Objective　To explore the cause, diagnosis and treatment of retroperitoneal fibrosis.Methods　5 cases of retroperitoneal fibrosis were respectively treated by moving ureter into abdomen cavity, encapsulating with pediculate omenta and ilel ureter.Results　Following-up of 5 cases for 1 to 3 years, all cases had normal renal functions and hydronephrosis were much decreased.Conclusions　Intravenous urogenous(IVU),retrograde pyelography(RGP) and computed tomography (CT) are important methods to diagnose the disease. And the treatment method chosen depends on the range, location of ureterostenosis, and whether the ureter is open or not.

Objective To validate the clinical applicability of the published standard reference interval of routine clinical chemistry(WS/T 404.1-2012,WS/T 404.1-2012) based on the results of health examination.Methods This was a retrospective study.The results of serum TP(Biuret),ALB (BCG),ALT(Rate without 5'-pyridoxal phosphate),AST (Rate without 5'-pyridoxal phosphate),ALP (Rate,AMP),GGT(Rate) from healthy examinatiou individuals (from January to July,2013) were collected to calculate the 2.5％ and 97.5％ pereentiles,excluding the significant abnormal results according to the Medical Deciding Level 2 recommended by Staland.The number of the cases after excluding were 19 708(M 12 044,F 7 664) 、19 728(M 12 069,F 7 659) 、45 569(M 26 299,F 19 270) 、45 877(M 26 739,F 19 138)、5 965(M 4 208,F 1 757)、4 726(M 3 164,F 1 562),respectively.The proportions of all the examined results (with and without the excluded results) that fell in the published standard reference interval were also calculated.Results The test of normality revealed that the frequency distributions of all verified items were skewed distributions after excluded the abnormal results.The 2.5％-97.5％ percentiles of TP,ALB,ALT(M),ALT(F),AST (M),AST (F),ALP (F20-49),ALP (F50-79),GGT (M) and GGT (F) were 64-79 g/L,40-59 g/L,9-52 U/L,7-39 U/L,13-41 U/L,12-33 U/L,42-116 U/L,36-98 U/L,44-130 U/L,11-72 U/L and 7-50 U/L respectively.More than 90％ results of TP,ALB,ALT(M),ALT(F),AST (M),AST(F),ALP(F20-49),ALP(F50-79),GGT(M) and GGT(F) (with and without the excluded results) fell in the reference intervals of national standards,GGT(M) was 80％ and 91％.Conclusions The published standard reference interval of routine clinical chemistry (WS/T 404.1-2012,WS/T 404.1-2012) are applicable to our laboratory.

Purpose:To assess the value and limitation of CT in staging colorectal carcinoma.Methods:CT was performed prior to surgery in 46 patients with 48 colorectal carcinomas for staging the tumor. The results were compared with those of surgical and pathological examinations in all cases in order to study the sensitivity of staging the tumor before operation.Results:(1) CT depicted 31 of 33 pathologically confirmed T4 lesions (beyond the serosa) in all 48 primary carcinomas,appearance of T4 lesion were defined as either strands of soft tissue or nodules into the peri-colorectal fat ,or hyperdensity of pericolorectal fat. (2)Pathologic examination of lymphatic metastases unfirmed 20 of 40 patients who underwent complete resections, and these lymph nodes were not larger than 1cm in 17 patients.The sensitivity is 70%(14/20)and the specificity 85%(17/20)respectively in detection of lymphatic metastases for CT. (3) The accuracy of CT staging was 81.25%,77.50% in T,N respectively in this group of patients,and CT showed all 4 cases of liver metastases and 6 of 7 peritoneal metastases. Conclusions:CT is accurate in detecting T4 stage of colorectal carcinoma. It is effective in depicting local extension and distant metastases. The value of CT for early T staging and N staging in colorectal carcinoma is limited.

