To disscus the characteristics of leukorrhea treatment of the four great famous doctors in Jin-Yuan Danasty, including the recognition of etiopathogenisis and pathogenesis, the view of determination of treatment based on differentiation of symptoms and signs, therapeutical principle and medication. LIU Wan-su believed fireheat was the important factor leading to illness. He firstly advocated differentiating symptoms and signs of leukorrhea with heat and treating it by clearing away heat evil and eliminating damp. ZHANG Zi-he considered the leukorrhea due to humid-heat flowing down to small intestine. He advocated lowing heart fire and tonifying kidney yin as the therapeutical method of leukorrhea with emetic and purgation method. LI Dong-yuan considered the injury of qi of the spleen and stomach was the main factor, so he diagnosed and treated leukorrhea on basis of the spleen and stomach. ZHU Dan-xi deemed leukorrhea happened when damp and sputum obstructed the spleen, so he thought that deprived the evil wetness was the fi rst and important method of treating leukorrhea.

Objective To summarize and analyze the emergency management for acute renal failure of solitary kidney induced by upper urinary calculi. Methods A total of 78 cases of acute renal failure of solitary kidney induced by upper urinary calculi were included.The mean course was 2.8 days (range,1 to 8 days).The time from onset to emergency management was within 72 hours in 68 out of the 78 cases.10 cases were treated with percutaneous nephrostomy drainage (PCN) under the guidance of B-ultrasound;25 cases with emergent open surgery;12 cases with indwelling ureteral stent retrogradely;and 31 cases were treated with transurethral ureteroscopy ballast lithotrity. Results One died of bleeding and infection after operation.In 65 cases treated with in 72 hours after obstruction, the serum Cr level decreased from 202～885 ?mol/L to 58～130 ?mol/L;the serum BUN level decreased from 9.8～42.4 mmol/L to 2.8～7.0 mmol/L after urgent treatment during a period of 3 to 12 days,and the renal functions recovered. Conclusions The principles of management for this acute condition should be diagnosing early and promptly,releasing obstruction as soon as possible,preventing complications effectively and reserving renal functions.KUB and B-ultrasonography are the first choice of diagnostic measures.Transurethral ureteroscopy ballast lithotrity can be recommended as the first choice of emergent treatment.

Objective To explore the diagnosis and treatment of phyllodes tumor of the breast. Methods Clinical data from 30 patients with phyllodes tumor confirmed surgically and pathologically were analyzed retrospectively. Results Of the 30 cases of phyllodes tumor, there were 16 cases of benign tumor, 9 cases of borderline tumor and 5 cases of malignant tumor according to the standard histological criteria. Local mass excision, total mastectomy, modified radical mastectomy and tumor mass excision were performed in 8, 8 and 13 patients, and 1 patient, respectively. A follow up of 20 cases for 1-24 years found 1 death, but all the others survived. Four patients out of the 20 patients underwent total mastectomy or modified radical mastectomy due to tumor recurrence. Conclusion The preoperative diagnosis of phyllodes tumor is difficult. Intraoperative frozen section examination of the suspicious lesions should be conducted. Multiple slices of the specimen should be performed. Surgical options are closely associated with the prognosis. Wide local excision or total mastectomy is recommended in surgical options.

