Objective To study and evaluate frequency-doubled-double-pulse laser (FREDDY) lithotripsy of ureteral calculi. Methods The experience of 150 cases of ureteral calculi treated with FREDDY from April to December in 2001 was summarized.94 are male patients and 56 female with an average age of 42.There were 48 cases of upper,35 middle and 64 lower ureteral stone. Results Of 150 cases,136(90.6%) were successful on the first lithotripsy.Of which in 131 cases (96.8%) the stone fragment completely expelled in one week.The procedure failed in 9 cases of upper ureteral calculi.Among them,5 cases was due to up drift of calculi or incomplete lithotripsy and was then shifted to ESWL therapy.2 was due to angular twist of the ureter and changed to open operation,and another 2 was due to perforation of ureter during the procedure.Of the 5 failed cases with middle and lower ureteral calculi,1 was due to incomplete lithotripsy,nonfragmentation in 1 case and failure of ureteroscopy in 3(changed to open operation).Different degree of hematuria was seen in every case after operation.High fever or pyonephrosis after operation has not been observed.The average operation time was 32 minutes,and the average time for laser working was 3.3 minutes.The average hospitalization after operation was 2.5 days. Conclusions FREDDY is a kind of laser with the characteristics of single function,simple operation,safe,less damage to the soft tissue and high efficiency of lithotripsy.The procedure is indicated if ESWL failed or not indicated.

Objective To analyze the epidemiological characteristics of human brucellosis in Harbin City.Methods Retrospective study was used to collect the information of brucellosis epidemic situation and monitoring data.The information of brucellosis cases was from China disease surveillance information system and from the Harbin surveillance results of brucellosis between 2004 and 2013.According to the results of epidemiological characteristics of brucellosis in Harbin,analysis of regional distribution,time distribution,population distribution and brucellosis serology positive rate were conducted in 18 counties (cities,districts) of Harbin.Data were analyzed using SPSS 13.0 software.Results From 2004 to 2013,2 602 cases of brucellosis were reported.In particular,the largest increase was in 2012,a total of 481 cases was reported,which was 2.11 times that of 2011 (228 cases).The incidence was raised from 2.20/100 000 to 5.98/100 000,and the epidemic range expanded from 15 counties (cities,districts) to 18 counties (cities,districts).Age of onset concentrated in young adults,the 20-59 years old group accounting for 86.47％ (2 250/2 602) of the total incidence.The proportion of male and female was 2.90 ∶ 1.00 (1 936 ∶ 666).The occupation of most new cases was farmers,accounting for 83.55％ (2 174/2 602) of the total incidence.In brucellosis surveillance,4 877 people was undergo serological test,the positive number was 145,and the positive rate was 2.97％.Conclusion Human brucellosis epidemic has an increasing trend in Harbin,age of onset is concentrated in young adults,males are more than females,and the epidemic range expands year by year.

