Objective:To reinforce the effect of clinical teaching by introducing the conception of CP to the course of clinical teaching.Methods:Sixty clinical medical students were randomly divided into Clinical Pathway group and traditional group,and the compound valuation was proceeded after some cycles.Result:The compound achievement measure of CP group is significantly higher than that of traditional group.Conclusion:The method of CP teaching promotes significantly the effect of clinical teaching.

The author summed up how to improve the urologic practice teaching quality from the following seven aspects: To give students a full understanding of urology clinical practice;To pay attention to the professional quality of teachers;To emphasize the training of interns agility;To organize intern participated in case discussion;To pay attention to the important role of writing medical record in clinical practice teaching;Properly handle the relationship between clinical practice and taking part in the entrance exams for postgraduate schools and employment options;To enhance the quality of medical humanities education in clinical teaching.

Objective To investigate T cell-mediated effects of dendritic cells(DC)transfected with kidney associated antigen G250 gene using adenovirus(Ad)as vector in the treatment of kidney cancer. Methods Peripheral blood mononuclear cells(PBMC)were isolated by standard FicollPaque density gradient centrifugation of heparinized blood obtained from healthy donors.After removal of the nonadherent ceils,the adherent cells were divided into gene transfer group,protein pulsed group and control group.The gene transfer group was infected with Ad/G250 virus;the protein pulsed group was added with G250 protein; the control group was added with PBS.The DCs were cultured and proliferated in vitro using recombinant human granulocyte macrophage colony stimulating factor and inlerleukin-4.The autologous T cells were added into the 3 DC groups(responders:dendritics,20:1).After 5 d co-culture,3 eytotoxic T lymphocyte(CTL)groups were collected.TheG250 mRNA expression was detected in transduced DCs using RT-PCR.The G250 protein translation products and cell surface marker of DCs were analyzed by flow cytometry.The specific cytolytic activities of CTL to different target cells(renal carcinoma 786-0 cell line and lung cancer A549 cell line)were assessed by MTT method. Results Ad/G250 transfected DC successfully and the G250 expression was confirmed by RT-PCR. The expression levels of CD_(80), CD_(83). HLA-DR and CD_(86) in the Ad/G250 group were higher than those in the other 2 groups. The cytotoxicity to 786-0 of T lymphocytes activated by Ad/G250 transfecting DCs(83. 4±2. 8)% was greater than those of T lymphocytes in the protein pulsed group(79. 6±2. 4)% and control group(77. 3±2. 1)%. There were no significant differences of the cytotyxicities to A549 among the 3 cytotoxic T lymphocyte groups(F=0. 373.P=0.693). Conclusions Ad-loading DCs may be useful for immunotherapeutic protocols against self-antigens for the kidney cancer.

For adapting the demands of modern society to medical talents,we applied problem-based learning pattern to urology practice teaching.By breaking the limits of subjects,we enable students to acquire more knowledge of science and problem-solving skills and self-learning skills in the limited time available.The role of teacher shifts from imparting knowledge to leaders.

Administration, Inhalation ; Adrenal Cortex Hormones ; administration & dosage ; adverse effects ; pharmacology ; therapeutic use ; Asthma ; drug therapy ; Child ; Drug Administration Routes ; Drug-Related Side Effects and Adverse Reactions ; Female ; Humans ; Male

Objective To explore the causes of congenital hypothyroidism by single photon emission computed tomography(SPECT) thyroid imaging.Methods Nineteen cases with congenital hypothyroidism were collected,and SPECT thyroid imaging was performed 15 minutes late after injected 99m TcO_ 4- 18.5-37.0 MBq.Results Five cases were found with normal glands,1 case with enlarged thyroid, 2 cases with enlarged thyroid and increased radiation,4 cases with ectopic thyroid,4 with a hypogenetic thyroid,and the last 3 cases showed no thyroid imaging.Conclusions The causes of congenital hypothyroidism can be found by SPECT thyroid imaging,which is important to the diagnosis of congenital hypothyroidism combined with detection of T_3,T_4,TSH.

