Objective To investigate a new method of pneumatic ballistic lithotripsy for the treatment of bladder calculi. Methods A ureteroscope or nephroscope was inserted into the bladder via outer sheath of resectoscope. Then pneumatic ballistic lithotripsy was performed under endoscope to fragment and remove bladder stones. Results Stones were thoroughly removed from the bladder on one session in all 20 patients. No major haemorrhage, perforation of the bladder, or water intoxication happened intraoperatively or postoperatively. Follow-up for 2~18 months (mean, 4 6 months) in the 20 patients showed no recurrence of calculi under B-ultrasonography or symptoms of urethral stricture like dribble urination. Conclusions Pneumatic ballistic lithotripsy via outer sheath of resectoscope is effective in the treatment of bladder calculi.

Objective To evaluate the efficacy and safety of percutaneous nephrolithotomy under ultrasonic guidance for the treatment of renal calculi. Methods Percutaneous nephrolithotomy using pneumatic or holmium laser lithotripsy under ultrasonic guidance was performed in 26 patients from January 2005 to November 2006.Among them,46 patients had single stones and 27 had multiple renal calculi.Unilateral renal calculi were found in 67 patients and bilateral calculi in 6.Staghorn calculi were identified in 11 patients.Results Of the 73 patients,a successful stone removal on one session was achieved in 57 patients,a second-look stone removal was needed in 13 patients,and 3 patients underwent three times of operation.During the operation,a single tract was used in 53 patients,double tracts in 18 patients,and three tracts in 2.A mini-invasive tract(F14～F18) was used in 47 patients,and a standard tract(F24) was established in the remaining 26 patients.The operation time was 50～160 min(mean,86 min).The stone-free rate was 96.2%(68/73),and the residual stones in other 5 patients were all

Objective To evaluate the efficacy and safety of percutaneous nephroscopic lithotripsy for the treatment of bilateral upper urinary calculi. Methods From July 2004 to December 2008,we performed percutaneous nephroscopic lithotripsy under X-ray or ultrasonic guidance for 35 patients with bilateral upper urinary calculi. Of the 35 patients,bilateral renal calculi were found in 18 patients,unilateral renal and unilateral ureteral calculus in 10,bilateral ureteral calculi in 7. Results In 35 patients (70 sides),the calculi was removed through a single tract in 49 sides,through double tracts in 18 sides,and through triple tracts in 3 sides. The mean operation time for unilateral PCNL was 66 min (ranged from 20 to 185 min). The stone-free rate was 80% (56/70) on one session. A second-look stone removal was needed in 8 laterals,and 3 laterals underwent three times of lithotomy. In three sides,a few residual renal stones were found after the first operation,but no second operation was performed. The final stone-free rate was 91.4% (64/70) in all of the cases,among which the stone-free rate was 100% (24/24) for ureteral stones and was 87% (40/46) for renal stones. In this series,no chest or abdominal injuries,intestinal perforation,or injuries to surrounding organs were detected. The patients were discharged from hospital in 5 to 30 days,and then were followed up for 3 to 6 months. During the follow-up,B-ultrasonography and KUB+IVP found no recurrence of calculi. Conclusions Percutaneous nephrolithotomy is effective and safe for bilateral upper urinary calculi. By skilled urologists in conditioned hospital,simultaneous bilateral percutaneous nephrolithotomy performed on bilateral upper urinary calculi can shorten the cycle time of treatment and hospitalization.

Bioethics, one of the focus subjects in 21 century,attracts the attention in the worldwide.Originated from western developed countries,it has been branded with distinct western civilization,which is disadvantageous to the development of the subject.Some suggestions are put forward as following: 1.Communication between the East and the West should be promoted in order to form a solid multi-cultural base for bioethics. For instance, in America ethics bears the imprint of religious conventionality,while in China politics is infiltrated into traditional ethical ideas. Both of them are not perfect. So they cannot form the base of bioethics. 2.Research on the "base line" of the bioethics should be emphasized in order to provide freer academic atmosphere. Transplanting the western bioethical ideas to the developing countries will never work. As for the bioethical"base line",different countries should establish feasible ethical codes according to their own actual situations. 3.Scientists should be encouraged to adopt various technical ways to explore the problems in the field of bioethics.Such methods as tissue-engineering,antologous stem-cell replanting and cell diffrenttation inducing may bring about earlier breakthrough than fetus stem-cell.Equal attention,encouragement and support should be given to bioethics.

