Objective To evaluate the use of flexible cystoscope in the surgical management of complex renal calculi. Methods Flexible cystoscope and a set of stone baskets were used to help the surgical of complex renal calculi via the renal pelvis incision or the dilated ureter during operation.A pyelostomy with the use of a Foley's catheter was carried out if necessary and the residual stones could be removed via the pyelostomy tract later on. Results 31 cases of complex renal stones have been surgically treated.Flexible cystostomy was used intraoperatively in 11,postoperatively for the removal of residual stones in 16 and being used both intra and postoperatively in 4.A total of 106 stones have been removed.26 patients ( 83.9 %) have been free from any stone.2(6.4%) have undergone ESWL followed by flexible cystoscopy to remove the residual stones.3 patients (9.7%),however,still had residual stones in spite of the above procedure. Conclusions Flexible cystoscopy as an adjuvant procedure is an effective means in the surgical treatment of complex renal calculi especially for the removal of residual stones.The procedure is simple,safe and less expansive.

Objective To explore the effect of a novel colloidal gold immunochromatographic test strip for detection of group B streptococci (GBS).Methods A total of 202 cases of swab of vagina or neck of uterus were collected,and they were detec-ted by novel strip and control strip to evaluate their clinical applications.Results Sensitivity of novel strip was about 105 CFU/ml and the detection time was about 5 to 8 minutes,and it showed better sensitivity and shorter detection time com-pared with control strip.In the 202 cases of clinical samples,the detection results of 197 cases were in consistent with the control strip,however,the detection results of 5 cases were not in consistent.The positive coincidence rate and negative coin-cidence rate were 97.5% and 97.54% respectively,and the total coincidence rate and Kappa value were 97.52% and 0.948 respectively.The consistency test showed no significant difference between this strip and control strip.Conclusion This method was a effective technology for diagnosing of infection caused by GBS,and had high value in clinical application.

OBJECTIVE To investigate the pathogenic causes of community-acquired pneumonia(CAP) in adult patients in Tongling.METHODS A prospective study was performed on 260 consecutive adult patients with CAP in Tongling city during last three years.Bacteria culture of sputum and serological tests in paired serum samples were detected.RESULTS Of 260 patients with etiological evaluation,128(49.2%) patients had an identifiable etiology,63(24.2%) had positive outcome from sputum cultured,atypical pathogens were detected from 75(28.8%)patients.Pathogens identified in 128 patients were:Mycoplasma pneumoniae(35.4%),Chlamydia pneumoniae(17.7%) and Streptococcus pneumoniae(13.6%).6.5% All patients had mixed infection.The resistance rate of S.pneumoniae to penicillin and erythromycin was 5 and 50%,respectively.CONCLUSIONS Atypical pathogens have important role in CAP,of which M.pneumoniae is the most common pathogen.S.pneumoniae and K.pneumoniae are the commonly encountered bacteria for CAP in Tongling.

Objective To investigate the source of the elevated serum prostatic specific antigen(PAS) in prostate hyperplasia patients with large volume prostate. Methods Open surgery (ie,suprapubic prostatectomy) was performed in 27 patients who had a preoperative PSA between 8.1 and 75.1 ng/ml and the volume measured by ultrasonography over 50 ml,DER≥Ⅲ? size,but without symptoms and signs of prostate cancer (PCa).The 27 patients were post operatively followed up to measure the serum PSA,to analyze the change in PSA and the source of pre operative elevated PSA. Results The post operative gross examination showed that the average weight of the prostate enucleated was 82.7 g (40 to 185 g).Pathological evaluation of the surgical specimen revealed that no prostate cancer lesion was found in 25 patients;however,PCa lesions were found in 2.Within 1 month the PSA rapidly dropped down to normal in 26 patients;however,in the remaining one with pathologically proven PCa,PSA increased.24 patients were followed up between 17 and 57 months after surgery.The average PSA level was 1.16 ng/ml(0.08 to 2.39 ng/ml). Conclusions In BPH patients with large volume prostate the increased PSA originates from hyperplastic gland (transition zone),not from the peripheral zone.

Transarterial chemoembolization (TACE) combined the embolization with chemotherapy,whose efficacy has been verified in the treatment of hepatocellular carcinoma.Factors like the incomplete embolism,the formation of collateral circulation,neoangiogenesis and the like greatly weaken the clinical efficacy of TACE in the long term.Thus,the improvement of TACE efficacy depends on the comprehensive treatment.This paper reviewed the present application status and the progress on the treatment of hepatocellular carcinoma with TACE.

(1)H-NMR and (13)C-NMR assignments of 12-oleanene-3,11-dione (compound 1) were completely described for the first time through conventional 1D NMR and 2D shift-correlated NMR experiments using (1)H-(1)HCOSY, HMQC, HMBC techniques. Based on its NMR data, the assignments of 28-hydroxyolean-12-ene-3,11-dione (compound 2) were partially revised.
Euonymus ; metabolism ; Magnetic Resonance Spectroscopy ; Molecular Conformation ; Oleanolic Acid ; analogs & derivatives ; analysis ; chemistry ; Triterpenes ; analysis ; chemistry

