Objective To evaluate intrasinusal pyelolithotomy for giant staghorn calculi. Methods The data of 22 cases treated with intrasinusal pyelolithotomy were analysed. Results Lithotomy was successful in all cases with the average operation time 116 minutes.Blood transfusion during the procedure was required in 8 cases with an everage of 550 ml.Postoperative examination of 12 cases with B ultrasound revealed residual calculus in 3,the diameters being less than 0.8 cm. Conclusions The procedure for giant staghorn calculi was easy,safe,and effective with renal parenchyma intact.

Objective To investigate the effect of rice water on prevention of diarrhea in patients with traumatic head injury undergoing enternal nutrition. Methods 110 patients with traumatic head injury in neurosurgery department were selected and randomly divided into the observation group and the control group.The observation group was fed with rice water in the early two days of entemal nutrition and then begun with nutrient solution on the third day, as to the control group,patients were fed with nutrient solution at the beginning of enternal nutrition. Incidence of diarrhea in these two groups were viewed and underwent χ2 test. Results The number of samples with diarrhea in the observation group(3 cases) was significantly less than that of the control group (12 cases). Conclusions Feeding with rice water can clean the intestine, regulate the function of gastrointestinal tract and reduce the incidence of diarrhea obviously in patients with traumatic head injury during the early period of enternal nutrition.

Objective To inquire into the diagnosis and management of renal angiomyolipoma.Methods The 22 cases of RAML were studied restrospectively.Results The diagnosis accuracy was 54.5% for B ultrasound and 81.8% for CT,18 were diagnosed as RAML and 4 were misdiagnosed as renal cell carcinoma preoperatively,of which 3 were diagnosed as RAML based on intraoperative frozen section study.11 had been performed enuoleation,7 partial nephrectomy,3 nephrectomy and 1 radical nephrectomy. Conclusions CT is the first line imaging method for RAML.the cow fatty component,intratumor hemorrhage and small tumor are the main canse of misdiagnosis in RAML.careful analysis to clinical feature and imaging data,intraoperative frozen sect,ion study can avoid misdiagnosis.nephron sparing surgery is the best operative management.

Objective To study the clinical features,etiology,misdiagnosis of inflammatory pseudotumor in anterovesical space. Methods Four cases of inflammatory pseudotumor in anterovesical space were retrospectively reviewed.Their clinical processes and features were analyzed based on literature. Results In all 4 cases,partial bladder wall was infiltrated.Two cases were misdiagnosed as bladder carcinoma.All tumors and partial walls of bladder were successfully resected.All 4 patients were followed up for 3 months to 6 years.No recurrence was observed. Conclusions Prior ligation of fallopian tube and infection are important etiological factors of inflammatory pseudotumor in anterovesical space.Misdiagnosis can be avoided by analysing the history,clinical condition and special examination.The operative therapy is effective.

Objective To investigate the clinical features,diagnosis and treatment of spontaneous rupture of renal angiomyolipoma (RAML). Methods A total of 23 cases of spontaneous rupture of renal angiomyolipoma were studied retrospectively.The main clinical manifestations were summarized as follows.Sudden and unexpected lumbar and abdominal pain occurred in 21 cases and lumbar swollen pain in 2.Of them 3 cases concomitantly had hematuria.Nausea and vomiting occurred in 2 cases,shock in 3 and fever in 1.All cases underwent B-ultrasonic examination and 21 had CT examination. Results Diagnosis of RAML was established preoperatively in 16 cases,but 4 cases were misdiagnosed for carcinoma of kidney,1 case for renal infectious disease.Two cases were diagnosed by frozen-section sample during operation.Nephrectomy was performed in 10 cases and nephron sparing nephrectomy in 12,and digital subtraction angiography (DSA) embolization in 1. Conclusions Spontaneously ruptured RAML often changes its clinical symptoms and imaging features,which may result in a high misdiagnosis rate and subsequent nephrectomy.Comprehensive analysis of clinical manifestations and image findings can improve preopreative diagnosis rate,and frozen slice sample examination during operation can avoid unnecessary nephrectomy.

