Objective Discusses the clinical effect of makes the micro fistula after Pi Shenjing the holmium laser lithotrity treatment kidney stone and the complication prevention measure. Method Under the color ultra locali-zatiun puncture,and after making the micro fistual,uacs the wolf sign(WOLF)8/9.8 F ureter hard mirror,apphes the holmium laser stone crusher,the power establishes in 12～20 W,carries on crushed stone parallel conjunction Shi Qianqu the stone. Results This group of 103 examples,the even puncture is successful. The single channel crushed stone takes the stone 97 examples, the double channel takes the stone 6 examples. The complete case main stone is taken out, the pure renal pelvis or the calyx stone takes leads is 96% only, sends, the cast or the antler stone takes on-ly leads is 67%. Surgery time is 90～150 min generally,the special 1 example 7 hours,in the technique the obvious oozing of blood 5 examples,the surgery ended when the serious massive hemorrhage 1 example,changed the opening surgery, the excision trouble kidney,periphery did not have the internal organs damage and the death case. After the technique,is hospitalized the time is 7 ~ 15 d. After the technique,pcor character in vitro seismic wave crushed stone case. Makes a follow-up visit the complete case 2 ~ 6 months, hematuria, frequent micturition, the urine pain and the waist ache symptom vanishes,non-stone recrudescence. Conclusion Micro makes the fistula after Pi Shenjing the liolmium laser lithotrity has the wound to be small,the complication few,restores,unvoiced aspirated consonants to e-liminate the stone rate high quickly, the curative effect accurate and so on merits, is worth the clinical promoted use.

Objective:To investigate the expression of AQP4 during the development of presyrinx state of experimental syringomyelia in rabbits.Methods:The experimental syringomyelia models of rabbits were established by intra-cisternal injection of Kaolin.The expression of AQP4,AQP4mRNA and the water content of upper cervical spinal cord were measured with immunohistochemistry,Western blot,RT-PCR and dry-wet measurement on days 1,3,7,14,and 21 after operation,respectively.Results:Compared with animals of control group,the water content increased in those of Kaolin group from the 1st day(68.35%?0.70%),reached its peak on the 7th day(72.92%?0.86%),lasted to the 14th day(72.58%?0.55%),and then began to drop on the 21st day(70.03%?0.77%),while AQP-4 immunoreactive expression decreased on the 3st day[integral optical density(IOD)320.5?44.2],reached its minimum on the 7th day(IOD 258.7?26.5),lasted to the 14th day,and recovered partially on the 21th day approximately(IOD 321.5?46.1).RT-PCR found the decreasing of AQP4 mRNA coincided well with that of AQP4 immunoreactive expression in presyrinx state.The linear regression analysis indicated that expression of AQP4 and its mRNA in cervical cord had a negtive correlation with the change of spinal water content(r=-0.769,P

Objective To comparison between radiofrequency ablation introduced by tri-dimension reconstruction and ultrasound and operation for the treatment of small hepatocellular carcinoma. Methods 94 patients with small hepatocellular carcinoma from Jan 2009 to Mar 25 in Shanxi Cancer Hospital were analyzed. 45 patients were both given CT examination to rebuild tri-dimension and radiofrequency ablation treatment. 49 patients were given excision. Both groups were given CT examination to rebuild tri-dimension before the treatment. The differences in recurrence rate, overall survival and complication ratio between the two groups were compared. Results After 1, 2 and 3 years radiofrequency ablation treatment, the survival rate in radiofrequency ablation group were 95.56 % (43/45), 86.67 % (39/45), 60.00 % (27/45) respectively, comparing with 93.88%(46/49), 79.60%(39/49), 59.20%(29/49) in operation group. The difference was not statistically significant (P>0.05). There was no statistical significance in 1-year, 2-year and 3-year recurrence rates between the two groups (P> 0.05). There were statistical significances in incidence of post-treatment pains [13.33%(6/45) vs 100.00%(49/49),χ2=60.416, P<0.05] and complication (P<0.05) between the two groups. By Mar 25th, 2015, there was no needle tract implantation in the patients with radiofrequency ablation treatment. Conclusions For the small hepatocellular carcinoma with less than 3cm in diameter, introduced by CT tri-dimension image reconstruction and ultrasound, the radiofrequency ablation treatment excels in effect with fewer damages, infective complications, lower cost and can be applied many times. The overall effect is close to surgical removal, and therefore it can be used as the first line therapy for small hepatocellular carcinoma.

