Objective To evaluate the efficacy of calicecotomy combined with trans-renal parenchyma pneumatic lithotripsy for complicated staghorn renal calculi.Methods The severe hydrocalycosis was incised using electrocautery,then pneumatic lithotripsy was performed and the broken stones were taken out.For those patients with stenotic entrance to renal calyces without hydrocalycosis,we stabbed into the stones with the lithotriptic pole(1 mm in diameter) through renal parenchyma and took the broken stones out of the entrance.Results The renal pedicle were not blocked in 19 cases.The operation time was 90-150 minutes,with a mean of 120 minutes.There was no blood transfusion with the blood loss ranging form 100 to 250 ml.The procedures were successful in 17 cases without residual stones after operation;intraoperative residual sand-like calculi were found in 1 case and removed by irrigation and drainage through nephrostomy tube;intraoperative missing calyceal calculi occurred in 1 case and were cleared by extracorporeal shock wave lithotripsy(ESWL).A follow-up for 10-60 months(mean,18 months)in 15 patients showed recurrence in 2 ones,and the stones were removed by ESWL.Conclusions Calicecotomy combined with trans-renal parenchyma pneumatic lithotripsy for complicated staghorn renal calculi has the advantages of less blood loss and definite efficacy.

Antibacterial Chinese drug Dingxiangliao has been studicd on botanical,pharmacognostical characters and microspectroscopic Properties.The results provide a scientific mean for the identification of the drug.

Objective To explore the clinical feature and diagnosis of the X linked adrenal hypoplasia congenital (X-AHC). Methods The clinical data and gene detection results of one case of AHC were retrospectively analyzed. The related literatures were reviewed. Results Two-month-old male infant was suffered with slow weight gain, vomiting, and salt craving of adrenal insufifciency after birth. Gene detection found a new missense mutation on NROB 1 gene. The diagnosis of X-AHC was conifrmed. Conclusions X-AHC is a kind of rare disease and is diagnosed by clinical manifestation, laboratory testing, and NROB 1 gene detection.

Objective To investigate the correlation of anthropometric indicators and blood pressure in children. Methods A total of 6 790 children aged 6 to 13 years were inspected by random sampling. The body mass index (BMI), waist circumference (WC), hip circumference (HC), and blood pressure were measured. The waist/hip ratio (WHR) and waist/height ratio (WHtR) were calculated. The data wrer analyzed by SPSS16.0 statistical software. Results The detection rate of hypertension in children was 5.57%. After controlling for age, both in male and female children, the BMI, WC, HC, WHR, WHtR and systolic blood pressure showed a significant positive correlation by partial correlation analysis (all P<0.05). Both in male and female children, the BMI, WC, HC, WHR, and WHtR were significantly higher in children with hypertension than those in children with normal blood pressure (all P<0.05). Among all subjects, 280 children (4.12%) were obese, 622 children (9.16%) were overweight. The detection rates of hy-pertension were significantly different among obese, overweight and normal weight children (P<0.01). The detection rate of hypertension was significantly higher in obese children than that in overweight and normal weight children. The systolic and diastolic blood pressure were all significantly higher in obese and overweight children than that in normal weight children (P<0.05). Conclusion The hypertension prevalence of children aged 6 to 13 years in Zhengzhou is in the low to median level in the same age groups. The BMI, WC, HC, WHR, WHtR are signiifcantly correlated with blood pressure in both gender, and the correlation is the most obvious in HC.

Objective Boy sexual development is affected not only by age, but also by environment factors .The present study was to survey and evaluate the status of sexual development in boys from Zhengzhou area and to explore their influencing factors. Methods The height, weight, waist circumference, hip circumference, penis and testicles in 3779 boys aged from 6 to 13 years old in Zhengzhou were measured .The penis length and testicular volume of different ages and their influencing factors were compared, and the beginning age and sexual development characteristics were explored .The development of genitalia and pubes were evaluated by Tanner staging criteria and standards, which were divided into five stages. Results There were 3779 boys, including 395 overweight cases (10.45%) and 208 obesity cases (5.50%).The testicular volume and penis length increased by age, which increased slowly at the age of 6 to 11, followed by a rapid increase after the age of 11 year old.Testicular volume increased more rapidly than that of penis length. The medians quartile of testicular volume in overweight group ,obese group and normal group were 2.50 mL, 2.50 mL, 2.00 mL, 2.00 mL,2.00 mL,1.00 mL respectively .The testicular volume in overweight group and obese group were significantly greater than that in nor -mal group (P<0.01) and there were no difference between overweight group and obese group .The penis length in overweight group and obese group were significantly less than that in normal group (P<0.01), and there was no difference between overweight group and obese group.Testicular volume and penis length were positively correlated with age, height, weight, body mass index, waist circumference and hip circumference; the correlation between testicular volume and height, penis length and age were the strongest. The age of development of testicle (average 12.02 years) in urban area was later by 2.73 years than that in the rural area (average 9.9 years), the difference was statistically significant (P<0.001).The age of pubic development (P2) and maturity (P5) was (12.34 ±0.83) years and (12.39 ±1.24 ) years.The incidence of precocity in boys was 0.40%. Conclusion The sexual development of boys from Zheng-zhou area is similar to the results of large scale survey from China .Attention should be paid to the effect of obesity on sexual develop-ment, and early intervention should be given, the occurrence of adverse events of sexual development can be avoided .

