BACKGROUND:Pneumatic lithotripsy and holmium laser lithotripsy for distal ureteral calculi have their own advantages and disadvantages in efficacy and complications, but both of them are currently better treatments. ＜br> OBJECTIVE:To compare the efficacy and safety of holmium laser lithotripsy and pneumatic lithotripsy for the treatment of distal ureteral calculi through a meta analysis. ＜br> METHODS:A online search of China Biological Medicine disk, PubMed, Cochrane Library, Springerlink, Medline, and Embase databases was performed from March 1999 to December 2013. A manual retrieval of relevant journals was also done for clinical trials about holmium laser lithotripsy and pneumatic lithotripsy for treatment of distal ureteral calculi. RevMan 5.1.5 software (Cachrane Library) was used for meta analysis. The fol owing indexes were used to compare the results:mean operative time, early stone free rate, stone migration rate, ureteral perforation rate, postoperative hematuria rate and retaining double-J catheter rate. ＜br> RESULTS AND CONCLUSION:Four prospective studies (a total of 275 patients) were enrol ed, and there were 140 cases in the group of holmium laser lithotripsy and 133 cases in the pneumatic Lithotripsy group. Holmium laser lithotripsy conveyed significant benefits compared with pneumatic lithotripsy in mean operative time [WMD=-16.38, 95%CI (-20.29,-12.47), P＜0.000 01], stone migration incidence [OR=0.25, 95%CI (0.10, 0.63), P=0.003], retaining double-J catheter rate [OR=0.44, 95%CI (0.25, 0.78), P=0.004], while early stone free rate, postoperative hematuria rate and ureteral perforation rate had no significant changes between the two groups. Compared with pneumatic lithotripsy, holmium laser lithotripsy can shorten mean operative time and reduce the stone migration rate. Because of the lack of prospective studies and smal sample size, large-sized randomized control ed studies are urgently needed to provide evidence.

Objective To screen the conservative,stable and specific DNA signature sequence in the plasmid of Yersinia pestis.Methods Specific validation trials and stability of the qualification test were carried out to 40 strains of Yersinia pestis,47 strains of non-Yersinia pestis of home and wild types of rodent in Yunnan,by using 32 DNA sequences derived from Yersinia pestis in the plasmid and conventional PCR technology,and Yersinia pestis vaccine strain EV76 as a positive control.Results Four pairs of relatively conservative,stable and specific DNA marker genes were screened:YPMT1.05c,YPMT1.03c,YPMT1.42 and YPMT1.04c.Conclusions The 4 pairs of Yersinia pestis DNA signature sequences can be used for rapid diagnosis of plague.

Objective To establish a rat model of chronic nonbacterial prostatitis (CNP) and investigate the histopathological characteristics of CNP in rat. Methods The prostate tissues of 4 male SD rats were taken out under aseptic condition,and prostate tissue homogenate supernate (PTHS) was made.Another 20 male SD rats were randomly divided into control group and CNP group with 10 rats each.Each rat of group CNP was immunized with 1.0 ml PTHS (20 mg/ml) emulsified by isopyknic Freund's complete adjuvant (FCA) intradermally in the multiple points,and simultaneously immunized with 0.5 ml pertussisdiphtheria-tetanus (PDT) vaccine intraperitoneally on 0 and 30th day.Each rat of control group was injected with equivalent normal saline in the same way.Rats from each group were sacrificed 45 days after immunization,and the prostates were harvested under aseptic condition.Prostatic tissues were examined macropathologically and histologically for degree of inflammation.Another 80 CNP rats were established after confirming success of the modeling.They were divided into high-dose androgen group (H),medial-dose androgen group (M),low-dose androgen group (L) and control group (C) with 20 in each.Rats of group H,M and L were injected with different concentrations of testosterone propionate ( 1,2,4 mg/ml).Rats of group C were injected with sterilized peanut oil.O.5 ml was applied through subcutaneous injection every other day.Each group was equally divided into 4 subgroups,in which the durations of medication were 1,2,4 and 6 weeks,respectively.After the expiration of the injection,animals from each subgroup were sacrificed and the macropathological and histological features of the prostatic tissues were examined as above. Results Macroscopic features of prostate tissues of group CNP at the 45th day were serious congestion and edema,adhesion with surrounding tissues,aneretic prostate capsule and so on.Histologically,the prostatic tissues were characterized by lymphoid tissue proliferation and chronic inflammatory cell infiltration in the stromal connective tissue around the acini or ducts.The rats of control group showed no inflammatory manifestations as above.After injection of testosterone propionate,the inflammatory degree of the CNP rats was lessen in varying degrees.For example,the destructive glands and stroma appeared repair and regeneration,the lymphoid tissue proliferation was alleviated,and the locations,ranges and amount of chronic inflammatory cell infiltration were also decreased.Furthermore,the relief of inflammatory degree had a positive correlation with the concentration and duration of testosterone propionate.The degree of inflammation in group C scarcely changed. Finally,the histopathological characteristics of CNP in rat model were summarized according to the results of histopathology,including inflammation locations,ranges and grades.Inflammation locations:①inflammation in the glands referred to the inflammatory cell infiltration in the ductal epithelium,alveolar epithelial and (or)glandular cavity; ②inflammation in the periglandular tissues referred to the inflammatory cell infiltration in the stroma and around the glandulartube; ③inflammation in the stroma referred to the inflammatory cell infiltration in the stroma without the glandulartube.Inflammation-rangeg:①focal inflammation indicates that the area of inflammatory cell infiltration was less than 10％ ; ②multifocal inflammation indicates that the area of inflammatory cell infiltration ranged from 10％ to 50％ ; ③diffuse inflammation indicates that the area of inflammatory cell infiltration was more than 50％.Inflammation grades:①grade Ⅰ meant that scattered inflammatory cells were in the specific area,cell count 1 - 10/HP; ②grade Ⅱ meant that inflammatory cell assembled without glandular epithelial tissue destruction or lymphoid nodule/follicle formation,cell count l1 -20/HP; ③grade Ⅲ meant that inflammatory cell assembled with part of glandular epithelial tissue destruction or lymphoid nodule/follicle formation,cell count ＞ 20/HP; ④grade Ⅳ meant that inflammatory cell assembled with a mass of glandular epithelial tissue destruction or lymphoid nodule/follicle formation,cell count full field of vision/HP. Conclusions The CNP rat model can be established by immunized with syngeneic PTHS plus FCA and PDT.The histopathological characteristics of CNP in rat can be evaluated according to the locations,ranges and grades of inflammation,which serve for further research of pathogenesis and treatment of this disease.