Objective To discuss the influence of different doses budesonide aerosol inhalation on serum cytokines levels in children with severe asthma.Methods 96 children with severe asthma aged 4 to 14 years old in our hospital were chosen,and they were randomly divided into the observation group and the control group,48 cases in each group.All patients were given conventional treatment, and the control group was given 1mg/time budesonide treatment on the basis of conventional treatment (3 times a day),while the observation group was given 2mg/time budesonide treatment (3 times a day).Before and 1 week after treatment,the clinical symptoms of two groups were observed and compared,as well as the changes of IL-4,IFN-gamma,IL-10 and TNF-α.Results In the obser-vation group,wheezes,coughing,wheezy sound and rales disappearance time were (2.10 ±0.77)d,(5.45 ±1.20)d, (3.46 ±1.03)d,(5.55 ±1.35),which were significantly shorter than (2.98 ±1.02)d,(7.48 ±1.19)d,(5.43 ± 1.06)d,(7.56 ±1.67)d in the control group (t=4.77,8.32,9.23 and 8.32,all P<0.01).4 weeks after treat-ment,the total effective rate of the observation group was 89.6%,which was significantly higher than 72.9% of the control group (χ2 =4.376,P<0.05).After treatment,the IL-4,IL-10,TNF-alpha,IFN-gamma levels in the observation group were (4.06 ±1.77)pg/mL,(12.77 ±2.05)pg/mL,(4.15 ±1.11)ng/mL,(26.23 ±2.78)pg/mL, which had significant changes compared with (9.02 ±2.23)pg/mL,(10.21 ±1.30)ng/mL,(6.66 ±1.62)pg/mL, (17.33 ±2.31)pg/mL before treatment(t=12.07,24.56,16.20,17.25,all P<0.01).After treatment,the IL-4, IL-10,TNF-alpha,IFN-gamma levels in the control group were (9.11 ±2.05)pg/mL,(6.80 ±1.23)ng/mL, (9.88 ±2.20)pg/mL,(21.22 ±2.80)pg/mL,which had significant changes compared with (9.11 ±2.05)pg/mL, (10.38 ±1.37) ng/mL,(6.71 ±1.77) pg/mL,(17.30 ±2.05) pg/mL before treatment( t=5.36,13.47,7.77, 7.83,all P<0.01).But IL-4,TNF-alpha levels in the treatment group were significantly lower than those in the control group (t=7.32,11.08,all P<0.01),while IL-10 and IFN-gamma levels were significantly higher than those in the control group (t=6.65,8.80,all P<0.01).The incidence of adverse reactions of the two groups had no statistically significant difference (χ2 =0.771,P>0.771).Conclusion High doses of budesonide aerosol inhalation in the treatment of children with severe asthma has obvious clinical curative effects,which could significantly improve the patients'clinical symptoms,and also has low incidence of adverse reactions,which is worthy of clinical promotion.

Contemporary hospital information systems normally contain multiple applications,which are traditionally deployed as one application per server.More servers in the system will incur high system costs,low server efficiency and poor management and maintenance.The information system reform project of Wuxi Maternal and Child Health Hospital called into play the virtualization based on VMware.The project brought forth a number of merits,namely sizably raising efficiency of servers integration,simplifying server group management,reducing cost and promoting hospital informationization.

Objective: To observe the therapeutic efficacy of astragalus polysaccharide (APS) in combination with three-dimensional conformal radiotherapy (3D-CRT) for elderly patients with non-small cell lung cancer (NSCLC). Methods: A total of 80 elderly patients with I～IV stage NSCLC were randomly divided into two groups. The 40 patients in the therapeutic group received radiotherapy in combination with APS. The 40 patients in the control group received radiotherapy alone. Both groups received 3D-CRT with a total dose of 50～ 70Gy, 2.0Gy/fraction, once a day, 5 times per week. The patients in the therapeutic group were treated with radiotherapy combined with injection of APS (250mg in 5% glucose) or normal saline (500 mL) intravenously once a day until the end of radiotherapy. The short-term efficacy and patients' quality of life were evaluated. The T-lymphocyte subpopulation and peripheral blood leukocyte count were also measured after treatment. Results: The short-term effective rates of the therapeutic group and the control group were 87.5% and 72.5%, respectively, without significant difference between the two groups (P＞0.05). The decrease of peripheral blood leukocyte count after treatment in the control group was significant (P＜0.05). In the therapeutic group, the T-lymphocyte subsets CD8 and CD4/CD8 were improved after treatment, with a significant difference (P＜ 0.05). But in the control group, no significant changes in T-lymphocyte subsets CD8 and CD4/CD8 were observed after treatment (P＞0.05). Patients' quality of life in the therapeutic group was superior to that in the control group, with a significant difference (P＜0.05). Conclusion: APS in combination with 3D-CRT can reduce the side effects of radiation and improve the quality of life of elderly patients with NSCLC.

