Objective To study and evaluate various therapeutic means for upper urinary tract calculi. Methods 3 218 cases of upper urinary tract calculi were reviewed.1 365 were pure kidney stones,651 complicated kidney stones,558 group Ⅰ ureteral stones,452 group Ⅱ ureteral stones and 192 group Ⅲ ureteral stones. Results ESWL (extracoporeal shock wave lithotripsy) has been the treatment of choice for pure kidney stones and for groupⅠ ureteral stones.Open surgery has been the best for complicated kidney stones and group Ⅱ,Ⅲ ureteral stones.1 164 patients underwent lithotomy and 1 923 ESWL.131 cases of group Ⅱ ureteral stones in the middle or lower segment of ureter were treated by ureteroscopic lithotripsy.Of the complicated kidney stones,residual stones were observed in 57 (8.8%).1.8%( n =12) of such cases underwent nephrectomy.The complete stone elimination rate in 3 months after ESWL was 81.6% whereas open operation was needed in 18.4%.Ure teroscopic lithotripsy yielded the poorest outcome,nephrectomy being undertaken afterwards in 0.8% and lithotomy in 6.1%. Conclusions ESWL,ureteroscopic lithotripsy,ballast lithotripsy or the combined use of 2 methods makes the surgical management of upper urinary tract calculi easier with less suffering to the patients.The use of double internal stent could reduce the surgical complications.Stone street after ESWL should be well taken care of and inflammation should be well controlled.Skilled technique is needed for ureteroscopic lithotripsy.

The effects of tetramethylpyrazine ( TMPZ ) on the contraction of isolated guinea pig trachea induced by leukotrienes,histamine,prostagladin F2a , acetylcholine were observed. It was found that TMPZ exerts an inhibitory effect on the contraction induced by these asthmogenic mediators. It is non-competitive antagonist.

Objective To investigate the importance for early operation in severe acute pancreatitis (SAP) treatment. Method We retrospectively compared the mortality of 37 cases of SAP gradeⅡthat were treated by non-operative and early operative methods.Result The mortality of the nonoperative group was significantly higher than operative group (88.9% to 42.1%). Conclusion In the early course of SAP, nonoperative treatment should not overemphasized and,operation should be considered as a therapeutic method according to different pathophysiological changes.

The present study was to develop and design a new sonography rigid bronchoscopy and corollary vacuum-assisted biopsy device system with less injury and complication. The system combined ultrasonic-probe with ultrasound catheter, a new medical ultrasound technique, and rigid bronchoscopy (RB) which is improved with an auxiliary vacuum-assisted biopsy device. The principle of the device is vacuum suction and rotary knife. The reduced outer diameter of the RB led to less pain and lower complications for the patient. With the help of ultrasonic-probe (30 MHz), lesions and blood vessels can be identified clearly and unintentional puncture and damage to blood vessels can be avoided. Plenty of lesions can be obtained quickly through the vacuum-assisted biopsy device without getting puncture needle in and out repeatedly. The novel endobronchial sonography rigid bronchoscopy and matched vacuum-assisted biopsy device has many remarkable advantages. It can enlarge the applied range of the RB from endobronchial to mediastinal lesions, avoiding unintentional puncture of vessels. Obtaining multiple samples with a higher accuracy rate than that by other sampling techniques, minimizing operation time, alleviating pain and decreasing the complication rate, the system makes up the technical deficiency for the diagnosis and treatment of the mediastinal lesions, to a certain degree.
Biopsy, Needle ; instrumentation ; Bronchoscopy ; instrumentation ; Equipment Design ; Humans ; Mediastinum ; pathology ; Ultrasonography ; instrumentation ; Vacuum

Objective To compare the safety,feasibility,and long-term outcomes between combined thoracoscopic and laparoscopic esophagectomy (TLE) and open three-field esophagectomy (OE) for esophageal cancer.Methods The data of 183 patients with esophageal cancer who accepted TLE (n =94) or OE (n =89) from February 2009 to December 2011 were retrospectively collected and compared.Results Demographics,pathologic data in each cohort were almost identical.No significant differences were observed in operative time,the number of lymph node harvested,rates of anastomotic leak,thoracic abscess,chyle chest,re-operation,vocal cord paralysis,gastric emptying dysfunction and morbidity.A significant difference was observed in blood loss (86.6 ±38.3 ml in TLE group vs.217.4 ±87.2 ml in OE group,P=0.000),rate of transfusion (1.1％ vs.6.7％,P =0.045),hospital stay (13.9 ±7.5 d vs.17.1 ±10.2 d,P =0.017),rate of overall surgical complications (23.4％ vs.38.2％,P =0.030),rate of pulmonary complications (9.6％ vs.27.0％,P =0.002) and rate of arythmia (4.1％ vs.12.4％,P =0.046).Median follow-up time was 28.0 ±2.0 months (95％ CI:24.2-31.8).No difference between the two groups concerning survival was observed (P =0.954).Conclusion The TLE for esophageal cancer is safe and feasible.Although it cannot improve the survival of long-term,it is worth spreading in intraoperative and postoperative advantages compared with OE group.