Animals ; Codonopsis ; chemistry ; Diabetes Mellitus, Experimental ; drug therapy ; Female ; Male ; Mice ; Polysaccharides ; therapeutic use

‘University and college students' innovative ability training plan’ were launched from 2009 in Second Military Medical University. The innovative thinking and practical ability of students were improved by participation in research projects, writing scientific papers, academic exchanges and other activities. Students' innovative thinking, practice ability and cooperative spirit were promoted and unifica-tion of teaching and learning was achieved.

Previous researches showed that the expression level of E-Cad in most infiltrating cancer cells was reduced or negative. This study explored whether 4HPR restrained the infiltration of bladder cancer cells through regulating the expression of E-Cad. The infiltrating bladder cancer cells T24 were cultured, and then treated by a proper dosage of drug. Their viability was a determined by MTT method. Western blotting and RT-PCR were adopted to detect the changes of E-Cad gene expression at both protein and mRNA levels. Moreover, immunofluorescent staining and confocal fluorescence microscopy were employed for the observation of the expression of E-Cad. The result showed that, at both mRNA and protein levels, the expression level of E-Cad in T24 cells treated by 4HPR was significantly higher than that of control group, while the β-Cat expression was also relocated from the cell nucleus to cytoplasm. Our findings suggested that the regulatory function of 4HPR on infiltration of bladder cancer cells T24 is at least partly achieved by regulating the expression of E-Cad.

Objective To compare the efficacy and safety of nicardipine versus urapidil in blood pressure (BP) management during the acute phase of intracerebral hemorrhage (ICH).Methods ICH patients admitted in Emergency Intensive Care Unit of Shenzhen People's Hospital from March,2013 through March,2016 were retrospectively studied.Patients were enrolled as nicardipine group or urapidil group depending on the initial antihypertensive drug given at admission.The differences in rate of patients reached the goal BP within the first 24 h,time required for getting goal BP,blood pressure variability (BPV),rebleeding or hematoma expansion during the first 24 h,cerebral state index (CSI) within 7 days and 28-day mortality were compared between the two groups.The differences in adverse events including bradycardia,tachycardia and hypotension were also compared between two groups.An independent t test and x2 test were performed to compare different variables.An analysis of variance of repeated measurement was performed to compare CSI within 7 days between two groups.Results Seventy-seven patients were included with 42 in nicardipine group and 55 in urapidil group.Rate of patients getting goal BP in nicardipine group was (94±5)％ and (86±11)％ in urapidil group (P＜0.01).Time required to get goal BP was (35 ± 28) min in nicardipine group and (52 ± 37) min in urapidil group (P =0.02).BPV was (11.23 ± 2.38) in nicardipine group and (13.16 ± 3.15) in urapidil group (P =0.003).Rebleeding or hematoma expansion rate during the first 24 h and 28-day mortality rate were comparable between the two groups (P ＞ 0.05).Through analysis of variance of repeated measurement,CSI in nicardipine group improves more rapidly than that in urapidil group (F =1 581.115,P =0.000).Hypotension,bradycardia and tachycardia were also comparable between groups (P ＞ 0.05).Conclusion Compared with urapidil,nicardipine produces effect more rapidly with more stable BP and higher rate of patients with ICH getting goal BP.Moreover,the application of nicardipine may be better to improve the CSI of ICH patients.

