Objective:To discuss the operative procedure and clinical therapeutic efficacy of urethrostenosis treatment by ureteroscope combined with self-made urethral sound.Methods:4F ureteral catheter or Teflon paintcoat guidewire was passed through narrow section to bladder.the self-made,midheaven and ringent anterior urethral sound was inserted into by the ureteral catheter or Teflon paintcoat guidewire to expand that 14F ureteral catheter for drainge under F9.8 ureteroscope and sacral anesthesia.Results:All cases could be detained with 22F ureteral catheter and voided well afert 1 month of treatmeat,no relapse cases were observed after 1year follow-up.Conclusion:It is an micro-traumatic,quick healing with shorter hospitalization and effective method to treat urethrostenosis by ureteroscope combined with urethral sound.

Objective:To observe the change of the oxygen free radical and antioxygen level that existed in cavernous body of penis of diabetus mellitus(DM) rat with erection dysfunction(ED),and observe the morphology change on the electron microscope to probe into the nosogenesis of DMED. Methods:To make the DMED model on rat by streptozotocin,breed for 12 weeks after it,then to determin the indexes about oxygen free radical and antioxygen level and ultrastructure of cavernous smooth muscle after anesthetize. Results:The level of oxygen free radical increased and antioxygen decreased,the blood capillary thrombogenesised,the chondriosome swelled and distend,the desmocyte activated,the nerve fiber medullary sheath degenerated,all those were observed in the DMED group,and had significant different with control group. Conclusion:The change of ultrastructure occurred in DMED rat induced by the oxygen free radical damage and decrease of antioxygen level,it has associativity with the aggravation of smooth muscle endodermis,the blood vessel endothelium,the nerve fiber and the chondriosome,it's ONE OF the nosogenesis of DMED.And it suggested to use oxygen free radical scavenger may be relieve the change of ultrastructure and ED,it may be supply anthoer therapy pathway for DMED.

BACKGROUND: Acellular amniotic membrane used widely in treating ocular surface disease as well as extensive burn wounds due to its low antigenicity and excellent histocompatibility. However, it is poorly understood whether it can be used in repairing urethral defects.OBJECTIVE: To evaluate role and the feasibility of human acellular amniotic membrane (HAAM) in the rabbit urethral reconstruction.DESIGN, TIME AND SETTING: The randomized control experiment of animals was performed at the Laboratory Center of Guangxi Medical University between April and June 2007.MATERIALS: Thirty-two New Zealand rabbits were supplied by animal center of Guangxi Medical University. The human HAAM was obtained from Department of Obstetrics, First Affiliated Hospital of Guangxi Medical University.METHODS: HAAM was prepared by detergent-enzymatic approach. Firstly, the fresh amniotic membrane was protected with cross linking of 1% formaldehyde- 0.2% glutaral, digested with 0.125% trypsogen- 0.05 mol/L EDTA, followed by washing with 0.5% Triton X-100. Totally 32 New Zealand male rabbits were assigned into 3 groups: experimental group (n=12), control group (n=12) and sham operation group (n=8). Rabbits were prepared for urethral defects models in the experimental and control groups, which were repaired with HAAM or anastomosised directly. There was no urethral operation in the sham operation group.MAIN OUTCOME MEASURES: The growth of epithelial cells and smooth muscle cells, as well as inflammatory cell infiltration was observed by histopathologic examination at days 10, 21 and 42 after operation. The urethral pressure changes and urinary bladder was examined by retrograde urethrography at day 42 after operation.RESULTS: ①The prepared HAAM was translucent, there was no residual cells or fragments. ②The pathological section examination showed that in the experimental group, some epithelial cells has grown without acute rejection at day 10 after operation, and several layers of urothelium covered HAAM at day 21 with reduced inflammatory cell infiltration. At day 42, a sprinkle of smooth muscle grew in HAAM with few inflammatory cells. Urodynamic studies indicated that there were no significant difference among 3 groups in the bladder volume, maximum urethral pressure and minimum urethral pressure (P > 0.05). The weight of bladder had obvious difference between the sham operation and control groups (P < 0.05).CONCLUSION: HAAM is an ideal biomaterial with well histocompatibility, biocompatibility and low antigenicity. HAAM is a good choice for urethral reconstruction.

