Objective To explore the selection and clinical effects of internal or external drainage for upper urinary tract obstruction complicated with acute renal failure.Methods A total of 25 cases of upper urinary tract obstruction complicated with acute renal failure were treated with double J(DJ) tube internal drainage(12 cases,15 times) or percutaneous nephrectomy(PCN) external drainage(19 cases,23 times).15 cases of obstruction were induced by tumor and 10 cases of obstruction induced by benign disease.Results The drainage treatments were performed successfully in 23 cases,with the success rate of PCN and DJ drainage being 86.9%(20/23) and 60.0%(9/15),respectively.Postoperative bleeding occurred in 1 patient with PCN.Conclusions PCN is superior to DJ in the treatment of malignant obstruction,but DJ internal drainage may be the first choice for non-malignant obstruction.

Animals ; Animals, Newborn ; Antioxidants ; therapeutic use ; Female ; Hyperoxia ; complications ; drug therapy ; Lung Injury ; drug therapy ; etiology ; Male ; Rats ; Rats, Sprague-Dawley

A rapid and sensitive liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) method for quantification of sitagliptin in human plasma and urine had been developed. This method was applied to the pharmacokinetics study of sitagliptin tablet after single- and multiple-dosing in Chinese population. Plasma samples were prepared by a liquid-liquid extracted method, and urine samples were diluted. Compounds were analyzed by multiple reaction monitoring (MRM) mode with a electrospray ionization (ESI) interface. Mobile phase consisted of methanol and water (85 : 15, v/v). The linear concentration range of calibration curve was 0.5-1 000 ng.mL-1. and 0.2-100 µg.mL , intra-run/between-run accuracy was 98.98%-103.69% and 97.63%-102.29%, intra-run/between-run precision was <5.51% and 4.26% for plasma and urine sample, respectively. The stability of sitagliptin stock solution was tested for 55 days at -30 °C. Sitagliptin was stable when stored under the following conditions: 24 hours in the autosampler after sample preparation; 24 hours at room temperature, after 3 freeze and thaw cycles (from -30 °C to room temperature), 40 days at -30 °C for plasma and urine samples. The absolute recovery in plasma was 71.1%, and no matrix effect was founded. This method was proved simple, specific, sensitive, rapid and suitable for pharmacokinetics study of sitagliptin in human being.
Calibration ; Chromatography, Liquid ; Humans ; Liquid-Liquid Extraction ; Sitagliptin Phosphate ; blood ; pharmacokinetics ; urine ; Tandem Mass Spectrometry

