Objective To evaluate the therapeutic effects of functional reconstructive technique of laparoscopic radical prostatectomy (LRP) for organ confined prostate cancer. Methods From October 2000 to September 2004,54 patients with organ confined prostate cancer (TNM stage of T 1b-T 2) underwent LRP.After completion of the first group of 15 consecutive cases (group A) by Monstouris techniques, the functional reconstructive surgical technique, which is basically composed of anatomical radical prostatectomy,was introduced to LRP in the second group of 39 consecutive cases (group B).These techniques mainly consisted of preservation of urethral and bladder outlet sphincter muscles,reconstruction of bladder neck,and fine anastomosis between urethra and bladder neck with fixation of anterior wall of anastomotic stoma and retropubic vascular complex.The operative time, bleeding volume,complications,continence recovery time and PSA level were comparatively analyzed between the 2 groups. Results All the operations were successful in 54 patients.In group A and group B,the mean operative time was 390 min(range,270-660 min)vs 240 min(range,180-360 min);the mean bleeding volume was 430 ml(range,200-1100 ml) vs 160 ml(100-400 ml);the complication rate was 40% (6/15) vs 13% (5/39) and the continence recovery time was on average 6 months vs 3 months,respectively. There were statistically significant differences in these parameters between the 2 groups (P

Objective To evaluate the technique of laparoscopic pyeloplasty. Methods 11 cases with ureteropelvic junction (UPJ) obstruction underwent laparoscopic pyeloplasty via post abdominal cavity approach. Results All the operations have been successful,the operating time being 2 to 4 h and the blood loss 40 to 90 ml. Ultrasound B investigation 3 to 24 months after the procedure showed no hydronephrosis in all and IVU analysis in 6 cases one year after the operation disclosed good outcome with less morbidity. Conclusions Laparoscopic pyeloplasty is an effective way to treat UPJ obstruction with minimal trauma to the patient.

Objective To evaluate laparoscopic radical prostatectomy for prostate cancer. Methods 8 patients presented clinical stages pT 1b to pT 2 prostate cancer.Laparoscopic radical prostatecomy was carried out transperitoneally with combining posterior and anterior approachs to the prostate,transecting the bladder neck,lateral dissection of the prostate and urethrovesical anastomosis. Results The operation time was 5 to 11 h with an average of 7.3 h and the blood loss 200 to 1 100 ml,averaged 620 ml.All the patients recovered well and uneventful with no complications such as urethral stricture or incontinence. Conclusions Laparoscopic radical prostatectomy is a better approach and least invasive.The procedure provides clear anatomic vision that facilitates operative performance and quicker recovery.

Objective To describe the ureteroplasty of congenital obstructive megaureter by laparoscopy and to evaluate the efficacy and feasibility of laparoscopic intervention for congenital obstructive megaureter. Methods Six patients with congenital obstructive megaureter were prepared for the laparoscopic surgery.The surgical procedure was briefly described as follows.The dilated ureter was dissected and cut off near the ureter orifice to the bladder by laparoscopy.Next,the free ureter was pulled out through the skin trocar site and was tailored as open surgery.After that,the ureter was placed back to the abdominal cavity and reimplanted laparoscopically into the bladder. Results The operation duration was 2 to 4 h (mean 2.4 h) and blood loss was very little (20～35 ml).No complication developed.The double J stent was removed at 3 months after the operation.Follow-up for half to 2 years showed that all the ureter drainage in the 6 cases was well without any infection. Conclusions Our preliminary result shows that laparoscopic surgery is a safe and effective method for treatment of megaureter.

Objective To evaluate the minimally invasive technique of laparoscopy by retroperitoneal access for the treatment of parapelvic cyst. Methods Twelve patients(7 men and 5 women;mean age,52 years;age range,34-75 years) with parapelvic cysts were included.The cyst size ranged from 2.8 cm?3.0 cm to 2.5 cm?11.5 cm.The cysts were on the left side in 6 cases and on the right in another 6 cases.Laparoscopic resection or de-roofing of the parapelvic cysts by retroperitoneal access was performed in them.The relevant parameters of the procedures were summarized.Results The success rate of the operation was 100%.The mean operative time of the first 6 patients was 190 min,while it was 86 min in the rest 6 patients.The mean intraoperative blood loss was 25 ml.No injury to the kidney pedicle or pelvis occurred.The mean hospital stay was 9 d.In 11 patients,no recurrence of the cyst occurred during a follow-up of 7-31 months.Only 1 patient with concomitant renal cyst had recurrence of the cyst found by B-ultrasound 2 years after operation.Conclusions Therapeutic laparoscopy by retroperitoneal access has advantages of minimal trauma,less blood loss,rapid recovery and better effect,therefore it is the ideal treatment choice for parapelvic cyst.

