Objective To analyze the efficacy of different intracavitary operations for calyceal diverticulum calculi,so as to provide reference for the diagnosis and treatment of such disease.Methods A retrospective analysis of the data of 21 patients with calyceal diverticulum calculi was conducted during Jan.2015 and Dec.2021.The patients were divided into the retrograde intrarenal surgery(RIRS,n=14)group and percutaneous nephrolithotomy(PCNL,n=7)group.The perioperative data were compared.Results There was no significant difference in stone load between the RIRS group and PCNL group[(11.56±4.79)mm vs.(13.06±6.27)mm,P=0.609].There were significant differences in the thickness of renal parenchyma at the top of the diverticulum[(10.08±4.81)mm vs.(5.24±2.23)mm,P=0.005],operation time[(58.57±19.23)min vs.(88.29±25.28)min,P=0.007],hospitalization time[3(1,5)vs.12(5,7),P=0.023]days.After operation,there were no significant differences in stone-clearance rate,decrease of hemoglobin,and postoperative complications between the two groups(P＞0.05).Conclusion Both RIRS and PCNL are viable options for treating renal calyceal diverticulum calculi.RIRS has advantages of shorter operation time and hospital stay.PCNL can be an alternative treatment when RIRS is unsuccessful.

Objeetive To investigate tear film lipid layer thickness (LLT) and its association with clinical symptom and sign in different types of dry eye patients.Methods A serial case-observational study was carried out.Three hundred and six eyes of 306 dry eye patients were included in Beijing Tongren Hospital from April to August 2016.Ocular surface disease index (OSDI) questionnaire,eyelid slit lamp examination,the measurement of tear film lipid thickness (LLT),tear film break-up time (TBUT),Schirmer Ⅰ test (S Ⅰ t) and the infrared meibomian photography were performed on the patients.The 157 patients with OSDI ＞12 and eyelid score ≥2 served as the MGD group;53 patients with OSDI ＞12 and S Ⅰ t value ＜ 5 mm/5 minutes served as ADDE group;96 patients with OSDI＞12,eyelid score ≥2 and S Ⅰ t value ＜ 5 mm/5 minutes served as MGD/ADDE group.Tear film LLT was detected with LipiView(R) ocular surface interferometer and the association of LLT with clinical characteristics of the patients was analyzed.This study protocol was approved by Ethic Committee of Beijing Tongren Hospital and written informed consent was obtained from each patient prior to any relative medical examination.Results Tear film LLT of the participants was normally distributed with the average was (60.41±18.57)nm.LLT in the MGD group,ADDE group,MGD/ADDE group were (57.04 ± 18.26),(63.52 ± 18.44) and (60.56 ± 18.71) nm,respectively,with a significant difference among the three groups (F =2.347,P =0.035),and the LLT value was significantly lower in the MGD group than that in the ADDE group (t =2.077,P =0.039).The LLT value showed negative correlations with the severity of dry eye symptom,S Ⅰ t and meibomian gland loss rate (r=-0.201,P=0.003;r=-0.146,P=0.005;r=-0.156,P=0.046).OSDI score was significantly correlated with LLT only in the MGD group (r =-0.285,P =0.000).No significant correlation was seen between LLT and S I t in all the groups (all at P＞0.05).In the MGD/ADDE group and MGD group,the correlation between LLT and meibomian gland loss rate was significantly greater than the overall correlation (r=-0.335,-0.248,-0.156).The dry eye symptoms in OSDI questionnaire like foreign body sensation,eye pain,discomfort when watching TV or computer showed significant correlations with LLT (r =-0.243,-0.205,-0.223,-0.258,all at P ＜0.05).Conclusions The tear LLT is appeared to be varied in different types of dry eye.The LLT is thinner in the dry eyes with MGD and thicker in the dry eyes with ADDE.There are association between tear LLT and foreign body sensation,eye pain,discomfort when watching TV or computer.

