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 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.

Through the comparative analysis of undergraduate specialty settings of medical colleges and universities in minority areas in the different periods,this paper reveals the characteristics of undergraduate specialty settings.It is necessary to follow the demand for social and economic development,and adhere to the medical and national characteristics,promoting the durable development of undergraduate specialty settings of medical colleges and universities in minority areas.

Objective To investigate the effect of diuretic (furosemide) therapy on kidney injury induced by melamine and cyanuric acid in rats. Methods 36 male Spragne Dawley rats were random disided into 3 groups. Group A was treated with 2mL of water daily, group B was treated with melamine and cyanuric acid ( each 100 mg/kg) daily for 4 days and then 2ml of water daily, group C was treated with the same as group B at the first 4 days and then treatment with furosemide (20mg/kg) daily. Samples of blood and 24h urine were collected to detective biochemical indexes, and kidney sections were performed on days 4 and 11 ( each end point, n = 6). The kidneys were observed with histopathology and renal crystal deposition scores were determined. Results On the 4th day, group B and group C were resulted in acute kidney injury such as oliguria [ ( 3. 39 ± 1.02 ) ml, ( 3. 20 ± 0. 86 ) ml ] and high serum creatinine [ ( 153.54 ±27. 08)μmol/L, (160. 11 ± 19. 55)μmol/L] and renal melamine cyanurate crystal were found in the renal tissues. On the 11th day, the renal crystal deposition score in the rats was reduced by 9. 52% ( P >0. 05). Compared with those of the 4th day in group B, it reduced by 63.63%( P <0.05) in group C. Urine volume were increased significantly compared with those of the 4th day( P < 0. 05 ) in group C [ from (3.20±0. 86)ml to (25.96 ±5.97)ml] and group B [ from(3. 39 ± 1.02)ml to (8. 57 ± 1.66)ml] , and Urine volume in group C was increased significantly more than that in group B ( P < 0. 05 ). The serum creatinine was obviously reduced as compared with those of the 4th day in group B and C( P <0.05), from[ (153. 54±27.08) μmol/L] to [ ( 106. 10 ±5.53) μmol/L] in group B and from [ ( 160. 11 ± 19. 55) μmol/L] to [ (67. 17 ± 12. 80 ) μmol/L] in group C, but the serum creatinine in group B was still higher than that in group A and C ( P < 0. 05). Conclusions Furosemide can attenuate the damage of acute kidney injury induced by melamine and cyanuric acid.

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 investigate the expression and clinical significance of Ang-2 and MMP-7 protein in laryngeal carcinoma tissue.Method:Immunohistochemical technique was used to detect the expression of Ang-2 and MMP-7 protein in 65 tissues of laryngeal carcinoma and 34 biopsies of adjacent non-cancerous tissue. The relationship between the expression of Ang-2 and MMP-7 and invasion, metastasis or prognosis in laryngeal carcinoma tissue was analyzed.Result:The positive rates of Ang-2 and MMP-7 were significantly higher in laryngeal carcinoma tissue than those in adjacent non-cancerous tissue(P＜0.05).The level of Ang-2 and MMP-7 expression had no significant correlations with the age and course as well as the smoking, drinking, histological differentiation of carcinoma and clinical classification (P＞0.05).While the expression of Ang-2 significantly differed between patients with different T stage and clinical stage(P＜0.05), and the expression of MMP-7 was notably correlated with the T stage,clinical stage and lymph node metastases (P＜0.05).There was a correlation between the expression of Ang-2 and MMP-7 (P＜0.05).The Kaplan-Meier survival analysis showed that patients with positive expression of Ang-2 had worse overall survival(P＜0.05).However,MMP-7 expression was not related to overall survival or disease-free survival (all P＞0.05).Cox regression analysis indicated that Ang-2 and MMP-7 expression were independent prognostic factors of laryngeal carcinoma.Conclusion:Overexpression of Ang-2 and MMP-7 was observed in laryngeal carcinoma and they might be served as an objective indicator for biological behaviour and prognosis.

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 studythe cephalocaudal relationship ofabdominal aortic bifurcation relative toumbilicus and iliac crest vertex and their correlations with abdominal adipose tissue thickness and age. Methods The vertical distances,cephalocaudal relationship and other related anatomic parameters of aortic bifurcation relative to umbilicus and iliac crest vertex in 108 patientswere measured by consecutive abdominal CT scanning. The correlations of the acquired data with abdominal adipose tissue thickness and age were analyzed using Pearson correlation coefficient. Results Umbilicus was located at cephalad to aortic bifurcation in 67 patients(62.0%), caudal in 34(31.4%)andthe same level in 7(6.5%),with the vertical distance of(4.53 ± 17.51)mm to the aortic bifurcation. No statistically significant relationship was found between abdominal adipose tissue thickness(P>0.05) or age(P>0.05). Iliac crest vertex relative to aortic bifurcationwas located at cephalad,caudal and the same level in 31,71 and 6 patients,taking up 28.7%,65.7%and 5.6%,respectively. Its vertical distance to the bifurcation was(-6.34 ± 14.49)mm,nonrelated with abdominal adipose tissue thickness(P>0.05),but positively correlated with age(P<0.01). The difference in the cephalocaudal relationship of aortic bifurcation relative to umbilicus and iliac crest vertex was statistically significant(P<0.01). Conclusion Compared with iliac crest vertex,umbilicus is an important landmark of locating abdominal aortic terminal occlusion position in vitro because it mostly lies cephalad to aortic bifurcation in the front of the body,not easy to vary with abdominal adipose tissue thickness and age.

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.