Objective To explore the effects of micro channel (mPCNL)and standard channel percutaneous lithotripsy (sPCNL)on hemodynamics and blood gas analysis in patients with renal calculi.Methods From March 2007 to June 2015,180 patients with kidney stones were selected as the research subjects,through digital said method,the patients were randomly divided into MPCNL group and sPCNL group,the former F16 plastics through established channels of percutaneous nephrolithotomy.The latter F24 plastics through established channels of percuta-neous nephrolithotomy.The changes of hemodynamics and blood gas analysis were observed and compared in the two groups during perioperative period .Results In MPCNL group ,theoperation time was significantly shorter in sPCNL group(t =-6.018),the perfusion fluid was higher than that of sPCNL group(t =20.506,P <0.05).The perfusion of MAP and CVP of the two groups were significantly lower than those before anesthesia,and irrigation flow after dif-ferent time and postoperative were significantly higher than those before hemoperfusion,60 min,120min,after opera-tion MAP value of MPCNL group,test value was as follows(t60min =5.878,t120min =6.802,tpostoperative =7.070,all P <0.05);60min,120min,after operation CVP value of MPCNL group,test value was as follows (t60min =5.987,t120min =6.505,tpostoperative =7.180,all P <0.05).60min,120min,postoperative MAP value of sPCNL group,test value was as follows (t60min =5.613,t120min =7.238,tpostoperative =7.170,all P <0.05);60min,120min,postoperative the CVP value of sPCNL group,test value was as follows (t60min =7.682,t120min =7.135,t[postoperative]=9.218,all P <0.05). Blood gas analysis showed that the two groups of postoperative Na +,Cl - compared with before anesthesia had no sta-tistically significant difference(P >0.05).Two groups of postoperative K +,pH,BE,Hb were lower than before anes-thesia,the differences were statistically significant (P <0.05).The two groups of patients with no postoperative urina-ry sepsis and other serious complications.Conclusion With the increase of operation time filling fluid absorption on hemodynamics and arterial blood gas analysis of influence gradually increased;in heart,lung and normal renal function patients,due to the compensatory organ function,caused by MPCNL and sPCNL irrigation fluid absorption differences in the amount is not enough to cause different hemodynamics and blood gas analysis.

Objective To study the inhibitory effect of miR-199a on bladder cancer.Methods T24 bladder cancer cells were divided into control group, pre-scamble group and pre-miR-199a group according to different treatment.Cell proliferation was assayed by MTT, cell apoptosis and cell cycle by flow cytometry, and cell invasion by Transwell.ResuIts The OD value of pre-miR-199a group (0.436 ±0.042) was significantly lower than that of control group (0.634 ±0.020) and pre-scamble group (0.601 ±0.059)(P<0.05).Cell apoptosis of pre-miR-199a group(19.25 ±1.57)% was higher than that of control group(10.19 ±0.98)% and pre-scamble group(12.27 ±1.38)%(P<0.05).The cell ratio in G1 phase of control group、pre-scamble group and pre-miR-199a group was 45.09%, 47.57%, and 58.62%, respectively.The cell cycle arrested in G1 phase after transfected with pre-miR-199a.The cells migration number of pre-miR-199a group (46.00 ±1.58) was lower than those of control group(67.00 ±1.58) and pre-scamble group(61.20 ±1.30)(P<0.05).ConcIusion MiR-199a could inhibit the growth of bladder cancer cells.

OBJECTIVE To investigate the biological and molecular biological characteristics of Klebsiella pneumoniae in burn patients in order to give the first hand information for preventing and controlling of hospital acquired infections.METHODS The identification was done by Bio-Merieux ATB expression.Antimicrobial susceptibility test was performed with K-B method.The plasmid DNA was extracted by Alkaline Lysis,and separated by electrophoresis on the gel.The ESBLs detection was based on NCCLS.RESULTS The K.pneumoniae from the burn patients and the environment were sensitive to CIP,FOX and IPM,but showed resistance to the rest 12 antibiotics.The plasmid DNA profile analysis showed 3 types,and the relative molecular mass was approximately 4.7?106,3.6?106 and 2.0?106.The molecular biological characteristics showed these pathogens were ESBLs-producing K.pneumoniae,which was different from the control bacteria.At the same time,the pathogens caused the original infection were detected,and they were accordingly Staphylococcus aureus,Streptococcus pyogenes,and Pseudomonas aeruginosa.CONCLUSIONS The outbreak in burn patients is caused by ESBLs-producing K.pneumoniae,which has the same antibiotic resistance spectrum and plasmid DNA profile.This ESBLs-producing K.pneumoniae has the same origin.The pathogen might be transmitted by the case history clips and the door knobs.It was suggested that something must be done to enhance the antisepsis administration in order to prevent the hospital acquired infection.

