Objective To explore the feasibility of making cystoscope training model with rapid prototyping technology and its training method in cystoscope operation. Methods Constructed a cystoscope training model, and designed a set of corresponding training methods ac-cording to the process and behavioral essentials of cystoscope operation. Selected 20 students who have never learned cystoscope operation and trained them with the new designed cystoscope training mode and training methods, and the training results were verified. Results Compared before and after the training, the operation time of all the trainees were significantly shortened, and their operation steps and skills were more proficient. Conclusion Cystoscope training model can help beginners to grasp the theoretical basis of cystoscopy, operation steps, and behavioral essentials, so as to shorten the learning curve of the cystoscope operation.

Objective To explore the differences in morphology and structure of collagen fiber of the hilar bile duct between human and rat. Methods The morphology and structure of vertical and horizontal cross-section of human and rat collagen fiber of the normal and dilated hilar bile duct, and their changes under stress were observed after Masson trichrome staining. Results The morphology and structure of collagen fiber of hilar bile duet in human was similar to that in rat. The collagen fiber mainly distributed in the middle and outer layer of the hilar bile duct. The wave-like collagen fiber bundles were arranged in parallel, consistent with the longitudinal axis direction of the bile duct, and connected by the small branches. Conclusions The morphology and structure of collagen fiber of the hilar bile duct in human is similar to that in rat. The anatomical structure of the collagen fiber is adapted to its function.

Objective To explore long-term effects of flow-restricted portal vein arterialization on hepatic function and structure in a rat model. Methods SD rats were divided into three groups to undergo respectively total portal vein arterialization ( PVA) , arterial inflow restricted portal vein arterialization (RPVA) ,and sham operation (SO). Postoperative portal blood flow and cross section after one month and six months, portal vein pressure, liver function and structure after six months were observed. Results The cross section and blood flow of the portal vein in PVA group consistently increased, serum ALT level was elevated after six months(F=7. 72,P

Objective To explore the application value of three-dimensional (3D) visualization combined with portal vein (PV) arterialization technologies in pancreaticoduodenectomy.Methods The retrospective descriptive study was adopted.The clinical data of 1 patient with duodenal cancer who was admitted to the Chenggong Hospital of Xiamen University in August 2015 were collected.The preoperative plain scan images in the upper abdomen and enhanced scan images in the arterial and PV phases using 320-slice spiral CT were converted to the 3D images by 3D visualization technology.The 3D data were used for detecting tumor invading pancreatic head and organizational structure surrounding hepatic hilus,and making a preliminary surgical plan.Open exploration found that tumor involved pancreatic head and didn't invade superior mesenteric artery and vein,and then pancreaticoduodenectomy was applied to the patient during operation.Intraoperative proper hepatic artery-PV end-to-side anastomosis was used for increasing R0 resection rate.Operation time,volume of intraoperative blood loss,result of postoperative pathological examination,liver function and complication and vascular patency at postoperative week 1 and vascular patency at postoperative month 1 were observed.The patient underwent color Doppler ultrasound and digital subtraction angiography (DSA) at postoperative month 1 in order to detect blood vessels,and was followed up by outpatient examination for observing tumor till November 2015.Results There was a clear and solid 3D reconstruction model between anatomical position of tumor and blood vessels,and preoperative assessment was consistent with intraoperative finding.Operation time and volume of intraoperative blood loss were 6.5 hours and about 1 500 mL.The patient was confirmed as intestinal diffuse large B-cell lymphoma by postoperative pathological examination.The patient had normal liver function at postoperative week 1 and discharged from hospital at postoperative week 2,without abdominal secondary hemorrhage,infection,pancreatic fistula,intestinal fistula and other severe complications.PV blood flowing was normal by color Doppler ultrasonography at postoperative week 1 and month 1.DSA examination showed that there was no proper hepatic artery images and visible compensatory liver artery at postoperative month 1.During follow-up,no tumor recurrence was detected.Conclusion 3D reconstruction model can provide an accurate preoperative assessment,and PV arterialization technology for unreserved hepatic artery has a certain degree of clinical value in pancreaticoduodenectomy.