AIM: To study the change of cellular immunological function in patients with locally advanced lung cancer before and after operations. METHODS: A lung cancer group of 20 cases with locally advanced lung cancer (group A), a benign disease group of 20 cases with lung benign disease (group B) and a normal group of 20 cases from healthy volunteers (group C) were set up. The levels of the peripheral blood T lymphocyte subsets (CD~+_3, CD~+_4, CD~+_8, CD~+_4/ CD~+_8 ratio) were detected in the group A before operation and on the 10th day and 17th day after operation by indirect immuno-fluorescence assay and contrasted with the group B and group C. RESULTS: The levels of T lymphocyte subsets in group A were abnormal before operation, CD~+_3, CD~+_4/ CD~+_8 ratio were significantly lower than those in group B and group C (P

Objective To investigate mRNA expression level changes of dopamine transporter gene (DAT1) and dopamine receptor gene(DRD4) in attention deficit hyperactivity disorder(ADHD) children's peripheral blood before and after methylphenidate treatment,and to explore associations between the mRNA expression level and symptom severity,as well as methylphenidate response.Methods Forty five ADHD children by DSM-Ⅳ diagnostic criteria,aged six to fifteen years old participated in a six-week drug titration treatment of metbylphenidate.ADHD-RS-Ⅳ Home Version, WCST and VCPT were used to evaluate the ADHD clinical symptoms and cognitive functions.RNA Simple Total RNA Kit was used to extract the total RNA.After reverse transcription, the obtained c-DNA was used in the following qRT-PCR to evaluate relative mRNA expression of the candidate genges before and after medication.Results The DRD4 mRNA relative expression level after taking methylphenidate was significantly higher than that before methylphenidate treatment (0.23 ± 0.23 vs 0.16± 0.18, P =0.041).There was no significant difference between DAT1 mRNA relative expression level before (0.43 ± 0.40) and after (0.43±0.40) methylphenidate treatment.No significant difference was found on eitber basal DAT1/DRD4 mRNA expression or fold change of DAT1/DRD4 mRNA expression before and after medication between methylphenidate treatment responders and non-responders groups.There was a positively significant correlation between baseline DRD4 mRNA relative expression level and erroneous T score of CPT(r=0.424, P=0.025) , however, no other statistically significant correlation was found between basal DRD4 mRNA relative expression level and ADHD-RS-Ⅳ total score,WCST conceptual level, CPT missing T score, and CPT reaction T sco~ (all P＞0.05).There was also no statistical significant correlation between basal DAT1 mRNA relative expression level and ADHD-RS-Ⅳ total score,WCST conceptual level,and CPT T scores(all P＞0.05).Conclusion DRD4 gene function may be increased after methylphenidate treatment and play an important role in impulsivity behavior of ADHD.Therefore, DRD4 mRNA expression level might be a biomarker for ADHD diagnosis and a predicting indicator of drug efficacy.

Objective To evaluate the short?term efficacy and safety of endoscopic photodynamic therapy ( PDT ) for esophageal squamous cell carcinoma ( ESCC ) and precancerous lesion. Methods Retrospective analysis was performed on 30 patients with early ESCC or precancerous lesions who received PDT between September 2013 and April 2015 in Endoscopy Center, Henan Tumor Hospital,and its indications were summarized. The main outcomes including histological complete response rate ( CR ) , recurrence rate and adverse events after treatment of one year were analyzed. Results Three patients with middle grade dysplasia( MGD) , 18 with high grade dysplasia( HGD) and 4 with squamous cell carcinoma in situ, all negative lymph node metastasis, received PDT. CRs were 72?0%(18/25) and 88?0%(22/25)after one PDT session in 3 months and 12 months, respectively. One?year follow?up showed 3 recurrences ( 12?0%) ,4 ( 16?0%) severe strictures, and no perforation. Five patients with advanced squamous cell carcinoma received palliative PDT. Partial remission rate was 60?0%( 3/5) after one PDT session in 3 months, and 40?0% ( 2/5) after 12 months. Two died of tumor metastasis, one died of gastrointestinal bleeding one year after PDT. No perforation occurred. Conclusion Endoscopic photodynamic therapy for esophageal squamous cell carcinoma and precancerous lesions is safe and feasible, with remarkable short?term effect. As for the patients with advanced squamous cell carcinoma, it is equally safe and effective in the short term.

Objective:To compare three different routes for nutritional support after thoracolaparoscopic esophagectomy. Meth-ods:The clinical data of 310 esophageal cancer patients undergoing thoracolaparoscopic esophagectomy in Affiliated Cancer Hospital of Zhengzhou University from January 2010 to October 2013 were analyzed (early oral feeding group:110, nasojejunal tube feeding group:102, and jejunostomy tube feeding group:98). The serum albumin and body weights were compared among the three groups be-fore operation and four days after operation. The postoperative recovery time of the first exhaust time and hospitalization days were al-so compared. The fistula of esophageal anastomosis, pulmonary infection, and complications from intubation such as throat inflamma-tion were also compared. Results:No postoperation mortality occurred in the three groups. In addition, no significant difference was ob-served between the nasojejunal tube group and jejunostomy group for the first exhaust time and hospitalization days. The recovery of the early oral feeding group was significantly faster than the other two groups. Postoperative acute dilatation of the stomach and func-tional delayed gastric emptying were not found in the three groups. The anastomotic leakage and pulmonary infection rate had no signif-icant difference. The throat inflammation from intubation in the nasojejunal tube feeding group was significantly more than that in the jejunostomy tube feeding group. Eleven percent of the patients removed the tube by themselves. In the jejunostomy tube feeding group, five patients suffered from postoperative fistula drainage, including one case with serious symptoms. Five patients had incomplete ileus. Conclusion:Early oral feeding is a suitable nutritional support route after thoracolapascopic esophagectomy and it is a good way to re-duce operation stress, improve patient compliance, induce fast recovery, and shorten hospitalization days.