Objective To introduce a better and quicker technique of transperitoneal laparoscopic ureterolithotomy. Methods 42 cases of ureterolithiasis (23 males and 19 females;mean age of 42.4 years,range from 16 to 63 years) were included.Of them 26 cases had calculi on the left side and 16 cases,on the right side.All the cases underwent laparoscopy through 3-port technique. Results The operations were successful in all of 42 cases.The mean operative time was 43 min (range,33 to 56 min).Blood loss was 20 to 50 ml.The postoperative hospital stay was 3 to 5 days.None experienced urinary leakage.During the follow-up of 12～18 months no ureteral stricture was found.The renal functions were improved. Conclusions Our experience indicates that appropriate trocar location,exactly checking of calculi,good D-J tube drainage and skillful intra-abdomenal suturing are the keys to perform laparoscopic ureterolithotomy quickly.

Objective To describe the new technique of transperitoneal laparoscopic dismembered pyeloplasty and to evaluate its clinical effect. Methods Of the 18 cases of ureteropelvic junction (UPJ) obstruction who underwent transperitoneal laparoscopic dismembered pyeloplasty,8 cases had severe hydronephrosis;7,intermediate;3,mild. Results Operations were all successful in 18 cases with the operating time being 100 to 210 min (mean,142 min) and the blood loss,40 to 200 ml.All the pores of puncture healed at phase 1;mean hospitalization was 7.4 d.Only 1 case had postoperative urine leakage.Follow-up of 3 to 12 months showed there was no stricture at UPJ and hydronephrosis was remitted (intermediate hydrops in 4 cases,mild in 7 and resolution in 7).The renal functions were improved. Conclusions Laparoscopic dismembered pyeloplasty is an effective and minimally invasive approach and can be used as an alternative to open surgery for UPJ obstruction.

Objective To introduce the new technique of transperitoneal laparoscopic ureterovesical reimplantation and to evaluate its feasibility and clinical significance. Methods Overall,17 cases (5 men and 12 women) of ureterovesical obstruction (left,7 and right,10) were included.Of them,10 cases were diagnosed with simple congenital ureter outlet stricture;1 had calculi and polyp formation at right ureter outlet;2 had recurrent ureter outlet stricture after open ureterovesical reimplantation (1 of them had 2 calculi at lower part of the ureter);1 had double nephroureteral upper unit ureter outlet stricture with 2 calculi;2 had recurrent ureter outlet stricture after holmium laser section;1 with urinary TB had right ureter outlet stricture after left nephrectomy.Among the 17 cases,severe hydronephrosis occurred in 12,and moderate,in 5.Transperitoneal laparoscopic ureterovesical reimplantation was performed in the 17 cases (ureterovesical anastomosis in 15 and bladder flap ureterovesical reimplantation in 2). Results The operations were all successful in 17 cases with operating time of 90～160 min (mean, 112 min) and blood loss of 60～100 ml.The drainage tubes were removed 1～3 days after surgery without urine leakage.The urinary catheters were removed 1 week after surgery and double J stents,1 month after surgery. Six months after surgery cystography showed Ⅲ?urine reflux in 6 cases, Ⅰ?-Ⅱ? urine reflux in 5 and no reflux in 6.One year after surgery cystography showed Ⅲ? urine reflux in 3 cases, Ⅰ?～Ⅱ? urine reflux in 4 and no reflux in 10.During 3～24 months' follow-up, ultrasound B and IVU showed moderate hydronephrosis in 4 cases,mild,in 5 and no obvious hydronephrosis in 8. Conclusions Laparoscopic ureterovesical reimplantation is a feasible,less painful and minimally invasive alternative method for treatment of ureterovesical diseases.By comparison,bladder flap ureterovesical reimplantation has better anti-urine reflux effect but more complicated than ureterovesical anastomosis does.Long term efficacies of the methods need further observation.

In the process of responding to public health emergencies,the conflicts between the principles of management and ethics are constantly revealed.Combining with a unit's practical experiences of participating in several major public health emergencies,this paper put forward that it should take into account both the rescue and notification to achieve the unity of effective rescue and informed consent;take into account both the enforcement and obedience to achieve the unity of the interest of groups and individuals;take into account both the equality and priority to achieve the unity of urgency priority and equal opportunity;take into account both the rescuing and suf-fering to achieve the unity of interest between the rescuers and the victims,and thus to provide references for the reasonable solution of the ethical conflicts in the process of responding to public health emergencies.

