Objective To improve the experience of diagnosis and evaluate the clinical efficacy and safety of the surgical management for ureteral fibroepithelial polyp.Methods The clinical date of 29 patients with ureteral polyps admitted in Peking Union Medical College Hospital during 2001 to 2014 were analysed retrospectively.The patients' age was between 1 1 to 84 years and 19 were male.Twenty patients with frank pain and two patients with hematuria were enrolled.Seven patients were found hydronephrosis.Results Twenty-nine cases were treated surgically.Fifteen cases were treated by ureteroscopic laser ablation,10 cases local resection and reanastomosis,1 case of abnormalities duplex kidney and ureter underwent local resection and ureteroplasty,2 case Partial ureterectomy including the polyps and pyeloplasty,1 cases nephroureterectomy because of giant hydronephrosis and nonfunctional kidney.No recurrences were seen during a mean follow-up of 32 months (range 10-56 mos).No ureteral stricture occurs.Conclusions Ureteral fibroepithelial polyps represent a rare pathology.Local resection is the main treatment.Endoscopic management is recommended to minimize morbidity and complications in treatment of ureteral fibroepithelial polyps.Recurrences seem to be rare in these tumors.

Objective To investigate the safety and efficacy of flexible ureteroscopy and holmium laser lithotripsy for the treatment of renal stones in patients with a solitary kidney.Methods Between May 2014 and June 2016,Clinical records of 17 cases of stones in a solitary kidney who underwent flexible ureteroscopy and holmium laser lithotripsy were reviewed.10 of these cases were male and the others female;mean age of these cases was 45.8 (32-67) years.9 were on the left side while 8 were on the right.6 cases were with functional solitary kidney (with the GFR of the contralateral kidney less than 10ml/min),while 11 others were with anatomical solitary kidney (6 due to tumor,2 due to tuberculosis,3 being congenital).All cases underwent BUS,KUB as well as CTU to confirm diagnosis before surgery,with 8 diagnosed with renal pelvis calculi,5 were with upper or middle calyx calculi,and 4 were with subrenal calyx calculi.The mean ± SD size of the stones was 1.2 ± 0.3 cm.Clinical m anifestations were asymptomatic in 10cases,backache in 5 cases and fever in 2 cases.All patients underwent exams of CBC,urinalysis,liver and kidney function,coagulation function,ECG,chest X-ray as well as cleaning midstream urine cultivation after admission.Results Mean ± SD operation time among all cases was (74.2 ± 23.6) min,the amount of bleeding during surgery was 5-15 (mean:8) ml,duration of hospitalization was 3-12 (mean:4.5)days,ureteral stents are kept for an average time of 4 weeks after surgery.3 patients developed fever after operation,1 developed urosepsis;all these patients recovered after active anti-infection treatment.No post-operative complications such as fever,renal colic,hematuresis,ureteral perforation,active bleeding as well as sepsis were found among the other patients.The preoperative and postoperative serum creatinine had statistical difference (P ＜0.05).14 patients were proved to be stone-free by KUB or CTU.The stone-free rate after a single operation was 82.3％ (14/17).Residual stone were found in the 3 patients,who subsequently underwent a second flexible ureteroscopy and holmium laser lithotripsy.The stone-free rate after a second operation was 94.1％.Conclusions Flexible ureteroscopy and holmium laser lithotripsy is a safe and effective method for the treatment of nephrolithiasis in patients with a solitary kidney with a lower procedure-related injury rate,smaller amount of bleeding,a lower complication rate and a shorter time required to recover after surgery.

