Objective To discuss the etiology of male pseudohermaphroditism. Methods The clinical data of 42 male pseudohermaphroditisms were retrospectively analyzed.Among the 42 cases (mean age of 10 years,range from 8 to 19 years),39 caseg social gender were female sex and 3 were male.Physical examination indicated abnormal external genitalia,cryptorchidism,hypospadias and mass of pelvis or inguinal.Chromosome examination showed that 39 cases were 46,XY,2 cases of 45,X/46.XY and 1 case of 45,X/47,XXY.Etiology analyses were established in 42 cases by eytogeneties,endocrinology,B-ultrasound or CT examination,celiac exploration and pathology examination.Results All the 42 cases received operation.All cases were treated by hormone replacement according to the social gender which they selected.Thirty-three cases were followed up for 7 to 10 years. Conclmion The etiology of male pseudohermaphroditism includes anti-androgen syndrome,testosterone synthetase deficiency,resistant LH/hCG by testis,simple gonadal dysgenesis,mixed gonadal dysgenesis and resistant mullerian duct syndrome.

Objective To study the efficacy of hypo responsiveness of allogenic T cells induced by curcumin (Cur)-treated dendritic cells (DCs) and influence on survival time of renal allografts in rats.Methods DCs were generated from Wistar rat bone marrow and treated with Cur. The costimulatory molecules (CDl1c, CD80, CD86 and major histocompability complex Ⅱ ) were determined by using flow cytometry,and the production of IL-12 in DCs culture supernatant was examined by using ELISA.The probability of Cur treated DCs to stimulate the proliferation of Lewis rat T cells was detected by using mixed leukocyte reaction (MLR),and the antigen specific T cell hypo responsiveness was analyzed by using secondary MLR. Allograft renal transplantation animal models were established by using Wistar rats as donors,and Lewis rats as recipients.At 7th day before allograft renal transplantation,Cur-treated DCs from donors were injected into recipients through tail vein, meanwhile the non-treated control group and immature DCs control group (immature DCs from donors were injected into recipients through tail vein) were set up.The allograft survival time and allograft pathology after transplantation were assayed.Reaction of T cells from the recipients to mature DCs of donors was analyzed at 14th day.Results Cur restrained the expression of DCs phcnotypc and production of IL-12 (P＜0.05). Cur treated DCs displayed poor ability to stimulate T cells proliferation,and potential to induce antigen specific T cell hypo-responsiveness.The survival time of the renal allograft in Cur-treatcd CDs group [(31.5 ± 6.9) days] was significantly longer (P＜0.05) than in control group [(8.6± 2.1) days] and immature DCs control group [(22.4± 7.4) days],and the pathological lesions in the renal allografts in Cur treated CDs group were milder than in the control group and immature DCs control group.T cells from the recipients injected with Cur-treated DCs showed significant hypo-responsiveness to mature DCs from donors (P＜0.05),but higher proliferation ability to the stimulation of third party independent antigen.Conclusion Cur can suppress the maturation and function of DCs,and induce immune suppression of allogeneic T cells,while infusion of Cur-treated immature DCs can prolong the survival of renal allograft remarkably.

Leydig cells derived from a SD rat aged one month were transplanted to the hind leg subcutaneous of a 2 week-castrated outbred rat. At 1, 3, 4, 6 months after implantation, the grafts were removed and taken to have a histochemical staining for 3?-hydroxygsteroid dehydrogenase (3b-HSD), light and electron microscopy. The results indicated that there were a lots of 3b-HSD positive leying cells in the grafts. The well revascularized and no lymphocytic infiltration were seen around the implanted cells with 4 months after transplantation. Electron microscopy displayed that the implanted cells had abundant mitochondria and smooth endoplasm reticulum, suggesting that the implanted ceils could survive and had better secretary testosterone function for 4 months.