Objective To evaluate the clinical effect of Ho:YAG laser lithotripsy in management of ureteral calculi and to investigate its influential factors. Methods The data of 137 cases of ureteral calculi (66 males and 71 females;aged 19-71 years with a mean of [(45.0?10.4)years;disease course from 4 days to 10 years with a mean of (1.50?0.65)years] treated via ureteroscope with Ho:YAG laser lithotripsy were analyzed retrospectively.Of them 112 cases had 1 stone,and 25 had more than one.Fifty five cases had stones on the left side,71,on the right side;11,on both sides;107 cases had stones in the lower ureter and 30,in the middle or upper ureter.The size of the stones were 0.6-2.0 cm in diameter with a mean of ( 1.1? 0.3) cm.Of them 23 cases had ureteral polyp and they underwent Ho:YAG laser vaporization resection of the polyp;11 cases had ureteral stricture and they underwent ureter dilatation or Ho:YAG laser incision of the stricture and lithotripsy.Double J tube was placed after operation. Results The overall stone fragmentation rate was 94.9%(130/137) with a single procedure.Stone free time was 5-56 d with a mean of ( 21.5 ?13.4) d.Operating time was (20-120)min with a mean of (60.4?18.3)min.Post operative hospital stay was 1～10 d with a mean of (2.4?1.1)d.In the successful operation group (130/137),the mean stone size was (1.03?0.24)cm in diameter, while in the failure group it was (1.47?0.51) cm. Four cases of the failure group had ureteral stricture;2 of them underwent shift to open operation, the other 2 experienced failure because of difficulty of placing D J tube. Three cases also experienced failure because of stone shift in the operation;of them 1 underwent shift to open operation,the other 2 were treated by ESWL.The differences of the stone size,concomitant ureteral stricture, stone shift in operation between success group and failure group were statistically significant ( P

BACKGROUND: Human adipose tissue-derived stromal cells (ADSCs) possess exert proliferation and multi-directional ability. As a novel stem cell, it has been widely utilized in tissue engineering and plays an important role in biological and potential therapeutic applications.OBJECTIVE: To review the research progress, applications and existing problems of human ADSCs in tissue engineering and cell therapy by retrieving relevant publications. METHODS: PubMed and CNKI databases were undertaken to identify the relevant articles published from January 1960 to January 2009 with the key words of "human adipose tissue-derived mesenchymal cells, isolation, differentiation, immune phenotype, application" both in English and Chinese. The articles relate to biological characteristics and applications of ADSCs were selected. In the same field, the documents published earlier or in the authoritative journals were preferred, and the repetitive studies were excluded. RESULTS AND CONCLUSION: A total of 81 documents were searched by computer, and 57 references were included in the final analysis. The results demonstrated that, human ADSCs share many characteristics, including the high proliferative potential and exhibiting the exert ability to undergo multilineage differentiation under appropriate conditions. Human ADSCs can not only utilize for tissue repairing, but also for cell immune modulation and gene therapy. However, there are still problems in its application. With the development of research on human ADSCs, their biological characteristics will be revealed, and their application in tissue repairing, cell therapy, transplantation, as well as gene therapy must be hold a great promise.

