Objective To explore the best minimal invasive method in treating renal pelvic stones less than 1.5 cm.Methods A total of 90 patients with renal pelvic stone less than 1.5 cm were enrolled, including 47 cases of retrograde intrarenal surgery(RIRS)by rigid and flexible ureteroscopy with holmium laser lithotripsy,and 43 cases of percutaneous nephrolithotomy(PCNL)by holmium laser lithotripsy.Opera-tion time,stonefree rate(SFR),hospitalization,and complications were analyzed for comparison.Results The average sizes of stone in the RIRS group and PCNL group were 1.2 cm(range 1.0 ~1.5 cm)and 1.3 cm (1.0 ~1.5 cm),respectively.In the RIRS group,45(95.74%)patients out of 47 had complete clearance and 32 patients needed combination of flexible ureteroscopy to fragmentate the stones falling into the renal calices.The operation time was 44 min(range 27 ~70 min)with postoperative fever in 2 cases.The decrea-sing in hemoglobin and hematocrit was(0.18 ±0.06)g/L and 0.11%,respectively.No major complication was recorded.In PCNL group,the mean operation time was 70min(range 45 ~90 min)with a stone-free rate of 95.35%(41 /43).The decreasing in hemoglobin and hematocrit was(17.25 ±6.70)g/L and 5. 62%,respectively.The complications in PCNL group were postoperative fever in two cases and bleeding in two cases.Conclusion RIRS has the advantages of natural orifice endoscopic surgery in shortening opera-tion time,reducing blood transfusion requirements,and decreasing postoperative complications.For renal pelvic stone less than 1.5 cm,RIRS can be the primary choice.

Granulocyte-Macrophage Colony-Stimulating Factor ; therapeutic use ; Humans ; Recombinant Fusion Proteins ; therapeutic use

Objective To explore the effect of xanthine oxidase inhibitors allopurinol on collagen remodeling of non-infarcted myocardium after myocardial infarction in rats.Methods Myocardial infarction models were produced by ligation of anterior descending coronary artery.The survivals were randomly divided into 3 groups:sham operation group, MI group and allopurinol group(50 mg/kg).On the 7th, 14th, 21st and 28th day respectively, the collagen content were examined. The type Ⅰ and type Ⅲ collagen volume fraction(CVF) and Ⅰ/Ⅲ ratio in non-infarcted zones(NIZ) were examined with PSR staining, mRNA expressions were detected with RT-PCR, the activities of xanthine oxidase(XO) and O—?2,?OH-scavenging in NIZ were examined by colorimetry.In addition, the expression of XO protein by Western blotting analysis and pathological change in LV were detected on the 28th day.ResultsCompared with sham group,the mRNA expressions, CVF of typeⅠand type Ⅲ collagen in NIZ were increased in MI group.The typeⅠ/Ⅲ ratio in NIZ was increased after decreased.The collagen content and activity of XO were boosted but the activities of O—?2,?OH-scavenging were decreased(P

OBJECTIVETo investigate the application of relay flaps pedicled by perforator from digital artery for reconstruction of soft tissue defects at finger tip.

METHODSFrom Mar. 2012 to Jun. 2014, 9 cases with soft tissue defects at finger tip were reconstructed with relay flaps at one side of finger pedicled by perforator from digital artery. The flap size ranged from 1.3 cm x 1.6 cm to 1.6 cm x 2.2 cm. The defects at donor sites were covered by adjacent web perforator V-Y advanced flaps.

RESULTSAll the 18 flaps in 9 cases survived completely with primary healing both in recipient and donor sites. The patients were followed up for 5 months to 2 years ( average, 12 months) with good elasticity and cosmetic results. No pain happened in the treated finger. The 2-point discrimination distance was 7-8 mm in fingertip flaps, and 10-12 mm in web perforator flaps. Hand function was graded as excellent in 7 cases, good in 2 cases, based on ATM assessment. The affected fingers had normal temperature and cold-resistance during winter. The width and depth of web in the donor site were not affected.

