Objective To evaluate vagina reconstruction with the use of sigmoid colon. Methods 21 cases underwent vagina reconstruction with the use of sigmoid colon were reviewed of which 13 were male pseudohermaphrodism and 8 congenital devoid of vagina. Results The appearence of the reconstructed vagina has been good in all the 21 patients.15 of the 21 have been followed up for 3～24 months with no overproduction of mucus and no need of routine dilatation. Conclusions Vagina reconstruction with the use of an isolated sigmoid loop is an ideal procedure for juveniles and adults.

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 The double J stent was withdrawn in 2 months after the operation,and 1-year follow-up showed no ureteral stenosis or obstruction by intravenous pyelography.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.

Objective To investigate the effect of nephrostomy on the infections after ureteroscopic holmium laser lithotripsy.Methods From March 2007 to May 2008,100 patients with unilateral upper ureteral calculi complicated with hydronephrosis were divided into control and experiment groups according the patients number (50 cases in each). Ureteroscopic holmium laser lithotripsy was carried out in the control group,while in the experiment group,nephrostomy was performed two days prior to ureteroscopic holmium laser lithotripsy. The clinical data including highest body temperature after the operation,recovery of body temperature,blood routine and urine routine,as well as hospital cost,were compared between the two groups. Results Compared with the control group,patients in the experiment group showed significantly lower highest temperature [(37.8?0.5) ℃ vs (38.6?0.5) ℃,t=-8.000,P=0.000],quicker recovery of body temperature [(1.6?0.2) d vs (2.8?0.4) d,t=-18.974,P=0.000],blood routine [(2.7?0.4) d vs (4.1?0.6) d,t=-13.728,P=0.000],and urine routine [(3.6?0.6) d vs (5.2?0.7) d,t=-12.271,P=0.000],as well as lower hospital cost [(8.6?1.5) thousand RMB vs (9.5?1.1) thousand RMB,t=-3.421,P=0.000]. Conclusion Nephrostomy shows positive effect on relieving infections after ureteroscopic holmium laser lithotripsy.

The study aims to investigate the effect of the ratio of long axis to short axis (RLS) of upright polypropylene infusion bag on discharging process and to search the best RLS. Aiming at five different RLS (1. 5 : 1, 2 : 1, 3 : 1, 4 : 1 and 5 : 1, respectively) with the volume of 100 mL, 250 mL and 500 mL, respectively, based on finite element method, analyzing the variation of stress distribution, emptying rate, drugging space and steadiness coefficient, etc. For the bags of the same volume, emptying rate increased with increasing of RLS, but the steadiness coefficient decreased with increasing of RLS. The specific increasing amplitude of emptying rate and decreasing range of steadiness coefficient were as follows: 20% and 49% for 100 mL infusion bag, 9% and 51% for 250 mL infusion bag, and 11% and 46% for 500 mL infusion bag, respectibvely, when RLS increased from 1. 5 : 1 to 5 : 1. Comparatively speaking, the increasing amplitude of the emptying rate is remarkably less than the decreasing range of the steadiness coefficient. By comprehensive consideration of both emptying rate and steadiness coefficient, lower RLS is recommended for upright polypropylene infusion bag.
Drug Delivery Systems ; instrumentation ; Finite Element Analysis ; Polypropylenes

Objective To study the CT and MRI features of peripheral primitive neuroectodermal tumor(PNET).Methods CT and MRI appearances of 10 patients with PNET pathologically proved were analyzed retrospectively.All cases underwent CT scan and 2 cases underwent MR imaging examination.There were 5 men and 5 women,the age ranged from 11 years to 54 years old(mean 24 years).Results The tumors were located in the chest wall(n=4),abdomen and sinus(n=2,each),cervical vertebra and humerus(n=1,each).The lesions in the chest wall and abdomen appeared as larger masses(5~16 cm in diameter).The masses were circular and lobulated with heterogeneous density and in company with bone destruction or periosteal reaction.The solid masses were enhanced after contrast medium administration.The lesions in the sinus showed the soft tissue mass with bone erosion.The lesions in bone demonstrated local iso-intensity on T1WI,hyper-intensity on FSE T2WI and on FATSAT T2WI.There were distant metastasis in 3 cases.Conclusion The clinical and imaging features of pPNET in chest wall were more specific than in other locations.CT and MRI can showed intra-tumor structure,and are helpful in delineated the extent of tumor,predicting resectability and monitoring treatment.

OBJECTIVE:To study the therapeutic effect of naloxone early to administer on acute craniocerebral trauma ME_THODS:46 patients with acute craniocerebral trauma were randomly divided into two groups:Besides routine treatment,25 patients were treated with naloxone in a dose of 8mg q d ,21 patients did not treated with naloxone The GCS score,plasma ET levels,transcranial Doppler(TCD),and electroencephalogram(EEG) were measured 1 day,7 days after the administration The results were analyzed statistically RESULTS:In treatment group,GCS score was obviously improved,the level of ET in plasma was reduced;brain vasospasm incidence rate was lower and abnormal rate of EEG was lower in comparison with those in control group As a result,the detecting indices in treating group were superior to those in the control group(P