Objective: To report our prelimilary experience of laparoscopic radical prostatectomy (LRP) for clinically localized prostatic cancer.Methods:23 cases with localized prostatic cancer underwent LRP in our institution from October 2000 to August 2003. The median age was 64.5 years old, the median PSA was 13 ng/ml and median Gleason score of biopsy specimens was < 7. The operations were performed according to Montsouris technique. Briefly, operations were carried out transperitonealty, combining posterior and anterior approachs to the prostate, transecting the bladder neck, lateral dissection of the prostate, urcthrovesical anastomosis, completing the operation.Results:No death and no conversion rate were observed in this series of 23 cases of LRP. No re-intervention was needed. The median operating time was 325 minutes (range 270 to 660 min) including the lymphadenectomy phase that was considered necessary in the case whose PSA value was 51ng/ml and pathological reading was negative to thoses lymph nodes; The median intraoperative blood loss was 430 ml(rang 200 to 1100 ml). Postoperative bladder catheterization time was 20 days. Surgical positive margin was found in I case of pathlogical stage of pT2b and Casodex 50 mg had been used on this case for 3 mon after the PSA value was < 0.2 ng/ml. Postoperation follow-up of 3 to 24 mo. showed no signs of complications such as urethral stricture or urine incontinence. The PSA concentrations was < 0.3 ng/ml in all cases.Conclusions: LRP provides a clear and magnified anatomical image to allow a more precise and safer dissection.

Objective To investigate the curative effect of modified tracheal catheter in acute respiratory failure caused by central airway stenosis.Methods 16 cases inpatient with acute respiratory failure caused by central airway stenosis were involved.Found out the position and range of stenosis of central airway by X-ray and CT of chest and fiberbronchoscope,chose the suitable silicon suction tube and cut it to make a tracheal catheter,then guided the catheter through the stenosis by fiberbronchoscope to construct artificial airway.Results The dyspnea of all 16 cases of acute respiratory failure caused by central airway stenosis could by relieved in short time,the PaO_2 raised from(39?12)mm Hg to(72?10)mm Hg,SaO_2 raised from(75?13)% to(93?3)%,PaCO_2 dropped from(102?21)mm Hg to(62?13)mm Hg after therapy.The effective rate is 100%.There was no other serious complication except for 2 cases of little amount of bleeding in trachea.15 cases survived and one died of serious muhisystem organ failure.Conclusions The use of modified tracheal catheter in treatment of acute respiratory failure caused by central airway stenosis can relieve the acute dyspnea in short time,it also can dilate central airway,save the cost of tracheal balloon dilatation for the follow-up therapy.

The depositions of immunoglobulins on the retina of diabetic rat were studied with immunohistochemistry,immunofluorecence and computer analysing system.In comparison with control group, depositions of IgG,IgA and IgM on the retina of diabetic rat induced by streptozotocin were significantly increased (all P＜0.05 ).So the immunoglobulin depositions may contribute to the pathogenesis of diabetic retinopathy.

Objective To discuss the feasibility and curative effect of broncho-alveolar lavage(BAL)through bronchofiberscope in the treatment of severe toxic pulmonary edema caused by irritative gas.Methods 16 cases se- vere toxic pulmonary edema caused by irritative gas were performed BAL through bronchofiberseope.The index of oxygen in arterial blood,clinical and radiological changes before,during and 2 hours after BAL were observed.Results 2 hours after BAL through bronchofiberscope,the partial pressure of oxygen in arterial blood(PaO2)obviously in- creased,the partial pressure of carbon dioxide in arterial blood(PaCO_2)did not change much.PaO_2 and PaCO_2 had no obvious change before and during BAL.The shadow area in the X-ray film of chest obviously decreased 24 hours af- ter BAL.In all 16 cases,13 cases were cured,1 case got improvement,and 2 cases died.The curative rate was 81%. Conclusion BAL through bronchofiberscope could clear the noxious substance in airway and improve the ventilation function.It was safe and had confirmed curative effect.

Objective To explore a method for isolation and culture of human epidermal stem cells. Methods Epidermis was obtained by digesting human foreskin with Dispase Ⅱ and Trypsin-EDTA.After suspension on the epidermal stem cell medium (ESCM), these single epidermis cells were inoculated onto human collagen Ⅳ-coated flasks and cultured at 37 ℃ in a humidified atmosphere containing 5% CO_2 for 10 min. The nonadherent cells were rinsed off 10 min after inoculation, and the adherent cells continued to be cultured after enriching and abstraction by type Ⅳ collagen. The cell growth was observed through inverted microscope, and the cell cloning efficiency and time of clone sustain were also detected. Immunocytochemistry was used to observe the expression of ?_1-integrin and keratin 19(K19). Keratinocytes were served as controls. Results It was revealed by histological observation that colonies were formed 24 hours after inoculation. The isolated and cultured cell cloning efficiency was higher and the time of clone sustain was longer than that of the control group. Positive expression of ?_1-integrin and K19 of cultured cells was detected by immunocytochemistry. Conclusion Adult epidermal stem cells could be successfully isolated and cultured by adhension with type Ⅳ collagen and culture with ESCM.