Objective To investigate the treatment of complicated upper urinary tract calculi. Methods 138 cases of upper urinary tract calculi were treated by the combination of extracorporeal shork wave lithotripsy (ESWL),ureteroscopic lithotripsy and minimally invasive percutaneous nephrolithotomy were reviewed.There were 110 cases of complex ureteral stone and 28 cases of complex kidney stone among the group.All cases had variable degree of hydronephrosis.The treatment program for complex upper urinary tract calculi was initially,ESWL and followed by ureteroscopy and pneumatic lithotripsy in 24 hours.For the complex kidney stone and upper ureteral stone,which was difficult for ureteroscopy lithotripsy.The program was firstly percutuneous minimal pyelostomy,ESWL after 5～7 days,then urteroscopy lithotripsy and lithotomy through the fistula in 24 hours. Results Total stone-free rate was 97.1%(134/138),in ureteral stone group was 100%(110/110),in kidney stone group 85.7%(24/28).Satisfactory result has been observed in all cases. Conclusions The endoscopic manipulation become easy and fast by means of endoscopic manipulation in the treatment of complex upper urinary tract calculi.This technique is minimally invasive and has less complications,it increases the stone-free rate.

Objective To recognize the factors which influence the therapeutic efficacy of transurethral resection of the prostate (TURP) and to improve the qualities of TURP. Methods The data of 600 patients with benign prostatic hyperplasia (BPH) were retrospectively studied based on the mastering of TURP.The patients’age ranged from 52 to 92 years,with a mean of 64.8 years.Preoperatively,the volume of the prostate was 16.3～210.4 ml,with a mean of 46.2 ml,measured by color Doppler B-ultrasound.The average maximum urinary flow rate (Qmax) was 8.4 ml/s,and average urinary flow rate (Qave) was 4.3 ml/s.The average residual urinary volume (RU) was 75 ml,and the average IPSS was 23. Results TURP was successfully performed on all the 600 patients.The average resected prostate tissue weight was 31.8 g.The average electric ablation time was 51 minutes.Intraoperative blood transfusion was performed in 38 cases. Aura of transurethral resection syndrome (TURS) occurred in 4 cases,but no TURS occurred.Of the 600 cases,508 cases (85%) were followed up for 1～32 months.Postoperative average Qmax increased to 16.9 ml/s,Qave increased to 10.8 ml/s and RU decreased to 15 ml.Compared with those of preoperation,the differences were statistically significant (P

Objective To evaluate endoscopic manipulation such as ureteroscopy,air pressure lithotripsy and double J catheter placing for the emergency treatment of obstructive acute renal failure (OARF). Methods 23 cases of obstructive acute renal failure,with an average age of 53,were treated by instant endoscopic manipulation.Blood uria nitrogen (BUN) before treatment was 16.1～55.6 mmol/L and serum creatinine (SCr) 465～2 099 ?mol/L.The patients were followed up for 1～9 months. Results Satisfactory result has been observed in all. 24 h urine output reached 2 400～5 600 ml with BUN and SCr dropped significantly.Normal renal function has been regained in 19 whereas SCr dropped to 200 ?mol/L in the other 4 patients. Conclusions Endoscopic management has the advantages of minimal invasion,safety,quick recovery and bilateral ureteral obstruction could be dealt with simultaneously.Instant endoscopic management plays an important role in the treatment of obstructive acute renal failure.

Objective:To improve the radiologic diagnostic and treatable rate of mannmmary ductal diseases.Methods:We retrospectively analyzed the galactographic materials of 369 cases.Results:The mammary ducts were classified into 4 types according to their morpholgy,including general fruticoses,multiple fruticoses,less fruticoses and single fruticoses.In this group,the multiple and less fruticoses were the most common,the general and single fruticoses were the less.Conclusion:Understanding radiologic anatomy of mammary duct is very valuable in the diagnosis and treatment of mammary ductal diseases. [

Objective To analyze the factors that influence joint function after plate fixation of unstable pelvic fractures.Methods A retrospective study was conducted to analyze the 109 patients with unstable pelvic fracture who had been treated with plate fixation from January 2007 to September 2014.They were 69 men and 40 women,23 to 72 years of age (average,46.3 years).By the Tile classification,15 cases were type B1,37 type B2,14 type B3,19 type C1,16 type C2,and 8 type C3.Their postoperative joint function was evaluated according to the Majeed criteria for functional evaluation.There were 86 cases in the good-to-excellent group (78.9％) and 23 in the fair-to-poor group (21.1％).Their data were analyzed in terms of gender,age,preoperative injury severity scale (ISS),body mass index (BMI),operation time,fracture type,reduction quality,postoperative complications,bone density,and postoperative weight bearing time.The influential factors were determined using Logistic regression analysis.Results All the 109 patients obtained a mean follow-up of 18.7 months (from 12 to 53 months).Preoperative ISS (P =0.000),fracture type (P =0.008),reduction quality (P =0.009) and postoperative complications (P =0.000) were identified as the factors influencing joint function after plate fixation of unstable pelvic fractures.Conclusion Preoperative assessment by ISS,a clear understanding of the pelvic fracture type,anatomical reduction of the fracture and efforts to reduce postoperative complications can effectively improve functional recovery of the joint after plate fixation of unstable pelvic fractures.

