Objective To investigate the metabolic profile of uric acid and the significance of the altered renal expression of urate trans-porter 1(URAT1) in patients with uric acid nephrolithiasis. Methods The data of 24 patients in our hospital from January 2012 to October 2013 were analyzed retrospectively. Participants in the research were divided into three groups:patients with uric acid nephrolithiasis,other patients with nephrolithiasis and normal participants. The basic clinical data and the related data of uric acid metabolition of participants were collected,URAT1 gene expression in renal tissures of three groups was detected by Real-time PCR technique. All data were statistically ana-lyzed and compared between these groups. Results Uric acid levels in plasma,body mass index and age were significantly higher in patients with uric acid nephrolithiasis than other two groups (P<0. 05),but urine PH value was significantly reduced in patients with uric acid neph-rolithiasis. Urine and uric acid output of 24 hours urine were no significant difference among the three groups (P>0. 05). The result of Real-time PCR suggested that the URAT1 renal expression was significantly higher in patients with uric acid nephrolithiasis than other two groups (P<0. 05). Conculusion Patients with uric acid nephrolithiasis are closely related with hyperuricemia,but unrelated with renal over-ex-cretion of uric acid. The upregulated URAT1 expression in the kidney may be an important molecular mechanism of the clinical features.

Objective To evaluate the curative effect of polyscope modular flexible ureteroscope combined with Holmium laser lithotrip-sy in the treatment of renal calculi. Methods 53 patients with renal calculi were performed CTU to detect the position of renal calculi before operation. The patients were treated with polyscope modular flexible ureteroscope combined with Holmium laser, and the double J tube were routinely indwelled 4 to 12 weeks after surgery. Results All the 52 patients has successfully completed the operation in the frist stage. The mean operative time was about 38 minutes. 6 patients were treated with flexible ureteroscope for second stage operation. One week after oper-ation, the review showed that there were residual calculi existed in 24 cases and there were 56 cases of post-operative infection, including 17 cases of sepsis or sepsis shock. Conclusion Polyscope modular flexible ureteroscope can be used for all kinds of kidney stones surgery and is characterized by safety and mild tissue injury. But we should pay more attention to the post-operative infection especially urosepsis.

Objective To explore the establishment of disabled grade assessment scale for long-term care insurance (LTC).Methods Based on the results of literature review and long-term care needs survey,an initial scale of disabled grade assessment was formulated,then the Delphi method was combined to conduct the consultation on 22 specialists.Results After two rounds of expert consultation,the unanimous disabled grade assessment scale included four first-class indexes of sensation perception,daily activity ability,recognition ability and emotion behavior,the importance mean (M) was 4.64-5.00 points,which ≥4.0 points,the variable coefficient (CV) was 0.00 ％-13.86 ％,which ≤25 ％,the full mark rate (Fr) was 72.73 ％-100.00 ％,which ≥50 ％,recognition rate (Ar) was 90.91％-100.00％,which ≥80％,which indicated that the experts reached a consensus opinion.Among the 22 second-class indexes,the M was 4.27-4.95 points,which ≥4.0 points,CV was 4.20％-25.62％,Fr was 63.64％-95.46％,Ar was 77.27 ％-100.00 ％.The two items of touch sense and getting up from sitting position were newly added,the transferring of table and chair,recent memory and procedural memory were modified into sitting down on the bench and chair,immediate memory and short term memory,the experts reached the consistent opinion.Conclusion The replenished and modified disabled grade assessment scale for LTC has higher authority and expert consistency,which can provide a theoretical reference for the disabled grade assessment work of LTC.