Objective To study the effect of transplanted endothelial progenitor cell (EPC) on hyperoxia-induced lung injury in neonatal rats.Methods Rat bone marrow mononuclear cells were cultured in endothelial cell growth medium to obtain EPCs,which were identified by morphology,phagocytosis and CD34+ analyses.Sixty neonatal Sprague-Dawley rats were allowed to acclimate in room air for 24 h after birth,and were then divided into four groups (15 per group),including the air group,the hyperoxia group,the EPCs transplantation group and the N ω-nitro-L-arginine methyl ester (L-NAME) intervention group.Neoborn rats in the Air and Hyperoxia groups were fed in the room air or hyperoxia (85％ oxygen) for 28 days.For rats in transplantation group were exposed continuously to hyperoxia for 28 days,and got an EPC (1 × 105 cells) injection on the 21st day.Rats in Intervention group were exposed continuously to hyperoxia for 28 days,got an EPC (1 × 105 cells) injection on the 21st day,and a daily injection of L-NAME from day 21 to day 28,with a daily dose of 20 mg/kg.Levels of circulating CD34+ cells and serum VEGF expression were detected.Specimens from lung tissues were analyzed by immunohistochemistry or immunofluorescence.The expression of vascular endothelial growth factor (VEGF),VEGF receptor 2 (VEGFR2) and eNOS were detected by realtime polymerase chain reaction and Western-blotting.NO production were detected by nitrate reductase assay.One way ANOVA and Bonferroni test were used for statistical analysis.Results (1) The cultured cells had a typical cobblestone appearance; double positive cell binding of fluorescein Ulex Europaeus agglutinin-1 and uptake of Dil-labeled acetylated low density lipoprotein accounted for approximately 85％ of the total number of cells.CD34+ cells accounted for 68.2％-72.4％ of total cultured cells.(2) Circulating CD34+ cells in the air group,hyperoxia group,EPC transplantation group and L NAME intervention group were (1.91 ± 0.34)％,(1.06 ± 0.10)％,(1.47 ± 0.06)％ and (0.77 ± 0.11)％ (F=32.710,P=0.000).The number of circulating CD34+ cells in the hyperoxia group was lower than the air group,in the EPC transplantation group the number of these cells was higher than the hyperoxia group,and in the L-NAME intervention group the number of these cells was lower than that in the EPC transplantation group,and the differences between these two groups were statistically significant (P ＜ 0.05,respectively).Serum VEGF in the four groups was (7.90±2.72),(6.38±0.72),(14.00± 1.66) and (11.70± 1.91) pg/ml,respectively.The difference between the four groups was statistically significant (F=22.809,P=0.000),and serum VEGF in the EPC transplantation group was higher than that in the hyperoxia group (P ＜ 0.05).(3) Transplanted EPCs could engraft in pulmonary vascular endothelium and alveolar interstitium,and L-NAME intervention significantly reduced the engraftment of EPCs in the lungs (10.7±0.47 / field vs 16.95±0.5 /field,t=17.820,P=0.000).(4) There were significant differences in the radial alveolar count (RAC) and number of microvessels between the four groups (F=859.580 or 211.150,P=0.000,respectively).RAC and the number of microvessels in the hyperoxia group were less than those in the air group (7.98±0.23 vs 13.12±0.20,3.98±0.42 vs 9.50±0.22,P ＜ 0.05,respectively).The number of microvessels in the EPC transplantation group was 5.40±0.41,being higher than that in the hyperoxia group (P＜0.05).(5) VEGF mRNA in lungs in the hyperoxia group was lower than that in the air group (0.23 ± 0.16 vs 1.05 ± 0.33,P ＜ 0.05); in the EPC transplantation group,VEGF mRNA was higher than that in the hyperoxia group (0.69 ± 0.09 vs 0.23 ± 0.16,P ＜ 0.05); and in the L-NAME intervention group,VEGF mRNA was lower than that in the EPC transplantation group (0.31 ±0.08 vs 0.69±0.09,P ＜ 0.05).VEGF protein in the lungs in the hyperoxia group was lower than the air group (0.52±0.01 vs 0.82±0.01,P ＜ 0.05),and was higher in the EPC transplantation group than the hyperoxia group (0.58±0.05 vs 0.52±2501,P ＜ 0.05).VEGFR2 mRNA in the hyperoxia group was lower than the air group (0.35±0.13 vs 1.07±0.45,P ＜ 0.05).eNOS mRNA in the hyperoxia group was lower than the air group (0.46±0.10 vs 1.05±0.36,P ＜ 0.05).eNOS protein in the hyperoxia group was lower than the air group (0.32±0.01 vs 0.51 ±0.03,P ＜ 0.05),and was higher in the EPC transplantation group than the hyperoxia group (0.86±0.02 vs 0.32±0.01,P ＜ 0.05).Conclusion Transplanted EPC can engraft in the lung tissue,improving alveolar and pulmonary vascular development,which may be associated with upregulation of the expression of eNOS and VEGF in lung.

Objective:To provide anatomic image data for ossointegrated implant for patients with nasal defect. Methods: 100 cases of (50 males, 50 females) 3D spiral CT images of normal bone of skull were measured with mimics 10.01 software. Results: The minimum distance between the root tips of central incisor and the anterior nasal floor was 13.03 in males and 11.06 in females. The minimum distance between the root tips of lateral incisor and the anterior nasal floor was 15.95 mm in males and 13.04 mm in females, the minimum thickness of palatine process 6mm inferior to piriform aperture was 9.96 mm, the minimum thickness of alveolus 6mm inferior to piriform aperture was 11.57 mm in males and 10.61 mm in females, the thickness of glabella adjoin to frontal sinus was 3.57mm. Conclusion: The lateral incisor region is an optimal one for nasal implants 4-8 mm in length. The inclined direction can either be forward or backward. When the vertical bone depth is not enough, horizontal placement of the implants in the inferior region of piriform should be considered. 4-8 mm implants is suitable in this region. The glabella region is not optimal but an alternative option for nasal implants.

To obtain a most appropriate method for the evaluation of the three basic skills of clinical doctors,we designed an objective structured clinical examination(OSCE) model with standardized patients and applied it to the "three-basic" examinations among 50 doctors from various clinical departments.The results showed that this model provided a new way for the effective,objective and reliable evaluation of doctors' clinical knowledge and skills.

