Objective To evaluate the efficacy and safety of double-J stents in extracorporeal shock wave lithotripsy for the treatment of middle and upper ureteral calculi, and to explore the reasonable application of double-J stents. Methods 511 patients with middle and up-per ureteral calculi in our hospital were selected as the statistical objects. 161 patients of the catheter group were indwelled double-J stent be-fore extracorporeal lithotripsy while the other 350 patients in the no-catheter group underwent extracorporeal shock wave lithotripsy directly. The satisfaction rate of X-ray display location, gravel effect, and rate of adverse reaction were compared. Results The satisfaction rate of X-ray display location in the catheter group was higher than the no-catheter group (P=0. 025). And the gravel effect of the two groups were of statistical significance (P=0. 041). The incidence of hematuria and lower urinary tract symptoms in the catheter group was significantly high-er than that in the no-catheter group (P<0. 05). The incidence of renal colic in catheter group was lower than that in no-catheter group (P=0. 001). Conclusion Indwelling double-J stents is useful for stones display and localization, and it can improve the stone clearance rate. For ureteral stones whose diameter were less than 1 cm, double-J stents has little influence on the rate of stone clearance, but it can reduce the occurrence of severe renal colic.

Female ; Humans ; Hyperkeratosis, Epidermolytic ; pathology ; Infant, Newborn

Objective To analyze the survival statistics and perioperative parameters of clinical stage Ⅰ non-small cell lung cancer patients who received systemic or selective mediastinal lymphadenectomy,and explore the value of selective mediastinal lymphadenectomy for clinical stage Ⅰ non-small cell lung cancer.Methods The clinical data of 984 patients with clinical stage Ⅰ non-small cell lung cancer who underwent lobectomy and systemic/selective lymph node dissection in Zhongshan Hospital from January 2005 to December 2010 were analyzed retrospectively.There were 581 males and 403 females with an average age of(59.6 ± 10.2) (24-84) years.786 patients received systemic mediastinal lymphadenectomy,and 198 patients received selective mediastinal lymphadenectomy.Results Average operation time of selective mediastinal lymphadenectomy group was(132.3 ±30.3) minutes,and that of systemic mediastinal lymphadenectomy group was(150.7 ±41.8) minutes with significant difference(P ＜ 0.01).Average amount of intraoperative bleeding of selective mediastinal lymphadenectomy group was (96.2 ± 53.5) ml,and that of systemic mediastinal lymphadenectomy group was (124.4 ± 65.4) ml with significant difference(P ＜0.01).There was no significant difference in overall survival rate between two groups(P =0.844).Recurrence rates were 25.3 ％ and 27.5 ％,respectively (P =0.533).Subgroup analysis showed no significant difference of 5-year survival rates between the two groups.Conclusion For patients with clinical stage Ⅰ non-small cell lung cancer,selective mediastinal lymphadenectomy can reduce operation time and amount of intraoperative bleeding.Survival of patients who received selective mediastinal lymphadenectomy was no worse than that of patients who received systemic mediastinal lymphadenectomy.

Objective To explore the pathogenesis and diagnosis of chronic granulomatous disease. Methods Clinical features and laboratory examination results of a child with chronic granulomatous disease were retrospectively analyzed. Genome DNA was extracted from peripheral blood of the child and his parents. The high-throughput sequencing was performed by Illumina sequencing platform, using the Agilent SureSelect exome capture method. Results The child had recurrent infections along with liver enlargement and dysfunction. The anti-infection and symptomatic treatment were unsatisfactory. Gene sequencing analysis revealed a homozygous point mutation (c.7C?>?T, p.Gln3*) in CYBA gene. His mother had the same heterozygous mutation in this locus, and his father had a large fragment heterozygous deletions. No other candidate gene mutations were identiifed. Conclusions The diagnosis of chronic granulomatous disease is conifrmed in this child. It is caused by CYBA gene mutation.