Clinical characteristics were analyzed in a child with very long chain acyl-CoA dehydrogenase deficiency( VLCADD) . The gene analysis was performed in 20 exon all coding regions and 10 bp shear zone in the very long chain acyl-CoA dehydrogenase( VLCAD) gene of the case and his family members by direct sequencing of PCR-DNA from peripheral blood. The results showed that the patient presented with acute onset, clinical manifestations of repeated vomiting, poor spirit, abnormal liver function, increased myocardial enzyme kinase. At the age of one year old, this child was diagnosed with Reye's syndrome for liver injury. Genetic testing results revealed that E14 c. 1349G>A, p. R450H heterozygous mutation in VLCAD gene was found in this case, his mother, and his younger sister, and E15 c. 1532G>A, p. R511Q heterozygous mutation was found in this case and his father. The pathogenic genes of the case are from his mother and the younger sister is a carrier.

Objective: To study the expression and significance of VEGF-C, D2-40, and E-Cad in Human breast carcinoma. Methods: S-P immunohistochemical method was used to assess the expression of VEGF-C in 88 cases of infiltrating ductal carcinoma of the breast (with intact clinicopathologic and follow-up in-formation) and 54 cases of different intraductal hyperplastic lesions. The relationship of VEGF-C expression with D2-40 and E-Cadherin in infiltrating ductal carcinoma of the breast was analyzed. Results: VEGF-C ex-pression was higher in the invasive group than that in the dysplasia group and benign lesions. VEGF-C ex-pression in the metastatic group was significantly higher than that in the group without lymph node metasta-sis, indicating that VEGF-C plays an important role in the growth and metastasis of breast cancer. VEGF ex-pression in breast cancer group was higher than that in the dysplasia group and benign lesions. LVD count in the group with lymph node metastasis was significantly higher than that in the group without lymph node me-tastasis. The positive rate of E-Cad expression in the invasive group was significantly lower than that in the dysplasia group and benign lesions. VEGF-C expression was positively correlated with D2-40 expression. VEGF-C expression was negatively correlated with E-Cad expression. Conclusion: VEGF-C and D2-40 could be used for the detection of early lymphatic metastasis of breast cancer. VEGF-C and E-Cad can be used as important indices for the evaluation of the prognosis of breast cancer.

This study was aimed to explore a new method to identify the original plant of Plantaginis Semen and its adulterants by the ITS2 regions. The second internal transcribed spacer (ITS2) of ribosomal DNA was amplified and sequenced by bidirectional sequencing of PCR products. Sequence assembly and consensus sequence generation were performed by using CodonCode Aligner. The ITS2 secondary structure was predicted using ITS2 database and web-sites. The phylogenetic tree was constructed by MEGA5. The results showed that the maximum intraspecific K2P dis-tance of Plantago asiatica was 0.009 9, while the minimum interspecific K2P distance was 0.497 6; the maximum in-traspecific K2P distance of P. depressa was 0.005 2, while the minimum interspecific K2P distance was 0.519 1. The ITS2 secondary structure showed that P. asiatica and P. depressa can be differentiated obviously from its adulterants. Different samples of P. asiatica and P. depressa were gathered together and can be distinguished from its adulterants by NJ tree. It was concluded that the ITS2 sequence was able to identify original plant of Plantaginis Semen and its adulterants correctly. It provided a new method for the identification of original plant of Plantaginis Semen.

Objective To summarize the correlation between cytotoxic T lymphocyte associated antigen-4 (CTLA-4) promoter-49 A/G polymorphism and Graves' disease (GD)in China.Methods The publications before Sep.30,2011 about the correlation between CTLA-4 promoter-49 A/G polymorphism and GD in China were collected by searching CNKI,CBM,and Wanfang database.Meta-analysis was performed to check the difference of genotypes such as AG,GG,GG + AG,and G allele between GD group and the control group.Results A total of 6 studies involving 570 cases in GD group and 486 cases in the control group were included in the meta-analysis.According to the heterogeneity of these studies,meta-analysis was performed to analyze the correlation between AG,GG,GG + AG genotype,G allele and GD by fixed effects model.The pooled OR value(95％ CI) of various studies was 1.97 (1.37-2.82),3.66 (2.42-5.53),2.55 (1.82-3.58),and 1.99 (1.49-2.65).Conclusion The meta-analysis demonstrates that CTLA-4 promoter-49 A/G polymorphism increases the possibility of getting GD in Chinese.