Objective To find out about the current state of and need for general practice training in communities so as to provide basis for the formulation of relevant training strategies and methods. Methods A qualitative and quantitative investigation was made on the state of and need for general practice training at the community based health services centers or stations in the 3 cities of Chengdu, Shenyang and Shanghai. Results Of the 171 physicians surveyed, 39.8% once received general practice training; of the 162 nursing personnel surveyed, 12.3% once received general practice training; of the 67 preventive healthcare personnel surveyed, 35.8% once received general practice training. While the medical personnel who once received general practice training did not think highly of the training result, they did have high demands for general practice training. Conclusion It is suggested that centers for training general practitioners be established, training of community health services personnel strengthened, and their quality improved.

Objective To study the effects of repeated hypoxic exposures (HEs) on glycolysis, mitochondrial oxi-dative phosphorylation and energy charge in mouse brain. Methods Adult BALB/c mice were repeatedly exposed to hypoxia for 5 times and the standard tolerant time and body temperature were recorded. The activities of PFK, PK and mitochondrial complex Ⅰ in the brain were assayed. Phosphoadenosines and energy charge were measured. Results Repeated HEs prolonged the hypoxic tolerance and reduced the body temperature. The activities of PFK and PK experienced regular changes, with an increase in 1st and 3rd HEs and a decline to control levels in 5th HE. The complex Ⅰ activity continued to decrease during HEs. The energy charge was stable. Conclusion HEs lead to a regular change of glycolysis, a continued inhibition of mitochondrial oxidative phosphorylation, and a main-tained energy charge in the brains of mouse.

Objective To evaluate the application of the transurethral vapor-resection of the prostate(TU- VRP) for bladder outlet obstruction(BOO) in patients with prostate eaneer(PCa). Methods Of 33 patients with BOO. 18 were definitely diagnosed with PCa and after treatment they still had symptoms of BOO;15 cases were di- agnosed with benign prostate hyperplasia(BPH). All patients underwent TUVRP for BOO. Results All cases were successfully done. Postoperative complications included transient urinary ineontinenee in 5 ,and gross hematuria in 9. 27 patients were followed up(10-36 months).8 cases died of PCa,with a mean survival of 31 months.5 cases died of other diseases. After treatment, PSA levels decreased to ( 10.2 ± 6.7) μg/L. The average residual urinary volume (RU) decreased to (39.7 ± 13.9) ml, and the average IPSS was (8.7 ± 1.6 ). Compared with those of preoperation, the differences were statistically significant ( P < 0.05 ). Conelnsion TUVRP is a reliable treatment for prostate cancer with bladder outlet obstruction.

Objective To investigate the therapeutic effects of cystitis glandularis by TUR. Methods The clinical data of 40 patients with cystitis glandularis who were treated with TUR, transurethal plasma kinetic resection or postoperative mitomycin instillation of bladder in our hospital from January 2003 to December 2006 were retrospectively analyzed. Results Vesical perforation occurred in 2 patients,and the complications of urinary incontinence and vesical neck constriction were not observed postoperatively. 37 patients were followed up for an average of 1.8years, 32 patients were cured ,3 patients turned better, 2 patients reoccurred, and no cancer was observed. Conclusion The transurethra resection combined with mitomycin irrigation of bladder has satisfactory therapeutic effects on cystitis glandularis,and there are fewer adverse reaction and can be taken as the primary choice for treating cystitis glandularis.

Objective To explore sonographic manifestation of fetal malformations of cortical development.Methods From August 2012 to January 2014 three hundred and twenty-five pregnancy women referred to our institution for fetal brain MRI,which were diagnosed or suspected of central nervous system abnormalities by prenatal ultrasound examination.Results In 325 of cases,14 cases (4％) were diagnosed of malformations of cortical development.Ten eases were indicated by prenatal ultrasound,including three cases of heterotopic gray matter,six cases of microcephaly and one case of hemimegalencephaly; four cases were missed by prenatal ultrasound,including two cases of schizencephaly,one case of tuberous sclerosis,and one case of hypoplasia.Conclusions Cortical malformations can be diagnosed by prenatal ultrasonography based on typical imaging characteristics.Prenatal ultrasound combined with MRI is a powerful tool in diagnosing fetal malformations of cortical development.