Concurrent chemoradiotherapy is the optimal regimen for patients with inoperable locally advanced non-small cell lung cancer (LA-NSCLC).The application of new technologies such as positron emission tomography (PET)/CT and four dimensional CT (4D-CT) enhances the accuracy of radiotherapy and decreases adverse reaction.Induction chemotherapy and consolidation chemotherapy do not show benefit to survival.The targeted therapy and immunotherapy have the potential of improving the outcomes of inoperable LA-NSCLC.

To explore the value and attentive problems of the innovative practical teaching reform of dermatology staff room,the author constructed a new practical teaching system by carrying out advanced teaching methods,gradually establishing the on-line test system and setting up the evaluation and feedback system. The result showed that the innovative practical teaching reform of dermatology staff room had strong applicability and operability.

Objective To assess the value of endoscopic ultrasonography (EUS) and abdominal CT scan on preoperative T and N staging of advanced gastric cancer.Methods A total of 188 patients with advanced gastric cancer received EUS and CT scan to evaluate the T and N staging and lymphatic metastasis before surgical operation.The postoperative pathologic results acted as gold standard for comparison of the two methods.The results consistent with pathologic results were considered as correct otherwise were incorrect.The accuracy of EUS and CT and the each consistency of two methods with pathology were analyzed.Results For T staging, the accuracy of EUS and CT was 87.2%(164/188), 76.6%(144/188), respectively, and Kappa value of EUS and CT was 0.726 and 0.509, respectively.There was a statistical difference between the two methods(χ2=7.181,P=0.007).For lymph node metastasis, the accuracy of EUS and CT was 72.9%(137/188) and 79.8%(150/188), respectively, and Kappa value of EUS and CT was 0.397 and 0.487, respectively.No statistical difference was found between them(χ2=0.963,P=0.326).The consistency test between the two methods for T and N staging and lymph node metastasis revealed that the Kappa value was 0.507 and 0.649, respectively.The accuracy of EUS on T staging was 93.0%, 93.3%, 96.8% and 91.5% in cardiac cancer, gastric fundus cancer, gastric corpus cancer, and gastric antrum cancer, respectively.Corresponding Kappa value in the 4 different positions were 0.843,0.881,0.940 and 0.710, respectively according to consistency tests.The accuracy of gastric antrum cancer with pylorus invasion was 63.2% and the consistency test Kappa value was 0.340.Conclusion EUS is an accurate method for T staging and lymphatic metastasis of advanced gastric cancer, but there is a lower accuracy for T staging of gastric antrum cancer with pylorus invasion.

Objective To explore whether hydrochloride penehyclidine can inhibit rat pulmonary hypertension induced by monocrotaline and prevent or relieve the remodeling of pulmonary vascular.Methods Thirty healthy male SD rats (aged 3-4 weeks,weighing 90-100 g)were randomly divided into normal control group (group C),monocrotaline pulmonary hypertension group (group M)and hydrochloride penehyclidine treatment group (group P,n = 10 each).Rat pulmonary hyper-tension model was established by abdominally injecting 60 mg/kg monocrotaline all at once;The con-trol group was abdominally injected equal volume of normal saline all at once;the treatment group P 2 mg/kg hydrochloric penehyclidine 1 5 minutes before model building 1 mg/kg hydrochloric penehyclid-ine two days after model building;while the other two groups received equal volume of normal saline as placebo at the same time of medicine injecting,which lasted consecutively for 3 weeks.21 days af-ter model building,the haemodynamics (pulmonary artery pressure and right ventricular pressure) test was performed for all groups;Venous blood was sampled for blood biochemical tests (using ELISA method to test the content of NO and ET-1 )before executing the rats.The left lung tissue was sliced to observe the pathological morphological changes of lung tissues.The right lung tissue was cryopreserved for other tests.Results Compared with the normal control group,the pulmonary artery pressure and right ventricular pressure of monocrotaline pulmonary hypertension group notably enhanced (P <0.05);The pulmonary arterioles strongly thickened;The lumen of pulmonary arteri-oles became narrow and even blocked;The inflammatory cells of lung tissues apparently infiltrated. When compared with the monocrotaline pulmonary hypertension group, the pulmonary artery pressure and right ventricular pressure of the hydrochloride penehyclidine treatment group greatly lowered (P <0.05);Both the thickening degree of pulmonary arterioles walls and the infiltrating de-gree of inflammation cells of lung tissues lessened.When compared with the normal control group, the NO content of other groups significantly lowered and the ET-1 content apparently increased;When compared with the monocrotaline pulmonary hypertension group,the NO content of hydrochlo-ride penehyclidine treatment group was higher and the ET-1 content was lower.The differences were statistically significant (P <0.05).Conclusion The rat pulmonary hypertension model has been suc-cessfully built with the help of monocrotaline.The reducing of NO content and increasing of ET-1 was relevant to the formation of rat pulmonary hypertension induced by monocrotaline;The fact that hy-drochloric penehyclidine lowered the pulmonary artery pressure of rat pulmonary hypertension model and improved the thickening degree of pulmonary arterioles walls might involve the increasing of NO cotent and reducing of ET-1 content.

