Objective;To evaluate the endourethral surgery for urethrostenosis and urethratresia. Methods:68 patients with urethrosteno-sis or urethratresia were treated by endourethral surgery, such as internal urethrotomy, transurethral scar resection. Results: Of the 68 cases, the outcome was satisfactiory in 61 (89. 71% ). Endourethral surgery was carried out once for 55 patients and twice for 6,7 patients required open surgery. All patients had followed by urethral dilatation. 59 patients were followed - up for 3 months to 5 years. 54 cases can micture normally. Conclusions; Endourethral surgery is simple,safe,efficient treatment for urethrostenosis and urethratresia.

Objective To evaluate the cost-effectiveness of the aneurysm intra-artery GDC embolization and the aneurysm clapping of intracranial aneurysm, and to give the instruction for the clinical practice. Methods A case control study (1 vs. 1) was developed to evaluate the cost in hospital, the cost for return visit and the Quality-adusted Life-Year (QALY) and lifetime costs of the intra-artery GDC embolization and the aneurysm clapping of intracranial aneurysm, under the matching of the age, sex, living place, the size and place of the aneurysm, and the Hunt & Hess score. Clinically effectiveness dates were derived from the medical records. Cost dates were derived from follow-up by telephones or letters. The correlation analysis was done with the SPSS 13. 0. Results The cost in hospital in AC group was (54 945±16 946) RMBs,which washigher than the ones in AE group(63 768±12 665) RMBs, (t = 1.71, P <0. 05). The cost of missed working in AE group was 200 RMBs(the median), which was lower than the ones in AC group 650 RMBs (z =2. 57,P < 0. 01). The cost of return visit in AE group was 1200 RMBs, which was lower than the ones in AC group1950 RMBs (z = 1.82, P < 0. 05). The cost-effectiveness of the intra-artery GDC emhalization and the aneurysm clapping had no difference 3805 RMBs/year vs. 3028 RMBs/year(z =0. 42,P >0. 05). Conclusion The results suggest that the two therapies have no difference in cost effective rate. Considering the physical and mental loss, the aneurysm intra-artery GDC embolization was better than the aneurysm clapping for the patients with aneurysm that diameter less than 25 mm.

Objective To investigate and analyze the risk factors,morbidity and mortality rates of multiple organ dysfunction syndrome (MODS) after multiple trauma.Methods The clinical data of all 155 patients with multiple trauma admitted to our ICU from Sep 2008 to Jun 2011 were retrospectively analyzed,including treatment,injury severity score (ISS) and its relationship with MODS.Results The morbidity of MODS among all 155 patients was 18.7％ (29/155).There were 3,7 and 19 patients died due to multiple trauma in 39 ISS ＜ 16,58 ISS 16-25,and 58 ISS ≥25 cases respectively.The morbidity of MODS was significantly higher in patients with ISS ≥25 ( x2 =12.321,P =0.002) than in others.There were 15 cases with MODS and 28 cases without MODS died respectively in multiple trauma patients ( x2 =10.236,P =0.001 ).Conclusion MODS is the important reason for death in multiple trauma patients.It is pivotal to actively deal with primary trauma to avoid the second insult to the patients and support vital organs early in order to improve the prognosis of multiple trauma.

ObjectiveStudy on the effect of nasal decontamination hefor aerosol inhalation in elderly patients with general anesthesia postoperation.Methods130 elderly patients with general anesthesia postoperation were randomly divided into routine treatment group and nasal decontamination group.The time of first sputum,the time of postoperative sputum changing characters,respiratoty-related indicators,sputum cuhure positive rate of bacterial,the incidence of postoperative pulmonary complications was examined.ResultsCompared with routine group,nasal decontamination group obviously shorten sputum character changing time ( P ＜ 0.05 ).Postoperative nasal decontamination group and conventional group sputum Staphylococcus aureus positive rate were 7.7％ (5 cases) and 20.0％ ( 13 cases) respectively,the difference was significant(x2 =4.13,P ＜0.05).ConclusionGiven nasal decontamination before aerosol inhalation could improve character of sputum and reduce sputum bacterial culture positive rate,and had good efficacy and safety.

Objective To explore the characteristics of type 1 diabetic mice models induced by multiple low dcee streptozotoein(MLD-STZ).Methods Type 1 diabetic mice models was induced with intraperitoneally injection of STZ(40mg/kg body weight,daily)for 5 consecutive days and detected fasting blood glucose,urine glucose and histological ehange of panereata.Results The incidence of type 1 diabetes mdlitus was 65%;compared with normal control group,blood glucose and urine glucose levels increased significantly and histological analysis of pancreata showed marked insulitis in diabetic model group,and the hyperglycemia maintained from the fourth to the eighth week after the firml STZ injection.Conelnsion Type 1 diabetie mice models could be made successfully by MLDSTZ,and the hyperglycemia could maintain for a rather long time.