Objective It is purposed to evaluate clinical efficacy of adefovir dipivoxil combined with anti-tuberculosis (TB) drugs in treatment for chronic hepatitis B (HB) complicated with pulmonary TB. Methods Ninety-four eases of pulmonary TB complicated with chronic HB receiving anti-TB drug treatment at Liaocheng Hospital for Infectious Disease during September 2006 to September 2008 were divided into treatment and control groups matched on their pulmonary TB lesion, damage in liver function and HB virus (HBV) DNA load. Forty-seven cases in the treatment group were administered with anti-TB drugs, i.e., isoniazid (INH) 0. 3 g daily, rifapentine (RFT) 0.45 g twice a week, pyrazinamide (PZA) 1.5 g daily, streptomycin (SM) 0. 75 g daily or ethambutol (EMB) 0. 75 g daily, and regular liver-protection drags, as well as oral adefovir dipivoxil 10 mg daily for eight months, and another 47 cases in the control group were administered with the same anti-TB drugs and regular liver-protection drugs as the treatment group. Two to eight weeks after treatment, clinical symptoms, liver function, HBV DNA load, negative conversion of acid-fast staining bacteria in sputum smear, and absorption of pulmonary TB lesion were evaluated for all the patients in both groups. Data were analyzed with U-test and χ2-test, respectively. Results After treatment, damage in liver function worsened in three cases (6.4%), as compared to that in 47.3 percent of the control group (P<0.05). Clinical symptoms, including tiredness, loss of appetite, abdominal distension, uncomfortable in upper abdomen, and so on, appeared in three cases of the treatment group (6.4%) during anti-TB treatment, as compared to those in 18 cases of the control group (47.3%) (P<0.05). HBV DNA conversed to negative (less than 1.0×103 lg copies/ml) in 24 cases of the treatment group (51.1%), HBV load went down to 1.0×103-1.0×104 lg copies/ml in 23 cases (48. 9%), sputum smear bacteria conversed to negative in 41 cases (87. 2%) and pulmonary lesion absorbed in 45 cases (95.7%), all with statistically significance as compared to those in the control group (47. 3% , 0. 0% , 2. 6% , 39. 5% and 50. 0% , respectively, P <0. 05). Renal function was all in normal in both groups and no patient with drug resistant variant HBV was found during and after treatment, and no obviously adverse reaction was found in patients with adefovir dipivoxil. Conclusion Adefovir dipivoxil has a good safety and can reduce laver damage in anfi-TB drug treatment for patients of chronic hepatitis B complicated with pulmonary TB.

Objective To investigate the expression of focal adhesion kinase in peripheral blood of colorectal cancer and its clinical significance.Methods Focal adhesion kinase in peripheral blood was determined with flow cytometry in 40 cases of colorectal cancer and 20 cases of control group.Results The positive rate of focal adhesion kinase in colorectal cancer group was 60.0% and in control group was 25.0%,respectively(P

Objective To investigate the clinical efficacy and value of percutaneous transluminal angioplasty (PTA) in treating arteriosclerosis obliterans (ASO) of lower extremity that shows no visualization of its vascular outflow tract. Methods A total of 19 patients with ASO of lower extremities showing no outflow tract visualization were included in this study. The patients included 11 males and 8 females with a median age of 66 years (48-79 years. The main clinical symptom was rest pain of the leg in all patients; 10 cases had different degrees of foot ulcer and gangrene. Preoperative multi-slice CT angiography and DSA examination were performed in all patents. After PTA, the patients were followed up for 12 months, the changes of the clinical symptoms and signs were recorded. The claudication distance, toe skin temperature, ankle-brachial index (ABI), toe-brachial index (TBI), and CT angiography or color Doppler examination were separately performed before and one, 3, 6 and 12 months after PTA. Results In the 19 patients (38 diseased limbs in total), ASO with no visualization of vascular outflow tract was detected in 54 arteries, 3%), posterior tibial artery (n=18, 33.3%), peroneal artery (n=9, 16.7%) and popliteal artery (n=2, 3.7%). The technical success rate of limb PTA was 89.5%, while the technical success rate of single artery PTA was 85.2%. After PTA, the skin temperature of all the diseased limbs that had been successfully treated was obviously improved, the pain was significantly relieved or disappeared. One, 3, 6 and 12 months after PTA, the claudication distance, toe skin temperature, ABI and TBI were strikingly improved when compared with those determined before PTA (P<0.05). Twelve months after PTA the vascular restenosis rate was 39.5% (15/38), the limb vascular patency rate was 55.3% (21/38), and the limb salvage rate was 81.6%(31/38). Conclusion For the treatment of lower extremities arterial obliterans with obstructed outflow tract, PTA is safe and effective in short-term period. Although its long-term restenosis rate is higher, this technique can effectively control the progress of the disease, relieve the clinical symptoms, and help improve the limb salvage rate of ischemic limbs.

The Wnt signaling pathway plays an important role in bone metabolism. Inducing the Wnt signaling pathway promotes bone formation while restraining it results in osteopenic states. Although the regulation of this signaling pathway may bring enormous therapeutic potential, it still requires cautious approach because of the risks of tumorigenesis. The role of the Wnt signaling pathway in bone metabolism and the molecular targets of therapeutic potential for osteoporosis are discussed in this review.