Objective To evaluate retroperitoneal laparoscopic Anderson-Hynes pyeloplasty. Methods 6 patients underwent laparoscopic and 10 patients underwent open Anderson-Hynes pyeloplasty.The clinic outcome including subjective and objective findings was compared between the two groups. Results All the procedures were successfully completed.The mean operating time was 279 minutes for laparoscopic pyeloplasty being much longer than the open procedure 121 minutes(P0.05).No severe postoperative complications were found.3 months after the procedure,the pain-free rate was about the same between the two groups.However the open surgery group had much pain and prolonged convalescence due to the flank incision. Conclusions Laparoscopic pyeloplasty is a minimally invasive technique that provides similar clinical and radiographic results as open pyeloplasty.

Objective To inevestigate the changes of the responses by changing the parameters in the neural response tetemety(NRT).Methods In this project,twenty patients who were implanted in Nucleus C124M were measured the electrically evoked compound action potential(ECAP)using the NRT system.It was expected to observe the changes of the responses by changing the parameters in the NRT 2.04 software.Results It was found that the parameters that made great influences to the responses were current level,stimulate pulse width,gain,delay and masker advance.Conclusion The parameters that made great influences to the record time were stimulate rate and number of sweeps.

Objective To observe the effect of ulinastatin on the expression of interleukin 15 (IL-15), connective tissue growth factor (CTGF) and malondialdehyde (MDA) in rat peritoneal mesothelial cells (RPMCs) induced by high glucose. Methods RPMCs were isolated, cultured and passaged by trypsin, then identified. The third generation of cultured RPMCs were used in the experiment. RPMCs were divided into normal control group, high glucose (1.5%, 2.5%, 4.25%) for 6 hours and 12 hours, high glucose (2.5%) for 3, 6, 12, 24 hours or ulinastatin (160, 320, 640U/ml) for 12 hours. IL-15 mRNA was detected by real-time PCR. IL-15 and CTGF protein in supernatants was detected by ELISA. MDA protein was detected by TBAS. Results Compared with the control group, the expression of IL-15, CTGF and MDA was significantly increased in the groups stimulated by high glucose (P＜0.05) in dose- and time-dependent manner. Ulinastatin could significantly decrease the expression of IL-15, CTGF and MDA induced by high glucose in dosedependent manner both in protein and gene levels (P＜0.05). Conclusions High glucose can up-regulate the expression of IL-15, CTGF and MDA in RPMCs. Ulinastatin can reverse these changes.

Objective To observe the effect of 1,25(OH)_2D_3 on expression of vitamin D receptor (VDR), tumor necrosis factor α (TNF-α) and transforming growth factor β1 (TGF-β1) in rat peritoneal mesothelial cells (RPMCs) stimulated by lipopolysaccharide (LPS), so as to provide some evidence for clinical use of 1,25 (OH)_2D_3 on peritoneal dialysis-associated peritoneal inflammation. Methods RPMCs were isolated, cultured and passaged by enzymaticdisaggregation, then identified by phase contrast inverted microscope, transmission electron microscope with immunocytochemistry method. RPMCs were incubated with LPS (1,10,100 mg/L) and LPS (10 mg/L) for 2,6,12 hours, or stimulated by 1,25(OH)_2D_3 (10~(-8) mol/L, 10~(-7) mol/L, 10~(-6) mol/L) after incubated with LPS (10 mg/L) for 2 hours. RPMCs in the control group were justincubated with medium. Expression of VDR mRNA and protein was detected by RT-PCR and Western blot. In addition, ELISA was performed to investigate the changes of TNF-α and TGF-β1 in culture medium. Results Compared with control group, the expression of VDR mRNA and protein was decreased in LPS group (P<0.05). LPS could significantly induce the expression of TNF-a and TGF-β1 in RPMC (P <0.01), which could be partially reversed by different concentrations of 1,25 (OH)_2D_3 (P<0.01). Conclusions 1,25 (OH)_2D_3 can reverse the decrease of VDR mRNA and protein induced by LPS as well as the induction of TNF-a and TGF-β1 up-regulated by LPS in RPMC in a dose- and time-dependent manner. Our research provides experimental evidence of VDR ameliorating peritoneal dialysis-associated peritoneal inflammation and peritoneal fibrosis.

Objective To study the present situation of legionella pneumophila(Lp) infection of low respiratory tract infection in children less than 5 years old.Methods Three hundred hospitalized patients with the diagnosis of low respiratory tract infection were enrolled in the study,191 males,109 females,aged 27 d to 5 years old,course from 1 d to 6 months.Serum antibody(IgM,IgG) of Lp serogroup 1-7 was detected by enzyme-linked immunosorbent assay(ELISA).Results In the patients,17 cases were positive,and the positive rate was 5.67%.Of the 17 children,the males(n=11) and females(n=6) did not significantly influence the positive rate(5.76% vs 5.50%).Four of them were between 27 days and 1 year old;7 were 1 to 3 years old,6 were 3 to 5 years old.The positive rates were significantly different among the 3 groups(2.53% vs 7.37% vs 12.77%) and tendentially increased following the increase of age(?2=7.8164 P

