In dynamic state,the airflow and particle distribution of class Ⅲ biosafety laboratory is simulated by means of the CFD.The identical results of the simulation and the practical survey show good reliability of this experiment.The result indicates that the good unidirectional air distribution is formed in main lab and air distribution is the main factors to determine the character of particle distribution.

This paper analyzes and simulates the effect of the air change rate per hour (ACH) on contamination diffusion airflow field in turbulent clean-room of hole-board ventilation by using CFD. The quality of Contaminant Removal Effectiveness (CRE) is compared with ACH ranging from 15 to 70. According to the simulation,it is the best condition of CRE in clean room when air change rate is 55 per hour,and the conclusion provides a theoretic basis for engineering design.

Objective To explore the operative approach, method,indication,and clinical feasibility of laparoscopic or retroperitoneoscopic treatment of ploycystic kidney.Methods The renal cyst unroofing(bilateral,9 cases;unilateral,4 cases) was performed under laparoscope(2 cases) or retroperitoneoscope(11 cases).The renal adipose capsule was dissected with a harmonic scalpel to fully visualize the whole kidney.According to preoperative positioning results,the cysts at all sizes were exposed.Then all visible cysts were unroofed or fenestrated with a margin 0.5 cm from the renal parenchyma.The cystic fluid was drawn out as much as possible.Results The operations were completed smoothly in the 13 cases.Pneumatothorax developed on the day of laparoscopic operation in 1 case,and then was cured by closed thoracic drainage.The operation time was 50～240 min(mean,139 min),and the blood loss was 10～200 ml(mean,58 ml).Patients began out-of-bed activities in 1～2 days after operation and were discharged from hospital at 3～10 days.The pathological findings were in accordance with changes of ploycystic kidney.Follow-up examinations were carried out for 1～30 months(mean,14.3 months).Back pain was relived in 8 out of 11 cases.In 3 patients with a high blood pressure,the systolic pressure was decreased by 16～19 mm Hg at 9 months after operation.Ten patients presented normal hepatic and renal functions,while the remaining 3 patients with preoperative increased creatinine levels of 194～301 ?mol/L had a drop by 20～40 ?mol/L.Conclusions Treatment of cyst unroofing under laparoscope or retroperitoneoscope is a safe and effective method in the treatment of ploycystic kidney,being worthy of clinical recommendation.

Objective To evaluate the clinical efficacy of retroperitoneoscopic nephrectomy for tuberculous nonfunctioning kidneys.Methods From October 2003 to November 2006,retroperitoneoscopic nephrectomy was performed in nine cases of tuberculous nonfunctioning kidneys in our hospital.Dissecting kidney and ureter with ultrasound scalpel,blocking kidney pedicle with Endo-GIA(n=4) or Hem-o-lok(n=5),kidney was put into kidney bags and taken out.Results All nine cases were performed nephrectomy successfully without conversions to open surgery.The mean of operative time was 110 min(range,90-180 min);the mean of blood loss was 94.4 ml(range,20-200 ml);the mean of postoperative hospital stay was 5.5 days(range,3-8 days).One case had a little cheese-like pura extravasation induced by laceration of kidney capsule.Peritoneum damage occurred in one case.The nine patients showed a primary healing of the wound.Follow-up of 1-38 months in nine cases showed normal function of contralateral kidney.Conclusions Retroperitoneoscopic nephrectomy for renal tuberculosis has advantages of minimal invasion,less blood loss and quicker recovery,therefore it is a fairly safe and reliable procedure for tuberculous nonfunctioning kidneys.

