Objective To summary our experiences on the clinical management of early complications caused by ureteroscopy and pneumatic lithotripsy. Methods From May 2002 to December 2007,totally 660 patients received ureteroscopy and pneumatic lithotripsy in our hospital,25 of them had surgical complications. Their clinical data were analyzed retrospectively. Results Among the 25 cases,22 patients had ureteral perforation,2 had ureteral disruptions,and 1 showed pelvic hematoma owing to ureteral perforation and injury to the ovary vein. Of the 22 cases of ureteral perforation,13 patients received lithotripsy and placement of a double J stent into the renal pelvis via the perforation site;and 4 patients underwent repair of the ureter. The other 5 of the 22 cases refused open surgery,and showed symptoms of urinary extravasation,loin pain,fever,or hematuria postoperatively;PCN was successfully completed in 3 of them but failed in the other 2,who underwent open surgery afterwards. For the 2 patients with ureteral disruptions,ureteroureteral anastomosis was performed. And in the case of pelvic hematoma,we carried out open surgery to ligate the bleeding vessels. All of the 25 patients were cured and discharged from hospital prosperously. The double J stent was withdrawn in 2 months after the operation,and 1-year follow-up showed no ureteral stenosis or obstruction by intravenous pyelography. ConclusionsPrimary management of ureteral injury by indwelling double J stent or percutaneous nephrostomy results in significantly deceased rate of re-operation. Conversion to open surgery timely can stop the incidence of other severe complications.

BACKGROUND:It is important to produce and save a large amount of high-activity feeder cel s for the culture of human embryonic stem cel s.
OBJECTIVE:To establish the optimal method for isolation and culture of Kunming mouse embryonic fibroblasts, and to evaluate the feasibility of preparing feeder layers for culture of human embryonic stem cel s.
METHODS:Embryonic fibroblasts were isolated and cultured by different concentrations of trypsin from Kunming mouse fetuses in vitro. The biological characteristics and growth rule of mouse embryonic fibroblasts were investigated, and then the feeder layers for human embryonic stem cel s culture were produced. The growth of human embryonic stem cel s on the prepared feeder layer was tested.
RESULTS AND CONCLUSION:The optimal fetal age for preparing Kunming mouse embryonic fibroblast feeder layer was 13.5 days. Kunming mouse embryonic fibroblasts at different concentrations grew wel with high purity and active proliferation by trypsin digestion method. There was no significant difference in the survival rate of cel s after cryopreservation for 2 weeks, 1 month, 3 months and 6 months. The cel s were proliferative from the second to fourth passage and declined sharply after the fifth passage. Human embryonic stem cel s which grew on Kunming mouse embryonic fibroblasts feeder layers were stil to remain the typical undifferentiated morphology and were strongly positive for alkaline phosphatase and periodic acid-Schiff after long-term subculture. The
mouse embryonic fibroblasts can be used as the stable and high-quality feeder cel s for human embryonic stem cel s.

Objective To investigate the role of Rho in SiO2 induced α-SMA expression in human bronchial epithelial cells (HBECs). Methods HBECs were cultured and stimulated with SiO2. Immunocytochemistry and Western blot were used to detect the expression of α-SMA. The activity of Rho was determined by GST pull down assay. In the prevention experiment,SiO2-stimulated HBECs were incubated with Rho inhibitor Y27632,and the expression of α-SMA was examined by Western blot. Results With SiO2 (0-300 μg/mL) treatment,the expression of α-SMA increased gradually,and 200 μg/mL of SiO2 led to the highest expression of α-SMA which was (5.09±1.98) times of the expression of α-SMA in the control group(P＜0.01). HBECs treated with SiO2 (200 μg/mL) for indicated time (1,2,6,12,and 24 h)showed an obvious increase of Rho activity(P＜0.01). Y27632 inhibited SiO2-induced α-SMA expression significantly,and the inhibition rate of 20 and 30 μmol/L Y27632 was 68% and 75%,respectively (P＜0.01).Conclusion Rho signaling pathway may mediate SiO2 induced α-SMA expression in HBECs.

