ObjectiveTo study the diagnosis and therapy of circumcaval ureter.MethodsFifteen cases of circumcaval ureter were studied retrospectively.The cardinal symptoms include discomfort over the back and loins,nephrocolic and bloody urine.The diagnosis mainly depends on IVU and retrograde urography.12 patients underwent ureteroureterostomy,2 ureteropyeloneostomy and 1 nephrectomy.ResultsAll the patients have been follewed up from 1 to 15 years by IVU and ultrasonography,and no nephrohydrosis or stenosis of the anastomosis site has been noted.All the patients have been free from any complaints.ConclusionsIVU and retrograde urography are the cardinal means for the diagnosis of circumcaval ureter,and operation is indicated in order to improve the renal function.It is important to choose a proper time and an adequate surgical technique.

Objective To develop a more ideal procedure of living donor nephrectomy. Methods Ten cases of living relate donor who received laparoscopic nephrectomy were regularly followed up from 2 to 12 months. Results These donors were discharged on the day 5 after operation. Renal function of the recipients was normal in 4 days after operation. The advantages of laparoscopic living related donor nephrectomy included smaller incisions, less pain, faster recovery and short hospitalization. Conclusion Laparo- scopic living related donor nephrectomy is effective and safe.

0.05. Conclusions Radical nephrectomy remains the cardinal method for the treatment of primary renal cell carcinoma. Extensive retroperitoneal lymphadenectomy does not improve the survival.

Objective To study the effect of foot motor imagery on lower extremity motor function in hemiplegics after stroke. Methods 72 hemiplegics were randomly divided into two groups: the experiment group and the control group. Normal rehabilitation was performed in the both groups and motor imagery was added in the experiment group. They were assessed with lower extremity Fugl-Meyer Assessment (FMA) and gait analysis. Results The scores of FMA in knee, ankle and lower extremity, gait frequency and speed improved in experiment group more than in controls（P<0.05）. Conclusion Foot motor imagery can improve lower extremity motor function.

BACKGROUND: Adequate preparation of donors and recipients prior to living-related donor renal transplantation, short warm and cold ischemia time for donor kidney, good histocompatibility of human leukocyte antigen match, and low postoperative rejection incidence provide feasibility for use of low-dose immunosuppressive agents after living-related donor renal transplantation. OBJECTIVE: To investigate the safety and effectiveness of low-dose calcineurin inhibitors (CNI), an immunosuppressive agent, in living-related donor renal transplantation. METHODS: A total of 38 recipients who underwent living-related donor renal transplantation at the Center of Renal Transplantation of the First Affiliated Hospital of Nanjing Medical University from January 2006 to June 2008 were randomized for treatment with mycophenolate mofetil (750 mg twice a day), prednisone, and either standard-dose CNI (n=18) or low-dose CNI (n=20) during 12 months post-transplantation. Ciclosporin A was given orally (starting dose, 6 and 4 mg/kg per day, respectively) in two divided doses to achieve the 12-hour whole blood concentration as measured by fluorescence polarization immunoassay. The starting dose of tacrolimus was 0.12 and 0.08 mg/kg per day respectively, and its whole blood concentration was measured by enzyme-multiplied immunoassay technique. After transplantation, patients were followed up. Renal function, pulmonary infection, liver dysfunction, and CNI nephrotoxicity at different time periods were compared between different regimens. RESULTS AND CONCLUSION: During 12 months post-transplantation, patient death occurred in one of 18 patients (5.6%) in the CNI standard-dose group and none of 20 patients (0%) in the CNI low-dose group. There was no significant difference in renal function and acute rejection between CNI standard-dose and CNI low-dose groups (P > 0.05). The incidence of liver dysfunction and CNI nephrotoxicity was significantly lower in the CNI low-dose group than in the CNI standard-dose group (P < 0.05). In addition, a low-dose CNI regimen helped recipients to lessen the economic burdens. These findings indicate that it is effective, safe and economical to use a low-dose CNI regimen in living-related donor renal transplantation.

Objective To investigate the expression of OPN, α-SMA, E-cadherin and their correlation in the chronic allograft nephropathy (CAN) rat model, and to explore the possible role of OPN in CAN.Methods Orthotopic renal-transplantation using Fisher rats as donors and Lewis rats as recipients was done to establish CAN group, and Lewis to Lewis rats as control group. Rats in each group were sacrificed 12 weeks after the surgery. Blood and urine were collected for further test. Allograft samples were collected and sectioned for HE, Sirus-red staining, immunohistochemistry and Western blot.Results There were CAN morphological changes of the allograft in CAN group. As compared with control group, immunohistochemistry and Western blot revealed that the expression of OPN and α-SMA in CAN group was significantly increased, and that of E-Cadherin reduced. Its trend was correlated with the inflammatory response and the EMT of tubule epithelial cells.Conclusions OPN expression in rat CAN model is significantly up-regulated. OPN may play a role in CAN. OPN might affect the CAN by promoting EMT of tubule epithelial cells.