Objective To investigate the effect of constraint abstinence duration on regional homogeneity (ReHo) of heroin addicts in resting state.Methods Twenty heroin addicts abstinent for 6 months (PA6 group),sixteen heroin addicts abstinent for 11 months (PA11 group) and 30 demographically matched healthy controls (HC group) were enrolled.ReHo values were calculated and difference among three groups was analyzed.The relationship between ReHo values of differential brain regions and abstinent duration was performed with Pearson method.Results The results demonstrated statistically significant difference in ReHo values among three groups in the left parahippocampal gyrus,caudate,insula,cingulate gyrus,postcentral gyrus and right orbitofrontal cortex.Compared with the PA6 group,the PA11 group demonstrated lower ReHo value in left parahippocampal gyrus,caudate,insula,cingulate gyrus and postcentral gyrus,ReHos value were higher than PA6 and HC in right orbitofrontal cortex.Meanwhile,the ReHo values of left parahippocampal gyrus (r=0.53,P=0.000 8),caudate (r=0.54,P=0.000 6),insula (r=0.62,P＜0.000 1),cingulate gyrus (r=0.47,P=0.003 5) and postcentral gyrus (r=0.35,P 0.034 8) were negatively correlated with abstinence duration and ReHo value of right orbitofrontal cortex (r=0.66,P＜0.000 1) were positively correlated with abstinence duration.Conclusion During long-term abstinence,most of heroin addicts' damaged brain regions (mainly involved in craving,inhibitory control,learning and memory) tends to be normal,thus benefit reducing the risk of relapse,but motivation related brain region's (orbitofrontal cortex) neural activity increases abnormally,that may be one of the important reasons for relapse after abstinence.

Objective: To explore comprehensive treatment for severe infection caused by ureteral calculus. Methods: The clinical data of 12 patients with severe infection caused by ureteral calculus in the Second People's Hospital of Lianyungang from January 2016 to December 2017 were reviewed.The patients cured by anti-infective therapy received one-stage surgical treatment.The patients with ineffective anti-infective therapy received one-stage cystoscopic retrograde double J tube or B ultrasound-guided percutaneous nephrostomy first, then ureteral calculus was treated. Results: Two patients were cured by empirical antimicrobial agents.One patient was successfully cured by extracorporeal shock wave lithotripsy (ESWL) and the other by retroperitoneoscopic ureterolithotomy.Ten patients were not responsive to empirical antimicrobial agents.Two patients refused treatment and requested discharge from the hospital.The other 8 patients received two-stage treatment.In the stage I, cystoscopic retrograde double J tube was accomplished in 3 patients, and 5 patients were treated successfully by percutaneous nephrostomy guided by B ultrasound.In the stage II, one patient with ureter stone-street was cured by lithagogue drugs, 2 patients were successfully cured by ESWL, one patient by holmium laser lithotripsy under ureteroscope, 2 patients by ureterolithotomy and 2 patients by percutaneous nephrolithotomy by endoscopy and holmium laser. Conclusion The therapy of retrograde double J tube at cystoscopy or percutaneous nephrostomy guided by B ultrasound combined with empirical antimicrobial agents in the satae I, combined with lithotripsy according to guidelines in the stage II in treating severe infection caused by ureteral calculus have more advantage such as simple, less injury, rapid control of infection, less complication and satisfactory effect.It is an ideal method.

