Objective To evaluate intrasinusal pyelolithotomy for giant staghorn calculi. Methods The data of 22 cases treated with intrasinusal pyelolithotomy were analysed. Results Lithotomy was successful in all cases with the average operation time 116 minutes.Blood transfusion during the procedure was required in 8 cases with an everage of 550 ml.Postoperative examination of 12 cases with B ultrasound revealed residual calculus in 3,the diameters being less than 0.8 cm. Conclusions The procedure for giant staghorn calculi was easy,safe,and effective with renal parenchyma intact.

0. 05) . The sensitivity and specificity of NMP-,2 in diagnosing transitional cell carcinoma of bladder were 85. 7% and 60% when the cut-off was set 10 u/ml, In contrast, the sensitivity and specificity of urinec cytology were 32. 1% and 100%. Conclusions: Urinary NMP22 can be used to screen and follow up transitional cell carcinomas of bladder with high sensitivity and high specificity.

Objective To investigate the clinical features,diagnosis and treatment of spontaneous rupture of renal angiomyolipoma (RAML). Methods A total of 23 cases of spontaneous rupture of renal angiomyolipoma were studied retrospectively.The main clinical manifestations were summarized as follows.Sudden and unexpected lumbar and abdominal pain occurred in 21 cases and lumbar swollen pain in 2.Of them 3 cases concomitantly had hematuria.Nausea and vomiting occurred in 2 cases,shock in 3 and fever in 1.All cases underwent B-ultrasonic examination and 21 had CT examination. Results Diagnosis of RAML was established preoperatively in 16 cases,but 4 cases were misdiagnosed for carcinoma of kidney,1 case for renal infectious disease.Two cases were diagnosed by frozen-section sample during operation.Nephrectomy was performed in 10 cases and nephron sparing nephrectomy in 12,and digital subtraction angiography (DSA) embolization in 1. Conclusions Spontaneously ruptured RAML often changes its clinical symptoms and imaging features,which may result in a high misdiagnosis rate and subsequent nephrectomy.Comprehensive analysis of clinical manifestations and image findings can improve preopreative diagnosis rate,and frozen slice sample examination during operation can avoid unnecessary nephrectomy.

Objective To study the clinical features,etiology,misdiagnosis of inflammatory pseudotumor in anterovesical space. Methods Four cases of inflammatory pseudotumor in anterovesical space were retrospectively reviewed.Their clinical processes and features were analyzed based on literature. Results In all 4 cases,partial bladder wall was infiltrated.Two cases were misdiagnosed as bladder carcinoma.All tumors and partial walls of bladder were successfully resected.All 4 patients were followed up for 3 months to 6 years.No recurrence was observed. Conclusions Prior ligation of fallopian tube and infection are important etiological factors of inflammatory pseudotumor in anterovesical space.Misdiagnosis can be avoided by analysing the history,clinical condition and special examination.The operative therapy is effective.

Objective To study the effect of anisodamine (654-2) combined with exogenous pulmonary surfactant (PS) on tumor necrosis (TNF- ?) ,structure of lung tissue changes during pig's lung ischemic-reperfusion injury. Methods 24 pigs ,approximately 45-day-old, were randomly divided into four groups: a control group,a 654-2 group,a PS group and a 654-2 plus PS group. The TNF-? concentration of every lung was analysed with ELISA methods at the point of pre-clamping right pulmonary aortery,post-clamping 60',90'(opening),post-unclamping 60',90',120'.Finally ,we examined the pathologic changes of the lungs. Results After clamping right pulmonary artery , TNF-? concentrations in every experimental groups were significantly lower than that of the control group (all P

OBJECTIVE:To evaluate the therapeutic effect of pagosid on prostatodynia.METHODS:30patients with prostatodynia were evaluated;pagosid was taken orally1tablet t.i.d and NIH-CPSI was scored before treatment and q.w.4weeks after treatment.The results were evaluated.RESULTS:Effective rates from the first to the fourth week were16.7%,33.3%,40.0%,76.7%respectively.No obvious adverse reactions were found in the period of treatment.CONCLUSION:Pagosid has obvious effect on prostatodynia with pain as chief complaint,and few adverse reactions will develop.However it is slower to take effect,and therefore nonsteroid analgesic is recommended in the early stage of treatment.