Objective:To investigate the mechanism of survivin, p53 and Ki-67 on Hep-2 human laryngeal cancer endothelial cell proliferation and invasion.Methods:Laryngeal squamous cell carcinoma and paracancerous normal tissues were collected, total RNA was extracted from tissues,survivin,p53and Ki-67gene mRNA expression levels in laryngeal cancer and the adjacent tissues were detected by Real-time PCR. Human laryngeal cancer Hep-2 epithelial cells were selected,survivin gene was overexpressed, and cell proliferation was detected by MTT.p53 andKi-67gene expression changes in overexpressedsurvivin gene were detected by Western blot. Changes in Hep-2 cell invasive ability were studied whensurvivin was overexpressed as detected by Transwell invasion assay.Results: In the adjacent tissues, survivin,p53andKi-67 gene relative expression levels were 1.72 ± 0.9, 13.7 ± 5.7 and 5.7 ± 1.3, respectively; while in cancer tissues, gene relative expression levels were 53.7 ± 8.3, 66.7 ± 5.2 and 61.0 ± 3.1, respectively, which was significantly increased. As detected by MTT, relative cell survival rate within 12 h ofsurvivinoverexpression were: load control group, (88.5±1.6)%; overexpressed group, (90.3±1.9)%. Transwell invasion assay results indicated that overexpressedsurvivincould significantly increase the relative survival rate of cells. Conclusions:Expressions ofp53,Ki67 and survivin are increased in cancer; and there is a positive correlation betweensurvivin, p53andKi67 expressions in laryngeal carcinoma.

Background Diclofenac sodium eye drops,pranoprofen eye drops and bromfenac sodium hydrate eye drops are three clinical commonly used nonsteroidal anti-inflammatory drugs(NSAIDs).The variation of cytoxicity among these drugs and whether the cytoxicity is related to the supplements are also unknown.Objective This study was to compare the cytotoxicity of three non-steroidal anti-inflammatory eye drops and their active components with cultured human corneal epithelial cells (HCECs) in vitro,and to discuss toxic origins of these drugs.Methods HCECs were cultured in different drugs with the final concentration of 0.10％,0.05％,0.02％ and 0.01％.Cell proliferation was evaluated by MTT assay.Then,0.002％ eye drops (1∶50) was added,and the migration and damage of the cells were deceted by transwell migration assay and lactate dehydrogenase (LDH) assay.Results The cytotoxicity of three nonsteroidal anti-inflammatory eye drops on HCECs was concentration-dependent (all at P=0.00).Diclofenac sodium eye drops showed the most dominant effects on the proliferation,migration and damage of HCECs among the three eye drops,while bromfenac sodium eye drops showed the least effect on the cell damage (proliferation:Fdrug =20.25,P=0.00;migration:F =103.43,P =0.00;damage:Fdrug =164.16,P =0.00).Compared with the eye drops,their active components showed less cytoxicity.Pranoprofen appeared the least effects on the proliferation,migration and damage of HCECs (proliferation:Fdrug =332.27,P =0.00;migration:F =332.27,P =0.00;damage:Fdrug=154.83,P=0.00).Conclusions The cytotoxicity ofdiclofenac sodium eye drops is more obvious than that of pranoprofen eye drops or bromfenac sodium hydrate eye drops.The cytotoxicity of the three eye drops originates from their supplements or the interaction between the supplements and active components.