Objective To report our initial experience on the complications of retroperitoneoscopic live donor nephrectomy(RPLDN)and their managements in 117 cases.Methods From December 2003 to January 2009,117 cases of RPLDNs were carried out in our hospital.The operation was performed through 3 lumbar ports,after the kidney was liberated fully and the ureter was severed 7-8 cm under the lower pole of the kidney,the renal artery and vein were blocked with Endo-cut or Hem-o-lok and then cut off.Endo-cut was used in 3 patients and Hem-o-lok in 114 donors.Afterwards,the kidney was taken out quickly from the donor and infused with 4℃ kidney preserving fluid(HCA)immediately.We reviewed the intraoperative and postoperative complications in the donors and the grafts and the managements of the cases.Results All the 117 operations were successfully completed.No patients died during the operation or had delayed graft function recovery postoperation.No one was converted to an open surgery or needed blood transfusion during the procedure.Surgery-related complications occurred in 5 donors(4.3%)including intraoperative bleeding in 2(cured by hemostasis during the operation)and retroperitoneal hematoma in 3(cured by conservative management).Graft-related complications occurred in 8(6.8%)cases;among which extra arteries in the graft owning to endovascular stapler was found in 1 patient(who had a short common stem of the main renal artery,the three branches were anastomosed with the external iliac artery and 2 branches of internal iliac artery respectively);two graft kidneys were lacerated by laparoscopic instruments superficially and were repaired using absorbable sutures;renal subcapsular hematoma was noted in 2 grafts,capsulotomy was performed in one of them while the other received no treatment,both the cases had normal function of the transplanted kidneys;ureteral complications occurred in 3 grafts,in which vesico-urethral anastomotic leakage was developed in 10 days after withdrawal of the double J stents,they were cured by ureteral re-implantation.All the donors and recipients with complications were followed up for an average of 50 months(range 15-62 months).No other complications were found in the cases.During the follow-up,blood and urine routine,liver and renal functions,and blood glucose level are all in a normal range,abdominal B-ultrasonography revealed no abnormalities.B-ultrasonography of the implanted kidneys showed normal morphology and renal functions.Conclusions RPLDN is a safe and reliable method.Most of its complications complications may be attributed to the learning curve.Refinements in surgical techniques may decrease the rates of both donor and graft complications.

To identify Taenia cestodes from 6 regions of Yunnan province by PCR and sequencing of mtCOXⅠfragment. the genomic DNA of Taenia cestodes was extracted from proglottid collected in 6 region of Yunnan province, and mtCOXⅠ gene fragments were amplified by PCR, and then sequenced. The genomic distance and phylogenetic tree were constructed in comparison with other known mtCOXⅠgene sequences of T.solium , T.saginata and T. asiatica in GenBank using DNA MAN software. Through distance matrix,it was found that the homologie of NJ4, NJ1 and DQ2 was 99.8%, DL4 and NJ3 homologie was 99.5%, NJ2 and DQ3 homologie was 98.8%; the homologie of DL3 and BZ3 was 98.3%, while the homologie was 96.0% with BZ2; The phylogenetic tree demonstrated that 10 Taenia cestodes including NJ1-4, DL2-3and DQ1-3 occupied one brance with BZ3. BN1, CX1, LC1 and BZ2 occupied one brance, then two brance occupied and occupied with other one which was occupied by DL1 and BZ1. Taenia cestodes from Nujiang and Diqing were T. asiatica. Taenia cestodes from XiShangbanna,Lincang and Chuxiong were T.saginata.Taenia cestodes from Dali were T.solium or T.asiatica.Because same species have no difference from different regions. mtCOXⅠfragment sequencing is valid for tapeworms identification.

Objective To determine relative risk factors for positive surgical margins in extraperitoneal laparoscopic radical prostatectomy(LRP). Methods From February 2004 to September 2007,33 patients(mean age 70 years old)with prostate cancers underwent extraperitoneal LRP.All patients were diagnosed by pathology preoperatively.Gleason score:3+3 14 cases(43%),3+4 11 cases(33%),4+3 6 cases(18%),4+4 2 cases(6%).Clinical stage:T1a-T1b 4 cases(12%),T1c 14 cases(43%),T2a-T2b 5 cases(15%),T2c10 cases(30%).Logistic regression analyses were performed. Results LRP was successfully performed on 31 cases.There were 2 cases converted to open surgery.Nine cases(27%)had PSMs.There were 6 cases(67%)and 4 cases(17%)of clinical stage T2c in PSM and negative surgical margin(NSM)groups respectively(P=0.010).There were 3 cases(33%)and 0(0)with high Gleason score(higher than 7)in PSM and NSM cases(P=0.015).There were 4 cases(44%)and 5 cases(21%)with t-PSA higher than 20dg/ml in PSM and NSM cases respectively(P=0.178).In these 9 cases,there were 4 cases(44%)positive with DRE.However there were 9 in the 24 NSM cases(38%)(P=0.509).Clinical stage T2c was independently positively correlated with PSM(OR=24.69).High Gleason score(higher than 7)and t-PSA higher than 20 ng/ml were positively correlated with PSM. Conclusions Clinical stage is positively correlated with PSM.It is an independent factor.High Gleason score(higher than 7)and t-PSA higher than 20 ng/ml mignt be the risk factors in predicting PSM and should be used together with clinical stage.Positive DRE findings may be also useful to predict PSM.