Objective To compare the clinical efficacy of laparoscopic radical nephrectomy for large renal cell carcinoma (＞7 cm) between retroperitoneal approach and transperitoneal approach.Methods From Jan 2008 to Dec 2013,the data of 68 patients who underwent laparoscopic radical nephrectomy for large renal tumor(＞7 cm) in our hospital were reviewed.There were 41 male patients and 27 female patients,whose age ranged from 43 to 73 (mean 58.4t6.9) years old.The size of tumor was between 7.0 to 12.5 cm (mean 8.9± 1.1 cm).Left renal tumor was found in 37 patients and right renal tumor in 31 patients.Clinical stages of the tumors were T2 to T3.All patients were undergone the laparoscopic radical nephrectomy,including retroperitoneal approach in 42 cases (observation group)and transperitoneal approach in 26 cases (control group).The exclusive criteria included inferior vena cava tumor thrombus,lymphatic or distant metastasis,previous operation history in the same region,multiple tumors.There were no significant differences in the age,gender,tumor size and location within two groups (P＞0.05).The perioperative indexes and oncological outcomes,such as operation time,blood loss,incidence of blood transfusion,incidence of SIRS,postoperative hospital stay,complications and follow-up results,were collected and compared between two groups.Results Conversion occurred in two cases from observation group and one case from control group.Operative time in observation group was significantly shorter than that in control group (114.9±24.4 min vs.131.2±29.9 min,P＜0.05).Bowel function recovered more rapidly in observation group than in control group (1.7±0.6 d vs.2.2±0.6 d,P＜0.05).However,the estimated blood loss,the incidence of blood transfusion,the postoperative hospital stay,the incidence of SIRS and perioperative complications showed similar results in the 2 groups (P＞0.05).The histopathological examination confirmed renal cell carcinoma in all cases.Observation group included 35 pT2 stage and 7 pT3a stage cases,while control group consisted of 21 pT2 stageand 5 pT3a stage cases.The follow-up duration ranged from 4 to 38 months (mean 17 months).Mean overall survival were 17.1 months in observation group and 18.7 months in control group.Progression free survival time was 15.7 months in observation group and 17.1 months in control group.Cox survival analysis showed that only pre-operative stage of the tumor were independent risk factor for the survival time (P=0.018) and progression free survival time (P=0.020),while the operative approach was not the independent risk factor (P=0.298,0.314).Conclusions For large renal tumors (＞7 cm),laparoscopic radical nephrectomy was safe and feasible.Compared to the transperitoneal approach,retroperitoneal approach cost less operative time and faster bowel recovery.But the operation approach is not an independent risk factor for the survival time and progression free survival time.

OBJECTIVE: Discussing the use of endoscopy in the operation of microvascular decompression of cranial nerves to treat trigeminal neuralgia (TN), hemifacial spasm (HFS), glosspharyngeal neuralgia (GN) and some tumors of the cerebellopontine angle (CPA). METHOD: Since 2006, 973 cases (including 420 cases of TN, 487 cases of HFS, 66 cases of GN) had received the operation of nervous decompression by approach of postauricular suboccipital to the CPA. All cases who used the endoscopy and the material was described in detail. RESULT: In 420 TN patients, 390 (92.9%) were found responsible blood vessels. Two (0.5%) were found no responsible blood vessels but arachnoid adhesion, 28 were found CPA tumor secondary trigeminal neuralgia. In 487 HFS patients, 486 were found responsible blood vessels. Between the vascular and trigeminal nerve, teflon was used to decompress and isolate the facial nerve. In 66 GN, the glossopharyngeal nerve were cut and vagus nerve were decompressed. The short-term cure rate was 100%. Cerebrospinal fluid rhinorrhea occurred in 3 cases, 1 case of cerebellar infarction, 2 patients of cerebellar hemorrhage, 2 cases of pneumatosis. All complications were cured at last. There were no deaths. All cases were followed-up for 1 to 5 years. Four cases of TN and 4 cases of HFS recurrent, and none of GN recurrence. CONCLUSION The microneurosurgery of nervous decompression endoscopy technology for the treatment of TN, HFS, GN and some tumors of the CPA is an ideally functional and etiotropic operation. It is helpful to detect the responsible blood vessel and to protect the brain tissue and nerve function with endoscope, which can improve the success rate of the operation and avoid the complications. This technology has clinical application value.
Adult ; Aged ; Aged, 80 and over ; Cerebellopontine Angle ; surgery ; Decompression, Surgical ; methods ; Female ; Humans ; Male ; Middle Aged ; Neuroendoscopy ; Retrospective Studies ; Young Adult

OBJECTIVETo investigate if immunological factors associated with rheumatoid arthritis (RA) affect the result of human immunodeficiency virus (HIV) screening by electrochemiluminescence immunoassay (ECLIA) and enzyme-linked immunosorbent assay (ELISA).

