The role of NLRP3/GATA-4/VEGF signal pathway in neovascular age-related macular degeneration / 中国医师杂志

Objective:To explore the potential role of nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3)/GATA-binding protein 4 (GATA-4)/vascular endothelial growth factor (VEGF) signal pathway in neovascular age-related macular degeneration (nAMD).Methods:We applied the TRANSFAC Public database to search the human and mouse VEGF promoters and upstream transcription factors, analyzed the transcription factors that may influence the transcriptional activity of VEGF. The RAW264.7 cells were divided into control group and lipopolysaccharide (LPS) stimulated group (LPS group). Real time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the activation of NLRP3 inflammasome, and the mRNA levels of GATA-4 and VEGFA. Thus, we applied the specific small molecular NLRP3 inhibitor MCC950 pretreated RAW264.7 cells (LPS+ MCC950 group), and detected the gene expression of NLRP3, Caspase-1, interleukin 1β( IL-1β), GATA-4 and VEGFA.Results:There were multiple GATA transcription factor binding sites upstream of human and mouse VEGF promoters. Compared with the control group, mRNA expression of NLRP3, Caspase-1, IL-1β, GATA-4 and VEGFA in LPS group were increased (all P<0.05). Compared with LPS group, mRNA expression of NLRP3, Caspase-1, IL-1β, GATA-4 and VEGFA in LPS+ MCC950 group were significantly decreased (all P<0.05). Conclusions:NLRP3/GATA-4/VEGF signal pathway may play a significant role in the pathologic processes of nAMD.

Pulse pressure loss after extracorporeal cardiopulmonary resuscitation is an independent predictor of ECMO weaning failure / 中华危重病急救医学

OBJECTIVE@#To analyze the predictors of successful weaning off extracorporeal membrane oxygenation (ECMO) after extracorporeal cardiopulmonary resuscitation (ECPR).@*METHODS@#The clinical data of 56 patients with cardiac arrest who underwent ECPR in Hunan Provincial People's Hospital (the First Affiliated Hospital of Hunan Normal University) from July 2018 to September 2022 were retrospectively analyzed. According to whether ECMO was successfully weaning off, patients were divided into the successful weaning off group and the failed weaning off group. The basic data, duration of conventional cardiopulmonary resuscitation (CCPR, the time from cardiopulmonary resuscitation to ECMO), duration of ECMO, pulse pressure loss, complications, and the use of distal perfusion tube and intra-aortic balloon pump (IABP) were compared between the two groups. Univariate and multivariate Logistic regression analyses were performed to identify the risk factors for weaning failure of ECMO.@*RESULTS@#Twenty-three patients (41.07%) were successfully weaned from ECMO. Compared with the successful weaning off group, patients in the failed weaning off group were older (years old: 46.7±15.6 vs. 37.8±16.8, P < 0.05), higher incidence of pulse pressure loss and ECMO complications [81.8% (27/33) vs. 21.7% (5/23), 84.8% (28/33) vs. 39.1% (9/23), both P < 0.01], and longer CCPR time (minutes: 72.3±19.5 vs. 54.4±24.6, P < 0.01), shorter duration of ECMO support (hours: 87.3±81.1 vs. 147.7±50.8, P < 0.01), and worse improvement in arterial blood pH and lactic acid (Lac) levels after ECPR support [pH: 7.1±0.1 vs. 7.3±0.1, Lac (mmol/L): 12.6±2.4 vs. 8.9±2.1, both P < 0.01]. There were no significant differences in the utilization rate of distal perfusion tube and IABP between the two groups. Univariate Logistic regression analysis showed that the factors affecting the weaning off ECMO of ECPR patients were pulse pressure loss, ECMO complications, arterial blood pH and Lac after installation [pulse pressure loss: odds ratio (OR) = 3.37, 95% confidence interval (95%CI) was 1.39-8.17, P = 0.007; ECMO complications: OR = 2.88, 95%CI was 1.11-7.45, P = 0.030; pH after installation: OR = 0.01, 95%CI was 0.00-0.16, P = 0.002; Lac after installation: OR = 1.21, 95%CI was 1.06-1.37, P = 0.003]. After adjusting for the effects of age, gender, ECMO complications, arterial blood pH and Lac after installation, and CCPR time, showed that pulse pressure loss was an independent predictor of weaning failure in ECPR patients (OR = 1.27, 95%CI was 1.01-1.61, P = 0.049).@*CONCLUSIONS@#Early loss of pulse pressure after ECPR is an independent predictor of failed weaning off ECMO in ECPR patients. Strengthening hemodynamic monitoring and management after ECPR is very important for the successful weaning off ECMO in ECPR.

