Objective To evaluate the clinical efficacy of retroperitoneal laparoscopic ureterolithotomy.Methods A total of 34 cases(38 sides) of middle(5 sides) or upper(33 sides) ureteral calculus were treated by retroperitoneal laparoscopic ureterolithotomy.The stones were(0.8 cm?1.0 cm)~(1.5 cm?3.0 cm) in size.Twenty cases had been previously treated by unsuccessful extracorporeal shock wave lithotripsy(ESWL).Results The operation was successfully completed in 33 cases and a conversion to open surgery was required in 1 case because of extensive adhesion and blood oozing.The operating time was 45~190 min(mean,85.5 min),the intraoperative blood loss was 10~50 ml(mean,20.6 ml),and the postoperative hospitalization,3~7 d(mean,4.3 d).Postoperative recovery was uneventful.No complication was observed during a 3~24 months(mean,9.7 months) of follow-up.Conclusions Retroperitoneal laparoscopic ureterolithotomy is micro-invasive,simple to perform,and safe.

BACKGROUND:With the development of microsurgical techniques, free flap transplantation has been widely used, which can solve the problem of insufficient local tissues.
OBJECTIVE:To observe the clinical effects of latissimus dorsi free flap transfer on the repair of al kinds of body surface defects, as wel as the role in complete tissue and functional reconstruction.
METHODS:From 2010 to 2013, 18 cases of various types of body surface defects were selected and using the microsurgical techniques, these complex wounds were repaired with free latissimus dorsi myocutaneous flaps. According to defect reason, primary wounds were treated for arteriovenous separation in the recipient zone. Most of the flaps were latissimus dorsi myocutaneous flaps at the affected side which were cut according to the wound size. If the cut muscle flap had a larger size and secondary wounds were difficult to be directly sutured, free skin grafts could be used to cover the residual secondary wounds.
RESULTS AND CONCLUSION:After transplantation, al the flaps survived with normal blood supply and wel-recovered function. Patients were more satisfied with the flap appearance. Latissimus dorsi myocutaneous flaps characterized as large donor area and secluded location have a great advantage in the repair of complex wounds using microsurgical techniques that can improve the survival rate of latissimus dorsi myocutaneous flaps.

Action Potentials ; drug effects ; Animals ; CA1 Region, Hippocampal ; cytology ; Drug Antagonism ; Male ; Neurons ; drug effects ; Pentylenetetrazole ; pharmacology ; Propofol ; pharmacology ; Rats ; Rats, Wistar ; Synaptic Transmission ; drug effects

Objective To investigate the safety and effectiveness of transurethral bipolar plasmakinefic resection in treating urethral stricture. Methods Totally 46 patients with urethral stricture were treated with transurethral bipolar plasmakinetic resection, and they were followed up for 3～12 months to observe the clinical effects. Results The segments of urethral scar were accurately incised and resected in all the 46 cases,24～26F bougies could pass through the urethra smoothly, and miction should be kept unobstructed. Totally 41 cases were followed up postoperatively, the maximal flow rate(Qmax) was ( 18.6±4.1 ) ml/s, which was obviously ameliorated as compared with that before operation(t=14.25, P＜0.05);sexual function had no obvious changes before and after operation;no serious complications of urethral massive bleeding, urinary incontinence, fistula of urethral diverticulum,urethral perforation, rectal injury, etc. was observed. Conclusion Transurethral bipolar plasmakinetic resection is an effective method for treating urethral stricture, because it has fewer complications, faster postoperative recovery and lower recurrence.

Objective To investigate the safety and efficacy of transurethral plasmakinetic vaporization of prostate(PKVP)in treating benign prostatic hyperplasia.Methods Totally 180 BPH patients were treated with PKVP from January 2003 to December 2006.Results The weight of the resected prostatic tissue was)52.4? 26.8)g,operating period was)61.2?32.8)minutes,and the amount of bleeding was)70.1?46.3)ml.No transurethral resection syndrome(TURS)and obturator nerve reflex was observed.The patients were followed up for 1～25 months postoperatively,and the maximum urine flow(Qmax)was increased from)6.2?4.1)ml/s preopera- tively to)21.2?4.6)ml/s postoperatively;the international prostate symptom score(IPSS)was decreased from (25.6?4.8)points to)6.8?2.6)points;the residual urine volume was reduced from)67.8?27.3)ml to)17.5 ?7.3)ml;the quality of life(QOL)score was decreased from)5.1?1.5)to)1.8?0.5),and there were signifi- cant differences before and after operation(P