BACKGROUND:Manual reduction for external fixation of distal radius fractures can achieve good outcomes.
OBJECTIVE:To carry out the bibliometric analysis on manual reduction for external fixation of distal radius fractures.
METHODS:Literatures concerning reduction for external fixation of distal radius fractures were retrieved in CNKI database from 2003 to 2012. The keywords were“external fixation;distal radius fractures”. Duplicate and irrelevant articles were eliminated, and a total of 408 articles were retrieved. A bibliometric analysis of these 408 articles was performed in terms of publishing time and number, subject categories, source journals, research institutions, times cited and download frequency.
RESULTS AND CONCLUSION:Literatures concerning manual reduction for external fixation of distal radius fractures exhibit an upward trend in number. In 2012, there were 85 relevant articles. In the past 10 years, 18 relevant articles have been published in Chinese Journal of Traditional Medical Traumatology&Orthopedics, which is the most. There are not many relevant studies in various research units, only 1-7 articles published per unit, and five articles are funded.

Objective To evaluate the efficacy and safety of InVance bulbourethral sling for stress urinary incontinence after radical prostatectomy.Methods Six male patients with stress urinary incontinence after radical prostatectomy were treated with perineal sling (InVance) from March 2005 to March 2011,and the clinical data were analyzed.Results The operation time was 80-120 min and intra-operative blood loss was 20-50 ml.The catheter was removed at the second day after surgery.In a follow-up of 12 to 29 months,4 patients were dry,1 patient was improved,and 1 patient suffered treatment failure.There were 2 patients transient acute urinary retention and 1 patient short-term perineal pain in the main post-operative complication.In six months after the operation,urodynamic examination showed (15.9 ± 7.7) ml/s at Qmax and 0-20 ml/s at postvoid residual.Conclusion InVance bulbourethral sling for the treatment of stress urinary incontinence after radical prostatectomy appears to be safe,simple in the procedure and good effect to mild and middle incontinence.

Objective To investigate the failure causes of bladder spasm after bladder cancer and prostate operation with epidural self-controlled analgesia pump and ifnd countermeasures.Methods From March 2010 to March 2016, 302 patients were adopted PCEA after transurethral resection of bladder tumor and prostate to prevent bladder spasm while failed in 18 cases and occurred bladder spasm. Among the 18 cases, 2 cases because of power loss of the pump, 3 cases occurred slippage of epidural catheter, 2 cases suffered catheter obstruction, 2 cases suffered joint leakage, 3 cases of deifciency of anesthetic dose formula, 2 cases of incomplete analgesia, 4 cases of chemotherapy drug stimulation. All the patients were relieved from countermeasures.Results In the 18 patients, the countermeasures were effective and satisfactory, with no serious complications such as severe hematuria, urinary tract infection and ifstula infection occurred.Conclusions PCEA prevent postoperative bladder spasm with deifnite effect. If the postoperative analgesia effect is poor, then we should analyze the reasons timely and ifnd countermeasures to avoid serious complications.

Objective To observe the different expression of somatomedin-receptor in cell membrane of prostate epithelial cells at anoxic or normoxic condition.Methods Human prostate epithelial cells line RWPE-1 were cultured in vitro.At 4,8,12,24,48 h after cells had been seeded,the gene and protein expression of epidermal growth factor receptor (EGFR),fibroblast growth factor receptor (FGFR),transforming growth factor β1 receptor (TGF- β 1R),insulin-like growth factor-1 receptor (IGF-1 R) and vascular endothelial growth factor receptor (VEGFR) in prostate epithelial cells were tested by RT-PCR and immunohistochem-istry methods,respectively.Results The expression of mRNA and protein of EGFR,FGFR,IGF-1R,TGF- β1R,VEGFR were significantly increased in anoxic and normoxic prostate epithelial cells (P ＜ 0.01 ).At different time point,the expression of mRNA and protein of EGFR,FGFR,IGF-1R,TGF- β1R,VEGFR significantly higher in anoxic than those in normoxic prostate epithelial cells (P＜ 0.01 )besides 4 h EGFR mRNA,12 h EGFR protein,4 h IGF-1R mRNA,4 and 8 h IGF-1R protein,4 and 8 h TGF-β 1R mRNA,4 and 8 h TGF-β 1R protein,4 h VEGFR mRNA (P ＞ 0.05).Conclusion Anoxic prostate epithelial cell can up-regulate the expression of somatomedin-receptor.

