Objective To evaluate the curative effect of endoscopic treatment of ureteral stones accompanied with polyps. Methods A total of 35 cases of ureteral stones complicated with polyps were treated under ureteroscope by using electrocauterization and pneumatic lithotripter. Results All polyps were successfully cauterized. Stones were fragmented in 88.6% (31 of 35) of the cases.Because the stones moved into renal pelvis, ESWL was adopted after the intubation of double-J catheter in 2 cases. Conclusions After polyps have been cauterized by electrocauterization in advance, the treatment for ureteral stones by using ureteroscopy and pneumatic lithotripter is safe and effective.

A 37-year-old male patient presented with persistent generalized itching erythema and papules for more than 1 month.The patient had received surgical treatment for type B3 thymoma in stage Ⅳ.Five months prior to the presentation,he developed myasthenia gravis.He also complained of chronic diarrhea for two years.Physical examination revealed white patches in the oral mucosa as well as scaly erythema of varying size on the face,trunk and extremities.Lamellar scales could be seen after scratching,while removal of scales could not result in the appearance of bleeding points.There was scaly hyperkeratotic erythema of palms and soles.Histopathological examination revealed psoriasis-like epidermal hyperplasia and parakeratosis with multiple dyskeratocytes,and some of the dyskeratocytes were surrounded by lymphocytes.There was a perivascular infiltration with a small number of lymphocytes.Immunohistochemical study showed positive staining for CD3,CD4 (dermis),CD8 (epidermis) and CD45RO,but negative staining for CD20,CD68 and CD30.The patient was diagnosed as thymoma-associated graftversus-host-like disease,myasthenia gravis and mucosal candidiasis.After treatment with tacrolimus and prednisone,the condition was gradually relieved.

Objective To obtain reasonable treatment by urodynamic detection and analysis in patients with diabetic cystopathy (DCP) complicated with benign prostatic hyperplasia (BPH).Methods Sixty patients with DCP complicated with BPH were selected,among the total 32 patients (duration of diabetes ＞ 12 years,blood glucose control was not ideal) were recognized as experimental group,and 28 patients (duration of diabetes ≤ 8 years,blood glucose control was stable) were recognized as control group.Using the Laborie UDS-120XLT urodynamic detection instrument,the urodynamic was detected and the international prostate symptom score (IPSS) was evaluate,and the results were compared between the 2 groups.Results There was no statistical difference in residual urine volume between experimental group and control group [(146 ±71) ml vs.(160 ±64) ml,P ＞0.05].The maximum urinary flow-rate in experimental group was significantly lower than that in control group [(5.4 ± 2.0) ml/s vs.(8.0 ± 3.2) ml/s],the symptom total score of IPSS was significantly higher than that in control group [(25.8 ± 4.1) scores vs.(22.6 ±5.0) scores],there were statistical differences (P ＜0.01).The maximum bladder capacity,compliance,incipient micturition desire volume in experimental group were significantly lower than those in control group,there were statistical differences (P ＜ 0.01).Conclusions The influence of DCP on the function of the bladder in BPH patients is significant.Urodynamic detection can provide objective basis for the selection of therapeutic methods,suitable to be operated and forecast the postoperative effect.It has an important reference value in DCP complicated with BPH patients.

Objective To investigate the treatment values of precise target delineation of chest MRI for lung cancer Methods From August 2011 to February 2015 , 45 non-small cell lung cancer patients were given chest CT scans and MRI scans before radiotherapy , and then active target tumor delineation , then related influencing factors were analyzed. Results All patients completed CT scans and MRI positioning. For patients that it was difficult to identify lung tissue lesions caused by lung cancer through CT , their MRI imaging showed high signal and the boundaries between the tumor and surrounding normal tissue became relatively clear. Meanwhile , 20 patients of borders were diagnosed by CT , while 25 by MRI; 36 patients with lymph node metastasis were diagnosed by CT while 40 by MRI. The difference was statistically significant (P<0.05). Univariate logistic regression analysis showed that pathological type and atelectasis were the influence factors for CT and MRI tumor target delineation differences (P<0.05), and multivariate logistic regression analysis showed the atelectasis was the main factor (P<0.05). Conclusion Compared with CT, breast MRI can precisely delineate target to improve the accuracy of target localization before radiotherapy. It can help determine lymph node metastasis and avoid the impact of atelectasis then ensure the accuracy of radiotherapy.

