Objective To study the histopathological features of injured urethra managed by urethral realignment or suprapublic cystotomy and to sum up the experience on its treatment. Methods Urethral realignment or suprapublic cystotomy were carried out for 20 dogs as the instant management;tissue specimens from the two groups were studied using hematoxylin and eosin stain,immunohistochemistry and electron microscopy and the result has been studied. Results Regeneration of urethra was demonstrated in the urethral realignment group at 8 weeks after urethral injured whereas regeneration has been in the suprapublic cystotomy group.The average length of urethral emphraxis was 3.8 cm in the suprapublic cystotomy group whereas that of urethral stricture only 2.5cm in the urethral realignment group at 32 week. Conclusions Urethral realignment might be the treatment of choice for the instant managerment of urethral disruption as compared with suprapublic cystotomy.

Objective To evaluate the application of urine diversion in prostatectomy for hemostasis. Methods In 86 cases underwent suprapubic prostatectomy urine diversion was carried out.The prostatic bed was compressed by the inflated baloon of the urethral catheter.The operation time was recorded and the amount of blood loss both during and after the operation were measured.Postoperative blood hemoglobin and urodynamic parameters were compared with those before operation. Results The average operation time for the 86 patients was 45 min.The average blood loss during the operation was 140 ml and the average postoperative drainage 190 ml.Blood transfusion is not needed in all.The ureteral catheters for urine diversion were maintained for an average of 7.2 days and the urethral catheter for 8.6 days.Normal micturation was noted right after the removal of urethral catheter in all the 86 patients.Postoperative blood routine and biochemical assays were not significantly different from those before operation.The average maximum urine flow rate was 21.5ml/s.2 of the patients have experienced difficulty in micturation.Normal micturation was resumed on endoscopic urethrotostomy.No secondary bleeding or upper urinary tract infection has been noted. Conclusions The application of urine diversion is an effective means of hemostasis in prostatectomy.

Objective To study the clinical features of penetrating renal trauma. Methods From March 1996 to November 2002,28 patients (male,mean age 31) with penetrating renal trauma were treated,the clinical data of these were studied and reviewed. Results Nonoperative treatment was carried out in 6 patients of grade Ⅱ injuries were reconstructed and the other 2 patients were managed by embolization with an excellent renal salvage rate.In 12 patients with grade Ⅳ injuries,6 underwent embolization successfully,2 were successfully managed reconstruction,4 required nephrectomy.3 patients were of grade Ⅳ injuries,2 of whom underwent nephrectomy and 1 was died. Conclusions The condition of vascular injury should be considered in treatment of penetrating renal trauma.Emblization is a ideal treatment for the grade Ⅲ-Ⅳ penetrating renal trauma.

Objective To summarize the experiences on clinical application of flexible cystoscopy,and evaluate the significance of applying flexible cystoscopy in urologists' daily practice.Methods A total of 379 patients underwent examination with flexible cystoscopy,of them 74 patients were with the aim of therapy or related operation.The operation time was counted and the patients' discomfortableness was recorded according to a visual analog scale(VAS).What's more,a satisfaction questionnaire was made by no doctor presenting to check the patients' response to cystoscopy operation.36 male patients were undergone both rigid and flexible cystoscopy operation.The statistical significance of the differences was analyzed after reading the VAS scores and the results of questionnaires were evaluated.Results 223 patients were found to have relative diseases by the examination of flexible cystoscopy.The mean operation time in using flexible cystoscopy was 7.8?0.27 minutes.The median pain scores of male and female patients were 2.9 and 1.3,respectively.The maximum pain was felt by male patients when the cystoscopy went through the membran of urethra.Satisfactory rate in male patients was 99%,and it was 100% when evaluating the questionnaires answered by female patients.For the 36 male patients undergone both rigid and flexible cystoscopy operation,the median pain score was 2.1(0.5-4.5) for flexible cystoscopy,and was 5.7(1.0-10.0) for rigid cystoscopy.After flexible cystoscopy examination,all the 36 patients were satisfied by the operation.However,only 61.1%(22/36) patients were satisfied by the rigid cystoscopy operation.Statistical analysis showed significant difference(P

