Objective To study the application of transurethral bipolar plasma kinetic vaporization of the distal ureterectomy in radical nephroureterectomy for renal pelvic or ureteral carcinoma. Methods A total of 6 patients with renal pelvic or ureteral carcinoma without involvement in ipsilateral distal ureter,ureteral orfice,and the bladder were included.Radical nephroureterectomy was performed by using transurethral bipolar plasma kinetic vaporization combined with either flank incision nephrectomy (5 patients) or retroperitoneal approach laparoscopic nephrectomy(1 patient). Results The operation was completed smoothly in the 6 patients with comparatively little blood loss.The operation time was 120~210 min(mean,150 min).Obturator nerve reflex happened in no patients during the operation.Postoperative bladder irrigation found no bleeding in the bladder.The time of indwelling the catheter was 7~9 d(mean,8 d).Hypogastralgia and fever occurred in 1 patient on the 5th postoperative day.And the patient was confirmed as having mild urinary extravasation and was given catheter indwelling for 5 days. Transuretheral cystography found no leakage and a full recovery of voiding function was achieved.Postoperative pathological findings showed negative margins in all the patients.One patient died of myocardial infarction 3 months after operation,while follow-up in the remaining 5 patients for 7~21 months(mean,16 months) showed no tumor recurrence. Conclusions Application of transurethral bipolar plasma kinetic vaporization of the distal ureterectomy is micro-invasive,with little hemorrhage and few complications.It is an effective assistant option in radical nephroureterectomy.

Objective To raise the awareness of the glandularis ureteritis. Methods Five cases with glandularis ureteritis confirmed by pathological examination from Jan 2001 to Jun 2012 were reviewed. The diagnosis was assessed on histopathologic studies in all. The clinical manifestations, the diagnosis and treatment were discussed. Results Resections of the affected ureter and ureteroplasty were undertaken for 2 patients. Ureteronephrectomy was performed for 2 patients because of serious hydronephrosis due to obstruction. Electrofulguration via-ureteroscopy was carried out for another patient. All patients have been well and without recurrence on following up for 15 to 152 months, with an average of 86.6 months. Conclusion Glandularis ureteritis is not frequently seen and the etiopathogenesis is not yet clear. Biopsy is very important for suspected neoplasm of ureter before performing nephrectomy.

Objective To evaluate the risk factors of septic shock after mini-percutaneous nephrolithotripsy (mPCNL). Methods Clinical data of 1 590 cases who underwent mPCNL from January 2013 to December 2014 were retrospectively analyzed. The x2 test and logistic regression were used to identify the key risk factors for septic shock after mPCNL. Results Of the 1 590 patients, 18 patients suffered septic shock, including 6 male patients and 12 fe﹣male patients. Their mean age was (45.6 ± 13.5) years (28 ~ 69 years). White cell in urine was 100 percent, the stone diameter ranged from 1.5 to 5.0 cm, unichannel for 15 cases while multichannel for 3 cases, the operation du﹣ration ranged from 45 to 200 min, mean (87.0 ± 56.0) min. 2 in 18 cases died in multiple organ failure, the others recovered till discharged. In x2 test, female gender (P = 0.001), (+++ ~ ++++) white cells in urine (P= 0.042), un-preoperative nephrostomy drainage (P=0.041) had significant association with septic shock after mPCNL. While in multivariate analysis, female gender ( O? = 5.471, 95 % CI: 0.756~21.452, P< 0.05) and un-preoperative nephrostomy drainage (O? =3.106, 95%CI:1.283~7.907, P<0.05) were identified as independent risk factors for septic shock after mPCNL. Conclusions Female gender and un-preoperative nephrostomy drainage are the key risk factors for septic shock after mPCNL.

