Objective To evaluate the efficacy and safety of ultrasonography-guided percutaneous nephrolithotomy(PCNL).Methods Between May 2006 and June 2008,110 patients underwent PCNL by a single urological team at our hospital.The clinical data of the patients were retrospectively reviewed.Of the cases,supracostal access(the 11th intercostal space) was made in 62 patients(supracostal group),and subcostal access was obtained in 48 patients(subcostal group).Forty-five patients in the supracostal group(45/62) and 36 of the subcostal group(36/48) received CT three dimensional reconstruction.Results The stone free rate of the supracostal group was 72.6%(45/62),while that of the subcostal group was 60.4%(29/48;?2=1.818,P=0.178).The mean operation time of the supracostal group was(78.6?5.1) min,while that of the subcostal group was(102.4?7.1) min(t=-20.454,P=0.000).There was one patient in each group received blood transfusion.One patient in the supracostal group had pneumothorax and recovered uneventfully by conservative treatments.Conclusion Ultrasonography-guided PCNL via the supracostal approach is effective and safe with short operation time.

Objective To explore the influence of structured lipid emulsion on inflammatory cell factors and immunologic function in gastrointestinal cancer patients after operation.Methods From July 2010 to February 2012,80 postoperative patients with gastrointestinal cancer were randomly divided into 2 groups with 40 cases each by stratified sampling method:structured lipid emulsion group (observation group),physical mixture of medium-chain/long-chain triglycerides group (control group).Both groups received isonitrogenous and isocaloric parenteral nutrition for 6 days after operation.The general conditions after operation were compared between two groups.Inflammatory cell factors and immunologic function were measured before operation,the 1st day and 7th day after operation.Results After 6 days parenteral nutrition,the vital sign data,blood routine,liver and renal function,blood fat etc was normal in two groups.There was no significant difference in the incidence of postoperative infection complication and hospitalization duration between observation group and control group [12.5％(5/40) vs.25.0％(10/40),[( 12.9 ± 0.7 d) vs.(13.1 ±0.9) d] (P ＞0.05).The serum levels of interleukin (IL)-1,IL-2,IL-6,tumor necrosis factor (TNF)-α on the 1st day after operation in two groups decreased,then gradually increasing.The serum levels of IL-2,IL-6,TNF- α on the 7th day after operation in observation group[(987 ± 203),(277 ± 107),( 197 ± 98) ng/L] were lower than those in control group [(1347 ± 195),(752 ± 187),(342 ± 106) ng/L](P＜0.05 ).The serum levels of IgG,IgA,IgM,CD3+,CD4+ and CD8+ on the 1st day after operation in two groups decreased,then gradually increasing.The serum levels of IgG,CD3+,CD4+ were higher in observation group [( 14.2 ± 1.8 ) g/L,0.746 ± 0.111,0.580 ± 0.067] than those in control group [( 12.1 ± 2.8) g/L,0.606 ±0.101,0.404 ± 0.072] (P ＜0.05).Conclusion Structured lipid emulsion can reduce immunological suppression and inflammation in gastrointestinal cancer patients after operation,regulate the inflammatory cell factors producing and releasing,improve the immunologic function.

SUMMARY Intravesical bacillus Calmette-Guérin ( BCG) was a common treatment for non-muscle inva-sive urothelial carcinoma of the bladder. The complication of prostatic abscess was rare. We reported a case of tuberculous prostatic abscess after BCG therapy. A 65-year-old man was diagnosed as bladder cancer and accepted transurethral resection of bladder tumor ( TURBT) treatment. He received a 6-week induction course without any infection complication. Following the second BCG maintenance instillation, he complained of fever and dysuria. Transrectal ultrasound ( TRUS) demonstrated a well-defined complex mass in the right lobe of his prostate. The diagnosis of tuberculous prostatic abscess was considered after excluding other bacterial infection. The patient was treated with an anti-tuberculous regimen of isoniazid, rifampicin, and ethambutol. The symptoms were relieved after 4 weeks of anti-tuberculous therapy. Be-cause of the good response to the medicine, no further aspiration or drainage of prostatic abscess was car-ried out. The anti-tuberculous therapy had to be stopped for serious drug induced liver injury after 6 weeks of anti-tuberculous therapy. Eight weeks later of stopping anti-tuberculous therapy, the follow-up TRUS showed the disappearance of the prostatic abscess and the test of his liver function was normal. Considering the virulence of BCG is weaker than that of common tuberclebacillus, the shorter course of anti-tuberculous therapy maybe an alternative choice, and surgical drainage is not always necessary.

