Objective To improve the diagnosis and treatment of primary ureteral cancer. Methods Thirty-six cases of primary ureteral cancer ascertained by pathological studies were reviewed.There were 22 men and 14 women with the mean age of 63 years.All patients underwent operation. Results Thirty-four cases (94%) were followed up for 6 to 180 months.Among them,6 died of metastasis,6 died of other diseases and 22 survived.Local recurrence in ureter or bladder occured in 3 patients 1～5 years after partial ureterectomy. Conclusions Nephroureterectomy and bladder cuff resection is the best treatment for primary carcinoma of ureter.Ureterectomy and bladder cuff resection should be carried out prior to nephrectomy for the lower segment ureteral carcinoma in order to lessen carcinoma cell transplantation in bladder.

Objective To investigate the incidence and prognosis of multiple primary malignant neoplasms of urologic and male genital system. Methods 22 cases of multiple primary neoplasms patients treated from Jan 1980 to Jun 2000 were studied retrospectively. Results The total incidence rate of the multiple malignant neoplasms was 3.2%.In the 7 patients with synchronous occurrence of multiple pramary malignant neoplasms,the survival time was 6 to 40 months,with a mean of 15;In the other 15 patients,3 died after 7 months to 5 years,12 have survived 8 months to 15 years after the second carcinoma being treated. Conclusions Multiple primary malignant neoplasms of urologic and male genital system is more frequently seen ronadays.Early diagnosis and adequate treatment of the second primary carcinoma is the only means to achieve a long survival.So the patient should be closely followed up after the first carcinoma being treated.

An online algorithm balancing the efficiency and equity principles is proposed for the kidney resource assignment when only the current patient and resource information is known to the assignment network. In the algorithm, the assignment is made according to the priority, which is calculated according to the efficiency principle and the equity principle. The efficiency principle is concerned with the post-transplantation' immunity spending caused by the possible post-operation immunity rejection and patient's mental depression due to the HLA mismatch. The equity principle is concerned with three other factors, namely the treatment spending incurred starting from the day of registering with the kidney assignment network, the post-operation immunity spending and the negative effects of waiting for kidney resources on the clinical efficiency. The competitive analysis conducted through computer simulation indicates that the efficiency competitive ratio is between 6.29 and 10.43 and the equity competitive ratio is between 1. 31 and 5.21, demonstrating that the online algorithm is of great significance in application.

An online algorithm balancing the efficiency and equity principles is proposed for the kidney resource assignment when only the current patient and resource information is known to the assignment network. In the algorithm, the assignment is made according to the priority, which is calculated according to the efficiency principle and the equity principle. The efficiency principle is concerned with the post-transplantation' immunity spending caused by the possible post-operation immunity rejection and patient's mental depression due to the HLA mismatch. The equity principle is concerned with three other factors, namely the treatment spending incurred starting from the day of registering with the kidney assignment network, the post-operation immunity spending and the negative effects of waiting for kidney resources on the clinical efficiency. The competitive analysis conducted through computer simulation indicates that the efficiency competitive ratio is between 6.29 and 10.43 and the equity competitive ratio is between 1. 31 and 5.21, demonstrating that the online algorithm is of great significance in application.

Objective Pathogen and antimicrobial susceptibility in children with bacterial meningitis were reviewed.Methods The positive cultures of cerebrospinal fluid samples or blood samples and its antimicrobial susceptibility were analyzed in 401 patients with the clinical diagnosis of bacterial meningitis.Results 401 cases cerebrospinal fluid samples and blood samples submitted to microbiology laboratory, 97 cases (24%) were microscopically and culturally proven to be bacterial meningitis. The most frequent pathogen was staphylococcus aureus (28%), followed by the streptococcus pneumoniae (19%) and escherichia coli (13%). Pediococci as conditioned pathogen, were found in purulent meningitis patients. One of the isolates of Staphylococcus aureus was simultaneously resistant to both vancomycin and teicoplanin. Three isolates showed simultaneous resistance to imipenem/cilastatin.Conclusions Staphylococcus aureus as the predominant pathogens of pediatric ranks first among pediatric patients of purulent meningitis. Serious drug resistance of isolated pathogenic bacteria and its in antimicrobial susceptibility in the bacterial meningitis should be considered in clinical therapy.

Objective To investigate the clinical characteristics of aerophagia in children,and to evaluate the effect of 24 hours esophageal multichannel intraluminal impedance monitoring in diagnosis of aerophagia.Methods The clinical data of 30 children with aerophagia hospitalized in Department of Digestive Disease,Nanjing Children's Hospital Affiliated to Nanjing Medical University from July 2005 to June 2013 were reviewed.The 24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases of aerophagia.The treatment of these patients normally included psychological counseling,dietary adjustment,Iactulose,Domperidone and vitamins,while Simethicone was given to the patients if normal treatment was invalid.Results Of the 30 patients,aged 2 to 13 years,averaged (8.6 ± 4.5) years,the chief complaints were abdominal distention in 30 cases (100.00％),visible or audible air swallowing in 28 cases (93.33％),repetitive belching in 27 cases (90.00％),reduced appetite in 25 cases (83.33％),constipation in 22 cases (73.33％),psychological stresses in 15 cases (50.00％),recurrent abdominal pain syndrome in 10 cases(33.33％),chronic diarrhea in 3 cases(10.00％) and acute abdominal pain in 3 cases(10.00％).Among the 30 patients,24 hours esophageal multichannel intraluminal impedance monitoring was performed in 8 cases,averaging 149.63 (47-553)times of air swallowing were recorded.In the 30 patients,24 cases (80.00％) were relieved after being treated with psychological counseling,dietary adjustment,lactulose,domperidone and vitamins,and only 6 cases(20.00％) were invalid for normal treatment but well responeded to Simethicone.Conclusions Aerophagia is a kind of functional gastrointestinal disorders in children.Abdominal distention,air swallowing,repetitive belching,reduced appetite,constipation and pain are common symptoms.It can be cured through psychological counseling management,diet modification,laxatives,propulsives and vitamins.24 hours esophageal multichannel intraluminal impedance monitoring is a useful technology in the diagnosis of aerophagia children.

