0.05).The lobular sign was markedly more in peripheral pulmonary squamous carcinoma than in other histopathological group(P0.05).Conclusion There are certain relation between spiral CT appearance and histopathology in peripheral pulmonary carcinoma.CT appearance may be one of the evidence in diagnosing the histopathological type in peripheral pulmonary carcinoma.

Objective To assess the clinical value of high frequency ultrasound diagnosis for little bone fracture of ankle. Methods Thirty-seven ankle wound patients with negative X-ray examination underwent high frequency ultrasound. The second X-ray examination was performed on patients with hinted little bone fracture of ankle, and then CT/MR examination was performed on patients whose second X-ray examination was negative. The consequence of the second X-ray examination was counted and the sonographic features were analyzed. Results ①Little fracture of fibula (lateral malleolus) was in 16, of tibia (medial malleolus) in 12, of talus in 2, of scaphoid bone in 4, of metatarsale in 2 and of calcaneus in one patients. ②The second X-ray examination was positive in 26 patients (26/37, 70.27%), indicating that the detection rate of the second X-ray is higher than that of the first X-ray. ③Sonographic features of little bone fracture of ankle included incomplete bone surface of bone was rough and soft tissue swelling and thickening. No malposition of bone fracture was found. Conclusion High frequency ultrasound is supplementary for X-ray examination, being able to possess important clinical priority in the diagnosis of little bone fracture.

Objectives To investigate the changes of cystatin C in the serum of patients with acute kidney injury ( AKI) or end-stage renal disease ( ESRD), and study its significance in the early diagnosis of AKI and its correlation with the degree of renal function injury. Method The cases in Xiangya hospital were enrolled in this study according to the RIFLE criteria, including 20 cases of slight acute kidney injury, 30 cases of medium-severe acute kidney injury, 48 cases of victims of the 5. 12 wenchuan earthquake, 32 cases of end-stage renal disease and 20 healthy patients. The microparticle-enhanced immunoturbidimetry method was used to detect serum cystatin C, and the colorimetric method was used to detect urine N-acetyl-beta-D-glucosaminidase (NAGase). The enzymic method was used to detect serum creatinine. The correlation between serum cystatin C and serum creatinine was analyzed, and the sensitivity and specificity of serum cystatin C were evaluated with the receiver operator characteristic curve (ROC curve). Results Compared with healthy control group, the serum cystatin C increased obviously in acute kidney injury group and ESRD group( P <0. 05 and P <0. 01). The serum cystatin C was positively correlated with serum creati-nine( P <0.01). The serum cystatin C in the 5. 12 wenchuan earthquake injured group was also higher than that in healthy control group ( P <0.05), an the serum cystatin C had an AUC - ROC of 0.931 ( P <0. 01). Conclusion Compared to the conventional biomarkers, the earlier emergence of serum cystatin C can contribute better to early clinical diagnosis of AKI. The serum cystatin C is positively correlated with renal function, and reflect changes in renal function accurately.

Objective To investigate the clinical efficacy of the urethra URSL combined with micro-puncture and drainage treatment for pediatric calculus of lower urinary tract. Methods From January 2003 to January 2013, 66 cases with pediatric urinary tract calculi in our hospital were randomly equally divided into experimental group and control group. The experimental group was treated with transurethral bladder micro URSL combined puncture and drainage treatment, and the control group was given a simple transurethral URSL method of treatment. The operative time, postoperative urine turned clear time,pulling stone clearance after catheter time,postoperative hospital stay and the incidence of postoperative urethral stricture were observed and recorded. In addition, these data were compared between the two groups. Results The operations of two groups have successfully completed. The mean operative time, postoperative urine turned clear time, pull out the catheter stone clearance after time and postoperative hospital stay of control group was 30.2±2.45 minutes,2.5±0.5 days,2.1±0.8 days and 4.0±0. 5 days, respectively. Patients were followed up 1 year after operation, and 1 case of urethral stricture occurred. However, the mean operative time, postoperative urine turned clear time, pull out the catheter stone clearance after time and postoperative hospital stay of the test group was 20.36±2.35 minutes,1.5±0.7 days,1.1±0.25 days and 3.1±0.3 days,respectively,with no urethral stricture case occurred. There were significant differences between the two groups ( <0.05) . Conclusion Transurethral bladder URSL micro puncture and drainage combined with transurethral ureteroscopy lithotripsy treatment for children with lower urinary tract calculi has better efficacy and safety. It could shorter operative time, postoperative urine turned clear time, the gravel discharge time and average hospitalization time, reduce the incidence of postoperative secondary urethral stricture.

