AIM: To evaluate the efficacy and safety of multiple vitamin E, C, B facial mask for the patients with acne vulgaris. METHODS: One hundred and seventeen patients aged over 13 a, with acnes mainly sited on the face and an acne severity rating above grade 2 were enrolled in this study. The mask treatment was used once a day with 8 wk as a course.The primary endpoint included the number and the degree of acne lesions including comedoes, papules, pustules and cysts. The secondary endpoint was the overall efficacy evaluation by the physicians. RESULTS:After 8 wk of treatment with multiple vitamin E, C, B facial mask, the mean number of acne lesions:comedoes, papules, pustules and cysts decreased 13 + s 13,10 ± 12, 5 + 7 and 3 + 3, respectively. These changes were statistically significant (P ＜ 0.01 ). The results of overall efficacy evaluation showed that 7 patients '(6.0 % ) symptom was greatly improved, 44 patients '(37.6 % ) symptoms were moderately improved, 56patients'(47.9 % ) symptoms were slightly improved,and 10 patients' symptoms did not change. Among all 117 patients, 59 patients (50.4 % ) showed no adverse reactions, including swelling, redness, itching,burning or scaling. CONCLUSION: Multiple vitamin E, C, B facial mask is efficacious for the treatment of acne and more than half study subjects experienced in none adverse reaction. Multiple vitamin E, C, B facial mask possesses an alternate therapy in acne vulgaris.

Tumor tissue hypoxia is taken as an important biologic character of malignant tumors,it could reduce the therapeutic efficacy of radiotherapy and chemotherapy. Presenting a noninvasive approach in detecting hypoxic state in tumors,hypoxia imaging of nuclear medicine can be used in the differential diagnosis,prognosis evaluation and guiding therapy of malignant tumors.

Objective To investigate the clinical effect of ureteroscopic holmium laser lithotripsy for the treatment of ureteral calculus.Methods A total of 72 cases of ureteral calculus was treated with stone fragmentation from April to November 2004,by using the Lumenis VersaPulse PowerSuite 100W Holmium Laser system and the Circon ACMI Micro Ureteroscope.Under ureteroscopic visualization,the laser lithotrite was introduced to the stones,and holmium laser intraluminal stone fragmentation was carried out. Results The operation time was 14~83 min(mean,28 min).Three cases of fragmentation failure were due to upper ureteral stones migrating to the renal pelvis.The success rate of fragmentation on one session was 95.8%(69/72),which was 92.1%(35/38) for upper segment calculi and 100%(34/34) for middle-to-lower segment calculi.Intraoperative complications included 3 cases of ureteral perforation(4.2%),9 cases of stone migration(12.5%),and 72 cases of hematuria(100%).Postoperative complications included 45 cases of lumbago(62.5%),72 cases of hematuria(100%),and 5 cases of urinary tract infection(6.9%), without ureteral stricture.The kidney,ureter,and bladder(KUB) X-ray radiograph on the first postoperative day showed a stone-free rate of 86.1%(62/72),and the remaining residual stones were thoroughly expelled within following 2 weeks.The length of postoperative hospital stay was 2~5 d(mean,3 d).Re-examinations with B-ultrasonography or intravenous urography(IVU) at 3 months after operation in 46 cases revealed no ureteral stricture.Hydronephrosis subsided by 1.4?0.5 cm in 28 cases and completely disappeared in 21 cases.Conclusions Ureteroscopic holmium laser lithotripsy for treating ureteral calculus offers satisfactory clinical effects and low complication rates.

Objective To investigate the value of imaging diagnosis of endomyocardial fibrosis(EMF).Methods Imaging findings of 28 cases of EMF were restrospectively analyzed.Results There were three types:right ventricle type(n=21),left ventricle type(n=1),and dual ventricle type(n=6).The misdiagnostic rate of EMF by X-ray plain films was high(18/28). On angiography and MRI right ventricle type presented as shortened,deformed inflow-tract,obliteration of apex and dilated outflow-tract,marked tricuspid valve regurgitation(TR) and enlarged right atrium,even dilated superior vena cava,left ventricle type presented as narrowiug and deformed inflow-tract,small and deformed left ventride,even no markedly volume changes in relaxation or contraction,obtuse cardiac apex and mitral regurgitation.Dual ventricle type owned manifestations in the two types mentioned above,but predominated by right ventricle type. Conclusion In diagnosis of EMF X-ray plain films are of less value while MRI and cardioangiography are significant,MRI is a valuable non-invasive method,it can substitutd for cardioangiography as the first choice in diagnosing EMF.