Information resources of health education , disease knowledge and drug knowledge extracted by seconda-ry development fromhospital electronic librarywere disseminated on the Website , WIFI and WeChat platforms of People's Armed Police for the self-learning of users according to the demand of health dissemination and education in hospitals and health education at grass-roots level, in order to improve the efficiency and service of health edu-cation, solve the lack of resources and talents for health education, and to enhance the health service support ability for People's Armed Police.

Major depressive disorder (MDD) is a mental disorder with high prevalence,morbidity and recurrence rate.The treatment goal of acute stage is to achieve remission,which means asymptomatic.However,clinical treatments and studies found impairment of psychosocial functioning still exists even after remission,which means incomplete recovery.As is known,the normalization of psychosocial functioning is essential to the recovery and the recurrence prevention of MDD.In order to provide reference and guidance for the clinical treatments and studies,we reviewed the related studies and found many kinds of factors influencing the restoration of psychosocial functioning,including demographic factors,diseases related factors,psychological factors,social factors and therapeutic approaches.However,few interior studies focused on the recovery of MDD,and the results of foreign studies were inconsistent,while the understanding of how those factors influence the recovery of MDD is not clear enough.In order to make the characteristics of psychosocial functioning recovery and mechanisms of the influencing factors clear,more in-depth studies should be done in the future.

Objective To present the experience of laparoscopic extraperitoneal radical prostatectomy and evaluate its safety and efficacy. Methods A total of 91 patients diagnosed with localized prostate carcinoma were admitted from February 2003 to June 2008. The level of serum PSA ranged from 7. 5 - 47. 0 ng/ml(mean 14. 0 ng/ml). The volume of the prostate ranged from 35 - 75 ml(mean 52 ml). Biopsy was performed before the operation and the pathological results revealed prostate carcinoma with Gleason score no more than 8. CT, MR and ECT revealed there was no lymph node or seminal vesicle involvement and there was no bone metastasis. The procedures were performed with an-tegrade techniques and pelvic lymphadenectomies were performed in 32 cases and nerve-sparings were performed in 11 cases. Results The operation duration ranged from 105 - 270 min (mean 173 min). Intraoperative blood loss was 110 - 1200 ml(mean 315 ml). Incontinence occurred in 19 cases in early stage and 18 cases recovered within 3 months. Positive surgical margin occurred in 11 cases. There was no complication of urethra stricture during 3 - 30 months' follow-up. No lymph node was involved in 32 cases with pelvic lymphadectomy. Five of the 11 cases received nerve-sparing prostatectomy had normal erectile function during the follow-up. Conclusions Laparoscopic extraperitoneal radical prostatectomy is a safe, effective and efficient surgical procedure with the minimal invasion, less morbidity and rapid recovery. Laparoscopic radical prostatectomy is emerging as an alternative to open radical prostatectomy.

Objective　To evaluate the technique and clinical outcomes of modified transperitoneal laparoscopic radical prostatectomy.　Methods　A total of 285 patients received the operation with mean age of 67 years (50-76 years) from January 2008 to April 2012.Mean level of PSA was 15.7 μg/L (1.8 -50.0 μg/L),and mean prostatic volume was 44 ml (26 -74 ml). No lymph node or seminal vesicle involvement was found by CT or MR and radionuclide bone scan revealed no metastasis.271 cases were confirmed diagnosis by prostatic biopsy and 14 were detected through pathological studies of TURP specimens.Gleason score ranged from 6 to 8.14 cases were in clinical stage T1b,29 cases in T1c,214 cases in T2 and 28 cases in T3a.Transperitoneal approach and modified technique involving bladder neck dissection,nervesparing technique and vesicoureteral anastomosis were applied on patients.　Results　Mean operative time was 105 min (55 -150 min).Mean intraoperative estimated blood loss was 240 ml (50-800 ml).Rectal injures occurred in 2 cases and were repaired under laparoscopy.Drainage tube and urinary catheter were removed 48 -72 h and 5 -8 d postoperatively.Postoperative hospital stay was 7 d (5 - 11 d).Positive surgical margin was present in 58 patients.Mean follow-up time was 29 months (3 -50 months).Complete continence were found in 208 patients immediately after catheter removal.68 patient recovered continence within 3 months and 9 patients remained incontinence 3 months after surgery. Normal erection presented in 42 of the 57 cases with nerve-sparing.　Conclusions　Transperitoneal laparoscopic radical prostatectomy is safe and efficient.Higher efficiency and lower complication rate have been achieved through modified laparoscopic technique involving bladder neck dissection,nerve-sparing technique and vesicoureteral anastomosis.