Objective evaluate the role of vagus nerve?muscarinic cholinergic receptor ( M recep?tor) pathway in mitigation of myocardial ischemia?reperfusion (I∕R) injury by intrathecal morphine postcon?ditioning in rats. Methods Seventy adult male Sprague?Dawley rats in which intrathecal catheters were suc?cessfully placed without complications, weighing 250-350 g, were randomly assigned into 7 groups ( n=10 each) using a random number table:sham operation group (Sham group), I∕R group, intrathecal morphine postconditioning group ( MP group) , vagal transection ( VT) group, VT+ intrathecal morphine postcondi?tioning group (VT+MP group), atropine (ATP, M receptor antagonist) + morphine postconditioning group ( ATP+MP group) , and ATP group. Myocardial I∕R was produced by occlusion of the anterior descending branch of left coronary artery for 30 min followed by 2 h of reperfusion. Morphine ( 3μg∕kg, 10μl) was in?trathecally infused over 5 min starting from onset of reperfusion in MP group. Normal saline 10 μl was in?trathecally infused over 5 min starting from onset of reperfusion in NS group. The bilateral vagus nerves were transected at 10 min before reperfusion in VT+MP group. Atropine ( 0?1 mg∕kg, 0?5 ml) was intravenously infused over 5 min starting from 10 min before reperfusion in ATP+MP group. The occurrence of cardiac ar? rhythmia ( premature ventricular contractions ( PVCs) and ventricular tachycardia ( VT)∕ventricular fibrilla?tion ( VF) ) within the first 30 min of reperfusion was recorded. The rats were sacrificed at 120 min of reper?fusion, and myocardial specimens were obtained for determination of myocardial infarct size ( IS) as a per?centage of area at risk (AAR). IS∕AAR ratio was calculated. Results Compared with Sham group, the number of PVCs and VT∕VF and IS∕AAR ratio were significantly increased in the other groups. Compared with I∕R group, the number of PVCs and VT∕VF and IS∕AAR ratio were significantly decreased in MP group. Compared with MP group, the number of PVCs and VT∕VF and IS∕AAR ratio were significantly in?creased in VT+MP and ATP+MP groups. Conclusion Vagus nerve?M receptor pathway is involved in miti?gation of myocardial I∕R injury by intrathecal morphine postconditioning in rats.

Objective To investigate the effects of flexible ureteroscopic lithotripsy and percutaneous nephrolithotomy for treating renal pelvis calculus.Methods The clinical diagnosis and treatment data in 65 patients with single renal pelvis calculus treated in department of urology surgery of our hospital from Jan.2013 to Jan.2016.Among them,33 casesas the group A adopted flexible ureteroscopic lithotripsy and 32 cases as the group B adopted percutaneous nephrolithotomy.The operative time,lithotripsy success rate,complications and average hospitalization time were compared between the two groups.Results In the renal pelvis calculus diameter ≥ 2 cm,the operation time and lithotripsy success rate in the group B were significantly better than those in the group A,but the intraoperative blood loss and average hospitalization time in the group A were significantly better than those in the group B,the differences were statistically significant (P＜0.05).In renal pelvis calculus diameter ≤2 cm,the lithotripsy successful rate had no statistically significant difference between the two groups (P＞0.05),but the group A was significantly better than the group B in the operative time,intraoperative blood loss and average hospitalization time (P＜0.05).Conclusion Renal pelvis calculus diameter ＜2 cm is suitable for selecting flexible ureteroscopic lithotripsy,but which ≥2 cm is suitable to select percutaneous nephrolithotomy.

Objective To explore the efficacy and safety of Polyethylene glycol 3350 plus electrolyte bulk on the schizophrenia patients with constipation induced by clozapine. Methods 150 cases of schizophrenia inpatient and outpatient with constipation induced by clozapine treatment were selected and randoly dirided into the group of polyethylene glycol,lactulose group and non-intervention group with 50 patients in each group and each patient or their families signed the informed consent. The treatment groups took orally with Polyethyle ne glycol 3350 plus electrolyte 13. 7grams,2 times per day and lactulose oral solution 10ml,3 times per day respectively. The non-intervention group was not given a regular basis laxatives, but with cathartic therapy in demand. The period of experiment was 6 weeks including 2 weeks baseline observation period and 4 weeks treatment. Assessment criteria: an overall assessment of all symptoms of patients and each patient's constipation and safety parameters were assessed. Results After treatment for 4 weeks,the total effective rate in three groups was 90.0% ,68.0% ,38.0% (all P ＜0.05). The difference was statistically significant. The normal shape of stool rate was 84.0% ,60.0% ,28.0%. PEG group were better than the other 2 groups at baseline in the first defecation time,the average times of bowel movements per week,theutilization of laxatives during treatment, while symptom score improvement in the stool was significantly better than other groups after treatment. The safety parameters including liver and kidney function, lectrolytes, glucose, ECG, symptoms of schizophrenia such as PANSS score had no obvious change in each group after treatment. Conclusion PEG 3350 plus electrolytes was effective and safe in the treatment of clozapine-indueed constipation in chronic schizophrenia.