Objective To investigate the selection of flaps for the reconstruction of facial skin defects.Methods A total of 40 patients with facial skin defects were treated from February 2011 to February 2015 in our hospital,and they were given different surgery methods ac-cording to the different facial skin defect sizes.Minor defects were primarily treated by direct suturing;medium-sized defects were treated by local skin flap transposition or island skin flap;and larger defects were treated by expanded skin flap.Results All patients were followed up for 1 to 2 years.All the flaps survived with good color and texture match.All the scars healed well which were almost invisible.There was no obvious deformity in the donor and recipient sites.In addition,there was no lesion recurred.Conclusion Select suitable flaps for the recon-struction of facial skin defects according to the face defect area could get reliable blood supply of the flap,inapparent incision scar and a high level of satisfaction.

AIM:To investigate the effect of phosphodiesterase 4 (PDE4) inhibitor rolipram on the levels of cyclic adenosine monophosphate (cAMP), protein kinase A (PKA), cAMP response element-binding protein (CREB), phosphorylated CREB (p-CREB) and brain-derived neurotrophic factor (BDNF) in the hippocampus and the prefrontal cortex (PFC) of alcoholism model mice.METHODS:The mice (n=60) were randomly divided into control group , con-trol+rolipram group, alcoholism model group, and alcohol +rolipram (0.1, 0.5 and 1 mg/kg) groups.The mice were given alcohol preference test on days 6, 13, 20 and 27.After the test, the mice received withdrawal of alcohol for 1 d.On day 28, the mice were given behavior test of depression , and after the test, the mice were sacrificed.The cAMP levels in the hippocampus and PFC were detected by ELISA , and the protein levels of PKA , CREB, p-CREB and BDNF were detec-ted by Western blot.RESULTS:The mice showed an obvious drinking phenomenon (P<0.01), and the immobility time of forced swimming test and tail suspension test was significantly increased (P<0.01), with increasing drinking days and withdrawal times .However , chronic treatment with rolipram for 28 d reversed this phenomenon .Moreover , the cAMP lev-els in the hippocampus and PFC were significantly decreased after 28 d alcohol treatment ( P<0.01 ) , and pretreatment with rolipram (1 mg/kg) obviously reversed this decrease (P<0.01).Parallel to these changes of cAMP , the protein lev-els of PKA, p-CREB and BDNF were also decreased in the hippocampus and PFC (P<0.01), and 28 d rolipram adminis-tration inhibited the decreased cAMP , PKA, p-CREB and BDNF levels in the hippocampus .Moreover, 28 d rolipram ad-ministration also reversed decreased cAMP , PKA and p-CREB in the PFC.CONCLUSION:Rolipram treatment protects against alcohol-induced depression-like behaviors , and also reduces alcohol drinking .These effects may be related to PDE4-cAMP-PKA-CREB-BDNF pathway .