Objective: To assess the efficacy and safety of the ureteroscopic lithotripsy in treatment of ureteral calculi in children. Methods, From March 2008 to May 2009, thirteen pediatric patients with ureteral stones were admitted to our department. There were six males and seven females, with an age range of 23 months to 11 years old. Six patients with stones located at the lower segments of the ureter, four at the middle segments, two at the upper segments, and one at pyelo-ureteral junction and lower ureter. The average diameter of the stones was (1.1 ± 0.47) cm (range 0.6 - 2.0 cm). The patients were placed in a lithotomy position; under general or venous anesthesia, ureteroscopy was performed using a semirigid ureteroscope (WOLF Fr 7.5/6), and the ureteral orifice was dilated to 10-12 Fr. Then holmium laser (1.5 J, 10 Hz) or pneumatic lithotripter was employed to fragment the stones (diameter of fragment less than 3 mm). Fr4. 7 double-J stent was placed after operation and was removed 4 weeks later. Results: Eleven of the 13 patient underwent successful lithotripsy, with the first time successful rate being 84.6%. The mean lithotripsy time was 8 min and the mean operation time was 21 min. There was slight bleeding during operation, but with no noticeable perforation of ureter or post operation fever, etc. Post-operation B ultrasound examination and X ray image revealed no residual stones with diameter > 3 mm in the 11 cases. Partial fragmentation was achieved in one patient with stone at upper ureter segment and one patient with stone at pyelo-ureteral junction and lower ureter, and the stones were excreted after extracorporreal shock wave lithotripy. Conclusion: Ureteroscopic lithotripsy is safe and effective in treatment of children with ureteral stones, which might become one of the first line treatment for children.

Objective: To construct DNA vaccines expressing prostate-specific membrane antigen (PSMA) and/or granulocyte-macrophage colony-stimulating factor (GM-CSF) and to determine their immunoactivity. Methods: Recombinant plasmids pIRES-PS-MA-mGM-CSF, pIRES-PSMA, and pIRES-mGM-CSF were constructed with DNA vaccine vector pIRES. After identified by endonuclease digestion, the above 3 plasmids and blank pIRES vector were used to immunize C56BL/6 mice (n=15). LDH release assay was used to exam the cytotoxicity of cytolytic T lymphocytes in each group. Results: We successfully constructed the above mentioned recombinant plasmids. Mice in pIRES-PSMA-mGM-CSF immunized group had the highest specific cytotoxicity, followed by pIRES-PS-MA and pIRES-mGM-CSF immunized groups. The blank pIRES group had the lowest cytotoxicity (P<0.05). The cytotoxicity was the highest in all 4 groups at an effector/target ratio of 10/1. Conclusion: The bicistronic DNA vaccine expressing PSMA and mGM-CSF may have a promising therapeutic value in gene therapy of prostate cancer.

BACKGROUND:Spine, due to its complicated structure and special functions, is always the difficulty and emphasis in clinical practice and medical education. It is an interesting top how to apply modern software in clinical teaching. OBJECTIVE:To investigate the application of Spine Decide software in clinical teaching of spine surgery. METHODS:Teachers can actively guide students to learn the diagnosis of spine diseases and to design surgery program using Spine Decide software. Then the students wil participate in the surgical operation of the patients, which helps them better understand the diagnosis and treatment of spine surgery disease and the occurrence and development of spine diseases. RESULTS AND CONCLUSION:The students actively participated in the process of learning through Spine Decide software, which helps them learn systematical y, structural y the pathogenesis, diagnosis, treatment and prognosis of spine diseases in a short period. Application of Spine Decide into teaching activities has greatly improved the students’ abilities in self-learning and clinical analysis. Their enthusiasm to the learning and creativity has been greatly improved compared to traditional teaching methods;innovation and exploration have breakthrough improvement, final y achieving a good teaching effect.

Objective To assess the clinical analysis of trans laparoscope hysterectomy(TLH).Methods Retrospectively analyzed the TLH in 62 patients Which were compared with the trans alxtominal hysterectomy(TAH)in 64 patients.Results Blood loss during operation,analgesic use after operation,time to first passing flatus,hospital stay in TVH group were significantly lower than those in TAH group(P＜0.05),and mean operating time has no significant difference in TVH group and TAH group(P＞0.05).Conclusion TVH has been shown to be an effective modus operandi of mini-invasive and safe.

Objective To evaluate the adhesion, proliferation and osteogenic differentiation of rabbits' mesenchymal stem cells (MSCs) cultured in demineralized bone matrix coated with OB-Cadherin. Method The second generation of MSC s were seeded onto the OB-Cadherin cover over allogenic frozen-dried demineralized bone matrix(FDBM) and the FDBM without OB-Cadhefin as control, and then both were cultured separably in vitro. The densities of seeded cells, the adhesion rate were measured, and their ALP activity was assayed in order to take it as an index of cell adhesion, proliferation and osteogenic differentiation. The growth and adhension of MSCs on the FDBM was observed and evaluated microscopically and electronic scanning microscopically. Data were ex-pressed as means and standard deviation (x±s), and were analyzed with SPSS 12.0. Independent-Sanples T-test and Paired t test was used, and P<0.05 indicated statistically significant. Results There was no significant dif-ference in cell proliferation between modified FDBM and unmodified FDBM cultured fot 7, 14, 21 d. ays. After culture for 20 hours, the adhesion rate in the control group was (35.56±1.75)%, the densities of seeded cells were less than 2.7×104. The adhesion rate of cells in the modified group was consistent at 80%, whereas the densities of seeded cells were as high as 5.0×105 compared with control group (P<0.01). After cultured for 20 hours, the efficiency of cell adhesion in the modified FDBM was higher than that in the unmodified FDBM. After cultured for 7 days, the cultured MSC on modified FDBM expressed higher AIP activity, and after cultured for 14 days, the ALP activity on modified FDBM was much higher than that on unmodified FDBM (p<0.01). After cultured for 14 days, osteocalcin immunohistochemical positive rate of modified group was (71±11)%, while that of the control group was(49±8)% with significant difference Conclusion OB-Cadherin enhances cell adhesion to FDBM and promotes MSC to differentiate to osteoblast, but no obvious effects d OB-Cadherin on cell proliferation were observed.

