Objective:To explore the clinical effect ofpaishitang combined with tamsulosin hydrochloride on the patient with up per urinary calculi after extracorporeal shock wave lithotripsy (ESWL).Methods:120 cases with upper urinary calculi in our hospital from January 2015 to September 2016 were selected and divided into two groups according to the random number table,60 cases in each group.ESWL was given to both groups of patients and provided with tamsulosin hydrochloride postoperation,then paishitang were additionally given to the patients in the observation group.The clinical effect and changes of serum creatinine (Scr),neutrophil gelatinase as sociated lipocalin (NGAL),cystatin C (Cys-C) and glomerular filtration rate (GFR) levels before and after treatment were compared between two groups.Results:The total effective rate of observation group was 96.67％,which was 86.67％ in the control group,no signifi cant difference was found in the total effective rate between the two groups(P＜0.05).The stone discharge rate was 95.00％ in the observation group,which was significantly higher than that of the control group (P＜0.05);the incidence rate of renal colic was 6.67％,which was significantly lower than that of the control group(P＜0.05),the stone discharge time and the duration of hematuria were significantly shorter than those in the control group (P＜0.01).There was no significant difference in the recurrence rate between the two groups within one year (P＞0.05).The serum NGAL and Cys-C levels of both groups were gradually increased while the GFR levels were gradually decreased on the 1st,2nd day postoperation,but all the index mentioned above gradually recovered on the 3rd day postoperation.The levels of NGAL and Cys-C in the observation group were significantly lower than those in the control group on the 1st,3rd day postoperation while the GFR was significantly higher in the observation group than those of control group on the 1st,3rd day postoperation(P＜0.01).No significant difference was found in the Scr at different time points postoperation between two groups(P＞0.05).Conclusion:Paishitang combined with tamsulosin hydrochloride had significant clinical effect on thpatient with upper urinary calculus after ESWL and could effectively improve the renal injury induced by ESWL.

Objective To analyze the application of modified abdomen pathway for excising the adrenal huge pheoehromocytoma.Methods One patient(male,42-year-old)had adrenal huge pheochromocytoma.The pheochromocytoma was about 15.0 cm×8.0 cm×7.0 cm.After 3 weeks' preparations,the patient was operated.The operation was made through the modified abdomen pathway for excision,without excising the transverse on peritoneal,and the interference to organs of peritoneal was reduced.The tumor on adrenal gland adhered kidney very tightly.Expanded radical excision including tumor,kidney,adrenal gland was applied.Results The operative time was 300 rain and the volume of bleeding was about 1000 ml.In the operation process,blood pressure of the patient was stable,the visual field of operation was satisfactory.Blood pressure of the patient returned normal 6 months postoperatively.And there was no indication of tumour relapse or matastasis.Conclusion The modified abdomen pathway can expose the satisfactory visual field,and is safe and effective for adrenal gland tumor operation.

Objective:To explore the expression of cyclooxygenase-2(COX-2) and S-100 positive dendritic cell in laryngeal carcinoma tissue and their clinical significance.Method:Sixty-five samples of laryngeal carcinoma and thirty-four biopsies of adjacent noncancerous tissue were obtained. Immunohistochemical technique(SP method) was used to detect the expression of COX-2 and S-100 positive dendritic cell, and the relationship of their expression with clinical pathological parameters and prognosis was analyzed.Result:The rates of COX-2 expression were 63.08%(41/65)and 14.70%(5/34)in laryngeal carcinoma and control group, respectively. The difference was significant(P＜0.05).The positive expression of COX-2 was correlated with T and clinical stage in laryngeal carcinoma(all P＜0.05).The rates of S-100 positive dendritic cell expression were 61.54%(40/65)and 0 in laryngeal carcinoma and control group, respectively. The difference was significant(P＜0.05).S-100 positive dendritic cells showed significant differences between early and late clinical stage and lymph node metastasis (all P＜0.05).Kaplan-Meier survival analysis showed that patients with positive expression of COX-2 and S-100 positive dendritic cell had worse disease-free and overall survival(P＜0.05).Cox regression analysis showed that S-100 positive dendritic cell was indicated as an independent prognostic factor for survival(P＜0.05).Conclusion:COX-2 and S-100 positive dendritic cell are highly expressed in laryngeal carcinoma tissue. It suggests that the expression of COX-2 and S-100 positive dendritic cell is related to the process of carcinogenesis and may be the important indicators in laryngeal carcinoma for prognosis.

