Objectives To compare the effectiveness and safety of local anesthesia and epidural anesthesia with ureteroscopic pneumatic lithotripsy at distal ureteral stone. Methods A total of 160 patients with distal ureteral stone treated with ureteroscopic pneumatic lithotripsy from December 2013 to February 2014 were included. They were divided equally into 2 groups by method of random sampling. Patients in group A (n=80) treated with local anesthesia were compared to those in group B(n=80),who were dealt with epidural anesthesia. Results The statistical difference was significant in terms of hospital stay after operation and overall cost of therapy(P<0. 05) respectively,on the other hand,it was not significant in respect of the operation time,the operation successful rate,the stone clearance rate and the complications incidence rate (P>0. 05)respectively. Conclusion For the identified patients,the local anesthesia in ureteral ureteroscopic pneumatic lith-otripsy is a safe,effective and economical method for distal ureteral stone.

Objective To compare the clinical curative effect of percutaneous nephrolithotomy (PCNL) and flexible uretero‐scope lithotripsy (FURL) for the treatment of renal calculus ≤2 cm .Methods Totally 148 patients with kidney stone ≤2 cm whom have taken operation treatment in our hospital were chosen from January 2014 to December 2014 .Among them ,81 patients were taken PCNL treatment (PCNL group) and 67 patients were taken FURL treatment (FURL group) .Clinical curative effect were compared .Results There was no statistically significant difference in the comparison of stone clearance rate ,fever rate and postoperative WBC increase (P>0 .05);the operation time of PCNL group (64 .21 ± 11 .71)min was shorten than the FURL group (107 .32 ± 16 .35)min ,the postoperative hospital stay of PCNL group (6 .51 ± 1 .92)d was longer than the FURL group (3 .28 ± 1 .24)d ,the Hb decrease after operation of PCNL group (13 .31 ± 2 .71)g/L was higher than the FURL group (3 .88 ± 2 .10)g/L , the postoperative hs CRP increase of PCNL group (14 .21 ± 1 .62)mg/L was higher than the FURL group (5 .23 ± 1 .14)mg/L ,the differences were statistically significant (P<0 .05) .Conclusion For the treatment of renal calculus ≤2 cm ,the FURL has a great advantage on reducing postoperative complications ,decreasing the trauma of operation and shorten postoperative hospital stay .

Objective To explore the safety and efficacy of testosterone replacement therapy in patients with male late-onset hypogon-adism and Mild-to-moderate benige prostate hyperplasia. Methods Forty-three patients diagnosed as male late-onset hypogonadism and Mild-to-moderate benige prostate hyperplasia were selected,of which 28 patients were assigned to Eleven acid testosterone (40 mg each time, after a meal,2 times per day) ,other patients were in the control group. The patients were followed for 12 months and their data about digital rectal inspection,size of the prostate,IPSS score,maximum urinary flow rate ( Qmax) ,AMS clinical symptom score,serum testosterone level, serum PSA level,RBC hematocrit ( HCT) ,and other indicators were collected. Results Twelve months After testosterone replacement thera-py,both the prostate volume of treated and control groups were not significantly changed(P>0. 05). IPSS score and maximum urinary flow rate in treatment group were improved significantly(P<0. 05),but the control group showed no statistically significant changes(P>0. 05). Baseline AMS clinical symptom score and blood testosterone level were similar between treatment and control group (P >0. 05). Twelve months after treatment,the blood testosterone level of the treatment group reached the normal range,and the AMS clinical symptom scores de-creased significantly (P<0. 05). However,none indexes of control group significantly changed after the treatment (P>0. 05). Conclusion Testosterone replacement therapy in patients with male late-onset hypogonadism and the Mild-to-moderate benige prostate hyperplasia is safe and effective.

Objective To evaluate the tolerance and safety of sorafenib for elderly patients with advanced renal cell carcinoma.Methods Forty cases with advanced renal cell carcinoma were enrolled,26 were males and 14 were females,the average age was 70 years.Recurrence or metastasis was found in 32 patients who had received nephrectomy,22 of the 32 cases had received cytokine therapy before recurrence or metastasis.Primary renal lesions of 8 cases could not be resected,so patients get renal tumor biopsy.Pathological type of all patients was clear cell carcinoma.KPS of all the patients were ≥70 points.Sorafenib was used as first-line treatment,with 400 mg twice per day,until intolerance or disease progression occurred.Results The average treatment time was 7.5 months (3-18 months),CR 0 case,PR 6 cases,SD 29 cases,PD 5 cases.The overall objective response rate and disease control rate were 15.0% (6/40)and 87.5%(35/40),respectively.The median follow-up period was 11 months.The adverse reaction included hand-foot skin reaction(70.0%),alopecia (62.5%),rash(52.5%),diarrhea(37.5%),loss of appetite(32.5%),fatigue(27.5%).Most adverse reactions occurred around the second week after drug therapy initiation,their duration did not equal.And most of these adverse reactions could be released by symptomatic treatment,they did not affect the treatment.Conclusions The types of adverse reactions of sorafenib for elderly patients with advanced renal cell carcinoma are similar to those reported in the literature.Generally the degree of adverse reactions is minor,with good tolerance and safety.

AIM To establish an HPLC method for the simultaneous content determination of four constituents in Xiaojie'an Capsules (Forsythiae Fructus,Leonuri Herba,Spatholobi Caulis,etc.).METHODS The analysis of chloroform extract of this drug was carried out on a 30 ℃ thermostatic Diamond C1scolumn(250 mm ×4.6 mm,5 μm),with the mobile phase comprising of acetonitrile (A)-0.05 mol/L monosodium phosphate (B) flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 278 nm.RESULTS Berberine hydrochloride,palmatine chloride,phillyrin and rutin showed good linear relationships within the ranges of 0.033 7-0.337 2 μg (r =0.999 1),0.054 8-0.548 3 μg (r =0.999 0),0.025 9-0.258 8 μg (r=0.999 2) and 0.008 4-0.084 2 μg (r =0.999 6),whose average recoveries were 98.8％ (RSD =1.3％),99.8％ (RSD =0.7％),98.8％ (RSD =1.3％) and 96.8％ (RSD =1.0％),respectively.CONCLUSION This sensitive and accurate method can be used for the quality control of Xiaojie'an Capsules.

