Objective To investigate the effects of sodium cyanide (NaCN) and hemorrhagic shock on the level of serum oxidative stress in rabbits. Methods A total of 15 Japanese white rabbits were randomly divided into 5 groups: sham operation, hemorrhagic shock (HS), NaCN intoxation, HS+NaCN and HS+NaCN+4-dimethy laminophenol (4-DMAP). The rabbits were anesthetized for left arteria carotis communis cannulation, and connected with three-way tube and RM6240 electronic physiological signal recording system. The models of hemorrhagic shock and/or sodium cyanide intoxation (blood pressure was controlled at 5.3 kPa) were established. At 0.5, 1 and 2 h after the intraperitoneal injection of 2.5 mg/kg NaCN and/or 3.2 mg/kg 4-DMAP, the blood were drawn. The serum superoxide dismutases (SODs), content of malonaldehyde (MDA) and active oxygen (ROS) were detected by spectrophotometric method. Results After HS, NaCN intoxation, HS+NaCN, the SODs decreased significantly (P

Objective To study the human telomerase reverse transcriptase (hTERT) and spleen tyrosine kinase (SYK) activity expression and molecular margin in the tumor center and peripheral tissues of patients with colorectal cancer, and to explore the security of tumor surgical margins. Methods The expressions of hTERT and SYK were examined by SABC and Supervisan immunohistochemistry in 20 specimens of colorectal cancer and tissues 1 cm, 2 cm, 3 cm, 4 cm and 5 cm, away from proximal and distal margin of the tumor respectively. Results The positive expression rate of hTERT in colorectal cancer was 80.00 %, the rate in tissues 3 cm, 4 cm and 5 cm away from the tumor margin was 0. The positive expression rate of hTERT in tissues from the cancer center to 3 cm away from the tumor margin was gradually diminishing (P<0.01). The positive expression rate of SYK in colorectal cancer was 10.00 %, the positive expression rate of SYK in tissues from the cancer center to 3 cm away from the tumor margin was gradually increased (P<0.05). Conclusion There is molecular margin around colorectal cancer tissues. Considering hTERT and SYK expressions, 3 cm can be defined as the safe molecular margin for the radical operation of colorectal cancer.

Objective The rapid development of radiation equipment has put forward higher requirements for protective facil -ities.The aim of this study was to research the radiation protection status of treatment equipment room in thirty -three medical units from East China area , and to put forward corresponding countermeasures to improve the level of radiation protection . Methods The li-cense and archival of X-ray machine, CT, gamma knife, accelerator, after loading therapy machine were surveyed in the thirty-three medical units .The engine room size , wall thickness , lead equivalent of protection doors , and leakage level of equipment were detec-ted.All the data were evaluated and analyzed on the basis of the corresponding national standards . Results ①The inspection pass rates of radiation treatment equipments in the first class hospitals were afterloader (100%), X-ray apparatus(99%), gastrointestinal machine(98%), CT(98%), medical processing accelerator (98%), gamma knife(97%), DSA(94%), PET-CT(94%), ECT (90%), dental engine(84%)and molybdenum target drone (84%).The inspection pass rates of radiation treatment equipments in other class hospitals were medical processing accelerator (100%), X-ray apparatus(91%), CT(89%), gastrointestinal machine (80%), DSA(80%) and (80%) gamma knife.②The qualified rates of the leakage radiation levels of radiation therapy , diagnostic radiology and nuclear medicine were 100%, 99% and 97%. Conclusion The radiation protection of treatment equipments and facilities in thirty-three medical units from East China area needs to be strengthened . We should strengthen supervision , implement the rules and regulations , strictly perform the regulation of radiation protection evalua-tion, and strengthen the training of radiation protection regulations and skills .

Objective To compare the safety and efficacy of oblique supine position and lithotomy position in suctioning flexible ureteroscopic lithotripsy. Methods 82 patients with upper urinary calculi were divided into two groups. Group 1 included 47 patients who were treated by suctioning flexible ureteroscopy in oblique supine position. Group 2 included 35 patients who were treated in lithotomy position. There was no significant statistical difference in age, gender and complications between the two groups before surgery (P > 0.05). The operative time, stone-free rates at postoperative 30 d, renal pelvic pressure (RPP), postoperative complications (graded by the Clavien system) and length of stay were compared. Results Retrograde Intrarenal Surgery (RIRS) was successful in 73 cases, and 9 cases of patients were done successfully after indwelling DJ tube 2 weeks. Compared with lithotomy position, a significantly greater stone-free rate of 30 d, shorter operative time (P < 0.05). There was no difference in complication rate of Clavien grade I and Clavien grade II, RPP and length of stay (P > 0.05). Conclusions Suctioning flexible ureteroscopic lithotripsy in the oblique supine position is safe, and more effective than supine lithotomy position.