Objective:To investigate the feasibility of treating chronic HBV infection by inducing spe cific humoral immune response to HBV middle envelope protiens in normal and HBV transgenic mice with HBV DNA based immunization. Methods: The eukaryotic expression vector pCMV S2.S (PS) containing HBV S2.S gene and pc DNA3.0 were used respectively to immunize 5 C57BL/6 normal mice and HBV transgen ic mice. Each mouse was injected intramuscularly with one of those plasmids at t he same dose (100 ?g). Sera of mice were detected for anti HBs, anti preS2, HBsAg and HBeAg with ELISA. Pathological changes of transgenic mice liver were o bserved by microscopy. Results:PS can stimulate immune respons es of anti HBs and anti preS2 in normal and transgenic mice.The appearance of a nti preS2 was 1 2 weeks earlier than that of anti HBs. HBsAg and HBeAg in se ra turned negative 8 weeks after immunization. At the 8th week, hepatocytes show ed extensive granular degeneration and hydropic degeneration. There was no obvious difference in the amount of mononuclear lymphocytes between pre and post gen e immunization. Conclusion: It is showed that specific humoral immune response can be effectively induced by PS after DNA based immunization, and PS seems to be responsible for the disapearance of HBsAg and HBeAg in sera o f HBV transgenic mice. The results provide an evidence for furth er investigation of genetic vaccine in the treatment of chronic HBV infection.

Objective To explore the feasibility,safety and efficacy of laparoscopy assisted ultrasound guided radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) beneath the diaphragm.Methods Twentythree consecutive patients with solitary HCC beneath the diaphragm were treated by laparoscopy assisted ultrasound guided RFA in the Chinese PLA General Hospital from January 2013 to March 2016.We observed the p erioperative complications and followedup long-term effect.Results All the 23 patients successfully underwent laparoscopy assisted ultrasound guided radiofrequency ablation.No serious complications such as massive hemorrhage,biliary fistula and severe pleural effusion,hemopneumothorax occurred in the patients during perioperative period.CT examination 2-3 days after the operation revealed that the tumor was completely covered by the ablation area.Besides,the survival condition was satisfactory during follow-up period of 9-38 months.Conclusion Laparoscopy-assisted ultrasound-guided radiofrequency ablation is effective and safe for HCC beneath the diaphragm.

Objective To study the effects of medicated serum with total saponins from Rhizoma Dioscreae Nipponicae (RDN) on VEGF mRNA expression and AP-1 activity in rat synovial cell strain RSC-364 induced by IL-17 and TNF-α. To investigate the mechanism about total saponin from RDN inhibition of angiogenesis. Methods Medicated serum of total saponins from RDN and tripterygium (positive control) were prepared. Rat synovial cells RSC-364 were divided into four groups: the blank control,IL-17+TNF-α model,tripterygium medicated serum,and total saponins medicated serum groups. After one hour of incubation,all groups except for the blank control were incubated with both IL-17(10 μg·L-1 ) and TNF-α(10 μg·L-1 ) for 24 hours. VEGF mRNA expression in RSC-364 was detected by PrimeScriptTM real-time quantitative PCR (RT-PCR) detection kit,and the AP-1 DNA-binding activity was detected by electrophoretic mobility shift assay (EMSA). Results Compared with the control blank group,both of the VEGF mRNA expression and AP-1 activity in rat synovial cell strain RSC-364 induced by IL-17 and TNF-α increased remarkably (P<0. 05,P<0.01). The VEGF mRNA expression and AP-1 activity in tripterygium medicated serum group and total saponins medicated serum group were remarkably lower than those of the model control group (P<0.05). There was no significant difference between the two medicated serum groups. Conclusion Serum medicated with total saponins from RDN can remarkably decrease VEGF mRNA expression and AP-1 activity,indicating that the total saponins from RDN could influence VEGF secretion by inhibiting the AP-1 signal transduction pathway,VEGF is the key factor of angiogenesis,thereby to restrain angiogenesis.