Objective To inquire into the diagnosis and management of renal angiomyolipoma.Methods The 22 cases of RAML were studied restrospectively.Results The diagnosis accuracy was 54.5% for B ultrasound and 81.8% for CT,18 were diagnosed as RAML and 4 were misdiagnosed as renal cell carcinoma preoperatively,of which 3 were diagnosed as RAML based on intraoperative frozen section study.11 had been performed enuoleation,7 partial nephrectomy,3 nephrectomy and 1 radical nephrectomy. Conclusions CT is the first line imaging method for RAML.the cow fatty component,intratumor hemorrhage and small tumor are the main canse of misdiagnosis in RAML.careful analysis to clinical feature and imaging data,intraoperative frozen sect,ion study can avoid misdiagnosis.nephron sparing surgery is the best operative management.

OBJECTIVETo verify the clinical efficacy of acupuncture for mild cognitive impairment of stroke at subacute stage.

METHODSOne hundred patients at subacute stage of cerebral infarction or cerebral hemorrhage with scores of Montreal cognitive assessment (MoCA) less than 26 were randomly divided into an observation group and a control group,50 cases in each one. Based on the regulation of blood pressure and blood sugar and anticoagulation,cognitive rehabilitation training was adopted in the control group. On the basis of treatment in the control group,acupuncture was applied in the observation group. The acupoints were Baihui(GV 20), Sishencong (EX-HN 1), Shenting (GV 24), Yintang(GV 29), Hegu (LI 4) and Taichong(LR 3). Sishencong(EX-HN 1), Shenting (GV 24) and Yintang (GV 29) were connected to electroacupuncture apparatus. The treatment was given once a day,5 times a week, and 8-week treatment was acquired in the two groups. In the 4th week and the 8th week,limbs motor function, daily life ability and cognitive function were evaluated by Fugl-Meyer assessment (FMA) scale,Bathel index and MoCA scale.

RESULTSIn 4 weeks and 8 weeks, the scores of FMA, Bathel index and MoCA in the two groups were improved compared with those before treatment (all P < 0.05). After 8-week treatment, the scores of Bathel index and MoCA in the observation group were better than those in the control group (both P < 0.05).

CONCLUSIONBased on the cognitive rehabilitation training and the conventional treatment, acupuncture can improve the cognitive function and daily life ability of stroke patients at subacute stage with mild cognitive impairment.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Cognition ; Cognitive Dysfunction ; psychology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; psychology ; therapy

Objective To study the effect of docosahexaenoic acid ( DHA ) and eicosapentaenoic acid (EPA) on cognition impairment and huntingtin associated protein 1 ( HAP1 ) expression in hippocampus of rat model with Alzheimer' s disease(AD). Methods Forty healthy Sprague-Dawley rats were randomly divided into control group, AD group, DHA group and EPA group on average. Alcl3 was injected intraperitoneally and D-galac tose was injected into subcutaneous to establish the model of rat with AD. ABC method of immunohistochemistry was used to observe the expression level of HAP1 in the hippocampus. Morris water maze was used to study the spatial learning and memory in rats. Results Compared with control group,the HAP1-positive neurons of hippo campus decreased and poorer performance in Morris water maze test was observed in AD group. Compared with AD group, DHA and EPA treatments significantly caused the decreases in escape latency and searching distance in the Morris water maze test. The number of HAP1- positive cells in DG region of DHA group(43.57 ±6.14) increased obviously compared with AD group( 28.56 ± 4.23 ) (P ＜ 0.05 ＝. Conclusion The immunoreactivities of HAP1 decrease in hippocampus of AD rat. The applications of DHA and EPA in AD rats significantly improve the ability of learning and memory;and the mechanisms may be related to the decrease of HAP1 expressions in hippocampus.

Objective To contrast the efficacy of mechanical stapler and hand suture for cervical esophagogastrostomy in the treatment of esophayeal cancer.Methods From January 2001 to August 2007,217 cases of cervical esophagogastrostomy were done in esophageal carcinoma.Among them.136 cases were treated by mechanical stapler and 81 cases by hand.Results The incidence of anastomotic fistula was 2.2%(3/136)in mechanical stapler group and 11.1%(9/81)in the group by hand.There was significant difference between the two groups(P＜0.95).The incidence of cervical incision infection was 2.9%(4/136)in mechanical stapler group and 14.8%(12/81)in the group by hand.There was significant difference between these two groups(P＜0.05).There was no significant difference between these two groups about pulmonary infection,arrhythmia,chylothorax and laryngeal nerve injury.Conclusion The incidence of anastomotic fistula and cervical incision infection was reduced by mechanical stapler which was displayed to advantage in esophagogastrostomy.