Objective To study the epidemiological features of the endemic arsenism in Hohhot of Inner Mongolia in 2004-2006 in order to get scientific evidence for the control and prevention. Methods The historical data in Huhhot revealed that 51 arsenic villages in 3 counties(Tumotezuo,Tuoketuo and Helingeer) were investigated. When arsenic content in drinking water was 0.05-0.15 mg/L,the situation of endemic arsenism was investigated in the households having high arsenic contents of water. When arsenic content in drinking water was greater than 0.15 mg/L,the survey was conducted to investigate arsenic patients with census. Census rate was not lower than 90%. Patients of endemic amenism were diagnosed by The Standard of Diagnosis for Endemic Arsenism (WS/T 211-2001). Results A total 28 083 people were examined,3978 were determined to be patients with arsenism,including 1722 being suspicious, 1897 mild,329 secondary and 30 severe. The total incidence of arsenism was 14.17% (3978/28 083),while the incidence of suspicious,mild,secondary and severe disease was 6.13% (1722/28 083) ,6.75% (1897/28 083),1.17% (329/28 083) and 0.11% (30/28 083),respectively. Suspicious and mild patients were most frequently seen. The incidence of dyspigmentation,pigmentation,ketatoses,both dyspigmentation and pigmentation and all of skin disorders was 8.65% (2428/28 083),3.19% (895/28 083),6.48% (1821/28 083),2.13%(598/28 083) and 0.94%(265/28 083),respectively. The most seen skin disorders were dyspigmentation and ketatoses. The disease mostly occurred in those aged over 40 years,the incidence was 89.52% (3561/3978). The incidence of male [15.08%(2209/14 644)]was more than that of female[13.16%(1769/13 439)].Conclusions Current condition of arsenism in Hohhot is mild,arsenic disease surveillance should keep going. Prevention and control needs to be reinforced in the future.

Objective To evaluate the surgical technique and clinical significance of the therapy for ankle soft tissue defect with 2 different flee perforator flaps.Methods Twenty-five cases of ankle soft tissue defect with exposed bone of the ankle were involved in this study from August 2006 to April 2012.and the wound sizes varied from 4.0 cm × 5.5 cm to 11.0 cm × 23.0 cm.Twenty cases with acrotarsium soft tissue defect were repaired by free anterolateral thigh perforator flap,five cases with pelma soft tissue defect were repaired by free saphenous artery perforator flap.Results All Twenty-five flaps survived.At 3 to 50 months follow-up [on an average of (18.0 ± 0.8) months] postoperatively,appearance of the flaps was satisfactory,with 10 to 22 mm in 2-PD,and the sensation percentage beyond S2+ was 13/20 cases and 5/5 cases at 3 months follow-up,respectively.Conclusion The optimal therapy for the acrotarsium soft tissue defect is the free perforator anterolateral thigh flap,and free saphenous artery perforator flap should be used for pelma soft tissue defect.Avoid secondary orthopaedic surgery,pay more attention to the donor site of the flap.VSD can significantly promoting the survival rates of the free perforator flaps if the soft defects are caused by open injury.

