Effect of combined spinal and epidural anesthesia on pain and cognitive function in elderly patients with lower limb fracture / 中国基层医药

Objective:To analyze the effect of combined spinal-epidural anesthesia on the degree of pain and cognitive function in elderly patients with fracture of lower extremity.Methods:From January 2016 to January 2018, 82 elderly patients with lower extremity fracture treated in Dajiangdong Hospital of Hangzhou were randomly divided into control group and observation group according to the random digital table method.The patients in the control group were treated with general anesthesia, and the patients in the observation group were treated with combined spinal and epidural anesthesia.The anesthesia effects of the two groups were analyzed.Results:The onset time of anesthesia and sensory block, and duration of sensory block in the observation group were (5.69±2.00)min, (32.65±2.59)min and (98.21±10.14)min, respectively, which were shorter than those in the control group ( t=5.646, 19.576, 22.613, all P<0.05). Before operation, there were no statistically significant differences in VAS score and MMSE score between the two groups ( t=0.093, 0.056, all P>0.05). On the 1st day, 3rd day and 7th day after operation, the VAS scores in the observation group were lower than those in the control group ( t=2.118, 1.718, 5.372, all P<0.05). The scores of MMSE in the observation group were significantly higher than those in the control group ( t=6.175, 4.628, 3.078, all P<0.05). The VAS score in the observation group was lower than that in the control group on the 14th day after operation ( t=5.582, P<0.05), and there was no statistically significant difference in MMSE score between the two groups ( t=0.023, P>0.05). The incidences of adverse reaction and postoperative cognitive dysfunction in the observation group were 4.88% and 12.20%, respectively, which were significantly lower than those in the control group (29.27% and 31.71%) (χ 2=8.613, 4.556, all P<0.05). Conclusion:Combined spinal-epidural anesthesia can relieve postoperative pain, promote the recovery of cognitive function, and reduce the incidence of adverse reactions and postoperative cognitive dysfunction in elderly patients with lower limb fracture.

The median effective doses of dexmedetomidine to induce adequate sedation in elderly patients undergoing epidural anaesthesia / 中国医师进修杂志

Objective To study the median effective doses (ED50) of dexmedetomidine to induce adequate sedation in elderly patients undergoing epidural anaesthesia. Methods Seventy-five elderly patients undergoing lower extremity operation under epidural anesthesia were selected, and the patients were divided into 5 groups according to the random digits table method with 15 cases each: D1 group (dexmedetomidine 0.2 μg/kg), D2 group (dexmedetomidine 0.4 μg/kg), D3 group (dexmedetomidine 0.6 μg/kg), D4 group (dexmedetomidine 0.8μg/kg) and D5 group (dexmedetomidine 1.0μg/kg). After 20 min of dexmedetomidine injection, adequate sedation was defines as observer′s assessment of alertness/sedation score (OAA/S score) ≤ 3 scores. The ED50 and 95% effective dose (ED95) of dexmedetomidine and 95% CI in elderly patients undergoing epidural anaesthesia were calculated by probit regression method. The changes of mean arterial pressure (MAP), heart rate, pulse oxygen saturation (SpO2) and OAA/S score among 5 groups were compared. The incidences of adverse effects such as hypotension, bradycardia, hypoxemia and excessive sedation were compared. Results The ED50 in elderly patients was 0.36 μg/kg (95% CI 0.27 - 0.44 μg/kg); the ED95 was 0.94 μg/kg (95% CI 0.71 - 1.62 μg/kg). After dexmedetomidine injection, the MBP, heart rate, SpO2 and OAA/S scores in 5 groups were decreased, but in the D4 group and D5 group the decreases were more significant. The incidences of hypotension, bradycardia and excessive sedation in D1 group, D2 group and D3 group were significantly lower than those in D4 group and D5 group:2/15, 5/15 and 8/15 vs. 14/15 and 15/15;1/15, 6/15, 7/15 vs. 13/15 and 14/15;0, 0 and 1/15 vs. 5/15 and 7/15, the incidences of hypoxemia in D1 group, D2 group and D3 group were significantly lower than those in D5 group: 0, 0 and 0 vs. 3/15 and 4/15, and there were statistical differences (P0.05). Conclusions The ED50 of dexmedetomidine in elderly patients undergoing epidural anaesthesia is 0.36μg/kg, (CI 0.27-0.44μg/kg). The incidences of adverse effects are increased when single-dose dexmedetomidine is more than 0.8μg/kg.