CONCLUSIONSThe relay flaps pedicled by perforator from digital artery can be applied for reconstruction of soft tissue defects at finger tip. The procedure is easy with satisfactory results and reservation of main artery. No skin graft is necessary for closure of defects on donor sites.

Arteries ; Elasticity ; Finger Injuries ; surgery ; Fingers ; blood supply ; Follow-Up Studies ; Humans ; Perforator Flap ; transplantation ; Time Factors ; Transplant Donor Site ; Wound Healing

BACKGROUND:The interaction of neural network and motor function in post-stroke brain tissue remains unclear.
OBJECTIVE:To observe neural network impairment fol owing subacute stroke by using diffusion tensor imaging, and to investigate the relationship with neurological defects and motor dysfunction.
METHODS:A total of 19 patients after subactue stroke and 20 healthy adults were examined with diffusion tensor imaging. The fol owing parameters were compared:fractional anisotropy, apparent diffusion coefficient, asymmetry indices of fractional anisotropy and apparent diffusion coefficient. The neurological defect and motor function were evaluated with the corresponding scales. The 10-meter walking speed was measured. The correlation of diffusion tensor imaging parameters with the scale scores and 10-meter walking speed was analyzed.
RESULTS AND CONCLUSION:The stroke group exhibited reduced fractional anisotropy value asymmetry and fractional anisotropy value in bilateral posterior limbs of the internal capsule. Apparent diffusion coefficient value asymmetry and apparent diffusion coefficient value in the posterior limb of the internal capsule were lower than control unaffected side (P<0.05). Apparent diffusion coefficient value and apparent diffusion coefficient value asymmetry in posterior limb of the internal capsule showed a strong negative correlation with Fugl-Meyer assessment scores of the lower extremities (P<0.05). Diffusion tensor imaging parameters is closely linked with motor dysfunction of the lower extremities in subacute stroke patients. Local stroke lesion-caused neurological defect is the leading cause of motor dysfunction of the lower extremities.

Objective To analyze the clinical features of fungal septicemia in premature infants in a hospital,and provide reference for clinical diagnosis and treatment.Methods Clinical data of 18 premature infants with fungal septicemia in a hospital between January 2011 and December 2013 were analyzed retrospectively.Results Gesta-tional ages of 18 premature infants were 27-36 weeks,birth weights were 1 050 g-3 100 g,8 of whom were very low birth weight infants(VLBWI);all premature infants were treated with broad-spectrum antimicrobial agents,and were given long-term parenteral nutrition before infection,10 with mechanical ventilation,2 with peripherally insert-ed central catheters(PICC).The main clinical manifestations were apnoea,twitch,feeding difficulty,and poor reac-tion;manifestations appeared 3 hours-52 days after birth.13(72.22%)premature infants had abnormal white blood cell count,12 (66.67%)had thrombocytopenia (< 100 × 109/L),18 (100.00%)had elevated C-reactive protein (CRP),the average CRP level was (41 .90 ±26.77)mg/L.The main pathogens were Candida spp .(n = 17, 94.44%),including Candida parapsilosis (n=7),Candida albicans (n =5 ),biovariety of Candida albicans (n =4),and Candida famata (n=1);premature infants were treated with fluconazol and amphotericin B,15 (83.33%) were cured,2 (11 .11 %)improved,and 1 (5.56%)died.Conclusion Fungal septicemia in premature infants are mainly caused by Candida,there is no specific clinical manifestations,clinical symptoms in premature infants with high risk factors should be closely observed,blood routine and CRP should be detected periodically,timely treat-ment with antifungal agents should be given,which are beneficial to achieve good therapeutic effect.