Objective To investigate the effect of cannabinoid receptor 1 ( CBR1 ) on spatial learning and memory function of neuropathic pain ( NP ) model rats and the expression of N-methyl-D-aspartic acid receptor 1(NR1) subunit in medial prefrontal cortex (mPFC).Methods Thirty-six healthy male Wistar rats were randomly divided into 4 groups, with 9 rats in each group: the sham operated group (SO group), the neuropathic pain model group (NP group), the NP model group with an mPFC injection of saline ( NS group ) , and the NP model group with an mPFC injection of the CBR 1 antagonist AM251 ( AM251 group).The NP model was prepared using the operation of chronic constriction injury ( CCI) of the right sciatic nerve.The mechanical withdrawal threshold ( MWT ) and the thermal withdrawal latency (TWL) of the rats in each group were detected at 3, 7, 14, 21 and 28 days after the operation.At 29 days after the operation , 18 rats of NP model were randomly selected and given an mPFC injection of saline or AM251 using a three-dimensional brain puncture.At days 30-37 after operation , the eight-arm maze test was performed to detect the spatial learning and memory function of the rats , and the rats were sacrificed immediately after this test.The expression levels of CBR1, NR1 and phosphorylated-N-methyl-D-aspartic acid receptor 1 ( p-NR1 ) ( Ser896 ) in the mPFC brain region were detected by Western blotting , RT-PCR and immunofluorescence.Results Compared with the SO group , the pain thresholds and the spatial learning and memory function of the rats in the NP group were significantly lower ( both P <0.05 ).Compared with the NS group , the rats in the AM251 group showed improvement about spatial learning and memory function ( P<0.05).Compared with the SO group ( the mRNA and protein level of CBR 1:0.23 ± 0.06,0.42 ±0.03), the mRNA(0.43 ±0.12) and protein (0.53 ±0.05) level of CBR1 in NP group increased (both P<0.05).Compared with the NS group (the mRNA and protein level of CBR1:0.42 ± 0.11,0.52 ±0.10), the mRNA (0.53 ±0.05) and protein (0.98 ±0.17) level of CBR1 in AM251 group increased (both P<0.05).Compared with the SO group (the mRNA and protein level of NR1 and the protein level of p-NR1:1.50 ±0.15,0.65 ±0.05,0.79 ±0.15), the mRNA (0.94 ±0.07) and protein (0.24 ±0.05) level of NR1 in NP group decreased (both P<0.05), the protein level of p-NR1 (0.33 ± 0.04) decreased (P<0.05).Compared with the NS group (the mRNA and protein level of NR1 and the protein level of p-NR1:1.09 ±0.14,0.26 ±0.06,0.31 ±0.08), the mRNA(1.58 ±0.10) and protein (1.42 ±0.10) level of NR1 in AM251 group increased (both P<0.05), the protein (0.95 ±0.15) level of p-NR1 increased ( P<0.05).Conclusion CBR1 can decrease the expression level of NR 1 and p-NR1 in the mPFC brain region of NP model rats and induce the spatial learning and memory impairment.

OBJECTIVE:To explore the effects of the different compatibility ratios of rutin with quercetin on the pharmacoki-netics of rutin in rats in vivo. METHODS:30 rats were randomly divided into rutin group(rutin-quercetin molar ratio of 4:0,the same below),quercetin group(rutin-quercetin ratio of 0:4),BL1 group(rutin-quercetin ratio of 3:1),BL2 group(rutin-quercetin ratio of 2:2)and BL3 group(rutin-quercetin ratio of 1:3),6 rats in each group,all group was administrated 10 mg/kg(calculat-ed by quercetin core of rutin and quercetin) intragastrically. The blood sample 0.3 mL was respectively taken from tail vein after 0.25,0.5,0.75,1,1.5,2,3,4,6,8,10,12,16,20,24 h of administration,the plasma concentration of quercetin(rutin me-tabolite) was determined by HPLC. DAS 2.0 software was used to calculate the pharmacokinetic parameters. RESULTS:The AUC0-24 h in rutin group,quercetin group,BL1 group,BL2 group and BL3 group were (4.908 ± 0.877),(8.382 ± 3.671), (8.473 ± 0.709),(4.366 ± 2.297),(8.914 ± 2.642)μg·h/L;MRT0-24 h were (9.675 ± 1.359),(3.142 ± 0.489),(3.517 ± 1.128), (3.376 ± 1.046),(4.494 ± 1.653) h;tmax were (5.726 ± 5.645),(1.375 ± 0.703),(1.125 ± 1.438),(1.417 ± 2.300),(1.292 ± 0.954) h;and cmax were (0.609 ± 0.202),(2.341 ± 0.539),(2.425 ± 1.217),(1.464 ± 0.677),(3.325 ± 2.425)μg/L. Compared with rutin group,AUC0-24 h and cmax in quercetin group,BL1 group and BL3 group were significantly increased(P<0.05),tmax and MRT0-24 h were significantly decreased(P<0.05);cmax in BL2 group was significantly increased(P<0.05),tmax and MRT0-24 h were significantly decreased(P<0.05). Compared with quercetin group,except AUC0-24 h was significantly decreased in BL2 group(P<0.05),there were no significant differences in AUC0-24 h,MRT0-24 h,tmax or cmax in BL1 group,BL2 group and BL3 group(P>0.05). CONCLUSIONS:Quercetin can inhance the related indexes of rutin in rats in vivo.

