Objective To investigate the modified fixation method in clinical use of intravenous indwelling needle.Methods 100 cases of patients with venous indwelling needle in our hospital emergency center were randomly divided into the observation group and the control group with 50 cases in each.The control group used conventional method of fixation,while the observation group was given modified method of fixation.The fixation effect of the 2 groups was compared.Results In the observation group,48 cases was with normal extubation,2 cases with abnomal extubation; while in the control group,35 cases was with normal extubation,15 cases with abnormal extubation.The comparison between the two groups showed statistically significant difference.Conclusions In the process of clinical use of intravenous indwelling needle,the modified fixation method is superior to conventional fixation method,which is worthy of clinical use.

Objective To evaluate the efficacy and advantages of the technique by combined PCNL and retrograde intrarenal surgery (RIRS) in a second stage to treat the complex renal stones in solitary kidney cases.Methods PCNL most with a single 18-24 F tract was performed first and RIRS was carried out at a second stage in solitary kidneys of 21 patients,of which congenital in 14.3％ (3 cases),contralateral nephrectomy in 42.8％ (9 cases),and functional solitry kidneys in 42.8％ (9 cases).Of the 21 patients,the average age was 45 years with 15 males and 6 females.The stones were 8 multiple,6 partial staghorn,and 7 complete staghorn with a mean size of 4.6 (3.8-6.8) cm.Results Of the 21 PCNL cases,a single tract,double,triple tracts were established in 18 (85.7％),2 (9.5％),1 (4.8％) cases,respectively.Mean operation time of PCNL was 95 (45-175) min.After 1 day of PCNL,all case had residual stones with a mean size of 1.9 (1.0-3.5) cm.Two case occurred fever after PCNL and one case presented bleeding resolved by selective renal artery embolization.The mean operation time of RIRS was 72 (35-95) min.Stone-free rate after RIRS was 85.7％ (18/21).The final stone free rate increased to 95.2％ (20/21) after one case received a second-look PCNL and two cases accepted ESWL.Two cases occurred fever and steinstrasses after RIRS resolved by rigid ureteroscopy.At the 3 months follow-up,renal function became stable,improved and worse in 71.4％ (n=15),23.8％ (n=5),and 4.8％ (n=l) of patients.Conclusions PCNL combined with RIRS could be an effective and safe option for complex stones in solitary kidneys with less bleeding,reduced tracts,minor complications and good renal function preservation.

This paper analyzed innovative education management system,innovative education resources,innovative education mode and innovative education evaluation standard through practicing‘integration of production,study and research’ teaching platform. Meanwhile,this paper explored the optimization system of innovative education in medical undergraduate teaching.

0.05),there was not statistically different before and after HIFU. However,the normal myometrium after HIFU enhanced obviously just as that before treatment. Conclusion MRI was useful for the evaluation of the intensity, volume changes and the blood supply in leimyomas before and after HIFU.

Objective To clone.and express Tp0453 outer membrane protein of Treponema pallidum and develop an indirect ELISA for sero diagnosis of syphilis. Methods The immuno-dominant epitope of Tp0453 was amplified by PCR and subcloned into the expression vector pQE32.The recombinant protein was expressed in E.coli M15 and purified with Ni-NTA affinity chromatography columns. Indirect ELISA was developed to detect the antibody to Tp in human sera.Results 60 control sera was tested by ELISA.The sensitivities was 100%(30/30), and the specificities was 100%. While detecting uninfected and infected T. pallidum human sera, the sensitivities of ELISA was 96.8% compared with the results of the TPPA tests, and the specificities was 100% when the results of ELISA was compared with those of the TPPA test. The concordance of results between the ELISA test and the TPPA test was 98.2%.Conclusion The recombinant Tp0453 outer membrane protein showed excellent immuno-reactive activity, and were suitable for development of ELISA for sero-diagnosis of syphilis.

Objective To evaluate therapeutic effects of endovascular therapy for in-stent restenosis of superficial femoral artery,and the risk factors of restenosis of re-intervention therapy.Methods We retrospectively summarized the clinical data of 35 patients(38limbs)who suffered from in-stent restenosis of superficial femoral artery(SFA)stent from 2010 to 2012.Results 35 patients (38 limbs)were enrolled in this study,there were 24 males and 11 females.Mean age was (68 ±8)years.The success rate of endovascular therapy was 89.5％ (34/38),including in-stent angioplasty in 14 limbs,in-stent and beyond-stent angioplasty in 5 limbs,in-stent angioplasty and beyond-stent re-stenting in 15 cases.The primary patency and sencondary patency rate for 6,12 and 24 months was 65.2％,46.5％,46.5％,and 87.5％,80.2％,55.8％ respectively.The independent risk factors for re-obliteration were age ＞ 70 years (P ＜ 0.05) and diabetes mellitus (P ＜ 0.05).Conclusions Endovascular therapy is effective and safe in treatment in-stent restenosis of superficial femoral artery.The long-term in-stent patency is not satisfactory,with age ＞ 70 years and diabetes mellitus as independent risk factors.