Objective To investigate the methods and clinical value of multi-slice CT virtual cholangioscopy in the detection of biliary calculus.Methods Volume scanning was performed in 38 patients with suspected biliary calculi after injection 50% Meglumine adipiodone injection 20 ml through vien.All data sets were transferred to ADV3.1 workstation.MSCTVC reconstruction were done with Navigator soft-ware.All cases were proved by ultrasound,axial CT and MSCT 3 D results or operations.Results MSCTVC could well demonstrate 3D fashion of biliary calculi and it was similar to ultrasound,axial CT and MSCT 3D results.Conclusion MSCTVC combined with CT 2D 3D results has a high diagnosis accuracy and clinical usefulness,thus,improve the diagnosis of biliary calculi.

Objective To evaluate the methodology and the clinical usefulness of multi-slice helical CT virtual endoscopy(MSCTVE).Methods Twenty-six cases by suspected colorectal carcinoma underwent multi-slice helical CT virtual endoscopy after colon was cleaned and insufflated with air.The parameters were used:120 kV,250 mA,pitch 6,reconstructure thickness 2.5 mm,interval 1.0.All data sets were transferred to ADV 3.1 workstation,CTVE reconstruction were done with Navigator and used CTVE to view colorectal and rectum carcinoma.Of 26 cases,16 cases were proved by colonoscopy and 22 cases by operation.Results 14 cases carcinoma in rectum,8 cases in sigmoidcolon,1 case involved both rectum and sigmoidocolon.MSCTVE results were similar to colonography.Conclusion Multi-slice helical CT virtual endoscopy has clinical usefulness for detecting colorectal and rectum carcinoma as it is non-invasive,safe,feasible.MSCTVE is a supplement to colonoscopy especial in incomplete colonoscopy.

Objective To investigate efficiency of centipede extracts on apoptosis induction, proliferation inhibition to Human A549 cell line and growth suppression of subcutaneous transplanted sarcoma in nude mice. Methods Centipede extracts prepared by enzymolysis and acetone precipitation methods were used to treat human lung cancer A549 cell line. Proliferation inhibition was evaluated by MTT assay and half inhibit concentration (IC50) was calculated. Cell morphological change and apoptosis were detected by flow cytometry and Hoechst stain. The subcutaneous transplanted sarcoma models were prepared with nude mice and randomly divided into model group, control group and centipede extracts group, with 10 mice in each group. Changes of tumor volume, quality and anti-tumor rate were observed.Results In vitro experiment, proliferation of A549 cells was inhibited with dose-dependency and IC50 value was 0.603 mg/mL. The G0/G1 phase of cells was down regulated and G2/M and S phase cells were up-regulated. The apoptotic character cells were been found by Hoechst stain. In vivo experiment, the tumor weight and volume decreased significantly compared with model control group, with statistical significance (P<0.01).Conclusion The centipede extracts shows dose-dependent anti-proliferative effect on A549 cells, which can induce apoptosis by arresting A549 cells at G2/M phase and suppressing growth of subcutaneous transplanted sarcoma of lung cancer in nude mice.

Objective To study predicting results of the back propagation (BP)neural network model for hematoma enlargement (HE)in patients with intracerebral hemorrhage. Methods The clinical data of 128 patients with cerebral hemorrhage admitted to the 309th hospital of People′s Liberation Army from January 2011 to December 2014 were analyzed retrospectively. The Matlab 7. 14 software was used to achieve BP neural network model for predicting hematoma enlargement within 24 hours in patients with intracerebral hemorrhage (HE ≥6. 0 ml and HE ≥12. 5 ml). The mean square error (MSE)of the model and the accuracy of the overall prediction were calculated. The receiver operation characteristic (ROC) curve was drawn for predicting HE. Results When the BP neural network predicted HE ≥6. 0 ml and HE ≥12. 5 ml,the mean square deviations of the training set,validation set,and test set were 0. 061, 0. 143,0. 052 and 0. 023,0. 057,and 0. 065,respectively. The best fitting performance verification of hematoma enlargement was as follows:≥ 6. 0 ml for network training 11 times and the error value 0. 224;≥12. 5 ml for network training 20 times,and the error value 0. 057. The overall accuracies of predicting HE ≥6. 0 ml and HE ≥12. 5 ml were 92. 2% (118/ 128)and 96. 9% (124/ 128)respectively. Conclusion The BP neural network model have no special limitation for data. It can accurately fit the hematoma expansion model of cerebral hemorrhage.

Objective To assess the clinical value of high-frequency electrocautery in the treatment of massive hemorrhage of presacral venous plexus. Methods The clinical data of 8 patients with presacral venous hemorrhage treated with high-frequency electrocautery from February 2005 to March 2008 were analyzed. Once the presacral venous hemorrhage happened, the bleeding site was pressed with a gauze or finger and the accumulated blood was aspirated. Then, while simultaneously withdrawing the gauze or finger over the bleeding sites, high-frequency electrocautery was applied with a power of 80-100 W to coagulate all the bleeding sites. Results High-frequency electrocautery was used to stop bleeding in the 8 patients, and no electrocautery related complica-tions occurred postoperatively. Conclusions High-frequency electrocautery for massive hemorrhage of presacral venous plexus is simple, efficient and safe.