AIM: To investigate the effects of angiotensinⅡ receptor type Ⅰ antagonist irbesartan and angiotensin-converting enzyme inhibitor perindopril on the myocardial expression of connexin 43 (CX43), desmin and cardiac troponin T (cTnT) in the pressure overload-induced rat cardiac hypertrophy. METHODS: 40 male adult Sprague-Dawley rats were divided into 5 groups (8 animals for each): sham operation group and other four groups with ventricular hypertrophy caused by banding aortic artery. Drugs were given one week after operation as follows: sham operation group, normal saline (2 mL?kg~-1?d~-1 ig) was given; Operative groups: animals with ventricular hypertrophy were treated with normal saline 2 mL?kg~-1?d~-1 ig; Treatment groups: animals with ventricular hypertrophy were treated with perindopril 2 mg?kg~-1?d~-1 ig, irbesartan 20 mg?kg~-1?d~-1 ig or irbesartan 20 mg?kg~-1?d~-1 ig plus perindopril 2 mg?kg~-1?d~-1 ig, respectively. Left ventricular mass index (LVMI), transverse diameter of myocardial cell (TDM), and myocardial expression of CX43, desmin and cTnT by immunohistochemistry were performed at the end of 8 weeks of drug intervention. RESULTS: LVMI, TDM were remarkably decreased after drug intervention, compared to animals of operative group (P

Objective: To observe the clinical efficacy of umbilical therapy with herbal cakes made of Ge Gen Qin Lian Tang prescription of different dosages in treating damp-heat diarrhea in young children. Methods: Seventy-two kids with diarrhea of damp-heat pattern were recruited and divided into a high-dosage group and a low-dosage group using the random number table method, with 36 cases in each group. They all received conventional antidiarrheal treatment and umbilical application with herbal cakes. However, the herbal cakes for the high-dosage group were made of the mixture of Ge Gen Qin Lian Tang powder and water, and those for the low-dosage group consisted of 10％ Ge Gen Qin Lian Tang powder and 90％ auxiliary materials (corn starch) plus water. The treatment duration was 3 d. The clinical efficacy, antidiarrheal rate, effective rate for symptoms and signs of traditional Chinese medicine (TCM), TCM symptoms score, and safety indicators were compared between the two groups. Results: After the treatment, the TCM symptoms scores dropped significantly in both groups (P<0.01) and were lower in the high-dosage group than in the low-dosage group (P<0.05). The clinical efficacy was more significant in the high-dosage group than in the low-dosage group after the treatment, and the between-group difference was statistically significant (P<0.05); the antidiarrheal rate was markedly higher in the high-dosage group than in the low-dosage group (P<0.05). Regarding the TCM symptoms and signs, the high-dosage group showed better results in improving the greasy and yellowish tongue coating, bowel movement frequency, watery excrement, short and dark urine, red tongue body, red anus, vomiting, bowel sounds, and abdominal bloating compared with the low-dosage group, and the between-group differences were statistically significant (P<0.01). Conclusion: Umbilical therapy with herbal cakes made of Ge Gen Qin Lian Tang is safe, reliable, and effective in treating damp-heat diarrhea in young children; the high-dosage herbal cakes produce more significant efficacy than the low-dosage ones and are worth further investigation.

MicroRNA (miRNA for short) can induce mRNA cleavage or inhibit mRNA translation and regulate gene expression in the post-transcriptional level, which involves cell development, proliferation, differentiation, apoptosis, and a series of important biological processes. Recent studies have found that the abnormal regulation of miRNA's target genes may be involved in tumor resistance. And it is expected to become important tumor resistance-associat-ed molecular markers and therapeutic targets. Mechanism of traditional Chinese medicine (TCM) and its active ingre-dients can affect miRNA to regulate target proteins and target genes mediated tumor multidrug resistance. It can pro-vide new ideas for the mechanism of reversing multidrug resistance by TCM.

AIM: To investigate the correlation between renal transforming growth factor-?1 (TGF-?1) expression and cellular apoptosis, and effect of tea polyphenols (TP) on TGF-?1 expression and apoptosis. METHODS: Four group animals in a rat model of CsA-induced chronic nephrotoxicity were respectively treated by vehicle (olive oil, 0.1 mL?kg~(-1)?d~(-1), sc), TP (80 mg?kg~(-1)?d~(-1), ig), CsA (15 mg?kg~(-1)?d~(-1), sc) and TP (80 mg?kg~(-1)?d~(-1), ig) plus CsA (15 mg?kg~(-1)?d~(-1), sc). At the end of 28th day of treatment, renal creatinine clearance and tissue pathology were analyzed. The TGF-?1 expression was detected by immunohistochemistry and Western blotting. TUNEL assay, apoptosis-related enzymatic activity caspase-3 were also detected. RESULTS: Compared to CsA-treated rats, the animals treated with CsA plus TP showed a significant increase in the renal creatinine clearance (0.12?0.03 vs 0.22?0.02,P