Objective:To study and sum up the experience of diagnosis and treatment of ureter obstruct by Simplification ureteroscope.Methods:the patients of 750 cases for ureterolith underwent ureteroscopic lithotomy and pressune orbit lithotripsy by using caudal anesthesia in outpatient the 11 cases ureterostensis were treated by watery capus expand,ureteroscopic hard expand and ureterotectomy by using of self-made electrode.Then,transurethral electro incisions of ureterocles were carried out for 2 patients.Results:Successful rate of ureteroscopic lithotomy is 98.4%;12 patient of upper ureter stone received ESWL because of stone entering the renal pelvis,and 3 cases complicated ureteral perforation;11 cases ureterostensis and 7 cases ureterocele were cured.Conclusions:It is frist chosen for ureteroscope to ureteral stone,ureteral stricture,and ureteroceles with a diameter of ≤3cm,and the method have ideal cure effect and the patients will receive.

BackgroundThe study of the molecular mechanism of visual plasticity is helpful for the explaining and prevention of strabismus and amblyopia.The effect and significance of NogoA in the strabismus and amblyopia formation are attracting more attention.ObjectiveThe present study was to investigate the expression of NogoA in 21a area of visual cortex in strabismic-induced amblyopia cats and explore the possible molecular mechanism of strabismic-induced amblyopia.MethodsSixteen 4-week old clean cats were randomizedly divided into normal group and strabismic-induced amblyopia group and eight for each group.The strabismic-induced amblyopia models were created by cutting off the external rectus in 8 cats.Pattern visual evoked potentials ( P-VEP ) were recorded 1 week after operation and compared with normal cats,and depression of amplitude and prolongation of implied time of P100 wave were as the successful criterion of model.The 200 ml paraformaldehyde was infused via heart to fax the brain under the deep anesthesia and then the cats were sacrificed and the brain cortex sections were prepared.The morphology of 21a zone of cat visual cortex was examined by haematoxylin and eosin staining,and the expressions of NogoA in 21a area of visual cortex were detected by immunohistochemistry with a monoclonal antiNogoA antibody.The use of the animals complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.ResultsThe implied time and amplitude ratio of VEP P100 wave were (98.10±7.07)ms and (0.83±0.14) in normal group,and those in strabismic-induced amblyopia group were (108.50±6.95 )ms and (0.35 ±0.09 ),showing significant differences between two groups (t=4.450,P=0.005 ; t =5.970,P =0.005 ).The numbers of neurons were similar in 21a area of visual cortex between the two groups,but the volume of the neurons was lessen in strabismic-induced amblyopia group.The positive cell densities for NogoA were ( 387.37±2.01 ) cells/mm2,( 354.58± 1.85 ) cells/mm2 and ( 289.68± 1.81 ) cells/mm2 in layer Ⅱ/Ⅲ,Ⅳ and V/V[ respectively in strabismic-induced amblyopia group,and those in normal group were ( 161.39± 1.98 ) cells/mm2,( 128.93 ± 1.26 ) cells/mm2 and ( 96.25 ± 1.49 ) cells/mm2,indicating a significant increase in model cats ( t =- 160.400,- 201.890,- 164.740,P =0.000 ).Conclusions NogoA may play an important role in the regulation of the sensitive developmental period of visual sense and its plasticity.

Background Lowing intraocular pressure (IOP) is the only effective treating method in glaucoma.Making sure the change of optic disc parameters and retinal nerve fiber layer thickness(RNFLT) in primary open-angle glaucoma (POAG) patients after IOP reduced can provide objective evidence for evaluating the effect of lowing-IOP on the function of optic nerve.Objective The present study was to evaluate the change of optic disc parameters and RNFLT in POAG patients after trabeculectomy,and analyze the affecting factors of image parameters.Methods A serial case-observational study was adapted.Forty eyes of 39 patients with POAG underwent trabeculectomy were recruited in the study.IOP was examined and perimetry was performed before operation and 2 weeks,1 month,3 months,6 months and 1 year after surgery.Optical parameters and RNFLT were measured using Heidelberg retina tomography (HRT) and optical coherence tomography (OCT) in above-mentioned time points.The correlations between lowing-IOP range or disease severity and optical disc parameters or mean RNFLT (mRNFLT) were analyzed by Pearson linear correlation.Results Mean IOP of the 40 eyes was (32.77±8.64) mmHg before operation and (12.45 ±3.65) mmHg,(13.05±3.90) mmHg,(13.42± 3.33) mmHg,(14.22± 2.60) mmHg and (14.74±2.46)mmHg 2 weeks,1 month,3 months,6 months and 1 year after operation,with a significant difference among various time points (F=13.73,P =0.00).However,no significant difference was seen in the mean defect of perimetry among the different time points (F=1.02,P=0.41).The cup area (CA),cup/disc area ratio (C/DAR),cup volume (CV),mean cup depth (MCD),cup shape measurement (CSM),horizontal C/D,vertical C/D,rim area (RA),rim/disc area ratio (R/DAR),height variation contour (HVC),rim volume (RV),mRNFLT,RNFL cross sectional area (RNFLA) were gradually improved after operation in comparison with before operation.One year after operation,RV,CSM,mRNFLT,RNFLA were still increased,but vertical C/D was reduced after operation than that of before (P＜0.05).No significant differences were found in the whole mRNFLT and superior quadrant mRNFLT,inferior quadrant mRNFLT,nasal quadrant mRNFLT and temporal quadrant mRNFLT among before and after operation (F=1.63,P=0.16; F=0.51,P=0.77; F=1.44,P=0.20;F=1.02,P=0.32; F=1.31,P=0.30).Positive correlations were found between lowing-IOP range and the improvement of RV,CSM,vertical C/D (r =0.45,P =0.02; r=0.41,P=0.04; r=0.58,P=0.00),and negative correlations were seen between absolute value of MD and the improvement of RV,CSM 1 year after operation (r=-0.43,P=0.03; r=-0.62,P=0.00).Conclusions Reduction of IOP after trabeculectomy results in the reversal of optic disc parameters.The improvement of the optic disc parameters may be a protective factor for progression of glaucomatous optical nerve damage.