Objective To evaluate the effects of curcumin on the activity of NR2B and NR1 in the spinal dorsal horn in a rat model of diabetic neuropathic pain (DNP).Methods Diabetes mellitus was induced by high-sucrose and high-fat diet and intraperitoneal streptozotocin 35 mg/kg,then confirmed by fasting blood glucose level ≥ 16.7 mmol/L 3 days later in male Sprague-Dawley rats.DNP was confirmed by the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) measured on day 14 after streptozotocin administration ＜ 80％ of the baseline value.The rats were then randomly divided into 3 groups (n =27 each) using a random number table:DNP,DNP+ curcumin group (group DCur)and DNP + solvent control group (group DSC).Curcumin 100 mg· kg-1 · d-1 and corn oil 4 ml· kg-1 · d-1 were injected intraperitoneally for 14 consecutive days starting from 14 days after administration of streptozotocin in DCur and DSC groups,respectively.Another 27 normal male Sprague-Dawley rats served as control group (group C) and were fed with normal forage.At 3,7 and 14 days after curcumin injection,MWT and TWL were measured and the lumbar segments (L4-6) of the spinal cord were removed.The expression of pTyr1472-NR2B and pSer896-NR1 in the spinal dorsal horn was determined by immunohistochemistry and Western blot.Results Compared with group C,MWT was significantly decreased,TWL was shortened,and the expression of pTyr1472-NR2B was up-regulated at each time point in group DNP.Compared with group DNP,MWT was significantly increased,and TWL was prolonged at 7 days after curcumin injection,and the expression of pTyr1472-NR2B was down-regulated at 3 days after curcumin injection in group DCur.There was no significant difference in each parameter between DNP and DSC groups,and in the expression of pSer896-NR1 between the four groups.Conclusion The mechanism by which curcumin mitigates neuropathic pain in type 2 diabetic rats may be related to inhibition of up-regulation of pTyr1472-NR2B expression,while unrelated to pSer896-NR1 expression in the spinal dorsal horn.

Objective To explore the influence of structured lipid emulsion on acute phase protein and acute inflammatory reaction in gastrointestinal cancer patients after operation.Methods Eighty postoperative patients with gastrointestinal caner from July 2010 to February 2012 were randomly divided into observation group and control group,and 40 cases for each group.Patients in observation group were given structured lipid emulsion,while in control group were given physic mixture of medium-chain/long-chain triglycerides group.Meanwhile patients in both groups were received isonitrogenous and isocaloric parenteral nutrition for 6 days after operation.The general conditions after operation were recorded.Acute phase protein and acute inflammatory reaction were measured before operation,the 1 st day and 7th day after operation.Results After 6 days parenteral nutrition,the vital sign data,blood routine indices,liver and renal function,blood fat were back to normal values in two groups.There was no significant difference in the incidence of postoperative infection complication and hospitalization duration between observation group and control group (12.5％ (5/40) vs.25.0％ (10/40) ; (12.9 ± 0.7) d vs.(13.1 ± 0.9) d; P ＞ 0.05).The serum levels of Albumin (ALB),Prealbumin(PAB) and Transferrin(TRF) on the 1st day after operation in two groups were significantly lower than those before operation,while the serum levels of C reactive protein (CRP) and fibrinogen (Fib) were significantly higher,then gradually recovering.The serum levels of ALB,PAB,TRF,CRP,Fib on the 7th day after operation in observation group were (37.11 ± 3.30) g/L,(0.25 ± 0.08) g/L,(2.35 ± 0.49) g/L,(21.84±16.76) mg/L,(3.95 ± 1.23) g/L,significant different from those on the 1st day before nutrition therapy ((31.52±2.92) g/L,(0.15 ±0.02) g/L,(1.90 ±0.54) g/L,(83.80 ±47.13) mg/L,(4.35 ±0.98) g/L) and control group ((34.50 ±2.71) g/L,(0.18 ±0.05) g/L,(2.00 ±0.52) g/L,(41.36 ±23.49) mg/L,(4.76 ± 2.35) g/L; P ＜ 0.05).The serum levels of interleukin (IL)-1,IL-2,IL-6,tumor necrosis factor (TNF)-α decreased on the 1st day after operation of two groups,then gradually increasing.The serum levels of IL-2,IL-6 on the 7th day after operation in observation group were (987 ±203) ng/L) and (277 ± 107) ng/L,significant different from those on the 1st day before nutrition therapy ((890 ± 197) ng/L and (355 ± 107) ng/L;P ＜0.05),and lower than those in control group ((1 347 ± 195) ng/L,(752 ± 187) ng/L; P ＜0.05).The serum levels of TNF-α on the 7th day after operation in observation group was (197 ±98) ng/L,which was as same as that on the 1 st day before nutrition therapy ((167 ± 79) ng/L,P ＞ 0.05) and lower than this in control group((342 ± 106) ng/L;P ＜0.05).Conclusion Structured lipid emulsion can effectively improve the synthesis of acute phase protein in gastrointestinal cancer patients after operation,regulate the inflammatory cell factors producing and releasing,which is benefit to smoothly through stress reaction period.

