Objective To evaluate the efficacy of percutaneous pneumatic nephrolithotripsy combined with ultrasonic lithotripsy for the treatment of renal calculi. Methods From January 2005 to December 2006, 132 cases of renal calculi were treated by percutaneous pneumatic nephrolithotripsy and ultrasonic lithotripsy. Percutaneous nephrolithotripsy was performed under the guidance of B-ultrasonography, and then the calculi were removed by pneumatic nephrolithotripsy combined with ultrasonic lithotripsy.Results Single-tract procedure was performed on 122 cases, while two-tract in the other 10. One-stage lithotripsy was performed on 127 cases, and two-stage operation was carried out in 5. The operation time ranged from 30 to 150 minutes with a mean of (60?12) minutes. The stone clearance rate was 90.2% (119/132) one week after the operation. Five patients had 200-to 500-ml hemorrhage 1 to 4 days after the operation, and were cured by blood transfusion and anti-infection treatments. No serious complications were found in the other patients. The nephrostomy tube was withdrawn 4 to 7 days (mean 6 days) after the operation. The hospital stay was 6 to 22 days with a mean of 15 days. Among the patients, 98 were followed up for 3 to 20 months (mean 13 months). No hemorrhage, infection, or recurrence of renal calculi was found during this period. Conclusion Percutaneous pneumatic nephrolithotripsy combined with ultrasonic lithotripsy is safe, effective, with mild surgical trauma and a few complications for patients with renal calculi.

BACKGROUND:COX-2 gene actual y exists in the joint fibroblast-like synoviocytes, it affects osteoarthritis occurrence and development. Understanding the differences of COX-2 gene expression levels at different stages of osteoarthritis synoviocytes has important theoretical significance for the occurrence and development of osteoarthritis, as wel as the role of synoviocytes in this process.
OBJECTIVE:To analyze the difference of COX-2 mRNA at different stages of osteoarthritis fibroblast-like synoviocytes.
METHODS:Synovial membrane from 44 osteoarthritis patients and 12 normal cases were selected. Primary cells were cultured to passage 4 fibroblast-like synoviocytes for the use in the experiment. COX-2 mRNA expression in osteoarthritis fibroblast-like synoviocytes and normal fibroblast-like synoviocytes was detected using real-time fluorescence quantitative RT-PCR. The relative quantitative analysis was performed using 2-ΔΔCt method.
RESULTS AND CONCLUSION:Expression of COX-2 mRNA in osteoarthritis fibroblast-like synoviocytes was significantly higher than that in normal fibroblast-like synoviocytes (P<0.05). The expression levels reached a peak at early osteoarthritis group, with significant differences compared with middle and late osteoarthritis groups (P<0.05). There was no significant difference between middle and later osteoarthritis groups (P>0.05). COX-2 mRNA might be important biological marker for the inflammation in osteoarthritis, and mainly plays a role in early osteoarthritis stage.

Objective To analyze the 10-year survival outcome and failure patterns for patients with nasopharyngeal carcinoma (NPC) after intensity-modulated radiotherapy (IMRT),aiming to provide reference for optimized treatment for NPC.Methods Clinical data of 866 patients with NPC receiving IMRT from January 2001 to December 2008 were retrospectively analyzed.Survival analysis was performed using the Kaplan-Meier estimator.Univariate analysis was carried out by log-rank test and multivariate analysis was performed using Cox proportional hazards model.Results The median follow-up time was 132 months.The 10-year local recurrence-free survival (LRFS),distant metastasis-free survival (DMFS),progression-free survival (PFS) and disease specific survival (DSS) were 92.0％,83.4％,75.7％ and 78.6％,respectively.A total of 210 patients died including 124 patients (59.0％) from distant metastasis,which was the primary cause of death,and 47 (22.3％) from local regional recurrence.Independent negative factors of DSS included age＞50 years (P=0.00),LDH ≥ 245 IU/L (P=0.00),Hb＜ 120 g/L (P=0.01),T2-T4 staging (P=0.00),N1-N3 staging (P=0.00) and GTV-nx＞20 cm3(P=0.00).The 10-year LRFS,DMFS and DSS of stage Ⅱ NPC patients did not significantly differ after IMRT alone and chemoradiotherapy (P=0.83,0.22,0.23).For patients with stage Ⅲ NPC,the 10-year LRFS and DSS in the chemoradiotherapy arm were significantly higher than those in the IMRT alone (P=0.01,0.01),whereas no statistical significance was observed in the DMFS between two groups (P=0.14).The overall survival of stage Ⅳa+Ⅳb NPC patients is relatively poor.Conclusions IMRT can improve the long-term survival of NPC patients.Distant metastasis is the primary failure pattern.Patients with stage Ⅰ-Ⅱ NPC can obtain satisfactory survival outcomes after IMRT alone.The addition of chemotherapy can further enhance the LRFS and DSS of stage Ⅲ NPC patients.However,the optimal therapeutic strategy remains to be urgently investigated for stage a+ Ⅳb NPC patients.