Objective To investigate the therapeutics of solitary kidney complicated with complexcalculi,and improve the effect and safety of treatment.Methods Experiences in the treatment of 32 patients with solitary kidney complicated with complex calculi were summarized.Congenital solitary kidney was 6 cases (18.8%),postnatal reason was 26 cases(81.2%),left was 12 cases(37.5%),right was 20 cases (62.5%).All patients were with mould or multiple calculi,9 cases were complicated with ureter calculi,and 8 cases were hospitalized because of obstructive anuria.The patients with mould calculi received extracorporeal shock-wave lithotripsy (ESWL) prior to percutaneous nephrolithotomy(PCNL).While the patients with multiple calculi received PCNL prior to ESWL. Some cases were treated by lithedialysis.Results Twenty-nine cases (90.6%)were cured by ESWL combined with PCNL 12 cases received lithodialysis during PCNL. Eight cases with obstructive anuria recovered in 12 hours after emergent ESWL or lithodialysis,3 cases(9.4%)underwent open operation because of deformity or obstruction in renal pelvis and ureter,1 case had to keep nephrostomy because of repeated infection.Followed up 4-36 months,29 cases (90.6%)kept good kidney function,3 cases(9.4%)had renal insufficiency,2 cases(6.2%)reoccurred calculi.Conclusions The therapeutics of ESWL combined with PCNL may clear complex calculi of solitary kidney effectively and safely.It is necessary to take emergent ESWL in renal obstructive calculi cases.And the patients with lower ureter obstructive calculi may take lithodialysis first.It is proper to choose open operation on the patients with deformity of renal pelvis or obstruction of ureter.

Objective To compare the outcomes of antegrade and retrograde approach ureteroscopy for impacted upper ureteric calculi and assess the safety and efficiency of the two types of minimally invasive technique. Methods A total of 106 patients with impacted upper ureteric calculi were treated with ureteroscopy. The procedure was performed via antegrade percutaneous nephrostomy tract in 50 patients (antegrade group) and via retrograde transurethral access in 56 patients (retrograde group). Results The success rate of retrograde group was 92.9% (52/56). Operating time was (45 ± 5 ) min, hospital stay was (6 ± 1) days. The stone free rate was 80.4%(45/56) at 1 month follow-up,7 patients with residual calculi required ESWL combination. Complication rate was 5.4% (3/56). The success rate of antegrade group was 100.0% (50/50). Operating time was (55 ± 8 ) min, hospital stay was (8 ± 2) days. The stone free rate was 100.0% (50/50) and no complication was noted. The stone free rate and the complication rate indicated significant difference between the two groups (P ＜ 0.05). Conclusions Antegrade and retrograde access ureteroscopy for impacted upper ureteric calculi are safe and effective. Success rate and stone free rate of antegrade approach are higher than those of retrograde approach.

Objective To evaluate the clinical effects and safety of percutaneous nephrolithotomy (PCNL) by middle renal calice used as the main target for the treatment of staghorn stones with the combination of pneumatic and ultrasonic lithotrite.Methods Clinical data of 73 patients underwent PCNL by middle renal calices as main access with 57 incomplete staghorn stones and 35 complete staghorn stones.To observe the situation calculus removal rate and complications.Results Seventy cases (88 sides) underwent one session PCNL by single access tract (middle caliees),3 cases (4 sides) underwent one session PCNL by double access tracts (2 cases by middle and low calices,1 case by up and middle caliees).After the first period of lithoclasty,17 patients (25 sides) residual stones and the stone removal rate 72.8％ (67/92),among these patients,1 case (1 side) had fragments of lateral renal calyeeal stones with no further treatment.Other 16 cases (24 sides)underwent second session PCNL,all were treated by single access tract (middle calices) and 2 cases (2 sides)had extracorporeal shock wave lithotripsy before the second PCNL.After the second period of lithoclasty,76 sides composed of 27 complete staghorn stones and 49 incomplete staghorn stones had no residual fragments with the stone removal rate 82.6％ (76/92).The operative time lasted 120-320 min.Hemoglobin dropped 1-4 g/L,11 cases in the operation procedure and 3 cases after operation needed blood transfusion respectively.One case of renal pelvic infection after operation and 1 case had split renal dysfunction with peri-parenchyma infection.The hospitalization time was 9-18 days.Conclusion It is effective and safe to perform PCNL for staghorn stone by middle calices as a main access.Combining pneumatic and ultrasonic lithotrite will be very useful with high stone clearance,short procedure time and less complications.