Retrospective analysis of one-year outcomes after modified single-armed suture technique for microsurgical intussusception vasoepididymostomy / 中华显微外科杂志

Objective To retrospectively analyze the one-year outcomes of modified single-armed suture technique for microsurgical vasoepididymostomy in men with epididymal obstructive azoospermia (EOA).Methods From February,2012 to November,2013,microsurgical longitudinal intussusception vasoepididymostomies using a modified single-armed suture technique in 51 men with EOA was performed.The followed-up period was designed as 1 year.The correlations between the sperm motility in epididymal fluid,unilateral or bilateral procedure,anastomotic site,and the female partner age and the patency or pregnancy rate were analyzed.Results Followups were carried out for 39 (76.5％) men.The patency was noted in 24 (61.5％) men and pregnancy was reported in 15 (38.5％) female partners,including 1 received in vitro fertilization using fresh ejaculated sperm.Motile sperms in epididymal fluid were observed intraoperatively in 14 (58.3％) patent men and 3 (20.0％) nonpatent men,respectively (P ＜ 0.05).In patent cohort,the mean ages of the pregnant and non-pregnant female partners were 26.5 and 32.7 years(P ＜ 0.05),respectively.Conclusion The modified single-armed suture technique showed favourable patency and pregnancy rates in this study.It's a practical alternative in the areas without the specialized double armed suture.

Correlation between chronic prostatitis and erectile dysfunction / 中华泌尿外科杂志

Objective To discuss the clinical correlation between chronic prostatitis (CP) and erectile dysfunction (ED).Methods A retrospective analysis was made on the clinical data from patients who were diagnosed as CP in urology department of the First People's Hospital of Yunnan Province and the First Affiliated Hospital of Sun Yat-sen University.Patients' data were collected from July 2005 to July 2012.All the patients were diagnosed as CP based on their clinical manifestation,the NIH Chronic Prostatitis Symptom Index,prostatic fluid examination,routine urine examination and ultrasonography.The condition of erectile function was inquired on every patient and recorded.Results There were 4 315 patients diagnosed as CP in present study,while their age ranged from 17 to 64 years (average,31 years).Sixty-one (1.41％) patients were identified as moderate and severe types of ED (International Index of Erectile Function 5 ≤ 11),while 42 (0.97％) patients were confirmed as ED after they got CP.435/4 315 patients (10.08％)felt obviously sexuality descent after they got CP,and the sexuality was reported improved in 426/435 pa-tients after prostatitis symptomatic relief.Conclusions The incidence rate of ED in CP patients is not ob-viously higher than that in common community.And sexuality descent in patients might be caused by localindisposition and anxiety after CP.

Perforated whole-cell patch recording of L-type calcium current with β-escin in osteoblasts / 中国病理生理杂志

[ ABSTRACT] AIM:To establish a perforated whole-cell patch-clamp technique withβ-escin to record L-type cal-cium current (ICa,L) in osteoblasts.METHODS:ROS 17/2.8 is a rat osteoblast-like osteosarcoma cell line.β-escin was applied to the pipette solution to permeabilize the cell membrane and the perforated patch recording mode was obtained. RESULTS:β-escin at concentration of 50μmol/L easily permeabilized the cell membrane and obtained a perforated patch recording mode in 2~7 min.This technique prevented ICa,L rundown and preserved cytoplasmic signaling pathways.CON-CLUSION:β-escin may be used as an alternative ionophore for perforated patch-clamp studies in osteoblasts and results in minimal rundown that could facilitate recordings of ICa,L in osteoblasts.