With the development of basic disciplines such as molecular biology,immunology,cell biology and so on. the pathogen biology research do not stop at the organ and cellular level,but go deep into the protein and gene level. It is a great boost to the deep studies of pathogen biology in diagnosis,treatment,pathogenesis,prevention and epidemiology.

PurposeTo analyze the urinary stone chemical composition using dual source CT (DSCT) dual energy imaging.Materials and MethodsNinety-seven stone samples with known chemical composition were placed in fresh swine kidneys and examined with DSCT dual energy scan, including 55 calcium oxalate stones, 13 hydroxyapatite stones, 9 uric acid stones, 4 cystine stones, 2 struvite stones and 14 mixed stones. The mean attenuation values and dual energy index (DEI) were measured at 80 kV and 140 kV. The stone composition was analyzed to determine the sensitivity, specificity and accuracy.ResultsDual energy analysis showed 59 calcium oxalate stones, 11 hydroxyapatite stones, 9 uric acid stones, 4 cystine stones and 14 mixed stones. 2 hydroxyapatite stones were erroneously marked as calcium oxalate stones and 2 struvite stones as calcium oxalate stones. The accuracy was 95.88% (93/97). The difference CT value at 80 kV and 140 kV and DEI value were statistically significant (P<0.05). The sensitivity for detecting calcium oxalate stones, hydroxyapatite stones, uric acid stones and cysteine stones were 100.00%, 84.60%, 100.00% and 100.00%, respectively; with specificity of 85.70%, 100.00%, 100.00% and 100.00%, respectively; and the accuracy were 95.18%, 97.59%, 100.00% and 100.00%, respectively.ConclusionDSCT dual energy imaging accurately analyzes the chemical composition of urinary stone in vitro, which provides important clinical value in analyzing the urinary stonesin vivo.

Objective To compare the efficiency between mini-percutaneous nephrolithotomy (MPCNL) and extracorporeal shock wave lithotripsy (ESWL) for monotherapy of renal calculi in infants less than 3 years.Methods Forty-six infants were treated with either SWL (22 infants) or MPCNL monotherapy (24 infants).The mean age was (22.6 ± 8.7) months vs (23.5 ± 6.6) months and the stone size was (21.4 ± 3.5) mm vs (21.7 ± 1.7) mm,and there were no significant difference.Results For MPCNL,mean operating time was (76.2 ± 23.4) min and mean hospital stay was (14.13 ± 5.8) d.The stone-free rates were 84.0％ (21/25) after first session and 96.0％ (24/25) after second-look procedure.Postoperative fever happened in 4 (16.0％) cases.Hemoglobin drop was (8.5 ± 4.4) g/L and no one needed blood transfusion.For ESWL,the stone-free rate were 31.8％ (7/22) after first session and 86.3％ (19/22) after second session for 11 infants (50.0％).Mean hospital stay was (6.6 ± 2.3) d and 10 cases (45.5％)had complications.Hemoglobin drop was (10.6 ± 12.7) g/L.MPCNL was lower than ESWL in complications rate and re-treatment rate,and the stone-free rate was higher,but the hospital stay and operation time was longer (P ＜ 0.05).GFR revealed improve or stable after operation in both groups.Conclusions For a higher success rate,lower complication rate and re-treatment rate,MPCNL was an effective option for the management of relatively larger stones in children (even in infants).

Objective To prepare a detective membrane strip for detection of food allergen-specific IgE in serum samples and estimate its clinical application value in allergic diseases. Methods The crude extracts of the food allergens were prepared. Nitrocellulose membrane as the solid support was selected and the coating and the detecting conditions were optimized. The membrane strips were used to detect serum samples in 210 patients with allergic diseases and the results were compared with German Allergy Screentesting system. Results The optima] experimental conditions were as follows: The NC membrane was adopted as the solid support. After being spotted, the food allergens were incubated for 2 hours at room temperature, followed by 2% PVA blocking for 1 hour. After serum samples were diluted (1: 10) and incubated for 2 hours at room temperature, the concentration of anti-human IgE was 2 μg/mL Compared with the German Allergy Screen-testing system, their positive detectical coincidence was 63.6%, and negative detectical coincidence was 94. 6%. The two methods had no difference in detecting the majority of food allergens such as egg white, milk, peanut, soybean, crab and shrimp (X2 2.53, 2.40, 2.08, 2.38, 0.17,1.13, P>0.05). Conclusions The advantages of our method for detecting allergic diseases are little serum needed, multiple detective allergens, simple manipulation and low cost. This method has obvious clinical application value, which should be a new detective method for the allergic diseases with broad perspectives.