Gallbladder Diseases ; Gallbladder Neoplasms ; Humans ; Polyps

Objective To investigate the recovery of affected side kidney function after upper urinary tract obstruction was relieved Methods 78 patients who had been diagnosed with upper urinary tract obstruction were enrolled from January to December of 2015 in our hospital.All patients received the surgery to relieve the obstruction.GFR of the affected side kidney was done after one months of the surgery.The average age was(51.3 ± 12.8)years old.The reason of obstruction was upper urinary tract calculi (72 cases) and upper urinary tract stenosis (6 cases) respectively.All the patients received CT and ECT before and after operation.All the patients was divided into 3 groups by the decreased degree of affected side kidney function,including moderately decreased group [15 rnl/min ≤ GFR ＜ 30 ml/min,n =43,mean value =(23.1 ±5.0) mL/min],severely decreased group [7.5 rnL/min≤ GFR ＜ 15 ml/min,n =23,mean value =(11.2 ± 2.3) ml/min],and extreme severely decreased group [GFR ＜ 7.5 ml/min,n =12,mean value =(4.3 ± 2.9)ml/min].Linear correlation analysis was used to analysis the relationship analysis between the GFR value (pre-operation,post-operation) and the renal cortical thickness.The follow up time of extreme severely decreased group extended to 8-12 months.Results The GFR of moderate decreased group recovered to(30.6 ± 8.5) ml/min,regained averagely (7.56 ± 7.62) ml/min;the severely decreased group recovered to (13.1 ± 4.5) ml/min,regain (1.94 ± 3.38) ml/min.Extreme severely decreased group recovered to (11.1 ± 3.4) ml/min,regained averagely (6.75 ± 4.76) rnl/min,the GFR mean value after operation 8-12 months recovered to (12.7 ± 3.6) ml/min.All groups got significant recovery of kidney function of the affected side.The correlation coefficient between GFR value and the renal cortical thickness was 0.59 (before the surgery) and 0.70 (after the surgery) respectively (P ＜ 0.05).Conclusions Most of affected side kidneys got different degree of recovery.Obstruction influenced the accuracy of ECT at the time of evaluating the actual renal function before operation.The kidneys which had been supposed should be resected in presurgical evaluation could recover to the level of kidney reserve after the surgery.

Objective:To investigate the effects of ursolic acid on proliferation and apoptosis of hepatic carcinoma cell line HepG2 and its partial mechanism.Methods:The human HepG2 cells were cultured by different concentrations of ursolic acid.The inhibitions of ursolic acid on cell proliferation were determined by using MTT.The effects of ursolic acid on on cell apoptosis and cell cycle were detected by using flow cytometry.The expressions of pERK1/2 and Cyclin D1 proteins after culturing by different concentrations of ursolic acid were tested by using Western blotting.Results:The human hepatoma HepG2 cell proliferations were inhibited by different concentrations of ursolic acid,and the effects showed dose and time-dependent manner(P＜0.05).The cell apoptosis rate for human hepatoma cell line HepG2 was achieved to the maximum under 60 μ mol/L ursolic acid for 72 h,which was (78.723 ± 3.623)％.Ursolic acid could significantly increase the Go/G1 phase cells proportion,and induce HepG2 apoptosis.Ursolic acid could inhibit the expressions of pERK1/2 and Cyclin D1 proteins,and inhibitory effects showed more apparent along with the concentration and time gradually increasing.Conclusion:Ursolic acid could inhibit the proliferation of human hepatic carcinoma HepG2 cell line,block of cells in G0/G1 phase,and promote the cell apoptosis.This might be related with down-regulation of the expressions of pERK1/2 and Cyclin D1 proteins.

Objective To summarise and analyze the clinical effecacy of endovascular treatment(internal holmium laser incision,bal-loon dilation,ureter dilator,rigid ureter dilation)for ureteral stricture.Methods The clinical data of 628 patients from January 2010 to Jan-uary 2015 in our hospital were analyzed.The relevant operation indicators,postoperative complications and recovery condition were recorded and analyzed.Results The operation time was 5.5 to 29 minutes,with average time of 16.5 minutes,no ureteral avulsion,ureteral fragmen-tation and massive haemorrhage happened.All patients were followed up for 6 to 36 months,591 cases(94.1%)were cured,29 cases (4.6%)of postoperative stricture recurrence received endovascular treatment again,8 patients(1.3%)conversion to open ureterolithotomy. Conclusion Endovascular treatment of ureteral stricture is diversified within holmium laser incision,it has the advantages of shorter opera-tion time,fewer complications,less trauma,repeatability and so on,which is an effective and safe treatment method.

Objective To investigate the clinical significance in diagnosis and prognostic judgments of acute myelocytic leukemia with combined detection of morphology ,peripheral blood and immune typing of bone marrow cells .Methods Microscopic examina‐tion of bone marrow cell morphology ,automatic blood cell analyzer detection of peripheral blood parameter and flow cytometry anal‐ysis of immune markers of leukemia cells ,all these datas were analyzed statistically .Results Peripheral blood cell analysis showed that instruments may indicate the presence of abnormal or naive cells in about 85% patients ,different kinds of leukemia had signifi‐cant difference in total leukocyte count (majority higher in M1 - 2 ,M5 ;majority lower in M3) ;while anemia and thrombocytopenia were observed in most patients ,but the degree was different ;M1 - 2 and M5 can not be identified by classification of leukocyte by automatic blood cell analyzer ,CD7 ,CD10 and CD2 can cross express in myeloid leukemia ,which have a prompt effect with treatment and prognosis .Conclusion Detection of peripheral blood parameters has an important role in early screening ,differential diagnosis and prognosis judgment of leukemia ,immunological markers detection is the powerful supplement and support for leukemia diagno‐sis and typing ,sensitive markers have close contact with prognosis ,which significantly improves the effect of the diagnosis and treatment of leukemia .

