Objective;To evaluate the endourethral surgery for urethrostenosis and urethratresia. Methods:68 patients with urethrosteno-sis or urethratresia were treated by endourethral surgery, such as internal urethrotomy, transurethral scar resection. Results: Of the 68 cases, the outcome was satisfactiory in 61 (89. 71% ). Endourethral surgery was carried out once for 55 patients and twice for 6,7 patients required open surgery. All patients had followed by urethral dilatation. 59 patients were followed - up for 3 months to 5 years. 54 cases can micture normally. Conclusions; Endourethral surgery is simple,safe,efficient treatment for urethrostenosis and urethratresia.

Objective To observe the effect of HBO in the treatment of artery complications after liver transplantation.Method Five cases were treat by HBO(202.65 kpa,once every day,oxygen inhalation 60 min) and other therapies after operation.Result After HBO,the whole-body situations were obviously improved,liver functions were ameliorated,no new necrotic focuses were found,and the primary necrotic focuses were reduced or vanished.Conclusion HBO was an effective way to treat and prevent the artery complications after liver transplantation and protect the ischemic liver cells.

Great advances have been made in understanding the genesis,diagnosis,risk stratification and the targeted therapy of myeloproliferative neoplasms (MPNs) in the past decade.This article reviews the current situation in the genesis,diagnosis and risk stratification of these classic bcr-abl-negative MPNs presented in the 56th American Society of Hematology (ASH) annual meeting.

Primary myelofibrosis is a kind of chronic myeloproliferative neoplasms.The discovery of the JAK2V617F mutation as well as other molecular abnormlities underly the pathogenesis of Philadelphia negative myeloproliferative neoplasms (MPN).The initial description of JAK2V617F mutation in 2005,the reporting of calreticulin (CALR) mutations last year and the clinical application of JAK inhibitors,showed the gradually deepening understanding with regard to the pathogenesis and the development of therapeutic strategies for primary myelofibrosis (PMF).This article reviewed the progress in diagnosis,risk stratification of of PMF,the benefits and potential side effect of JAK inhibitors,which reported on the 2014 European Hematology Association annual congress.

Oxidative stress and inflammation are two main factors in the progress of diabetic nephropathy(DN) and its complications. NF‐E2 p45‐related factor (Nrf2) is a crucial transcriptional factor which manipulates downstream genes that encode some antioxidant enzymes and phase Ⅱ detoxifying enzymes ,to maintain the redox homeostasis and cellular detoxification response. Therefore ,more and more researchers are focusing on the role of Nrf2 in DN. In this review ,the detailed role of Nrf2 in DN will be discussed. Hopefully ,our work can epitomize recent research progress and provide novel clues for diabetic nephropathy prevention and treatment.

Objective To observe the effect of intranasal dexmedetomidine on total intravenous anesthesia for thyroid surgery postoperative analgesia.Methods Sixty female patients who were undergoing elective thyroid surgery were enrolled.Patients by total intravenous anesthesia were randomized in mechanical sampling method to receive intranasal dexmedetomidine 1 μ g/kg (group Ⅰ,30 cases),or the same volume sodium chloride (group Ⅱ,30 cases) before anesthesia induction,then flurbiprofen 100 mg intravenous 10 min before surgery.The postoperative surgical pain was assessed utilizing visual analogue scale (VAS),and the postoperative pain of cough was assessed by comfort score (BCS) at 1,2,4,6,8,12,24 h after surgery,in addition,the adverse reactions were recorded.Results The VAS scores at 1,2,4,6,8,12 h in group Ⅰ were lower than those in group Ⅱ,and there were statistically significant (P ＜ 0.05).The BCS scores at 1,2,4,6,8 h in group Ⅰ were higher than those in group Ⅱ,and there were statistically significant (P ＜ 0.05).The nausea and dizziness morbidity in group Ⅰ were lower than those in group Ⅱ (8 cases vs.14 cases,6 cases vs.14 cases),and there were statistically significant (P ＜ 0.05).Eight patients were required supplemental analgesic within 12 h after surgery in group Ⅱ,which was more than that in group Ⅰ (0 case),and there was statistically significant (P ＜ 0.05).Conclusion Receive total intravenous anesthesia for thyroid surgery,the patients who are given intranasal dexmedetomidine 1 μ g/kg combined with flurbipmfen can reach satisfactory postoperative analgesia,decrease the nausea and dizziness morbidity,increase the comfortable degree.