Objective To evaluate the clinical and pathological characteristics and treatment of penile schwannoma.Methods One case of penile schwannoma was reported,and the relevant literature was reviewed to investigate the histogenesis,diagnosis and treatment of this disease.Related literature from PubMed and Wanfang databases to date(up to April 2017)with"penis" or"penile" combined with "schwannoma" or"neurilemmoma" as search terms was reviewed.Results One 40-year-old male presented in October 2015 with a tumor at the root of the dorsal penis for 1 year.Physical examination revealed a non-tender,easily movable without adhesion to the skin,1.2cm ×0.8cm nodule at the root of the dorsal penis,the overlying skin was smooth and intact.No evidence of neurofibromatosis was found.Hypoechoic well-defined nodule(1.7cm ×0.4cm)located between the superficial skin and corpus cavernosum was showed on ultrasound without blood flow signal.Simple excision of the tumor was performed under local anesthesia.Grossly,the tumor was a well-defined,white,soft 1.5cm ×1cm ×0.7cm nodule.Microscopically,the tumor was composed of Antoni A area with hypercellular and nuclear palisading.Immunohistochemical staining showed S-100(+++),SMA(-),Act(-).The pathological diagnosis was penile schwannoma.Postoperatively,the patient recovered well without erectile dysfunction.During a follow-up 18 months,the patient had no recurrence.By literature review,we found 14 cases in Chinese articles with one malignant case,while 33 cases in English articles with six malignant cases.The average age of onset was 39.2 years.Most of the tumors are benign and located in the dorsal side of the penis.Penile schwannoma can be diagnosed properly based on pathological examination,owing to the lack of typical clinical and imaging manifestation.The tumor resection was the treatment of choice for benign penile schwannoma without postoperative complications.Conclusion Penile schwannoma is extreme rarity,but can be diagnosed properly based on postoperative pathological examination,owing to the lack of typical clinical and imaging manifestation.S-100 is a useful marker for the diagnosis of schwannoma.The tumor resection is the treatment of choice for benign penile schwannoma without erectile dysfunction or recurrence ;for the malignant,the final diagnosis relies on postoperative pathological examination after the secondary operation with local recurrence.The tumor resection combined with radiotherapy and chemotherapy is reliable treatment,but the prognosis is poor.

Objective:To investigate the effects of constant body temperature (37 ℃), constant room temperature (24 ℃) and cold liquid (20 ℃) on shivering and inflammatory response after holmium laser lithotripsy under ureteroscope.Methods:A total of 132 patients receiving holmium laser lithotripsia under ureteroscope treated in the Second People′s Hospital of Lianyungang City from July 2020 to July 2023 were selected as the study objects. According to the intraoperative lavage fluid temperature, they were divided into cold liquid group (20 ℃, n=44), equal room temperature group (24 ℃, n=44) and equal body temperature group (37 ℃, n=44).. Anova was used to compare the occurrence of postoperative chills in the three groups at 10 min, 30 min, immediately after the operation, and the anti-inflammatory response of stress before and after the operation. Chi-square test was used to compare the occurrence of postoperative chills. Results:The difference of core body temperature between the three groups at 10 min, 30 min and immediately after operation was statistically significant. The core body temperature of the cold liquid group was lower than that of the equal room temperature group and the equal body temperature group at the above time point ( P<0.05). There was no significant difference in core body temperature between the isoroom temperature group and the isobody temperature group at 10 min, 30 min and immediately after operation ( P>0.05)..The levels of norepinephrine and serum cortisol in the three groups were higher after surgery than before surgery, and the levels in the cold liquid group were higher than those in the isothermal group and the isothermal group ( P<0.05), but there was no statistical significance between the isothermal group and the isothermal group ( P>0.05).The levels of C-reactive protein, interleukin-10 and white blood cells were higher after operation than before operation, but there was no statistical significance among the three groups ( P>0.05).There was a statistically significant difference in the incidence of postoperative chills among the three groups ( χ2=6.87, P=0.03). Nine cases of postoperative chills occurred in the cold body fluid group, the highest incidence of chills was 20.45%, 3 cases occurred in the room temperature group, and 2 cases occurred in the body temperature group. There was no significant difference in the incidence of chills (6.81% vs 4.55%) ( P>0.05). Conclusion:In holmium laser lithotripsy under ureteroscope, compared with cold liquid lavage, intraoperative equi-room temperature lavage and equi-body temperature lavage can maintain constant intraoperative body temperature, relieve stress reaction, reduce postoperative inflammatory reaction and lower incidence of postoperative chills.