ObjectiveTo investigate the role and its mechanism of the NOD-like receptor 3 (NLRP3) inflammasome in alveolar macrophages in ventilator-induced lung injury (VILI) in rats.Methods Thirty adult male Sprague-Dawley (SD) rats were randomly divided into three groups, with 10 rats in each group: spontaneous breathing control group, normal tidal volume (VT) group (VT 8 mL/kg) and high VT group (VT 40 mL/kg). All of the rats underwent tracheotomy. Then rats in spontaneous breathing control group were kept to have spontaneous breathing, while rats in normal VT group and high VT group received mechanical ventilation. After 4 hours, the rats were sacrificed by carotid artery bleeding, and the bronchoalveolar lavage fluid (BALF), blood serum and lung tissue were collected. Lung wet/dry ratios (W/D) were measured. Light microscopy and electron microscopy were performed to observe the pathological changes in lung tissue, and the ultrastructural changes in alveolar macrophages. Enzyme linked immunosorbent assay (ELISA) was performed to measure the total protein content in the BALF and the interleukins (IL-1β and IL-18) in the serum and BALF. The mRNA expressions and protein levels of NLRP3, apoptosis-associated speck-like protein containing CARD (ASC), caspase-1, and nuclear factor-κB (NF-κB) in alveolar macrophages were assayed by real-time fluorescent quantization reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot.Results The structure of lung tissue and alveolar macrophages of rats in spontaneous breathing control group and normal VT group appeared normal, while obvious inflammatory changes were found in high VT group. Compared with spontaneous breathing control group and normal VT group, the ratio of W/D (8.89±0.90 vs. 5.18±0.86, 5.71±0.82, bothP< 0.05), contents of total protein, IL-1β, IL-18 in BALF were significantly increased [total protein (g/L):2.34±0.41 vs. 1.77±0.14, 1.81±0.06, IL-1β (ng/L): 133.48±10.48 vs. 81.54±3.12, 83.80±5.22, IL-18 (μg/L):4.57±0.45 vs. 3.04±0.51, 3.43±0.43, allP< 0.05], and IL-1β and IL-18 in serum were also increased [IL-1β(ng/L): 105.06±10.18 vs. 65.11±8.58, 75.30±10.62, IL-18 (μg/L): 2.27±0.09 vs. 1.18±0.34, 1.43±0.15, all P< 0.05]. The mRNA and protein expressions of NLRP3, ASC, caspase-1 and NF-κB in alveolar macrophages of high VT group were significantly increased compared with that of spontaneous breathing control group and normal VT group. The mRNA expressions of NLRP3, ASC, caspase-1 and NF-κB in high VT group were (8.53±2.21), (5.75±1.17), (7.47±1.23) and (10.86±2.38) folds of those in spontaneous breathing control group, and the protein expressions of NLRP3, ASC, caspase-1 and NF-κB were (1.50±0.14), (1.49±0.04), (1.53±0.15) and (1.51±0.11) folds of those in spontaneous breathing control group (allP< 0.01). There were no significant differences in all the indexes between normal VT group and spontaneous breathing control group.ConclusionNLRP3 inflammasome in alveolar macrophages may be involved in the mechanism of occurrence of VILI.

Combining with the disharmonious ethical phenomena in employment of medical students at present,this paper analyses its subjective and objective reasons,and puts forward some practical approaches to the cultivation of harmonious employment ethics of medical students.

ve To explore the effectiveness of non-hazardous treatment of excreta on control of intestinal infectious diseases and parasitosis. Methods The popularization rate of sanitary latrines, the non-hazardous treatment rate of excreta, the prevalance rate of B-class intestinal infectious diseases and infectious rate of worm eggs were sta-tistically analyzed. Results With the increasing popularization rate of sanitary latrine and the non-hazardous treat-ment rate of excreta, the prevalance rates of 3 kinds of intestinal infectious diseases (dysentery, typhoid and hepatitis) decreased from 175.14/100 000 in 1991 to 57.78/100 000 in 2 000 namely decreased 67.01% . The infectious rates of helminth eggs decreased from 76.88% in 1991 to 22.16% in 2000 namely decreased 71.17%. Conclusion Non-hazardous treatment of excreta presented obvious effectiveness on disease prevention, which should be widely popularized in countryside.

Objective To study the prognostic factors of primary ureteral carcinoma,and to analyze the risk factors of the occurrence of subsequent bladder cancer. Methods This series included 160 cases of primary ureteral carcinoma (93 men and 67 women;mean age,63.7 years).Of them,81 cases had the tumors on the left and 79 on the right;the tumors were located at the upper and middle parts of the ureter in 51 cases,and at the lower part in 96.Pathological staging showed T a (9 cases),T 1(58),T 2(46),T 3(41) and T 4(6);the grading showed G 1(4),G 2(119) and G 3(37).All the 160 cases underwent surgery.Among them,renal and full length of ureter resection plus sleeve resection of bladder were performed on 124 cases (77.5%).All the cases were followed up and the results were statistically analyzed. Results The overall 5-year survival rate was 53.0%.The 5-year survival rates of T a,T 1 and T 2 cases (83.3%,71.9%,59.1%,respectively) were significantly higher than those of T 3 and T 4 cases (37.5% and 16.7%,P

Objective To analyse the X-ray characteristics of the intraductal papilloma and to improve the diagnostic accuracy.Methods The mammographic data of 80 cases of intraductal papilloma of breast by pathology were analysed.Results 24 cases showed circular filling defect, 12 cases showed stringy filling defect,ductal blocked in 30 cases, ductal dilation in 48 cases. Conclusion Galactography is a effective method for diagnosing intraductal papilloma of the breast.