Objective To investigate the methods of anesthesia,infusion and the skill of removing urinary calculus for the treatment of uretemlith stones using ureterescope air pressure path lithoclasty.Methods Six hundred and ninety ureterolith stone patients using ureterescope air pressure path lithoclasty,383 patients were anesthetized by single sacro-anesthesia,and the diclofenac sodium suppositories were added in 312 cases to strengthen the anesthesia effeets.Antegrade perfusion with furosemide in the operation was used.Results Broken the stones in orthophoria were successful in 645 patients.the total success rate Was 93.5%and the total rate of removing urinary calculus was 93.8%.Conclusions Ureteroscope air pressure path lithoclasty is high efficiency,safety and easy manipulation.It is a satinfactory method for the treatment of ureterolith stones,and the correct method of anesthesia and infusion perfect skill of removing urinary calculus can improve the rate of removing urinary calculus and decrease the costs.

Objective To investigate the distribution of the CTX-M- extended spectrum beta-lactamase (ESBLs) producing Esche- richia coli(ECO) and the molecular mechanism of dissemination. Methods To analyze the drug resistance of the 43 isolates, Kirby-Bauer susceptibility method was used. Multiple polymeraso chain reaction (PCR) was used to amplify the gene of ESBLs, AmpC, full length of blaCTX-M-like gene, insertion sequence (IS) ISEcp1B, IS903 , IS26 and integron I. NEST-PCR was used to detect if the beta-lactamase gene lo- cated in the integron I. The product of full length of bla-CTX-M like gone amplified by PCR was sequenced. Results Susceptibility test showed the resistance from high to low in turn was Ampicillin (97.68%), Coftriaxone (67.44 % ), piperacillin(65.12 % ), Cefotaxime (62.79 % ) ,Coftasidime(58.14% ), Cofasolin(55.81% ), Cofepime (53.49%), Cefexitin(51.16%), ciprofloxacin (44. 19% ), Aztreo- nam(41.86% ), Cefoperasone/Sulbactam ( 20.93% ), Amikacin (0% ), Imipenem (0% ), respectively. ECO was susceptive to Imipenem. CTX-M-G1 was found in 25 strains of ECO , TEM, SHV, CTX-M-G1, ISEcp1B, and integron I were found in the nine isolates. IS903 were found in ECO 3 and 5, and IS26 was found in ECO 3. In ECO 3 and 5, blaCTX-M-like was flanked upstream by ISEcp1B element that provided -35 and -10 promoter sequences and a right inverted repeat (IRR) recognized by transposase, downstream by IS903 provided an inverted re- peat, ISEcp1 B and IS903 composed the complex transpeson. Conclusion ISEcplB may drive the expression and dissemination of blaCTX-M-like gene at a high level.