The clinical characteristic of ocular findings secondary to hemophagocytic lymphohistiocytosis / 中国医师杂志

Objective:To describe the characterization of ocular changes secondary to hemophagocytic lymphohistiocytosis (HLH).Methods:The clinical data of 5 patients with HLH complicated with ocular involvement treated in Beijing Friendship Hospital Affiliated to Capital Medical University from September 2020 to May 2021 were retrospectively analyzed, the patients′ systemic examination and treatment were sorted out, and the ocular examination results were analyzed. The relevant literatures on ocular involvement of HLH patients were searched in China National Knowledge Infrastructure (CNKI), Pubmed, WOS, Embase and Medicine databases to summarize the characteristic manifestations of ocular involvement of HLH.Results:Of the 5 patients, 1 had primary HLH, 3 were Epstein-Barr virus-associated HLH (EBV-HLH), and 1 had diffuse large B-cell lymphoma-associated HLH. 4 patients showed unilateral or bilateral focal retinal hemorrhage and exudates. 1 male patient performed bilateral retinal pigment epithelial detachment. The literature search results showed that a total of 1 paper on ocular involvement in HLH patients was retrieved from the Chinese database and 11 papers were retrieved from the foreign database. HLH mainly involved the optic nerve, retina and choroid.Conclusions:The ocular involvement of HLH is easy to be missed or misdiagnosed because of its occult onset and complex and diverse clinical manifestations. Early examination and effective treatment may save vision and avoid missing the opportunity of systemic treatment.

Influence of factors before initiation of extracorporeal cardiopulmonary resuscitation on the prognosis of patients / 中华急诊医学杂志

Objective:To analyze the influence of factors before initiation of extracorporeal cardiopulmonary resuscitation (ECPR) on the prognosis of patients, so as to explore the intervention timing and improvement strategy of ECPR.Methods:A retrospective analysis was performed on 29 patients who underwent ECPR in the First Affiliated Hospital of Hunan Normal University (Hunan people's Hospital)from July 2018 to April 2021. Patients were divided into the survival group ( n = 13) and death group ( n = 16) according to whether they survived at discharge. The duration of conventional cardiopulmonary resuscitation (CCPR), initial heart rate before ECPR, the ratio of out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA), and the ratio of transported cases outside the hospital were compared between the two groups. According to different CCPR time, the patients were divided into the ≤45 min group, 45-60 min group and >60 min group to compare the hospital survival and sustained return of spontaneous circulation (ROSC) rate . According to the location of cardiac arrest, the patients from emergency department and other department were divided to compare the survival of IHCA. Results:The total survival rate was 44.83%, the average duration of extracorporeal membrane oxygenation (ECMO) was 114 (33.5, 142.5) h, and the average duration of CCPR time was 60 (44.5, 80) min. The duration of ECMO was longer in the survival group than in the death group ( P = 0.001). The duration of CCPR (the time from CPR to ECMO) in the survival group was significantly shorter than that in the death group ( P = 0.010). Patients with defibrillatory rhythm had higher hospital survival rate ( P = 0.010). OHCA patients had higher mortality than IHCA patients ( P = 0.020). Mortality of patients transferred from other hospitals was higher ( P = 0.025). Hospital survival and ROSC decreased in turn by CCPR duration ≤ 45 min, 45-60 min, and > 60 min ( P = 0.001). The location of CA occurrence had no impact on the hospital survival rate of IHCA patients ( P=0.54). Conclusions:Hospital survival of ECPR is higher than that of CCPR. ECPR is effective for refractory cardiac arrest. The prognosis of ECPR is significantly related to the duration of CCPR, initial heart rate, and location of CA. Education and team training should be strengthened to improve the survival rate of ECPR.