Objective To investigate the relationship of antithrombin‐Ⅲ activity and thrombosis risk in liver cirrhosis with Child‐Pugh classification .Methods In our hospital from June to December 2014 ,60 liver cirrhosis patients were selected randomly included into this experiment group ,The 60 cases of control group were from medical examination of health in our hospital .The plasma AT‐Ⅲ activity and D‐D concentration in all these cases were detected and analyzed .Results The AT‐Ⅲ in cirrhosis patients were significantly lower than which in healthy persons(P<0 .05) .The lower level of AT‐Ⅲ is in these patients which were in seri‐ous condition(P<0 .05) ,the abnormal rate of D‐D concentration is also higher at the same time(P<0 .05) .Conclusion The detec‐tion of AT‐Ⅲ level in patients with liver cirrhosis is directly related to the severity of clinical and thrombosis risk .The AT‐Ⅲ de‐tection level can be used to judge the patient′s condition and develop appropriate treatment strategies .

Objective To explore the clinical application of humoral mode of the Sysmex XE-5000 automatic blood cell analyzer in the count and differential count of hydrothorax and ascites white blood cell(WBC).Methods The 196 clinical specimens of hy-drothorax and ascites from the hospitalized patients were collected and conducted the WBC count and differential count by the hu-moral mode of the Sysmex XE-5000 automatic blood analyzer (streaming technology with semiconductor laser-instrument method) and the artificial microscope counting method (manual method).The specimens were divided into two groups according to the in-strument counting results,the group A:(0 -1 500)× 106/L and the group B:>1 500 ×10 6/L and the correlation between two methods was analyzed.Results The data analysis demonstrated that the two kinds of methods for detecting the WBC count and dif-ferential count of hydrothorax and ascites had good correlation,and the difference had no statistical significance (P >0.05).Conclu-sion The humoral mode of the Sysmex XE-5000 automatic blood cell analyzer has a good application value for detecting WBC count and differential count of hydrothorax and ascites.

Objective To investigate the metabolic profile of uric acid and the significance of the altered renal expression of urate trans-porter 1(URAT1) in patients with uric acid nephrolithiasis. Methods The data of 24 patients in our hospital from January 2012 to October 2013 were analyzed retrospectively. Participants in the research were divided into three groups:patients with uric acid nephrolithiasis,other patients with nephrolithiasis and normal participants. The basic clinical data and the related data of uric acid metabolition of participants were collected,URAT1 gene expression in renal tissures of three groups was detected by Real-time PCR technique. All data were statistically ana-lyzed and compared between these groups. Results Uric acid levels in plasma,body mass index and age were significantly higher in patients with uric acid nephrolithiasis than other two groups (P<0. 05),but urine PH value was significantly reduced in patients with uric acid neph-rolithiasis. Urine and uric acid output of 24 hours urine were no significant difference among the three groups (P>0. 05). The result of Real-time PCR suggested that the URAT1 renal expression was significantly higher in patients with uric acid nephrolithiasis than other two groups (P<0. 05). Conculusion Patients with uric acid nephrolithiasis are closely related with hyperuricemia,but unrelated with renal over-ex-cretion of uric acid. The upregulated URAT1 expression in the kidney may be an important molecular mechanism of the clinical features.

Objective To analyze the clinical efficacy of physical vibration lithecbole in treatment of urinary calculi. Methods Ana-lysed the efficacy of 80 patients who underwent physical vibration lithecbole only or combination therapy with surgery in urinary calculi in our hospital from February 2014 to July 2014. Result There were 1 to 4 times calculi discharge among the 80 patients. One month after the sur-gery, the calculi discharge rate was 33. 3% and the calculi clean rate was 22. 2% in the upper ureteral; the calculi discharge rate was 16. 7%and the calculi clean rate was 50. 0% in the distal ureteral; the calculi discharge rate was 40. 0% and the calculi clean rate was 23. 3% in the upper renal calyx;the calculi discharge rate was 27. 7% and the calculi clean rate was 38. 8% in the middle renal calyx;the calculi discharge rate was 60. 0% and the calculi clean rate was 20. 0% in the lower renal calyx. One month after the surgery of physical vi-bration lithecbole combined with Holium laser lithotripsy, the calculi discharge rate was 52. 1% and the calculi clean rate was 39. 1%. Con-clusion Physical vibration lithecbole is a noninvasive treatment for urinary calculi. It has good efficacy in calculi discharge and it can relieve the pain caused by calculi.

Objective To evaluate the curative effect of polyscope modular flexible ureteroscope combined with Holmium laser lithotrip-sy in the treatment of renal calculi. Methods 53 patients with renal calculi were performed CTU to detect the position of renal calculi before operation. The patients were treated with polyscope modular flexible ureteroscope combined with Holmium laser, and the double J tube were routinely indwelled 4 to 12 weeks after surgery. Results All the 52 patients has successfully completed the operation in the frist stage. The mean operative time was about 38 minutes. 6 patients were treated with flexible ureteroscope for second stage operation. One week after oper-ation, the review showed that there were residual calculi existed in 24 cases and there were 56 cases of post-operative infection, including 17 cases of sepsis or sepsis shock. Conclusion Polyscope modular flexible ureteroscope can be used for all kinds of kidney stones surgery and is characterized by safety and mild tissue injury. But we should pay more attention to the post-operative infection especially urosepsis.