Objective To investigate the efficacy of twice irradiating with focused ultrasound on recurrent and metastasized U14 cervical cancer implanted in the legs of mice. Methods Seventy-two mice with U14 cervical cancer cells implanted in their legs were divided into three groups randomly,with 24 rats in each group.One group received a single dose of focused ultrasound,while mice in the second group were irradiated twice and surgery resection was administered to the third group 7 or 8 days after the tumor was implanted.After 23 days post implantation of the tumor,local tumor recurrence and metastasis to the lungs and lymph nodes were evaluated. Results The inhibition rate after double irradiation was 61.70％ for local recurrence and 68.18％ for metastasis,significantly higher than in the other two groups. Conclusions Both single and double irradiation with focused ultrasound are effective for inhibiting local recurrence and metastasis,but double irradiation is more effective.

Objective To analyze the endoscopic features of patients with the lower esophageal sphincter (LES) and crural diaphragm (CD) separation and explore its significance in hiatus hernia (HH) diagnosis.Methods From January 2011 to June 2012,the data of patients underwent esophagus high resolution manometry (HRM) examination were retrospectively analyzed and of which the patients with LES-CD separation were selected.Patients who received digestive tracts operation or lack of complete endoscopic date were excluded.A total of 93 cases were enrolled for analysis.According to Chicago Criteria,the cases were divided into three groups.There were 21 cases in type Ⅰ group (LES-CD separation＜1 cm),37 cases in type Ⅱ group (LES-CD separation≥l cm and ＜2 cm),35 cases in type Ⅲ group (LES-CD separation≥2 cm).The differences among groups in endoscopic features were analyzed.HRM were taken as golden standard,the sensitivity and specificity of endoscopy in HH diagnosis were analyzed.Measurement data were expressed as x ± s,one-way ANOVA was performed for multi-groups comparisons,LSD method or Dunnett T3 test for pairwise comparisons and chi-square test or Fisher's exact test for two groups' comparisons.Results There were no significant differences in the distance between esophagus gastric junction (EGJ) and foreteeth of the three groups (P＞0.05).Distances between EGJ and diaphragmatic HH pressure impression in type Ⅲ group,type Ⅱ group and type Ⅰ group were (3.57±0.78) cm,(1.89±0.81) cm and (1.14±0.67) cm,respectively and the differences were significant (LSDt=9.26,11.44,3.57; all P＜0.05).The percentage of continuously-open cardia and showing pressure impression of the gastric pouch of type Ⅲ group was higher than that of type Ⅱ group and the percentage of continuously-open cardia and showing pressure impression of gastric poach of type Ⅱ group was higher than that of type Ⅰ group (80.0％,40.5％ and 4.8％,x2 =11.64,29.76 and 8.59; 91.4％,27.0％ and 4.8％,x2 =30.69,40.73 and 4.32' all P＜0.05).The occurrence rates of the His angle blunting and sac of type Ⅲ group were higher than those of typeⅡ group and type Ⅰ group (74.3％ and 77.1％,24.3％ and 24.3％,4.8％ and 4.8％,x2 =17.97 and 25.41,both P＜0.05),there was no significant difference between type Ⅱ group and type Ⅰ group (P＞0.05).The rates of esophagitis of type Ⅲ group and type Ⅱ group were higher than that of type Ⅰ group (71.4％,59.5％ and 14.3％,x2 =17.14 and 11.15,both P＜0.05),there was no significant difference between type Ⅲ group and type Ⅱ group (P＞0.05).There was one case of Barrett's esophagus in each group.The sensitivity and specificity of endoscopy in HH diagnosis were 91.4％ and 81.0％,respectively.Conclusions The distance between EGJ and hiatal pressure impression,continuously-open cardia,the His angle blunting,hiatal pressure impression of the gastric pouch and hernia sac were important indicators of HH endoscopic features.The sensitivity of endosocopy is higher than the spcificity of endosocopy in HH diagnosis.