METHODS100 RA cases were enrolled from January 2012 to February 2013 into this study. HIV screening was conducted with ECLIA detecting both HIV-1 p24 antigen, HIV-1 and HIV-2 antibodies, with ELISA and colloidal gold method detecting HIV-1 and HIV-2 antibodies. The samples producing positive results were submitted to the Center for Disease Control for confirmation using Western blotting method. The antibody titers of rheumatoid factors (RF) including RF-IgG, RF-IgM, RF-IgA, and CCP-IgG were analyzed by ELISA.

RESULTSThe HIV positive-rate determined by ECLIA was significantly higher than that by ELISA and colloidal gold method (P<0.01). The false-positive rate of HIV screening was associated with antibody titers of RF-IgG, RF-IgM, RF-IgA, and CCP-IgG in RA (P<0.01).

CONCLUSIONSImmunological factors, including RF and anti-CCP antibody, may influence the screening of HIV by ECLIA, producing false-positive result.

Adult ; Aged ; Arthritis, Rheumatoid ; physiopathology ; Enzyme-Linked Immunosorbent Assay ; False Positive Reactions ; HIV Antibodies ; blood ; HIV Antigens ; blood ; HIV Infections ; diagnosis ; Humans ; Middle Aged ; Rheumatoid Factor ; physiology

Objective To evaluate the feasibility of laparoscopic nephroureterectomy with bladder-cuff resection by TUR for upper urinary tract carcinoma. Methods Eighty-two patients with upper urinary tract transitional cell carcinoma(69 cases in renal pelvis and 13 in ureter)underwent retroperitoneal laparoscopic nephroureterectomy and bladder-cuff resection by TUR. This group of cases was retrospectively summarized including operative time, blood loss, drainage mounting days, catheterizing days, post-operative complications and hospital stays. Results All 82 operation procedures were successfully performed without severe complication. The mean operative time was 135 minutes.The mean length of hospital stay was 7 days postoperatively. The mean time with drainage and Foley catheter were 3 days and 6 days respectively. Follow-up time ranged from 6 to 76 months for 74 patients. The 3-year carcinoma recurrence was 10.6% (5/47). Only 1 patient was found incision tumor recurrence in 8 month after the procedure. Conclusion Retroperitoneoscopic nephroureterectomy with bladder cuff resection by TUR could be a feasible procedure to treat upper urinary tract transitional cell carcinoma.

OBJECTIVETo examine the spatial distribution of dead and vital bacteria in the early formation of native dental biofilm.

METHODSAn experimental dental biofilm model in the oral cavity was established by enamel slabs and the spatial distribution of dead and vital bacteria in the early colonization of native dental biofilm on the enamel surface was observed by in situ real-time and dynamic observations and optical sections utilizing confocal laser scanning microscope (CLSM) and live and dead bacterial fluorescence staining technique.

RESULTSAt the initial stage of dental biofilm formation, the structure was sparse and the percentage of dead cells reached 70% - 80% at the inner layers. In the middle layers the structure became denser than in the inner layers, which was mainly composed of vital cells (40% - 70%), and void-like structures were surrounded by vital bacteria. In the outer layers, the structure was sparse and vital cells occupied 20% - 40%.

CONCLUSIONSNative dental biofilms showed an uneven spatial distribution of vital and dead microorganisms. The percentage of vital microorganisms was lower adjacent to the enamel surface, increased in the z-axis towards the central parts, and decreased again towards the outer layers. The dead bacteria is an integral component in the early formation of native dental biofilm. Bacteria in the biofilms increased with time forming abundant channels.

