Objective To evaluate the surgical treatment of huge staghorn stones. Method The clinic dates of 184 cases treated with an incision of the infrarenal sinus supplemented by a postrenal low pole segmental incision were studied. Result 184 cases were all successful.Conclusion We conclude that this method, need no interruption of renal blood flow had advantages of simple procedure less bleeding, completely removing calculi, protecting renal function.

Objective To discuss the value of emergency bedside ultrasound in diagnose of blunt abdominal injury. Methods Portable ultrasound was used in 184 patients with blunt abdominal trauma in emergency department. The abnormal changes of the sound and image of the abdomen were observed,paying equal attention to free intraperitoneal fluid and gas. Results The emergency bedside ultrasound identified 169 (91.8%) patients with blunt abdominal injury, of whom 149 patients (95.5%) with single-organ injury and 20 patients (71.4%) with multi-organ injury. There were 21 patients missed diagnosis and three misdiagnosed, with rate of missed diagnosis and misdiagnosis of 13%. Surgical treatment was performed in 119 patients and conservative treatment in 65, which were proved by CT/MRI examination or clinic conservative treatment. Conclusion Emergency bedside ultrasound can provide fast and credible diagnostic information for blunt abdominal trauma, with high diagnosis accordance rate.

p53 gene mutation (exon4 , 5 , 6 . 7 . 8 and intron6) in gastric cancer and precancerous le- sions and p53 gene (exon4 and intron6) .APC gene deletion in gastric carcinomas were studied by PCR/ SSCP and PCR/RFLP. Results showed: mutation rate of p53 in intestinal metaplasia ,dysplasia and gas- tric carcinoma was 37. 5% (3/8) ,42. 1 % (8/19) , 53. 3% (16/30) ,respectively. There was significant dif- ference between groups of metaplasia、dysplasia、cancer and that of normal control. We found there were no exon8 mutation in metaplasia and dysplasia , but 4 cases in cancer group. lt is suggestted that exon8 mutation occurs at the late stage of gastric cancer , but exon 5 , 6 , 7 mutation occur in the course of pre- cancerous lesions to cancer. Loss of heterozygosity (LOH) of exon4 . intron6 . APC was 47. 4 % ( 9/19) . 8. 7%C2/23).16. 7%(3/18) ,respectively. There are some relationship between LOH of exon4 and poor- ly differentiation , lymph node metastas , depth of invasion. LOH of exon4 may be one of prognostic marker of gastric cancer. We concluded that p53 gene mutation is an early event and perhaps has syner- gism with ras oncogene in gastric carcinogenesis

ObjectiveTo observe the effect of raloxifen, a selective eastrogen receptor modulator, on postmenopausal osteoporosis.MethodsSixty six patients with postmenopausal osteoporosis were randomly divided into test group and control group with 33 cases in each group. Patients in the test group were treated with raloxifen (60 mg/day) for six months, at same time; cases in the control group were treated with placebo. Before and after treatment,routine laboratory examinations, transvaginal B type ultrasonic examination, and diagnostic curettage were performed. ResultsThe bone mineral densities of lumbar vertebrae and hip were significantly higher in the test group(60.6%) than in the control group(21.2%) (P<0.01). ConclusionRaloxifen is an effective medicine to treat postmenopausal osteoporosis, and it is also safe, without side effect of stimulating endometrim, etc.

Objective To detect left atrial (LA) function and left ventricular (LV)-LA coupling using vector flow mapping (VFM) and two-dimensional tissue tracking (2DTT) echocardiography in patients with diabetes.Methods A total of 51 patients with type 2 diabetes (DM group) and 38 healthy volunteers (control group) were studied.LA and LV strain were assessed by 2DTT.The energy loss (EL) of LA and LV during ventricular systole (ELs),early diastole (ELed),and atrial contraction (ELac) were measured by VFM.Results LVEL in DM group was significantly increased compared to that in control group (P<0.05).LAELs and LAELed in control group were higher than those in DM group (P<0.05);while LAELac decreased in control group (P<0.05).Multivariate regression analysis identified E and LVELed as independent predictors of LAELed;Peak torsion,LA peak systolic strain and LVELac were independent predictors of LAELac.Conclusions The reservoir and conduit function of LA are impaired in patients with DM,while the pump function increases as a compensation.Abnormal LA-LV coupling also appears in patients with DM.

Objective:To study the expression of neuroglobin (Ngb) in rat cerebral ischemia model and the neuroprotective effect of Ngb after ischemia and hypoxia. Methods: Totally 113 Sprague-Dawley rats were randomly divided into sham-operated group, middle cerebral artery occlusion (MCAO) group, hemorrhagic infarction (HI) group and hemin treatment group. The brain water content, infarcted tissue volume, neuropathologic changes (H-E staining) and expression of Ngb (immunocytochemical staining) were examined 3, 6, 12, and 24 h after model establishment. Results: The brain water contents and the infarcted tissue volumes in the hemin treatment group were significantly different from those of the MCAO group and HI group (P

Objective:To investigate the effects of interferon-? on bleomycin-induced pulmonary fibrosis in rats and to study the mechanism of its effects.Methods:60 SD rats were randomly divided into 3 groups of 20:normal control group(Group N), model control group(Group M) and interferon-?(IFN-?)treated group(Group R). The pulmonary fibrosis model was established by a single intratracheal injection of 5 mg/kg of bleomycin. The rats were sacrificed at days 3,7,14,28 after modeling in batch. Lung tissues were restored to analyze the pathological changes, the content of hydroxyproline,mRNA expression of IFN-? and transforming growth factor-?(TGF-?).Results:The scores of alveolitis in Group M and R were higher than that in Group N at each poin-in-time after modeling.The scores of alveolitis in Group R were higher than that in Group M. The scores of pulmonary fibrosis and the content of hydroxyproline in lung tissues in Group M and R were higher than that in Group N at day 14 and 28. The expression of IFN-? mRNA in lung tissues at day 3,7,14,28 and TGF-? mRNA at day 3 in Group R were higher than that in Group M(P