Objective To investigate the clinical effect of antidepressants combined with α-blockers in the treatment of chronic prostatitis.Methods A retrospective analysis of 90 cases of chronic prostatitis treated in our hospital from January 2016 to December 2016 was divided into two groups according to the random number table.The control group was treated with α-blocker Combined with vitamin C treatment, the study group using antidepressants combined with α-blockers treatment.The NIH-CPSI score and SDS score were recorded before and after treatment, and the therapeutic effects were compared between the two groups.Results There were no significant differences in NIH-CPSI scores and SDS scores between the two groups.After treatment, the scores of NIH-CPSI and SDS were significantly better than those before treatment, and the study group was superior to the control(91.1%) was higher than that of the control group(71.1%), the total effective rate of depression(93.3%) was higher than that of the control group(73.3%), and the total effective rate was 91.1%, The difference was statistically significant(P<0.05),comparable.Conclusion Antidepressants combined with α-blockers are effective in the treatment of chronic prostatitis, which is beneficial to the alleviation of clinical symptoms and the improvement of their symptoms.Therefore, it has a good clinical value and worthy of further popularization.

Objective To assess the value of procalcitonin (PCT) levels compared to C-reactive protein (CRP) levels and blood white cell count in early detection of sepsis following percutaneous nephrolithotomy.Methods This prospective observational study included 91 patients,including 59 male patients and 32 female patients,undergoing percutaneous nephrolithotomy between April 2014 and October 2015.Their mean age was (54 ± 15)years old,ranging 15 to 88 years old.The average size of stone was (20.9 7.0) am.Those patients were classified into two groups,based on whether the postoperative sepsis existed.In this group,51 cases were concluded in the sepsis group and 40 in the non-sepsis group.A statistically significant difference between patients with and without sepsis was found in the hydronephrosis (44 vs.25,P =0.009),urine white cell count [(402 ± 970) / μ1 vs.(70 ± 171) / μ1,P ＜ 0.01],positive urine culture(36 vs.20,P ＜ 0.05),positive pelvic urine culture (22 vs.5,P =0.001).There was not any significant difference in sex,age,size of calculi and blood culture between patients with and without sepsis (P ＞ 0.05).Blood white blood cell count,CRP,and PCT were measured in patients with an acute onset of sepsis.Diagnostic accuracy of PCT values was analyzed by the receiver operating characteristics (ROC) curve.Results A statistically significant difference between patients with and without sepsis was found in the PCT [(7.43 ± 10.15)μg/L vs.(0.14 ± 0.10)μg/L,P ＜ 0.01] and blood white cell count [(14.18 ± 6.47) × 109/L vs.(11.22±4.22) × 109/L,P ＜0.05].There was not any significant difference in CRP [(64.93 ± 68.60) mg/ml vs.(70.76 ± 53.36) mg/ml,P ＞ 0.05] between patients with and without sepsis.ROC curve analysis showed that blood white cell count and PCT concentrations had similar predictive values for the development of sepsis (area under the curve,0.78 and 0.90,respectively) with the best cut-off values of blood white cell count for 12 × 109/L (sensitivity 50％,specify 88％) and 0.5 μg/L (sensitivity 64％,specify 100％)for PCT.54 cases were performed blood culture,which showed positive in 12 cases and negative in 42 cases.The significant difference of PCT level could be noticed in two groups [(16.99 ± 11.64) μg/ L vs.(3.77 ± 7.23) μg/ L,P ＜ 0.05)].No significant difference was found in CRP,Blood white cells count among those groups (P ＜ 0.05).ROC curve analysis showed that PCT concentrations had predictive values for the positive blood culture (area under the curve,0.80) with the best cut-off values of 8 μg/L (sensitivity 71％,specify 88％) for PCT.Conclusions PCT was a useful marker for the diagnosis of the sepsis after percutaneous nephrolithotomy as compared with WBC and CRP.

Objective To evaluate the clinical characteristic,diagnosis and treatment procedures for renal oncocytoma and chromophobe cell renal carcinoma.Methods Eight cases of renal oncocytoma and 5 cases of chromophobe cell renal carcinoma were analysed.The average of oncocytoma was 58.8 years old(23～74),and mean tumor size was 5.1 cm(range,3～7 cm);The mean age of chromophobe cell renal carcinoma was 54.5 years old(35～72),and mean tumor size was 5.8 cm(range,3～8 cm).Doppler ultrasonography and CT scan were performed in all patients.All cases accepted surgical operation and were confirmed by pathology.Results Renal oncocytoma was characterized by homogeneous round cell containing aboundant axyphil pellets.Color Doppler ultrasonography show isoechoic or hypoechoic masses.CT scan revealed that the tumors were homogeneous solid masses,and most of them were visualized as homogeneous enhancement.All the patients were followed up for 10 to 53 months,and no recurrence or metastasis was noted.Color Doppler ultrasonography show mainly hyperechoic masses,CT scan revealed most of the tumors were heterogeneous enhancement.All the patients were followed up for 12 to 49 months,and 1 case died from metastasis after 1 year.Conclusion Renal oncocytoma and chromophobe cell renal carcinoma can be differentiated by clinical characteristic,ultrasonic and CT scan examination.The diagnosis is confirmed by pathology.Partial nephrectomy is good for renal oncocytoma,while radical nephrectomy is still the first choice for chromophobe cell renal carcinoma.

