Objective To evaluate the efficacy and safety of domestic Holmium laser lithotriptor for the treatment of ureteral calculi.Methods The clinical data of 160 cases of ureteral calculi treated by trans-ureteroscope with domestic Holmium laser lithotriptor were retrospectively analyzed.Among these patients,85 were male,and 75 were female,59 in the upper uremr and 101 in the mid-lower ureter.Results The overall Successful operation rate for all level of ureteral stones in single procedure was 91%(146/160),while the upper one and mid-lower were 85%(50/59)and 95%(96/101),respectively.The average postoperative hospital stay was(4.7±1.4)d.The average clearance time to calculi-free was(21.5±10.1)d.Only 1 patient had urinary infection.No complication such as ureteral perforation or secondly hematouria were seen in this post cohort operation.The postoperative follow-up from 3 to 7 months revealed that the stone-free rate was 98%(147/150).Conclusion Treatment of ureteral calcuh by trans-ureteroscope with domestic Holmium laser lithotriptor is safe and effective.

Objective To investigate the diagnosis and treatment outcomes of testieulax endodermal sinus tumor. Methods Twenty-four cases diagnosed with testieular endodermal sinus tumors from November 1996 to April 2007 were retruspeetively reviewed. Eighteen patients presented with stage Ⅰ disease, 4 presented with stage Ⅰ , and 2 presented with stage Ⅲ. Inguinal radical or-chieetomy were performed in all patients. Retroperitoneal lymph node dissection was performed in 8 ea-ses. Results The histological structures were rather complicated in 24 tumors. Twenty-three eases (96%) were found with reticular pattern, 22(92%) with hyaline body, 20(83%) with glandlike structure, 16(67%) with Shiller-Dural body, and 13(54%) with solid formation. The former 3 kinds were regarded as the main diagnostic criteria. Twenty-one eases were followed up for 20 months to 12 years. During the follow-up, 2 patients died of the disease. Condesions Early diagnosis and combi-nation therapy, including radical orehieetomy and chemotherapy, are the keys to improve the curative effect of testieular endodermal sinus tumors. Active surveillance of AFP is critical for monitoring the recurrence and metastasis of this tumor.

Objective To translate Parents' Perception of Uncertainty Scale (PPUS) into Chinese,analyze and selected items,and then test the reliability and validity of the Chinese version of PPUS initially.Methods 210 parents of hospitalized children were recruited for the investigation.Frequency analysis,dispersion degree analysis,correlation analysis and so on were applied to analyze and select items.Internal consistency test,Pearson correlation analysis and exploratory factor analysis etc.were applied to test reliability and validity of the scale.Results The final Chinese version of PPUS contained 28 items.The Cronbach α and parity split-half reliability coefficients were 0.844 and 0.835; The Cronbach α coefficient of 4 dimensions ranged from 0.537 to 0.770.The item-total scale correlation coefficient ranged from 0.300 to 0.737.Item-dimension correlation coefficients ranged from 0.376 to 0.762.Item-other dimension correlation coefficients ranged from 0.028 to 0.514.Dimension-total scale correlation coefficients ranged from 0.480 to 0.863 and those between dimensions ranged from 0.226 to 0.536.In the content validity assessed by experts,I-CVI ranged from 0.75 to 1.00,S-CVI/Ave was 0.928.Four-factor model was performed in the principal component analysis and they explained for 41.401％ variances.The maximum factor loading of all items were higher than 0.3,and most of items had adequate loadings in related dimensions.Conclusions Chinese version of PPUS had appropriate reliability and validity as an assessment tool for parental uncertainty in illness of hospitalized children' parents.

Objective To explore the application of the paries anterior vagina U shape muscularis mucosal flap for the repairing of female complicated urethrovaginal fistula. Methods Fifteen complicated urethrovaginal fistulas patients resulted from severe pelvic frac-ture and with history of failing repairing urethrovaginal fistulas were analyzed retrospectively. The mean diameter of maximum urethrovagi-nal fistula was approximately 2.3 cm. The parias anterior vagina U shape mucosal flaps were used to repair the urethrovaginal fistulas, and the paries anterior vagina muscularis mucosae were used to cover the fistulas surface again. Results Fifteen patients were followed up for 6 to 80 months, and they gained normal voiding, with no urine leakage, urinary incontinence and urethra] stricture occurring. Conclusion The paries anterior vagina U shape mucosal flap is an effective technique for repairing complicated urethrovaginal fistula.

Objective To explore the therapeutic efficacy of posterior internal fixation and anterior debride-ment with autogenous bone grafts at one stage on tuberculosis of thoracic or lumbar spine . Methods 16 cases of thoracic or lumbar spinal tuberculosis patients were treated with combined anterior (radical debridement and bone autograft) and posterior (instrumentation) surgeries in one stage between September 2003 and September 2007. The degree of the kyphosis (Cobb angle) was measured and the interbody fusion was observed preoperatively and postop-eratively. The ASIA grading system was used to assess the neurological status. Results All patients were followed up for 10 months to 36 months,on average of 12 months. All patients showed sucessful interbedy fusion,but Cobb angle was not progressed. No recurrence or wound infection was found. 6 cases all got nerve function recovery. Conclusion Thoracic or lumbar tuberculosis treated with this surgical technique can achieve stable internal fixation and a high satisfactory rate with restoring the spinal stability, arresting the disease early, providing early fusion, correcting the ky-pbosis particularly.

