Objective To explore the clinical characteristics and surgical indications of polypoid lesions of the gallbladder (PLG).Meth-ods The clinical data of 33 1 patients with PLG who underwent surgery in Department of General Surgery from August 2008 to December 2013 were analyzed retrospectively.Comparison of ratios between two groups was analyzed by chi -square test.Results Among the 331 surgical cases,there were 13 cases with adenomatous polyps (3.9%)and 318 cases with non-adenomatous polyps (96.1%).After com-paring the clinical characteristics of the two groups,significant differences were observed in the following parameters:sex (χ2 =6.2,P =0.013),age (≥40/<40)(χ2 =3.90,P =0.048),sizes of polyps (≥10 mm/<10 mm)(χ2 =77.4,P <0.000 1),number of le-sions (multiple/solitary)(χ2 =6.2,P =0.013),PLG basal width (≥6 mm/<6 mm)(χ2 =111.8,P<0.000 1),and presence or absence of concomitant calculi (χ2 =7.5,P =0.006).Conclusion Clinical symptom is considered an indication for surgery.For most of the gallbladder polyps,the risk of malignant transformation is extremely low.Other surgical indications for gallbladder excision include age≥40 years,single polyps measured ≥10 mm in diameter,polyp basal width ≥6 mm,recent rapid polyp growth,and tumor-associated factors such as polyps with calculi.

Objective To study the effect of shengmai injection on the cytotoxicity of lactate-buffered peritoneal dialysis solutes (L-PDS) to human peritoneal mesothelial cells (HPMC). Methods HPMC was separated with trypsin-EDTA. HPMC proliferation and the concentration of lactate dehydrogenase (LDH) in supernatants were detected by MTT assay and automatic biochemical analyzer respectively. Results LDH levels of supernatants increased and prolifernation of HPMC was inhibited in L-PDS groups ( P

Objective The aim of the study was to observe the change of blood lipid in uremic patients after hemodialysis or peritoneal dialysis. Methods Sera cholesterol(CH), triglyceride(TG), LDL, HDL, ApoA1, ApoB and LP(a) were measured in all patients who were dialystic treated before and after six months.Results CH, TG, LDL, HDL, ApoA1 and ApoB were significant increased in patients with uremia,but HDL, ApoA1 was significant decreased,they were apparent especially after peritoneal dialysis .However,the blood lipid levels of patients with hemodialysis or non-dialysis did not significant difference before or after treatment. Conclusions The metabolism of blood lipid in uremic patients have been changed. The disturbance will aggravate after peritoneal dialysis.We consider that therapy of reducing blood lipid is necessary in the both patients with dialysis and non- diaylsis for the uremic patients.

Objective To evaluate the efficacy and safety of holmium laser for treatment ureteric stones in patients with acute obstructive renal impairment.Methods Thirty-two patients were included in this study.None of the patients had a ureterie stent or nephrostomy tube before the ureteroseopy.All patients were treated with holmium laser.Results 30 patients with ureter stones in middle and inferior segment were free of stones by ureteroscopic lithotripsy.The success rate for treatment of ureteral stones lithotripsy and calculus removal was 93.7%.Ureter stones located in superior segment in two patients were sent back pelvis.Extracorporeal shock-wave lithotripsy were performed.The two patients were free of any stone fragmens a month later.In all patients, including the five with obstructive anuria,the renal impairment resolved or improved as evidenced by normalization or fall in blood urea and creatinine.100% of the patients were free of any stone fragments postoperatively.Conclusion A holmium laser was a safe and effective modality of ureteroscopic lithotripsy in patients with significant renal impairment or even obstructive anuria.It also had merits of small wound and fast postoperation recovery.Treatment of both-side ureteral stones could be handled at the same time.The use of holmium laser by ureteroacopy could be considered the first choice in patients with acute obstructive renal impairment.

