Objective To evaluate the clinical efficacy and safety of Holmium laser in the treat ment of calyceal stricture and atresia through antegrade percutaneous nephrostomy. Methods Ante grade percutaneous nephrostomy was performed in 68 patients with calyceal stricture and atresiathrough a rigid 8/9.8 F ureteroscope. The stricture and atresia was incised in a linear fashion by theHolmium laser with a 550 mm fiber. After completion of the incision,a double J ureteral stent wasplaced for 6-8 weeks and nephrostomy tube was kept for 7 days thereafter. Patients were then fol lowed up with IVU and/or ultrasound at 3-6 month intervals. Results The mean operative timewas 90 min,ranged from 80 to 120 min. The mean postoperative hospital stay was 8 d(7-9d). Hy dronephrosis was significantly improved in 38 cases in an average follow up of 9 months (4-26 months). Repeated laser incision was performed to 4 treatment failures and all turned out to be suc cessful. Conclusions The Holmium laser treatment through antegrade percutaneous nephrostomyfor calyceal stricture and atresia has characteristics of minimal invasion,short hospital stay,good effi cacy in short term and repeated cases. This procedure to be used as the first choice for patients withgood renal function and mild hydronephrosis,especially accompanied with renal calculus.

OBJECTIVE: To explore the diagnostic value of magnetic resonance urography (MRU) in ectopic ureters. METHODS: Seventeen female children with ectopic ureter were examined by sonography, intravenous urography (IVU), computer tomography (CT), MRU and so on. The mean age of the female children was 4.5 years (7 months approximately 12 years). RESULTS: Seventeen patients were examined by sonography, including 3 dysplasia little kidneys, 1 kidney absence, 12 duplex kidneys with hydroureter, 1 normal.Seven patients were examined by IVV, including 3 hydronephrosis and 4 no image or not clear. Fourteen patients were examined by CT, including 3 dysplasia little kidneys, 11 duplex kidneys with hydronephrosis. Five were determined by cystoscope, including 2 ecto-pic urethral orifices which angiography could only display the expansion of ureter. All children were diagnosed by MRU and an accurate anatomical picture of the entire urinary tract was obtained. CONCLUSION To accurately and noninvasively depict the urinary tract and the independence of renal function, MRU may be used for patients with ectopic ureter undiagnosed with sonography and IVU.
Child ; Child, Preschool ; Female ; Humans ; Infant ; Magnetic Resonance Imaging ; methods ; Ureter ; abnormalities ; Urography ; methods

Objective To study the effect of stress on the degradation rate in vitro of novel magnesium alloy bone screw. Methods A three-dimensional （3D） model of the tibia fracture was established using the reverse engineering method. Then, based on the FE model, the in vitro degradation experimental device for bone screws was designed. The stress distribution of the screw by finite element calculation was used as the in vitro experimental load, which effectively improved the accuracy and efficiency of the experiment. The experimental samples were divided into four groups. Group A was treated as control group without force application, while Groups B, C and D were subjected to 150, 250 and 350 N axial forces. The influence of different mechanical environment on the degradation rate in vitro of bone screws was investigated. Finally, combining the stress distributions with the degradation experiment results in vitro, the curve between the stress and the degradation rate in vitro of novel magnesium alloy bone screws was obtained. Results Degradation experiments in vitro showed that Group A had the lowest weight loss and hydrogen production, and the average degradation rate was (0.315±0.005) mm/a. While in the stress groups, the weight loss and hydrogen production increased gradually with the axial force increasing. The average degradation rates of Groups B, C and D were (0.379±0.006), (0.469±0.007) and (0.547±0.009) mm/a, respectively. Conclusions When the novel magnesium alloy bone screw was degraded in mechanical environment, the greater stress on the screw would cause the faster degradation rate in vitro. The obtained relationship between the maximum stress and the average degradation rate in vitro of the novel megnesium alloy bone screw provided data support and theoretical guidance for material selection, design and clinical application of magnesium alloy bone screws.

