Objective To evaluate the clinical efficacy and security of retroperitoneal laparoscopic ureterolithotomy(RLUL) for impacted ureteral calculi after radical cystectomy and ileal conduit.Methods 5 patients with unilateral impacted ureteral calculi after radical cystectomy and ileal conduit received RLUL were selected,and a retrospective study was performed for manner,duration of surgery,complications and length of stay and other indicators,and the treatment effect was evaluated.Results All procedures were successful and the mean operation time was (82.0±27.7)min,the extubation time was (5.4±1.1)d,hospitalization time was (10.0±2.9)d.Postoperative follow up for 6-48 months,there were no obvious complications.Conclusion The RLUL showed satisfactory availability and security for management ureteral calculi after radical cystectomy and ileal conduit.

Objective To investigate the impact of desmoglein 3 (Dsg3) on the proliferation of peripheral T lymphocytes from patients with pemphigus vulgaris (PV).Methods Peripheral blood mononuclear cells (PBMCs) were obtained from 12 patients with PV and 22 normal human controls,cultured with or without the presence of Dsg3 or phytohemagglutinin for 3 days.Flow cytometry was performed to detect the changes of T-lymphocyte subsets in PBMCs stimulated with Dsg3 and proliferation of T-lymphocytes.Results In patients with PV,the percentage of Th2 and Th1 cells was 12.17%±5.32% and 4.08%±1.50%,respectively in Dsg3stimulated PBMCs,9.84%±5.41% and 3.91%±1.38%,respectively in non-stimulated PBMCs.Increased percentage of Th2 cells was observed in Dsg3-stimulated and non-stimulated PBMCs from patients with PV compared with those from normal human controls (both P<0.05).After stimulation with Dsg3,there was a significant proliferation of T cells from patients,and the proliferation rate of CD4+T cells was 4.65%±3.28%,which was significantly higher than that from normal controls(P<0.05).Conclusion Dsg3 can induce the specific proliferation of CD4+T cells,especially Th2 type CD+4 T cells,from patients with PV.

Objective To study the effect of Jieyuyubao prescription on endometrial pinopodes and HOXa-10 mRNA in chronic stress rats , and reveal the regulatory mechanisms of the endometrial receptivity. Methods Totally 48 SPF SD rats were randomly divided into three groups with weight stratified: normal control group (group A), model control group (group B) and experimental drug group (group C). Rat model of chronic stress was established in group B and group C. On the first day of stimulation, Jieyuyubao solution (1 g·mL-1 ) was intragastrically administered (11. 8 mL·kg-1 ) to the rats of group C at 9:00 am, once daily, and stopped giving at the fourth day of pregnancy (pd4) after being confirmed by vaginal smears. Purified water (11. 8 mL·kg-1 ) was intragastrically administered to the rats of group A and group B at 9:00 am. All the rats were mated at the sex ratio of female:male = 2:1 at 16:00 pm on the 21st day. The rats were sacrificed at the pd4. Maturity of endometrium pinopodes was assessed under transmission electron microscope. HOXa-10 mRNA content was evaluated by real-time fluorescence-PCR. Results The maturity of pinopodes was as follows: the maturity score of normal control group, model control group and experimental group was (2. 7 ± 0. 3), (1. 3 ± 0. 3), and (2. 1 ± 0. 2), respectively, with significant difference between experimental drug group and model control group (P<0. 05). HOXa-10 mRNA expression was significantly decreased in model control group (0. 658±0. 031) as compared with normal control group (0. 965±0. 102) (P<0. 05). Conclusion Jieyuyubao prescription maybe increase the number and maturity of pinopodes through promoting HOXa-10 mRNA expression in endometrial epithelium cells, and then improve endometrial receptivity.

