Objective To investigate the pathogenesis ,d iagnosis and treatment of traumatic pseudoaneurysmal-ureteral fistula. Methods A 49-year-old male patient with traumatic iliac pseu doaneurysmal-ureteral fistula was reported.The patient presented with recurrent massive hematuria,and then was diagnosed by DSA and ureteroscopy.By reviewing t he published literature on arterio-ureteral fistula, we analyzed and discussed the patient’s clinical data. Results The patient was cu red by endovascular management.The procedure was as follows.First,the right exte rnal iliac artery was dilated with balloon;then the right internal iliac artery was embolized;finally,a covered stent was placed into the right external iliac a rtery.During 18-month follow-up,no hematuria recurred. Conclusions Traumatic pseudoaneurysmal -ureteral fistula is clinically rare.Th e main symptom is massive hematuria.DSA and ureteroscopy are important means for diagnosis of the disease.Endovascular therapy with covered stents is a safe,eff icacious method for the treatment of the disease.

Objective Inflammatory response is an important part in pathological change of traumatic arthritis(TA).Studies show that hydrogen has antioxidate and anti-inflammatory properties, however, there are few reports on treating TA with it.So this research aimed to investigate curative effects of curing traumatic arthritis in rabbits with intraperitoneal injection of saturated hydrogen saline solution . Methods A total of 26 New Zealand white rabbits were divided into three groups:normal control group (n=6), model experimental group (n=10), and model control group (n=10).Rabbits in model experimental group were intraperitoneally injected with 8 ml /kg saturated hy-drogen saline, once every three day;equivalent saline was injected in rabbits of model control group;while no treatment was done on normal control group.The treatment lasted for 6 weeks.Before and after the treatment, the serum and joint fluid of the rabbits in the three groups were respectively taken to determine the content of nitric oxide (NO) and hyaluronic acid (HA), which was used to evaluate therapeutic effect in combination with the behavioral performance of the rabbits . Results Significant improvement in behavior was found in model ex-perimental group after the treatment (P<0.05).No statistical differences were found in knee swelling scores of the three groupsbefore the treatment(P>0.05), but model experimental group was superior to model control group in knee swelling scores after the treatment (P<0.05).The contents of NO both in serum ([79.58 ±13.46] vs [76.23 ±12.15]) and joint fluid ([89.45 ±14.98] vs [80.36 ±12.78]) in two model groups increased before the treatment, which was of statistical difference (P<0.05), but the NO content decreased dramatically in model experimental group after the treatment ([436.82 ±60.91] vs [340.21 ±40.57],P<0.05), and no obvious changes were observed in model control group (P>0.05).The content of serum HA in model experimental group declined dramatically (P<0.05) and the joint fluid increased after the treatment ([1.72 ±0.37] vs [2.47 ±0.62],P<0.05), while no significant changes were found in model control group before and after the treatment. Conclusion The intraperitoneal injec-tion of saturated hydrogen saline may be effective in the treatment of trau-matic arthritis.

AIM:To investigate the effects and mechanisms of sphingosine-1-phosphate receptor-2 (S1P2R) on lipopolysaccharide (LPS)-induced acute lung injury (ALI).METHODS:ALI model was induced by intratracheal ad-ministration of LPS in both wild-type mice and S1P2R-deficient mice.The pathological changes in the lung tissues were ob-served, and the protein concentration , total cell number, neutrophil ratio, TNF-αlevel and IL-6 level were determined in the bronchoalveolar lavage fluid (BALF) 24 h after LPS injection.In order to investigate the mechanisms of S1P2R in LPS-induced ALI, 10 min before LPS injection, both wild-type mice and S1P2R-deficient mice were injected with nitric oxide synthase inhibitor by tail vein injection , the pathological changes of the lung tissues were observed , and the protein concen-tration and total cell number in BALF were determined 12 h after LPS injection .RESULTS: Compared with wild-type mice, S1P2R-deficient mice showed more severe LPS-induced ALI, and the protein concentration , neutrophils and inflam-matory cytokines in BALF were significantly increased in S1P2R-deficient mice.Administration of nitric oxide synthase in-hibitor Nω-L-nitro-arginine methyl ester protected S1P2R-deficient mice from aggravation of ALI .CONCLUSION:S1P2R mediates the protection from LPS-induced ALI possibly through inhibiting nitric oxide synthase .