Objective To evaluate an improved technique of vertical mammaplasty with purse string suture for correction of breast ptosis and its clinical application.Methods The adjustable markings of vertical mammaplasty was improved with an upper pedicle for the areola,and breast reduction was adapted with the lower part.The breast tissue was lifted and fixed on the second rib level to reshape the breast,which did not rely on the skin,with purse string suture for the lower half of vertical incision.32 patients with breast ptosis had been operated from May 2009 to February 2014.Results 32 cases were treated with vertical mammaplasty with short scar.The shape of the breasts was strengthen,without obvious scar,and follow-up results of patients were satisfied.Conclusions The vertical mammaplasty with short scar design is simple,operation is convenient,breast shape is plump,and postoperative long-term effect is great.This procedure can be used as one of the feasible operation for breast ptosis correction.

Objective To induce and identify the differentiation of rat bone marrow mesenchymal stem cells(MSCs)into cardiomyocytes in vitro,and observe the expression of Nesprin protein during the differentiation. Methods Rat MSCs were isolated and purified by Ficoll density gradient centrifugation,and adhered for serial subcultivation.Surface-associated antigens of MSCs of the second passage were dedected by flow cytometry.MSCs of the second passage were induced by 10μmol/L 5-azacytidine(5-Aza)to differentiate into cardiomyocytes,and the morphological changes were observed.The expression of Desmin,α-sarcomeric actin and cardiac Troponin I(cTnI) mRNA and protein was detected by RT-PCR,immunocytochemistIv and immunofluorescence staining, and the expression of Nesprin protein was detected by Western blotting. Results The morphology of MSCs induced by 5-Aza was bigger and longer,and the nuclei became bigger,exhibiting more consistent patterns.The expression of Desmin,α-sarcomeric actin and cTnI mRNA and protein of MSCs was positive.Immunofluorescence staining revealed that Nesprin protein positioned in the nuclear membrane,and Western blotting detection demonstrated that the expression of Nesprin protein significantly increased after differentiation(P<0.05).Conclusion MSCs may be successfully induced to differentiate into cardiomyocytes.The expression of Nesprin protein in the differentiated MSCs may significantly increase,indicating Nesprin may play a role in the differentiation from MSCs to cardiomyocytes.

This article describes a novel Multifunctional and Transparent Urinary System Model (MTUSM), which can be applied to anatomy teaching, operational training of clinical skills as well as simulated experiments in vitro. This model covers kidneys, ureters, bladder, prostate, male and female urethra, bracket and pedestal, etc. Based on human anatomy structure and parameters, MTUSM consists of two transparent layers i. e. transparent organic glass external layer, which constraints the internal layer and maintains shape of the model, and transparent silica gel internal layer, which possesses perfect elasticity and deformability. It is obvious that this model is preferable in simulating the structure of human urinary system by applying hierarchical fabrication. Meanwhile, the transparent design, which makes the inner structure, internal operations and experiments visual, facilitates teaching instruction and understanding. With the advantages of simple making, high-findelity, unique structure and multiple functions, this model will have a broad application prospect and great practical value.
Female ; Humans ; Kidney ; Male ; Models, Anatomic ; Models, Biological ; Prostate ; Ureter ; Urethra ; Urinary Bladder ; Urogenital System ; anatomy & histology

