Objective;To evaluate the endourethral surgery for urethrostenosis and urethratresia. Methods:68 patients with urethrosteno-sis or urethratresia were treated by endourethral surgery, such as internal urethrotomy, transurethral scar resection. Results: Of the 68 cases, the outcome was satisfactiory in 61 (89. 71% ). Endourethral surgery was carried out once for 55 patients and twice for 6,7 patients required open surgery. All patients had followed by urethral dilatation. 59 patients were followed - up for 3 months to 5 years. 54 cases can micture normally. Conclusions; Endourethral surgery is simple,safe,efficient treatment for urethrostenosis and urethratresia.

ObjectiveStudy on the effect of nasal decontamination hefor aerosol inhalation in elderly patients with general anesthesia postoperation.Methods130 elderly patients with general anesthesia postoperation were randomly divided into routine treatment group and nasal decontamination group.The time of first sputum,the time of postoperative sputum changing characters,respiratoty-related indicators,sputum cuhure positive rate of bacterial,the incidence of postoperative pulmonary complications was examined.ResultsCompared with routine group,nasal decontamination group obviously shorten sputum character changing time ( P ＜ 0.05 ).Postoperative nasal decontamination group and conventional group sputum Staphylococcus aureus positive rate were 7.7％ (5 cases) and 20.0％ ( 13 cases) respectively,the difference was significant(x2 =4.13,P ＜0.05).ConclusionGiven nasal decontamination before aerosol inhalation could improve character of sputum and reduce sputum bacterial culture positive rate,and had good efficacy and safety.

Objective To investigate and analyze the risk factors,morbidity and mortality rates of multiple organ dysfunction syndrome (MODS) after multiple trauma.Methods The clinical data of all 155 patients with multiple trauma admitted to our ICU from Sep 2008 to Jun 2011 were retrospectively analyzed,including treatment,injury severity score (ISS) and its relationship with MODS.Results The morbidity of MODS among all 155 patients was 18.7％ (29/155).There were 3,7 and 19 patients died due to multiple trauma in 39 ISS ＜ 16,58 ISS 16-25,and 58 ISS ≥25 cases respectively.The morbidity of MODS was significantly higher in patients with ISS ≥25 ( x2 =12.321,P =0.002) than in others.There were 15 cases with MODS and 28 cases without MODS died respectively in multiple trauma patients ( x2 =10.236,P =0.001 ).Conclusion MODS is the important reason for death in multiple trauma patients.It is pivotal to actively deal with primary trauma to avoid the second insult to the patients and support vital organs early in order to improve the prognosis of multiple trauma.

Objective To study the prognostic factors of primary ureteral carcinoma,and to analyze the risk factors of the occurrence of subsequent bladder cancer. Methods This series included 160 cases of primary ureteral carcinoma (93 men and 67 women;mean age,63.7 years).Of them,81 cases had the tumors on the left and 79 on the right;the tumors were located at the upper and middle parts of the ureter in 51 cases,and at the lower part in 96.Pathological staging showed T a (9 cases),T 1(58),T 2(46),T 3(41) and T 4(6);the grading showed G 1(4),G 2(119) and G 3(37).All the 160 cases underwent surgery.Among them,renal and full length of ureter resection plus sleeve resection of bladder were performed on 124 cases (77.5%).All the cases were followed up and the results were statistically analyzed. Results The overall 5-year survival rate was 53.0%.The 5-year survival rates of T a,T 1 and T 2 cases (83.3%,71.9%,59.1%,respectively) were significantly higher than those of T 3 and T 4 cases (37.5% and 16.7%,P

Objective To analyse the X-ray characteristics of the intraductal papilloma and to improve the diagnostic accuracy.Methods The mammographic data of 80 cases of intraductal papilloma of breast by pathology were analysed.Results 24 cases showed circular filling defect, 12 cases showed stringy filling defect,ductal blocked in 30 cases, ductal dilation in 48 cases. Conclusion Galactography is a effective method for diagnosing intraductal papilloma of the breast.

Combining with the disharmonious ethical phenomena in employment of medical students at present,this paper analyses its subjective and objective reasons,and puts forward some practical approaches to the cultivation of harmonious employment ethics of medical students.

This is a review on the new progress in the study of regulation mechanism of Plasmodium falciparum Var gene family. The mutually exclusive expression system caused expression only one in 60 var genes while others were silenced. It was regulated on the transcriptional level mainly through three pathways:non-coding DNA elements,chromatin structure and perinuclear localization.

It remains an urgent need to develop effective malaria vaccine for global control of malaria.Application of high technologies such as biotechnology has facilitated the process of vaccine development for malaria.In the past 30 years,a large number of vaccine candidate antigens for malaria have been identified and some of them are currently in clinical trials.Major progress in malaria vaccine development has also been made in China.The PfCP-2.9 blood stage vaccine for malaria has entered clinical studies and some other vaccine candidates including combination malaria vaccine are currently in pre-clinical studies.The availability of various national research programs and international funding has stimulated laboratory and pre-clinical studies of malaria vaccine candidates.It remains a long-term goal to develop a safe and effective malaria vaccine to control and even eliminate the disease in the world,and many issues including malaria immunology and various types of technologies need to be addressed.However,efforts need to be continued toward the goal.

Objective To explore the association between rheumatoid arthritis (RA) with HLA-DRB1 in China. Method The reported articles about HLA-DRB1 RA in China were searched and Meta-analysis was performed. Result Fourteen studies enroll 1118 RA patients and 1301 controls, the associated gene was HLA-DR4 (OR=4.05, P

Objective To investigate the clinical features,treatment and prognosis of paraneoplastic pemphigus (PNP).Methods A retrospective study was performed on 11 patients with PNP hospitalized in the Department of Dermatology,Ruijin Hospital.Clinical characteristics of these patients were analyzed.Results Of the 11 patients,10 had oral or labial erosions or ulcers,and 6 had obstructive bronchiolitis.Computed tomography (CT)showed solitary internal tumors in all the patients after appearance of skin lesions,and 8 of them were diagnosed with Castleman's disease.All the patients had been treated with corticosteroids before operation,but achieved no obvious improvement.After 2-7 months of postoperative treatment with low-dose prednisone and thalidomide,both cutaneous and mucosal lesions healed with the relief of pulmonary symptoms in 5 patients.Conclusions Oral erosions or ulcers appear to be the most common initial manifestation of PNP with Castleman's disease as the most frequent accompanying tumor.Early detection and timely resection of tumors are keys to successful treatment of PNP,and postoperative treatment with glucocorticoids and thalidomide proves to be effective for PNP.