OBJECTIVE: To examine the expression of Maspin in the bladder carcinoma, and to explore the relationship among Maspin expression, clinical pathology and lymph node metastasis.
 METHODS: The expression of Maspin in 72 bladder cancer tissues and 12 normal bladder tissues were detected by immunohistochemistry. Preoperative pelvic CT images and postoperative pathological results of lymph node metastasis in 72 bladder cancer patients were analyzed retrospectively. The sensibility, specificity, positive predictive value and negative predictive value were calculated, and the advantage for diagnosis of lymph node metastasis was compared between Maspin examination and CT scan.
 RESULTS: 1) The expression of Maspin in 72 bladder cancer tissues was significantly lower than that in the normal bladder tissues (P<0.05); 2) The expression of Maspin was obviously decreased with the progress in clinical stage, pathlogical grade and lymph node metastasis, with significant difference (all P<0.05); 3) There were 27 patients diagnosed as pelvic lymph node metastasis by CT scan, and the positive rate was 37.5% (27/72); there were 22 patients diagnosed as pelvic lymph node metastasis by pathological results, and the positive rate was 30.5% (22/72). The pathological diagnose for pelvic lymph node metastasis was the gold standard. The sensitivity, specificity, positive predictive value and negative predictive value for CT was 45.5%, 73.3%, 37.0%, and 66.7%, respectively; the sensibility, specificity, positive predictive value and negative predictive value was 81.8%, 50%, 41.8% and 86.2% in the diagnosis of lymph node metastasis for the 72 bladder cancer cases by Maspin examination; the sensitivity, specificity, positive predictive value and negative predictive was 90.9%, 78.0%, 64.5% and 95.0% in the diagnose of lymph node metastasis by Maspin examination combined with CT scan.
 CONCLUSION The expression of Maspin in bladder cancer is significantly lower than that in normal bladder cancer, and a statistically significant correlation is also observed between Maspin expression and lymph node metastasis. Maspin maybe a valuable biomarker in diagnose of bladder cancer with lymph node metastasis. Maspin examination combined with CT scan has more advantage in the evaluation of bladder cancer with lymph node metastasis than Maspin or CT alone.
Biomarkers, Tumor ; metabolism ; Humans ; Immunohistochemistry ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; Neoplasm Staging ; Retrospective Studies ; Sensitivity and Specificity ; Serpins ; metabolism ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms ; metabolism ; pathology

The purpose of this study is to provide a simple and reliable genetic typing approach for molecular drug susceptibility test of Mycobacterium tuberculosis, through the developing of fluorescence molecular marker of rifampicin resistance gene rpoB. Eleven fluorescent molecular markers of the rpoB gene were established by using the sequence difference between the amino acid positions 531, 526, 516, 511 and 513 of rpoB gene of rifampicin-resistant strains and the alleles of rifampicin-sensitive strains, combined with the PARMS technique (Penta-primer amplification refractory mutation system). We used 104 clinical isolates of Mycobacterium tuberculosis to validate this marker and it was verified by sequencing as 100% correct. These samples were also tested with proportional drug sensitivity test. The coincidence rate was 94.23%. The molecular markers had high reliability for genotyping of rpoB gene. It can also detect low-concentration drug-resistant samples (511/533 unit point mutations) whose phenotypic susceptibility cannot be detected. The eleven sets of fluorescent molecular markers could cover 92%-96% of rpoB gene mutation types of rifampicin-resistant strains, and provide new idea for rapid detection of rifampin-resistant Mycobacterium tuberculosis.
Bacterial Proteins/genetics* ; DNA-Directed RNA Polymerases/genetics* ; Drug Resistance, Bacterial/genetics* ; Microbial Sensitivity Tests ; Mutation ; Mycobacterium tuberculosis/genetics* ; Reproducibility of Results ; Rifampin/pharmacology* ; Technology

Objective : To study the resistance pattern of streptomycin and ethambutol in Mycobacterium tuberculosis in Luoyang area , guide clinical medication and supplement epidemiological data on local drug⁃resistant tuberculosis . Methods : The positive results of high⁃resolution melting curve (HRM) in 2 941 cases in Luoyang area were analyzed to assess the risk factors associated with streptomycin and ethambutol resistance . Results : Of the 2 941 HRM⁃positive patients , 18 . 4% were resistant to streptomycin and 8. 0% were ethambutol . Both streptomycin and ethambutol and resistance rates were higher in men than those in women ( 19. 0% vs 16. 9% , P = 0. 129 ; 8. 0% vs 7. 9% , P = 0. 987) . The resistance rates to streptomycin and ethambutol were higher in urban than those in rural areas (21 . 3% vs 16. 6% , P = 0. 002 ; 9. 8% vs 6. 9% , P = 0. 004) . The resistance rate was much higher in previously treated patients than those newly diagnosed for MTB infection (25 . 8% vs 17. 3% , P < 0. 001 ; 12. 1% vs 7. 4% , P = 0. 002) . The resistance rates to streptomycin were higher in the < 51 years than those in the > 50 years group (21 . 1% vs 16. 1% , P < 0. 001) . According to age , the highest resistance rates to streptomycin and ethambutol occurred in the age range of 31 - 35 years and 56 - 60 years in men , respectively , while in the age range of 21 - 25 years and 56 - 60 years in women , respectively . In multivariate models , prior treatment history , age less than 51 years , and urban area were positively associated with streptomycin and ethambutol resistance after adjusting for smear results and year testing . Conclusion Men , prior treatment history , age less than 51 years , and urban residents are key monitoring targets for streptomycin and ethambutol resistant tuberculosis .