Objective To investigate the feasibility and safety of endoscopic treatment of ureteral calculi acute obstruction with urinary extravasation. Methods 56 patients with ureteral calculi acute obstruction and urinary extravasation were randomly divided into two groups:the treatment group and the control group,28 cases in each group. Patients in the treatment group were given URSL or percutaneous nephrostomy drainage, and the secondary fistula was given URSL stone clearance treatment. Patients in control group were given traditional ureterolithotomy treatment. The stone clearance rate, the average recovery time after surgery, postoperative wound infection rate and the abnormal rate of postoperative albumin were observed in two groups. Results In the treatment group,28 patients had no residual stones with mean postoperative recovery time of (5.2 1.3) days,postoperative fever was found in 3 cases,obvious abnormal postoperative albumin in 3 cases. In the control group,residual stones were found in 3 cases,the average recovery time after surgery was (7.9 2.6) days,postoperative fever was found in 10 cases, and obvious abnormal postoperative albumin in 11 cases. There were statistically significant differences in stone clearance rate, the average recovery time after surgery, postoperative wound infection rate and the abnormal rate of postoperative albumin between two groups (P<0.05) . Conclusion Endoscopic treatment of ureteral calculi acute obstruction and urinary extravasation has advantages including better efficacy, less trauma, less complications and quicker recovery.

This study was aimed to investigate the diuretic effect ofMori Cortex and to identify effective fractions inM. Cortex. Metabolic cages were used to firstly observe the diuretic effect ofM. Cortex aqueous extracts on rats. Medications were continuously given for 5 days to screen for the best dosage of diuretic effect. Picric acid assays were used to detect creatinine levels in serum and urine after 5-day medication. Then, the diuretic effect of each chemical split fraction inM. Cortex was studied in order to indentify the effective parts. The results showed that after administration ofM. Cortex aqueous extracts for 3 to 5 days, compared with the control group, there was a significant diuretic effect on rats (P<0.05 orP<0.01). And the medium-dose ofM. Cortex aqueous extracts showed the best effect (P<0.01). However,M. Cortex aqueous extracts had no significant effect on creatinine levels in serum and urine. Assays of diuretic effect of chemical split fractions ofM.Cortex indicated that compared with the control group, 30% ethanol fraction and fatty oil fraction had the best diuretic effect (P<0.01). It was concluded thatM.Cortex aqueous extracts had a significant diuretic effect. And the chemical fractions contributed mostly to this effect were mainly existed in the 30% ethanol fraction and fatty oil fraction.

The most prevalent kind of renal calculi,calcium oxalate(CaOx),is characterized by its propensi-ty for recurrence in the urinary system.The development of CaOx renal calculi is greatly affected by macrophage polariza-tion.Particular oxalate causes an imbalance in macrophage polarization,which skews the M1/M2 ratio and makes it easier for CaOx crystals to accumulate in the kidneys and grow into calcium plaques in the renal papilla.Notably,M2 macro-phages can prevent CaOx renal calculi by consuming crystals and reducing inflammatory stress.As a result,immunothera-peutic techniques that alter M1 and M2 macrophage polarization are extremely promising for preventing CaOx renal calcu-li.To clarify the respective roles of M1 and M2 macrophages in the formation of CaOx crystals and provide insights for de-veloping immunotherapeutic interventions against CaOx renal calculi,this review summarizes the mechanisms underlying macrophage polarization in the genesis of CaOx renal calculi.