ObjectiveTo explore the childhood trauma experience and its relation to the eye emotion recognition ability in patients with schizophrenia.MethodsSeventy-one schizophrenic patients and fifty-two healthy subjects were assessed with the Childhood Trauma Questionnaire (CTQ) and the Eye Basic Emotion Discrimination Task (EBEDT).ResultsThe CTQ total score in the patients group was significantly higher than those in the control group (47.86 ± 13.26 vs 34.27 ± 7.27,P ＜ 0.01 ).The subscores in emotional abuse,physical abuse,sexual abuse,emotional neglect and physical neglect of CTQ in the patients group were also significantly higher than those in the control group.(all P＜ 0.01 ).Compared with controls,the patients had significantly lower total accuracy( (86.74 ± 6.16vs73.42 ± 11.86) ％,P ＜ 0.01 ) and longer total reaction time ( (2776.75 ± 703.42 vs 4321.40 ± 1956.83 )ms,P ＜ 0.01 )of EBEDT.The significant difference were also found on the accuracy and reaction time of the EBEDT six basic emotion between the two groups ( all P ＜ 0.01 ).Correlation analysis indicated that CTQ total score were negatively correlated with the EBEDT total accuracy ( r=-0.390,P＜0.01 ),and its sub-accuracy of happiness,surprise,sadness,and anger ( respectively r =- 0.419,r =- 0.451,r =- 0.391,r =- 0.344,P ＜ 0.01 ) in the patients group.The correlation between CTQ total score and EBEDT total accuracy was also found in the control group.ConclusionChildhood trauma is related to eye basic emotion recognition in schizophrenia patients,suggesting that the trauma during childhood can affect the social recognition ability.

Objective To investigate The Th1/Th2 and Tc1/Tc2 polarization in the peripheral blood of first degree relatives of pemphigus vulgaris(PV) and healthy control individuals, and to approach the mechanism of the Dsg3-specific autoimmunity in PV. Methods The peripheral blood mononuclear cells (PBMC) from first degree relatives and healthy control was stimulated for72 h with Dsg3 and without Dsg3. Th1/Th2, Tc1/Tc2 was assessed by four-color flow cytometry. Results The mean frequency of Dsg3-spe-cific Th2 cells for PV antibody positive first degree relatives was 10.13%±3.72%, compared with stimula-tion without antigen 7.28%±3.58%, the difference was significant (P<0.05). The percentage Dsg3-spe-cific Th2 was markedly higher in the PV antibody positive first degree relatives group than that in the control group(10.13%±3.72% vs 6.10%±2.82%, P<0.05) , Tc2 was markedly higher also (20.01%± 10.43% v514.91%±8.06%, 20.01%±10.43% vs 9.58%±5.49%, P<0.05). Conclusion When Dsg3 stimulated PBMC were used to stimulate autologous T cells an increased amount of Th2 and Tc2 was observed, it is implied that the imbalance of Th1/Th2, Tc1/Tc2 might play an important role in the initia-tion of PV.

Objective To study the effect of Eclipta alba on learning and memory ability and brain derived neurotrophic factor(BDNF) in brain of Alzheimer's disease (AD) model rats.Methods Healthy adult SD rats were randomly divided into control group,model group,low dosage group and high dosage group.There were 10 rats in each group.The model of Alzheimer's disease was established with subcutaneous injection of D-galactose and microinjection Aβ25-35 on bilateral hippocampus.All rats were treated with saline solution or different dosage of Eclipta alba respectively lasting 8 weeks.Then the ability of learning and memory of AD rats was evaluated by the Morris water maze test.The levels of expression of BDNF in brain were determined by immunohistochemical staining method and Western Blot method.Results The Morris water maze test:the average escape latent period prolonged besides the percentage of the swimming time in the target quadrant from the total swimming time and the times across the platform((34.14± 1.43) s,(33.71±3.82) ％,(3.40±0.70) times) decreased significantly in model group compared with control group((18.83±0.62) s,(41.98±3.96) ％,(5.40± 1.17) times,P＜0.01).The average escape latent period shortened besides the percentage of the swimming time in the target quadrant from the total swimming time and the times across the platform increased significantly in high dosage group compared with the model group (P＜0.01).Immunohistochemical staining and Western blot:the level of expression of BDNF in brain in model group was prominently less than control group (P＜ 0.01).The BDNF level in drug treated groups was prominently higher than model group(P＜0.01).The expression of BDNF increased with the drug dosage increasing.Conclusion Eclipta alba can improve the learning and memory function of AD rats by enhance the expression of BDNF.