Objective To assess the effect of alprostadil on accelerating early recovery of renal transplant patients with delayed graft function.Methods A randomized control clinical trial was designed in renal recipients with delayed graft function(DGF)who were administered with 50μg alprostadil each day after the operation.The effects of alprostadil were compared with the control group which included 14 recipients with DGF to determine the influences of alprostadil on urine,serum creatinine(SCr).Under Doppler ultrasound,the renal blood flow resistance-indexes(RI)were measured.The rates of acute renal graft rejection(AR)were also calculated in both groups,and the 1year patient/graft survival rates were compared between the two groups.Results Urine was significantly higher in alprostadil-treated group than in control group(P ＜ 0.05).On the contrary,SCr and RI were significantly lower in alprostadil-treated group than in control group(P ＜ 0.05).No significant differences were found between the two groups in AR rate(6.25％ vs 7.14％)and the 1-year patient/graft survival rates(P ＞ 0.05).Conclusion The application of alprostadil in renal recipients with DGF had beneficial effects on accelerating recovery of renal graft function.

Objective To evaluate the effectiveness of the treatment of high risk benign prostatic hyperplasia (BPH) with transrectal high-intensity focused ultrasound (TR-HIFU) by urodynamic test. Methods One hundred and thirty patients with BPH, most of who suffering with diabetes mellitus,cardio-cerebrovascular disease, respiratory disease. All patients were given the operation with Sonablate-500 high-intensity focused ultrasound (HIFU). International prostate symptom score (IPSS), quality of life (QOL), maximum urinary flow rate (Qmax), post void residual urine volume (PVR), pressure-flow tests (A-G) were employed for the evaluation of curatives effect on preoperation, 30th and 90th day after the treatment. Results The duration of the TR-HIFU prostate ablation treatment was 15-85 rain. One hundred and seven patients after treatment were followed up for 3 months. Compared the effect before treatment with that after treatment, IPSS improved from (27.0 ±11.5) scores to (8.5±1.4) scores, Qmax increased from (5.7±2.3) ml/s to (14.1±4.2) ml/s, PVR decreased from (118.5±78.0) ml to (30.0±15.0) mI,A-G parameters reduced from 62.4±19.3 to 25.6±13.0 and urine volume (VV) increased from (85.8 + 42.0) ml to (194.0±52.0) ml. The parameters all altered obviously (P < 0.05). Conclusions TR-HIFU appears highly attractive as a new optional, safe and efficacious and minimally invasive treatment for the high risk BPH. Main post-operative urodynamie parameters are more obviously improved than those of the preoperation.

Objective To analyze videourodynamic characteristics of female bladder outlet obstruction (BOO). Methods Retrospective analysis of videourodynamic characteristics were performed in 42 women with BOO. On the basis of the videourodynamic findings, women with BOO were categorized into five groups: bladder neck obstruction, middle urethra (urethral sphincter) obstruction, distal urethra obstruction, external orifice of urethra obstruction, high-grade pelvic organ prolapse. Data of five groups were compared in Qmax, maximum cystometric capacity, Pdet at Qmax, residual urine, detrusor instability and hydronephrosis. Data of all patients were analyzed by SPSS13 statistical software, measurement data by t-test and enumeration data by x2-test. Results Five groups had not significant deviation in the maximum cystometric capacity. however patients with bladder neck obstruction had significant deviation with others in Pdet at Qmax (78. 0 ± 23. 6)cm H2O, residual urine (120. 6±115.2)ml, Qmax (7.0±2.3)ml/s (P<0.05). There was significant deviation between middle urethra (urethral sphincter) obstruction(76.9%)and others in detrusor instability(P<0. 05). In all patients with hydronephrosis, bladder neck obstruction(57. 1 %) had significant deviation with others (P<0. 05). Conclusions Videourodynamic tests could assess lower urinary tract function, and may guide clinic management. The bladder neck obstruction was most serious and harmful to upper urinary tract.