Objective To summarize the minimally invasive transthoracic ventricular septal defect (VSD) occlusion operation experience in the clinical application. Methods 142 VSD patients (admitted from August, 2013 to October, 2014) were chosen. All patients were treated with minimally invasive transthoracic device closure under the monitoring of transoesophageal echocardiogram. Results 136 cases received successful closure, and 6 cases still need CPB conventional extracorporeal circulation operation. After follow-up for 3 ~ 12 months for 102 patients, 16 cases remain residual shunt. Conclusion The short-term therapeutic effect of minimally invasive transthoracic device closure of VSD is satisfying. However , the long-term follow-up remains to be studied.

Objective To assess the impact of learning curve on perioperative complications in laparoscopic radical prostatectomy (LRP) by a series of consecutive 200 cases in a single center.Methods Two hundred patients who were biopsy proved prostatic carcinoma and underwent LRP were retrospectively evaluated.All the operations were performed by professor Ma Lulin.The patients were divided into 4 groups according the time of operation.All the clinical data,including age,body mass index (BMI),preoperative PSA level,biopsy Gleason score,and clinical stage were collected.Operative parameters and peri-operative complications were evaluated,including operative time,blood loss,transfusion rate,and perioperative complications.The complications were evaluated by Clavien classification system.Results Age,BMI,PSA,prostate volume,biopsy Gleason score and clinical stage had no significant difference among the 4 groups (P ＞ 0.05).The operative time was gradually lowered from group one to group four.Significantly less blood loss occurred after every 50 cases of LRP (P ＜ 0.001).The complication rates were 15.5％ in this series,28.0％,18.0％,12.0％ and 4.0％ for group one to group four respectively.The complication rate reduced as experience was gained (P =0.008).The rates of mild complications were 24.0％,14.0％,6.0％ and 4.0％,and severe complication rates were 4.0％,4.0％,6.0％ and 0,respectively.Conclusion With experience was gained and technique was improved,the operative time and blood loss of LRP decreased and complication rate reduced substantially.

Objective:To describe a feasible surgical technique for patients with renal cell carcinoma associated with a supradiaphragmatic tumor thrombus that avoids cardiopulmonary bypass procedure. Methods:We retrospectively analyzed 2 cases with right kidney tumor and tumor thrombus above the dia-phragm treated in April and August,2015.The two patients were both female,aged 73 and 67 years. The tumor sizes of right kidneys were 7.0 cm ×6.3 cm ×5.7 cm and 8.7 cm ×7.0 cm ×5.2 cm,and the tumor thrombuses were 1.3 cm and 1.8 cm above the diaphragm.The second patient had synchro-nous metastasis in right adrenal gland ,and the tumor thrombus arose from the adrenal vein but not the renal vein.Intraoperative transesophageal echocardiography (TEE)was used to assess real-time mobility of the thrombus.A modified chevron incision was used,the right kidney was mobilized laterally and pos-teriorly,and the renal artery was identified,ligated,and divided.The infradiaphragmatic inferior vena cava (IVC)was exposed and isolated by mobilizing the liver off the diaphragm or to the left (piggyback liver mobilization,case 2).The central diaphragm tendon was dissected or incised in the midline until the supradiaphragmatic intrapericardial IVC was identified and gently pulled beneath the diaphragm and into the abdomen.The tumor thrombus was then “milked”downward out of the intrapericardial IVC un-der the guidance of TEE.The distal and proximal IVC to the tumor thrombus,porta hepatis,and left re-nal vein were clamped.Tumor thrombus was removed from the IVC.The IVC was sutured and vascular clamps were placed below the major hepatic veins.Pringle’s maneuver was then released and hepatic blood drainage was permitted during closure of the remaining IVC.Related literature was reviewed.Re-sults:Complete resection was successful through the transabdominal approach without CBP in both pa-tients.Estimated blood loss was 1 500 mL and 2 000 mL,and 1 200 mL and 800 mL of blood were trans-fused.The postoperative courses were uneventful.Both patients subsequently underwent tyrosine-kinase inhibitor therapy.Both patients were alive without tumor recurrence or new metastasis during the follow-up of 6 months and 9 months.Conclusion:In selected cases,renal cell carcinoma extending into the IVC above the diaphragm can be resected without sternotomy,CBP or DHCA.