Objective To evaluate the long-term results of extended parietal cell vagotomy (EPCV) for the treatment of acutely perforated duodenal ulcer. Methods EPCV was performed on 239 patients. Results were analyzed retrospectively. Results Follow up was made on 203 out of 239 patients (84.9%). There was no operative mortality. Inhospital complications included injury to the spleen in 4 cases (1.7%), adhesive ileus in 6(2.5%), acute diarrhea in 3 (1.3%), and postprandial epigastric distention in 18 (7.5%). Long-term complications included epigastric pain and sour regurgitation in 16 cases(7.8%), enterolysis in 4(1.9%), duodenal bulb allaxis in 39(18.2%), chronic gastritis in 21(10.3%), and recurrent ulcer in 6(2.9%). Basic acid output, maximal acid output and peak acid output decreased by 84.7%, 60.0%, and 58.0% respectively(all P

OBJECTIVE To investigate the expression of Cyclooxygenase-2(COX-2)andVascular endothelial growth factor(VEGF)in laryngeal carcinoma tissue and its clinical significance. METHODS Sixty-five samples of laryngeal carcinoma and thirty-four biopsies of adjacent noncancerous tissue were immunohistochemically examined for expression of COX-2 and VEGF, whose relationship with clinicopathological parameters was also analysied. RESULTS Percentages of COX-2 and VEGF expression in laryngeal carcinoma tissue were 63.08% and 70.77% respectively, which were higher than those in adjacent noncancerous tissue(P

BACKGROUND: With an aging population increasing, the incidence of senile femoral intertrochanteric fractures is on a rise because of osteoporosis. Due to the aged usually accompanied with systematic diseases, conservative treatment will lead to high mortality after long-term bedridden. Thereafter, early surgery is recommended. OBJECTIVE: To investigate the incidence of femoral intertrochanteric fractures and its epidemiological features. METHODS: The digital radiography data and basic information of 179 patients (over 50 years of age) with femoral intertrochanteric fractures admitted in the General Hospital of Tianjin Medical University from 2013 to 2015 were analyzed retrospectively. The data including age, gender, injury causes, fracture types, complications, treatment procedures, and hospitalization time were recorded and compared. RESULTS AND CONCLUSION: All the 179 cases of femoral intertrochanteric fractures were enrolled, including 66 (36.9%) males and 113 (63.1%) females. The mean age was (76.98±9.73) years, and the number of patients aged 80-90 years was the most (n=71, 39.7%). With the age increasing, the incidence of fall-induced hip fractures was increased. By AO classification, type 31-A1 was the most common fracture type (46.4%), and type 31-A3 was the least common type (22.9%). By Evans classification, type I was the most common type (50.3%), and type V was the least common type (2.2%). There were 93.3% patients underwent surgical treatment (167/179), and 6.7% received conservative treatment (12/179). In the age group of 51-60 years, the male patients were more than females; in the age group 61-70 years, the male patients were more than females except in 2013; in the age groups of 71-80, and 81-90 years, the female patients were more than males; in the age group of over 90 years, there was no significant difference between female and male patients. These results manifest that the majority of hip fracture patients are the elderly, and slipping and osteoporosis are the leading causes. In spite of accumulating operative risks with aging, surgical treatment remains the predominant management strategy. Besides, the incidence of femoral intertrochanteric fractures shows a trend of increase yearly, with the highest incidence in the age group of 71-90 years, especially in females.