twenty-one cases required transfusion, 10 cases received angiography and embolization. One case experienced perirenal hematoma and 1 case had pneumatothorax. Conclusions MPCNL has the advantages of less bleeding, high clearance rate and short hospital stay. MPCNL is an effective and feasible treatment option for renal calculi in solitary kidneys and should be the first line choice.