Objective To explore the safety and efficiency of holmium laser percutaneous nephrolithotomy in the treatment of upper ureteral calcui.Methods A retrospective analysis was made on 132 cases of upper ureteral calcui treated by holmium laser percutaneous nephrolithotomy.After retrograde placement of the ureteral catheter,a track from the skin surface into the middle renal calyx was established under the guidance of a C-arm fluoroscopy.Then a ureteroscope was passed to introduce a holmium laser lithotriptor.Stones were broken up and a nephrostomy tube was placed in the incision to carry fluid from the kidney.Results Holmium laser percutaneous nephrolithotomy was completed on one session in all the 132 cases(155 sides),including 116 cases of single-tract nephrolithotomy and 16 cases of double-tract nephrolithotomy.The stone-free rate was 95.5%(148/155).The duration of operation was 30~320 min(mean,108 min).The intraoperative blood loss was 50~200 ml(mean,100 ml).No blood transfusion was required and no postoperative hemorrhage happened.No analgesics were needed after operation.The nephrostomy tube was left for 3~8 d(4.6 d).The length of postoperative hospital stay was 5~11 d(mean,7.4 d).Follow-up observations in the 132 cases for 1~6 months(mean,3 months) showed complete relief of symptoms.B-ultrasonography showed a mean of renal pelvis separation of 15 mm,which had decreased by 9~28 mm postoperatively.Conclusions Holmium laser percutaneous nephrolithotomy is safe and effective in the treatment of upper ureteral calcui.

ObjectiveTo report 18 cases of Bowen dis ea se and erythroplasia of Queyrat.MethodsClinicopatholog ical data of 18 cases of Bowen disease and erythroplasia of Queyrat were present ed.10 cases (mean age 49 year)underwent circumcision and local resection and 8 c ases electric coagulation.Results15 cases have been fo llowed up for 4～48 months.2 cases had new disease at an untreated area and the o ther 13 have been free of the disease.Recurrence ocurred in 2 were cured with 5% 5-fluorouracil cream external application.ConclusionsThe result of the surgical treatment for Bowen disease and erythroplasia of Qu eyrat is good and an alternative therapy with 5-fluorouracil for external appli cation may be considered.Adequate biopsy including deeper tissue is necessary fo r differential diagnosis between carcinoma in situ and invasive penile carcinoma or a variety of lesions of the male genitalia.

Objective To evaluate the clinical efficiency of laparoscopic operation for the treatment of ureteropelvic junction obstruction(UPJO).Methods A total of 19 patients with UPJO underwent laparoscopic dismembered pyeloplasty.The operation was performed under general anesthesia.The patients were maintained in a lateral decubitus on unaffected side.After the establishment of pneumoperitoneum,3~4 trocars were introduced at proper sites.During the operation,the lateral peritoneum was opened and the ureteropelvic junction obstruction was dissociated and dissected.The end-to-end anastomosis of the renal pelvis and ureter was conducted and a double-J stent was placed in the ureter.Results All the operations were performed successfully.The operation time was 110~240 min(mean,150 min),the blood loss was 50~100 ml(mean,80 ml),and the postoperative hospitalization time,6~10 d(mean,7.8 d).No severe complications occurred.Follow-up assessment with intravenous urography for 3~15 months(mean,6 months) in 14 patients showed no ureteral stricture.Conclusions Laparoscopic dismembered pyeloplasty is an effective and safe procedure in the treatment of UPJO.It can replace the open surgery.

Objective To investigate the sexual development in adolescents after surgical treatment for undescended testes. Methods A total of 166 adolescents underwent surgery for cryptorchidism before age of 10 years.They were divided into 2 groups according to surgical methods,ie,orchiectomy group and orchiopexy group;for the latter,they were subdivided into

iple occurrence of the tumor, which can decline its recurrence and postpone its progression.