Objective: To investigate the position and the size of ureteral stone in patients before treated with ureteroscopic lithotripsy or percutaneous nephrolithotomy (PCNL), as well as the dilatation of ureter caused by stone, which may be helpful for better understanding of pathogenesis of ureteral stone and improvement of the diagnosis and treatment in clinic.Methods: A total of 129 cases with ureteral stone for endourologic lithotripsy in Peking University People''s Hospital from Aug.2016 to Mar.2017 were included for the retrospective review.The CT data of the ureteral stones and the ureteral dilatation were collected, including the position of stone, the transverse and longitudinal diameter of stone, and the transverse diameter of dilated upper ureter and ureteropelvic junction (UPJ).The distribution of ureteral stones and dilatation in different parts of ureter were compared and analyzed.Results: All of the 129 cases of ureteral stone, stones were located at UPJ in 9 cases (7.0%), proximal ureter in 75 (58.0%), ureter crossing external iliac vessel (UEIV) in 6 (4.7%), distal ureter in 26 (20.2%), and ure-terovesical junction (UVJ) in 13 (10.1%).The mean transverse diameter of proximal ureteral stones was greater than that of distal ureteral stones [(8.47±2.36) mm vs.(6.74±1.99) mm, P<0.001], as the same as the mean longitudinal diameter [(11.00±4.41) mm vs.(7.50±4.28) mm, P<0.001].In 114 cases of dilated ureter for stone, the UPJ had a greater transverse diameter compared with the upper ureter [(14.39±6.09) mm vs.(11.45±3.85) mm, P<0.001].Conclusion: The most common location of stone is the proximal ureter in patients for endourologic lithotripsy, as the location in UEIV is rare.Both transverse and longitudinal diameters of stone in proximal ureter are greater than those in distal ureter.For dilated ureter, it is more severe in UPJ than in upper ureter.Traditionally, it is accepted that the stones lodge at 3 sites of natural narrowing in ureter, which may be questioned.

Objective To evaluate the effects of reserved jejunal feeding tube during postoperative chemotherapy of gastric cancer. Methods Forty-two patients with gastric cancer underwent radical gastrectomy and going to adjuvant chemotherapy,conventional placed jejunal feeding tube. All of the patients weredivided into group A and group B randomly by pathological staging and tumor site, group A reserved jejunal feeding tube and received enteral nutrition through the tube during chemotherapy, and group B non-reservedjejunal feeding tube and been given daily diet,compared nutrition and immune indicators of two groups beforeand after chemotherapy ,compared the rate of vomiting,and observed complications long-term reserved jejunal feeding tube. Results In post-chemotherapy,nutrition and immune indicators of group A were betterthan those of group B, the difference was statistically significant (P＜0.05) ,the rate of vomiting in group Awas significantly lower than that of in group B (X2= 9.75, P＜0.01 ), no serious complieations occurred forlong-term reserved jejunal feeding tube. Conclusions Reserved jejunal feeding tube and received enteralnutrition through the tube during postoperative chemotherapy of gastric cancer can significantly improve the nutritional and immune status. It is safe and reliable, worth promoting.