Investigation and analysis on the capacity of cardiopulmonary resuscitation in Hunan Province / 中华危重病急救医学

Objective:To investigate the people's cardiopulmonary resuscitation (CPR) ability in Hunan Province and whether there are differences in the skill level of CPR among respondents of different ages and education levels.Methods:A self-made questionnaire was conducted to survey people in Hunan Province by means of WeChat from May 2018 to April 2019. The questionnaire referred to 2016 National consensus on cardiopulmonary resuscitation in China issued by Cardiopulmonary Resuscitation Specialized Committee of Chinese Research Hospital Association and 2017 version of American Heart Association (AHA) CPR operational guide, and combined with the CPR assessment scale of Hunan Provincial People's Hospital. The contents of the survey included the basic information of the subjects, the common knowledge and skills of first aid, the willingness to learn CPR skills and implement CPR, and the operational requirements of high quality CPR, etc. Results:A total of 6 563 people received the on-site first aid knowledge questionnaire, and 4 355 people completed and submitted the questionnaire. The recovery rate was 66.36%, of which 3 602 valid questionnaires were from IP in Hunan Province, and the qualified rate was 82.71%. Among the subjects, 1 532 were men (42.53%) and 2 070 were women (57.47%). The majority aged group from 19 to 30 (59.41%) and from 31 to 50 (36.70%). 307 were rural (8.52%) and 3 295 were urban (91.48%); and the majority levels of education were senior or technical secondary school (38.26%) and undergraduate or junior college (44.50%). Of the 3 602 respondents, 39.09% indicated that they had been exposed to CPR knowledge and only 0.36% indicated that they did not wish to participate in CPR training. 69.93% of the respondents said they would actively to help if they wet cardic arrest, and 97.92% of those were willing to do so if the patients were relatives or friends. The survey results showed that only 8.91% of respondents chose relatively high-quality CPR options (chest compressions were performed first, the pressing point was located in the sternum of the midpoint of bilateral nipple line, the pressing frequency was 100-120 times/min, pressing depth was 5-6 cm, the ratio of chest compression to artificial ventilation was 30∶2). Among these people, the correct rate was higher in the ages of 31-50 years old and ≤ 18, 19-30 than those ≥51 years old (12.71% vs. 0%, 6.87%, 8.70%, χ2 = 41.420, P < 0.01). The correct rate of education at graduate level and above was higher than those in junior middle school and below, high school or technical secondary school, undergraduate or junior college (19.57% vs. 2.07%, 3.41%, 13.72%, χ2 = 152.262, P < 0.01). Conclusions:The public in Hunan Province have a strong sense of first aid, and some of the theoretical knowledge of CPR. People between 31 years old and 50 years old of age and with graduate education and above know more about CPR, but the overall mastery of CPR skills is poor. It is necessary to further improve the ability of the public as the first witness by teaching various skills of CPR in various forms.

Efficacy of intense pulsed light combined with hydroquinone cream to treat melisma / 中华医学美学美容杂志

Objective To evaluate the efficacy and safety of intense pulsed light (IPL) combined with hydroquinone cream for melasma treatment.Methods Thirty-five patients with melasma were treated between February 2015 and February 2017,20 patients treated with IPL combined with hydroquinone cream and 15 patients with IPL alone.All cases were female patients with Fitzpatrick skin types Ⅲ and Ⅳ,and subjected to 4 weeks treatment 1 time,5 times for a course of treatment.All patients were followed up for six months and the efficacy and safety of the treatment were analyzed comprehensively by subjective satisfaction and physician evaluation.Results All the patients were treated without discomfort and treated patients were effectively followed up.The satisfactory rate of IPL treatment group was 73.3％,and that of combined with hydroquinone cream group was 100％.Two groups of satisfactory rates were higher in IPL combined with hydroquinone cream.The total effective rate of the IPL treatment group was 53.3％ compared with that of the 35 patients before and after treatment;in IPL combined with hydroquinone cream treatment group the total effective rate was 85.0％.IPL combined with hydroquinone cream treatment group was significantly more effective than the treatment group (P＜0.05).All treatment patients did not present with tissue damage,pigmentation and other adverse reactions.Conclusions IPL combined with hydroquinone cream is a safe and effective treatment of melasma,and patients get a higher rate of satisfaction.