A high performance liquid chromatographic method with fluorimetric detector was developed for the simultaneous determination of three sulfonamides in vegetable samples. Vegetable samples were extracted with methanol for three times, and then the combined extracts were evaporated to dryness under reduced pressure at 45 ℃. The residue was dissolved in 0.1 mol/L HCl and the analytes were derivatized with fluorescamine. The chromatographic separation was performed on an ODS column with a gradient elution program using mobile phases based on mixtures of acetonitrile and 0.5% acetic acid aqueous solution. The derivatized compounds were detected with fluorimetric detector. The limit of detection was 1.02-1.29 μg/L and the limit of quantification was 3.4-4.3 μg/kg(fresh weight, F.W.) for three sulfonamides in vegetable. The average recoveries were higher than 87%, inter and intra RSDs were lower than 10% for all samples spiked with 0.2-1.0 μg/g of sulfonamides. The proposed method has been applied to the analysis of vegetables sold in Hefei markets. The result indicated that 3 SAs were found at different degree in the practical vegetable samples with the total concentrations between 0.0726-0.3709 μg/g(F.W.).

To investigate the incidence and treatment of benign prostatic hyperplasia (BPH) with prostatitis. Methods:2 152 cases of patients withBPH were investigated about their illness history, and the rou tine examination of prostatic fluid, the ultrasonography of prostate, the prostatic special antigen in serum and the urine routine had been done. Results:Among them , 385 patients suffered prostatitis, 87 patients have the obvious symptom of prostatitis, of which only 35 patients were treated discontinuously as prostatitis. Conclusions: The di agnosis and treatment of BPH with prostatitis should be paid special attention to

Purpose:To present the experiences and lessons of emergency management for the obstructive renal failure induced by urinary calculi.Methods:Clinical data of 81 cases of patients with obstructive renal failure from January 1988 to May 2000 was reviewed retrospectively.Results:14 cases were treated by emergent open operation (one died of bleeding ceaselessly), 36 cases by dwelling ureteral stent retrogradely(28 cases succeeded and no severe complications observed, the other 8 cases received nephrostomy of TUL),38 cases treated with percutaneous nephrostomy drainage(3 cases had to undergo nephrectomy, and the other 2 patients died after the primary treatment because of bleeding continually). The serum creatinine level decreased significantly after treatments(P＜0.01).Conclusions:It is noteworthy that the surgical interventions were affected severely by the bleeding tendency caused by uremia, and the complicated surgical intervention could not be carried out before the bleeding tendency be corrected. The indwelling ureteral stent retrogradely is recommended as the first choice of emergent treatment for patients with obstructive renal failure.

Objective To discuss the long term clinical effect of ileal orthotropic neobladder.Methods From 1991 to 1998,79 patients,mean age 55(41～75)years,male 74,female 6,were followed up.The serum creatinine and urea,electrolytes,blood routine,B ultrasonic scan of the neobladder residual urine and IVU or MRU of the patients were followed up.The max transverse diameter of renal pelvis and the max verticaI/level diameter of neobladder were measured in 5,10 to 14,15 years of postoperative when IVU or MRU.All results of different time were compared by the multiple comparisons.The local or distant cancer recurrence and the complications of the operation Were evaluated. Results Sixty-four cases,58 male,6 famle,were long term followed up:mean time was 167 (range,121～216)months.Seven cases died of other diseases.Seven cases had pelvic recarrence.Two cases had urethral recurrence.Three cases died of tumor metastasis.One case had ureter recurrence.Forty-eight patients were alive more than 10 years.The value of the serum creatinine,urea,electrolytes and bloods routine of the patients were normal after 5,10 to 14 and 15 vears postoperative (P＞0.05).The max transverse diameter of the renal pelvis in 5,10 to 14 and 15 years Dostoperative were 14.0 mm,14.1 mm and 13.7 mm,respectively,P＞0.05.The max vertical/level diameter of the neobladder in 5,10 to 14,15 years of postoperative were 110.4 mm/90.4 mm,111.5 mm/95.3mm and 127.0 mm/97.0 mm,respectively,P＞0.05.The residual urine of 5 cases was more than 50 ml and had not increased during follow up.Eight cases with neobladder stone were cured by the intracavitary lithothrypsis.Two cases with uretheral stricture were cured by the intracavitary therapy.Twelve cases of 14 cases with inguinal hernia were cured by reoperation,2 cases accepted conservative treatment.Only 17 cases had no complication involve of the cancer and the operation. Conclusion The upper urinary tract and neobladder of the ileal orthotopic neobladder could be stable for long time,the cure rate of tumor is satisfactory and the lifetime follow up is necessary.

