Objective To evaluate the value of imaging examination and diagnosis of airway foreign body in children. Methods 218 of airway foreign bodies confirmed by bronchoscopy were retrospectively analyzed in terms of clinical and imaging data. Results 218 patients included 140 males and 78 females. Their ages ranged 6 months to 12 years(mean,19.2 months). All patients had conventional radiographs on frontal chest films,neck lateral films and fluoroscopy. 34 cases underwent 64-slice spiral chest CT examination. According to the location of the foreign bodies,29 cases were in throat and subglottic,55 cases in trachea and 134 cases in bronchus(79 cas-es in the right,55 cases in the left). According to the character of the foreign bodies,5 cases were metal,29 cas-es in bone,93 cases in peanuts,59 cases in seeds,22 cases in fruits and vegetables and 10 cases in others respec-tively. Thirty-fourcases showed a direct sign of the foreign body and 177 cases showed the indirect signs. 34 cases on CT examination directly were showed foreign body in the tracheal bronchi. The diagnostic accuracy of CT exami-nation was 100%. Conclusions X-ray photograph and fluoroscopy were the first choice for aspiratory foreign bod-ies in children. CT examination is an important supplementary method when conventional X-ray examination is neg-ative.

Objective To explore the diagnostic value of MSCT in tumors of intra-abdominal cryptorchidism in children.Methods MSCT findings of 8 children with tumors of intra-abdominal cryptorchidism confirmed by surgery and pathology were analyzed retrospectively.Results Six tumors located in the right,2 (1 tumor of left cryptorchidism turned to the right abdominal) in the left.Eight children showed ovoid soft tissue tumor in abdomen.Three children displayed the long axis of the tumors consistent with regular descending course of embryonic testes.Six teratomas manifested as the cystic and solid mass with fat,calcification (ossification) insidey.Two yolk sac tumors manifested as the large cystic and solid mass with irregular necrosis and abundant tumor vessels.Conclusion The pathologic types of tumors for intra-abdominal cryptorchidism in children are different from adult.Most of them are teratomas or yolk sac tumors,and have some characteristics in MSCT.MSCT is helpful in diagnosis of tumor for intra-abdominal cryptorchidism with medical history.

Vacuum pyrolysis of phenolic resin laminate substrate in temperature-programmed furnace reactor was studied.The sample and product oils were characterized by elemental analysis, Fourier transform infrared (FT-IR) analysis and gas chromatography-mass spectrometry(GC-MS).Analytical results showed that the up per clear liquid of pyrolysis oils was mainly consisted of water-soluble substances, such as phenol, cresol, xy lenol, sugars, hydantoins, morpholines, pyranones and pyridine derivatives compounds, etc., while the lower sediment was mainly insoluble or hardly water-soluble substances, such as the big substituent phenolics (the number of substituent carbon atoms of which is greater than or equal to 2), aryl phosphate esters, fatty acid esters and nitrile compounds, and so on.Both of the upper clear liquid and lower sediment have a higher content of melamines.

Objective To evaluate if the flexible ureteroscopy could treat stones located in lower calyx with the infundibulopelvic angle (IPA) less than 30°.Methods Thirty-six patients with inferior caliceal calculi on whom flexible ureteroscopic procedures were performed between November 2009 and June 2015 were reviewed.The mean age of the patients was 52.1 years (34-71),with the mean stone diameter of (1.5 ± 0.8) cm (1.2-2.6 cm).IPA was smaller than 30° in all 36 cases,which confirmed by CTU examination.IPA was less than 10° in 15 patients,between 11 ° and 20° in 13 patients and between 21 ° and 30° in 8 patients.Results The success rate was 63.9％ (23/36 patients) in patients with IPA smaller than 30° after first session of procedure,and the stone free rate reached 100％ after the second session of procedure.The mean operation duration was (95.5 ± 31.4) min(51-127 min).The mean hospital stay after operation was(4.1 ± 1.2)days (3-5 days).No major complications were recorded and no patients needed to convert to open surgery.Double J tube was removed after 4 weeks postoperatively.Patients were followed up for 4-12 months,during which ultrasound and CT scan were used for stone detection.Conclusions The small IPA (＜30°) negatively affected the SFR in the first session operation.However,its negative effect was solvable by using modern endoscopes.A complete stone clearance was achievable even in case of unfavorable anatomic conditions in experienced hand.