Objective To observe the effect and safety of the treatment of urethral stricture with guide wires leading a balloon dilatation catheter.Methods The clinical date of 25 cases of male patients suffering traumatic posterior urethral stricture were analyzed retrospectively,was treated with a balloon dilation catheter led by guide wires.Results All our patients were cured successfully with a guide-wire-leading balloon dilatation catheter expanding only once and there were no complications such as urethral perforation,rectal injury etc.Although 2 cases had not been ohviously improved risht after dilatation,but improved furtherly six months later.The follow-up was six to twelve months.23 cases were cured.2 osses were improved.The recovery rate was 92%.The effective rate was 100%.Conclusion It was safe and effective to treat urethral stricture with balloon dilation catheter led by guide wires.

Objective To investigate the effect of methylguanidine and 1-methylhydantoin on cells cytotoxicity, apoptosis in human renal tubular epithelial cell line (HK-2). Methods Human PTEC cell line HK-2 was used in this study. HK-2 was cultured and divided into 3 groups: Norma1 control group (A), methylguanidine group(B) and 1-methylhydantoin group (C). The cell inhibitory rate of HK-2 was detected by MTT method. The cytotoxicity of methylguanidine to HK-2 was determined by NAG release test. Cell apoptosis was evaluated by using Hoechst stain and FACS with Annexin-V/PI. Results The OD value and NAG concentration of creatinine, methylguanidine and 1-methylhydantoin group were compared with normal control group. OD value decreased and NAG concentration significantly increased(0.188±0.011, 0.176±0.010 vs 0.545±0.021, F＝1557.74, P＜0.01; 20.488±0.473, 22.225±0.565 vs 5.125±0.198, F＝3848.22, P＜0.01). By Hoechst stain, pycnosis and apoptotic body could be found when HK-2 was cultivated in methylguanidine 1-methylhydantoin group. In methylguanidine, 1-methylhydantoin group apoptotic HK-2 apparently increased, compared with that in control group (18.23±1.1581, 20.22±1.1433 vs 2.473±0.321, F＝526.06, P＜0.01). Compared with group B, the OD value in group C decreased significantly (0.176±0.010 vs 0.188±0.011,t＝2.26, P＜0.05), NAG concentration increased significantly (22.225±0.565 vs 20.488±0.473,t＝-6.67, P＜0.01), and apoptotic rate in-creased significantly (20.22±1.1433 vs 18.23±1.1581,t＝-2.762, P＜0.05). Conclusions 1-methylhydantoin has more powerful cytotoxic effect to renal tubular epithelial cells than that of Methylguanidine.

Objective To investigate the effects of connective tissue growth factor (CTGF) siRNA delivered by pRetro-Super (PRS) retrovirus vector on extracellular matrix and VEGF expression in human peritoneal mesothelial cells (HPMC). Methods Four pairs of oligonucleotides including 64 bp DNA were designed and synthesized in vitro according to siRNA target sequence and PRS retrovirus desire.PRS-CTGF-siRNA1-4 recombinant retrovirus vectors were constructed.The recombinant retrovirus vectors containing CTGF-siRNA were transferred into PT67 packaging cell lines with lipefectamine 2000,then infected HPMC.mRNA expression was determined by semi-quantitative RT-PCR and protein expression was determined by Western blot.Results Both mRNA and protein expressions of CTGF,FN,Col I,laminin (LN) and VEGF were significantly increased in HPMC with 5 μg/L TGF-β1 stimulation (P＜0.01,respectively).CTGF,FN,Col I,LN mRNA and protein and VEGF mRNA expression stimulated by TGF-β1 were significantly decreased in HPMC infected with PRS-CTGF-siRNA1～4 retrovirus vectors (P＜0.01,respectively).The inhibitory rates on CTGF were 69.3%,22.2%,27.4% and 38.8%,respectively (P＜0.01).At the same time,there was also a significant reduction of VEGF protein expression in HPMC infected with PRS-CTGF-siRNA1 vector (P＜0.01).There was no significant difference in HPMC infected with PRS void vector. Conclusion CTGF siRNA delivered by PRS retrovirus vector can effectively inhibit the enhancement of extracellular matrix and VEGF expression stimulated by TGF-β1 in HPMC.