Objective To review the occurrence of allergic reactions during therapeutic plasma exchange(TPE)and to explore the risk factors of TPE allergic reactions.Methods The clinical data of 929 patients treated with TPE using plasma components by the Department of Transfusion Medicine in our medical center from 2018 to 2023 were collected.The influen-cing factors of allergic reactions were analyzed by univariate analysis,and the independent risk factors of allergic reactions were analyzed by logistic multivariate regression analysis.Results A total of 4 071 TPEs were performed in 929 patients.A-mong them,198 patients(21.31%)experienced 349 times(8.57%)of allergic reactions,with the incidence of gradeⅠ,Ⅱ and Ⅲ allergic reactions of 16.33%,81.38%and 2.29%,respectively,and no deaths.The univariate analysis showed that the patient′s age,allergy history,diagnosis of immune-related diseases,ICU admission,plasma consumption,total blood volume,maximum blood flow rate and combined use of albumin were related to the occurrence of allergic reactions(P＜0.05).Multivariate regression analysis showed that young patients,a history of allergy,immune-related diseases and non-ICU patients were prone to allergic reactions in TPE,but the treatment options of TPE such as substitute fluid category,plasma consumption and blood flow rate were not related to the occurrence of allergic reactions.Conclusion There are sig-nificant individual differences in the occurrence of allergic reactions for TPE,and young age,history of allergies,immune-related diseases and non-ICU patients are risk factors for allergic reactions in TPE.Identifying patients with risk factors be-fore TPE treatment and giving corresponding preventive measures can reduce the incidence of allergic reactions.

Background and objective Cathepsin X (Cat X) has been identiifed as a member of cathepsin family. Studies have shown that Cat X is involved in tumorigenesis and tumor development of various cancers. hTe aim of this study is to investigate the relationship between the clinicopathological prognosis and the levels of Cat X and cystatin C in the serum of patients with lung cancer. Methods Blood samples were collected from 84 patients with lung cancer and 36 healthy control subjects. Cat X and cystatin C were determined by quantitative ELISA. Results Cat X and cystatin C levels were signiifcantly higher in the patients with lung cancer than that in the healthy control subjects (P<0.01). Cat X level was correlated with the pathological types of lung cancer (P=0.076). Cystatin C was positively correlated with TNM stage (P=0.01). Furthermore, cystatin C/Cat X was correlated with lymph node metastasis (P=0.058). hTe patients with high Cat X levels experienced sig-niifcantly shorter overall survival rates compared with those with low Cat X. Univariate analysis indicated that Cat X and TNM stage were related to overall survival. Multivariate Cox analysis indicated that TNM stage may be used as an independent prog-nostic variable in patients with lung cancer. Conclusion Cat X and cystatin C levels were signiifcantly higher in patients with lung cancer. Cat X and cystatin C detection in the sera may contribute to the diagnosis of lung cancer and may be used to evalu-ate the prognosis of patients with NSCLC.

【Objective】 To investigate the effects of lamellar surgical techniques with urethral plate to strengthen the tissue of glans penis to widen the two flanks of glans penis on the basis of Duckett method in the treatment of congenital hypospadias with small glans penis deformity. 【Methods】 A total of 22 patients admitted to our hospital during Jun.2017 and Oct.2020 were involved. Urethral plate was used to replace the glans penis tissue to widen the two flanks of glans penis based on Duckett method. Lamellar surgical techniques were adopted to fully dissociate the two flanks of glans penis and urethral plate for urethroplasty. 【Results】 Of the 22 operations, 19 were successful,with a success rate of 86.3%. The success rate of penile head urethroplasty reached 96.1%. 【Conclusion】 Widening the glans penis by using the urethral plate based on Duckett method combined with lamellar surgical techniques can improve the success rate of glans penis urethroplasty.