OBJECTIVETo explore the choice of therapeutic methods for talar fractures and analyze its clinical effects.

METHODSFrom October 1998 to October 2009, 44 patients with talar fractures were treated in the study, of them, 38 cases obtained follow-up, in which 10 cases with plaster external fixation, 22 cases with open reduction and internal fixation, 6 cases with Blair joint fusion. There were 28 males and 10 females,ranging in age from 19 to 65 year with an average of 33.5 years. According to classification of Matti-Weber, type I was in 3 cases, type II in 15, type III in 16, type IV in 4. The clinical effects were evaluated by the Hawkins standard including pain, active range of the joint, limping.

RESULTSThe mean time of follow up was 4.8 years (range, 1 to 11 years). According to the Hawkins standard, in 10 cases with plaster external fixation, 4 cases obtained excellent results, 2 good, 3 fair, 1 poor; in 22 cases with open reduction and internal fixation, 2 case obtained excellent results, 6 good, 6 fair, 8 poor (the 8 patients accepted second treatment with joint fusion at 3 to 5 years after operation, affected limb of 1 patient occurred crispation for 3 cm, walking with limp, and further treatment was refused result in poor,and others got fair results); in 6 cases with Blair joint fusion, 1 case obtained good results, 4 fair, 1 poor. Diaz disease was found in 12 cases and traumatic arthritis was found in 13 cases in the period of follow-up.

CONCLUSIONTalar fracture usually results in complications and gets bad prognosis. The prognosis is relative with the traumatic degree. Plaster external fixation beseems to the displacement of fracture less than 2 mm; open reduction and internal fixation beseems to the displacement of fracture more than 2 mm; Blair joint fusion beseems to talar body fracture with total dislocation or whose talar body fracture is comminuted severely and the surface of joint can not be repaired.

Adult ; Aged ; Female ; Follow-Up Studies ; Fracture Fixation ; Fractures, Bone ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Talus ; injuries ; surgery ; Treatment Outcome

Objective To evaluate the diagnostic value of fluorescent quantitative polymerase chain reaction(PCR) for Mycoplasma pneumoniae (MP) in children with MP pneumonia(MPP).Methods From Jun.2008 to Jan.2009,153 cases hospitalized with pneumonia were enrolled,and 30 cases without respiratory infection were enrolled as control group.Their respiratory secretion (including nasopharyngeal secretion,sputum,bronchialalveolar lavage fluid or pharyngeal swab) samples were collected for fluorescent quantitative PCR for MP.And their single or paired serums were collected for specific MP antibody detection.Results There were 123 cases confirmed with MPP by serology,among whom 114 cases were MP PCR positive.The quantitation of MP DNA was among 1.20?106-3.66?1010 gene copys/L. There were 30 cases with pneumonia negative with MP by the paired serum serology,among whom 2 cases were MP PCR positive,and the quantitation of MP DNA was (1.08-3.02)?107gene copys/L.All cases of control group were MP PCR negative.During the first and second weeks of the MPP onset,the sensitivity of MP-IgM from the first single blood samples were 66.7% and 83.9%,respectively.While the sensitivity and specificity of MP PCR were 92.7% and 93.3%,respectively.From the third week of the disease onset,the sensitivity of MP-IgM from the first single blood samples increased to 90.9%-100%.The clinical manifestations of MPP were nonspecific.Conclusions PCR is superior to serology for early diagnosis on MP infection.Combination of the 2 methods may be helpful to early and accurate diagnosis on MP infection.