Factors Inlfuencing Shear Wave Velocity by Using Elasiticity Imaging Technique / 中国医学影像学杂志

Purpose To investigate the influence on shear wave velocity (SWV) by different probe frequency, scanline angle and ROI depth. Materials and Methods The elasticity QA Phantoms was used in the study. First the SWV was measured by curve probe at depths of 1 cm, 2 cm, 3 cm, 4 cm, 5 cm, 6 cm, 7 cm and 8 cm. The scanline angle changed from 0°from midline, 1°-15°, 16°-30°and 31°-45°. Then the SWV was measured again by using line probe at depths of 1 cm, 2 cm, 3 cm and 4 cm. The measured data were analyzed statistically. Results The SWV showed difference by using the two probes (P<0.05). As depth increased, the measurement by curve probe changed from overestimate to underestimate, while the measurement by line probe always showed underestimate from standard value. When the curve probe was used, the angle and depth affected SWV interactively (F=85.87 and 35.96, P<0.01), and had interactive effects (F=17.63, P<0.01). When the scanline angle was within 15°, the angle had little inlfuence upon the measurement. When the scanline angle was 0 °, the measurement was the closest to the standard value at the depth of 4 cm, and the maximum deviation occurred at the depth of 5 cm. The inlfuence of depth upon measurement had signiifcant difference when the line probe was used (P<0.05). The measurement was the closest to the standard value at the depth of 1 cm, and the maximum deviation occurred at the depth of 4 cm. Conclusion Factors like probe frequency, scanline angle and ROI depth can affect the SWV. When the curve probe is used, the accurate measurement occurs at the depth of 4 cm when the scanline angle is within 15°. When the line probe is used, the accurate measurement occurs at the depth of 1 cm.

Effects of butorphanol pretreatment on myocardial injury induced by limb ischemia/reperfusion / 中国医师进修杂志

Objective To investigate the effects of butorphanol pretreatment on myocardial injury induced by limb ischemia/reperfusion.Methods Forty patients with distal lower extremity orthopedic surgery (ASA Ⅰ or Ⅱ) were divided into two groups by random digits table method with 20 cases each:butorphanol group and control group.Epidural anesthesia was selected in all patients.In butorphanol group,patients were given butorphanol 0.04 mg/kg intravenously 15 min before tourniquet.In control group,equal volume of normal saline was infused at the same time.Blood samples were taken from jugular vein before tourniquet (T0),then 5 min(T1),2 h (T2),6 h (T3),12 h (T4) and 24 h (T5) after the second reperfusion of tourniquet.The serum creatine kinase isoenzyme MB (CK-MB),cardiac troponin Ⅰ (cTnI),tumor necrosis factor-α (TNF-α) and malondialdehyde (MDA) levels were determined.Results Compared with those at T0,the serum C K-MB levels were increased at T2-T5,the serum cTnI,MDA,TNF-α levels were increased at T1-T5 in control group,and there were significant differences (P ＜ 0.05).Compared with those at T0,the serum CK-MB levels were increased at T3,T4,the serum TNF-α levels were increased at T1-T3,the serum cTnI levels were increased at T1-T5 in butorphanol group,and there were significant differences (P ＜ 0.05).Compared with those in control group,the serum CK-MB levels were decreased at T2-T5 [(20.2 ± 5.0) U/L vs.(35.3 ±6.8) U/L,(32.3 ±3.7) U/L vs.(48.6 ±8.5) U/L,(29.5 ±5.4) U/L vs.(51.5 ±8.0) U/L,(22.2 ±4.8) U/L vs.(33.7 ±6.7) U/L],the serum cTnI,TNF-α levels were decreased at T1-T5 [(0.158 ± 0.016) μg/L vs.(0.278 ±0.021) μg/L,(0.169 ±0.036) μg/L vs.(0.332 ± 0.062) μg/L,(0.357 ±0.049) μg/L vs.(0.623 ±0.083) μg/L,(0.178 ±0.045) μg/L vs.(0.383 ±0.059) μg/L,(0.138 ±0.016) μg/L vs.(0.263 ±0.023) μg/L; (1.63 ±0.13) μg/L vs.(2.12 ±0.08) μg/L,(1.69 ± 0.08) μ g/L vs.(2.28 ± 0.09) μ g/L,(1.63 ± 0.09) μ g/L vs.(2.25 ± 0.07) μ g/L,(1.23 ± 0.14) μμg/Lvs.(1.93±0.12) μg/L,(1.13±0.15) μμg/Lvs.(1.79±0.07) μμg/L],theserumMDAlevelswere decreased at T1-T4 [(4.82 ±0.53) nmol/L vs.(6.68 ±0.67) nmol/L,(4.99 ±0.61) nmol/L vs.(7.59 ±0.72) nmol/L,(5.02 ±0.43) nmol/L vs.(7.54 ±0.63) nmol/L,(4.52 ±0.55) nmol/L vs.(6.52 ±0.47) nmol/L] in butorphanol group,and there were significant differences (P ＜0.05).Conclusion Butorphanol pretreatment can improve the serum CK-MB,cTnI levels,and has a protective role for myocardial injury induced by limb ischemia/reperfusion.