Objective To prepare a new bone-targeting drug of epirubicin-oxidized dextran-alendronate compound,and investigate the compound's bone targeting effect.Methods Based on Schiff base theory,we synthesized a new bone-targeted drug delivery system:epirubicin-oxidized dextran-alendronate compound.The physicochemical character was evaluated through ultra-violet (UV) spectroscopy,infrared (IR) spectroscopy and nuclear magnetic resonance (1H-NMR) spectroscopy.The character of affinity to bone in vitro was evaluated through HA absorbing test and the affinity to bone in vivo was evaluated by fluorescence microscopy.Drug distribution in different organs and different time point were investigated through liquid chromatograph.Results There were typical physicochemical characters of dextran,oxidized dextran,Dex-ALN compound,EPI-Dex-ALN compound through UV spectroscopy,IR spectroscopy and 1H-NMR spectroscopy,showed successful preparation of the bone targeting drug.HA binding rates were 86.13％,13.91％ in epirubicin-oxidized dextran-alendronate compound and epirubicin groups respectively through HA absorbing test in vitro.Luminescence microscope showed luminescence located in cortical bone,cancellous bone of metaphysic,no luminescence was found in bone marrow in affinity to bone in vivo.Compared by EPI group,IOD value of fluorescence in EPI-Dex-ALN group was 2.7 times.In HPLC drug concentration test,we detected drug concentration in different organs during the period of 10 min,1 h,2 h,24 h,48 h after injection in EPI,EPI-Dex-ALN compound group.The maximum concentration was at 2 h,and tissue distribute was different in different organs; there was statistical difference during the period of 10 min,1 h,2 h,24h,no statistical difference during the period of 48 h after injection in bone tissue between EPI group and EPI-Dex-ALN compound group.Conclusion We successfully synthesized a new bone-targeting drug delivery system,which showed better bone affinity in vivo and in vitro,and had powerful targeting function.

Construction of learning-oriented hospital must establish a clear goal,and under the guidance of the target,comrehensive mearures of whole advancement must be adopted and staffs study must be emphasized according to their different needs to motivate them,and meanwhile incentive mechanism should be established to realize the benign circulation and sustainable development of construction of learning-oriented hospital.

OBJECTIVETo observe the effect of Tangke Decoction (TD) on the expression of TGF-beta1/Smad4 of rats with early diabetes and to explore the effect and mechanism of TD against the renal injury induced by diabetes.

METHODSSD rats were randomly divided into the normal control group (n = 12), the model group (n = 10), the Chinese herbs prevented group (n =10), the Chinese herbs treated group (n = 10), and the Western medicine control group (n = 10). TD (18 mg/kg) was given by gastrogavage to rats in the Chinese herbs prevented group immediately after successful modeling for 12 weeks, once daily. At the 4th week of successful modeling, rats in the rest 4 groups were administered by gastrogavage. Equal volume of normal saline was given to rats in the model group and the normal control group. Benazepril suspension (1 mg/kg) was administered by gastrogavage to rats in the Western medicine control group for 8 weeks, once daily. TD (18 mg/kg) was given by gastrogavage to rats in the Chinese herbs treated group for 8 weeks, once daily. The body weight, kidney weight, index of kidney weight, fasting blood sugar, 24 h urinary albumin excretion rate were examined after experiment. The pathological changes of the renal tissue were observed by HE staining, Masson staining, and electron microscope. The expression of renal transforming growth factor-beta1, (TGF-beta1) and Smad4 were detected using immunohistochemical assay.

RESULTSCompared with the normal control group, the body weight of rats decreased significantly; the kidney weight, index of kidney weight, blood sugar, 24 h urinary protein excretion, the urinary albumin excretion rate,TGF-beta1 and Smad4 expression increased significantly in the model group (all P < 0.01). Compared with the model group, the aforesaid indices were improved in each treatment group with statistical difference (P < 0.05, P < 0.01). Compared with the Western medicine control group, the kidney weight, index of kidney weight, blood sugar, 24 h urinary protein excretion, and the urinary albumin excretion rate were obviously improved in the Chinese herbs prevented group (P < 0.01). The renal pathological changes were most obvious in the model group significantly, but they were improved in all treatment groups.

CONCLUSIONTD could obviously improve the symptoms of diabetes and down-regulate the expression of renal TGF-beta1 and Smad4 of early diabetic nephropathy rats, which suggested that TD had certain preventive effect on early diabetic nephropathy.

Animals ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Kidney ; metabolism ; Male ; Rats ; Rats, Wistar ; Smad4 Protein ; metabolism ; Transforming Growth Factor beta1 ; metabolism