BACKGROUND: Fibrous scaffolds prepared by electrospinning possess similar structure to extracellular matrix, and exhibit convenience in introducing bioactive ceramics into polymer matrices, which have distinct superiority in making bone tissue scaffolds materials.OBJECTIVE: To evaluate the bioactivity of gas-jet/electrospun nanosized hydroxyapatite (nHAP)/poly (3-hydroxybutyrate) (PHB) scaffolds for being used as bone tissue engineering scaffolds.DESIGN, TIME AND SETTING: The in vitro cytology experiment was performed at the State Key Laboratoty of Oral Diseases,Sichuan University between March 2008 and April 2009.MATERIALS: The gas-jet/electrospun PHB and 10% nHAP/PHB scaffolds were prepared.METHODS: Rats bone marrow-derived mescenchymal stem cells were incubated on the nHAP/PHB scaffolds were served as experimental group, incubated on the PHB scaffolds were as control group, and cells incubated on cell culture plate were consided to be blank control group.MAIN OUTCOME MEASURES: mRNA transcript expression of bone-related markers, including alkaline phosphatase, type I collagen, and osteocalcin, were quantified utilizing reverse transcription-polymerase chain reaction (RT-PCR) at day 14 after culture.RESULTS: After 14 days, the bone-related markers were expressed in three groups, and had higher transcript levels in the cells cultured on the nHAP/PHB scaffolds than those on the PHB scaffolds and cell culture plate.CONCLUSION: The gas-jet/electrospun nHAP/PHB scaffolds present good bioactivity in vitro and have the potential to be used in bone tissue engineering.

Objective To evaluate effectiveness and safety of the transobturator tension-free vaginal tape technique (TVT-O) for the treatment of female stress urinary incontinence(SUI). Methods Twenty-six cases of SUI patients with average (52.6±6.3) years old were included. Mean course of disease was (9.2± 2.3) years. Two cases were type Ⅱ ,23 cases were type Ⅱ/Ⅲ,and 1 case was type ID. One case had history of pelvic operation procedure,2 cases accompanied by urgent urinary incontinence. All cases were undergone TVT-0 procedure. The methods of this procedure and the outcomes and complications were closely analyzed. Results The average operating duration was (18.0 ±2.3) min (15-20 min) and average blood loss was (20.0±3.4)ml (10-40 ml). Twenty-four cases (92.3%) were cured, 2 cases (7.7%) were improved, 2 cases (7.7% ) had dysuria, 1 case improved after prolonged indwelling of catheter, 1 case was recovery with urethral dilations. Four cases (15.4% ) suffered pain of thigh skin around the wound, and relieved by analgesia. One case (3.8%) complained of frequency of micturition, and improved by medicine. Twenty-six cases were followed up of 8-16 months with no recurrence. Conclusion TVT-0 for the treatment of SUI is a simple optimal and reliable method with less complications and eusemia.

BACKGROUND:Poly(3-hydroxybutyrate) is approved as its excel ent biocompatibility, biodegradability and piezoelectric properties, but there are also some deficiencies, such as high breakability and poor hydrophilicity. METHODS:Poly(3-hydroxybutyrate) was mixed with different mass percentages of nanohydroxyapatite (0, 10%, 20%and 30%) to prepare new composite fibrous scaffolds through electrospinning process. The microstructure, group composition, crystal ine phase distribution, thermal properties and surface wettability of the scaffolds were detected. RESULTS AND CONCLUSION:Under the scanning electron microscope, with the increase of nano-hydroxyapatite content, more and more nano-hydroxyapatite particles were distributed evenly on the composite fiber surface;the fiber surface was basical y covered with nano-hydroxyapatite particles at the content of 30%, and the roughness of the fiber surface also increased. Results from differential scanning calorimetry and X-ray diffraction showed that the nano-hydroxyapatite reduced the crystal inity of poly(3-hydroxybutyrate) and the crystal tacticity, and this phenomenon became more evident with the increase of nano-hydroxyapatite content. Additional y, the higher the content of nano-hydroxyapatite content, the lower the contact angle and the higher the hydrophily. These findings indicate that the nano-hydroxyapatite/poly(3-hydroxybutyrate) ultrafine-fibrous scaffold using electrospinning technology can effectively improve the surface wettability and crystal inity of the material as wel as the material hydrophily and brittleness, and the higher the content of nano-hydroxyapatite, the more obvious the effect.

