ObjectiveTo evaluate the value of CT in diagnosis and discrimination of acute focal bacterial nephritis(AFBN). Methods 6 cases of AFBN were reported which were all performed with ultrasound and CT scan.4 of 6 cases were observed by delay contrast enhanced CT examination. ResultsCT scan showed wedge-shaped masses with thickened Gerota fascia.The delayed contrast enhanced CT revealed more clear shapes and verges of the lesions than immediate contrast enhanced CT. ConclusionCT scan is of significant value in diagnosis and discrimination of AFBN with overall review of documents and statistic analysis.

Objective To evaluate the improvement of diagnosis and treatment of hypercatecholaminism. Methods A total of 95 cases of hypercatecholaminism were reviewed.Of them 74 cases were of pheochromocytoma and 21 cases were of adrenal medullary hyperplasia (AMH).In pheochromocytoma group,67 cases (90.5%) had symptom of hypertension.Increase in 24 h urinary VMA occurred in 62 cases (83.8%) and elevated urinary catecholamine level in 67(90.5%).All thses had positive findings of ultrasound,CT scan and MRI.In AMH group,all the patients were hypertensive and their 24 h urinary VMA was increased.Most of them (15/16) had higher urinary catecholamine level than normal;14 out of the 21 cases had positive findings of B-ultrasound examination. Results Surgical operations were performed in the 74 patients with pheochromocytoma including 9 cases of extra-drenal pheochromocytoma.Of them 5 cases were confirmed as malignant pheochromocytoma.In the 21 cases of AMH,18 undewent surgical operation.Of them 12 received unilateral resection and 6 received bilateral resection of adrenal gland.The pathological examination confirmed the diagnosis of AMH. Conclusions The diagnosis of pheochromocytoma should be focused on endocrinological examination,ie,qualitative examination,whereas it is diffucult to localize the lesion in AMH compared with pheochromocytoma.The establishment of notion of AMH as an isolated clinicopathological entity broadens and perfects the theory of hypercatecholaminism.

Objective To investigate age-related changes of serum prolactin(PRL) and testosterone (T) in aging males and to study the correlation between PRL and prostatic hyperplasia. Methods 84 aged males were divided into four groups, the fifties, the sixties, the seventies and the eigh- ties . Serum PRL and T were measured using radioimmunoassay. The volume of prostate was evaluated by ultrasound in 38 and it's correlation with PRL studied. Results Serum T level of the 4 age groups from fifties to eighties was (25.92?2.54),(21.00?1.92),(18.37?2.49) and (14.75? 2.38 ) nmol/L respectively and PRL concentration (1.11?0.16), (0.96?0.20), (0.99?0.18) and (0.91?0.29) nmol/L. Analysis of variance showed that serum T concentration significantly decreased with age ( F =3.44, P 0.05). No association between PRL and volume of prostate has been observed. Conclusions PRL play a physiological role in the development and growth of prostate via androgen. But such effect of androgeno-dependence on prostate is greatly diminished because of the decrease of androgen hormone with age especially in the aged.

Objective To compare the efficacies of mini-incision dismembered pyeloplasty assisted by retroperitoneal laparoscopy and routine retroperitoneal laparoscopic dismembered pyeloplasty for ureteropelvic junction(UPJ) obstruction.MethodsThe clinical data of 47 patients with UPJ obstruction,who underwent dismembered pyeloplasty from January 2004 to November 2006 in our hospital,were retrospectively analyzed.Of the patients,22 were treated by mini-incision dismembered pyeloplasty assisted by retroperitoneal laparoscopy(group A),in whom a 4-cm incision was made under the costal margin at the posterior axillary line;and the other 25 cases underwent retroperitoneal laparoscopic dismembered pyeloplasty(group B).The clinical data of the two groups,including the operation time,blood loss,average airway resistance and partial pressure of carbon dioxide,recovery of intestinal function,length of drainage and hospital stay,incidence of urinary leakage,and remission rate of hydronephrosis and improvement of GFR,were statistical analyzed by SPSS 13.0.ResultsNo intra-operative complications occurred in either group.Compared with Group B,Group A had shorter operation time [(92.9?16.3) min vs(155.8?18.6) min,t=-12.251,P=0.000],more blood loss [(18.9?6.3) ml vs(13.6?6.7)ml,t=2.782,P=0.008],lower average airway resistance [(15.6?2.6) cm H2O vs(26.9?4.3) cm H2O,t=-10.715,P=0.000] and partial pressure of carbon dioxide [(36.0?6.9) cm H2O vs(51.6?6.7) cm H2O,t=-7.855,P=0.000].No statistical differences were detected in the recovery of intestinal function,postoperative length of drainage and hospital stay,incidence of urinary leakage,and remission rate of hydronephrosis and improvement of GFR.ConclusionMini-incision dismembered pyeloplasty assisted by retroperitoneal laparoscopy is a safe,effective,and minimally invasive therapy for UPJ obstruction.

Objective To explore the efficacy of outpatient treatment for residual ureteral calculi after minimally invasive percutaneous nephrolithotomy(MPCNL).Methods The treatments were conducted in an outpatient setting.The patients with residual ureteral calculi(

Objective To explore the effect of targeted surveillance on the control of nosocomial infection in neonatal intensive care unit (NICU).MethodsThe nosocomial infection rates were retrospectively analyzed after continuous improvement of targeted surveillance in NICU from January 2013 to June 2015.ResultsDuring the research period, 59 cases has nosocomial infection in 1011 case who were selected in accordance with inclusion criteria, nosocomial infection rate is 5.8% and daily infection rate is 3.5%. On semiannual basis, the daily infection rates decreased from 8% in the ifrst half of 2013 to 2.2% in the ifrst half of 2015. The ventilator associated pneumonia cases/1000 ventilator days decreased from 12.8‰ to 0‰ from the ifrst half of 2013 to the ifrst half of 2015. The central ventral indwelling catheter related bloodstream infection cases/1000 central ventral indwelling catheter days decreased from 4.5‰ to 0‰ from the ifrst half of 20133 to the ifrst half of 2015. The differences were statistically significant (P all?