Objective To monitor the renal pelvic pressure and to investigate its clinical significance during retrograde flexible ureteroscopic lithotripsy (RFUL).Methods The data of renal pelvic pressure measured in 60 cases of RFUL with the mean irrigation pump speed and pressure of 30 ml/min and 30 mmHg were analyzed retrospectively.The influence factors of renal pelvic pressure and its correlation with postoperative fever were analyzed.Renal pelvic pressure was measured by baroceptor,which was connected to PHILIP-MP4 monitor IBP channel and ureteric catheter positioned in renal pelvis through a dual channel ureteral access sheath (UAS).The renal pelvic pressure data was collected and analyzed in every 2 seconds by computer.The 60 cases were divided into 3 groups according to their intra-pelvic pressure situations:normal pressure group(NP,IPPmax ≤30 mmHg),high pressure group(HP,IPPmax＞30 mmHg,but high pressure duration≤ 10 min),and backflow pressure group(BP,IPPmax＞30 mmHg and high pressure duration＞ 10 min).Results The baseline intra-pelvic pressure (IPP0) and max imum intra-pelvic pressure (IPPmax) were (13.2±5.6) mmHg and (95.6±2.3) mmHg respectively.IPP levels during the RFUL were significantly higher than the IPP0(P＜0.001).There were 32,17 and 11 cases in NP,HP and BP groups,respectively.There were 6 cases with fever higher than 38.5 ℃ (10％),in which there were 1 case in NP,1 case in HP group and 4 cases in BP group.The postoperative fever rate in NP,HP and BP group were 3％,6％ and 36％ respectively,which were significantly different between groups(P＜0.01).There were 12 cases with procalcitonin ＞0.1 ng/ml and 8 cases with procalcitonin ＞0.5 ng/ml,in which 2 cases in HP group and 6 cases in BP group.Conclusions RFUL would result in a temporal elevated intrapelvic pressure greater than 30 mmHg.Postoperative fever is relevant with renal perfusion pressure and perfusion time.It's necessary for the surgeons to adjust the perfusion pressure during operation.

PurposePrimary chest wall rhabdomyosarcoma (RMS) is very rare with limited imaging characteristic studies in the literature. This paper analyzes the CT imaging features of chest wall RMS in children to improve the diagnostic accuracy.Materials and MethodsThe imaging data of contrast enhanced CT scan of pathology conifrmed chest wall RMS in ifve children were analyzed.ResultsThe lesion was located in the anterior chest wall in one case, in the posterior chest wall in two cases, and the lateral chest wall in two cases (axillary). The tumors were round or spindle in shape with shallow spiculation. Plain CT showed heterogeneous density with patchy low-density necrotic area in two cases, and homogeneous attenuation in three patients. In all ifve cases there was no calciifcation or fatty tissue. The tumor involvement of adjacent spinal canal was seen in one case. Visceral compression was evident including lung parenchyma in one case, heart and liver in one case. Tumor blood vessel growth was seen in two cases. All ifve lesions were adjacent to the ribs, humerus, scapula and the spine with bone destruction in one case. On contrast enhanced scan, all ifve cases demonstrated heterogeneous mild to moderate enhancement, more prominent in the periphery. There were enlarged feeding arteries. Necrotic areas did not enhance. In two cases there were pulmonary metastases. Pleural effusion and ascites were identiifed in one case. There was lymph node metastasis in one case.ConclusionThe CT manifestation of children's chest wall RMS for chest wall include large soft tissue mass, heterogeneous density, no calciifcation or fatty tissue, partial necrosis, adjacent tissue compression, lymph node or distant metastasis. Combining with clinical manifestations, comprehensive analysis of contrast enhanced CT imaging can improve diagnostic accuracy.