Background: Percutaneous radiofrequency ablation (RFA) is a first-line treatment for very-early-stage hepatocellular carcinoma (HCC), whereas the efficacy of percutaneous microwave ablation (MWA) for very-early-stage HCC remains unclear. The purpose of this study was to clarify this issue by comparing the safety and efficacy of percutaneous MWA with percutaneous RFA in treating very-early-stage HCC. Methods: Clinical data of 460 patients who were diagnosed with very-early-stage HCC and treated with percutane-ous MWA or RFA between January 2007 and July 2012 at the Eastern Hepatobiliary Surgery Hospital, The Second Mili-tary Medical University, in Shanghai, China were retrospectively analyzed. Of these 460 patients, 159 received RFA, 301 received MWA. Overall survival (OS), recurrence-free survival (RFS), local tumor progression (LTP), complete ablation, and complication occurrence rates were compared between the two groups, and the prognostic factors associated with survival were analyzed. Results: No significant differences were observed between the two groups in terms of the 1-, 3-, or 5-year OS rates (99.3%, 90.4%, and 78.3% for MWA vs. 98.7%, 86.8%, and 73.3% for RFA, respectively;P= 0.331). Furthermore, no signif-icant differences were observed between the two groups in terms of the corresponding RFS rates (94.4%, 71.8%, and 46.9% for MWA vs. 89.9%, 67.3%, and 54.9% for RFA, respectively;P= 0.309), the LTP rates (9.6% vs. 10.1%,P= 0.883), the complete ablation rates (98.3% vs. 98.1%,P= 0.860), or the occurrence rates of major complications (0.7% vs. 0.6%,P= 0.691). By multivariate analysis, LTP, antiviral therapy, and treatment of recurrence were independent risk fac-tors for OS (P < 0.001), and the alpha-fetoprotein level was an independent prognostic factor for RFS (P= 0.002). Conclusions: MWA is as safe and effective as RFA in treating very-early-stage HCC, supporting MWA as a first-line treatment option for this disease.

OBJECTIVETo determine the exact location of the opening of the ejaculatory duct in men and provide some basic anatomical evidence for seminal vesiculoscopy and the treatment of ejaculatory duct obstruction.

METHODSWe performed ureterocystoscopy for 21 male patients aged 26 - 47 years with hematuria (n = 12), hematospermia (n = 2), glandular cystitis (n = 6), and anejaculation after radical resection of rectal carcinoma (n = 1), and meanwhile, with the consent of the patients, massaged the prostate and ejaculatory duct and observed the outlet of the expelled fluid. Under the microscope, we described the fluid samples with sperm as the expulsion from the ejaculatory duct.

RESULTSUreterocystoscopy showed that the exact anatomical sites of the expulsion of prostatic fluid and semen in the patients were the side and lower side of the prostatic utricle opening above the verumontanum and the ventral side of the verumontanum. Quantities of sperm were found in the expulsion fluid of 13 of the patients, and no expulsion, including semen, was seen from the prostatic utricle opening.

CONCLUSIONAnatomically, the ejaculatory duct openings of males are located at the two sides of the verumontanum adjacent to the opening of the prostatic utricle, rather than in the prostatic utricle above the verumontanum.

Adult ; Cystoscopes ; Ejaculation ; physiology ; Ejaculatory Ducts ; anatomy & histology ; physiology ; Endoscopy ; instrumentation ; methods ; Hematuria ; Hemospermia ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Prostate ; anatomy & histology ; physiology ; Rectal Neoplasms ; surgery ; Semen ; secretion ; Spermatozoa

Objeetive To analyze the clinical significance of serial microproteinuria and urease detection in early diagnosis of antibiotics damage to kidney by observing the changes of urine microalbumin/creatinine ratio (mAlb/Cr),transferrin (TRF),IgG,α1-microglobulin (α1-M G),β2-microglobulin (β2-M G),retinol-binding pmtein(RBP) and N-acetyl-β-D-glucosaminidase(NAG).Methods A total of 161 children with pneumonia whose test results were normal of urine protein,blood urea nitrogen (BUN) and serum creatinine (Scr),and had no related history of kidney diseases were selected.All the patients were divided into three groups according to antibiotics for the treatment,the penicillins (penicillin G,amoxicillin and potassium clavulanate,ticarcillin and potassium clavulanate) group,the cephalosporins (cefazolin,cefuroxime,ceftriaxone,cefoperazone,ceftazidime) group and the macrolides (erythromycin,azithromycin) group.Changes of mAlb/Cr,TRF,IgG,α1-MG,β2-MG,RBP,NAG,BUN,Scr levels of the patients one week before and after use the antibiotics were observed,and statistically analyzed.Results In the penicillins group and macrolides group,the results showed that none of the serial microproteinuria and urease changed(all P ＞ 0.05).In the cephalosporins group,the urine mAlb/Cr,TRF,β2-MG and NAG were higher than before using the antibiotics [(15.56 ± 5.98) mg/g vs.(21.08 ± 10.88) mg/g,(1.61 ± 0,14)mg/L vs.(1.66 ±0.14) mg/L,(0.25 ±0.09)mg/L vs.(0.28 ±0.11)mg/L,(4.62 ±3.80) U/L vs.(4.98 ±3.97) U/L,t =-5.11,-3.24,-2.29,-2.04,P ＜ 0.05 ～ 0.001].The levels of BUN and Scr revealed no change in all the patients(all P ＞ 0.05).Conclusion Combined detection of serial microproteinuria and urease has great clinical significance in judgment and warning of early renal damage by antibiotics.

AIM: To observe the changes of cystathionine-lyase/hydrogen sulfide(CSE/H_2S) in vivo in vascular calcification and to explore the role of CSE/H_2S in vascular calcification.METHODS: Vascular calcification model in rats was induced by administration of vitamin D_3 plus nicotine.The extent of calcification was estimated by assaying calcium content.[~(45)Ca~(2+)] deposition and alkaline phosphatase(ALP) activity were detected.CSE mRNA amount was determined by using competitive quantitative RT-PCR.The content of H_2S and activity of CSE in the plasma and cardiovascular tissues were also determined with biochemical methods.RESULTS: Calcium content in myocardium increased by 3.8 folds in a calcification model.Compared to control,calcium content,[~(45)Ca~(2+)] accumulation and ALP activity in calcified arteries increased by 6.8,1.4,and 1.9 folds,respectively(P