Research progress and application outlook of paracrine functions of adipose-derived stem cells in facial anti-aging / 中国组织工程研究

BACKGROUND:Adipose-derived stem cel s (ADSCs) are a subset of mesenchymal stem cel s obtained from adipose tissue, which have paracrine functions, already becoming a focus in anti-aging researching. OBJECTIVE:To review the research progress and application outlook of ADSCs’ paracrine functions in facial anti-aging. METHODS:The first author searched the PubMed and CNKI databases using the keywords of“adipose-derived stem cel s, paracrine, anti-aging”in English and Chinese, respectively, to retrieve relevant articles published from January 2001 to May 2016. Repetitive articles or those with no originality were eliminated. Total y 176 articles were searched initial y, and 66 articles were included in result analysis. RESULTS AND CONCLUSION:ADSCs have paracrine function, which can secrete various growth factors (e.g., epidermal growth factor, transforming growth factorβ, platelet-derived growth factor, vascular endothelial growth factor, col agen and fibronectin) and inflammatory factors (e.g., interferon-γ, interleukin-lβ, interleukin-8, interleukin-9, interleukin-12, interleukin-15, interleukin-17 and tumor necrosis factor-α). These paracrine products of ADSCs have significant effects on anti-aging, such as inhibiting skin aging, whitening skin, assisting lipotransfer, promoting hair regeneration.

Study on the Quality Standard of Solanum tuberdsm / 中国药房

OBJECTIVE:To establish the quality standard for Solanum tuberdsm. METHODS:The microscopic characteristics were detected;TLC was used for qualitative identification;moisture,ash,heavy metals and the amount of extract were deter-mined;HPLC was conducted for content determination of oxidized cyanidin:the column was Alltima C18 with mobile phase of ace-tonitrile-0.1% trifluoroacetic acid(80∶20,V/V)at a flow rate of 1.0 ml/min,detection wavelength was 538 nm,column tempera-ture was 30℃. RESULTS:It showed clear microscopic identification map. S. tuberdsm TLC had clear spots and well separated. The water content was 8.5%-11.0%;total ash was 2.0%-2.9%;Pb was lower than 5 ppm and alcohol-soluble extracts was 15.6%-22.3%. The linear range of oxidized cyanidin was 0.043-0.215 μg(r=0.999 8);RSDs of precision,stability and reproduc-ibility tests were lower than 2.0%;recovery was 95.50%-99.65%(RSD=1.35%,n=9). CONCLUSIONS:The established method can be used for the quality control of S. tuberdsm.

Regulation of Toll-like receptors in fungal keratitis / 中华实验眼科杂志

Fungal keratitis (FK) ,a potential blinding disease,has been difficult to treat due to the limited number of approved antifungal drugs and the taxing dosing regimen.Toll-like receptors (TLRs) function as the pattern recognition receptors (PRRs) in mammals and play an essential role in the recognition of fungal components.There is a great amount of evidence that TLRs initiate the innate immunity in the FK.Furthermore, TLRs also play roles in shaping fungal-specific humoral and cellular adaptive immune responses.This review described the recent advances in interaction between TLRs and non-TLRs signal transduction,negative regulator and function of TLRs in corneal fungal infection.