Objective:To establish a protein-protein interaction (PPI) network of 5 microRNA (miRNA) target genes differentially expressed in the plasma of coal-burning fluoride exposed population, and to screen genes and gene modules with important roles.Methods:Five miRNA (hsa-miRNA-3131, hsa-miRNA-4516, hsa-miRNA-6501-5p, hsa-miRNA-10b-5p, hsa-miRNA-4683) target genes differentially expressed in the plasma of coal-burning fluoride exposed population screened by our previous study were mapped to the STRING online database (https://string-db.org), and the PPI network was screened. The Cytoscape v3.6.0 software was used to visualize the PPI network, the topological attribute values degree and betweenness centrality were obtained by the NetworkAnalyzer plug-in, and the central node was filtered in the network (the node with the highest degree and the highest betweenness centrality). At the same time, the maximal clique centrality (MCC) analysis method in the CytoHubba plug-in was used to determine the important nodes in the PPI network. The cluster analysis was conducted by the MCODE plug-in, and the gene modules were screened in the PPI network. The protein names contained in the gene modules were submitted online to the KOBAS v3.0 database (http://kobas.cbi.pku.edu.cn/), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed on the gene modules selected by the MCODE plug-in.Results:The PPI network of target genes was consisted of 1 035 nodes and 4 346 edges. The degree (101) and betweenness centrality (0.010 723 89) of ubiquitin A-52 residue ribosomal protein fusion product 1 (UBA52) were the highest, which was the central node of the PPI network. According to MCC analysis, UBA52 was an important node in the PPI network. The top 5 gene modules were selected from the PPI network, and the highly enriched gene pathways in the KEGG pathway enrichment analysis of the 5 gene modules included ubiquitin mediated proteolysis, spliceosome, endocytosis, neuroactive ligand-receptor interaction and vesicular transport.Conclusion:The PPI network of 5 miRNA target genes differentially expressed in the plasma of people exposed to coal-burning pollution of fluoride is successfully established, and the UBA52 gene and the 5 main pathways of gene modules are selected.

Pancreatic cancer is a highly malignant tumor with a high mortality.Surgery is the only potential hope of cure for patients with pancreatic cancer.Imaging examination plays an essential role in both the early diagnosis and preoperative assessment.Accurate tumor staging has guiding significance for clinical practice.Appropriate therapeutic schedule will be selected according to the tumor staging,and then patients' prognosis can be evaluated.Recently,the TNM staging systems for pancreatic cancer have been updated by American Joint Committee on Cancer (AJCC).Major changes were made in the T and N staging.This article will review the updates of the 8th edition of AJCC cancer staging for pancreatic cancer from radiography aspect.

Objective To compare the prophylactic effect of laminar closure between titanium miniplate and anchor fixation in open-door cervical laminoplasty.Methods Between January 2010 and December 2010,63 patients with cervical spondylotic myelopathy were treated by open-door laminoplasty.Of them,30 patients underwent laminoplasty by titanium miniplate fixation and 33 by anchor fixation.During follow-up,multi-detector CT was performed preoperatively,at 1 week and 6 months after surgery.At each level,the anteroposterior diameter (APD) of the spinal canal and opening angle (OA) were measured.And the spinal canal expansion rate are calculated.MRI was performed preoperatively and 1 year after surgery to evaluate the severity of cord compression.Results All incisions healed by first intention.The incidence of postoperative axial symptoms in miniplate fixation group and anchor fixation group were 33.3％ (10/30) and 39.4％ (13/33),respectively.The OA,APD,and the spinal canal expansion rate of patients in both groups improved significant postoperatively,but differing from miniplate fixation group.The OA,the APD and the spinal canal expansion rate in anchor fixation group after 6 months were reduced than one week after surgery,and the difference between the groups was statistically significant.Lamina close in two groups was not found.CT images at 6 months showed complete fusion of the hinge area by mature bone or callus in two groups,by cervical sagittal MRI assessment.The severity of spinal cord compression was improved after 1 year.Preoperative and 1 year after the surgery,the severity of spinal cord compression between the two groups showed no significant difference.The severity of spinal cord compression after 1 year in both groups were no more than three grade.Conclusion Open-door cervical laminoplasty by anchor fixation or titanium miniplate can effectively prevent the occurrence of postoperative lamina closure,which can help patients to do functional exercises early,but improvement of spinal cord compression has no significant difference between both of them.However,titanium miniplate fixation for maintenance of the expansive spinal canal is better.