Good self-management behaviors can control symptoms of the patients with osteoarthritis, improve the patients' joint function and quality of life. Patients' self-management behaviors have been impacted by disease knowledge, self-effcacy, emotional state, and social support. All the above factors should been taken into full consideration when intervening. Self-management program is an intervention mode which can improve patient self-management behaviors and promote patient health.

Objective To investigate the role of oxidative stress in the epithelial-to-mesenchymal transdifferentiation (EMT) of peritoneal mesothelial cells in rat model of peritoneal fibrosis and the effect of probucol on peritoneal fibrosis. Methods The rat model of peritoneal fibrosis was induced by 4.25% high glucose peritoneal dialysis fluid (PDF). The rats were randomly divided into 4 groups:the control group, the saline group, the peritoneal fibrosis group, and the probucol group. A 4 hour peritoneal equilibration test (PET) was performed 4 weeks later. The peritoneal function and net ultrafiltration (UF) volume were determined. The level of malondialdehyde (MDA) and glutathione peroxidase (GSH-Px) in peritoneal tissue were examined. The histology of peritoneal membrane was evaluated by light microscopy. E-cadherin and α-smooth muscle actin (α-SMA) protein expression was evaluated by immunohistochemical method and Western blot.Results The mesothelial cells were detached from peritoneal membrane in peritoneal firbosis rats. Comparing with the control rats, the thickness of visceral peritoneum, the level of MDA, and the-SMA protein expression were increased while the net ultrafiltration volume, the level of GSH-Px and E-cadherin protein expression were decreased in peritoneal firbosis rats. All these changes were reversed in the rats treated with probucol.Conclusion Oxidative stress plays an important role in transdifferentiation of peritoneal mesothelial cell in the peritoneal fibrosis rats. Probucol can improve structure and function of peritoneum, and partially reverse the EMT by reducing the oxidative stress.

Objective To investigate the correlation of infiltration of mast cells in kidney with renal interstitial fibrosis, expression of TGF-β1 and stem eel] factor (SCF) in rat models withprotein-overload nephropathy. Methods Sixty uninephrectomized SD rats were randomly divided into model group [intraperitoneal injections of bovine serum albumin (BSA)] and control group (intraperitoneal injections of equal volume of saline). Ten rats from both groups were sacrificed respectively at week 3, 7 and 11 after injection. 24 h urinary protein and serum biochemistry of these SD rats at the time of sacrifice were measured. The intensity of mast cell infiltration was examined by toluidine blue (TB) staining and immunohistochemistry using a monoclonal anti-MC chymase antibody. The expression of TGF-β1 and SCF was detected byimmunohistochemistry, using a monoclonal mouse anti-rat TGF-β1 antibody and a polyclonal rabbstanti-rat SCF antibody. Results Severe proteinuria was induced in the rats by BSA injectionpeaked at week 7 [(199.1±98.4) mg/d] after the BSA injection and gradually decreased until week11 [(133.7±67.8) mg/d]. Renal injury was accompanied with chymase-postitive and TB-postitive mast cell infiltration, in close proximity to areas of interstitial fibrosis. With aggravation oflesions degree, the number of mast cells increased,the difference between the modal rats and control rats was significant (P<0.05). Immunostainahle expression of SCIF and TGF-β1 was detected in tubular as well as interstitial cells, and increased with the BSA injection. The difference between the model rats and control rats was significant (P<0.05). Mast cells were positively correlated with interstitial fibrosis (r=0.772, P<0.01), expression of TGF-β1 (r=0.521, P<0.01) and SCF(r=0.916,P<0.01). Conclusions Increased infiltration of mast cells is involved in interstitial fibrosis of rats with protein-overload nephropathy. Proteinuria may attract mast cells to kidney by chemot actions of SCF,and mast cells may contribute to the development of renal fibrosis by secreting chymase and increasing expression of TGF-β1.