Objective To evaluate the test -retest reliability of sentence materials, and to standardize Man_darin Speech Test Materials (MSTMs). Methods Forty normal-hearing subjects aged from 18 to 30 years old were recruited in this study. The sentence materials were tested at 9 dB HL to these subjects according to the prepare ex_periment. The retest was carried out in the same condition after an interval of 14~28 days. The difference between test and retest score was examined by t-test, and the critical difference (CD) was analyzed with 95% confidence in_terval (CI). ResuIts There was no significant difference between the test and retest scores about speech perception performance. The critical difference was 18. 93% at 95% confidence interval, and the number of the corresponding key words was 10. ConcIusion The results showed that sentence materials of MSTMs have good test-retest relia_bility except list 6. The interventions could be considered effective just when the difference of the same subject's score exceed 18. 93%, that means 10 key words are necessary to improve that the intervention is effective.

Objective To evaluate the choices and surgical skills for tension-free femoral hernia repair under local anesthesia. Methods The clinical data of 109 nonincarcerated femoral hernia patients were summarized from December 2002 to December 2009. Patients were divided into 3 groups according the time period at which the surgery was performed. 85 patients from 2002 to 2008 were divided into 2 groups,45 cases treated with preperitoneal repair ( preperitoneal group), and the other 40 cases with mesh-plug repair (plug group). The 24 cases admitted from January 2009 to December 2009 received modified preperitoneal repair. Operation time, VAS, length of hospitalization, incidence of recurrence, foreign body feelings and seroma were compared among the three groups. Results All the 109 patients were repaired under local anesthesia, and there was no perioperative death. The statistical indicator value of incidence of recurrence, foreign body sensation and seroma in preperitoneal group was lower than plug group (P ＜0.05). The modified preperitoneal repair was better in operation time, VAS, length of hospitalization than preperitoneal group (P ＜ 0.05). Conclusions Modified preperitoneal repair under local anesthesia is the choice for treating femoral hernia without incarceration. Modified preperitoneal repair is faster, more minimally invasive and faster recovery.

Objective To research the clinical manifestations of renal tuberculosis and improve the diagnosis and treatment of renal tuberculosis. Methods From 1993 to 2007,223 cases of renal tuberculosis were hospitalized. Retrospective analysis was complied for all the cases about age, clinical manifestations, imaging and treatment. Results The incidence rates of the renal tuberculosis were obviously higher in the 20-40 years old(41.7%) and in the 41-54 years old (36.3%). The course of this disease was from 1 day to 30 years(mean 38. 5 months). Only 36 patients (16.1%) were made a definite diagnosis when they went to see a doctor primary. The miediagnosis of urinary tract infec-tions( 50.3%) was most frequent. The clinical manifestations of most patients included frequency(54.7%), urgency(50.2%), odynuria(42.2%)and hematuria(58.7%). About 58. 3% patients pres-ented with over 3 kinds of above manifestations. The positive yield of the tuberculin test in urine was only 41.9%. The positive diagnostic rate of renal tuberculosis was only 35.7% in KUB+IVU,72.2%in Type-B Ultrasonic, 76.0% in CT test. One hundred and seventy-three cases were performed with nephrectomy(78.6%) and partial nephrectomy(21.4%). Two cases were treated with dialysis due to uremia. Standard medication was taken for the other 48 patiernts, and effective for 41 cases. Conclu-sions The incidence of atypical renal tuberculosis is increasing. More attention must be paid especially to those patients with urinary infection.

Objective To evaluate the effects of different positions on cerebral blood flow in patients undergoing laparoscopic surgery.Methods Thirty patients of both sexes,aged 23-64 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic surgery,were included.Patients' position was changed using a random number table after induction of anesthesia.Patients were placed in the supine position and tilted 15° head-up or 15° head-down,and the parameters of the middle cerebral artery were monitored using the transcranial Doppler ultrasound.After admission to the operating room (baseline),after induction of anesthesia and before pneumoperitoneum,in the supine position,at head-up tilt and at head-down tilt,the mean blood flow velocity,pulsatility index,resistance index,mean arterial blood pressure (MAP) and heart rate were recorded.Results Compared with the baseline in the supine position,the MAP and bilateral mean blood flow velocity were significantly decreased at head-up tilt,and the MAP and bilateral pulsatility and resistance indices were significantly increased at head-down tilt (P＜0.05).Conclusion During laparoscopic surgery,head-up tilt can lead to a decrease in cerebral blood flow,and head-down tilt exerts no effect on cerebral blood flow.

The relationship of medical papers and growth tendency with medical and health funds in different countries of the world was studied by analyzing SCI-covered medical papers published in 2007-2016,which showed that medical and health field was one of the research hotspots in the world,the number of papers published by the top 10 countries showed a growth tendency,their medical and health funds were closely related with the production of scientific papers (r=0.99),and the compound growth rate of medical and health funds was closely related with that of the number of scientific papers (r=0.91).