Objective To assess the clinical efficacy of ultrasonography guidance percutaneous nephrolithot-omyⅠ period combining pneumatic ultrasosonic and holmium laser lithotrips of complex renal calculi.Methods Patients were under the general anesthesia in lithotomy position.By cystoscope first to one side retrograde insertion F5 ureteral catheter,the position to prone position was changed.Under ultrasonography guidance puncture target after the success of the calyx,fascia dilator gradually expanded from F8 to F20 channel was established.Then percutaneous nephroscope combining pneumatic ultrasosonic and holmium laser lithotripsy were administrated.Results One sided single channel was 92 cases,one sided dual channel was 11 cases,one sided three -channel was 1 case.On both sides single channel was 13 cases,one side of the dual channel and other side of the single channel was 3 cases.The operation time was (72 ±24)min.Intraoperative bleeding was in 50 -150mL,with an average of 80mL,and there's no intraoper-ative blood transfusion.2 cases of postoperative had secondary bleeding,in which 1 case remitted after non -operative treatment,the other case was treated in DSA downward super selective renal artery embolization to stop the bleeding. Postoperative hospital stay was 7 -14d,with an average of 10d.There were no septic shock,water uptake,water intoxi-cationand complications such as pleural effusion.One week after the CT,stones free rate was 91.7%(110 /120),in which 10 cases of residual stone with diameter <5mm,needn't surgery removed again.They were treated with oral platoon stone drugs,drinking lots of water and a moderate amount of sports such as processing.All cases were followed up for 6 months to 18 months,with no urinary tract infection,stone recurrence and the long -term complications such as perinephric space effusion.Conclusion As long as establish proper percutaneous renal channel,with intraoperative operating norms,combining pneumatic ultrasosonic and holmium laser,ultrasonography guidance percutaneous nephro-lithotomy Ⅰ period clear renal calculi is completely can be done.And it can shorten operation time,and has clear renal calculi with high efficiency,small trauma and less long -term complications.It is safe and effective,and worthy of clinical popularization and application.

Objective To assess the clinical diagnosis and treatment of 21-hydroxylase deficiency nonclassic congenital adrenal hyperplasia (NCCAH) complicated by testicular adrenal rest tumors (TART),thus to improve the recognition of the disease.Methods The clinical data of one patient of NCCAH with TART from our department in 2016 were retrospectively studied,and were analyzed combined with related literature,and the diagnosis was established for treatment.Results The patient was a 17 years old boy.At the age of seven began to appear the pubic hair,voice and other secondary sexual performance.More than their big penis development was significantly higher than their peers.At the age of 12 found bilateral testicular gradually enlarged and attendance.Physical examination:bilateral testicular swelling and a sense of nodules,hard texture,epididymis,normal bilateral varicocele.Laboratory exam indications showed increased levels of progesterone(P),adrenocorticotropic hormone(ACTH),17 hydroxyprogesterone(17α-OHP),aaldosterone(ALD),17-hydroxyl corticosteroids(17-OHCS),17-ketone corticosteroids(17-KS).By the ACTH stimulating test,17α-OHP was increased.Bilateral testes MRI:irregular bilateral testes,signal,see in space.Enhanced scan lesions uniform reinforcement,germ cell tumors to row.Adrenal CT:bilateral adrenal hyperplasia.Testicular biopsy:testicular adrenal genital syndrome tumor.Genetic testing:CYP21A2 heterozygous mutations.The above test results were diagnosed of NCCAH 21-OHD with TART.The patient was orally given 10mg/d prednisone 2 time.3 months after treatment,the 17α-OHP,CO and sex hormones returned to normal.Review the adrenal CT showed significant bilateral adrenal shrink,Pa/testis tubercle was narrow,but not obvious.Semen routine still suggested no sperm,considering the TART medical treatment effect was poor.Hence,further line tumor removed,followed up for 3 months without tumor recurrence at present.Conclusion NCCAH complex and varied clinical manifestations and hidden.Not easy to be noticed by patients and clinicians.For the early childhood in pubic hair growth accelerated leading to premature epiphyseal fusion and make the adult height is short stature consideration should be given to the disease.Further lines of sex hormones,adrenal related endocrine examination,genetic testing and ACTH stimulating test,etc.If concurrent bilateral testicular nodules,should consider to merge TART may.Testicular biopsy can be clear.Treatment can choose according to TART classification of glucocorticoid (a hormone steroid) or surgical treatment,concrete scheme should be individualized.