Objective To investigate the clinical feature,pathologic characteristics and prognosis of non-muscle invasive urothelial bladder tumor in young and old patients.Methods From January 2000 to March 2011,the clinicial data of 48 young patients (age ≤ 40 years) with non-muscle invasive urothelial bladder tumor and 50 patients randomly selected with non-muscle invasive urothelial tumor (age ≥ 60 years) were analyzed and compared retrospectively.There were 38 male and 10 female with a median age of 35.4 years (range,18 to 40).There were 34 male and 16 female with a median age of 68.5 years (range,68.5 to 87).All patients had postoperative intravesical instillation for one year.Young patients presented with gross hematuria mostly,which were similmar with old patients.Solitary tumor were 45 cases and 40 cases,and the multiple tumors were 3 cases and 10 cases in the young and old groups,respectively.Of the young group,40 patients were treated by transurethral resection of bladder tumor,and 8 patients by partial cystectomy.Of the old group,35 patients were treated by transurethral resection of bladder tumor,and 15 patients by partial cystectomy.Results According to 2004 WHO classification of papillary urothelial tumor,lower grade tumor were more frequentto occur in young group than in old group.There was significant difference in incidence of PUNLMP between young group and old group (16/48,33.3％ and 8/50,16.0％,P ＜ 0.05).There was significant difference in incidence of high grade bladder cancer between young group and old group (7/48,14.6％ and 17/50,34.0％,P ＜0.05).The incidence of PTa tumor was 70.8％ and 44.0％ in the young and old groups,respectively (P ＜ 0.05).Median follow up was 34 months (range,6 to 132) in young group and 35 months (range,6 to 130) in old group,respectively.Five-year recurrence rate was 36.7％ and 64.3％ respectively (P ＜ 0.05).Conclusions Non-muscle invasive urothelial bladder tumor in young patients had a better prognosis than those in the old group,with lower grade and stage at diagnosisand lower recurrence rate.

Objective To investigate the correlation between prostatitis and bladder outlet obstruction (BOO) in patients with benign prostatic hyperplasia.Methods From January 2008 to January 2012,Three hundred BPH patients were divided into two group according to whether had prostatitis determined by pathology.One hundred and thirty six patients with simple BPH and 164 patients with BPH combined with prostatitis were included with the median age of 69 years.PSA was (4.9 ± 8.3) μg/L and (7.0 ± 8.5)μg/L,the prostate volume was (41.4±18.1) ml and (48.7±20.7) ml,and IPSS was 21.9±7.0 and 27.5 ± 5.1 in BPH group and prostatitis group,respectively.The urodynamic parameters of bladder outlet obstruction between the two groups were analyzed.Results Qmax was (8.8 ± 4.8) ml/s and (6.3 ± 3.7)ml/s,Pdet.Qmax was (96.7 ± 33.0) cm H2O and (113.3 ± 39.8) cm H2O,AG value was 77.7 ± 31.9 and 93.9 ± 39.6,and Schafer grading value was 3.3 ± 1.5 and 4.4 ± 1.2 in BPH group and BPH combined with prostatitis group,respectively (P ＜ 0.05).Logistic regression analysis showed that prostatitis (OR =2.66,P =0.002),PV (OR =1.37,P =0.000),and Qmax(OR =0.72,P =0.000) were positively correlated with Schafer grading value.Conclusions Prostatitis increased the degree of BOO in patients with BPH.