Objective To investigate the species diversity and distribution of medical mollusca in Shanghai City. Methods From August 2012 to October 2013,all kinds of habitats in 8 districts and counties in Shanghai City,namely Jiading,Qingpu, Baoshan,Minhang,Songjiang,Jinshan,Chongming,Pudong,were selected for the field survey according to the distribution characteristics of the river system,and all the specimens of medical mollusca in the investigation sites were collected and classi?fied by morphological identification. Meanwhile,the species composition,habitats as well as the fauna of the medical mollusca collected were analyzed. Results A total of 5 211 specimens were collected,which belonged to 2 classes,14 families,18 gen?era and 25 species,including Oncomelania hupensis hupensis,Pomacea canaliculata,Parafossarulus striatulus,Alocinma longicornis,Physa acuta,Galba pervia,Hippeutis cantori,etc. The species numbers of medical mollusca in Chongming,Jin?shan,Pudong new area and Qingpu districts(counties)were 22,22,21 and 20,respectively,which were more than those of other areas. The habitat analysis suggested that the species numbers in the river and wetland were the most,both of which were 14 species. The main faunas of the medical mollusca in Shanghai were the cosmopolitan and oriental species. Conclusions The freshwater gastropod species are paucity in Shanghai City,but almost of them can be served as the intermediate hosts of certain parasites to transmit snail?related parasitic diseases,so the surveillance of medical mollusca should be strengthened.

Objective:To explore optimum surgical treatment of ureteral strictures after ureteroscopic holmium laser lithotripsy.Methods:The clinical data of 113 patients with ureteral stricture after ureteroscopic holmium laser lithotripsy from December 2014 to December 2019 were analyzed retrospectively. Of all the patients, there were 73 males and 40 females(aged from 31 to 68) with the mean age of 49 years. The mean length of ureteral stricture was 15mm (from 5mm to 25mm). The mean time since the last holmium laser lithotripsy was 6 months (from 3months to 10 months). According to the different treatment of stenosis, 113 patients were divided into endourological treatment group (34 patients) and reconstruction group(79 patients). According to the different surgical methods, endourological treatment group was divided into ureteral balloon dilatation (18 patients) and ureterotomy (16 patients). Reconstruction group was divided into laparoscopic surgery and open surgery, whose were ureteral stenosis resection and anastomosis. Patients were followed up closely postoperatively. Therapeutic success was defined as disappeared hydronephrosis, and unobstructed anastomosis. Success rate, operation time, postoperative changes of hemoglobin, hospital stay and the incidence of postoperative complications were measured.Results:The follow-up time ranged from 5 months to 53 months, with a median time of 18 months. There was no significant difference in age, sex, BMI, location of ureteral stricture, side of stricture and degree of hydronephrosis between endourological treatment group and reconstruction group( P>0.05). The length of ureteral stricture in reconstruction group was significantly longer than that in endourological treatment group (10.3±4.2 mm vs. 17.2±7.8mm, P<0.001). Although the operation time, postoperative changes of hemoglobin, hospital stay and the incidence of postoperative complications were lower in the endourological treatment group compared to reconstruction group ( P<0.001), the overall success rate of the reconstruction operation was significantly higher than that in endourological treatment group (96.2% vs. 61.8%, P<0.001). Furthermore, there was no significant difference in the success rate between laparoscopic surgery group and open surgery group (95.3% vs.97.2%, P<0.05), and there was no significant difference between the balloon dilatation group and the stenosis internal ureterotomy group (66.7% vs.56.3%, P<0.05).113 cases were followed up for an average of 18 (5-53) months. Conclusions:For the treatment of ureteral stricture after ureteroscopic holmium laser lithotripsy, the success rate of reconstruction group (laparoscopic surgery and open surgery)was significantly higher than that of endourological surgery (balloon dilatation and internal ureterotomy). Reconstruction surgery is the optimum surgical treatment to treat ureteral stricture after ureteroscopic holmium laser lithotripsy.