Objective:To investigate the efficacy and safety of semisupine-lithotomy position placement of Allium ureteral stent to treat ureteral stricture caused by pelvic tumours.Methods:The clinical data of 29 patients who received Allium ureteral stent(URS) placement for ureteral stricture in Sun Yat-sen Memorial Hospital, Sun Yat-sen University between April 2020 and March 2022 were retrospectively analyzed. There were 3 males and 26 females, with the median age of 56(54, 61) years old. All patients had a pathology confirmation of carcinoma before the treatment, including 26 patients with gynaecological tumours, two with urinary system tumours, and one with rectal carcinoma. A preoperative imaging examination confirmed the diagnosis of ureteral stricture. There were 15 patients with unilateral and 14 with bilateral stenosis, median stenosis length was 3.6(2.0, 4.9)cm. Preoperative median urine white blood cell count was 62(21, 354) U/L, median serum creatinine (SCR) was 170.0(85.5, 273.5) μmol/L, and renal pelvis separation was (32.98±6.64) mm. The median time of long-term indwelling double J (D-J)ureteral stent before surgery was 12.0 (6.5, 35.5) months. Seven patients had mild hydronephrosis, 18 had moderate hydronephrosis, and four had severe hydronephrosis. In all patients, Allium URS were placed in the way of the semisupine-lithotomy position (Galdakao-modified supine Valdivia position). Anterograde flexible ureteroscope was inserted into the percutaneous nephrostomy channel, and the retrogradel rigid ureteroscope were advanced simultaneously, looking for location of strictures. Allium URS were inserted retrogradely with transureteroscope when the two ureteroscope were connected. Perioperative conditions and postoperative follow-up for the last examination of SCR, renal pelvis width under ultrasound, and plain abdominal film (KUB). Allium URS patency and complications, hydronephrosis and renal function were evaluated.Results:A total of 61 Allium URS were successfully placed. Seven patients were placed in stages, and 18 patients were placed in series with multiple stents. The mean follow-up period was (12.1±5.8) months. At last follow-up, median SCR was 124.0(81.5, 193.0)μmol/L and renal pelvis separation was(14.96±5.18)mm, which were significantly decreased compared with preoperative(all P<0.01). There were 24 cases of hydronephrosis disappeared and 5 cases of mild hydronephrosis in the last follow-up. Postoperative follow-up, urinary tract infection occurred in 3 patients after operation, such as hematuria and fever within one week, and the symptoms were relieved after anti-infective and symptomatic treatment. One case had mild urine leakage, and 4 patients had occasional low back pain, which may be related to the activity. One case occurred stent displacement due to stent migration to the bladder after eight months, the URS was replaced and a D-J stent was inserted .The patency rate was 96.6%(28/29). Conclusions:Allium URS was placed in the semisupine-lithotomy position for treating pelvic tumour-induced ureteral stricture, with low incidence of complications, high patency and good curative effect.

Objective To analyze the diagnostic utility of combining susceptibility-weighted imaging(SWI)with arterial spin labeling(ASL)in patients with acute ischemic stroke(AIS).Methods Fifty AIS patients who admitted to Yongchuan Hospital,Chongqing Medical University from July 2020 to July 2021 were selected.Scans were performed using a 3.0T MRI scanner,including sequences such as FLAIR,DWI,3D-TOF-MRA,3D-ASL,and SWI.The perfusion status of the infarction core,the grading of draining veins around the infarction core,compensation by collateral circulation,the occurrence of hemorrhagic transformation,and prognosis were assessed.Results The grading of draining veins around the infarction core was significantly correlated with NIHSS scores(r=0.869,P＜0.05)and prognosis(r=0.825,P＜0.05).In addition,significant correlations were found between the perfusion status of the infarction core and the occurrence of hemorrhagic transformation(r=0.873,P＜0.05),compensation by collateral circulation and prognosis(r=0.883,P＜0.05).Conclusion The combination of SWI and ASL provides accurate indications of the hemodynamic conditions around the infarction core in AIS patients,and it can accurately assess the prognosis of AIS patients,contributing valuable information for clinical diagnosis and the selection of treatment strategies.

Objective To discuss the effectiveness and safety of Ommaya sar implantation through neuronavigation in treatment of intracranial cysts. Methods Twenty-eight patients with intracranial cysts (cystic glioma, cystic metastases, radioactive encephalopathy cystic necrosis), admitted to our hospital from January 2007 to December 2014, were chosen in our study; these patients accepted Ommaya sar implantation through neuronavigation. The clinical data, disease courses, CT scan results, operation efficacies and postoperative complications of these patients were retrospectively analyzed. Results In the 8 patients with cystic gliomas, improvement of clinical symptoms and activity of daily living was noted in 6 patients; imaging re-check indicated focus shrink<50%in 6 patients, enjoying an effective rate of 75%. In the 12 patients with cystic metastases, the improvement of clinical symptoms and activity of daily living was noted in 9 patients; imaging re-check indicated focus shrink<50% in 9 patients, enjoying an effective rate of 75%. In the 8 patients with radioactive encephalopathy cystic necrosis, the improvement of clinical symptoms and activity of daily living was noted in 7 patients;imaging re-check indicated focus shrink<50%in 7 patients, enjoying an effective rate of 87.5%. No antidromic intracranial infection was noted in these 28 patients. Conclusion Implantation of Ommaya sar through neuronavigation is an effective treatment in intracranial cysts, enjoying minimally invasiveness.