OBJECTIVE: To study the experience of clinical features and treatment of deep cervical necrotizing fasciitis. METHOD: All 29 cases of cervical necrotizing fasciitis patients were diagnosed by CT, 12 cases underwent tracheostomies, lateral neck incisions and drainage operations, the other 17 patients underwent lateral neck incisions and drainage operations. Sequently washing, dressing changes and anti infection treatments were taken. RESULT: Twenty-eight cases were cured, 1 cases died. During a follow-up of half a year,no relapse. CONCLUSION When patient was sufferd the cervical necrotizing fasciitis, surgical operation for exploration should be taken as soon as possible,and incision and drainage in the treatment of cervical abscess would obtain a satisfactory curative effect, which would prevent serious complications.
Adult ; Aged ; Fasciitis, Necrotizing ; diagnosis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Neck

ObjectiveTo evaluate the clinical efficacy and safety of astragalus injection on the immune function in patients with senile sepsis.Methods Sixty patients with old age sepsis in Critical Care Medicine Department of Guangdong Provincial Traditional Chinese Medicine Hospital were enrolled and randomly assigned into control and treatment groups according to the table of random numbers, 30 cases in each group. According to 2012 sepsis guidelines for treatment, including antibacterial drug, mechanical ventilation, visceral function support, etc., the therapy was given to the control group; besides the treatment in the control group, intravenous drip of 60 mL astragalus injection(10 mL per ampoule) in 250 mL 0.9% normal saline was additionally given in the treatment group, once a day for 7 days. Before and after treatment, the immunological indexes, acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, sequential organ failure assessment(SOFA) score, duration of mechanical ventilation and time of stay in intensive care unit(ICU), 28-day mortality and adverse drug reactions were compared between the two groups.Results Before treatment, there were no statistically significant differences in CD3+, CD3+CD4+, CD3+CD8+ and T helper cells /T suppressor cells(Th/Ts)levels between the two groups(allP>0.05), while CD3-NK+ of the control group was significantly higher than that in the treatment group〔(10.47±6.22)% vs. (6.26±4.13)%,P<0.05〕. After treatment in treatment group, CD3+, CD3+CD4+ and CD3-NK+ were increased, CD3+CD8+,Th/Ts were decreased compared with those before treatment; in the control group after treatment, CD3+,CD3+CD8+ and CD3-NK+ were decreased and CD3+CD4+ and Th/Ts increased compared with those before treatment. In the comparisons between the treatment group and control group after treatment, the differences in CD3+, CD3+CD4+ and CD3+CD8+ had statistical significance〔CD3+:(30.30±17.17)% vs.(41.91±22.29)%, CD3+CD4+:(31.54±13.24)% vs.(40.08±15.28)%, CD3+CD8+:(14.25±8.10)% vs.(9.52±9.33)%,allP<0.05〕; while the differences in Th/Ts and CD3-NK+ had no statistical significance(bothP>0.05). After treatment in the treatment group, IgG was increased compared with that in the control group〔IgG(g/L): 13.07±5.43 vs. 10.10±3.96,P<
0.05〕. The differences in IgA, IgM, complement(C3,C4) and total serum complement activity(CH50) in the comparisons between the two groups had no statistical significance after treatment(allP>0.05). The differences in APACHEⅡ score(13.83±6.18 vs. 15.90±7.48), SOFA score(7.38±4.66 vs. 6.89±4.19), time of stay in ICU(day: 11.63±5.13 vs. 13.62±8.08), invasive ventilation time(hour: 155.44±119.68 vs. 224.08±174.15) and noninvasive ventilation time(hour: 55.55±42.24 vs. 98.57±43.17) had no statistical significance in comparisons between the treatment group and control group after treatment(allP>0.05). The difference in 28-day mortality had no statistical significance in comparison between the treatment group and control group〔16.7%(5/30) vs. 20.0%(6/30),P>0.05〕. In 60 cases, there were 2 patients with adverse drug reaction, one diarrhea and another little rashes, the rest of the patients did not appear any drug side effect.ConclusionAstragalus injection combined with conventional western medicine therapy possibly has certain effect on adjustment of disturbance of immunologic functions in old patients with sepsis, and its therapeutic safety is well.

Objective To evaluate the role of nuclear factor kappa B (NF-κB) in sevofluraneinduced release of inflammatory factors in mouse microglias.Methods Microglial cells obtained from newborn C57BL/6 mice (aged 2-3 days) were seeded in 24-well plates (density 1 × 105 cells/ml, 1 ml/well) , a total of 80 wells.The cells were randomly divided into 4 groups using a random number table (n =20 each) : control group (group C);sevoflurane group (group S);NF-κB selective inhibitor pyrrolidine dithiocarbamate (PDTC) group (group P);PDTC + sevoflurane group (group P +S).In S and P+S groups, 4.1％ sevoflurane was inhaled for 6 h.In P+S group, 10 μmol/L PDTC was added at 1 h before sevoflurane inhalation.At 6 h of incubation with sevoflurane, NF-κB activity and expression and levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were determined.Results Compared with group C, the NF-κB activity and levels of IL-6 and TNF-α were significantly increased in group S, and no significant change in the above parameters was found in the other two groups.Compared with group S, the NF-κB activity and levels of IL-6 and TNF-α were significantly decreased in group P+S.There was no significant difference in NF-κB expression between the four groups.Conclusion NF-κB mediates sevoflurane-induced release of inflammatory factors in mouse microglias.