Qi-Gui-Yin (QGY) compound, which composes of five herbal medicines of Astragalus membranaceus (Fisch.) Bge., Angelica sinensis (Oliv.) Diels, Lonicera japonica Thunb., Artemisia annua L., and Polygonum cuspidatum Sieb.et Zucc., which is able to treat antibiotic-resistant bacteria with antibiotics, and also to delay or even reverse the bacterial resistance producing. However, QGY compound is a complex mixture. And it is very difficult to elaborate its material foundation. Therefore, chemical constituents in five herbal medicines were summarized through searching of the related literatures. And then, 170 kinds of bioactive ingredients were classi-fied in order to provide evidences for the study on chemical constituent of QGY compound and identify its mate-rial foundation of delaying drug resistance .

OBJECTIVE To investigate the effect of curcumin on proliferation of neural stem cells (NSCs) of rats and the mechanism. METHODS NSCs derived from the forebrain of rat E15 embryos were cultured in vitro and identified by neuroepithelial stem cell protein ( nestin and SOX2) staining. NSCs were treated with curcumin 0.1, 0.5, 2.5, 12.5 and 62.5 μmol.L-1 for 24 h, respectively. The cyto-toxicity was estimated by measuring the release of lactate dehydrogenase(LDH). Cell viability and prolif-eration were analyzed respectively by MTT and BrdU assay. The mRNA expression levels of glucocorti-coid receptor (GR), Stat3, Notch1 and p21 were detected by qRT-PCR. The protein expression levels of total GR, Stat3 and phosphorylated Stat3 were measured by Western blotting. RESULTS The primary neural stem cells were identified as NSCs. Curcumin 12.5 and 62.5 μmol.L-1 had cell cytotoxicity( P<0.05). Cell viability assay indicated that curcumin 0.5 and 2.5 μmol.L-1 enhanced NSCs viability( P <0.05), but in 62.5 μmol.L-1 group the cell cytotoxicity was inhibited(P<0.05). Curcumin 0.1, 0.5 and 2.5 μmol.L-1 increased NSCs proliferation ( P < 0. 05), whereas 12. 5 and 62. 5 μmol.L-1 caused a decrease in NSCs proliferation(P<0.05). The mRNA expression level of GR in 0.5 μmol.L-1 group was significantly reduced( P<0.05). Western blotting analysis revealed that the protein expression of GR, Stat3 and p-Stat3 was inhibited by curcumin in 0.5 μmol.L-1 group(P<0.05). CONCLUSION Curcumin stimulates NSCs proliferation, possibly by inhibiting GR mRNA and related protein expression.

Objective To evaluate the role of adenosine A1 receptors in hippocampal neurons in the cognitive dysfunction caused by isoflurane anesthesia in aged mice.Methods Sixteen male adenosine A1 receptor gene knockout homozygote mice (gene knockout mice) and 16 male wild-type mice,aged 18-22 months,weighing 27-32 g,were studied.Each type of mice was randomly divided into 2 groups (n=8 each) using a random number table:control group (group C) and isoflurane anesthesia group (group Ⅰ).Mice inhaled 1.4％ isoflurane in 100％ O2 for 2 h in group Ⅰ,and 100％ O2 for 2 h in group C.All the mice underwent Morris water maze test at 24 h after isoflurane or O2 inhalation.After the test,the mice were sacrificed and the hippocampal tissues were harvested to determine the number of β-amyloid1-42 (Aβ1-42) plaques (using immunohistochemistry) and expression of phosphorylated tau (p-tau) protein,and 2B subunit-containing N-methyl-D-aspartate receptors (NR2B) (by Western blot analysis).Results Compared with group C of wild type mice,the escape latency was significantly prolonged,the number of Aβ1-42 plaques was enlarged,the expression of p-tau protein was up-regulated,and the expression of N R2B was down-regulated in group Ⅰ of wild type mice.Compared with group Ⅰ of wild type mice,the escape latency was significantly shortened,the number of Aβ1-42 plaques was decreased,the expression of p-tau protein was down-regulated,and the expression of NR2B was up-regulated in group Ⅰ of gene knockout mice.There was no significant difference in the parameters mentioned above between group Ⅰ and group C of gene knockout mice.Conclusion Adenosine A1 receptors in hippocampal neurons mediate isoflurane anesthesia-induced cognitive dysfunction in aged mice,and the mechanism may be related to promotion of deposition of Aβ,phosphorylation of tau protein and inhibition of activities of NR2B.