Objective To investigate the long-term therapeutic effectiveness of transplantation of adrenals for the treatment of Addison's disease in the past 15 years. Methods Nine cases subject to adrenal transplantation were followed up for a long-term and the outcome after 15 years was evaluated. Results Seven cases of graft adrenal survived. In 6 patients, urine 17-OHCS, urine 17-KS and serum cortisol were normal. The remaining two grafts out of the 9 cases didn't survive and they had abnormal levels of urine 17-OHCS, urine 17-KS and serum cortisol. Conclusion The transplantation of adrenals for the treatment of Addison's disease had a good long-term effectiveness.

Objective To investigate the possibility of transplantation of adrenocortical cells to treat insufficiency of adrenocortical function using poly-?-hybroxybutyric acid (PHB) as cell carrier.Methods Adrenocortical cells were seeded to PHB and then implanted into rats bearing bilateral adrenalectomy, while adenocortical cells implanted into the similar rats as a contrast. The changes of blood corticosterone and aldostenone and local histological changes in these rats were observed.Results The blood corticosterone and aldostenone were elevated after transplantation. The levels of blood corticosterone and aldostenone in PHB group were higher than that of control group. Histological study showed that adenocortical cells in PHB grew well.Conclusion The implanted adrenocortical cells within PHB can not only survive in rat body but also secrete corticostenone and aldostenrone which can satisfy the need of adrenalectomized rats. It is more effective to use PHB in adrenocortical cell transplantation than that cell implanted singly.

Objective To investigate the morphology change of transplants of adrenocortical cells using poly-? -hybroxybutyric acid (PHB) as a cell carrier. Methods Adrenocortical cells were seeded on PHB and then implanted into rats bearing bilateral adrenalectomy. Histological changes and CD3 expression by using immunohistochemical staining were observed in local area of transplants on the postoperative week 2, 4, 8. Results Histological study showed inflaming cells were decreased as time passed, fibrous tissue disappeared step by step, PHB degraded gradually and adrenocortical cells tended to be organized; Ultrastratural observation revealed these cells maintained identical secreting function; Immunohistochemical assay indicated the expression of CD3 in the transplanted was similar to that in the normal adrenal cells. Conclusion The transplanted cells seeded in PHB can not only be survival, but also organized to the same tissue structure and ultrastructure as normal adrenal tissue.

Objective To explore the effects of different initial treatment protocols on the prognosis of pneumonia in the kidney transplant recipients. Methods Sixty-seven cases of pneumonia following kidney transplantation were divided into case group (34 cases) and control group (33 cases).The patients in case group were treated with Imipenem and Cilastatin, SMX/TMP and ganciclovir,and those in control group received routine treatments. Mortality and length of stay in hospital (LOS)were analyzed. Results Mortality (5.9 % ) and LOS (15 days) in case group were reduced as compared with those in control group ( 18. 2 %, 23 days, respectively) (P＜ 0. 05). Among the patients without severe pneumonia, the mortality and incidence of LOS beyond 21 days in case group (3. 4 %, 1/29; 3. 4 %, 1/29) were lower than those in control group (17. 2 %, 5/29; 37. 9 %, 11/29, respectively) (P＜0. 05). Whether the patients were admitted to hospital sooner or later, the incidence of LOS beyond 21 days in case group was lower than that in control group (P＜0. 05).Whether the etiologies were determined or undetermined, the incidence of LOS beyond 21 days in case group was lower than that in control group (P＜0. 05). The incidence of LOS beyond 21 days in case group was lower than that in control group among the patients with cardiopulmonary disease (P＜0. 05). Conclusion The initial appropriate treatment would improve the prognosis of pneumonia in the kidney transplant recipients.

Objective To evaluate if the flexible ureteroscopy could treat stones located in lower calyx with the infundibulopelvic angle (IPA) less than 30°.Methods Thirty-six patients with inferior caliceal calculi on whom flexible ureteroscopic procedures were performed between November 2009 and June 2015 were reviewed.The mean age of the patients was 52.1 years (34-71),with the mean stone diameter of (1.5 ± 0.8) cm (1.2-2.6 cm).IPA was smaller than 30° in all 36 cases,which confirmed by CTU examination.IPA was less than 10° in 15 patients,between 11 ° and 20° in 13 patients and between 21 ° and 30° in 8 patients.Results The success rate was 63.9％ (23/36 patients) in patients with IPA smaller than 30° after first session of procedure,and the stone free rate reached 100％ after the second session of procedure.The mean operation duration was (95.5 ± 31.4) min(51-127 min).The mean hospital stay after operation was(4.1 ± 1.2)days (3-5 days).No major complications were recorded and no patients needed to convert to open surgery.Double J tube was removed after 4 weeks postoperatively.Patients were followed up for 4-12 months,during which ultrasound and CT scan were used for stone detection.Conclusions The small IPA (＜30°) negatively affected the SFR in the first session operation.However,its negative effect was solvable by using modern endoscopes.A complete stone clearance was achievable even in case of unfavorable anatomic conditions in experienced hand.