Adult ; Biofilms ; Dental Plaque ; microbiology ; Humans ; Microscopy, Confocal ; Staining and Labeling ; Young Adult

OBJECTIVETo study the objective diagnostic mechanisms on Chinese medical (CM) syndrome patterns of rheumatoid arthritis (RA), and to research different titers of rheumatoid factor (RF)/citrullinated protein antibody (CCP) in CM syndrome patterns of RA.

METHODSTotally 230 early RA patients were assigned to five CM syndrome pattern groups, i.e., the dampness-heat blockage group (50 cases), the cold-dampness blockage group (50 cases), the Shen-qi deficiency-cold group (50 cases), the Gan-Shen yin deficiency group (40 cases), and the blood stasis blockage group (40 cases). Another 100 healthy subjects were recruited as the healthy control group. RF-IGM, RF-IGA, RF-IGG, and anti-CCP antibody were detected and compared.

RESULTSThe titers of RF-IGM, RF-IGA, RF-IGG, and anti-CCP antibody were higher in all groups than in the healthy control groups (P < 0.01). As for the 5 groups, RF-IGM, RF-IGA,RF-IGG, and anti-CCP antibody were higher in the RA active stage than in the nonactive stage. They were higher in the dampness-heat blockage group in the RA active stage than in the Shen-qi deficiency-cold group, the Gan-shen yin deficiency group, and the blood stasis blockage group.

CONCLUSIONTiters of RF-IGM, RF-IGA, RF-IGG, and anti-CCP antibody could be taken as judging indicators for differentiating objective lab indices of CM syndromes and assessing the active stage of RA.

Adult ; Aged ; Arthritis, Rheumatoid ; blood ; diagnosis ; immunology ; Autoantibodies ; blood ; Case-Control Studies ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Peptides, Cyclic ; immunology ; Rheumatoid Factor ; immunology

Objective To explore the clinical effects of different types of transurethral resection of prostate in the treatment of benign prostatic hyperplasia(BPH)complicated with diabetes mellitus.Methods Ninety-four patients with BPH complicated with type 2 diabetes mellitus admitted to Taizhou Municipal Hospital from January to December 2021 were randomly divided into control group and observation group,with 47 cases in each group.The control group underwent transurethral vaporization resection of prostate,and the observation group underwent transurethral plasmakinetic resection of prostate.The blood sugar,nerve growth factor(NGF),urodynamic indexes and complications of two groups were compared.Results During the operation,the blood sugar in observation group was significantly lower than that in control group(P<0.05).The rate of NGF positive cells in observation group was significantly lower than that in control group(P<0.05).One month after operation,the maximum urine flow rate and bladder compliance in observation group were significantly higher than those in control group,and residual urine volume was significantly lower than that in control group(P<0.05).Within one month after operation,the incidence of complications in observation group was significantly lower than that in control group(P<0.05).Conclusion Transurethral plasmakinetic resection of prostate for BPH patients complicated with diabetes mellitus can reduce the influence of operation on blood sugar,improve detrusor function and urodynamics,improve the therapeutic effect and reduce the incidence of complications.

OBJECTIVETo study the biological properties of human dental pulp cells (HDPC) by cloning and analysis of genes differentially expressed in HDPC in comparison with human gingival fibroblasts (HGF).

METHODSHDPC and HGF were cultured and identified by immunocytochemistry. HPDC and HGF subtractive cDNA library was established by PCR-based modified subtractive hybridization, genes differentially expressed by HPDC were cloned, sequenced and compared to find homogeneous sequence in GenBank by BLAST.

RESULTSCloning and sequencing analysis indicate 12 genes differentially expressed were obtained, in which two were unknown genes. Among the 10 known genes, 4 were related to signal transduction, 2 were related to trans-membrane transportation (both cell membrane and nuclear membrane), and 2 were related to RNA splicing mechanisms.

CONCLUSIONThe biological properties of HPDC are determined by the differential expression of some genes and the growth and differentiation of HPDC are associated to the dynamic protein synthesis and secretion activities of the cell.

Cloning, Molecular ; Cloning, Organism ; Dental Pulp ; Fibroblasts ; Gene Library ; Gingiva ; Humans ; Polymerase Chain Reaction