BACKGROUND: The changes in trabecular bone microarchitecture in osteoporosis have aroused much attention. The decrease in the number of trabecular nodes and increase in the number of free ends are found in osteoporosis, but the mechanism is still unclear.OBJECTIVE: To observe the trabecular remodeling process in ovariectomized rats as the osteoporosis models electron microscopically, and to explore the reasons for the decrease in the number of trabecular nodes and increase in the number of free ends.DESIGN: Randomized and controlled animal trial.SETTING: Department of Orthopedics, Third Hospital of Peking University.MATERIALS: The experiment was conducted in the Animal Laboratory, Third Hospital of Peking University from September 1999 to February 2000. Thirty-six female Wistar rats of 3 months old and 240-280 g were selected and randomly divided into ovariectomized group and control group with 18 rats in each group. The rats were observed at 4,8, and 12 weeks postoperatively with 6 rats at each time point.METHODS: The rats of ovariectomized group were subjected to ovariectomy 1 week after feeding, but the control group was not. The changes of proximal tibia trabecular microarchitecture was observed under scanning electron microscope at 4, 8 and 12 weeks, respectively, and the osteoclast, osteoblast, and structure of cell organs were observed under transmission electron microscope.MAIN OUTCOME MEASURES: [1]The re modeling process after ovariectomy by electron microscope; ②morphological changes of trabecular bone.RESULTS: [1]Scanning electron microscope observation showed that trabecular bone remodeling was distributed in every region of trabecular microarchitecture, especially St and Nd-St region. After ovariectomy, the transverse trabecular was easier to be perforated and broken; the trabecular network was almost intact at 4 weeks, but gradually damaged at weeks 8 and 12; moreover, the collagen fibers on the surface of trabecular bone were scrappy, disorder and thinner. ②By the transmission electron microscopic study, the tibial osteoclast were found active at 12 weeks. When absorbing cancellous bone, osteoclast closely adhered to its surface, and digitations stretched into the cancellous bone. The shape and size of digitations were significantly different, and around them, lucent area was observed. Osteoclast was polynucleation with abundant kytoplasm, and there were plenty of Golgi complex, smooth endoplasmic reticulum and mitochondrium. Lysosome inclusion compounds with different sizes and electron density were found in cells. Osteoblast was rarely found, and cell edge was rough, with bone lacuna.CONCLUSION: Bone remodeling is significantly active in St and Nd-St region of trabecular bone in ovariectomized rats.This may be the reason for the decrease in the number of trabecular nodes and increase in the number of free ends.

ObjectiveTo investigate the effects of selective splenectomy on modulation of portal vein flow and prevention of small-for-size syndrome (SFSS) in living donor liver transplantation.MethodsTwenty six recipients who received LDLT from September 2007 to March 2008 were reviewed.The data of the portal vein flow of these recipients were collected during the operation.Simultaneous splenectomy was performed in patients with portal blood flow ＞250 ml/(min · 100g).No splenectomy was performed when the portal blood flow was less than 250 ml/(min · 100g).The effect of selective splenectomy on modulation of portal vein flow and whether splenectomy prevented the occurrence of SFSS were analyzed.ResultsThe portal vein flow decreased significantly after splenectomy in 8 patients who received splenectomy (P＜0.01),No SFSS occurred in the patients with or without splenectomy.Actual graft-to-recipient weight ratio (GRWR) of patients with splenectomy was significantly smaller than those with no splenectomy (P=0.044).The portal vein flow of patients with splenectomy was much higher than those with no splenectomy (P＜0.01).ConclusionAccording to the portal blood flow,selective splenectomy in LDLT decreased the portal vein flow and prevented the incidence of SFSS.

AIM: To investigate the protective effect of microRNA-218 (miR-218) silencing on kidney tissue of streptozotocin (STZ)-induced diabetic nephropathy rats and the potential mechanism.METHODS: The diabetic rat model was established by a single intraperitoneal injection of STZ (50 mg/kg).Meanwhile, the miR-218 short hairpin RNA (shRNA) lentiviral vector was constructed.The Sprague-Dawley rats were randomly divided into 4 groups: healthy control group, diabetes group, empty vector group and miR-218-shRNA group.The blood glucose, 24 h urinary protein, serum creatinine (SCr) and blood urea nitrogen (BUN) in the rats at different time points (4, 8 and 12 weeks) were measured by an automated analyzer.The expression of miR-218 was detected by RT-qPCR, while the expression of heme oxygenase-1 (HO-1), nephrin and p38 mitogen-activated protein kinase (p38 MAPK) at mRNA and protein levels in the kidney tissues was determined by RT-qPCR and Western blot.The caspase-3 activity was detected by caspase-3 activity assay kit, and the cell apoptosis of the kidney tissues was analyzed by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL).RESULTS: Compared with healthy control group, the expression of miR-218 was significantly increased in STZ-treated rats.Meanwhile, the concentrations of blood glucose, 24 h urinary protein, SCr and BUN were significantly increased in STZ-treated rats (P<0.05).The mRNA and protein expression of HO-1 and nephrin was significantly decreased, while the level of phosphorylated p38 MAPK was significantly increased in STZ-treated rats.In addition, the activity of caspase-3 was also significantly increased in STZ-treated rats.When the model rats were infected with miR-218-shRNA, the expression of miR-218 was significantly decreased and the above effects were markedly reversed.Furthermore, TUNEL results showed that compared with diabetic group and empty vector group, miR-218 silencing significantly attenuated the cell apoptosis in the kidney tissues in miR-218-shRNA group.CONCLUSION: miR-218 is involved in the kidney injury in diabetic rats, and silencing of miR-218 by lentiviral vector-mediated miR-218-shRNA transfection effectively inhibits kidney cell apoptosis, suggesting that miR-218 is a potential target for the treatment of diabetic nephropathy.