Objective To know the situation of time delay from the patients with ischemic stroke arrived the emergency to accepted the thrombolysis treatment, and analyze the related factors in order to put forward effective process optimization measures. Methods Totally 122 patients with acute ischemic stroke admitted into a Beijing grade A tertiary hospital who needed receive thrombolysis treatment from June 2014 to June 2015 were selected as the research object according to the purpose sampling method. Then we recorded the time in the whole process which were devided into 4 steps ( arrived at the emergency department- obtained consultation of stroke physicians;obtained consultation of stroke physicians- arrived in CT chamber; arrived in CT chamber- got CT scan results; got CT scan results- accepted thrombolysis therapy ) . Results The time delayed in hospital of intravenous thrombolysis group and artery thrombolysis group were (114.95±29.48)min and (171.22±50.10)min. The step of biggest delta-T between the actual time and standard time of two groups were both from getting a CT scan results to accepting thrombolysis therapy.Conclusions The delay after getting a CT scan results is the most important reason of delay in hospital. Shorten the time of blood test, optimize the hospital management and perfect the construction of the green channel, can promote the situation of the delay in hospital, and, improve the efficiency of thrombolysis treatment.

Objective To assess the volume of epicardial adipose tissue(EAT) and intrathoracic adipose tissue(IAT) and the correlation of EAT,IAT and the EAT/IAT ratio with the severity of coronary artery atherosclerosis in patients with metabolic syndrome(MS) and coronary heart disease(CHD).Methods Ninty-seven MS subjects without coronary atherosclerosis and one hundred and eighteen MS subjects with CHD were enrolled in this study.The volumes of EAT,PAT and IAT were measured using axial data from base to apex traced manually with a dedicated semiautomatic software program-volume.Results (1)Compared with MS subjects without coronary atherosclerosis,MS subjects with CHD had significantly increased age[(60.6± 1 1.4)years vs.(57.9 ± 8.7) years,P=0.001],positive family history of cardiovascular disease(29.7％ vs.21.6％,P=0.03),EAT[(98.3±41.4) cm3 vs.(82.2±39.7) cm3,P=0.001],IAT [(171.3±64.1) cm3 vs.(156.2±48.1) cm3,P=0.001] and HbA1c[(7.1 ± 1.8)％ vs.(6.6±2.3)％,P=0.02],but siginificantly reduced total cholesterol[TC,(4.9 ± 1.2)mmol/L vs.(5.4 ± 1.0) mmol/L,P=0.003],low-density lipoprotein cholesterol[LDL-C,(3.0±1.1) mmol/L vs.(3.6±1.0) mmol/L,P=0.03] and high-density lipoprotein cholesterol[HDL-C,(1.0 ± 0.4) mmol/L vs.(1.1 ± 0.3) mmol/L,P=0.04].(2) In MS subjects without coronary atherosclerosis,the volumes of EAT,pericardial adipose tissue(PAT) and IAT were associated with gender,body mass index(BMI),waist circumference(WC),diabetes mellitus and hyperlipidemia(all P＜0.05); however,in MS subjects with CHD,the volumes of EAT,PAT and IAT were associated with BMI and WC (both P＜0.05).(3) The volumes of EAT and IAT were correlated with calcification grades(r values were 0.45 and 0.50,P values were 0.017 and 0.013,respectively) and Gensini score(r values were 0.476 and 0.563,P values were 0.015 and 0.017,respectively) instead of coronary artery calcifacation score(CACS).Moreover,the EAT/IAT ratio was negatively correlated with CACS(r=-0.321,P=0.028).Conclusions Compared with MS subjects without coronary atherosclerosis,MS subjects with CHD have significantly increased EAT and IAT volumes.In our subjects,the volumes of EAT,PAT and IAT were associated with BMI and WC.Only in MS subjects with CHD,the volumes of EAT and IAT were correlated with caleification and Gensini score.

