The clinical data of 30 patients with vesical calculus of 1.5 cm to 4 cm in diameter,who underwent combination of transurethral pneumatic and ultrasonic cystolithotripsy,were retrospectively analyzed.During the procedure the resectoscopic sheath was inserted into bladder through urethra,then the nephroscope was placed through the sheath.When the stone was located,the ultrasonic and pneumatic devices were used for lithotripsy and the fragments were cleared out.The procedures lasted from 10 to 25 min,all operations were successful.Transurethral resection of prostates (TURP) was performed simultaneously in 28 patients.No serious bleeding,bladder injury or transurethral resection syndrome occurred.One patient with simultaneous TURP developed bladder neck contracture one month after surgery and was later cured by endoresection.No residual chip or stone recurrence was detected.This procedure appears to be safe and highly efficient with low rate of urethrostenosis and is suitable for simotaneous prostate surgery.

Objective To explore the therapeutic effect and application value of retroperitoneal laparoscopic combined with resectoscopic radical nephroureterectomy for upper tract urothelial carcinoma Methods From Jan.2006 to Jul.2009,fifteen upper tract urothelial carcinoma patients underwent excision of bladder cuff with resectoscope at first,and then retroperitoneal laparoscopic radical nephroureterectomy.All tumors were confirmed to be localized,stage T1-T3.Clinical outcomes of the patients were retrospectively analyzed.Results Mean operative time was 150 (range:120-180) minutes and blood loss volume was 200 (range:100-400)ml.The function of intestinal canal recovered after 24-48 hours,the drainage tube could be removed after 3-4 days.Catheter was kept for 7-10 days.During the follow up for 1-40 months,all the 15 patients survived with one retroperitoneal lymphatic metastasis.There were no severe complications in perioperative and postoperative period.Conclusions Retroperitoneal laparoscopic combined with resectoscopic radical nephroureterectomy may be a practical surgical procedure for upper tract urothelial carcinoma patients with less intraoperative blood loss and early recovery.

Objective:To explore the assessment methodology for internal dose to workers exposed to 131I radionuclide. Methods:Workers were chosen in a 131I radiopharmaceutial manufacturer and a nuclear medicine department in a hospital using 131I to treat hyperthyroidism and thyroid cancer. A portable high purity germanium (HPGe) gamma spectrometer was used to measure the content of 131I in the thyroid for 4 consecutive times in a period of 7 d. The internal dose was estimated combining with the work rotation mode for workers dealing with 131I. Results:When the monitoring month was used as a typical month to estimate the internal dose, the annual committed effective dose was 0.09-1.93 mSv for the production staff engaged in the repackaging of 131I radiopharmaceuticals in the surveyed enterprise, and 0.06-0.58 mSv for the nuclear medicine staff in the surveyed hospital. After adjusting the monitoring result of the current monitoring period based on the rotation mode, the annual committed effective dose was estimated to be 0.06-1.22 mSv for radiopharmaceutical production workers and 0.03-0.15 mSv for nuclear medicine workers, respectively. Conclusions:In the assessment of internal dose to radiation workers exposed to 131I, using a single time measurement result to estimate the annual dose would lead to a larger error. In the case of continuous monitoring, the result of subsequent monitoring periods should be corrected according to the result of previous monitoring periods. In order to accurately estimate the internal dose of workers exposed to 131I, it is necessary to take full account of the 131I exposure pattern, time and frequency and the internal contamination route. For workers who may be exposed to 131I with potential internal dose greater than 1 mSv/year, a 14 day-routine monitoring period was appropriate.

Objective:To investigate the differences in applicability of both the portable high-purity germanium (HPGe) γ spectrometer and the portable lanthanum bromide (LaBr) γ spectrometer for measuring thyroid 131I activity and internal exposure monitoring for radiation workers. Method:Both DETECTIVE-DX100-KT portable HPGe γ spectrometer and InSpector 1000 portable LaBr γ spectrometer were used to measure the 131I content in thyroid of radiation workers for comparison of the measuring result, minimum detectable activity (MDA) and corresponding annual committed effective doses between two types of spectrometers. Results:The detection rate of 131I in thyroid of radiation workers was 67.7% for HPGe γ spectrometer and 26.2% for LaBr γ spectrometer, respectively. The MDA was 12.26-14.74 Bq (measuring time: 3-5 min) for HPGe γ spectrometer and 56.56-80.37 Bq for LaBr γ spectrometer (measuring time: 2-4 min). The annual committed effective dose corresponding to MDA was 0.07-0.08 mSv (3-5 min) for HPGe and 0.31-0.45 mSv (2-4 min) for LaBr, respectively, in the case of using chronic continuous intake mode and 7 d monitoring period. Conclusions:The minimum detectable activity (MDA) of the two types of portable spectrometers could meet the requirements specified in GBZ 129-2016 Specifications for individual monitoring of occupational internal exposure for thyroid monitoring equipment. The two types of spectrometers could be used for routine monitoring of internal contamination. The difference between the monitoring result of LaBr γ and HPGe γ spectrometers might be due to such factors as large uncertainty in short measuring time and low activity concentrations, incomplete identical of distance between probe and neck, probe angle setting, different response of equipment to the environment, background deduction method.