Objective To investigate the outcomes of a modified operation for renal pelvis and ureteral cancer.Methods A total of 13 cases of renal pelvis or ureteral cancer was treated in this hospital from January 1998 to July 2005.During the operation,for the first step,the kidney and the majority of the ureter were excised through a waist incision. Then a double-J catheter was inserted into the bladder by way of the residual ureter,and was fastened to the ureter.Afterwards,a transurethral resection of the ureteral orifice and part of bladder mucosa was conducted.Finally,the ureter was pulled down oversleevely into the bladder.Results Except for 1 case of failure of oversleeve excision,in which a re-operation via a lower abdominal incision was required,the surgery was successfully completed in all the other 12 cases.The operation time was 60～90 min(mean,78 min).The intraurethral catheter was indwelled for 7～9 d(mean,7.6 d).The postoperative length of hospitalization was 7～10 d(mean,7.9 d).The 13 cases were followed for 8～18 months(mean,11.5 months).Examinations of exfoliated cells in urine,cystoscopy,and B-ultrasonography found no recurrence.Conclusions Single waist incision combined with transurethral oversleeve resection has smaller surgical trauma,fewer complications,and faster recovery compared with the traditional surgery.

Objective To compare effects of compound Xueshuantong capsule and benazepril on inflammatory cyto-kines in type 2 diabetic patients with early diabetic nephropathy (DN), and its therapeutic mechanism thereof. Methods Ninety-four patients with type 2 diabetes were divided into diabetes without albuminuria group (DM,n=24) and early DN group (DN,n=70). DN group was then divided into three subgroups:group A (n=24) treated by benazepril alone, group B (n=22) treated by compound Xueshuantong capsule and group C (n=24) treated by compound Xueshuantong capsule combined with benazepril for 3 months. Levels of fasting blood glucose, glycosylated hemoglobin, serum creatinine, blood urea nitro-gen, lipid profiles, fibrinogen and urinary albumin excretion rate (UAER) were examined before and after treatment. The se-rum levels of hypersensitive c-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α) were determined as well. Results The serum levels of hs-CRP, IL-6 and TNF-αwere significantly higher in DN group than those of DM group (P<0.01). After treatment, the serum levels of UAER, hs-CRP, IL-6 and TNF-αwere significantly re-duced in groups A, B and C compared with those before treatment (P<0.01), and which were decreased more significantly in group C. The levels of blood lipids and fibrinogen decreased obviously in group C compared with those of group A and B ( P<0.01). Conclusion Compound Xueshuantong capsule combined with benazepril not only can improve the blood fat and high coagulation state in patients, but also impossibly retard the development of early DN through decreasing serum concen-trations of hs-CRP, IL-6 and TNF-αand inhibiting inflammatory reaction.

Objective To evaluate the intensity-modulated radiation therapy(IMRT)for the whole pelvis in the treatment for cervix cancer with the method of ionization chamber verification and fluence map verification.Methods IMRT plan was designed with Pinnacle 7.0 inversed treatment planning system,and the planning parameter was copied to the solid water phantom.The dose of the reference points in the phantom was calibrated with ionization chamber,and compared with those in IMRT plan.Then the gantry angle was set as 0 degree.The solid water phantom was irradiated with film,and the actual fluence maps were obtained 2cm below the phantom surface,and then the delivered films were compared with those fluence maps in plan.Results The error percentage at 4 points was less than 3% in absolute dose calibration,at 2 points was less than 5%,at another 2 points was less than 5%,at 1 point was over 10%,and at another 1 point was over 15%.It was found that the last two calibrated points were set in a region with a high dose gradient,resulting in high error.In fact they were impertinent.So another two points were chosen in uniformity area of dose distribution.The percentage of error were both less than 3%.The fluence maps between films and plan were consistent.Conclusion It is feasible to evaluate IMRT plan for whole pelvis in the treatment of cervix cancer with the method of ionization chamber verification and fluence map verification.The results can meet the clinical requirement.