Objective:To explore the safety and efficacy of ureteroscopy-assisted laparoscopic ureteroplasty in the healthy side-lying running position for the treatment of ureteral stenosis after pelvic surgery.Methods:The data of 92 patients with ureteral stenosis after surgery admitted to Ganzhou People’s Hospital from June 2017 to February 2023 were retrospectively analysed. There were 31 male patients and 61 female patients, with an average age of (46.4±23.3) years. Of the 92 patients, 53 patients had previously undergone stone fragmentation or stone retrieval surgery for urinary system stones, 35 patients had undergone gynecologic laparoscopic surgery for gynecologic diseases, 2 patients had previous intestinal surgery, and 2 patients had undergone laparoscopic ureteral reconstruction surgery. The mean preoperative serum creatinine was (120.33±16.52) μmol/L, the mean blood urea nitrogen was (14.28 ± 2.47) mmol/L, and the mean renal pelvis dilation was (3.23±2.47) cm. All patients were placed in healthy side-lying running position with general anesthesia. The patient's lower limbs were in the oblique supine position, and the angle of the lower limbs was 60-80°. By using a transabdominal approach, the narrow section of the ureter was mobilized and excised under the guidance of ureteroscopy. The posterior wall of the ureter was sutured and a zebra guidewire was placed into the renal pelvis. An F7 double-J stent was then retrogradely advanced over the guidewire. Then the anterior wall of the ureter was anastomosed to complete the surgery. The operation time, average length of hospital stay, perioperative complications, preoperative and postoperative pyelectasis and renal function changes were recorded, and the clinical efficacy were evaluated by comparative analysis.Results:Of the 92 patients, 90 patients were successfully treated with ureterovesical anastomosis. Two patients underwent ureterovesical reimplantation because of the low position and heavy adhesion of the stenosis segment. There were no cases of conversion to open surgery or intraoperative death. The mean surgery duration was (121.52±22.35) min, the mean drainage tube indwelling time was (3.16±1.23) d, and the mean hospital stay was (6.46±2.37) d. A patient with moderate hydronephrosis exhibited postoperative urinary leakage. Two patients developed symptoms of hematuria after ambulation. Following treatment with bed rest, adequate drainage, and appropriate hemostatic medication, all patients recovered smoothly and were discharged. The double J tube was removed 3 months after operation, and the CT reexamination after extubation showed that the degree of pyelectasis was (2.52±1.54) cm, the average serum creatinine was (89.64±15.21) μmol/L, and urea nitrogen was (9.42±1.36) mmol/L, which was all significantly different from that before operation ( P<0.05). The patients were followed up for 6 to 12 months, and there was no ureteral restenosis. Conclusions:Ureteroscopic-assisted laparoscopic ureteroplasty in the healthy side-lying running position is a safe and effective surgical method for the treatment of short segment (narrow segment <3 cm) ureteral cicatrix stenosis after surgery. And this surgical method has the advantages of accurate positioning of the narrow segment, safe and convenient ureteral free, exact ureteral anastomosis, and easy placement of double J tube.

Objective: To evaluate the effectiveness and safety of intelligent pressure control flexible ureteroscope for management of renal stones ≤2 cm. Methods: The clinical data of 267 cases of renal calculi treated with flexible ureteroscope lithotripsy at Department of Urology, Ganzhou People′s Hospital from June 2015 to December 2017 were analyzed retrospectively. There were 129 male and 138 female patients, with a mean age of 51.2 years (ranging from 19 to 76 years). Among them, 145 patients underwent intelligent pressure control flexible ureteroscope (intelligent control group) and 122 patients underwent flexible ureteroscope ordinary (ordinary group). The t test, χ² test or Fisher exact test were used for statistical analysis. The success rate of stone seeking, the stone free rates, the incidence of complications, the average operation time, the average hospital stay after operation were compared between the two groups. Results: The average mean operative time of the patients with intelligent control group was (26.17 ± 8.64) minutes, significantly shorter than (47.23±18.35) minutes of the ordinary group (t=1.968, P=0.000). The stone free rate of the patients with intelligent control group was 97.2%, it was higher than 86.0% of ordinary group (χ²=0.069, P=0.004). The complication rate of the patients with intelligent control group was 2.7%, which was significantly shorter than 18.0% of the ordinary group (χ²=17.586, P=0.000). However, there was no significant difference between the two groups in the success rate of stone seeking and postoperative hospital stay (P>0.05). Conclusion Intelligent controlled pressure ureteral flexible ureteroscope has the advantages of short operation time, high stone free rate and less complications in the treatment of renal calculi ≤2 cm compared with flexible ureteroscope ordinary.

