Objective To investigate the feasibility of kidney sparing operation in the surgical treatment of calculous pyonephrosis. Methods 31 cases of calculous pyonephrosis were treated by nephrolithotomy or ureterolithotomynephropyelostomy with a double J catheter stent in the ureter.23 cases have been followed up and evaluate. Results The renal function returned to some extent in 78.3%(18/23).However,renal atrophy was observed in 21.7%(5/23) one year after and stone recurrence in 13%(3/23). Conclusions Calculous pyonephrosis of short course on reliving the obstruction would cause the return of renal blood circulation and renal function in near 80.0% of the cases.Thickness of the remaining renal cortex might not be the sole parameter to keep the kidney or not.To save the kidney in calculous pyonephrosis of short course might be feasible.

Objective To study the clinic characters of patients with latent autoimmune diabetes in adults (LADA). Methods We evaluated the prevalence of acute and chronic complications in the LADA patients with serum antibodies to glutamic acid decarboxylase (GADA) or to islet cell cytoplasmic antigens (ICA). The prevalence of acute and chronic complications were further compared with that in patients with acute onset type 1 or type 2 diabetes. Results The mean age, BMI, fasting and postprandial C peptide levels of the LADA patients were higher than those of type 1 diabetes and lower than those of type 2 diabetes. Of the LADA patients, 29.3% had ketosis. Although the frequency of repeated attack of ketosis in the LADA patients was similar to that in type 1 diabetes, the duration from diabetic onset to first ketosis in the LADA patients was much longer. The prevalence of retinopathy in the LADA patients was 19.5%, which was similar to that in type 1 diabetes. The prevalence of cataract in the LADA patients was 48.8%, which was similar to that in type 2 diabetes. Less LADA patients had microalbuminuria, compared with the other groups. There was no difference in the prevalence of overt nephropathy, neuropathy and hyperlipidemia among the three groups. The prevalence of coronary heart disease in the LADA patients was similar to that in type 2 diabetes. The prevalence of hypertension in the LADA patients was higher than that in type 1 but lower than that in type 2 diabetes. Conclusion The clinic characters as well as acute and chronic complications in LADA patients are different from those in type 1 and type 2 diabetes.

Objective To investigate the value of quantitative analysis of spectrum CT in the differential diagnosis of lung cancer and tuberculosis in unenhanced phase.Methods Data of 51 patients with solitary pulmonary nodules or masses confirmed by pathology who underwent chest unenhanced spectrum CT were retrospectively analyzed.There were 36 cases of peripheral lung cancer (lung cancer group) and 15 cases of tuberculosis (tuberculosis group).The differences of 40～ 140 keV single energy CT value,shape and slope of energy spectrum attenuation curve,different base material of concentration values and effective atomic number (Eff-Z) between the two groups were compared.Results The single energy CT values of 40～70 keV in lung cancer group were higher than those in tuberculosis group (all P＜0.05),while no significant difference of the single energy CT values of 80～140 keV were found in both two groups (all P＞0.05).The shape of energy spectrum attenuation curve of lung cancer group was fast express reduction (36/36,100％).The energy spectrum attenuation curve of tuberculosis group showed walked straightly (11/15,73.33％) and back up type (4/15,26.67％).The slope of the energy spectrum attenuation curve in lung cancer group (K40～ 65 key,K65～90 kev,K90～140 kev)were higher than those in tuberculosis group (all P＜0.01).The calcium (water) concentration of lung cancer group was higher than that of tuberculosis group (P＜0.01),while the lipid (water) concentration of lung cancer group was lower than that of tuberculosis group (P＜0.01).The water (calcium) concentration in both groups was not statistically different (P=0.10).The Eff-Z of lung cancer group was higher than that of the tuberculosis group (P＜0.01).Conclusion The peripheral lung cancer and the tuberculosis have different energy spectrum CT quantitative parameters in unenhanced phase,which can provide valuable informations for diagnosis.

Objective To evaluate the efficacy of puerarin for prevention of brain injury in the patients undergoing open heart surgery under cardiopulmonary bypass (CPB).Methods Thirty ASA physical status Ⅲ patients of both sexes,aged 50-64 yr,weighing 50-75 kg,scheduled for elective cardiac valve replacement under general anesthesia,were randomly divided into 2 groups (n =15 each) using a random number table:control group(group C) and puerarin group (group P).Puerarin 400 mg was infused intravenously over 30 min immediately at skin incision in group P and the equal volume of 5％ glucose-sodium chloride injection was given in group C.Before induction of anesthesia (T0),at 30 min of CPB (T1),immediately after aortic unclamping (T2),and at 6,12 and 24 h after termination of CPB (T3.5),blood samples were collected from the jugular venous bulb for determination of the plasma concentration of neuron-specific enolase (NSE) and S-100 β protein.P300 eventrelated potential latency and amplitude were determined and cognitive function was assessed by Mini-Mental State Examination (MMSE) score at 1 day before surgery and 7 days after surgery.The patients were diagnosed as having post-operative cognitive dysfunction when MMSE score before surgery-MMSE score after surgery ≥ 2,or when M MSE score≤ 24.Results Compared with group C,the concentrations of plasma NSE and S-100 β protein were significantly decreased at T15,and P300 event-related potential latency was shortened,P300 event-related potential amplitude was increased,and the incidence of postoperative cognitive dysfunction was decreased at 7 days after operation in group P.Conclusion Puerarin can prevent the brain injury in the patients undergoing open heart surgery under CPB.

