Objective To evaluate the application value of the rabbit for training the basic skills of urologic laparoscopic surgery . Methods The rabbit models of laparoscopic nephrectomy ,ureteral anastomosis and pyeloureteroplasty were established ;in the self-made simulation training box ,8 clinical doctors without the actual operating experience of laparoscopic surgery participated in 10 rounds of simulation training by taking the 3 operation models .The operation completion time for each time was recorded .The learning curves and the training effects were observed .Results 8 doctors were successfully completed training .The operative time of laparoscopic nephrectomy was declined from (45 .75 ± 6 .88)min at the first time to (30 .75 ± 4 .53)min at the sixth time and (25 .86 ± 3 .31)min at the final time ;the operative time of laparoscopic ureteral anastomosis from (56 .75 ± 7 .13)min at the first time to(43 .00 ± 4 .34)min at the eighth time and(35 .50 ± 4 .04)min at the final time ;the operative time of laparoscopic pyeloureteroplas-tyfrom(77.38±5.34)minatthefirsttimeto(59.13±7.26)minatthefinaltime;thedifferenceswerestatisticallysignificant(P<0 .05) .Furthermore ,the probability of repeated sewing and tearing tissue were significantly decreased on the whole .The controlled stitch length and edge length also were more accurate .The quality and appearance of the complete operation were significantly im-proved .Conclusion Rabbit can be conveniently used to set up the animal models for training laparoscopic nephrectomy ,ureteral an-astomosis and pyeloureteroplasty ,which is suitable for clinical urologic doctors to train the basic operating skills of laparoscopic sur-gery .

Objective To explore the intrauterine disorders that leads to infertility and sterility in women.Methods From March 1993 to March 2008,a total of 2077 patients with infertility received hysteroscopic examination at Nanjing Drum Tower Hospital.Among the patients,531 were diagnosed with intrauterine abnormalities including primary infertility in 172(32.4%) cases,secondary infertility in 315 cases(59.3%),and sterility in 44(8.3%).The clinical data of these patients were analyzed retrospectively.Results The most common cause of infertility and sterility in the patients was intrauterine adhesion(231 cases,43.5%),followed by uterine deformities(152,28.6%) and endometrial polyps(88,16.6%).In the primary infertility group,the most common reason was endometrial polyps,which was detected in 38.4% of the cases(66/172).The rate was significantly higher than that in the secondary infertility group(6.0%,19/315) and sterility group(6.8%,3/44)(?2=80.7630,P=0.000;?2=16.0463,P=0.000).While in the secondary infertility group,intrauterine adhesion was detected in most of the patients(60.6%,191/315),that was significantly more than that in the sterility and primary groups(25.0%,11/44,?2=19.9232,P=0.000 and 16.9%,29/172,?2=86.0747,P=0.000,respectively).For the patients with sterility,the disease was caused by uterine deformities mostly(65.9%,29/44),which is significantly different from the other two groups(secondary group:25.1%,79/315,?2=30.5994,P=0.000;primary group:25.6%,44/172,?2=25.4673,P=0.000).Conclusion The major causes of primary infertility,secondary infertility,and sterility are endometrial polyp,intrauterine adhesion,and uterine deformities respectively.

Objective To study the efficacy of antibiotic prophylaxis in old patients with negative urine cultures,who were submitted to transurethral prostate resection(TURP).Methods One hundred and twenty old benign prostatic hyperplasia(BPH) patients with sterile urine were divided into two groups(60 patients in each group) randomly.Antibiotic group received empirical venous antibiotics 4 days postoperative.Control group received 5% glucose saline as placebo.Their postoperative infection-associated parameters were compared.Results There were no significant differences between two groups in bacteriuria and infection-associated complications at the 28th day postoperatively.The ratio of bacteriuria in antibiotic group decreased significantly at postoperative at the 4th day when compared with that of control group.The bacteriuria at postoperative at the 4th day had no specific correlation with the long-term bacteriuria,the clinical observation of bacteremia and urinal tract infection,or the culture of prostatic tissue chip.Conclusions Antibiotic prophylaxis reduces the early postoperative bacteriuria for old patients with sterile urine before TURP,but its effectiveness for postoperative infectious complications is debatable.The antibiotics according to empirical validity are not specifically sensitive to the bacteria from various sources.

The incidence, mortality and survivorship of female breast cancer in China, and the distribution of its several key characteristics were described brielfy in this article. The breast cancer incidence and mortality rates among Chinese women were increasing rapidly, especially in rural area during the recent 10 years, though they were still in low level worldwidely. The distribution of breast cancer incidence and mortality among Chinese women by age and district were showing signiifcant characters. The total survival rate was estimated to be closed to the average level of developing countries, while disparity between urban and rural area was recognized. Because of lacking population data, it is dififcult to describe the characteristics on histological subtypes, stages on diagnosis and molecular subtypes nationwide. The national strategies on breast cancer prevention and control should be focused on disease surveillance, etiological research and survival study. Moreover, measurement should be taken to improve the capacity on breast cancer prevention, screening and clinical services in rural area, in order to narrow the gap of survivorship between urban and rural area and control the rapid increase of mortality in rural area.

