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.

Objective To evaluate the clinical diagnostic significance of clinical laboratory indexes of anti-CCP,rheumatoid factor (RF),C reactive protein(CRP)and erythrocyte sedimentation rate(SR)in rheumatoid arthritis.Methods Anti-CCP,RF and CRP were quantitatively tested in 90 patients confirmed as rheumatoid arthritis(RA)and 93 patients with non-rheumatoid arthritis(non-RA)diseases by the electrochemiluminescence immunoassay(ECLIA),immunization rate scattering turbidimetry,etc.T test results were performed the statistical and comprehensive analysis by using the ROC curves.Results The levels of anti-CCP and RF had statistical differences between the RA group and the non-RA group(P <0.05 ),while there was no statistically significant differ-ences in the levels of CRP and SR(P >0.05 ).The areas under ROC curves(AUC)of anti-CCP,RF,CRP and SR were 94.0%, 84.0%,51.7% and 56.5% respectively;the sensitivity of anti-CCP and RF was 90.0% and 74.4% respectively,while the specifici-ty was 94.6% and 86% respectively;the Youden indexes were 84.6%and 60.4% respectively;the diagnostic sensitivity of CRP was only 52.2% and the diagnostic specificity of SR was only 50.5%.Conclusion Anti-CCP and RF have the good diagnostic value for RA,moreover the diagnostic performance of anti-CCP is better than RF;CRP and SR have the poor diagnostic preformance,the combination of above indexes has more clinical significance for diagnosing RA.

Objective To investigate factors affecting residual stones in pediatric patients with the upper urinary calculi un ‐dergoing minimally invasive percutaneous nephrolithotomy (MPCNL ) and evaluate MPCNL curative effect before the operation . Methods A total of 240 children underwent MPCNL to remove the upper urinary calculi in People′s Hospital of Xinjiang Uygur Autonomous Region during the period of January 2009 to November 2014 were analyzed retrospectively .Pediatric patients were di‐vided into two groups by the stone‐free rate after the first operation :those who were stone‐free after the first operation (n= 202) as the control group and those who were residual stones (n= 38) as residual stones observation group .Then the clinical data were sta‐tistically analyzed and find out risk factors which lead to residual stone .Results The stone‐free rate after primary M PCNL was 84 . 2% (202/240) .Univariate analysis showed that stone size (P= 0 .001) ,stone location(P= 0 .014) and number of stones(P= 0 .005) were significant factors which could affect residual stones between the two groups ,while did not relate with gender ,age ,stone side , urinary irritation symptom ,hematuria ,renal colic ,preoperative infection and the degree of hydronephrosis (P > 0 .05) .Multivariate analysis showed that stone size(OR = 2 .593 ,95% CI :1 .228 - 5 .475) ,stone location(OR = 2 .674 ,95% CI :1 .290 - 5 .540)and num‐ber of stones(OR = 2 .397 ,95% CI :1 .145 - 5 .019)were independent predictors of the surgical outcome .Conclusion Stone size , stone location and number of stones are significant factors affecting residual stones in pediatric patients with the upper urinary cal ‐culi undergoing MPCNL .According to the the clinical features of pediatric patients ,we can chose suitable management of upper uri‐nary tract calculi .

Objective The health risk behaviors of undergraduates exist universally, which can induce other social problems. The aim of this study was to describe the present situation and analyze the influencing factors of health risk behaviors of 404 undergradu-ates. Methods Adolescent Health Related Behaviors Questionnaires were conducted in 404 undergraduates chosen from a University in Nantong by stratified cluster sampling method.Logistic regression and multiplicative interactive effects were adopted to analyze the influ-encing factors. Results Health risk behaviors were common among college students.In the past 30 days, 33.4%of students had rule-breaking behaviors in bicycle riding and 45.3%had rule breaking behaviors in walking.In the past 12 months, 2.7%of students had in-tentionally hurt themselves, 2.5%had suicidal inclination, 19.8%had smoking history, 69.3%had drinking history, 7.4%participa-ted in the gambling, 7.7%and 11.9%played video games and surfed online over 4 hours everyday, respectively, and 4.5%of students have had sex.In the past 30 days, 94.3% of students lost their weight through the unhealthy way, and 37.8%of students participated physi-cal exercise over 60 minutes for at least 3 days in the past 7 days.Lo-gistic regression indicated that male, higher grade and higher education level of the student′s mother were the risk factors of some health risk behaviors.Interactive effect was not found between the different influencing factors. Conclusion Health risk behaviors exist widely a-mong college students and more attention should be paid to risk behaviors of college students.Health behaviors should be trained among adolescents to improve their overall health level.

Objective To study the anxiety and depression in patients with amyotrophic lateral sclerosis(ALS).Method One hundred and seventy-four ALS patients were evaluated by self-rating anxiety scale(SAS)and self-rating depression scale(SDS) to study the anxiety and depression in them.Results In 174 ALS patients,21 had anxiety(12.07%)and 65 the depression(37.36%). The scores of SAS and SDS in the ALS patients were significantly higher than the national norm(P<0.05).The depression incidence in the female patients was significantly higher than the male(P<0.05).Conclusions Anxiety and depression are more severe than those in ALS patients than those in normal people.Psychological support is important for these patients,especially for those female patients.