Objective To investigate the effect of ellagic acid extracted from gallnut on multiple myeloma SP2 / 0 cell line and related mechanisms. Methods Multiple myeloma SP2 / 0 cell line was treated for 48 h with different concentrations of ellagic acid in vitro. Cell morphology,proliferation,apoptosis and cell cycle were analyzed with microscope,MTT experiment and flow cytometry,respectively. Tumor cell proliferation and apoptosis-related gene expression of COX-2 were detected by Western blotting. Results Cell cycle was arrested at the G1 phase 48 h after treatment with ellagic acid, the cell in G1 were (55. 21±3. 01)% , (64. 48 ± 0. 43)% , (75. 10 ± 2. 46)% , respectively, with significant difference as compared with control group [(34. 04±1. 74)% ,P<0. 01]. Cell suppression rate (21. 18±5. 92)% ,(44. 58±3. 43)% and (70. 15±2. 90)% ,respectively, in 20,40 and 60 μg·mL-1 ellagic acid treatment groups. Compared with the control group,the differences were significant (P<0. 01). Cell apoptosis rate was (9. 60 ± 0. 56)% , (19. 30 ± 1. 51)% and (35. 10 ± 5. 26)% , respectively, in 20,40 and 60 μg·mL-1 ellagic acid treatment groups,with significant differences as compared with the control group[(3. 23±0. 85)% ,P<0. 01]. With the increase of drug concentration,COX-2 expression was decreased. Conclusion Ellagic acid can inhibit myeloma SP2 / 0 cell proliferation and promote apoptosis.

Objective To summarise the methods for a long segmental avulsed inj ury of ureter.Methods Ureteroscopies were performed on three male patients with upper ureteral calculi and one female patient with haematuria from upper urinary tract.Ureteral calculi caused small and middle hy-dronephrosis,obstruction wasn't seen on the upper urinary tract with haematuria.The kidney on the affected side showed normal founction on IVP.Four patients were suffered from a long segmental avulsed inj uries of full-thickness of ureter from ureteroscopy in a continuous epidural anesthesia.The injuries took place in UPJ and upper ureter.The length of avutsed ureters is 20-25 cm,mean length is 24 cm. Results The ureteroscopies were altered to open operations which were ileal ureteral substi-tutions on two patients,being anastomosed the avulsed ureter wrapped by caul on one patient and nc-phrectomy on one patient under general anesthesia in an emergercy.Two ileal ureteral substitutions had reached satisfied results that were no damaged renal functions,no metabolic acidosis,no repeatly U-rinary tract infections and no complains about micturition.One patient has maintained normal renal morphology and function after thirteen years followup,the other formed stricture in the anastomosis of the proximal piece of-ileum to the renal pelvis tWO years after operation,and then improved after ante-grade dilation.The patient with being replaced back and anastomosed the avulsed ureter had compli-cated with a renal atrophy on the affected side three months after the double-J was extracted.The kid-ney showed no function on isotop nephrogram and then was ablated.The last one with nephrectomy and the one before were followed up regularly,the renal functions and blood pressures remain normal.Conclusion Ileal ureteral substitution would be a good choice and has a stable curative effect and provide a good prognosis for treating long segmental avulsed injury of ureter suffered from ureterosco PY when no available urinary tract was utilized for reconstruction.

BACKGROUND:Most of lumbar degenerative diseases, such as lumbar instability, lumbar disc herniation and discogenic lumbago, need lumbar spinal fusion for the spine stability, but the choice of internal fixation approaches is controversial.
OBJECTIVE:To compare the effectiveness between lateral lumbar interbody fusion with single cage and single cage combined with unilateral pedicle screw fixation for the 4th and 5th single-level lumbar degenerative disease.
METHODS:The clinical data of patients with single-level lumbar degenerative diseases (L4 and L5) undergoing lateral lumbar interbody fusion with single cage in 30 cases (experimental group) and single cage combined with unilateral pedicle screw fixation in 45 cases (control group) were analyzed retrospectively, and the curative effects were compared between the two groups.
RESULTS AND CONCLUSION:Al patients in the two groups were fol owed up for 13 months on average (ranged from 10 to 37 months). The incisions in the two groups were stage I healing. One case in the experimental group occurred cage displacement, but no obvious syndromes were detected. No significant difference in the effective rate after operation, hospital stay, and volume of drainage was detected (P>0.05). The operative time and bleeding volume in experimental group were better than those in the control group (P<0.05). ODI and JOA scores were significantly improved after treatment when compared with preoperative ones in the two groups (P<0.05), but no significant difference was visible between the two groups (P>0.05). The effectiveness of lateral lumbar interbody fusion with single cage and single cage combined with unilateral pedicle screw fixation for single-level degenerative lumbar diseases was similar. However, the former has the advantages of less invasion and quick recovery.