Objective To investigate the value of N-termind pro-B-type natriuretic peptide(NT-pro-BNP)in differential diagnosis of dyspnea in emergency department, and to investigate the rapid diagnosis cutoff of dyspnea due to acute congestive heart failure. Methods Ninety. one cases of dyspnea in emergency department recruited from January to June ,2008 were divided into two groups: acute cardiac dyspnea group and none acute cardiac dyspnea group. To evaluate the value of different parameters in differential diagnosis of dyspnea in emergency department and analysis the area under the receiver-operating characteristic of different parameters for the diagnosis of acute cardiac dyspnea. To achieve the best cutoff of different parameters for the diagnosis of dyspnea due to acute congestive heart failure finally. Results Among two groups, NT-pro-BNP (acute cardiac dyspnea vs. none acute cardiac dyspnea,6203.50 ng/L vs. 1410.00 ng/L,P ＜ 0.01), Troponin Ⅰ (acute cardiac dyspnea vs. none acute cardiac dyspnea,0.12 μg/L vs. 0.03 μg/L,P ＜0.01) ,left ventricular ejection fraction(acute cardiac dyspnea vs. none acute cardiac dyspnea,46.25% vs. 65.60%, P ＜ 0.01), left atrial diameter (acute cardiac dyspnea vs. none acute cardiac dyspnea,42.75 mm vs. 36.00 mm,P ＜0.01) had significant difference. NT-pro-BNP at cutoff of ≥3715 ng/L was highly sensitive and specific for the diagnosis of acute cardiac dyspnea. Receiver-operating characteristic analyses demonstrated that NT-pro-BNP and left ventricular ejection fraction was the best diagnostic indices of acute cardiac dyspnea. The area under the receiver-operating characteristic curve of Nt-pro-BNP was 0.828 ± 0.045 (P ＜ 0.01),and left ventricular ejection fraction was 0.829 ± 0.049 (P ＜ 0.01). Correlation analysis showed that NT-pro-BNP was correlated with left ventricular ejection fraction (P ＜ 0.01). The combined test of NT-pro-BNP and left ventricular ejection fraction was performed. Specificity increased to 96.50%, total consistent rate increased to 83.50% ,positive predictive value increased to 91.30%, positive likelihood ratio 17.60, faulse diagnostic rate decreased to 3.50%. Conclusions NT-pro-BNP examination in emergency department was helpful to rapid differential diagnosis of dyspnea. It helped to differentiate the patients with acute congestive heart failure and none acute congestive heart failure causes of dyspnea.

Objective:To explore the effects of cognitive impairment on the performance of Binomial Forced-Choice Digit Memory Test (BFDMT). Methods: Subjects were screened by Mini-Mental State Examination (MMSE) and the brief form of WAIS-RC.BFDMT was administered to 38 dementias and 19 controls.Results: (1) There was no significant difference in the scores of two dimensions and total score of BFDMT between dementias and controls. (2) There was significant difference in the difficult item scores and the total score among three groups of subjects with different levels of IQ. The difficult item scores and the total score of the subjects with IQ 70～84 were significantly higher than those with IQ 50～69 and IQ 34～49. There were no significant differences among all groups in the easy item scores. (3) The false positive was 15.8% by the cutoff scores of total scores of BFDMT and increased with the decline of IQ. Conclusion: The performance of BFDMT is somewhat influenced by intellectual defect. A high false positive of BFDMT particularly happens in the patients with severe intellectual decline.

Objective To study the relationship of gastric carcinoma with serum trace elements and helicobacter pylori(Hp).Methods The contents of 6 serum trace elements and helicobacter pylori were determined in gastric carcinoma,chronic gastritis patients and normal control.Results The serum levels of Mg,Ca,Zn and Cu in the patients with gastric carcinoma were significantly lower than those in normal control Mg (0.71?0.15)mmol/L vs (0.97?0.26)mmol/L,Ca (1.68?0.28)mmol/L vs (2.03?0.31)mmol/L,Cu (12.27?5.91)mmol/L vs (16.57?3.55)mmol/L,Zn (16.18?4.77)mmol/L vs (21.78?7.37)mmol/L.The infection rates of Hp in the patients with gastric carcinoma and normal control were 71.4% vs 27.3%(?2=6.201,P=0.013),there was significant diversity.Conclusion Obvious changes of serum Mg,Ca,Cu,Zn and infection Hp may be related to carcinogenesis of gastric carcinoma.

AIM: To compare the release and percutaneous penetration in vitro among 2 kinds of the psoralen ointments and its gel. METHODS: Dissolution tester and Franz diffusion cells were adopted as the release and percutaneous penetration in vitro, and HPLC was used to measure the amount of psoralen in the releasing solution, receiving solution and the skin. RESULTS: The release and percutaneous penetration of psoralen from the 3 kinds of preparation conformed to the zero kinetic equation. The steady-state penetration rate of psoralen in the gel was higher than that of the ointment, and there was no significant difference between 2 kinds of ointments. CONCLUSION: Gel is a better choice for percutaneous penetration of psoralen.

OBJECTIVETo explore the auricular point specificity of the electric determination in stroke so as to provide the evidence for the objective study on the auricular point diagnosis in stroke.