Objective To explore the application of the paries anterior vagina U shape muscularis mucosal flap for the repairing of female complicated urethrovaginal fistula.Methods Fifteen complicated urethrovaginal fistulas patients resulted from severe pelvic fracture and with history of failing repairing urethrovaginal fistulas were analyzed retrospectively.The mean diameter of maximum urethrovaginal fistula was approximately 2.3 cm.The paries anterior vagina U shape mucosal flaps were used to repair the urethrovaginal fistulas,and the paries anterior vagina muscularis mucosae were used to cover the fistulas surface again.Results Fifteen patients were followed up for 6 to 80 months,and they gained normal voiding,with no urine leakage,urinary incontinence and urethral stricture occurring.Conclusion The paries anterior vagina U shape mucosal flap is an effective technique for repairing complicated urethrovaginal fistula.

Objective To compare the blood high mobility group box-1 (HMGB-l) versus N-terminal prohormone of brain natriuretic peptide (NT-proBNP) for assessment of cardiac dysfunction in the patients with severe sepsis.Methods Ninety-eight patients of both sexes,aged 18-75 yr,were divided into 3 groups according to left ventricular ejection fraction (LVEF):non-cardiac dysfunction group (LVEF ≥ 50 ％,n =43),mild cardiac dysfunction group (30％ ≤ LVEF ＜ 50％,n =41),and severe cardiac dysfunction group (LVEF ＜ 30％,n =14).Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was performed.Venous blood samples were obtained for determination of the concentrations of HMGB-1 and NT-proBNP.Days of hospitalization and the survival rates within 28 days after admission to hospital were recorded.Pearson correlation between blood HMGB-l,NT-proBNP concentrations and LVEF was analyzed.Results Compared with non-cardiac dysfunction group,LVEF was significantly decreased,APACHE Ⅱ score and blood HMGB-1 and NT-proBNP concentrations were increased,days of hospitalization were prolonged,and the survival rates were decreased in mild and severe cardiac dysfunction groups,and the changes in the parameters mentioned above were more obvious in severe cardiac dysfunction group.The correlation coefficient between blood HMGB-1 concentration and LVEF was -0.639 and between blood NT-proBNP concentration and LVEF was-0.521,showing significant difference.Conclusion Blood HMGB-1 concentration provides higher reliability than blood NT-proBNP concentration in assessing the degree of cardiac dysfunction in the patients with severe sepsis.

Objective To investigate the possibility of immune tole rance induced by bone marrow-derived mesenchymal stem cells in allogeneic organ transplantation. Methods Allogeneic bone marrow-derived mesenchymal stem cells and syngeneic bone marrow cells were cotransplanted to lethally irradiated female C57BL/6 recipient mice. FACS was used to analyze the chimerism 150 days later. Mixed lymphocyte reaction and ConA induced proliferation test were performed to evaluate proliferative activity of mice spleen cells in cell-transplanted group. Skin transplantation test was done to observe immune response of cell-transplanted group mice against organ graft from donor mice. Results About 5 97% donor T cells were detected in splenocytes of cell-transplanted group mice. MLR showed that mean SI of cell-transplanted group mice was 1.79, and that of untreated group mice was 7 28. ConA induced proliferation test showed that mean SI of cell-transplanted group mice was 31 92; and that of untreated group mice was 34 99. Mean survival time of donor-derived skin graft in cell-transplanted group mice was more than 90 days; and that in untreated group mice was 8 days. Conclusion Our results showed for the first time that induction of stable mixed hematopoietic chimerism after allogeneic bone marrow derived mesenchymal stem cells transplantation lead to stable donor-specific tolerance in allogeneic host and skin graft survival from donor mice.

Objective To study the diagnosis accuracy and features of echocardiography on aortic coarctation combined with hypoplastic aortic arch. Methods The echocardiographic characteristics of seven patients who were diagnosed as aortic coarctation combined with hypoplastic aortic arch were analyzed and compared with results of cardiac catheterization, CT scan and operation. The diagnostic features of echocardiography were summarized. Results Besides the echocardiographic characteristics of aortic coarctation,other specific echocardiographic characteristics of hypoplastic aortic arch were:distinct stenoses of transverse and decsending part of aortic arch were visualized in supra-sternal long-axis view; the range of hypoplastic part started from innominate artery beginning or left common carotid artery beginning; the ratio of diameter of hypoplastic aortic arch over that of descending aorta at diaphragm was less than 0. 5; the blood flow speed detected by Doppler at the site of aortic coarctation was in the normal range. The echocardiographic characteristics of the aortic coarctation combined with hypoplastic aortic arch were correspondent to the results of cardiac catheterization, CT scan and operation results. Conclusions There is high accuracy of echocardiography in diagnosis of aortic coarctation combined with hypoplastic aortic arch. Hypoplastic aortic arch should be paid more attention in diagnosis of aortic coarctation.

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.