Objective To look for a standard way to cure uric acid calculi in transplanted kidney with medicine.Methods Under the guide of the standard and widespread metabolic evaluation, citrate and allopurinol were used to treat 4 patients with uric acid calculi after kidney transplantation. These two kinds of medicines were used in the long term together with other conservative treatment to prevent the recurrence of calculi.Results In these 4 cases, all clinical syndromes disappeared and all the calculi dissolved. After follow-up for 1～2 years, no recurrence of calculi was found. Conclusion Citrate should be used to dissolve uric acid calculi in transplanted kidney and to prevent the recurrence of calculi under the guide of the standard metabolic evaluation.

ObjectiveTo review the experience of video-assisted thoracoscopic resection for posterior mediastinal neurogenic tumors,to investigate the technical features and difficulties of thoracoscopic approach.MethodsFrom May 2001 to June 2011,58 patients underwent thoracoscopic resection of posterior mediastinal tumors in our institution,including 36 males and 22 females.The average age of the patients was 38.7 years.The average tumor size was 4.9 cm.16 patients had neurogenic or pulmonary symptoms at the time of diagnosis,while the other 42 were asymptomic.24 lesions were located in the left side,33 lesions in the right side,1 lesion in bilateral sides.All procedures generally required 3 ports,and intracapsular enucleation was preferred,supplying vessels were ligated by hemoclips or Hem-o-lock clips; the nerves of origin were cut off at both edges of the tumor.For bulky tumor,dense adhesion,and massive bleeding,open conversions were performed by extending the incision anteriorly to 6-10 cm.ResultsAll procedures were successfully performed without death event occurring.The average operating time was 127.2 min.The average intraoperative blood loss was 206.4 ml.3 cases requied blood transfusion.The average chest tube duration was 2.72 days.The average postoperative stay was 5.19 days.53 procedures were performed entirely under thoracoscopy to achieve gross-total resection.Conversions to an open procedure were necessitated in 5 patients (8.6％).7 patients experienced post-operative complications,with 4 Horner syndromes.There were 25 neurilemomas,23 neurofibromas,8 ganglioneuromas,1 paraganglioma,and 1 malignant paraganglioma.No local recurrence was seen after an average follow-up of 44.9 months.ConclusionVideo-assisted thoracoscopic removes of the posterior mediastinal tumors are safe,reliable and minimally invasive for selected patients with mastered throcoscopic skills.intracapsular enucleation is a safe procedure with reduced risk,while tumors larger than 6cm and located in the apex are with increased risk.

[Objective] To summarize the experience of professor FAN Yongsheng who uses the herbal prescription"modified Simiao powder"to treat gouty arthritis, so as to direct our clinical practice better. [Method] By learning from professor FAN as well as collating his medical cases that applicating "modified Simiao powder" to the treatment of gouty arthritis, clearing and definiting how teacher FAN thinks etiologies and pathogenesis of gouty arthritis and analyzing the prescription of"Simiao powder"and giving two clinical cases, so that we can learn and discuss. [Result] Teacher FAN believes that gout pathogenesis for the body fluid metabolic abnormalities, and body fluid metabolism and liver and spleen and kidney three organs are closely related. Patients usually irritable or liver qi stagnation, or like to eat greasy meat, temper deficiency, or lack of kidney essence, gasification weakness, resulting in wet endogenous, wet evil staying in the joints, the emergence of local fever, phlegm, blood stasis, poisonous evil, into gouty arthritis. Acute onset of the pathogenesis of "hot and humid", the course of time for the "hot and humid phlegm stagnant each other", treatment should follow the law of "clear away heat-dampness", according to the cause, changes in the pathogenesis of flexible application of four wonderful addition and subtraction; And to Qufeng, detoxification, blood circulation, dredge meridian, so as to achieve dialectical treatment, with the card addition and subtraction. [Conclusion] Professor FAN Yongsheng uses"modified Simiao powder"to treat gouty arthritis and has achieved good clinical efficacy, worthy of clinical study and reference.