Objective To explore the effect of xanthine oxidase inhibitor allopurinol on cardiomyocyte apoptosis in rats after myocardial infarction(MI).Methods MI model was established by the ligation of anterior descending coronary artery.The survivors were randomly divided into 3 groups: sham operation group(n=5),MI group(n=16) and allopurinol group(n=15,receiving allopurinol 50 mg?kg-1? d-1).After 28 days,the infarct size was measured.In non-infarcted zone(NIZ),cardiomyocyte apoptosis was detected by TUNEL;the expression of Fas was detected by immunohistochemistry;the expressions of xanthine oxidase(XO) and caspase 3 were detected by Western blot.In addition,the activities of XO and ?O-2,?OH-scavenging in NIZ were detected by colorimetry.Results Compared with sham operation group,the apoptosis index and expressions of Fas,XO,caspase 3 in NIZ were significantly increased in MI group.The activity of XO was increased but the activities of ?O-2 and ?OH-scavenging were decreased(P0.05).Conclusion Allopurinol could inhibit the cardiomyocyte apoptosis in NIZ in rats.The protective mechanism of allopurinol involves the reduction of reactive oxygen species and depression of the expressions of Fas and caspase 3.

Objective: To study the impact of interferon-inducible protein 16 (IFI16) inhibition on apoptosis of human aortic adventitial fibroblasts (HAAFs). Methods: Our research included 3 groups: ① IFI16-siRNA group, specific small interference RNAs (siRNAs) of IFI16 were transfected into HAAFs in vitro to make IFI16 gene silence, ②Con-siRNA group, non-specific siRNAs were transfected into HAAFs as negative control and ③Untreated HAAFs group, blank control. HAAFs cell cycle and apoptosis rate were examined by flow cytometry, IFI16 mRNA expression was measured by real time qRT-PCR, protein expressions of IFI16, p53, p21, Bax and Bcl-2 were detected by Western blot analysis. Results: Compared with Con-siRNA group and Untreated HAAFs group, IFI16-siRNA group showed decreased apoptosis rate of HAAFs (3.33±0.41) % vs (7.42±1.51) % and (6.49±1.10) %, P<0.05, reduced ratio of G0/G1 phase cells (56.64 ± 4.77 ) % vs (69.67±3.54) % and (68.29±4.14) %, P<0.05, while increased ratio of S phase cells (25.23±5.19)% vs (13.76±2.07) % and (14.04±3.00) %, P<0.05. Meanwhile, IFI16-siRNA group presented down-regulated IFI16 mRNA and protein expressions, decreased protein levels of p53, p21, Bax and increased protein level of Bcl-2, all P<0.05. Conclusion: Inhibited IFI16 expression could decrease HAAFs apoptosis, promote cell cycle transition from G1 to S phase which might be related to the suppression of p53/p21 signaling pathway and regulation of Bax/Bcl-2 expression.

0.05).Conclusion There may be no significant difference in sensory block,motor block and prevalence of adverse effects between injection rates of 0.27 mL/s and 0.04 mL/s in spinal anesthesia with 20 mg isobaric ropivacaine.

Objective To understand the attitude and current situation of medical English stud y as well as its relevant factors among long schooling medical students so as to provide first hand information for constructing students-centered medical English teaching model. Methods A self-de-signed questionnaire including basic information of students, attitude and current situation of medical English students was given to 134 seven or eight year program clinical medical graduates from grade 2006 to grade 2008 in Tongji University. Questionnaires were collected timely and an-alyzed with SPSS 19.0 and results were described by percentage. Results Totally 132 copies of questionnaire were recovered with an recovering rate of 98.51%. 56.82%(75/132) students had interest in medical English study and 71.97%(95/132)students had a will to go abroad for learning exchange. Main pur-poses for students to learn medical English were ‘professional literature reading’(68.94%,91/132),‘SCI papers writing’(59.09%,78/132)and ‘international communication’(58.33%, 77/132). Main influencing factors of medical English study were ‘boring teaching methods ’ ( 45 . 45%, 60/132 ) ,‘difficult medical English’(41.67%,55/132) and ‘insufficient teaching time’(40.91%,54/132).Conclusions Medical students with long schooling have demand for medical English study;however, most of them have some difficulties in practical application. Measures should be taken from three as-pects including students, teachers and curriculum setting to improve students' medical English.