Objective To explore the effect of the thyroid morphologic change,the initiating treatment time and the thyroid function(serum FT_4,TSH)on mental development in children with congenital hypothyroidism (CH).Methods After diagnosed,52 cases of CH were orally administrated with L-T_4,then their mental and physical development were monitored and thyroid morphologic changes were observed by thyroid imaging(~(99m)TcO_4) and type B ultrasonography.The Bayley test was performed at the age of 10 to 30 months and expressed as mental developmental index(MDI)and psychomotor developmental index(PDI).Analysis was conducted upon treatment timing and thyroid morphologic changes.Results The MDI in those cases with morphologic abnormalities treated within 90 days was significantly lower than that with normal morphology(91?20 vs 105?15,P

Aim To investigate the role of NO/cGMP in the cardioprotective effects of intrathecal morphine preconditioning against myocardial ischemia-reperfu-sion injury in rats. Method 54 Male Sprague-Dawley Rats were used to establish the model of intrathecal catheter placement. The rats were randomly assigned to
9 groups. SHAM (sham group), CON (control, sa-line) , ITMP ( intrathecal morphine preconditioning, 3μg·kg-1 ) , L-NAME+ITMP ( NO synthetase inhibi-tor,L-NAME ) , ODQ + ITMP ( guanylate cyclase in-hibitor, ODQ ) , KT5823 + ITMP ( PKG inhibitor, KT5823),L-NAME,ODQ,KT5823,6ratsineach
group. ITMP were produced by three cycles of 5 min intrathecal injection of morphine and 5 min intermis-sion before myocardial ischemia, CON were achieved by intrathecal injection of saline in the same way, L-NAME+ITMP, ODQ +ITMP, KT5823 +ITMP were prepared by intrathecally administering L-NAME ( 30 nmol), ODQ(11 nmol) and KT5823(20 pmol) 10 minutes prior to ITMP respectively, L-NAME, ODQ, KT5823 worked as the control of inhibitors themselves respectively without ITMP. Subsequently, all rats were subjected to 30 min of left coronary artery occlusion followed by 2 h of reperfusion except the SHAM group. Myocardial infarct size, as a percentage of the AAR,
was determined by 2 , 3 , 5-triphenyltetrazolium stai-ning. Results Compared with CON, the volumes of IS and IS/AAR were reduced in ITMP ( P <0.01 );the protective effects of ITMP were abolished by pre-treatment with L-NAME, ODQ and KT5823 ( P <0.01 );Conclusions NO/cGMP might be involved in the cardioprotective effect of intrathecal morphine pre-conditioning against myocardial ischemia and reperfu-sion injury in rats.

OJECTIVETo observe the effect of tianma gouteng decoction (TGD) on the endothelial function and the renal protein expression of spontaneously hypertensive rats, and to analyze its possible mechanism.

METHODSTotally 18 6-week-old SHR were randomly divided into 3 groups according to randomized block design, the SHR control group, the TGD group, and the captopril group, 6 in each group. Meanwhile, Wistar Kyoto (WKY) rats of the same age were recruited as a WKY control group. Rats in the TGD group were administered with TGD at the daily dose of 10. 260 g/kg. Rats in the captopril group were administered with captopril at the daily dose of 3. 375 g/kg. 2 mL/100 g distilled water was administered to rats in the SHR control group and the WKY control group. All medication was performed by gastrogavage once per day till rats were 24 weeks old. Changes of blood pressure were measured once per two weeks. The relaxation of the thoracic aorta and the superior mesenteric artery was determined by vascular ring in vitro to reflect the endothelial function. The total renal protein was separated by two-dimensional electrophoresis (2-DE). The significantly deviated protein was verified by Western blot.