Objective To explore the expression of nestin and Ki-67 in malignant peripheral nerve sheath tumors (MPNST) and its significance in the differential diagnosis. Methods Immunohistochemical technique (SP) was used to detect the expression of nestin and Ki-67 in 42 cases of MPNST and 24 cases of benign peripheral nerve tumor.Results Total expression of nestin was found in 95.2 ％(40/42) of MPNST.Strong expression of nestin was detected more frequent in MPNST compared to benign peripheral nerve tumors [40.5 ％(17/42) versus 4.2 ％(1/24),x2 =8.403,P =0.004].Ki-67 labeling index in MPNST varied from 1％-70 ％.However,greater than 3 ％ labeling index of Ki-67 staining was observed in 64.3 ％(27 / 42) of MPNST while none of the 24 benign tumors had nuclear staining exceeding 3 ％. The higher Ki-67 labeling index showed significant differences between the two groups (x2 =23.518,P =0.000).Conclusion Nestin and Ki-67 are useful markers in distinguishing MPNST from benign tumors.

Objective To establish a hyperacute rejection model in ABO-incompatible renal allotransplantation in nonhuman primates.Method ABO-incompatible renal transplantation was performed using blood group B cynomolgus monkeys as recipients and blood group A cynomolgus monkeys as donors.The transplants were distributed into 2 groups according to whether the recipient monkey was presensitized or not:(1) non-presensitized control group (n =1),not receiving any pretreatment; (2) KLH-conjugated blood group antigen A (KLH-A) presensitized group (n =3),being presensitized by subcutaneous injection of KLH-A 2 weeks prior to ABO-incompatible renal transplantation.The serum anti-blood group A antibody levels were measured using a FACS method.The graft survival time was observed and the pathologic studies were performed using the endpoint renal graft tissue samples.Result In non-presensitized control group,no hperacute rejection was observed during the surgery.With the traditional CsA triple therapy,the renal allograft survived was more than 30 days without obvious rejection,and the serum creatinine level was 263 μmol/L at day 30.After the presentization with KLH-A,recipient monkeys of KLH-A presensitized group had a markedly increased anti-A antibody levels and rapidly rejected the renal allografts from blood group A donors within 1 h after the reperfusion,which was demonstrated to be a hyperacute rejection with the pathologic studies.Conclusion The strategy of presensitization with KLH-conjugated blood group antigen significantly increases the corresponding blood group antibodies and allows the establishment of a hyperacute rejection model in ABO-incompatible renal allotransplantation in nonhuman primates.

ObjectiveTo investigate the diagnosis and treatment of adrenocorticotropin-independent macronodular adrenal hyperplasia (AIMAH). MethodsThe clinical data of 14 cases of AIMAH from August 1972 to July 2010 were retrospectively analyzed.The cases included 5 males and 9 females with a mean age of 45 (range 26 to 58 ) years.Ten patients demonstrated typical Cushing's syndrome (CS) and 4 patients presented with weight gain,hypertension or diabetes mellitus without any signs of CS.The circadian rhythm of serum cortisol was abnormal.Low and high dose dexamethasone suppression tests failed to suppress cortisol secretion.CT scan showed bilateral enlargement of the adrenal glands with multiple macronodules.All patients underwent open surgery,including 5 cases of unilateral adrenalectomy,6 cases of adrenalectomy combined with contralateral subtotal adrenalectomy and 3 cases of bilateral adrenalectomy.ResultsIt was established by pathological examination that all patients had bilateral adrenal macronodular or adenomatoid hyperplasia.During the mean follow-up of 69 months (range 12 to 120 months),the clinical symptoms of CS disappeared after surgery in all cases.The 5 patients who received unilateral adrenalectomy had urinary free cortisol and serum cortisol within normal ranges and no further enlargement of the contralateral gland was noticed.Among the 3 patients who received bilateral adrenalectomy,1 case died of adrenal crisis on day seven post-operation.The remaining 2 cases presented with adrenal insufficiency but returned to normal after glucocorticoid replacement therapy.Nelson's syndrome was not observed in the other patients.ConclusionsAIMAH has unique endocrinological and pathological features,presenting as an independent etiology of CS.Unilateral adrenalectomy appears to be an effective and safe alternative treatment for AIMAH and long-term remission can be achieved.Bilateral adrenalectomy or unilateral adrenalectomy combined with contralateral subtotal adrenalectomy may be performed if the symptoms have not improved or recurred after unilateral adrenalectomy.