Wif-1 methylation and β-catenin expression in colorectal serrated lesions / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate methylation status of Wif-1 and β-catenin expression in colorectal serrated lesions.</p><p><b>METHODS</b>Various colorectal lesions were collected including 52 cases of hyperplastic polyps, 41 cases of sessile serrated adenoma, 23 cases of traditional serrated adenoma, 24 cases of colorectal cancer and 24 cases of normal mucosa. All specimens were subject to immunohistochemical staining of β-catenin.SYBR Green PCR analysis of Wif-1 promoter methylation was performed in 29 cases of hyperplastic polyps, 29 cases of sessile serrated adenoma, 19 cases of traditional serrated adenoma, 14 cases of colorectal cancer and 16 cases of normal mucosa.</p><p><b>RESULTS</b>Abnormal expression rates of β-catenin in normal mucosa, hyperplastic polyps, sessile serrated adenoma, traditional serrated adenoma and colorectal cancer were 12.5% (3/24), 59.6% (31/52), 63.4% (26/41), 73.9% (17/23) and 100.0% (24/24), respectively. The corresponding methylation rates of Wif-1 promoter were 2/16, 10/29 (34.5%), 16/29 (55.2%), 15/19 and 13/14 (P < 0.05), respectively. Abnormal β-catenin expression was positively correlated with Wif-1 promoter methylation in traditional serrated adenomas (r = 0.536, P < 0.05).</p><p><b>CONCLUSIONS</b>Abnormal β-catenin expression and methylation rate of Wif-1 promoter are significantly higher in colorectal serrated lesions. Methylation of Wif-1 promoter may be related to the abnormal expression of β-catenin through activation of Wnt/β-catenin signaling pathway, which may contribute to the development of colorectal serrated lesions.</p>

Clinical application of the new-type patent endotracheal tube in difficult endotracheal intubation patients / 中国综合临床

Objective To investigate the clinical efficacy of new-type patent endotracheal tube in difficult endotrachea intubation patients.Methods Seventy-three patients with the abnormal airways were selected as our subjects.Patients were given the traditional endotracheal tube by mouth after anesthesia.The successes patients in terms of endotracheal intubation were as group Ⅰ (n =73).The failed patients were asgroup Ⅱ (n =63),who performed the secondary endotracheal intubation with new type patent endotracheal tube.Analyze the success rate of intubation of the two groups when on use the tube core.Results The first time intubation success rate and intubation success rate was (2.7％ (2/73),13.7％ (10/73) respectively) in Ⅰ group,and 73.02％ (46/63) and 98.41％ (62/63) respectively in the group Ⅱ,and there was the significant difference between two groups (x2 =36.01,31.08 respectively,P ＜ 0.01).Conclusion The new type endotracheal tube was proved with three advamage of good plasticity,without need of auxiliary core intubation with trachealtube and give full play to lead the soft cannula guide tubes leading role.Therefore,the new type patent endotracheal tube has more efficacy over traditional tube.

Determination of melamine by high-performance liquid chromatography-mass spectrometry in urinary calculi / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a high-performance liquid chromatography-mass spectrometry (LC/MS)-based method for efficient determination of melamine in urinary calculi in children taking melamine-contaminated formula milk powder.</p><p><b>METHODS</b>LC/MS was employed to determine the contents of melamine in urinary calculi surgically removed from 17 children with a history of taking melamine-contaminated milk powder and in 4 samples of uric acid stone from adults. The positive ionization mode of electro-spray ionization source was used, and the limit of melamine determination was 0.1 mg/kg.</p><p><b>RESULTS</b>No melamine was detected in the 4 uric acid stone samples from adults. Melamine was detected in 4 samples of urinary calculi from the 17 children, with the concentration ranging from 0.8 to 64 mg/lkg.</p><p><b>CONCLUSION</b>LC/MS is simple and effective for detecting melamine in urinary calculi, which is helpful to the treatment and follow-up.</p>

Treatment of upper urinary calculi with MPCNL : experience of 10,452 cases of 19 years in a single-center / 中华泌尿外科杂志