Objective To investigate the clinical features of complex posterior communicating artery aneurysms and the outcome of microsurgical clipping.Methods The clinical and imaging data of the patients with posterior communicating artery aneurysm treated by craniotomy microsurgical clipping were analyzed retrospectively.The patients were divided into either a complex type group or a simple type group according to whether they had complex factors of surgical clipping or not.They were divided into a good outcome group and a poor outcome group according to their Glasgow Outcome Scale scores.Results A total of 55 patients with posterior communicating artery aneurysm were enrolled,and 17 (30.9％) of them were in the simple type group and 38 (69.1％) were in the complex type group.The proportion of higher Fisher grade in the patients of the simple type group was significantly lower than that of the complex type group (Z =-2.068,P=0.019).However,there were no significant differences in the proportions of age,sex,preoperative rupture,and Hunt-Hess grade between the two groups (all P ＞ 0.05).In the complex type group,the complex clipping (73.68％) and anterior clinoidectomy (42.11％) were the most common complex factors.Twenty-four patients (63.16％) had a number of complex factors.In the complex type cases,32 had good outcome,6 had poor outcome (3 of them died); in the simple type cases,15 had good outcome,2 had poor outcome (1 of them died).There was no significant difference in the good outcome rate between the complex type group and the simple type group (84.21％ vs.88.24％;x2 =0.153,P=0.696).In 55 patients with posterior communicating artery aneurysm,the age of the good outcome group was significantly lower than that of the poor outcome group (58.23 ± 12.41 years vs.68.38 ± 8.68 years,t =-2.212; P =0.031),and there were no significant differences in sex,Fisher grade,Hunt-Hess grade,factors of surgical complexity,and surgical clipping level (all P ＞ 0.05).Multivariate logistic regression analysis showed that only age was the independent risk factor for poor outcome of the complex posterior communicating artery aneurysm (odds ratio 1.142,95％ confidence interval 1.029-1.266; P =0.012).Conclusions Using the advanced microsurgical techniques,such as anterior clinoidectomy,anterior choroidal artery microdissection,and complex clipping for the treatment of complex posterior communicating artery aneurysm are no less favorable than the simple type,and age is an independent risk factor for the poor outcome of posterior communicating artery aneurysm.

Objective To explore different characteristics of the vertebral artery and basilar artery haemody-namics in different frequencies to provide a theoretical basis for clinical treatment .Methods 90 cases of sudden deaf-ness were induded and according to hearing curve ,the cases were divided into three groups with 30 cases for each while the control group had 30 subjects .All cases were examined by TCD ,the VA ,BA test .Results Compared with group of median and low frequency sudden deafness ,the abnormal blood flow rate were found with decreased hearing(P<0 .05) .High and the full frequency range showed the abnormal blood flow rate ,although results were different(P<0 .05) .There were more high velocity detection rates among patients of high frequency group than the other groups .The full-frequency group's blood flow detection rate increased significantly more than the first two groups of patients with sudden deafness .PI ,RI of sudden deafness increased slightly ,but there was no statistically significant difference compared with control group (P>0 .05) .High frequency hearing loss compared with the con-trol group patients with sudden deafness had a clear abnormal velocity (P<0 .05) ,characterized by high velocity . There was no statistically significant difference in blood flow rate among low and median frequency group ,full-fre-quency group and control group except for Vs of BA in low and median frequency group .Conclusion Vertebral and basilar arterial circulation disorders had present more significance in the incidence of sudden deafness ,evident espe-cially in high and all frequency sudden deafness .Early initiation of TCD examination can understand the change of the vertebral and basilar artery hemodynamics ,providing high clinical application values .