Objective To compare the effects of flexible ureterorenoscope holmium laser for treatment of different sizes lower pole caliceal stones. Methods 140 patients with lower pole caliceal stones from August 2011 to April 2015 were enrolled, 40 patients were divided into observation group which the largest stone diameter > 2.0 cm, 100 patients were divided into control group which the largest stone diameter ≤ 2.0 cm. All these patients received flexible ureterorenoscope holmium laser treatment. Then we observe and compare the prognosis. Results The postop﹣erative 3 d and 1 month of gravel success rates were 97.5 % and 80.0 % in observation group, while the control group were 98.0% and 95.0%. The postoperative 1 month of gravel success rates in observation group was signifi﹣cantly lower than that in control group (P< 0.05). The operative time and postoperative hospital stay in observation group were significantly higher than control group (P<0.05). The postoperative 1 month complications of lung infec﹣tion, hematuria, urinary extravasation and so on in observation group were significantly higher than that in control group (P<0.05). The postoperative 3 d creatinine contents in observation group were significantly higher than preop﹣erative (P< 0.05), and significantly higher than that in control group (P< 0.05). The creatinine contents compared between the two groups at other time points were not statistically significant (P> 0.05). Conclusion Compared with small lower pole caliceal stones, the success rate of flexible ureterorenoscope holmium laser treatment of large lower pole caliceal stones is declined, the patients also have some trauma, and the renal function is also fluctuate, postop﹣erative disease is relatively higher that clinically to be carefully chosen.

Objective To investigate the clinical study of sarcoside combined with tamsulosin in the treatment of type Ⅲ prostatitis. Methods 84 patients with type Ⅲ prostatitis who were treated and diagnosed in Jishuitan Hospital from November 2015 to December 2016 were randomly divided into experimental group and control group according to the time of hospitalization, 42 cases in each group. The control group was treated with tamsulosin hydrochloride sustained-release capsules, and the experimental group was treated with the addition of the new drug. The maximum urinary flow rate and mean urinary flow before and after treatment were recorded, compared and analyzed before and after treatment. Results The maximum urinary flow rate and mean urinary flow rate were increased in both groups after treatment, and there was significant difference between the two groups (P<0.05). The data of the maximum urinary flow rate and the mean urinary flow rate in the experimental group were significantly better than those in the control group. The data of the two groups were statistically significant (P<0.05). In addition, the experimental group after treatment of prostate symptom score was significantly better than the control group score, the two groups of data were significantly different, the data were statistically significant (P<0.05). In addition, the total effective rate of the experimental group was significantly higher than the control group(80.95%vs. 73.81%). The data were statistically significant (P<0.05). Conclusion The clinical efficacy of sorbenaside combined with tamsulosin in the treatment of type Ⅲ prostatitis is better than that of the original treatment. The treatment can improve the patient's urination and prostate symptoms and improve the patient's comfort.

Objective To explore the effect of different dosage of radial extracorporeal shock waves on fracture disunite and bone nonunions.Methods 42 patients were divided into 3 groups based on the different shock dosage, every group contained 14 patients and the shock dosages were 1000, 2000 and 3000 in Groups A, B and C respectively. All patients accepted the therapy for 3 times and followed up with X rays. Results 3 months after treatment, calluses were formated iin 2(14.7%), 8(57.1%) and 8(57.1%) patients in 3 groups respectively,which was lower in Group A than in Groups B and C (P<0.05), but there was no significant difference between Group B and Group C (P>0.05). 9 months after treatment, the corresponding cure rates were 28.6%, 85.7% and 78.6% in 3 groups respectively. The cure rate was lower in Group A than in Groups B and C (P<0.05), but there was no significant difference between Groups B and C (P>0.05). Conclusion The radial extracorporeal shock waves had dose-dependence and saturation for the shock dosage, 2000 is the optimal choice