Objective This article is to discuss the best injection time after alcohol disinfection during the prophylactic immunization,provide theoretical support to guarantee the effect of disinfection in practical work,also guarantee the effect of vaccination especially for the vaccination of attenuated live vaccine at the same time reduce the side effect in disinfection.Methods Choosing the vaccination objects as experimental subject,each period contained 40 people,who were named as group A,B,C,D,E,with a total of 200 people.Using sterile cotton swab sampling and agar plate cultivation method,counting bacteria.Selecting vaccine either in liquid or in lyophilized form,counting the time of picking up the vaccine,dissolving it,suction and preparing the injector.Results After alcohol disinfection,there was 1 person and 1 colony growth in group A within 25 s.There were 1 person and 4 colonies growth in group B within 40 s.There were 3 persons and 3 to 12 colonies growth in group C within 60 s,there were 5 persons and 2 to 8 colonies growth in group D within 80 s,there were 8 persons and 3 to 13 colonies growth in group E within 100 s.The difference between group A,B,C and D was not statistically significant.All four groups mentioned above had significant difference compared with group E.The time of whole process for vaccine either in liquid or in lyophilized form was 1.05 min and 29 s.Conclusions During vaccine injection,especially injectable attenuated live vaccine,it is safe time to finish injecting within 25 to 45 seconds.In the operating process of vaccine inoculation,the freeting and drying dosage-form vaccine,the operation sequence must be set as dissolve the seedlings,disinfection,checkup information again and injections.For water dosage-form vaccine,the operation sequence is to disinfection,pulling out seedlings,checkup information again and injections.

Objective To analyze the proportion of incidence of etiological agents in 133 cases with constitutional delayed puberty.Methods Clinical data of etiological agents in 133 patients with constitutional delayed puberty were retrospectively analyzed.Results Etiological agents in 133 cases with constitutional delayed puberty were as follows:Hypo-gonadotrophic hormone group(56.39%,n=75):39 cases with unknown reason(idiopathy,3 cases were female),intrapartum asphyxia/hypoxia or hemorrhage(n=23),pituitary glands dysplasia(n=6),cephal trauma(n=3),postoperative craniopharyngioma(n=2),empty sella turciea(n=2),combined hormone deficiency(n=59).Hyper-gonadotrophic hormone group(17.29%,n=23):17 cases with chromosomal disorders(n=17,male:female=7:16),3 cases with unknown reason(idiopathy).31 cases with constitutional delayed puberty(23.31%),4 cases with functional delayed puberty(3.01%).Conclusion Many etiological agents could result in delayed puberty,different origins of delayed puberty had different therapies.Classification of etiological agents in patients with constitutional delayed puberty phyed an important role in guiding option of clnical treatment.

Objective To investigate the correlation between different blood pressure levels and carotid atherosclerotic plaque formation.Methods The population participated in stroke screening were selected from September 2012 to January 2013 in Dongying,Shandong province.The subjects met the diagnostic criteria of ideal blood pressure (systolic blood pressure [SBP] ＜ 120 mm Hg and diastolic blood pressure [DBP] ＜80 mm Hg,1 mm Hg =0.133 kPa),normotensive (SBP 120-129 mm Hg and/or DBP 80-84 mm Hg),and high-normal blood pressure (SBP 130-139 mm Hgand/or DBP 85-89 mm Hg)were selected.The questionnaires,physical examinations,blood biochemical tests,and neck vascular ultrasound examination were performed.The detection rates of carotid plaque among the normotensive,high-normal blood pressure and ideal blood pressure groups were compared.Multivariatelogistic regression analysis was used to identify the independent risk factors for carotid plaque.Results The proportions of men and diabetes,as well as the levels of body mass index (BMI) and fasting blood glucose (FBG) of the normotensive and high-normal blood pressure groups were significantly higher than those of the ideal blood pressure group (all P ＜0.05).The detection rates of carotid plaque of the normotensive,high-normal blood pressure and ideal blood pressure groups were 12.41％,38.14％ and 49.45％,respectively.The proportions of men and age,as well as the levels of SBP,FBG,and homocysteine (Hcy) of the carotid plaque formation group were significant higher than those of the non-carotid plaque formation group (all P ＜0.05).Multivariable logistic regression showed that age,SBP,FBG,and Hcy were the independent risk factors for carotid atherosclerotic plaque formation,while female gender was an independent protective factor.After adjusting the risk factors such as age,FBG,and Hcy,etc,the risk of plaque formation of the high-normal blood pressure group was significantly higher than that of the ideal blood pressure group (odds ratio 1.354,95％ confidence interval 1.028-1.783; P =0.031),while there was no significant difference between the normotensive group and the ideal blood pressure group.Conclusions High-normal blood pressure was significantly associated with the increased risk of carotid plaque formation,which was an independent risk factor for carotid plaque formation.

Objective To investigate the risk factors and countermeasure of residual stones after single‐channel percutaneous nephrolithotomy for higher stone‐free rate and better operation result .Methods All patients who underwent single‐channel percu‐taneous nephrolithotomy in our hospital from June 2011 to December 2013 were retrospected and the cause of residual stones were analyzed .Results There were 42 patients who had residual stones after operation among total 262 patients undergone single‐chan‐nel PCNL .21 patients had residual stones because the stones they burdened were too complex .7 patients were concerned with com‐plications such as intraoperative hemorrhage .The stone fragments scattered into the calices in 7 patients with overlarge stone during fragmentation .The other causes concerned with stone residue included anatomic structural abnormalities of the kidneys(3 patients) , operation itself inherent limitations(3 patients) ,insufficient practice and experience in operation(1 patients) .Conclusion The main causes concerned with residual stones of single‐channel PCNL are complexity of urinary calculi ,bleeding ,scattering of stone frag‐ments and anatomic structural abnormalities of the kidney .