Objective To investigate the effect of the evaluation on teaching hospitals affiliat-ed to medical colleges in Guangdong province. Methods Questionnaire and on on-the-spot investi-gation was conducted among 18 teaching hospitals which owned the accreditation for 2-3 years based on Guangdong provincial teaching hospital accreditation indicator system 2008 modified version. Contents of investigation included general situation,teaching condition,management and implementa-tion of teaching activities as well as medical staffs' comments and suggestions for the teaching work. SPSS 13.0 software was used for frequency analysis. Results The general situation,teaching condi-tion,management and implementation of teaching activities were improved to varying degrees after the evaluation according to results of the questionnaire. 90.0%(54/90)people thought that the overall scale of the hospital was expanded and 5.0%(3/60)people thought that the overall scale of the hos-pital was obviously reduced or marinated the original level. 11.6%(7/60)and 88.3%(53/60)people thought that medical quality of the hospital was improved or obviously improved. 60.0%(36/60)people thought that educational occupancy of the hospital was improved while 5.0%(3/60)people thought that it was unsatisfactory. 83.3%(50/60)people thought that teaching mold and infrastructures were improved while 10.0%(6/60)people thought that it was unsatisfactory. 95.0%(57/60)people thought that teaching management was improved. Due to the lack of incentives and support in teaching work, management of teaching was loose. Conclusions The teaching work of t hospitals affiliated to medical colleges in Guangdong province do persevere basically and achieve desired purposes.

Objective To investigate the application value of breast scale membrane marking method to locate breast tumor lesion in neoadjuvant chemotherapy.Methods Before neoadjuvant chemotherapy for 120 cases of breast cancer,adopt scale membrane marking method was used to mark the position and boundaries of breast tumor lesion in the mean time.For non-protuberant breast tumor lesion,scale membrane was adhered directly to the breast and positive mark was made.For tumor lesion with vague boundaries,its boundaries was defined under the direction of ultrasound.For protuberant breast tumor lesion,scale membrane was only adhered to normal mammary skin beyond the tumor lesion and reverse mark was made.After two courses of treatment of TEC scheme,mark was made again and combined with ultrasound,molybdenum target and MRI results to comprehensive judgment of clinical curative efficacy so as to decide whether operation or change to TP scheme for continuous chemotherapy.Before operation,the first marking results were reset and then operation was conducted according to the position and boundaries of the marked tumor lesion.Results There were 26 cases of complete remission,76 cases of partial remission,10 cases of stabile disease and 8 cases of progressive desease.According to mark by scale membrane,breast conserving operations were conducted in 24 cases of complete remission and in 18 cases of partial remission according to position+ boundaries of the tumor lesion and tumor lesion position+ 1.5-2.0 cm beyond the original boundaries of tumor lesion marked by scale membrane,respectively.The simplified radical mastectomy was conducted in other 78 cases according to boundaries of the tumor lesion marked by scale membrane,in which 13 cases had insufficient locally advanced skin edges and adopted abdominal full-thickness free skin flap to cover the wound.Conclusion Tumor lesion location in neoadjuvant chemotherapy for breast cancer and scale membrane positioning method have the advantage of precision and non-invasion,which effectively save normal breat tissues and skin around tumor lesion with high patient compliance and tremendously outmatches traditional coordinate method,body surface tattoo method and mental marker method.Scale membrane marking method is easy to be operated with low cost,which is convenient for popularization and generalization.

Objective We invented mammary lump skin-positioning membrane (named scare membrane) to facilitate localization of mammary lump during ultrasound scan.This study is to measure the radius of mammary of Chinese adult women for designing different types of skin-positioning membrane.MethodsThe radius of mammary glands in 236 cases of adult females was detected with color Doppler ultrasound at 5 different clock positions:12:00,3:00,6:00,9:00 and 10:30 or 1:30.SPSS 16.0 statistical software was used to analyze the data.The cut-off values of mammary glands radius at 99％,95％,75％ and 50％ were calculated.Paired t tests or nonparametric tests (relative sample rank sum tests) were used to verify the consistency of mammary gland radius between left and right sides.ResultsThe cut-off value of 95％ mammary gland radius was:7.700cm at 12:00,7.810 cm at 13:00,8.100 cm at 3:00,5.330 cm at 6:00 and 6.300 cm at 9:00 for left mammary gland ; 7.500 cm at 12:00,6.015 cm at 3:00,5.500 cm at 6:00,8.510 cm at 9:00 and 7.930 cm at 10:30 for right mammary gland.In comparison of left and right mammary gland radius,the difference had statistical significance between the group of left side at 1:30 and right side at 10:30,the group of left side at 3:00 and right side at 9:00(P ＜0.05).The right mamma was relatively larger.The cut-off values of the right mamma at the above two clock points were taken as radius of scale membranes while the average of percentage cut-off values at 12:00,3:00 of both mammas,left side at 9:00 and right side at 3:00 are taken as radius of scale membranes.ConclusionsAccording to the cut-off values of 99％,95％,75％ and 50％ radius of adult female mammary glands,mammary lump skin-positioning membrane radius can be classified into 4 size-types:extra large,large,medium and small.The precise classification of radius of mammary scale membranes according to mammary glands of adult females provides convenience for production,manufacture and clinical application of mammary lump skin-positioning membrane.