Percutaneous nephrostomy was applied in some other urologic diseases and the efficacy was evaluated. Percutaneous nephrostomy for percutaneous nephrolithotomy (PNL) was performed in patients with various renal, perinephric and bladder diseases (n=79). The tract establishment, operation duration and complications were observed and the efficacy was assessed. The results showed that the tracts were successfully established in 79 cases. The operation lasted 4-20 min. 12F-16F single tract was established in nephrohydrop patients and 16F-20F single or multiple tracts were established in patients with pyonephrosis, renal cortical abscess, renal cyst and perinephric abscess. During dilation, no leakage of liquor puris was noted. Establishment of 18F single tract was achieved in one urinoma patient. In two patients with foreign body in kidney, the foreign bodies were removed via established 14F single tract. 18F tracts were established in 2 patients with bladder contracture, which was followed by the placement of 16F balloon urethral catheter for drainage. No complications, such as massive bleeding, intestinal injury and spreading of infection took place in our series. All the patients were followed up for 2-12 months. No long-term complications such as dropping of drainage tube occurred. It is concluded that as a minimally invasive technique, percutaneous nephrostomy has the advantages of convenience, simplicity and causing less complications and can be used for various urologic diseases.

Objective To compare the therapeutic effect of retrograde ureteroscopic Ho:YAG laser lithotripsy (UHL) and percutaneous nephrolithotripsy (PCNL) in treating patients with renal calculi of ≤3 cm.Methods From Feb.2008 to Apr.2011,a total of 109 cases (117 renal calculi in total) treated by either PCNL (50) or UHL (67) were retrospectively analyzed.Operative time,stone free rate,postoperative hospital stay,hospitalization expenses and complications were compared in the 2 groups.Results The mean stone burden of the UHL group and PCNL group was 2.5 cm (1.5-3.0) cm and 2.4 cm (1.3-3.0) cm,respectively.There was no significant difference in two groups.In UHL group,operations were performed successfully in all 67 calculi,of whom,43 patients needed combination of flexible ureteroscopy to break the stone fragments falling into the renal calices.No serious complication was recorded except postoperative fever in 3 cases.In PCNL group,all patients had been successful operated.Postoperative fever occurred in 2 cases.Obvious intraoperative and postoperative haemorrhage appeared in 1 case,and cured by selective renal artery embolization.The operation time of the UHL group and PCNL group was (117.0±36.5) min and (90.0±18.3) min respectively,and had no significant difference in two groups (P＞0.05).The stone free rate of the UHL group and PCNL group was 94％ (63/67) and 92％ (46/50) respectively,and had no significant difference in two groups (P＞0.05).Hemoglobin decline of the UHL group and PCNL group was (0.3±0.1) g/L and (20.6±8.1) g/L,and had significant difference in two groups (P＜0.05).Postoperative hospital stay of the UHL group and PCNL group was (5.0±2.4) day and (7.0±3.7) day,and had statistical difference in two groups (P＜ 0.05).Hospitalization expenses of the UHL group and PCNL group was (15 477.0±754.3) RMB and (27 453.0± 1763.5) RMB,and had statistical difference in two groups (P＜0.05).Conclusions Although UHL and PCNL have similar curative effect in treating renal stones of less than 3 cm,UHL have the advantages of lcss trauma and complication,lower expenses and fewer hospital stay.In treating renal stones of smaller than 3 cm,especially in the contraindication of PCNL,UHL may be a better choice.