Effects of butorphanol pretreatment on myocardial damage induced by limb ischemia/reperfusion in rats / 中华麻醉学杂志

Objective To evaluate the effects of butorphanol pretreatment on myocardial damage induced by limb ischemia/reperfusion (I/R) in rats.Methods One hundred and eight male Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 3 groups (n =36 each) using a random number table:sham operation group (group S),I/R group and butorphanol pretreatment group (group B).Limb ischemia was induced by occlusion of bilateral hind limbs for 2 h followed by reperfusion in I/R and B groups.At 10 min before ischemia,butorphanol 0.2 mg/kg was injected via the right jugular vein in group B,while the equal volume of normal saline was injected in group I/R.Six rats were chosen randomly before ischemia (baseline,T0) and at 2,6,12,24 and 48 h after reperfusion (T1-5) and blood samples were taken from the abdominal aorta for determination of the serum creatine kinase isoenzyme-MB (CK-MB) activity and cardiac troponin Ⅰ (cTnI) concentration.The animals were then sacrificed and myocardial specimens were obtained for determination of myocardial apoptosis (using TUNEL) and the expression of c-Jun N-terminal kinase (JNK) and extracellular signal-regulated protein kinase (ERK) (using Western blot analysis).Apoptosis index was calculated.Results Compared with group S,the serum CK-MB and cTnI levels were significantly increased at T1-5,and the apoptosis index and expression of JNK and ERK were increased at T2-5 in group I/R (P ＜ 0.05).Compared with group I/R,the pathological changes of myocardium were significantly reduced at T4,the serum CK-MB and cTnI levels were decreased at T2-5,the apoptosis index was decreased at T4,5,the expression of ERK was up-regulated at T2-5,and the expression of JNK was down-regulated at T2-4 (P ＜ 0.05).Conclusion Butorphanol pretreatment can reduce apoptosis in myocardial cells through activating MAPK signal transduction pathway,up-regulating ERK expression and down-regulating JNK expression,thus attenuating myocardial damage induced by limb I/R in rats.

The effects of sole desensitization physical therapy on the standing balance and walking of recovering stroke patients / 中华物理医学与康复杂志

Objective To explore the effects of sole desensitization physical therapy on standing balance and walking function among recovering stroke patients.MethodsStroke patients who met the inclusion criteria were randomly assigned to the observation group (40 cases) or the control group (40 cases). All patients received traditional rehabilitation. In addition, the observation group received sole densensitization physical therapy. The total course of treatment lasted for 1 month. The Berg balance scale (BBS) and Holden's functional ambulation classification (FAC) were used to evaluate balance and walking ability before and after treatment. The Fugl-Meyer assessment (FMA) was used to assess the motor function of the affected ankle, and footprint analysis was used to measure and record any changes in time and distance walked and to analyze improvements in gait.ResultsAfter the sole desensitization training, the BBS (37.41 ± 8.14), FAC ( 3.91 ±0.92) and FMA motor function (6.42 ± 1.12) results of the observation group were all significantly better than before training. Walking time and distance also improved.ConclusionsSole desensitization can affect foot proprioception. As a result, stroke patients' soles adapt to the surroundings, recover their ability to provide physiological support and promote improved motor function of the ankle.Sole desensitization can thus improve the standing balance and walking of stroke patients.