Objective　To analyze the clinical indications,efficacy and safety of Chinese minimally invasive percutaneous nephrolithotomy (MPCNL) in treating upper urinary calculi based on our experience.Methods　From June 1992 to September 2010,a total of 10,452 patients (6060 males and 4392 females)with a mean age of (47.6 ± 13.7) years (7 months-93 years) received MPCNL in our center.The mean stone burden was (777.4 ± 740.3) mm2 (20 - 4 080 mm2 ).The data of stone burden,operative techniques,operating time,stone-free rate,major complication,hospital stay and stone composition were investigated.　Results　Of the 10 452 cases,11 801 procedures were performed on 10 876 (5493 left and 5383right) renal units,including 10 102 first stage procedures,1604 secondary procedures,86 third procedures and 9 fourth procedures.There were 11 830 tracts established,including 373 (3.15％ ) tracts of 14 F,7867 (66.50％) tracts of 16 F and 3590 (30.35％) tracts of 18 F.There were 1207 (10.20％),9174(77.55％) and 1449 (12.25％) punctures located in upper,middle and lower pole,respectively.956(8.79％) renal units were managed with multiple tracts,which including 2 tracts in 846 (7.78％) units,3tracts in 85 (0.78％) units,4 tracts in 18 (0.17％) units and 5 tracts in 7 (0.06％) units.Pneumatic lithotripsy was used in 8563 (72.56％) procedures,Holmium:YAG laser lithotripsy was used in 2981(25.26％)　procedures and Pneumatic lithotripsy + Holmium: YAG laser lithotripsy was used in 257(2.18％) procedures.762 (7.29％) cases needed ESWL to clean the stone after MPCNL.The average operating time was ( 101.3 ± 44.2) min ( 10 -240 min).The stone-free rate of MPCNL was 89.9％,which increased to 93％ by adjunctive ESWL.And the mean hospital stay was ( 13.2 ± 6.4) days (2 - 72 days).The major complications happened on 321 (3.07％) cases,including 294 (2.81％ ) cases of blood transfusion,12 (0.11％ ) cases of sepsis,2 (0.02％) cases of renal abscess,9 (0.09％) cases of pleura injury,2 (0.02％) cases of colon injury and 2 (0.02％) cases of death.53 (0.51％) cases needed selective renal arterial embolization to achieve hemostasis.The main stone compositions were analyzed in 4345 cases.Calcium oxalate,calcium phosphate,magnesium ammonium phosphate,uric acid,ammonium urate,carbapatite and cystin were 91.74％,90.33％,14.91％,17.77％,4.83％,8.47％ and 0.51％,respectively. Conclusions　MPCNL is an effective and safe treatment option for all kinds of upper urinary calculi in patients at all ages with a high stone free rate and low major complication rate.

A study on microsatellite instability status for colorectal serrated lesions / 中华内科杂志

Objective To verify the traditional serrated pathway by comparing microsatellite instability(MSI) status among traditional serrated adenoma, traditional adenoma, serrated colorectal cancer and non-serrated coloreetal cancer. Methods Seventy-five paraffin-embedded tissue samples, including 15 with serrated adeneearcinoma (Sca), 20 with non-serrated adenocareinoma (N-Sca), 20 with traditional serrated adenoma(TSA) and 20 with villous adenoma(AD) were collected from the pathology department of our hospital. Genomic DNA was extracted from these samples and then amplified with fluorescently-labeled primer specific for BAT25 and BAT26. The MSI status was detected with DNA automatic sequencer. Results Six of 18 samples with TSA harbored MSI-H and twelve MSI-L/MSS; 18 samples with conventional adenoma were exclusively of MSS; 3 of 13 samples of serrated carcinoma harbored MSI-H and ten MSI-L/MSS; 18 of 19 N-Sca samples harbored MSI-L/MSS and only one MSI-H. With Chi-square test, the MSI frequency in AD group and N-Sca group was significantly lower than that in TSA group and Sca group ( P < 0. 05 ) ; but with no statistical difference between the TSA group and Sca groups ( P > 0. 05 ). Conclusion MSI-H frequency in AD group and N-Sca group was obviously lower than that of TSA group and Sca group. It is concluded that there might be a new traditional serrated neoplasia pathway which is different from the conventional adenoma-carcinoma carcinogenesis pathway, but we still need prospective follow-up studies to verify its existence.