Objective:To observe the effect of applying repetitive transcranial magnetic stimulation (rTMS) on swallowing function and auditory evoked potentials in the brain-stems of stroke survivors with dysphagia.Methods:Sixty stroke survivors with dysphagia were randomly assigned to an observation group and a control group, each of 30. Both groups were given 30 minutes of routine swallowing training 6 times a week for 5 weeks, while the observation group was additionally provided with two-second bursts of rTMS on the left and right brain hemispheres alternately for 20 minutes daily. The frequency was 3.0Hz and the strength was 80% of the resting motor threshold (RMT), with an interval of 10 seconds between bursts. Before and after the treatment, both groups′ swallowing was assessed using the functional communication measure (FCM) and the modified Mann swallowing capacity evaluation scale (MMASA). Brainstem auditory evoked potentials (BAEP) were recorded to detect any changes in the peak latency (PL) and inter-peak latency (IPL). The clinical efficacy was also observed.Results:After the treatment, the average FCM results of both groups had improved significantly, but the observation group had improved significantly more. The average MMASA total scores and the average scores on all the sub-items had improved significantly more in the observation group except for the expressive speech disorder and anarthria scores. After the treatment, improvement was observed in respiration, anarthria, range of motion of the tongue muscles, strength of the tongue muscles, gag reflex and soft palate movement compared with before the intervention. Peak and inter-peak latencies had also improved significantly more in the observation than in the control group, on average.Conclusions:rTMS combined with conventional swallowing training can significantly improve the swallowing of dysphagic stroke survivors, and shorten the PL of the BAEP so as to better regulate deglutition.

Objective To evaluate the efficacy and safety of suctioning flexible ureteroscopy with automatic control of renal pelvic pressure in the treament of intrarenal and proximal ureteral stones.Methods From November 2014 to December 2016,a total of 372 patients,including 200 males and 172 females,with upper urinary tract calculi were studied.The average age of patients was 48.1 years old.The average size of stone was 5-35mm,mean 15.7mm.There were 272 cases of renal calculi,80 cases of ureteral calculi and 20 cases of renal calculi combined with ureteral calculi.There were 252 cases of single calculi and 127 cases of multiple calculi.There were 237 cases of urinary tract infection and 14 cases of bacteremia.All patients were treated by suctioning fiexible uretemscopy with automatic control of renal pelvic pressure by a patented intelligent system including an irrigation and suctioning platform and a ureteral access sheath with a pressuresensitive tip.Statistical analysis was performed regarding renal pelvic pressure,operative time,stone-free rates,and complications.Results Three hundred and thirty of 372 patients only accepted one surgery to remove the stone.There were 12 cases of upper ureteral calculi were converted to ureteroscope lithotripsy.Seventeen cases were converted to percutaneous nephrolithotomy due to significant ureteral stenosis.Seven cases who failed the first surgery due to difficulty in placing the ureteral access sheath but flexible ureteroscopy were successfully performed in these patients after indwelling a D-J stent for 2 weeks.No stone was found in 6 cases,and the soft endoscope of ureter was examined.In all patients,the renal pelvic pressure of the pelvis was controlled within 20 mmHg.The average operative time was 15-180 min(mean 58.9 min).The stone-free rates was 95.55％ (322/337),the incidence of postoperative fever was 2.97％ (10/337),the sepsis rate was 1.19％ (4/337),the incidence of urinary sepsis was 0.89％ (3/337),the incidence of lumbago caused by extravasation was 0.59％ (2/337),and no peripheral viscera injury or death case.There was no statistically significant difference between preoperative and postoperative white and red blood cells (P ＞ 0.05).Conclusions This new type of suctioning flexible ureteroscopy with intelligent pressure-control has the advantages of perfusion attraction,pressure feedback,intelligent control and visualization of intracavity pressure.It could be a new type of operation with high safety,low complication and high stone free rate.