A comparative study of long-term results after hypospadias surgery / 中国医师进修杂志

Objective To compare the long-term results of hypospadias surgery and analyze the influencing factors. Methods Sixty-four hypospadiac patients were followed up, cosmetic and sexual functional results were assessed by hypospadiac patients and surgeon using a designed questionnaire and 5-item version of the international index of erectile function (IIEF-5). Selected 35 adult as normal controls. Maximum flow rate and average flow rate Were used to assess evaluation of voiding function. Results All cases were followed up for 3-11 (7.5 ± 2.3) years. The satisfaction with the long-term results of penile appearance had significant differences between hypospadiac patients and surgeon,hypospadiac patients were less satisfied than surgeon (P< 0.05 or < 0.01). No significant differences were noted between hypospadiac patients and normal controls regarding the maximum flow rate [(23.37 ±2.92), (24.41 ±2.94) ml/s], average flow rate [(16.84± 1.75), (17.34 ±2.14) ml/s] and erectile function [(22.31 ± 1.94), (22.80 ± 1.73) pointe](P> 0.05). The average penile lengths[(5.93 ± 1.06) cm] and circumferences[(6.17 ±0.83) cm] of hypospadiac patients under flaccid conditions after operation were significantly shorter than those of normal controls [ (7.38 ± 0.79 ), ( 7.53 ± 0.75 ) cm ] ( P < 0.01). The important factors to influence the results including the age at which surgery was completed, hypospadiac severity, the number of operation and complication. ConclusionsIt is useful to improve the long-term efficacy by minimizing the number of operation and complication, and treating hypospadiac patients earlier. Surgeon should pay more attention to the long-term cosmetic results of hypospadias surgery.

Sonographic findings compared with fiberoptic ductoscopy in the patients of spontaneous nipple discharge / 中华超声影像学杂志

Objective To investigate the ultrasound diagnostic value for nipple discharge disease by comparison with fiberoptic ductoscopy. Methods Fiberoptic ductoscopy and ultrasonic inspection were performed on fifty-seven patients with spontaneous nipple discharge,and the results were analysed. Results In all patients, 55 cases (96. 49 % ) were abnormal in high-frequency ultrasound inspection:27 mammary duct expansion(47.36%),19 occupying lesion with mammary duct expansion or cyst (33.33%),6 cystic echo ( 10. 52% ) ,3 only solid echopattern (5.26%) ,and 2 nothing found (3.51% ). In ultrasonic inspection,color and pulse Doppler signal were found in 7 cases. On the other hand, 26 galactophoritis (45.61%), 12mammary duct ectasia (21.05 %), 17 intraductal papilloma (29.82%), 2 breast carcinoma (3.50%) were diagnosed by fiberoptic ductoscopy. In all 19 cases with occupying lesion,ultrasonography's sensitivity was 52. 63% ,specificity was 89. 47%, misdiagnosis rate was 10. 50%, rate of missed diagnosis was 47.36%.Conclusions To nipple discharge disease, high-frequency ultrasound has high sensitivity, easy to find abnormal indication,but is not accurate enough in the diagnosis of smaller occupying lesion.

Clinical comparison of therapeutic methods for calculi in congenital anomalous kidneys / 中华泌尿外科杂志

