Objective To evaluate the effect of the department teaching management by using attending physician responsibility system. Methods Eight teachers were scored using the teaching management quantitative scoring standard before and after the implementation ofattending physician responsibility system. Score data of 12 months before the implementation ofattending physician respon-sibility system was defined as the control group, while the score data of 12 months after the implemen-tation ofattending physician responsibility system was defined as the study group. Groups were compared by using the paired t-test and P<0.05 means the difference has statistics significance. Results Com-pared with the control group , there was significant statistical difference between the two groups in teaching lectures, teaching rounds, case discussions, medical recordsquality, departmental rotation examination and the total score ( P<0 . 05 ) . No statistical difference was observed between the two groups on teaching score(P>0.05). Compared with the control group, there was significant statistical difference between the two groups in the senior grade and intermediate grade (P<0.05). Conclusion The attending physician responsibility systemfor teaching management is an effective way to improve the teaching management level.

Based on thermodynamic principle, the critical relative humidity of electrolytes is closely related to their solubility. The authors explored the relationship theoretically and calculated critical relative humidity of 21 electrolytes from their solubility in the light of Raoult's law and extended Wilson model. The results indicate that the critical relative humidity values calculated by Raoult's law can not accord with the reported ones and there is a systematic error in the high concentration range; while these calculated by extended Wilson model are comparable to the reported ones.

Objective To evaluate the feasibility and safety of transumbilical laparoendoscopic sin-gle-site dismembered pyeloplasty ( U-LESS-P ) for the treatment of ureteropelvic junction obstruction (UPJO). Methods Between Mar.2011 and Mar.2012, U-LESS-P was performed in 8 consecutive pa-tients with UPJO by one experienced laparoscopic surgeon .The patients included 5 males and 3 females, with an average age of 28 (16-45) years.Of the 8 patients, six presented with flank pain , and two were a-symptomatic and discovered incidentally by health check .Of the 8 patients, seven had UPJO on the left side and one on the right side .The diagnosis was established by renal ultrasonography , diuretic renal scan , intra-venous urography (IVU) or/and computed tomography urography (CTU).Renal ultrasonography, IVU and ( or) CTU showed hydronephrosis and UPJO in the affected side , while diuretic renal scan demonstrated re-nal function deteriorated .No patients had undergone abdominal surgery previously .A 2-2.5 cm umbilical in-cision was made for single-port access .The procedures were performed using 30°5 mm or 10 mm laparoscope with a combination of conventional and bent laparoscopic instruments . Results All procedures were com-pleted successfully .None was converted to open surgery or traditional laparoscopic surgery .The mean opera-tive time was 153 (117-190) min, and the average estimated blood loss about 20 (10-40) ml.The mean time to resume oral diet was 1.5 days.The drainage remained 2-7 days.The mean hospital stay was 6 (4-8) days.With the follow-up of 3-6 months, symptom-free was investigated in all 8 cases.Ultrasonography , diuretic renal scan and IVU showed decreased or disappeared hydronephrosis .No operative complication , such as anastomotic stoma stenosis , was founded . Conclusions U-LESS-P is a safe and effective proce-dure for the treatment of UPJO , with the advantages of decreased operative morbidity , postoperative rapid re-covery and improved cosmetic result .

OBJECTIVE: To investigate the clinical application of retroperitoneoscopic dismembered pyeloplasty for pediatric ureteropelvic junction obstruction (UPJO). METHODS: Of the 85 pediatric patients with UPJO, 56 were boys and 29 were girls. The age of the patients ranged from 2.5 to 11 years (mean = 4.6 years).B-ultrasonography showed hydronephrosis <15 mm (mild) in 15 patients,15-30 mm (moderate) in 59, <30 mm (severe) in the other 6. Intravenous urography (IVU) showed good imaging in 55 patients within 30 min, light imaging in 27 at 30-120 min, and no imaging in 3 after 120 min. The 85 patients underwent retroperitoneoscopic dismembered pyeloplasty. Conventional antegrade or modified antegrade double-J stenting was inserted in the 85 patients intraoperatively. RESULTS: The operation was successful in all, with no conversion to open surgery during the operation. The mean operation time was 146 min (125-240 min).The mean blood loss was 68 mL (55-112 mL).The mean postoperative hospitalization was 7 d (6-8 d ).Urine leakage occurred in 1 patient and with a good drainage, urine leakage disappeared in 1 week. Follow-up ranged 3-24 months (mean = 11 months).IVU showed on UPJ stricture, and good imaging in 75 patients within 30 min, light imaging in 10 at 30-120 min. Hydronephrosis was remitted:hydronephrosis resolution in 51 patients, mild in 6 and moderate in 3. CONCLUSION Retroperitoneoscopic dismembered pyeloplasty is a safe, effective and mini-invasive procedure for pediatric ureteropelvic junction obstruction, with a rapid postoperative recovery. It will be the ideal treatment for UPJO in pediatric patients.
Child ; Child, Preschool ; Female ; Humans ; Kidney Pelvis ; surgery ; Laparoscopy ; methods ; Male ; Retroperitoneal Space ; Ureteral Obstruction ; diagnosis ; etiology ; surgery ; Urologic Surgical Procedures ; methods