ObjectiveTo evaluate transcatheter arter ia l embolization(TAE) on congenital renal arteriovenous malformation(RAVM).MethodsFive cases of RAVM,diagnosed on digital substraction a ngiography have been treated between March 1995 and May 2002 by transarterial em bolization (TAE) with different embolic agents (ethanol,iodised oil,gelform part icles or metalic coils).The efficacy was evaluated.ResultsIn all the 5 cases,gross hematuria was controlled immediately after TAE,th e urine turned clear in 24 h and urinalysis became normal in 7 days.The patients have been followed up for 6～12 months with an average of 10 months with hematu r ia well controlled in all.There has been no hypertension or apparent renal funct ion damage.Bilateral renal emission computed tomography (ECT) reveated only some local loss of the renal cortical function on the concerned side.ConclusionsAt present renal arteriography is still the most reliable method in the diagnosis of RAVM.TAE has the benefits of less inva sive, a low incidence of complications, early resumption of normal activities an d shorter hospital stay,and can avoid renal resection and correlative surgical c omplications.The renal function could be well protected from harm.

Objective To study the therapeutic effects of pedicled greater omentum displacement for complex posterior urethral stricture. Methods This study included 6 cases (all males) of complex posterior urethral stricture.Their age ranged from 14 to 45 years with a mean of 26 years.In these cases,traffic accident injury occurred in 5 and falling injury in 1.The course of diseases ranged from 6 months to 5 years with a mean of 2.5 years.The length of stricture segment was from 3.0 to 5.5 cm.All cases were surgically treated via transpubic approach and pedicled greater omentum displacement. Results Good operative results were achieved in all 6 cases.Each of them could urinate when the catheter was taken out 4 weeks later,and no urinary incontinence,urinary tract infection were observed.All were followed up for a median period of 26 months (ranged from 6 to 38 months).4 patients had normal micturition with no need of urethral dilatation and 2 patients reencountered dysuria in 3 months and were all cured by the administration of urethral dilatation for 3 to 24 months. Conclusions This procedure has a higher success rate.It is suitable for those with complicated posterior urethral stricture,such as longer posterior urethral stricture,urethra-rectal fistula, false passage, and especially those having experienced failure of urethra repair via perineal approach. It can be regarded as one of the ideal and effective therapeutic methods for complex posterior urethral stricture.

Objective To improve the differential diagnosis between benign renal mass and renal cell carcinoma(RCC) so as to lower the misdiagnosis rate. Methods This study included 12 cases of renal mass,whose age ranged from 35 to 69 years with a mean of 52 years.Among the 12 cases,flank pain occurned in 9,2 of whom had gross hematuria.Three clinically asymptomatic cases were detected incidentally by ultrasound in physical examination.All the 12 cases underwent imaging examinations such as B-ultrasound and CT scan,and all of them were preoperatively diagnosed as RCC. Results All the cases were surgically treated.Seven underwent enucleation or simple nephrectomy because of the diagnosis of benign renal mass by intraoperative frozen section.Five underwent radical nephrectomy.None developed recurrence during follow-up of 1 to 3 years. Conclusions Clinicians should not overestimate the diagnostic significance of imaging examinations such as CT and ultrasonography.For cases who have no definite diagnosis,surgical exploration can be performed.Intraoperative frozen section by pathologic study can increase correct diagnostic rate. Most of the misdiagnosed benign renal masses have different imaging features from those of RCC.

Objective To improve the prevention and treatment level of child traumatic posterior urethral stricture. Methods This series included 22 male children (mean age 9 years) with pelvic fracture complicated by posterior urethral disruption.A medical nylon string was indwelled after uretheral reunion operation.Urethral stricture recurred in 9 patients 3 months after the operation,and they were all cured by performance of urethra dilatation with self-designed single J tube under the guidance of the medical nylon string. Results All of the 9 were doing well during the operation.The medical nylon string was not taken out until dysuria disappeared completely.The cure rate was 100%.All the cases were followed up for a mean period of 15 months(range,3 to 24 months).All had normal urination. Conclusions Application of self-designed single J tube and medical nylon string is effective,simple and economical for the treatment of child traumatic posterior urethral stricture.It is easy both for the doctors' training and for the children's cooperation.Thus,it provides a new approach for the prevention and treatment of child traumatic posterior urethral stricture.