AIM and METHODS: Electron cytochemical methods were used to study the changes of calcium and reactive oxygen species in rat kidney during ischemia and reperfusion period.RESULTS:By the end of 1h ischemia, intra-cellular calcium increased. There were no H 2O 2 generation at this time. In the early reperfusion period, large amount of H 2O 2 generated. At this time, there were no evident changes of intra-cellular calcium compare with 1h ischemia group. In the later reperfusion period, less H 2O 2 generated. Intra-cellular calcium increased continuously.CONCLUSION:Calcium and reactive oxygen species all participated in ischemia-reperfusion injury, but the time they participated and their effects were different.

Objective To study the process of hydroxypropyl-β-cyclodextrin (HP-β-CD) inclusion techniques for osthol. Methods The inclusion complex of osthol and HP-β-CD was prepared by unsaturated water solution and freeze-drying technique. Inclusion techniques were selected by screening on quadratic orthogonal rotation combination design method, and the entrapment efficiency was identified by HPLC. Results The optimal technical conditions were as follows:the ratio of HP-β-CD and drug was 4.5∶1;temperature for electric mixer was 35 ℃;the stirring time for thermostatic waterbath was 210 min. Conclusion This method is reasonable and it may have a prosperous future of development and application.

The expression of angiotensin II type 1 receptor (AT(1)R) and angiotensin II type 2 receptor (AT(2)R) in aldosterone-producing adenoma (APA) of the adrenal gland was detected, and their relationship with clinical indexes of APA was analyzed. The mRNA expression of AT(1)R and AT(2)R in 50 cases of APA and tissues adjacent to tumors and 12 cases of normal adrenal tissues was detected by using reverse transcriptase polymerase chain reaction (RT-PCR). The expression of AT(1)R and AT(2)R proteins in paraffin-embedded slices of tissue was detected by immunohistochemistry. The expression of AT(1)R in adenoma, tissues adjacent to tumor, and normal tissues of the adrenal gland showed no significant differences. The expression of AT(2)R in APA tissue was lower than that in normal adrenal gland tissues (P<0.05). Correlation analysis of the mRNA expression level of AT(2)R and clinical data from patients demonstrated that AT(2)R expression was negatively related to plasma aldosterone concentration (PAC) (r=-0.467, P<0.05), but positively related with plasma renin activity (PRA) (r=0.604, P<0.05). It is concluded that down-regulation of the AT(2)R expression is possibly related with the tumorigenesis of APA.

This study examined the association of polymorphisms in angiotensin II receptor genes (AT (1) R and AT (2) R) with the risk for aldosterone-producing adenoma (APA) in a Chinese Han population. Four polymorphisms including rs5182 (573T/C) in exon 4, rs5186 (1166A/C) in 3'-untranslated region (3'-UTR) in AT (1) R gene and rs5194 (2274G/A) in 3'-UTR, rs1403543 (1675G/A) in intron 1 in AT (2) R gene were detected in 148 APA patients and 192 normal subjects (serving as control) by using a MGB-Taqman probe. The distribution of genotypes of each locus was in accordance with Hardy-Weinberg Equilibrium (HWE) in the APA and control groups (P>0.05). The allele A frequency at rs5194 was significantly higher in the APA group (0.49) than in the control group (0.35) (χ (2)=12.08, P=0.001). Subjects with homozygotic genotype AA and heterozygotic genotype GA were at an increased risk for APA as compared to those with GG genotype (OR=2.66, 95% CI=1.45-4.87; OR=1.67, 95% CI=1.02-2.74). Furthermore, rs5194 single-nucleotide polymorphism (SNP) at AT (2) R gene was significantly associated with APA in additive (OR=1.64, 95% CI=1.21-2.20, P=0.001), dominant (OR=1.94, 95% CI=1.23-3.06, P=0.003), and recessive model (OR=2.01, 95% CI=1.17-3.45, P=0.01). It was concluded that rs5194 polymorphism at AT (2) R gene was associated with the risk for APA, which may constitute a genetic marker of APA.