Objective To evaluate the therapeutic methods for stones in congenital anomalous kidneys. Methods The clinical outcomes of 126 patients(75 males and 51 females: mean age 39 years, range 12-66 years)who underwent extracorporeal shock wave lithotripsy (ESWL, n= 37), minimally invasive percutaneous nephrolithotomy (MPCNL, n = 41) or open surgery (n = 48) were retrospectively reviewed. There were 40 horseshoe kidneys(31.8%), 51 duplex kidneys(40.5%), 35 malrotated kidneys(27.8%). Seventyl calculi were located in left kidneys(55.6%)and 56 in right kid-neys(44.4%). There were 96 single stones(76.2%)and 30 complex stones(23.8%). The greatest di-ameter of stone ranged from0.8 cm to 2.2 cm(mean 1.5 cm) in ESWL group, 1.0 cm to 4.0 cm (mean 2.5 cm) in MPCNL group and 1.5 cm to 3.8 cm(mean 2.7 cm) in open surgery group. The therapeutic effects of 3 methods were compared. Results The stone-free rate at 1 session was 78.4%(29/31) in ESWL group, 85.4%(35/41) in MPCNL group and 87.5%(42/48) in open sur-gery group. No significant difference was found among the 3 groups(x2 = 1.39,P=0.50). The inci-dence of complications was 13.5% in ESWL group, 9.7% in MPCNL group and 6.3% in open sur-gery group(x2=1.28, P=0.53). Only 1 case of malrotated kidney suffered massive hemorrhage and was cured by selective embolism of renal artery. No major complications occurred in the other pa-tients. Conclusions With rigorous indication, ESWL or MPCNL is as safe and effective as open sur-gery in the management of stones in congenital anomalous kidneys. It should be considered as the pri-mary therapy. But the treatment must be individualized in terms of the type anomalous kidney, stone characteristics and obstruction.

Screening and identification of renal cancer specific peptide from a phage displaypeptide library / 中华泌尿外科杂志

Objective To screen and identify the novel markers for renal cell carcinoma. Methods The renal cancer A498 cell line was used as the antigen and human normal renal cell line HK-2 was used as control for subtraction biopanning from a phage display peptide library at 37 ℃ The positive and specific binding clones were identified by cell-based ELISA and immunocytochemical staining, and the identified clones were sequenced. Thus the amino acid sequence was deduced and the peptide was synthesized. The peptide was identified by immunofluorescence. Results Through a cell-based ELISA, immunocytochemical staining, and immunofluorescence, the Phage ZT-2 and synthetic peptide ZT-2 were shown to specially bind to the A498. The affinity binding to A498 was the highest (A_(ZT-2)/A_(control) = 3. 15) among the peptides assayed. The optical density of ZT-2 in renal cancer tissue (0. 453±0. 123) was significantly higher than that in normal and inflammatory renal tissue (0. 148±0. 075)(P<0. 01). Conclusions A peptide ZT-2 which is specific binding to renal cancer cell line A498 had been selected from phage display peptide libraries. Therefore, it provides a potential tool for early diagnosis of renal cancer or targeted drug delivery in chemotherapy.

THE EFFECT OF SOYBEAN ISOFLAVONE ON LIPID PEROXIDATION AND LIVER ULTRASTRUCTURE IN OVARIECTOMIZED RATS / 解剖学报

Objective To study the effects of soybean isoflavone(SI) on lipid peroxidation and liver ultrastructure in ovariectomized rats. Methods Seventy female Sprague-Dawley(SD) rats were randomly divided into 7 groups according to the levels of total cholesterol(TC) in serum: hyper-lipoid group,estrogen group,low-dose SI group,middle-dose SI group,high-dose SI group,sham group and normal control group.After bilateral ovaries were extirpated except sham and normal control groups for a week,the estrogen,different doses of SI or deionized water were fed with intragastric administration for 12 weeks.The rat body weight was weighted once per week and blood samples were collected at the time of ovariectomization,the 4th and 8th weeks after administeration at the time of being killed.The serum TC,triglyceride(TG),high or low density lipoprotein-cholesterol(HDL-C,LDL-C),lipoprotein(a) and antioxygen enzyme were assayed. Results LDL-C levels in SI intervention groups were significantly lower than that in hyper-lipoid groups but higher than that in normal control group;the levels of lipoprotein(a) were changed;there was almost no effect on HDL-C in serum.SI could retain integrity and ultrastructure of hepatocyte;there was similar structure in high dose SI group and normal control group.An obvious damage was detected in hyper-lipoid group.Conclusion SI can improve lipoprotein(a) and lipid peroxidation in ovariectomized rats.A continuous intervention with high-SI can reduce LDL-C to normal lever and retain integrity and ultrastructure of hepatocyte.