Based on the characteristics of the scientific research for the hospitM in new period,this paper studied on the construction of management regulations for the laboratory animal center combining the developing condition of the laboratory animal in the hospital.

The paper reviewed the medical service pricing at home and abroad and progress in the price comparison system,and introduced the price comparison system of Shanghai's medical services. Proposals in the paper include building the price parameters fitting local conditions,and setting prices using the standardized price model;forming a comprehensive price adjustment scheme with reference to international price comparison relations and domestic pricing level; upgrading the fine pricing management level of medical service pricing and improving charging management dimensions;enhancing interactions and assessment of price-related departments to guide public hospitals to enhance.

Oxaliplatin, a third-generation platinum-based compound with significant activity against tumors, has become pivotal for the therapy of cancer after cisplatin and carboplatin.The digestive tract reaction, myelosuppression and nephrotoxicity have been alleviated, however, oxaliplatin induced neurotoxicity occurs prominently.Therefore, how to effectively eliminate and prevent chemotherapy-induced side and toxic effects becomes a great challenge for oncologists.plenty of evidence has hinted that combination of Chinese herbal medicine and oxaliplatin can not only reduce the toxicity, but also improve the actual efficacy, clinical research and experimental researches on increasing off cacy and decresing foxcity of Chinese herbal medicine combined with oxali-platin in the treatment of cancer in recent years were rewewed.to provide reference for the clinical use of oxaliplatin-based chemotherapy regimen.

Objective To investigate the therapeutic effect of CTLA4Ig gene on experimental autoimmune thyroiditis (EAT) by the use of portable synthetic costimulatory molecules of cytotoxic T lymphocyte antigen 4 (CTLA-4) antagonist (CTLA4Ig) eukaryotic expression vector.Methods Thirty C57BL/6J female mice were divided into three groups,named EAT model group (EAT,n =10),CTLA4Ig-treatment group (CTLA4Ig-EAT,n =10) and control group(n =10).At 28 day after first immunization,plasmids mixture with pCI or pCI/CTLA4Ig were injected into thyroid tissues of EAT and CTLA4Ig-EAT by surgery,respectively.Serum,thyroid tissues and spleens were collected as samples.Thyroid autoantibody and expression of interleukin (Th)1,Th2 related cytokinesby were measured by real-time quantitative PCR and ELISA.Results Compared with EAT group,the expression of CTLA-4 in thyroid of CTLA4Ig-EAT group was elevated double folds (P =0.038),and the expression of Th1 cytokine interferon γ and intercellular adhesion molecule-1 decreased significantly (P =0.016,0.042).Meanwhile,Th2 cytokine IL-4 was increased after CTLA4Ig treatment (P =0.044).The same changes were seen in spleen tissues and serum.There was no significant difference in terms of TPOAb between EAT and treated group.Conclusion Local thyroid injection of CTLA4Ig gene shows the therapeutic effect to same degree on EAT through adjusting the underlying Th1/Th2 imbalance.

Objective To examine the chracteristics of distribution of the FGF R before and after the flap transplantation and the influence of exogenic bFGF on the distribution of FGF R. Method Caudally based random skin flaps were raised on the backs of Wistar rats,bFGF was instilled under flaps after closure.An immunohistochemical techniques stanining method was used. Results FGF receptors distributes in the stratum basal of epidermis,the vascular endothelial cells in the dermis and hypodermis,the fibroblasts and the epithelial cells of the hair follicle and the sweat gland.In compared with preoperation,the quantity of increased gradually from the 1st day to the fifth day after operation,and the peak value is on the fifth day,it then recovered to the pre operation level on the serventh day.After applying the exogenic bFGF,the positive immunoreactive cells in the experimental group,increased remarkably from the Ist day to the 3rd day after operation in contrast with the control group.The peak value is on the 3rd day which was two days earlier than that of the control group and the peak value of the experimental group is remarkably higher than that of the control group.Conclusion\ FGF R distributes in the stratum basal of epidermis,the vascular endothelial cells in the dermis and hypodermis,the fibroblasts,and the epithelial cells of the hair follicle and the sweat gland.In compaired with pre operation,the quantity of the positive immunoreactive cells of FGF R were increased gradually from the Ist day to fifth day after operation,and the peak value is on the fifth day.After applying the exogenic bFGF,the positive immunoreactive cells of FGF receptors were increased.\;[