Objective To discuss the diagnosis and treatment of acquired cystic kidney disease complicated by kidney cancer. Methods Clinical data of 11 patients with acquired cystic kidney disease complicated by kidney cancer were analyzed retrospectively. Eight patients were male and three were female. The mean age was 55 years old (range 37 to 68). The time of hemodialysis ranged from 2.8 to 7. 4 years, mean 4. 8 years. Results Follow-up ranged from 17- 83 months, mean 55 months. One patient died of cardiovascular disease. Lung metastasis was detected in one patient two years after surgery. Seven patients survived free of tumor recurrence and there was no follow-up on one patient. Conclusions Increased incidence of cancer was observed in patients with end-stage renal disease who have undergone long-term dialysis. In particular, renal cell carcinoma (RCC) showed an excess incidence in ACKD patients. RCC showed an increased prevalence compared with the general population. Patients with predialysis azotemia or a dialysis duration of longer than 3 years should be screened for ACKD. Sonegraphy or CT scanning are useful for early diagnosis of ACKD. We should pay close attention to complications, including ACKD malignant tendency, in patients who have been taking long-term dialysis and positive therapy.

Objective To discuss the efficacy and safety of retroperitoneal laparoscopic ureterolithotomy in treatment of ureteral calculi.Methods All 33 cases with upper or midst ureter calculi were treated by laparoscopic ureterolithotomy,ESWL or URSL ineffective for 26 cases.The diameters of calculi ranged from 0.7 to 2.1 cm.Results All the operations were successful.The operation time was 30～120 min with a mean of 55 min.The intraoperative bleeding volume Was 40 ml (20～80 ml) on average no complication Was observed duing the follow-up of 6～12 months.All the hydronephrosis Was alleviated.Conclusion Laparoscopic ureterolithotomy is suitable for ureteral calculi treated unsuccesfully by open surgery.It is effective,safety and miniinvasive.

We amplified genes encoding UDP-glucose dehydrogenase, ecohasB from Escherichia coli and spyhasB from Streptococcus pyogenes. Both ecohasB and spyhasB were inserted into T7 expression vector pRX2 to construct recombinant plasmids pRXEB and pRXSB, and to express in E. coli BL21(DE3). After nickel column purification of UDP-glucose dehydrogenases, the enzymes were characterized. The optimum reaction condition of spyHasB was at 30 °C and pH 10. The specific activity reached 12.2 U/mg under optimum condition. The optimum reaction condition of ecoHasB was at 30 °C and pH 9. Its specific activity reached 5.55 U/mg under optimum condition. The pmuhasA gene encoding hyaluronic acid synthase was amplified from Pasteurella multocida and ligated with ecohasB and spyhasB to construct the coexpression vectors pBPAEB and pBPASB, respectively. The co-expression vectors were transformed into E. coli BW25113. Hyaluronic acid (HA) was produced by biotransformation and the conditions were optimized. When recombinant strains were used to produce hyaluronic acid, the higher the activity of UDP-glucose dehydrogenase was, the better its stability was, and the higher the HA production could reach. Under the optimal conditions, the yields of HA produced by pBPAEB/BW25113 and pBPASB/BW25113 in shake flasks were 1.52 and 1.70 g/L, respectively, and the production increased more than 2-3 folds as previously reported.
Biotransformation ; Escherichia coli ; enzymology ; Genetic Vectors ; Glucuronosyltransferase ; genetics ; Hyaluronan Synthases ; Hyaluronic Acid ; metabolism ; Pasteurella multocida ; enzymology ; Streptococcus pyogenes ; enzymology ; Uridine Diphosphate Glucose Dehydrogenase ; metabolism

Eighty six patients with renal masses≤4.0 cm underwent ultrasound or CT-guided core needle biopsies.The clinical data including the initial biopsy technique,pathologic findings,and the clinical outcome were retrospectively reviewed. Biopsies were failed for diagnosis in 6 cases ( 7％ ) because of necrosis or hemorrhage of the tissue specimens.Of 80 successful biopsies,52 cases (65％) were diagnosed as malignant tumor and 28 cases (35％) as benign. Five patients had biopsy complications (6％),including postoperative hypotension,hemouria and perirenal hematoma. Forty-seven patients underwent surgical extirpation ; the consistency rate of histopathological diagnosis between biopsy and surgical specimens was 100％ in these patients.The results indicate that ultrasound or CT-guided core needle biopsy is an effective and safe procedure for diagnosis of renal small masses.