Staged endoscopic treatment of refractory ureteral calculus / 中华泌尿外科杂志

Objective To investigate the feasibility, safety and clinical efficacy of staged endo-scopic treatment for refractory ureteral calculus. Methods Eighteen refractory ureteral calculus ea-ses (11 males and 7 females) treated with staged endoscopic treatment were retrospectively analyzed. The mean age of the patients was 32 years (range 2-65 years). Of the 18 cases, 2 had bilateral ure-teral calculi. Of the 20 ureteral calculi, 11 were in the upper, 6 were in the middle and 3 in the lower part of ureter. The mean diameter of the calculi was 0.9 cm (range 0.4-1.6 cm). Staged endoscopic treatment was offered to patients because of failure of ureterscopic lithotripsy or extracoporeal shock-wave lithotrispy caused by uretreal twist or eongential narrow. For all the cases, it was hard to com-pletely clear all the stone load and ureteral stents or percutaneous nephrostomy were performed to drain the kidney in the first session. Then, the calculi were removed by endoscopic manipulations in the second or third session. Results Thirteen patient's calculi were completely cleared in the second sessions 40-50 d after the first operation. The other 5 cases had to accept the third session 50-60 d after the second operations. There was no intra- or post-operative complication in all cases. During the 6 months' follow-up, there was no sign of recurrence. Conclusion Staged endoscopic treatment is a feasible and safe method and has high efficiency in the management of refractory ureteral calculi.

The clinical analysis of patients with complex renal calculi combined with fungous infection / 中国医师杂志

Objective To explore the etiology and the fungi distribution in patients with complex renal calculi,as well as the therapeutic efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL).Methods The mid-stream urine culture was underwent in 891 cases of patients with complex renal calculi.The MPCNL were performed in patients with complex renal calculi combined with fungous infection.Results Of 891 patients with complex renal calculi,3.7%(33/891) patients were presented with fungous infection,including 60.61%(20/33) with Candida albicans and 39.39%(13/33) with Candida glabrata.All the 33 patients had long-term use of broad spectrum antibiotics from 25 to 92 days(averaged 45.8 days).The patients with complex renal calculi combined with fungous infection were treated with MPCNL.The stone-free rate was 87.88%(29/33) and the insignificance stone-residual rate was 12.12%(4/33).Conclusion The patients with complex renal calculi are apt to fungous infection and the abuse of broad spectrum antibiotics should be avoided.The MPCNL is safe and reliable for the treatment of the patients with complex renal calculi combined with fungous infection.

Helicobacter pylori infection and gastric mucosa associated lymphoid tissue lymphoma / 中华消化杂志

Objective To study the relationship between gastric mucosa associated lymphoid tissue (MALT) lymphoma and Helicobacter pylori (H.pyori) infection retrospectively. Methods The paraffin embedded samples of the tumors in gastric intestinal tract and its corresponding normal tissues from 35 patients with non Hondgkin's lymphomas in gastric intestinal tract were sectioned. The slides, except routine histopathologic study, were submitted to immuno histochemical staining (CD 3,CD 5,CD 10 ,CD 20 ,C 23 ,CD 45 RO, kappa, lamda, cyclin, Ki67, TUNEL) and to HE staining for the detection of H. pylori infection. Results ①Twenty one cases were identified to be MALT lymphomas according to the results of immunohistochemical staining, of them 16 cases were gastric MALT lymphomas, 1 case of intestinal MALT lymphoma, and 4 cases of colonic MALT lymphomas. ② H. pylori infection in gastric MALT lymphoma was 100% except in 3 cases who had only tumor tissues, which could not be evaluated. ③ Two cases were stage Ⅰ 1 gastric MALT lymphomas, 5 were stage Ⅱ 1,and 9 were stage Ⅱ E. ④ Only 6 cases had recognized as gastric MALT lymphomas by endoscopy and biopsy. Three patients were misdiagnosed as gastric cancer, 1 as M?n?trier disease, 1 as atrophic gastritis, and 5 as chronic gastritis endoscopiclly. ⑤ One patient got a complete regression after 3 courses of anti H. pylori therapy and was in good health after 3 years of the treatment. Conclusions ① A close relation was present between H.pyloi infection and gastric MALT lymphoma. ② Early gastric MALT lymphoma may regress after eradication of H.pylori.