Objective To build a set of inexpensive wireless wide area network PACS based on open source code.Methods To improve the open source code MyFreePACS on Internet.Results The basic function of PACS can be achieved in an economical way,using internet explorer to browse and deal with the DICOM Images,with the capability of such functions as displaying and managing of the pictures.It is possible to make rounds at patient bedside with wireless device and remote medical consultation with specialists through Internet.Conclusion It is possible to utilize the free open source code MyFreePACS on the internet to construct an economical PACS on Web in the medium and small-scale hospital.

Bronchoalveolar Lavage Fluid ; Humans ; Interleukin-1beta ; metabolism ; Macrophages, Alveolar ; cytology ; drug effects ; metabolism ; Silicon Dioxide ; adverse effects ; Silicosis ; metabolism

Objective To report the clinical features a nd pathologic findings of 1 case of mixed epithelial and stromal tumor of the ki dney. Methods The patient who had a 20-year history of taking oral contraceptive was a 50-year-old woman with pain in left flank asso ciated with hematuria for half a year.CT and MRI revealed an 8 cm?6 cm cystic a nd solid mass located in the upper pole of the left kidney.A diagnosis of cystic renal carcinoma was made before operation.Radical left nephrectomy was performe d in July 2004. Results The upper pole of the left kidne y was found severely adhesive with peripheral tissues du- ring operation.Gro ssly,the tumor exhibited a 7.9 cm?8.9 cm?9.0 cm multilocular cyst full of coff ee- colored mucoid fluid with varying size ranging from 0.5 to 2.0 cm.Focall y thick-walled cysts with solid areas were seen.Microscopic findings showed the tumor was composed of a mixture of stromal elements formed by spindle cells and epithelial elements that were variable in cell types including cuboidal,columna r and hobnail cells.Differentiation of gastrointestinal tract was found in epith elial elements.Thick-walled blood vessels and distinctive bands of smooth muscl e cells were present in the stromal elements.Immunohistochemical staining reveal ed that the epithelial component was positive for AE1/AE3,and stromal component was positive for ER,PR,and SMA.No specific treatment was given and the patient w as free of signs of recurrence 8 months after operation. Conclusions Mixed epithelial and stromal tumor of the kidney is recognized to b e a kind of benign neoplasm.Differentiation of gastrointestinal tract in epithel ial elements is rare.It should be distinguished from any other benign and malign ant tumors in the kidney.

Culturing sientific research ability and innovative ability of medical college students is important for the development of themselves and the medical colleges as well,which also meets the needs of the local economy and social development.This paper studies the undergraduate research projects in recent five years,to underst and tmedical students' research ability.Countermeasures are proposed to improve the situation.

group Nor(P0.05).Conclusions The changes of ambulatory pulse pressure can reflect the degree of EH.The obvious increase of PP and decrease of DBP maybe are the exclusive features of ABPM in EH patients with target organs damage.

Objective To investigate clinical phenotype and the characteristics of gene mutation of patients with spinocercbellar ataxia type 2 and type 3.Methods The trinucleotide repeat mutations were detected by polymerase chain reaction (PCR),fluorescence-PCR and capillary electrophoresis in 9 patients and 43 members from 4 spinocerebellar ataxia families,1 sporadic patients,and 60 normal controls without family history.Results Six patients from 3 families and one sporadic patient had SCA3/MJD (CAG) n expansion mutation(n=68-75) ;Three patients from 1 family had SCA2 allele expansion for 37-41 times. Some of clinical menifestations were same among patients with type 2 or 3,while they showed significant difference in age of onset ,disease devetopment and nervous system injury.Conclusion The difference of clinical feature helps to distinguish SCA3/MJD and SCA2,however genotype analysis is the only method of definite diagnosis.