Objective To compare effectiveness and short-term outcomes between robotic-assisted and laparoscopic surgery for radical resection of rectal cancer.Methods A total of 410 patients diagnosed with rectal cancer,undergoing robotic-assisted surgery (RAS) for rectal cancer (215 cases) and conventional laparoscopic surgery(CLS) for rectal cancer (195) from Jan 2016 to Dec 2018 were included into the present study.Operative characteristics,postoperative complications and pathologic parameters were evaluated between RAS and CLS group.Results The RAS group had less intraoperative blood loss[(107 ± 46) ml vs.(147 ±35)ml,t =3.695,P＜0.05],longer operation time[(209 ±55)min vs.(195 ± 55)min,t=2.508,P＜0.05],earlier first flatus[(3.4 ± 1.4)d vs.(5.3 ± 1.6)d,t =-14.952,P＜ 0.05],and first liquid diet time [(4.3 ± 1.5) d vs.(6.2 ± 2.6) d,t =-9.109,P ＜ 0.05],more number of dissected lymph nodes[(12.6 ± 4.3) vs.(10.6 ± 4.5),t =4.468,P ＜ 0.05] compared with those in the CLS group.But more expensive total hospitalization costs[(71 775 ±45 089) yuan vs.(66 789 ± 16 721) yuan,t =4.224,P ＜ 0.05].Conclusion Compared with laparoscopic surgery,robotic-assisted surgery has less blood loss,shorter time of first flatus,more lymph nodes yield.

This study was aimed to investigate the estrogenic effects ofCoicis Semen in order to preliminarily discuss the mechanism. Mouse uterine weight test and MCF-7 cell proliferation assay were used to evaluate the estrogenic effects ofC. Semen. Reporter gene assays were adopted to explore the action mechanism ofC. Semen. In reporter gene assay, HEK293 cells were co-transfected with pERE-TAL-luc, pβgal-Control, pCXN2-hERα, or pCXN2-hERβ. And the expression of reporter gene luc was controlled by ERE. Mouse uterine weight test showed that compared with the control group, the aqueous extracts ofC. Semen can increase the uterus index of premature female mice (P<0.01). It can significantly promote the proliferation of MCF-7 cells in the medium without estrogen (P<0.01). The reporter gene controlled by ERE technology showed thatwhen mediated by ERα or ERβ respectively, the normalized luciferase activity of aqueous extracts ofC. Semen was significantly higher than activity of the control group (P< 0.05 orP< 0.01). It was concluded that the aqueous extracts ofC.Semen can increase the uterus index of premature female mice and promote the proliferation of MCF-7 cells in the medium without estrogen. We found the estrogenic effects ofC. Semen for the first time. And the estrogenic effects ofC. Semen were mainly mediated by ERβ.

This article was aimed to study effects of aqueous extracts and all chemical split fractions ofMori Cortex on hypoglycemic effect of diabetic mice model. Intra-peritoneal injection of 170 mg·kg-1 streptozocin (STZ) was given to male Kunming mice to establish type I diabetes mode. Continuous administration of medication was given for 4 weeks. And then, indicators such as body weight, water intake, food intake, fasting plasma glucose (FBG), insulin, C-peptide, total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-c), and low density lipoprotein cholesterol (LDL-c) were detected. Pathological morphology of the liver and pancreas were observed by light microscopy. The results showed that high-dose group ofM. Cortex aqueous extracts can improve weight loss of type I diabetic mice, significantly reduce water intake and food intake, reduce FBG, TC, TG and LDL-c levels in different degrees (P<0.05 orP<0.01), and increase C-peptide and HDL-c levels (P<0.05 orP<0.01). When dosages of 30% ethanol fraction and fatty oil fraction were only about 1/2 and 1/4 ofM.Cortex aqueous extracts, we found that it can improve lipid disorder status,repair liver cells, and improve liver tissue damage. Its effect was superior to M. Cortex aqueous extracts. It was concluded thatM. Cortexaqueous extracts showed a better hypoglycemic effect. The effective component parts were 30% ethanol fraction and fatty oil fraction. Its hypoglycemic mechanism may be related to the promotion of insulin secretion, regulation of blood lipid disorders, as well as the protection of liver structure and function.