Objective To assess the clinical efficacy and safety of transurethral plasmakinetic enucleation of prostate (PKEP) and suprapubic transvesical prostatectomy (SPP) in the treatment of large volume benign prostatic hyperplasia (BPH).Methods A total of eighty patients with large volume BPH were selected in the First People''s Hospital of Xuzhou from March 2014 to December 2016,and they were randomly divided into two groups,the PKEP group and SPP group,with 40 cases in each group.The comparison was made between the two groups in terms of operation indicators,postoperative complications followed up for 6 months after surgery and other related curative effect indexes.Results In the SPP group,the intraoperative blood loss was significantly higher than that of the PKEP group ((215.7±10.4) ml vs.(75.6±9.2) ml,t=6.541,P<0.05).There was no significant difference between the two groups in operation time and excised gland volume (P>0.05).But the catheterization time after operation,bladder irrigation time and length of hospital stay were significantly longer in the PKEP group than in the SPP group ((6.3±1.8) d vs.(2.4±0.6) d,(5.5±1.4) d vs.(1.3±0.6) d,(7.7±2.3) d vs.(3.1±0.7) d,t=4.357,2.542,2.975,P<0.05);in the 6-month follow-ups after operation,IPSS,Qmax,PVR and QOL were all significantly improved in both groups compared with the indexes collected before the operation (P<0.05),while there was no significant difference between the two groups (P>0.05).The rate of complication occurrence in the PKEP group were lower than that of the SPP group (P<0.05).Conclusion PKEP was effective in the treatment of BPH,with less bleeding loss,fewer complications and quick recovery.It can significantly improve the life quality of the patients and will be an ideal treatment for large volume BPH.

AIM:To evaluate the effects of pilocarpine, brinzolamide and the preservatives of them on corneal epithelial cells and the histopathology of rabbit conjunctiva. METHODS: Fifteen New Zealand white rabbits weighing 1.5 kg to 2.5 kg were randomly divided into three groups. One group with three rabbits served as untreated controls. Pilocarpine 1% and brinzolamide 1% each were administered to the right eyes in one treated group, and the preservatives (chlorobutanol 0.01% in pilocarpine, benzalkonium chloride 0.01% in brinzolamide) to the left eyes. Corneal epithelial damage was evaluated by scanning electron microscopy, and conjunctival specimens were examined under light microscopy. RESULTS: Compared with normal controls, brinzolamide and BAC caused corneal epithelium damage and increased number of inflammatory cells in the conjunctiva, while pilocarpine and the preservative chlorobutanol mainly influenced the corneal epithelium. Brinzolamide produced significantly more damage than pilocarpine (P

Brain Infarction ; diagnosis ; etiology ; therapy ; Cerebral Angiography ; Child ; Echocardiography, Doppler, Color ; Heart Atria ; Heart Neoplasms ; complications ; diagnosis ; surgery ; Humans ; Intracranial Embolism ; diagnosis ; etiology ; therapy ; Male ; Myxoma ; complications ; diagnosis ; surgery ; Pulmonary Edema ; diagnosis ; etiology ; therapy ; Thrombosis ; diagnosis ; etiology ; therapy

Objective To discuss the effects and methods of the surgical treatment of complex humeral nonunion.Methods Ten cases of scleroid humeral nonunion were treated by compressive interlocking medullary nailing and autografting of iliac bone.Fifteen cases of humeral nonunion combined with osteomyelitis or osteoporosis were treated with grafting of free vascularized fibular flaps.Results All the cases were followed up for six months to six years.They all obtained bone union.The average time of bone union was 3.1 months for the free vascularized fibular grafting group and 3.8 months for the interlocking medullary nail group.Conclusions Compressive interlocking medullary nailing and autografting of iliac bone is effective for scleroid humeral nonunion,while grafting of free vascu- larized fibular flaps is effective for humeral nonunion combined with osteomyelitis or osteoporosis because the free vas- cularized fibular grafting can well reconstruct the defective humerus bone with osteoporosis or osteomyelitis.