METHODSThirty patients of stroke were selected in an observation group; 30 patients of non-stroke internal medicine disorder were in a control group A; 30 persons of healthy examination were in a control group B. In the observation group.and the control group A, beside the conventional treatment, acupuncture was applied to all the cases. In the observation group, Jianyu (LI 15), Quchi (LI 11), Shousanili (LI 10), Hegu (LI 4), Waiguan (TE 5), Liangqiu (ST 34), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) were selected on the affected side. In the control group A, Yin-tang (GV 29), Baihui (GV 20), Sishencong (EX-HN 1), Fengfu (GV 16), Dazhui (GV 14), Fengchi (GB 20), Tianzhu (BL 10), Jiaji (EX-B 2) C4-C7 were selected. Acupuncture was given once a day in the two groups. The; treatment of one week made one session, and continuously 2 sessions were required. In the control group B, the convention physical examination was provided without any medication and acupuncture involved. The CLRH-A auricular point detector was used to detect the entire auricular point area in the subjects and the positive reaction sites of auricular points in the subjects of each group before and after treatment separately. The auricular point positive detecting score and positive point frequency were observed in the subjects.

RESULTSBefore treatment, the auricular points detecting score in the observation group was obviously higher than that in the control group A and control group B (both P<0. 05). The difference in the score between the control groups was not significant in' comparison (P>0. 05). In two weeks of treatment, the auricular points detecting score in the observation group was reduced apparently (P<0. 05). The difference was not significant before and after treatment in either the control grolip A or the control group B (both P>0.05). In the observation group, the first 15 points with high frequencies of positive reaction were naogan (AT3,4i), pizhixia (AT4), e (AT1), xin (CO15), gan (CO12), nie (AT2), zhen (AT3), shen (CO10), jiaogan (AH6a), pi (CO13) shenmen (TF4), wei (CO4), neifenmi (CO18), shenshangxian (TG2p) and erjian (HX6,7i). The differences were significant in the frequencies of positive reaction at 9 auricular points as compared with the control group A and the control group B respectively, named naogan (AT3,4i), pizhixia (AT4), e (AT1), xin (CO15), gan (CO12), nie (AT2), zhen (AT3), shen (CO10) and jiaogan (AH6a) (all P <0. 05).

CONCLUSIONThe pathological degree of positive reaction about auricular points in stroke patients is higher than those in the patients of non-stroke internal medicine disease and the healthy people. It is verified that the auricular diagnostic method is specific in stroke. naogan (AT3,4i), pizhixia (AT4), e (AT1), xin (C15), gan (GO12), nie (AT2), zhen (AT3), shen (CO10) and jiaogan (AH6a) are correlative with stroke.

Acupuncture Points ; Acupuncture, Ear ; Adult ; Aged ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Stroke ; therapy ; Treatment Outcome

Objective To establish a rapid and accurate method for the identification of Mycobacterium species by the gene microarray and to verify its clinical application value .Methods According to the gene sequence of 23 species of Mycobacteria ,the specific probes were designed and the gene chips were prepared .23 Mycobacterial standard strains ,9 non‐mycobacterial strains ,103 clinically isolated mycobacterial strains were detected by PCR‐based reverse blot hybridization assay in the gene chip .Results 23 mycobacterial standard strains ,9 non‐mycobacterial strains were detected by gene chip ,the results showed that the specificity was 100% .Of 103 mycobacterial clinically isolated strains ,87 strains were identified as Mycobacterium tuberculosis compounds (MTC) and 16 strains as non‐tuberculosis mycobacteria (NTM ) including 5 strains of M .abscessus ,3 strains of M .intracellulare ,3 strains of M .avium ,2 strains of M .fortuitum ,1 strain of M .kansas ,1 strain of M .marinum and 1 strain of M .gordonae .The identification results of 103 clinically isolated strains were completely consistent with the sequencing results .The lowest detection limit by this method was 103 copies/mL .Conclusion The gene microarray technique for rapidly identifying Mycobacteria and differentiate MTC and NTM has the advantages of simpleness ,rapidness ,high accuracy ,high specificity and high sensitivity .

Objective To summarize the outcome of treatment for thoracic vertebra ossification of ligamentum flavum (OLF)with en-bloc removal of the spinal canal’s posterior wall termed as the “thinned cap uncovering”technique.Methods From 2003 to 2013,56 patients with OLF were treated with thinned cap uncovering technique.In this group,there were 40 male patients and 1 6 female ones,with the average age of 45 years (range of 30-65 years)and the average history of 3 years.The 56 patients were followed up for an average duration of 2 years and 7 months (1-5 years).Results According to WANG’s evaluation,45 cases (about 80%) had excellent results,9 cases (about 1 6%)had good results,and 3 cases had improved symptoms,the excellence to good rates being 96%.Conclusion Removal of the posterior wall of the spinal canal via “thinned cap uncovering”technique is a reliable and effective treatment for thoracic OLF.The strategy for successful operation is to use high speed drill to cut bone accurately,which allows discectomy for thoracic vertebra and to diminish faults and complications during the surgical procedure.