Objective To discuss the application value of CT angiography (CTA) in evaluating renal artery anatomy of laparoscopic nephron-sparing surgery (LNSS) before operation. Methods Retroperitoneal LNSS was performed in 87 patients with renal tumors. Forty cases underwent CTA before LNSS, volume rendering and maximum intensity projection of renal artery were used as three-dimensional reconstruction. The other 47 without CTA were compared as control. Treatment out-comes of the 2 groups were compared, including operation time, warm ischemia time, blood loss, con-version to open surgery, hospitalization stay after operation, and complications after operation. Re-sults All the procedures were completed laparoscopically with no conversion to open surgery in CTA group. One patient underwent conversion to open surgery in the control group. In CTA and control group, the operation time was 94 min(range, 76-118)and 115 min(90-190, P<0.05). The warm ischemia time was 23 min(12-39)and 29 min(18-40, P<0.05). Blood loss was 90 ml(9.0-160) and 130 m1(90-600, P<0.01). Hospitalization stay after operation was 4.1 d(3-5) and 5.5 d(3-9), respectively(P<0.05). The pathologic examination showed negative surgical margin in all cases of renal cell carcinoma. The patients were followed up for 4 months to 32 months. Neither distant nor local recurrences were observed, and the renal function was normal in all cases. Urinary leakage oc-curred in 1 patient of each group. Conclusions CTA could be an effective method in evaluating the supply blood vessels of kidney before LNSS. And it can shorten the operation time and warm ischemia time, reduce the blood loss, as the result of helping the operaters deal with renal artery more quickly and accurately.

Objective To investigate the clinical presentations, pathologic features, and the di-agnosis and treatment of prostate sarcomatoid carcinoma. Methods Two cases of prostate sarcoma-told carcinoma were analyzed with review of the relevant literature. Case 1, a 51-year-old man com-plained of dysuria and perineal discomfort for 2 months, was admitted because of acute urinary reten-tion. His serum PSA was 2.31 ng/ml. Heterogeneous density of the prostate left lobe and bladder neck involvement was shown on CT scan. Prostate sarcomatoid carcinoma was confirmed by transrec-tal prostate biopsy, and patient accepted radical cystoprostatectomy and ideal conduit followed with lo-cal radiotherapy and hormonal therapy. Case 2 was a 54-year-old male. This ease was admitted with a history of dysuria and intermittent gross hematuria for 1 month. Hypoechoic lesion was found by ul-trasonography,and heterogeneous density of the prostate was shown on CT scan. His serum PSA was 2.61 ng/ml. The prostate biopsy result showed prostate sarcoma. Radical cystoprostatectomy and ide-al conduit was performed on this case. Results The diagnosis of prostate sarcomatoid carcinoma in the 2 cases was confirmed by postoperative pathology. Under microscope, the neoplasm was mainly composed of epithelial and sarcomatoid mesenchymal cells,with a transitional region of these cells. Im-munohistochemical staining showed that the cells were positive for cytokeratin and epithelial membrane antigen. Vimentin was negative in the epithelial cells, but was positive in the majority of sarcomatoid cell. Both patients died of multi-metastasis at 43 and 19 months after surgery respectively. Conclu-sions Sarcomatoid carcinoma of the prostate is extremely rare with a high grade of malignancy,and its prognosis is poor. The diagnosis depends on pathological features and immunohistochemical studies. Radical resection combined with endocrine therapy and radiotherapy is considered to be the most relia-ble treatment so far.

Objective Carbon/carbon ( C/C) composites are a potential material for bone repair .To improve the hydrophilicity and biological activity of C/C composites , polydopamine coating was prepared on the surface of C /C composites.Methods By changing the coating time and coating environment ( oxygen or air atmosphere ), a series of polydopamine coating samples were prepared . The water contact angle test , scanning electron microscope , energy dispersive spectrometer , atomic force microscope and protein adsorption test were used to characterize the properties of different samples.Then, the data were analyzed to optimize preparation conditions .Results When the concentration of dopamine was 2.0 g/L,and the coating time was 30 min (oxygen atmosphere) +11.5 h (air atmosphere), the water contact angle was decreased from 64.0°(blank sample) to 25.9°, suggesting that the hydrophilicity was improved greatly . The results of the scanning electron microscope , energy dispersive spectrometer and atomic force microscope showed that the coating was uniform and dense .The amount of protein adsorption per sample was 0.2817 mg.Conclusion The polydopamine coating on the C/C composites improves its hydrophilicity and biological activity , which indicates that the polydopamine coated C/C composites will be a new potential material for bone tissue repair .