Objective To summarize the experience of laparoscopic cholecystectomy ( LC) for acute cholecystitis (AC).Methods A retrospective study was conducted on 382 patients with AC, who were underwent LC.Results Of all 382 cases,370 cases were successfully finished with LC,and other 12 cases were finished with open surgery(3.14% ).The operation methods are successively anterograde cholecystectomy(267 cases),retrograde cholecystectomy(59 cases) ,anterograde and retrograde cholecystectomy(44 cases).Abdominal drainage was placed in all cases.Post-operation complications occurred in 15 cases (3.93% ).The complications are suppurative infection of sub-ensistemum incision(9 cases) ,abdominal infection(2 cases) ,adhesive ileus(2 cases) ,sub-ensisternum incision hernia(2 cases).There are no death cases,transfusion cases or latrogenic injury in our study.Conclusion The best time window of LC for AC was with in 72 hours since the symptom.The key factors for the surgery were careful dissection of calot's triangle,properly handling with the incarcerated cystic duct stone and thickened cystic duct,avoiding injury of cystic artery and over-dissection of gallbladder bed.Transfer to open surgery when necessary could reduce complications and latrogenic injury.

Objective To built up the ERP model,measure mode and P300 potential reference standard in mice with vascular dementia(VD),and characterize the P300 potential in mice with VD.Methods Fortyeight mice were randomly divided into a normal group.sham operation group and a VD group.The mice in the Vd group were subject to repetitive ischemia and reperfusion by using the ligation of bilateral common carotid arteries so as to establish the VD model.The behavioral abnormalities were investigated by step-down test and water maze test.The N2 and P3 components of P300 potentials were also recorded.Results It was shown that the learning and memory abilities as reflected by the step down test and water maze test scores were decrease in mice in the VD group when compared with those in the normal group and sham operation group(P<0.05).The N2 and P3 latencies significantly prolonged(P<0.01)and P3 amplitudes decreased(P<0.05)in VD group as well.Conclusions In VD mice,there is a significant prolongation of the P300 potential latency and a significant decrease of learning and memory abilities.Recordings of P300 from unanesthetized mice could be an objective,non-invasive,quantitative and valuable electrophysiological method for studying the cognitive function of VD mice.

Objective:To explore the correlation among serum levels of resistin ,oxidized low density lipoprotein (ox‐LDL) ,high sensitive C reactive protein (hsCRP) and severity of acute ischemic cerebrovascular diseases .Methods :A total of 92 patients with acute ischemic cerebrovascular diseases ,who were treated in our hospital from Nov 2013 to Nov 2014 ,were selected ,including 36 cases with transient ischemic attack (TIA ,TIA group) ,29 cases with re‐versible ischemic brain damage (RIBD ,RIBD group) and 27 cases with focal cerebral infarction (FCI ,FCI group) . Another 70 healthy volunteers were regarded as normal control group .Serum levels of resistin ,ox‐LDL and hsCRP were measured and compared among all groups .Pearson correlation analysis was used to analyze the correlation a‐mong serum levels of resistin , ox‐LDL , hsCRP and severity of acute ischemic cerebrovascular diseases . Results:Compared with normal control group ,there were significant rise in serum levels of resistin [ (0.26 ± 0.42)μg/L vs . (0.63 ± 0.38)μg/L vs .(0.91 ± 0.45)μg/L ,(0.89 ± 0.42)μg/L] ,ox‐LDL [ (334.3 ± 142.5) mg/L vs .(451.7 ± 15.8) mg/L vs .(518.3 ± 205.7) mg/L ,(520.7 ± 198.9) mg/L] and hsCRP [ (5.8 ± 4.9) mg/L vs .(8.7 ± 7.6) mg/L vs .(13.5± 9.1) mg/L ,(13.6 ± 7.4) mg/L] in TIA group ,RIBD group and FCI group (P< 0.01 all);those of RIBD group and FCI group were higher than that of TIA group (P<0.01 all) ,and there were no signifi‐cant difference in above indexes between RIBD group and FCI group (P>0.05 all) .Pearson correlation analysis in‐dicated that serum levels of resistin , ox‐LDL and hsCRP were significant positively correlated with severity of acute ischemic cerebovascular disease (r=0.473~0.902 , P<0.01 all) .Conclusion:Serum levels of resistin ,ox‐LDL and hsCRP can reflect severity of acute ischemic cerebrovascular diseases ,which is worth extending .

Objective To study the mechanism of serum thyroxin and insulin change after hemihepatectomy. Methods The hemihepatectomy was performed in rabbits, the fasting peripheral blood samples were drawn on the day prior to surgery, and 24 hour, 48 hour, the first week, one month after operation respectively for monitoring the serum thyroxin and insulin.Results The level of TT 3 was (1.93?0.47) nmol/L, TT 4 (53.56?8.4) nmol/L preoperatively. The levels of TT 3 and TT 4 significantly decreased at 24 hour postoperatively, and gradually rose at 48 hour and up to normal levels in the first month postoperatively. The level of insulin rapidly rose immediately after operation, and began to decrease in the first week, and returned to the preoperative level in one month after operation. Conclusions The syndrome of normal thyroid disease and the syndrome of non thyroid disease can occur after hemihepatectomy; and hyperinsulinemia also can occur after hemihepatectomy.