Objective To investigate the effects of mutated PS-1 on the proliferation and apoptosis of RA-induced PC12 cells . Methods The MTT assay, flow cytometry, TUNEL method were used in the research. Results An inhibition of proliferation was demonstrated in the RA-induuced PC12 cells expressing PS-1 mutant L286V. The proliferation of the cells was blocked in the G1→S phase. Whether with or without fetal bovine serum(FBS), PS-1 mutant L286V was able to accelerate the apoptosis of RA-induced PC12 cells. This action was enhanced markedly under the culture without FBS. Conclusions The RA-induced PC12 cells expressing PS-1 mutant L286V shows that the proliferation is inhibited and blocked in the G1→S phase. Whether with or without FBS, PS-1 mutant L286V can accelerate the apoptosis of RA-induced PC12 cells. This action is enhanced markedly under the culture without FBS.

Objective To investigate the characteristics of grafts after reconstruction of ACL with autogenous bone-patellar tendon-bone(B-PT-B)grafts. Methods Reconstruction of anterior cruciate ligament with free B-PT-B autograft fixed with interference screw was performed on 39 adult dogs. Mechanical testing was conducted on the grafts by translating the tibia anteriorly with the knee in 90 degrees of flexion, until complete failure. Failure site, cross sectional area, strength, stiffness and stress were documented. After decalcification and HE staining, the transformation of the intra-tunnel and intra-articular ligaments was evaluated, and the histological observation was conducted for the healing in the bone-tunnel, patellar tendon-tunnel and bone-patellar tendon interface. Results Union occurred in the bone-tunnel interface at 4th week. The patellar tendon-tunnel interface was linked by Sharpey's like fibers at 52nd week, the cement line and the tendency of chondrocyte lining were found. Mechanical testing of graft revealed that the rupture always occurred at mid-portion of ligaments instead of pulling-out from the tunnel under tension stress. Compared with the control group, the strength, stiffness and stress of the graft were 38%, 58% and 50% of normal anterior cruciate ligament at 52nd week respectively. Conclusion The union in the bone-tunnel interface occurs at 4th week, much earlier than the healing of the patellar tendon-tunnel interface. The healing of the tendon to tunnel presents to be indirect insertion at 52nd week with alignment of chondrocytes, which signifies the still ongoing of healing process at the interface. After fixation with interference screw for 4 weeks, the tendon proved to be the weakest part in bone-tendon-bone complex. No need to worry about the biomechanical character of the new insertion site during rehabilitation activities. The attachment fixed by interference screw is stable not only immediately after surgery but also during the healing of the insertion and the transformation of ligament. One year after reconstruction, the mechanical quality of the grafted tendon still remains inferior to that of normal anterior cruciate ligament in spite of similar histological structure. Protective device should be recommended during active activity.

Deep venous thrombosis is a common disorder, with a considerably high incidence and mortality. Inferior vena cava filter provides fruitful means in decrease and prevention of fatal pulmonary embolism. The authors reviewed the history, indications and applications of inferior vena cava filter for different types of deep venous thrombosis, with outlook of future trends.

Objective To study the vascular architecture and the indication of endovascular embolization of intramedullary AVMs and evaluate the therapeutic effect. Methods 15 patients (male 9 and female 6 , 9 to 43 years old) with acute or progressive paralysis were undergone DSA and endovascular embolization. The embolic material was PVA particles and silk suture segments. Lidocaine test was performed before embolization if it was necessary. Results There were 3 glomus AVMs and 12 juvenile AVMs among the 15 cases. The glomus AVM was usually fed by single artery, the juvenile AVM was fed by two or more arteries. Among 15 patients, 2 were cured, 3 had excellent effect, 6 had good effect, 4 showed no changed and no one became worsening. After 6 months to 5 years follow up, 7 patients with recurrency were re embolized,another 2 patients were lost of follow up. Conclusions Endovascular embolization is a mild invasive, safety and effective therapeutic method for curing AVMs by avascularizing the rudus and decreasing the drainage vein pressure and bleeding.

Objective To investigate the cholinergic neuron properties and the changes of proliferation and apoptosis of PC 12 cell induced by different concentrations of all trans retinoic acid(RA). Methods PC 12 cell was induced by RA of concentrations of 1-50 ?mol/L. Changes of cell growth curve and cycle, apoptosis and changes of activities of acetylcholinesterase(AchE) and choline acyltransferase(ChAT) were detected by MTT assay, flow cytometry, TUNEL method, spectrophotometry and radiochemistry assay, respectively. Results ① RA significantly enhanced the activity of ChAT with concentrations between 1 to 20 ?mol/L. The activity of ChAT with concentration of 10 ?mol/L was higher than those with other concentrations. ② The apoptosis of RA induced PC 12 cells was markedly enhanced when concentration was higher than 10 ?mol/L. ③ A concentration dependent inhibition of proliferation was demonstrated in the RA induced PC 12 cells. ④ PC 12 cells proliferation was blocked in the G 1→S phase. Conclusion RA can be used to induce PC 12 cells to show the properties of cholinergic neuron with an optimal concentration of 10 ?mol/L.