Objective To investigate the consensus and controversies on delineation of radiotherapy target volume for patients with non-small cell lung cancer(NSCLC). Methods Study questionnaires were designed by radiation oncologists in Peking University School of Oncology. The forms were sent through email to radiation oncologists in 10 radiation departments in China and 2 departments in US in November,2007. The brief introduction and PET/CT digital data of one patient with NSCLC were sent to radiation oncologists in 10 departments in Beijing. On Jan. 12,2008,the case discussion was held by more than 300 radiation oncologists from Beijing,Tianjin, Hebei, Liaoning Province and Inner Mongolia Autonomous Region. Results All receivers of the questionnaire responded . The set up error was 5-7 mm . For patients with locally advanced NSCLC treated with radiotherapy concurrently with near full dose chemotherapy,ll out ot 12 responding departments defined planning target volume(PTV) of primary tumor as gross tumor volume(GTV) plus 6-8 nun plus set-up error and respiratory movements ,and only one defined PTV as GTV plus set-up error and respiratory movements. For PTV of the mediastinal lymph nodes in the same patient,9 out of 12 responding departments defined PTV as GTV plus 6-8 mm plus set-up error and respiratory movements,and 3( of China) out of 12 defined PTV as GTV plus set-up error and respiratory movements. Stereotactic body .radiotherapy with high fraction dose was used in 11 out of 12 responding departments with fraction dose varying from 6 to 20 Gy,including 6 of which defined PTV of primary tumor as GTV plus 6-8 mm plus respiratory movements and set-up error, and 5 defined PTV of early stage lung cancer as GTV plus respiratory movements and set-up error. The consensus on delineation of primary tumor of the case discussion was that the appropriate window width and window level were 1600 Houasfield Units(HU) and -600 HU for lung window,and 400 HU and 20 HU for mediastinal window. The controversies was focused on whether the CTV for metastatic lymph nodes should be restricted as GTV plus 6-8 mm or enlarged to enclose all the involved lymph node region. Conclusions PIT of primary tumor and mediastinal metastatic lymph nodes should be GTV plus 6-8 mm plus respiratory movements plus set-up error. The basic controversies of target delineation are focused on the fraction dose and PIT range for early stage NSCLC, and on the possibility of defining the PIT as GTV plus respiratory movements and set-up error when treated with concurrent radiotherapy and full dose chemotherapy for locally advanced NSCLC.

Objective To explore the safety and efficacy of laparoscopic nephron sparing nephrectomy for renal tumor. Methods The data of 72 patients diagnosed as renal rumor and treated with laparoscopic nephron sparing nephrectomy were retrospectively analyzed.Procedure detailed as following:firstly,the renal tumor was exposed completely after routine institution of 4 passages;secondly,the tissue 3 cm around the tumor was labeled and then incised using cool scissors after Bulldog occlusion of the renal artery;thirdly,the lesion was covered with anti-bleeding gauze and then intermittently sutured using 1-0 absorbable Dixon suture and crossing Hem-o-lok. Results Operation time was 90-190 min,with warm ischemia time 12-40 min.Bleeding volume was 20-600 m1.with one intra-operative infusion and 4 post-operative infusions.Pathological diagnosis was clear cell RCC in 52 cases,angiomyolipoma in 14,chromophobe RCC in 5,and collective duct cancer in 1 case.Hospitalization time was 5-12 days.With 1-52 months follow-up,no tumor recurrence and metastasis was observed. Conclusions Treatment by laparoscopic nephron sparing nephrectomy for renal tumor could be safe and efficient,but operative experiences and skills are needed.The method of intermittent suture and crossing Hem-o-lok could be useful to shorten the operation time and reduce the complications.