Objective To explore the value of endoscopic retrograde cholangiopancreatography (ERCP)in the treatment of chronic pancre-atitis (CP).Methods Thirty patients with CP who underwent ERCP from January 2008 to December 2012 were retrospectively analyzed. Serum amylase levels were determined before and at 24 hours after surgery.The reduction in abdominal pain was dynamically evaluated be-fore and after treatment.A follow -up of patients with steatorrhea and anxiety was performed.Regular reexamination using abdominal ima-ging or ERCP was performed to identify pancreatic lesions and conditions of pancreatic duct stents.Results All patients were successfully treated by ERCP and had pancreatic duct stents placed.The remission rate of abdominal pain reached 83.3% at 72 hours after surgery.One patient was assigned to surgery due to insignificant improvement in symptoms,and the case -fatality rate after surgery was 0.Conclusion ERCP is an effective method in the treatment of CP,which has the advantages of being safe,effective,and minimally invasive.

Objective To examine the reliability and validity of the Chinese version of the perineal assessment tool (PAT),and explore its applicability in domestic patients with incontinence.Methods A convenience sample of 100 patients were recruited for evaluation.The patients with incontinence were assessed for lAD risk using the Chinese version of PAT.The reliability tests were conducted on internal consistency,interrater,test-retest,and the validity tests were conducted on content validity index(CVI),exploratory factor analysis,receiver operator characteristic curve (ROC).Results The Chinese version of PAT comprised 4 items,Cronbach's α was 0.512,and items related to the total score was appropriate; inter-rater reliability was 0.889; test-retest reliability was 0.791.CVI was 0.95.Exploratory analysis showed that the most interpretable solution consisted of 2 factors.The accumulative variance contribution explained 67.397％ of variance of the total scale.Predictive validity was moderate,the best cut-off point was determined at 6.5 points.Conclusions Due to the special design,its internal consistency reliability was low; content validity was relatively sufficient,but it still needs further revision and test.Inter-rater reliability,test-retest reliability,construct validity,predictive validity was generally good,and it could be used as the screening tool of IAD risk.The results prompt PAT could be used as a benchmark,and we can adjust the entry of PAT to provide a more accurate IAD predicting tool by studying the IAD risk factors.

Anemia is commonly observed in lung cancer patients,and it is mainly caused by chemotherapy.Anemia can cause several debilitating symptoms such as fatigue and tachycardia which will not only influence the patients' quality of life and therapy effect,but also short the survival time.So anemia has been regarded as a poor independent prognostic indicator of the disease.Transfusion the erythrocytes and using the erythropoiesis stimulating agents is the main treatments of the disease.Using the erythropoiesis stimulating agents is the main treatment before the hemoglobin decreasing significantly in order to reduce the times of transfusion.Keeping the hemoglobin between 10.0-12.0 g/dl can improve the patients' quality of life and avoid the adverse events such as thrombus formation at the same time.

Objective By investigating the departments of ECG and the staff in China,to study the current ECG status and thus provide references for training ECG workers,improving the work environment and stabilizing the ECG professional team.Methods One hundred and twenty four domestie grass-root hospitals were investigated through real-name questionnaire surveys.The data was collected and analyzed.Results Among the 124 investigated hospitals,the educational background description is:(1) The ECG workers in provincial or municipal hospitals had mainly been entitled with Bachelor's degree or above accounting for 72.7％ of whole ECG workers;the ECG workers in the county or township hospitals were entitled with college degree or below,accounting for 85.7％ of whole ECG workers.The difference between the two kind of workers was significant(P＜0.01).(2) The proportion of ECG workers owning senior professional titles in provincial or municipal hospitals and county or township hospitals were both low,which were 12.2％ and 3.6％,and the former one was significantly higher than the later(P＜0.01).(3) The proportion of hospitals which established dependent department of ECG was low;the percentage of provincial or municipal hospitals was 23.4％,which was significantly higher than that of county or township hospitals (3.3％,P＜0.05).(4) The provincial or municipal hospitals were well equipped and also conducted various of inspection projects in comparison to county or township hospitals.Conclusions The grass-root ECG staff in China has no satisfying education background and professional titles;ECG department belonging varies and the special inspection projects are insufficient and the economic benefit was low.So this study suggest that the competent departments take measures in improving ECG personnel enthusiasm,improving the working environment,and ensuring the healthy and orderly development of ECG profession.

Objective To investigate the clinlic therapeutic result of detenial sigmoid neobladder after radical cystectomy. Methods 50 patients with bladder cancer (41 males and 9 females;age range from 35 to 82 years) were admitted and underwent radical cystectomy and detenial sigmoid neobladder. Results All the 50 patients were followed up for a mean of 18.6 months(range from 6 to 29 months).The blood Cr and BUN levels were both in the normal range without acidosis in all the cases.Only 2 had unilateral ureteral urine reflux during cystography.Of the 50 patients 45 cases(90%) achieved continence during daytime;10 cases(20%) were incontinent at night,but 8 of the 10 cases could control urination by being woken up at night.The capacity of the neobladder was 220 to 550 ml with a mean of 350 ml and the maximal pressure of the neobladder during filling was 15 to 55 cmH 2O(1 cmH 2O=0.098 kPa) with a mean of 35 cmH 2O. Conclusions As a simple operation the detenial sigmoid neobladder can be performed easily with less complications and more reliable results.This operation may be generally applied in clinical practice.

Objective To study the diagnosis and trea tm ent of multiple endocrine neoplasia type 2b. Methods On e case of MEN2b was reported.The clinical features,the diagnosis and treatment o f MEN2b were reviewed and presented. Results The diagno sis was established on B-ultrasonography and CT scanning,and the patient was cu red by operation. Conclusions MEN2b has been rare.Endoc rine check up,imaging procedures,family investigation and DNA analysis are very important to early diagnosis.Surgical removal of the tumors is effective.