Minimally Invasive Percutaneous Nephrolithotomy for Calculi in Patients with Congenital Anomalous Kidneys / 中国微创外科杂志

Objective To assess the safety and effectiveness of minimally invasive percutaneous nephrolithotomy(MPCNL) in treating renal stones in patients with congenital anomalous kidneys.MethodsFrom January 2000 to November 2007 a total of 41 patients with renal stones complicated with congenital anomalous kidneys,including 12 cases of horseshoe kidneys,19 cases of duplex kidneys,and 10 cases of malrotated kidneys were treated by MPCNL in our hospital.Of the 41 patients,4 had upper calyx calculi,6 had middle calyx calculi,7 had lower calyx calculi,3 had pelvic calculi,4 had the upper segment calculi in duplex kidney,12 had multiple calculi,and 5 had staghorn calculi.The largest diameter of the stones ranged from 1.0 to 4.0 cm(mean 2.5 cm).Ureteral calculi that were found in 13 of the patients were treated at one time.ResultsThe procedure were completed in all of the cases with the operation time ranged from 45 to 210 minutes(mean 95 minutes),and blood loss ranged from 30 to 150 ml(mean 80 ml).The overall stone-free rate at one session was 85.4%(35/41).One of the duplex kidney cases and two of the horseshoe kidney cases were cured by a second operation.And two of the duplex kidney cases and one of the malrotated kidney cases were treated by ESWL after the MPCNL.One patient,who had malrotated kidney,suffered massive hemorrhage(800 ml) during the MPCNL,and was cured by selective embolization of the renal artery.No severe complications occurred in the other patients.The cases were followed up for 5-12 months,during the Period no patient had recurrence.ConclusionsMPCNL is safe and reliable for the treatment of stones in patients with congenital anomalous kidneys.The treatment must be individualized in terms of the type of the renal abnormalities,and the size and location of the stones.

A Clinical Contrast Study on the Tension-free Hernioplasty with Three Operative Methods / 中国医师杂志

Objective To compare the clinical efficacy of tension-free hernioplasty with three operative methods, and analyze the reasons of complications. Methods All Chinese articles dealing with the tension-free hernioplasty included in CNKI from 1997 to 2004 were collected, and divided into three groups according to different operative methods, the clinical efficacy of which was compared. Results The frequecy of foreign matter feel in the Rutknow group was significantly higher than that in the other two groups (P

EFFECT OF SOYBEAN ISOFLAVONE ON LIPID METABOLISM AND MYOCARDIAL ULTRAMICROSTRUCTURE IN OVARIECTOMIZED RATS / 营养学报

Objective:To study the effects of soybean isoflavone (SI) on metabolism of lipids and lipoprotein (a) [Lp(a)] in ovariectomized rats . Methods:Senventy female Sprague- Dawley (SD) rats were randomly divided into 7 groups according to the levels of total cholesterol (TC) in serum: high-lipid (HF) group, estrogen (EG) group, low-dose SI (L-SI) group, middle-dose SI (M-SI) group, high-dose SI (H-SI) group, sham group and normal control (NC) group. One week after bilateral ovaries were extirpated, except sham and NC group, estrogen, different doses of SI or deionized water were fed i.g. for 12 w. Except NC group, the other groups were fed high fat diet. Body weights were weighed every week and blood and heart were collected at the end of experiment. The serum TC, triglyceride(TG), high or low density lipoprotein-cholesterol (HDL-C, LDL-C), Lp (a), and antioxidative enzymes activities were assayed. Results:After SI intervention, the levels of LDL-C in SI groups were significantly lower than in HF group but higher than in NC group. The levels of Lp (a) were also changed, but there was almost no effect on HDL-C. Persistent intervention with SI can reduce TC, TG , and protect cadiocyte’s actin filament andmitochondrial ultramicrostructure from damage as shown in HF group. The ultramicroscopic pictures in EG and H-SI group almost resembled NC group. Conclusion:Persistent intervention of high-dose SI can reduce the levels of LDL-C, TC, TG and protect the myocardiac damages due to high fat diet in ovariectomized rats.