Objective To explore sub-clinical items in evaluating the prognosis of epileptic patients,the study on differences of regional cerebral blood flow (rCBF) in both effective treated and incomplete-controlled patients with idiopathic generalized tonic clonic seizure (GTCS) was carried out.Methods Interictal rCBF measurements using 99m Tc-ethyl cysteinates dimmer (ECD) SPECT was performed on 29 effective treated idiopathic GTCS patients and 12 incomplete controlled idiopathic GTCS patients. The rCBF distribution was semi-quantitatively analyzed by regions of interest (ROIs) comparing with abnormal rate of interictal hypoperfusion rCBF,clinical seizure time and EEG.Results ROI analysis showed that rCBF decreased in basal ganglia and thalamus of incomplete controlled patients with idiopathic GTCS compared to that of effective treated ones′ significantly ( P

Metastatic epidural compression of the spinal cord is a significant source of morbidity in patients with systemic cancer. With improvment of oncotheray, survival period in the patients is improving and metastatic cord compression is en- countered increasingly often. Surgical management performed for early circumferential decompression for the spinal cord com- pression with spine instability, and spine reconstruction performed. Patients with radiosensitive tumours without spine instabili- ty, radiotherapy is an effective therapy. Spinal stereotactic radiosurgery and minimally invasive techniques, such as vertebro- plasty and kyphoplasty, percutaneous pedicle screw fixation, radiofrequency ablation are promising options for treatment of cer- tain selected patients with spinal metastases.
Decompression, Surgical ; Humans ; Minimally Invasive Surgical Procedures ; Spinal Cord Compression ; therapy ; Spinal Neoplasms ; secondary ; therapy

Background Retinal retinoic acid (RA) plays an important role in the formation of the lensinduced myopia.However,it is not clear how RA transfer the myopic signal to choroid throughout the retinal pigment epithelium (RPE) barrier.Objective The aim of this study was to investigate the effect of all-trans retinoic acid (atRA) on the barrier of RPE in lens-induced myopic eye of guinea pig.Methods Thirty left eyes of 30 21-dayold clean guinea pigs were randomized into normal control group and the model group.The models of out of focus were induced by covering of-6.00 D concave lens on the left eyes for 15 days.Radius of corneal curvature was measured using corneal curvimeter,and diopeter of the guinea pig was examined by mydriatic optometry.The length of ocular axis was detected by A-sonography.The animals were sacrificed and the retinas of the left eyes were isolated for the culture and passage of RPE cells.The third generation of cells were incubated Millcell-PET microporous film,and atRA at the concentration of 1 × 10-6,1 × 10-7,1 × 10-8 and 1 × 10-9 mol/L was added to the micropore respectively for 12 hours,and the micropores with equal-solvent served as negative control group.Methyl thiazolyl tetrazolium (MTT)colorimetric method was used to detect the survival rate of the cells.Subsequently,the transepithelial electrical resistance (TER) of the monolayer cells was determined with CN10-EVOM2 resistance measuring meter.The vesicular transport change of RPE membrane in different groups was evaluated by FM1-43 fluorescence staining.Results The mean diopter was (-2.20±0.95) D in the models,and that in the controls was (+ 1.15 ±0.30) D,with a significant difference between them (t =14.57,P＜ 0.01).The axial length was (8.24 ± 0.09) mm in the models and it was significantly longer than (7.81±0.05) mm in the controls (t=17.20,P＜0.01).RPE cells grew well to form a monolayer in Millcell culture pool after one week.After 24 hours of the atRA treatment,the survival rate of RPE cells reduced gradually with the increase of atRA concentration with the highest rate in the 1 × 10-9 mol/L atRA group (93.3 ％) and followed by the 1 × 10-8 mol/L atRA group (88.2％).More than half of the cells dead in the 1 × 10-6mol/L and 1 × 10-7mol/L atRA groups (53.8％ and 47.1％).Significant differences in the TER value and fluorescence staining intensity of the cells were seen among the various groups (F =43.89,P =0.00 ; F =26.13,P =0.00),with the maximal values in the 1 × 10-8mol/L atRA group.The FM1-43 fluorescence located on the cellular membrane and cytoplasm.Conclusions AtRA can increase the functional state of tight junction and vesicular transport,which regulated the RPE cell barrier in the guinea pig.