Objective In this study,we aimed at investigating the clinical,laboratory and management characteristics of adolescent-onset SLE patients compared with adult-onset SLE patients.Methods 470 fe- male patients with SLE were divided into two subgroups:adolescent-onset SLE patients and adult-onset SLE patients.The analyzed variables included clinical,laboratory parameters,damage index and outcome charac- teristics.Results In 470 female patients with SLE,there were 98(20.85%)adolescent-onset SLE patients. The following manifestations occurred more frequently in adolescent-onset SLE patients:malar rash,cutaneous vasculitis,proteinuria and abnormal liver function.Adolescent-onset SLE patients had more severe disease features and had significantly higher mean value of SLEDAI.Mortality was higher in adolescent-onset SLE pa- tients than aduh-onset SLE patients.Renal and blood system were the organs that most frequently involved. Conclusion Adolescent-onset SLE patients accounts for roughly 20.85% of all SLE cases.It is necessary to pay more attention to adolescent-onset SLE patients because the management for them is usually more difficult and the prognosis is usually poorer than aduh-onset SLE patients.

Objective:To study the role of protein kinase C-δin the Dectin-1-Src-Syk-mediated killing of Candida albicans by macrophages and investigate the molecular mechanism of antifungal innate immunity .Methods:Cell surface receptors were accessed by Flow Cytometry.Mouse bone marrow derived macrophages were pre-incubated with different protein kinase inhibitors and then stimulated with C.albicans.The phosphorylation of related proteins was determined by Western blot.The ROS production,phagocytosis and killing of C.albicans by macrophages were measured.Results:Either Src or Syk inhibitor reduced C.albicans induced PKC-δphos-phorylation.PKC-δinhibitor Rottlerin reduced p40phox phosphorylation,ROS production and killing of C.albicans but had no effect on the phagocytosis of C.albicans by macrophages.Conclusion:PKC-δinhibitor Rottlerin reduced the killing of Candida albicans by mac-rophages through the inhibition of NADPH complex activation and ROS production ,suggesting that PKC-δplays an important role in an-tifungal innate immunity.

The aim of this study is to prepare self-microemulsifying drug delivery system (SMEDDS) of the mixture of paeonol (Pae) and borneol (Bor). Solubility test, ternary phase diagrams and simplex lattice method were employed to screen and optimize the formulation of the mixture of Pae and Bor-loaded SMEDDS. After formed into microemulsions, the particle diameter (PD) was determined and a TEM was employed to observe the microemulsions' morphology. The contents of Pae and Bor were determined by gas chromatography. As a result, while ethyl oleate (EO) as the oil phase, cremophor EL35 (EL35) as surfactant and Transcutol HP (HP) as cosurfactant, the range of the microemulsion on the ternary phase diagram was larger than other combinations. And at a ratio of 20:45:35, the microemulsions' PD was about 34 nm and the polydispersity index (PI) was about 0.2. There were 16% of Pae, 2% of Bor, 16% of EO, 37% of EL35 and 29% of HP in the prepared SMEDDS. The preparation process of the Pae and Bor-loaded SMEDDS based on Xingbi Fang is simple and feasible. This study provides a reference for the researches on the related traditional Chinese medicine and the related components.

Objective To understand the expiration date of alcohol-based hand disinfectant after it is opened for use,and provide reference for rational clinical application of alcohol-based hand disinfectant.Methods 20 bottles of the same brand alcohol-based hand disinfectant which opened at the same time by the clinical departments were selected as the study object,hand hygiene compliance in theses departments ranked fourth from the end in the hospital,specimens were taken on the first day after opening,and repeated every 10 days until the disinfectant was used up.Hand specimens were also taken after disinfected by disinfectant.Qualified condition of disinfectant and hand specimens was detected.Results A total of 98 disinfectant specimens were collected,by naked eye observation,20 bottles of alcohol-based hand disinfectant were free of discoloration,precipitation,and suspended matter during the whole study period.The qualified detection rates of alcohol-based hand disinfectant within 60 days after opening were all 100%.44 hand specimens were taken and detected after disinfection,3 of which were unqualified(all were disinfected by alcohol-based hand disinfectant 50 days after opening),then detected again after disinfected by the same batch of disinfectant,all were qualified,which suggested that unqualified detection result of hand specimens was not due to disinfectant.Conclusion Alcohol-based hand disinfectant still has a good bactericidal effect on the sixth day after opening.

Objectives To analyze the relationship between the multi-organ hypoxia damage and the death of acute high altitude sickness severe case. Methods 3220 cases from 1956. 06 to 2005.06 in the hospital were reviewed by questionnaire and the cases in MODS or death were screened out. The cause of death and feature were analyzed by the data as clinical symptom, physical signs and auxiliary examination. Results 281 cases complicated by MODS (include 35 dead cases) were found out by review. The incidence with MODS is 8.73% , and the death rate was 1.09%. The masculine incidence rate of the clinical symptom, physical signs and auxiliary examination in death were 2. 86% ~65. 71% , 2. 86% ~ 100% and 14. 29% ~ 100% , respectively. The MODS incidence in dead cases was 100%. Compared with the curing group, the MODS number, cardiac functional disturbance, brain disorder and renal functional disturbance in the death group had a significantly high incidence rate in all the 281 cases with MODS( P <0.05). With dependability analysis, there were a significantly direct correlation relationship between the death in the severe cases with acute high altitude sickness and the number of MODS ( r = 0. 3473, P < 0.001). Conclusion Hypoxia to the damage of multi-organ function play an important role in death of the severe cases with acute high altitude sickness in high attitude area, and the functional disturbance of important organs as heart, brain and kidney is the most important cause to death.