OBJECTIVE To survey the antibiotic susceptibility of Pseudomonas aeruginosa and medical treatment among the aged patients suffering from underlying disease.METHODS A total of 326 strains of P.aeruginosa were isolated among the aged patients with underlying disease by sputum culture.Drug susceptibility was performed and effective antibiotic treatment was given.RESULTS Amikacin(8.0%),imipenem(12.0%) and piperacillin/tazobactam(16.0%) could be chosen.The symptom of 326 patients was alleviated after clinical treatment,while some sputum samples were found still positive.CONCLUSIONS Combined use of two kinds of medicines may produce better effects in the patients with underlying disease,who infected with P.aeruginosa,but sputum should not be emphasized to converse negative in this case.

Age of Onset ; Aged ; China ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Pneumoconiosis ; epidemiology ; mortality

OBJECTIVETo evaluate percutaneous reduction by Kirschner pin and internal fixation with cancellous screw and plate through minimal incision at the lateral side of heel for the treatment of intra-articular displacement fracture of calcaneus.

METHODSFrom September 2009 to June 2012, 80 patients with close intra-articular displacement fractures of calcaneus were divided into treatment group and control group. There were 40 patients in the control group, including 21 males and 19 females, ranging in age from 23 to 64 years old, averaged (39.1 +/-11.7) years old; and the patients were treated with fixation by compress screws and plates of self-broken type. There were 40 patients in the treatment group, including 24 males and 16 females,ranging in age from 21 to 67 years old, averaged (39.6+/-14.3) years old;and the patients were treated with full thread cancellous screws and plates fixation. The fixation time,intra-operative blood loss and the number of injured medial plntar nerve were compared between the two groups. The Böhler angle, Gissane angle and the correction degree of calcaneal width were measured at 1 year after operation. The internal fixators were taken out after 1 year. The AOFAS ankle-hindfoot score was used to evaluate therapeutic effects.

RESULTSAll the patients were followed up,and the duration ranged from 9 to 32 months, with a mean of 16 months. There were shorter operation time, less injury, satisfactory postoperative Böhler angle and calcaneal width in treatment group compared with control group,which reduced the medial neurovascular injuries, and the plate was easily removed after fracture healing.

CONCLUSIONFull thread cancellous screws and plate fixation for the treatment of calcaneal fractures could get same therapeutic effects as compress screws and plate of self-broken type fixation, and also has follow advantages: shortening the operation time, reducing blood loss, easily to be removed, avoiding the medial neurovascular damage, reducing the incidence of complications.

Adult ; Aged ; Bone Plates ; Bone Screws ; Calcaneus ; injuries ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged

This study was aimed to observe the analgesia of curing-injury Cataplasma and discuss the Nav1 . 7 expression in dorsal root ganglion ( DRG ) in model rats with formaldehyde-induced inflammatory pain . A total of 36 Sprague-Dawley rats were divided into three groups, which were the blank control group (n = 12), model group ( n = 12 ) , and treatment group ( n = 12 ) . The blank control group was without any treatment . The model group was injected with 0 . 1 mL 5% saline formalin on the left rear foot . The treatment group was applied with curing-injury Cataplasma on the left rear foot 24 h before the injection of 0 . 1 mL 5% saline formalin in the establishment of animal model . The behavior reactions to pain of model rats were observed . Dubuisson score was recorded and compared . Meanwhile , L3-6 DRG was collected from rats in each group . The expres-sion of Nav1 . 7 was detected by real-time quantitative PCR and western blot . The results showed that the pain reaction integral in the treatment group was lower than the model group ( P < 0 . 05 ) . Results from the real-time quantitative PCR showed that the relative expression of Nav1 . 7 mRNA in the model group was more than the treatment group . And the relative expression of Nav1 . 7 mRNA in the treatment group was more than the blank control group . There was significant difference among three groups ( P < 0 . 05 ) . There was no statistical difference at the three time points within three groups. Results from the western blot showed that the relative expression of Nav1 . 7 in the model group was more than the treatment group . And the expression of Nav1 . 7 in the treatment group was more than the blank control group . There was significant difference among three groups (P < 0.05). There was no statistical difference at the three time points within three groups. It was concluded that the curing-injury Cataplasma can alleviate inflammatory pain response in rats, and have certain analgesia effect . Meanwhile , it can influence Nav1 . 7 expression in DRG in model rats with formaldehyde-induced inflam-matory pain .