Objective:To investigate the safety and effectiveness of multi-stent overlapping assisted coil embolization for ruptured intracranial blood blister-like aneurysms (BBA).Methods:Patients with intracranial BBA admitted to the Affiliated Quanzhou First Hospital of Fujian Medical University and treated with multi-stent overlapping assisted coil embolization from January 2013 to January 2019 were enrolled retrospectively. The embolization rate immediately after procedure, modified Rankin Scale (mRS) score at discharge, aneurysm embolization rate, recurrence rate and mRS scores at 3 months after procedure were collected.Results:A total of 38 patients with BBA were enrolled, including 21 females (55.3%) and 17 males (44.7%); their age was 54±9.3 years (range, 29-71 years); the maximum diameter of aneurysm was 5.1±1.0 mm, and the diameter of aneurysm neck was 4.9±0.7 mm. Raymond grading showed that the complete embolization rate immediate after procedure was 71.1%, the residual rate of aneurysmal neck was 18.4%, and the residual rate of aneurysmal body was 10.5%. During the perioperative period, 2 patients had stent thrombosis and 2 had intraoperative aneurysm hemorrhage. Imaging follow-up at 3 months after procedure showed that the aneurysms of 31 cases (83.8%) disappeared completely, 4 (10.8%) improved, and 2 (5.4%) recanalized. The good clinical outcome rate (mRS score ≤ 2) was 81.1%, 1 patient (2.6%) died, and no postoperative rebleeding occurred.Conclusion:Multi-stent overlapping assisted coil embolization is a safe and effective surgical method for the treatment of ruptured intracranial BBA.

Objective To investigate the expressions of Krüppel like factor 5 (KLF5) and tumor necrosis factor receptor superfamily member 11a (TNFRSF11a) in cervical cancer tissues and their effect on proliferation,migration,and invasion of HeLa cells. Methods Microarray technology was used to detect the mRNA expression of gene in cytocine stimulusin cervical tissues,and the result was verified by real-time fluorescence quantitative polymerase chain reaction. The expressions of KLF5 and TNFRSF11a in cervical tissues were detected by double immunofluorescence staining. HeLa cells were transfected with specific small interfering RNA to knock down the endogenous TNFRSF11a and KLF5 and were infected with adenovirus containing KLF5 to over-express KLF5,respectively. Protein level was detected by Western blot. The regulatory effect of KLF5 on candidate target gene (TNFRSF11a) was determined by dual-luciferase reporter assay. The activity of the cell proliferation,migration,and invasion was detected by using cell counting kit-8 assay and Transwell assay. Results The results of microarray technology showed that the expressions of KLF5 and TNFRSF11a were significantly higher in cervical squamous cell carcinoma tissues compared with normal cervical tissues (P=0.002,P=0.045),and real-time fluorescence quantitative polymerase chain reaction showed that the mRNA expressions of KLF5 and TNFRSF11a were significantly higher in cervical intraepithelial neoplasia (CIN) Ⅰ,CINⅡ-Ⅲ and cervical squamous cell carcinoma tissues compared with normal cervical tissues (KLF5:F=32.79,P=0.018,P=0.014,and P=0.011;TNFRSF11a:F=36.72,P=0.013,P=0.010,and P=0.009) and double immunofluorescence staining showed that the protein expressions of KLF5 and TNFRSF11a were significantly higher in CIN Ⅰ,CIN Ⅱ-Ⅲ and cervical squamous cell carcinoma tissues compared with normal cervical tissues (KLF5:F=42.38,P=0.014,P=0.008,and P=0.002;TNFRSF11a:F=35.42,P=0.021,P=0.012,and P=0.004) and increased with the carcinogenesis. The experiment in vitro confirmed that KLF5 promotes proliferation,migration,and invasion of HeLa by up-regulating TNFRSF11a expression. Clinical analysis showed that the expression of TNFRSF11a mRNA was positively correlated with tumor pathological grading,clinical stage,depth of invasion,and lymph node metastasis (all P<0.05). Conclusion KLF5 and TNFRSF11a are related to cervical cancer. KLF5 promote the proliferation,migration,and invasion of cervical cancer cells partly by upregulating the transcription of TNFRSF11a.