Objective To provide objective parameters for differentiating pancreatic cystic tumors via using computed tomography texture analysis (CTTA) to quantify the special imaging features of pancreatic cystadenomas.Methods Enhanced CT images of pancreas from patients who were admitted in Department of Radiology in First Hospital affiliated with Zhejiang University and First People's Hospital of Hangzhou City and pathologically diagnosed as pancreatic serous cystadenomas (n =48) and mucinous cystadenomas (n =34) from January 2009 to December 2016 were retrospectively analyzed.Regions of interest were drawn on the parenchymal phase CT images in 5 slices according to the border of the tumors.Mean grey level intensity (M),variance (V),entropy (E),skewness (Ske) and kurtosis (Kur) were obtained from fine texture (σ =1.0) to coarse texture (σ =2.5).Receiver operating characteristic (ROC) curve for texture parameters with statistically difference was drawn,and the area under curve (AUC),diagnostic sensitivity and specificity were calculated.The diagnostic accuracy of senior and junior doctors was compared with the traditional CT analysis method.Results Reliability coefficient of the two radiologists was 0.809 ～ 0.997 with high consistency.Compared with mucinous cystic tumors,serous cystadenomas had a significantly different V (5.93 ± 9.02 vs 1.29±0.62),E (2.39±0.61 vs2.02±0.39) and Kur(30.18 ±42.55 vs 8.80-±4.34) in Ske0 of 2.5 (P ＜0.05),and there were no statistically significant differences on other parameters.The AUC of differential parameters for diagnosing two kinds of cystic tumors ranged from 0.56 to 0.84.The diagnostic accuracy of the traditional CT analysis method by junior doctor and senior radiologist was 60％ and 71％,respectively.Conclusions CTTA can not only effectively quantify the heterogeneity of pancreatic cystadenomas,but also is effective in the differentiation.

Objective To investigate the correlation between aryl hydrocarbon receptor (A hR) gene polymorphisms and haplotypes and susceptibility of ulcerative colitis (UC) .Methods From January 2010 to October 2017 ,at the Second Affiliated Hospital of Wenzhou Medical University ,the First Affiliated Hospital of Wenzhou Medical University , Central Hospital of Wenzhou City and Wenzhou People Hospital ,a total of 396 UC patients were recruited as the UC group .In the same period ,573 age-and gender-matched healthy individuals were taken as the healthy control group . Three single nucleotide polymorphisms (SNP) of A hR (rs10249788 ,rs2066853 ,rs2158041) were examined by modified multiple ligase detection reaction technique .The correlation between the differences in the frequency of each SNP mutant alleles ,genotypes and clinical pathological features of UC was analyzed by unconditional logistic regression analysis .Haploview 4 .2 software was applied to analyze the linkage disequilibrium (LD) . Results The frequency of mutant allele C and genotype TC+CC of AhR (rs10249788) of UC group were higher than those of the healthy control group (75 .00％ ,594/792 vs .69 .98％ ,802/1146 ;95 .45％ , 378/396 vs .91 .10％ ,522/573) ,the differences were statistically significant (odds ratio (OR)=1 .287 , 95％ confidence interval (CI) 1 .049 to 1 .579 , P=0 .016 ;OR=2 .052 ,95％ CI 1 .180 to 3 .568 , P=0 .011) .Compared with the patients with distal colitis ,the frequencies of mutant allele C and genotype TC +CC of AhR (rs10249788) were higher in the patients with extensive colitis (71 .34％ ,341/478 vs . 80 .57％ ,253/314;93 .31％ ,223/239 vs .98 .73％ ,155/157) ,and the differences were statistically significant (OR=1 .666 ,95％ CI 1 .183 to 2 .347 ,P=0 .003 ;OR=5 .561 ,95％ CI 1 .260 to 24 .530 ,P=0 .023) .The results of LD analysis indicated that rs10249788 and rs2066853 ,rs10249788 and rs2158041 , rs2066853 and rs2158041 were linked to each other (D′=0 .636 ,0 .430 and 0 .980 ;r2 =0 .270 ,0 .023 and 0 .177 ) . Compared with the healthy control group , the frequency of haplotype TAC of UC group decreased (20 .20％ ,231 .5/1146 .0 vs .16 .24％ ,128 .6/792 .0) ,however the frequency of haplotype CAC increased (14 .43％ , 165 .4/1146 .0 vs . 20 .47％ , 162 .1/792 .0 ) , and the differences were statistically significant (OR=0 .767 ,95％ CI 0 .605 to 0 .973 , P=0 .029 ;OR=1 .529 ,95％ CI 1 .204 to 1 .941 ,P<0 .01) .The results of further analysis demonstrated that the frequency of haplotype CGC was higher in patients with extensive colitis than that of patients with distal colitis (38 .69％ ,121 .5/314 .0 vs . 29 .48％ ,140 .9/478 .0) ,and the difference was statistically significant (OR=1 .511 ,95％ CI 1 .119 to 2 .040 ,P= 0 .007) ,while the frequency of haplotype TAC in patients with extensive colitis was lower than that of patients with distal colitis (12 .10％ , 38/314 .0 vs . 17 .55％ , 83 .9/478 .0 ) , and the difference was statistically significant (OR= 0 .646 ,95％ CI 0 .483 to 0 .983 , P= 0 .037) .Conclusion A hR (rs10249788) may be a potential locus affecting susceptibility to UC ,and synergistically influence the risk and the location of UC .