Objective:To evaluate the clinical value of nanopore targeted sequencing (NTS) in pathogens detection in urinary tract by comparing the results of different tests performed on the same urine sample.Methods:The results of NTS and urine culture test collected from 326 patients in the Department of Urology of People's Hospital of Wuhan University from July 2020 to June 2021 were retrospectively analyzed. There were 224 males and 102 females. The average age was (56.88 ± 14.58)years old. χ 2 test and Student’s test and Wilcoxon's sign rank test were used to analyze the differences of the pathogen detection rate, pathogen types results and detection time consuming between NTS and urine culture. The clinical value of the NTS in rapid detection of urinary pathogens was evaluated. Results:Among 326 hospitalized patients, the urinary tract microbes’ detecting rate of NTS was significantly higher than that of urine culture[67.80%(221/326)vs. 23.93%(78/326), χ2=130.25, P<0.01]. The uropathogens detecting rate of NTS was significantly higher than that of urine culture[54.29%(177/326)vs. 23.31%(76/326), χ2=38.95, P<0.01]. The number of urinary tract microbes detected by NTS was significantly higher than that of urine culture ( Z=11.49, P<0.01), the number of uropathogens was significantly higher than that of urine culture ( Z=9.67, P<0.01). The detection time of NTS and urine culture positive samples was (24.29±2.65) h and (49.28±11.30) h, the difference was statistically significant ( t =39.48, P<0.01). The results obtained by using NTS and urine culture were consistent in 135 (41.41%) samples. In 150 (46.01%) samples, NTS could detect the urinary tract microbes while urine culture cannot find, of which 112 cases (34.36%) were uropathogenic. In 27 cases (8.28%), more pathogens were detected by NTS except those from urine culture. In 6 cases (1.84%) re-detecting NTS after antibiotic therapy, the number of reads of primary uropathogen decreased gradually with the growth of colonizing bacteria or opportunistic pathogens appeared in the end. Re-examinations of urine culture could verify the results of NTS detection on admission in 5 cases (1.53%). NTS in 2 cases (0.61%) could cover the uropathogens of subsequent several urine cultures. Conclusions:NTS has the advantages of rapid, sensitive and comprehensive detection of urinary tract infection pathogens. When urine culture is not yet reported or even negative, NTS already has a certain clinical reference value and can be used as an effective supplement to urine culture, which is conducive to the comprehensive judgment of the patient's condition.

Objective:To investigate the availability and safety of a domestic disposable digital flexible cystoscope compared with a reusable Olympus digital flexible cystoscope in cystoscopy and removal of double J stent.Methods:From August 2018 to March 2019, patients were enrolled in this prospective, open, multicenter, randomized, parallel positive controlled clinical trial study, which were from department of Urology in Renmin Hospital of Wuhan University, the First Affiliated Hospital of Xiamen University and the First Affiliated Hospital of Guangzhou Medical University. The experimental group and control group were assigned into a 1∶1 ratio by random table method. Inclusion criteria included age≥18 years and have indications for cystoscopy or removal of double J stent. Exclusion criteria included patients having acute genitourinary tract infection, having tuberculous bladder contracture, bladder capacity less than 50ml, having urethrostenosis, female menstrual period, pregnancy and lactation, having difficulty for lithotomy position, having serious cardio-cerebrovascular disease and liver or kidney dysfunction. A domestic disposable digital flexible cystoscope was adopted in the experimental group, whereas a reusable Olympus digital flexible cystoscope was used in the control group. Acceptability of image was defined as primary availability indicator, while success rate of working and performance score were defined as secondary availability indicators and mean operating time was calculated for cystoscopy only and cystoscopy plus removal of double J stent respectively, yet rate of adverse event as well as rate of equipment defects were sorted as safety indicators.Results:A total of 188 cases which were listed in per protocol set completed the clinical trial study successfully. There were 95 cases in the experimental group and 93 cases in the control group. Acceptability of image was 93.68%(89/95) and 96.77%(90/93) respectively in two groups( P=0.52). Success rate of working was 100.00%(95/95) and 98.92%(92/93) respectively in two groups ( P=0.49). Performance score was 14.41±0.93 and 14.56±0.84 respectively in two groups ( P=0.23). Mean operating time (MOT) only for cystoscopy was (15.3±2.6) min and (15.4±3.3)min respectively in two groups ( P=0.93), while MOT for cystoscopy plus removal of double J stent was (21.0±3.2) min and (21.7±3.9) min respectively in two groups ( P=0.69). Rate of adverse event was 8.42%(8/95) and 9.68%(9/93) respectively in two groups( P=0.76). There was no equipment defects in both groups. Conclusions:There is no statistical difference in acceptability of image, success rate of working, performance score, mean operating time for cystoscopy or removal of double J stent, rate of adverse events and rate of equipment defects. A domestic disposable digital flexible cystoscope has shown non-inferiority in the availability and safety compared with a reusable Olympus digital flexible cystoscope.