Objective To investigate the security and result of operation of one side polycystic kidney removal and homonymy kidney transplantation simultaneously for giga-polycystic kidney di-sease of terminal stage. Methods Forty-five patients with polycystic kidney of transplantation were retrospectively analyzed. The patients were divided into 2 groups. Patients of group A (n=23) under-went resection of the cystic kidney by extraperitoneum and the other 22 patients(group B) didn't re-move the cystic kidney. The data including average length of hospital stay, variance of blood pressure, lessen of abdominal circumference, lung capacity, total lung capacity, FEV1.0/FVC, incidence rate of delayed graft function (DGF) and 1 year patient/kidney survival rate of the 2 groups were compared. Results The average length of post-operative hospital stay of group A was (14.5±2.6)d,lessen of blood pressure was (30.0±0.7/13.34±8.4)mm Hg, lessen of abdominal circumference was (11.0+ 6. 3) cm, lung capacity increased (1.4±0.3)L, total lung capacity increased (2.0±1.0)L, FEV1.0/ FVC increased (5.3±1.0) %, the incidence rate of DGF was 8.7% (2/23), 1 year patient/ kidney survival rate was 100.0%/95.7%. The average length of post-operative hospital stay of group B was (28.45±7.9)d,lessen of blood pressure was (3.9±11.2/2.9±12. 0)ram Hg, lessen of abdominal circumference was (3.3±2.2)cm, lung capacity increased (0.44±0.3)L, total lung capacity increased (0.8±0.2) L, FEV1.0/FVC increased (2.0±0.9)%, the incidence rate of DGF was 9.1%(2/22), 1 year patient/kidney survival rate was 100.0%/95.5%. There were no significant differences of the incidence rate of DGF and 1 year patient/kidney survival rate between the 2 groups. While there were significant differences of the other data between the 2 groups(P＜0.05). Conclusions It is safe and convenient for one side polycystic kidney removal and homonyrny kidney transplantation simultaneous-ly for giga-polycystic kidney disease of terminal stage. The procedure could be applied to the patients of graveness complication or giga-polycystie kidney hampering operation of transplantation.

Objective To summarize the success of congenital penile curvature. Methods 401 cases of con-genital penile curvature,whose average age is 2. 5 years ,ranging from 1 year to 26 years old. Of all cases ,383 patients who have both hypespadias and penile cun, ature, only 18 patients are congenital penile curvatures. 295 paitents are slight curvature,85 patients are moderate curvature and 21 patients are severe curvature. Curvature correction was per-formed on a case-by-case basis by solution fibric trabs of ventrial urethra and surrounding,skin de-gloving, ff necessa-ry,dorsal plication,and confirmed by Gittes test. Results . Curvature correction was possible by mobilization of ure-thra after penile degloviag,only a few need dorsal plieation. Followup for 6 months to 2 years,396 patients are success at once. The others after a second surgery had 100% success. Conclusions Solution fibrie trabs of ventrial urethra and surrounding, skin de-gloving, if necessary,dorsal plication ,is the first choice to repair of the congenital penile cur-vature and have good results.

Objective To discuss the treatment of urethral stricture after hypospadias reDair.Methods Thirty-seven cases of urethral stricture after hypospadias repair from 1999 to 2006 were ret-rospectively analyzed. Of 37 patients,the stricture was located at the distal end of urethra in 7 cases.There were 3 1 cases with anastomotic stricture.There was 1 case with distal urethral stricture and anastomotic structure.There were 1 3 patients with the simple urethral stricture and the complicated 24 cases.Of 13 simple urethral stricture patients,4 patients were repaired with urethro-meatomy,6 patients with shelf operation and 3 patients with transurethral holmium laser urethrotomy.Eight Pa-tients with complicated urethral fistula,6 patients with urethral diverticula,4 patients with phallo-campsis and 6 patients with many times of postoperative urethral stricture were repaired with shelf op-eration or penis skin flap or septum of scrotum skin flaps urethroplasty. Results The simple stric-tures of 1 2 patients were cured by stage 1 operation,the other one cured after second surgery.Of 8 patients with fistula,7 were cured at stage 1,the other one was cured at the stage 2.Of 6 patients with diverticulum,all were cured at stage 1.Of 4 patients with phallocampsis,3 cases were cured at stage 1,the other one was cured at the stage 2.Of 6 patients with recurrent strictures,all were cured at stage 1.A1l patients were followed up 1 2 to 24 months.The micturition was without difficuItv at stand position. Conclusions Urethral stricture is one of the most common complications after hypos-padias repair.The simple urethral stricture could be repaired with urethro-meatomy or sheIf operation or transurethral holmium laser urethrotomy.The complicated urethral stricture could be reDaired with shelf operation or penis skin flaps or septum of scrotum skin flaps urethroplasty and overjetted with dortos of scrotum flaps.

Objective To study the mini-invasive surgical treatment for cholelithiasis disease in the primary hospital. Methods Laparoseope,duodenoscope and choledochoscope were combined to treat 293 cases with cholelith-iasis which included 2 cases cholecystolithisasis, 131 cases were cholecystolithiasis with secondary choledocholith,28 cases with primary choledocholith,39 cases with calculus of intrahepatic duct,93 cases with calculus of intrahepatic or extrahepatic duct. Results The program had minor trauma, mild suffering, and less operative complications,compared with traditional open operations. Conclusion The combined treatment of laparoscopy, duodenoscopy, choledochoscope and surgery for the cholelithiasis in the primary hospital is feasible, safe and effective.