ObjectiveTo investigate the effects of using spiral pedunculated bladder muscle flap ureteroplasty in the treatment of long ureteral segment defects ( ＞ 20 cm).MethodsA retrospective analysis was conducted on the clinical effects of five patients who encountered long ureteral segment defects caused during ureteroscopic lithotripsy.The five patients included three males and two females with an age range from 37 to 59 yrs ( average age 48 ).Four of the cases had defects on the left and one case on the right.Two cases had whole ureteral mucosal avulsion and three cases had whole ureteral ruptur from the pelvis to the bladder junction.Defect lengths measured from 21 to 25 cm( mean length 22.5 cm).All five patients underwent emergency surgery using spiral pedunculated bladder muscle flap ureteroplasty and 7 F double J stent placement in the repaired ureters which was fixed on psoas muscles.The average length of the new ureters using spiral pedunculated bladder muscle flap was 22.5 cm.ResultsAll the operations were successful and the operation time was 1 -2 hrs (average 1.5 hrs).Drainage tubes for four patients were removed three days after operation.IN the remaining case the drainage tube was removed 10 days after surgery due to urine leakage.All wounds healed uneventfully.Serum creatinine and blood urea nitrogen were normal two weeks after surgery.Double-J tubes were removed safely under cystoscope eight weeks after surgery.In following-up,one case was found to have mild hydronephrosis and ipsilateral ureter slight expansion six months after surgery,but renal function was normal.There was no abnomality found in the remaining four patients after 2 -4 years of follow-up.The IVU showed normal morphology and good developments in the ipsilateral ureter.ConclusionsSpiral pedunculated bladder muscle flap ureteroplasty is an ideal treatment method in repairing long ureteral segment defects.

Objective: To investigate the clinical characteristics and the effectiveness of surgical treatment of adrenal cysts. Methods: The clinical data of adrenal cysts in Affiliated Zhangye people′s Hospital, Hexi College from May 2005 to July 2018 were retrospectively analyzed, including clinical manifestations, diagnosis, surgical methods, postoperative pathological results and follow-up process. Seventeen patients with adrenal cysts were identified including 10 males and 7 females. The median age was 45.6 ranging from 30 to 75. There were 12 left lesions and 5 right lesions. Only 4 patients (23.5%) had clinical symptoms, including low back pain, abdominal pain and dizziness caused by hypertension. Ultrasound, CT and MRI were the main imaging methods for preoperative diagnosis. Results: All patients underwent surgical treatment. Laparoscopic surgery was adapted in 14 cases. The average operation time was (70.2 ± 18.5) min and the average bleeding was (47.0 ± 12.1) ml. For open surgery in 3 cases, the average operation time was (103.5 ± 25.0) min and the average bleeding was (85.6 ± 20.5) ml. Postoperative pathological results showed endothelial cysts in 11 cases, epithelial cysts in 3 cases and pseudocysts in 3 cases. No recurrence of cysts or hypoadrenalism occurred in 3-75 months′ follow-up. Conclusions Adrenal cysts are relatively rare and generally benign lesions. Imaging examination, especially abdominal enhanced CT is essential for diagnosis. Laparoscopic surgery is a safe and effective method for the treatment of adrenal cysts.

Objective To investigate the effect and underlying mechanism of roxadustat on apoptosis and senescence of renal tubular epithelial cell line HK-2 induced by heat stress.Methods After HK-2 cells were treated with different concentrations of roxadustat(10,20,30,40 and 50 μmol/L)for 24 h,CCK-8 assay was used to determine the optimal intervention concentration of roxadustat.HK-2 cells were divided into 4 groups(n=3):control group,roxadustat group(30 μmol/L,24 h),heat-stress group(43 ℃,2 h),and heat-stress+roxadustat group(30 μmol/L roxadustat treatmnet for 24 h followed by heat-stress 2 h).Cell viability was detected by CCK-8 assay.Expression of hypoxia-inducible factor-1α(HIF-1α),Cleaved Caspase-3,p16 and p21 at protein level was detected by Western blotting.Immunofluorescence assay was employed to observe the distribution of HIF-1α.β-galactosidase staining kit was utilized to detect SA-β-Gal activity.TUNEL staining was used to measure cell apoptosis.Results The highest cell viability was observed in the cells after 30 μmol/L roxadustat treatment.Heat stress resulted in a significant decrease in cell viability(P＜0.05),elevated protein levels of HIF-1α,Cleaved Caspase-3,p16 and p21(P＜0.05),enhanced SA-β-Gal activity(P＜0.05)and increased percentage of TUNEL-positive cells(P＜0.05)when compared with the cells in the control group.In comparison with the heat-stress group,the heat-stress+roxadustat group showed significant decrease in the protein levels of Cleaved Caspase-3,p16 and p21(P＜0.05),reduced activity of SA-β-Gal[(65.44±5.00)％vs(77.15±2.61)％,P＜0.05]and decreased percentage of TUNEL-positive cells[(16.73±2.20)％vs(46.40±13.87)％,P＜0.05],but increase in cell viability[(86.33±4.51)％vs(66.33±8.50)％,P＜0.05]as well as HIF-1α protein expression(P＜0.05).Furthermore,immunofluorescence assay showed that HIF-1α was mainly distributed in the nucleus and perinucleus.Conclusion Roxadustat attenuates heat stress-induced apoptosis and senescence of renal tubular epithelial cells by upregulating HIF-1α.