RESULTS(1) Compared with the SHR control group, blood pressure was significantly lowered in rats (10 - 24 weeks old) of the captopril group (P <0.01, P <0.05). The hypotensive effect of TGD was obvious at the beginning of hypertension (10 -12 weeks) (P <0. 01). But along with the progression of hypertension, its hypotensive effect was not obvious (P>0. 05). (2) Compared with the SHR control group, the relaxation of the superior mesenteric artery was obviously improved in the TGD group (P <0. 05); the relaxation of the thoracic aorta and the superior mesenteric artery was obviously superior in the WKY control group (P <0. 01, P <0. 05). But there was no statistical difference in each relaxation index between the captopril group and the SHR control group (P >0. 05).(3) RESULTS: of 2-DE found 16 significantly differential renal protein, mainly involved nitric oxide (NO) system, oxidative stress, and cytoskeleton-related proteins. Results of Western blot showed that TGD could significantly improve expressions of Cu-Zn superoxide dismutase (SOD), N(G, N(G)-dimethylarginine dimethylaminohydrolase 2 (DDAH2), and pterin-4-alpha-carbinolamine dehydratase 1 (PCBD1) (P <0. 05).

CONCLUSIONGTD could protect the endothelial function of the superior mesenteric artery in SHR, and its intervention mechanism of hypertension induced early renal injury might be relevant to regulating the NO system and antioxidative stress.

Animals ; Blood Pressure ; Captopril ; Drugs, Chinese Herbal ; therapeutic use ; Hypertension ; drug therapy ; Kidney ; metabolism ; Oxidative Stress ; Proteins ; metabolism ; Proteomics ; Rats ; Rats, Inbred SHR ; Rats, Inbred WKY ; Superoxide Dismutase ; metabolism

Objective To investigate the value of high-resolution magnetic resonance imaging (HR-MRI) for assessing the plaque stability as well as the risk factors for unstable plaque and severe stenosis in patients with symptomatic carotid stenosis.Methods The patients with symptomatic carotid stenosis were enrolled.HR-MRI was use to evaluate carotid plaque compositions and identify the stability of plaques.The carotid plaques from the patients underwent carotid endarterectomy were collected for pathological examination.The consistency of the preoperative HR-MRI and the postoperative pathological findings were compared.The clinical data of all patients were collected and the risk factors for the stability of carotid plaques and the severity of vascular stenosis were analyzed.Resulls A total of 219 patients with symptomatic carotid stenosis (stenosis ＞ 50％) who underwent HR-MRI were enrolled.Among them,102 patients (46.6％) had stable plaques and 117 (53.4％) had unstable plaques;118 (53.9％) had moderate stenosis and 101 (46.1％) had severe stenosis.Thirty-fiwe patients received carotid endarterectomy,HR-MRI showed that the plaque in 19 (54.3％) of them were instable,and pathological examination showed that the plaque in 20 (57.1％) cases were instable,and both were highly consistent (κ =0.942,P ＜ 0.001).The proportions of male (P =0.007),hyperlipidemia (P =0.013),smoking (P ＜0.001),as well as the levels of total cholesterol (P =0.001),low-density lipoprotein cholesterol (P ＜0.01),and fasting blood glucose (P =0.001) in the unstable plaque group were significantly higher than those in stable plaque group.Multivariate logistic regression analysis showed that male (odds ratio [OR] 2.33,95％ confidence interval [CI] 1.08-5.04;P=0.032),smoking (OR 3.45,95％ CI 1.67-7.14;P=0.001),and higher fasting blood glucose level (OR 1.26,95％ CI 1.07-1.48;P =0.006) were the independent risk factors for unstabke plaque.All the data did not show any significant difference between the moderate stenosis group and the severe stenosis group.Conclusions HR-MRI accurately assessed the plaque stability in patients with symptomatic carotid stenosis.Sex,smoking,and fasting blood glucose level were the independent risk factors for carotid artery unstable plaque.