ObjectiveTo investigate the role and its mechanism of the NOD-like receptor 3 (NLRP3) inflammasome in alveolar macrophages in ventilator-induced lung injury (VILI) in rats.Methods Thirty adult male Sprague-Dawley (SD) rats were randomly divided into three groups, with 10 rats in each group: spontaneous breathing control group, normal tidal volume (VT) group (VT 8 mL/kg) and high VT group (VT 40 mL/kg). All of the rats underwent tracheotomy. Then rats in spontaneous breathing control group were kept to have spontaneous breathing, while rats in normal VT group and high VT group received mechanical ventilation. After 4 hours, the rats were sacrificed by carotid artery bleeding, and the bronchoalveolar lavage fluid (BALF), blood serum and lung tissue were collected. Lung wet/dry ratios (W/D) were measured. Light microscopy and electron microscopy were performed to observe the pathological changes in lung tissue, and the ultrastructural changes in alveolar macrophages. Enzyme linked immunosorbent assay (ELISA) was performed to measure the total protein content in the BALF and the interleukins (IL-1β and IL-18) in the serum and BALF. The mRNA expressions and protein levels of NLRP3, apoptosis-associated speck-like protein containing CARD (ASC), caspase-1, and nuclear factor-κB (NF-κB) in alveolar macrophages were assayed by real-time fluorescent quantization reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot.Results The structure of lung tissue and alveolar macrophages of rats in spontaneous breathing control group and normal VT group appeared normal, while obvious inflammatory changes were found in high VT group. Compared with spontaneous breathing control group and normal VT group, the ratio of W/D (8.89±0.90 vs. 5.18±0.86, 5.71±0.82, bothP< 0.05), contents of total protein, IL-1β, IL-18 in BALF were significantly increased [total protein (g/L):2.34±0.41 vs. 1.77±0.14, 1.81±0.06, IL-1β (ng/L): 133.48±10.48 vs. 81.54±3.12, 83.80±5.22, IL-18 (μg/L):4.57±0.45 vs. 3.04±0.51, 3.43±0.43, allP< 0.05], and IL-1β and IL-18 in serum were also increased [IL-1β(ng/L): 105.06±10.18 vs. 65.11±8.58, 75.30±10.62, IL-18 (μg/L): 2.27±0.09 vs. 1.18±0.34, 1.43±0.15, all P< 0.05]. The mRNA and protein expressions of NLRP3, ASC, caspase-1 and NF-κB in alveolar macrophages of high VT group were significantly increased compared with that of spontaneous breathing control group and normal VT group. The mRNA expressions of NLRP3, ASC, caspase-1 and NF-κB in high VT group were (8.53±2.21), (5.75±1.17), (7.47±1.23) and (10.86±2.38) folds of those in spontaneous breathing control group, and the protein expressions of NLRP3, ASC, caspase-1 and NF-κB were (1.50±0.14), (1.49±0.04), (1.53±0.15) and (1.51±0.11) folds of those in spontaneous breathing control group (allP< 0.01). There were no significant differences in all the indexes between normal VT group and spontaneous breathing control group.ConclusionNLRP3 inflammasome in alveolar macrophages may be involved in the mechanism of occurrence of VILI.

ObjectiveStudy on the effect of nasal decontamination hefor aerosol inhalation in elderly patients with general anesthesia postoperation.Methods130 elderly patients with general anesthesia postoperation were randomly divided into routine treatment group and nasal decontamination group.The time of first sputum,the time of postoperative sputum changing characters,respiratoty-related indicators,sputum cuhure positive rate of bacterial,the incidence of postoperative pulmonary complications was examined.ResultsCompared with routine group,nasal decontamination group obviously shorten sputum character changing time ( P ＜ 0.05 ).Postoperative nasal decontamination group and conventional group sputum Staphylococcus aureus positive rate were 7.7％ (5 cases) and 20.0％ ( 13 cases) respectively,the difference was significant(x2 =4.13,P ＜0.05).ConclusionGiven nasal decontamination before aerosol inhalation could improve character of sputum and reduce sputum bacterial culture positive rate,and had good efficacy and safety.

Objective To explore the characteristics of type 1 diabetic mice models induced by multiple low dcee streptozotoein(MLD-STZ).Methods Type 1 diabetic mice models was induced with intraperitoneally injection of STZ(40mg/kg body weight,daily)for 5 consecutive days and detected fasting blood glucose,urine glucose and histological ehange of panereata.Results The incidence of type 1 diabetes mdlitus was 65%;compared with normal control group,blood glucose and urine glucose levels increased significantly and histological analysis of pancreata showed marked insulitis in diabetic model group,and the hyperglycemia maintained from the fourth to the eighth week after the firml STZ injection.Conelnsion Type 1 diabetie mice models could be made successfully by MLDSTZ,and the hyperglycemia could maintain for a rather long time.

Objective To evaluate the cost-effectiveness of the aneurysm intra-artery GDC embolization and the aneurysm clapping of intracranial aneurysm, and to give the instruction for the clinical practice. Methods A case control study (1 vs. 1) was developed to evaluate the cost in hospital, the cost for return visit and the Quality-adusted Life-Year (QALY) and lifetime costs of the intra-artery GDC embolization and the aneurysm clapping of intracranial aneurysm, under the matching of the age, sex, living place, the size and place of the aneurysm, and the Hunt & Hess score. Clinically effectiveness dates were derived from the medical records. Cost dates were derived from follow-up by telephones or letters. The correlation analysis was done with the SPSS 13. 0. Results The cost in hospital in AC group was (54 945±16 946) RMBs,which washigher than the ones in AE group(63 768±12 665) RMBs, (t = 1.71, P <0. 05). The cost of missed working in AE group was 200 RMBs(the median), which was lower than the ones in AC group 650 RMBs (z =2. 57,P < 0. 01). The cost of return visit in AE group was 1200 RMBs, which was lower than the ones in AC group1950 RMBs (z = 1.82, P < 0. 05). The cost-effectiveness of the intra-artery GDC emhalization and the aneurysm clapping had no difference 3805 RMBs/year vs. 3028 RMBs/year(z =0. 42,P >0. 05). Conclusion The results suggest that the two therapies have no difference in cost effective rate. Considering the physical and mental loss, the aneurysm intra-artery GDC embolization was better than the aneurysm clapping for the patients with aneurysm that diameter less than 25 mm.