Objective To discuss the medium-term follow-up of clinically insignificant residual fragments (CIRF) after minimally invasive percutaneous nephrolithotomy lithotripsy (MPCNL).Methods The clinical data of 72 patients with CIRF medium-term follow-up were analyzed retrospectively.Results Seventy-two patients with CIRF.The anatomical distribution of CIRF was 10 at upper pole,15 at middle,35 at lower,10 at renal ureteropelvie junction and 2 at upper and lower pole.Stone analysis showed that 41 cases of calcium oxalate calculi,16 of calcium oxalate calculi mixed with carbonate calculi,3 calcium oxalate calculi mixed with uric acid,4 calcium oxalate calculi mixed with struvite stone,3 struvite stone,2 uric acid stone and 3 carbonate apatite mixed with struvite stone.Fifteen cases had clinical symptoms,including 2 renal colic pain,8 hematuria,5 lower urinary tract symptoms,4 cases CIRF located in upper pole,1 case in middle pole,4 cases in lower pole,6 cases in ureteropelvic junction,the incidence of clinical symptoms in ureteropelvic junction was significantly higher than that in other locations (6/10 vs.4/12,1/15,4/37,P ＜0.05).Eight cases required surgical procedure,5 cases underwent extracorporeal shock wave lithotripsy,3 cases with ureteral CIRF were performed with ureteroscopic lithotripsy.CIRF were clear after surgery,7 patients with ureteral CIRF had renal colic pains.The stones were excluded after spasmolytic analgesic treatments.Conclusions CIRF can be located variously in the kidney and ureter.Most CIRF are calcium oxalate calculi and locate in the lower pole.Patients with the history of previous open surgery or extracorporeal shock wave lithotripsy are more likely to get CIRF.Medium-term follow-up of CIRF reveals that CIRF located in the renal ureteropelvis junction are more likely to have clinical symptoms.

AIM: To investigate clonal expansion and specific cytotoxicity of TCR V? subfamily T cells from acute myelogenous leukemia M_ 2a subtype (AML-M_ 2a)patients and normal individuals induced by AML-M_ 2a cells, respectively. METHODS: Complementarity determining region 3(CDR3) of TCR ? with variable region genes was amplified in autologous or allogeneic T cells from mixed lymphocyte and tumor culture (MLTC) using RT-PCR. The positive products were further analyzed to identify the clonality of T cells by genescan. The specific cytotoxicity of T cells was analyzed by MTT. RESULTS: T cells from both M_ 2a patients and normal individuals after MLTC showed high response to M_ 2a cells with 4-17 TCR V? subfamily dominant utilization, one or two clonal expansion of T cells were identified in some predominant TCR V? subfamilies. Difference of distribution and clonal expansion of TCR V? subfamily T cells were related to source of T cells and the phase during MLTC. Compared with LAK cell, most of T cells from MLTC were CD3+CD8+T cells with higher and more specific cytoxicity to the induced cells, M_ 2a cells, but not HL60 or K562 cell line. CONCLUSION: Clonal expansion of TCR V? subfamily T cells stimulated selectively by M_ 2a cells may be a specific immune response of autologous and allogeneic T cells to M_ 2a cells associated antigen. The T cells induced by M_ 2a cells have the ability of specific cytoxicity to the AML-M_ 2a cells.

Objective To investigate the proportion, risk factors and tendency of the change of stones composition in recurrent urolithiasis. Methods One hundred and fifty-six recurrent urolithiasis patients from January 2011 to January 2016 were enrolled. Compositions of initial and recurrent stones were measured by infrared spectrophotometry. Stones types, recurrence interval and recurrence frequency were studied as potential risk factors for composition change. Chi square test and Logistic regression analysis was employed in the statistical analysis. Results Stones composition changed during recurrence in 48 patients (30.8%). 22.8%(18/79) of calcium oxalate stones change to infection stones, and 25.8%(8/31) of infection stones changed to calcium oxalate. Univariate analysis showed the risk ratio of composition change in the patients with recurrence interval of 1- 5 years was 0.529(P = 0.039) , compared with those of less than 1 year or more than 5 years. Logistic regression analysis showed the odds ratio of recurrence interval of 1- 5 years was 0.242 (95%CI: 0.086- 0.718, P = 0.012). Conclusions Stones composition changes in about 30.8% of recurrent urolithiasis. The mutual conversion between calcium oxalate and infection stones is the most common. Recurrence interval is an independent risk factor to predict composition change.