AIM:To understand the effects and approach the mechanisms of matrix metalloproteinase-9(MMP-9)and cystoskeleton actin on the permeability increasing of blood-brain barrier(BBB)model which was induced by hypoxia/ischemia status in vitro.METHODS:The BBB model was build by the co-culture of cell ECV304 and astrocytes in vitro,then divided randomly into control group,hypoxia/ischemia group and BB-1101 pretreatment group.The permeability of BBB was determined by [125I]-BSA.The expression and the disposition of actin were detected by direct-immunofluorescence and Western blotting.BB-1101,the MMPs inhibitor,was used to investigate if MMP-9 participate the process of the increasing of BBB models' permeability in hypoxia/ischemia status.RESULTS:Post-stimulation of hypoxia/ischemia for 5 h,the permeability of [125I]-BSA and amount expression of MMP-9 in hypoxia-ischemia group was increased compared with control group(P

Objective To evaluate the clinical feasibility of laparoscopic cool-tip radiofrequency ablation (LCRFA)for renal cell carcinoma. Methods Twelve selected cases of primary renal, ceil carcinoma underwent LCRFA. Of them, 4 cases of left renal carcinomas, 7 cases had right renal carci-nomas and 1 case had bilateral renal carcinomas. The maximum diameter of the tumors was 2.1-8. 5 era. Eleven cases were T, No M0 and the other one was T2 N0 M0. Results The mean operation time was 92±24 min, and the mean blood loss was 50±29 ml. None of the cases need blood transfusion post-operation. No laparoscopic operative complications were observed. Six weeks after operation, complete ablation was achieved in 12 lesions and partial ablation in 1, with a complete ablation rate of 92.3%(12/13). There was no statistic change of Hb. ESR. SCr and GFR after operations (P>0.05). Ten cases underwent CT examination 3 months after the treatment ,9 cases showed complete necrosis of tumor,1 case showed partial necrosis. No recurrence was found. All of the 12 cases remained sur-vived during the follow-up for 1-16 months(median,7.8 months). Conelusions LCRFA for renal cell carcinoma is an accurate and effective intervention with a low incidence of complications, and is more accurate than ultrasound-guided pereutaneous radiofrequency ablation.

Objective To investigate the clinical and pathological characteristics of normotensive pheochromocytomas ( NP) . Methods This retrospective study included 97 patients with a pathological diagnosis of pheochromocytoma at the Drum Tower Hospital Affiliated to Nanjing University Medical School during January 2004 to December 2013. All available clinical, biochemical, and radiological records were reviewed in these patients who were then categorized into hypertensive pheochromocytomas (HP) (n=64) and NP (n=33) groups. 97 cases of Adrenal Gland Scale Score of pheochromocytoma were examined, including tissue microscopic pathology assessment, ki67 and phenylethanolamine-N-methyltransferase ( PNMT ) immunohistochemistry and catecholamine type. Biochemical examinations of 95 subjects with primary hypertension ( PH) were recorded for comparative study. Results The patients with NP showed lower proportion of clinical triad than HP, inapparent metabolic disorders, and lower urinary catecholamine levels than HP, but showed higher results than primary hypertension. The weight of tumor was positively correlated with 24 hour urinary norepinephrine level in patients with HP(Y=1. 376+0. 653X,R2=0. 118, P=0. 028), but not in patients with NP;and the size or diameter of the tumor was negatively correlated with PNMT immunohistochemistry in patients with NP(Y=0. 940-0. 356X, R2=0. 494, P=0. 005), but not in patients with HP, indicating that NP may be misdiagnosed clinically. Conclusion Patients with NP have distinct clinical, biochemical, and pathological phenotypes; the phenotypic changes are closely related with the expression levels of catecholamine pathway products during the occurrence and development of the tumors.

Objective To assess the intraoperative efficacy of contrast-enhanced ultrasonography (CEUS) in the radiofrequency ablation (RFA) of renal tumors.Methods RFA was performed on 110 renal tumors (size range:1.5-8.6 cm,49 located in the left,55 right and 3 bilateral) in 107 selected patients.Conventional tumor biopsy was conducted for pathological diagnosis using 18G biopsy needle after RFA.CEUS was performed in all patients before,during and after RFA to assess the necrotic area.Once suspicious residual lession was discovered by CEUS,another round of RFA was taken immediately.Initial follow-up enhanced CT and CEUS was performed seven days after the procedure,with subsequent CEUS and enhanced CT after one month,three months,and six months to assess the necrotic area.Technical success was defined as elimination of areas that enhanced at imaging within the entire tumor.Results With CEUS performed during RFA,110 tumors (100％) were successfully ablated during one operation.Of these,five tumors was subjected to additional RFA treatment for the suspicious residual lesion detected by CEUS right after initial RFA.Elimination of areas covered the entire tumor after the second RFA.No residual or recurrence tumors was confirmed by both enhanced CT and CEUS during follow-up.All patients survived in the follow-up phase which ranged from 3 to 18 months(mean 11 months).Conclusions With the application of intraoperative CEUS,there were less residual tumors after RFA.