Fifty five patients with alcohol induced-mental disorder (study group) and 43 local inhabitants without history of alcohol abuse (control group) were surveyed with family environment scale (FES-CV) and generic quality of life inventory-74 (GQOLI-74). The total score and the scores of all dimensions except material life in GQOLI-74 of study group were significantly lower than those of control group(P ＜0. 05). Compared with control group, the scores in FES of study group were lower for factors of cohesion, expressiveness, active-recreational orientation, moral-religious emphasis and organization in the patient's family, while the scores for conflict and control were higher( P ＜ 0. 05 or P ＜ 0. 01 ). The results indicate that family environment is closely correlated with quality of life in patients with alcohol-induced mental disorder, and family therapy would improve their quality of life.

Objective To explore the significance of palpation-negative breast tumor resection with ultrasound-guided methylene blue labeling and percutaneous suture traction.Methods 46 cases of small breast tumors with the diameter from 0.5 cm to 1.0 cm were double labeled with methylene blue under the guide of ultrasound l hour preoperatively.The tumors were fixed,drew outward with percutaneous suture and resected accurately.All the 46 cases were rechecked by ultrasound to verify whether residual or false resection occurred 1 month later.Results All the 58 tumors of the 46 patients were accurately resected.No residue or false resection occurred.The average operation duration was 10 min to 20 min.Conclusion Palpable-negative breast tumor resection with ultrasound-guided methylene blue labeling and percutaneous suture traction has the advantages of small invasion,accurate positioning and short operation duration.

AIM To investigate effect of dipfluzine on sodium current (INa+) in isolated single guinea-pig ventricular myocytes. METHODS INa+ was measured by whole cell patch-clamp technique in single isolated guinea-pig ventricular myocytes which were prepared by enzymatic dissociation method. RESULTSCardiac INa+ was elicited by 50-ms pulses to +50 mV from holding potential at -80 mV with a step of +10 mV, which could be blocked completely by tetrodotoxin 10 μmol·L-1. The peak INa+ occurred at about -20 mV and the reversal potential for INa+ was about +30 mV. Dipfluzine inhibited cardiac INa+ in a concentration-dependent manner. The blocking effect of dipfluzine on INa+ was reversible. Dipfluzine suppressed cardiac INa+, without modifying maximum activation potential and reversal potential. The peak of INa+ was decreased by about 46% at -20 mV and shape of I-V curve was not altered by dipfluzine 40 μmol·L-1. Dipfluzine shifted the steady-state inactivation curve of INa+ towards more negative without changing the slope factor and produced very little change in the steady-state activation curve towards more positive. The mean half activation voltage was (-34.9±5.1) mV and slope factor was (6.0±4.8) mV under control condition and (-33.7±3.6) mV and (5.6±2.4) mV following exposure to dipfluzine 40 μmol·L-1. The half inactivation voltage was (-73.0±4.6)mV and slope factor was (4.8±1.8)mV under control condition and (-82.8±7.2)mV and (4.8±1.8)mV following dipfluzine 40 μmol·L-1 treatment. Dipfluzine delayed recovery of cardiac INa+ from inactivation state. The time course of recovery was (36±11) ms in control group and (79±28) ms in dipfluzine 40 μmol·L-1 group. CONCLUSION Dipfluzine inhi- bits cardiac INa+ in a concentration-dependent manner and has higher affinity for the inactivated state than that for resting state of Na+ channels.