Objective To investigate the antiviral efficacy of standard treatment with interferon (IFN)-α 2b and ribavirin (RBV) in patients with chronic hepatitis C (CHC) originating from a same blood donor.Methods The test group consisted of 65 CHC patients originating from a same blood donor,and was treated with IFN-α 2b 3-5 MU every other day in combination with RBV 0.6-1.0 g/d.Meantime,the control group consisted of 32 CHC patients who visited the Department of Infectious Diseases in Qiannan People's Hospital,and was treated with Peg-interferon (PEG-IFN)-α 2a 180 μg every week in combination with RBV 0.6-1.0 g/d.All the patients in the two groups were treated for 48 weeks and followed up for 96 weeks.Assessment indictors included sustained virological response (SVR),early virological response (EVR),end of treatment virological response (ETVR),biochemical response after withdrawal of treatment.Side effects during treatment were also evaluated.Measurement data were analyzed by x2 test.Results In test group,SVR rate was 83.1％ (54/65),EVR rate was 93.8％ (61/65),ETVR rate was 86.2％ (56/65) and biochemical response rate after withdrawal of treatment was 100.0％.In control group,SVR rate was 87.5％ (28/32),EVR rate was 96.9 ％ (31/32),ETVR rate was 90.6 ％ (29/32) and biochemical response rate after withdrawal of treatment was 100.0 ％.SVR rates of the two groups were not significantly different (x2 =0.072,P=0.086).Patients of the two groups were divided into two subgroups according to viral load:hepatitis C virus (HCV) RNA＜1.0 × 106 copy/mL and HCV RNA≥1.0 × 106 copy/mL.SVR rates of patients with low and high viral load in test group were 88.9％ and 54.5％,respectively (x2=7.67,P=0.008),those in control group were 96.0％ and 57.1％,respectively (x2 =4.41,P=0.038).SVR rates were higher in the subgroup of patients with low viral load.Leukopenia and thrombocytopenia were more common in control group than in test group (x2 =9.805,P =0.003 ; x2 =6.643,P=0.009).Conclusion IFN-α 2b and RBV combination therapy has similar antiviral efficacy to that of PEG-IFN-α 2a and RBV combination therapy,and has a lower rate of side effects as well.

Objective To investigate the associations between the single nucleotide polymorphisms of TERT rs2736098, CLK3 rs11543198 and bladder cancer. Methods 201 bladder cancer cases and 200 healthy controls were included in the research, and the genotypes of TERT rs2736098 and CLK3 rs11543198 were determined using the PCR-RFLP method. Relationship between genotypes and bladder cancer risks was investigated. Results There were statistical significance in the rs2736098 genotype frequencies and allele frequencies between cases and controls (χ2= 6.973, P = 0.031; χ2= 7.412, P = 0.006). Compared with the individuals with the GG genotype , the risk of bladder cancer increased 2.069 times with the AA genotype (OR = 2.069, 95%CI: 1.181-3.624, P = 0.011). And there were no significant associations between the rs11543198 genotype frequencies and allele frequencies between cases and controls (χ2 = 0.202, P = 0.904; χ2 = 0.188, P = 0.665). Rs2736098 and rs11543198 genotype distribution in bladder cancer pathologic grade and stage had no statistical significance (P > 0.05). Conclusion Rs2736098 polymorphism is associated with risk of bladder cancer and rs11543198 polymorphism was not associated with risk of bladder cancer.

Objective To evaluate the value of Alberta Stroke Program Early CT Score on diffusion weight-ed imaging(DWI-ASPECTS)in predicting the leptomeningeal collateral circulation(LMA)compensation of isch-emic stroke with middle cerebral artery stenosis or occlusion after intravenous thrombolysis. Methods A total of 178 patients with ischemic stroke confirmed as severe middle cerebral artery stenosis or occlusion by imaging were enrolled in the study.All the patients were treated by rt-PA intravenous thrombolysis.The baseline clinical date, DWI-ASPECTS,mRS and NIHSS were collected. LMA was assessed by cranio-cervical CTA. Results Compared with the poor collateral circulation group,the triglyceride level and DWI-ASPECTS were significantly increased in good collateral circulation group(P<0.05).The proportion of hypertension,NIHSS score,mRS score in good col-lateral circulation group were significantly lower than those in the poor collateral circulation group(P < 0.05). Compared with the poor collateral circulation group,insula,the ASPECTS areas M1 to M4,M6 and insula showed significantly fewer infarctions in good collateral circulation group(P<0.05).ROC analysis showed the area under ROC curve(AUC)of DWI-ASPECTS to predict LMA compensation were 0.932,the cutoff point of DWI-ASPECTS was 7.5.the sensitivity and specificity were 81.% and 94.1%.Conclusions The tissue protective role of good lepto-meningeal collateralization seems to be more pronounced in cortical and subcortical areas M1 to M4,M6 and the in-sula.DWI-ASPECTS can effectively predict the collateral circulation compensation in patients with acute middle ce-rebral artery infarction.