Objective;To evaluate the endourethral surgery for urethrostenosis and urethratresia. Methods:68 patients with urethrosteno-sis or urethratresia were treated by endourethral surgery, such as internal urethrotomy, transurethral scar resection. Results: Of the 68 cases, the outcome was satisfactiory in 61 (89. 71% ). Endourethral surgery was carried out once for 55 patients and twice for 6,7 patients required open surgery. All patients had followed by urethral dilatation. 59 patients were followed - up for 3 months to 5 years. 54 cases can micture normally. Conclusions; Endourethral surgery is simple,safe,efficient treatment for urethrostenosis and urethratresia.

Combining with the disharmonious ethical phenomena in employment of medical students at present,this paper analyses its subjective and objective reasons,and puts forward some practical approaches to the cultivation of harmonious employment ethics of medical students.

Objective To study the prognostic factors of primary ureteral carcinoma,and to analyze the risk factors of the occurrence of subsequent bladder cancer. Methods This series included 160 cases of primary ureteral carcinoma (93 men and 67 women;mean age,63.7 years).Of them,81 cases had the tumors on the left and 79 on the right;the tumors were located at the upper and middle parts of the ureter in 51 cases,and at the lower part in 96.Pathological staging showed T a (9 cases),T 1(58),T 2(46),T 3(41) and T 4(6);the grading showed G 1(4),G 2(119) and G 3(37).All the 160 cases underwent surgery.Among them,renal and full length of ureter resection plus sleeve resection of bladder were performed on 124 cases (77.5%).All the cases were followed up and the results were statistically analyzed. Results The overall 5-year survival rate was 53.0%.The 5-year survival rates of T a,T 1 and T 2 cases (83.3%,71.9%,59.1%,respectively) were significantly higher than those of T 3 and T 4 cases (37.5% and 16.7%,P

Objective To analyse the X-ray characteristics of the intraductal papilloma and to improve the diagnostic accuracy.Methods The mammographic data of 80 cases of intraductal papilloma of breast by pathology were analysed.Results 24 cases showed circular filling defect, 12 cases showed stringy filling defect,ductal blocked in 30 cases, ductal dilation in 48 cases. Conclusion Galactography is a effective method for diagnosing intraductal papilloma of the breast.

Objective To investigate and analyze the risk factors,morbidity and mortality rates of multiple organ dysfunction syndrome (MODS) after multiple trauma.Methods The clinical data of all 155 patients with multiple trauma admitted to our ICU from Sep 2008 to Jun 2011 were retrospectively analyzed,including treatment,injury severity score (ISS) and its relationship with MODS.Results The morbidity of MODS among all 155 patients was 18.7％ (29/155).There were 3,7 and 19 patients died due to multiple trauma in 39 ISS ＜ 16,58 ISS 16-25,and 58 ISS ≥25 cases respectively.The morbidity of MODS was significantly higher in patients with ISS ≥25 ( x2 =12.321,P =0.002) than in others.There were 15 cases with MODS and 28 cases without MODS died respectively in multiple trauma patients ( x2 =10.236,P =0.001 ).Conclusion MODS is the important reason for death in multiple trauma patients.It is pivotal to actively deal with primary trauma to avoid the second insult to the patients and support vital organs early in order to improve the prognosis of multiple trauma.

Objective To evaluate the cost-effectiveness of the aneurysm intra-artery GDC embolization and the aneurysm clapping of intracranial aneurysm, and to give the instruction for the clinical practice. Methods A case control study (1 vs. 1) was developed to evaluate the cost in hospital, the cost for return visit and the Quality-adusted Life-Year (QALY) and lifetime costs of the intra-artery GDC embolization and the aneurysm clapping of intracranial aneurysm, under the matching of the age, sex, living place, the size and place of the aneurysm, and the Hunt & Hess score. Clinically effectiveness dates were derived from the medical records. Cost dates were derived from follow-up by telephones or letters. The correlation analysis was done with the SPSS 13. 0. Results The cost in hospital in AC group was (54 945±16 946) RMBs,which washigher than the ones in AE group(63 768±12 665) RMBs, (t = 1.71, P <0. 05). The cost of missed working in AE group was 200 RMBs(the median), which was lower than the ones in AC group 650 RMBs (z =2. 57,P < 0. 01). The cost of return visit in AE group was 1200 RMBs, which was lower than the ones in AC group1950 RMBs (z = 1.82, P < 0. 05). The cost-effectiveness of the intra-artery GDC emhalization and the aneurysm clapping had no difference 3805 RMBs/year vs. 3028 RMBs/year(z =0. 42,P >0. 05). Conclusion The results suggest that the two therapies have no difference in cost effective rate. Considering the physical and mental loss, the aneurysm intra-artery GDC embolization was better than the aneurysm clapping for the patients with aneurysm that diameter less than 25 mm.

Great advances have been made in understanding the genesis,diagnosis,risk stratification and the targeted therapy of myeloproliferative neoplasms (MPNs) in the past decade.This article reviews the current situation in the genesis,diagnosis and risk stratification of these classic bcr-abl-negative MPNs presented in the 56th American Society of Hematology (ASH) annual meeting.

Primary myelofibrosis is a kind of chronic myeloproliferative neoplasms.The discovery of the JAK2V617F mutation as well as other molecular abnormlities underly the pathogenesis of Philadelphia negative myeloproliferative neoplasms (MPN).The initial description of JAK2V617F mutation in 2005,the reporting of calreticulin (CALR) mutations last year and the clinical application of JAK inhibitors,showed the gradually deepening understanding with regard to the pathogenesis and the development of therapeutic strategies for primary myelofibrosis (PMF).This article reviewed the progress in diagnosis,risk stratification of of PMF,the benefits and potential side effect of JAK inhibitors,which reported on the 2014 European Hematology Association annual congress.

Oxidative stress and inflammation are two main factors in the progress of diabetic nephropathy(DN) and its complications. NF‐E2 p45‐related factor (Nrf2) is a crucial transcriptional factor which manipulates downstream genes that encode some antioxidant enzymes and phase Ⅱ detoxifying enzymes ,to maintain the redox homeostasis and cellular detoxification response. Therefore ,more and more researchers are focusing on the role of Nrf2 in DN. In this review ,the detailed role of Nrf2 in DN will be discussed. Hopefully ,our work can epitomize recent research progress and provide novel clues for diabetic nephropathy prevention and treatment.

Objective To investigate the clinical features,treatment and prognosis of paraneoplastic pemphigus (PNP).Methods A retrospective study was performed on 11 patients with PNP hospitalized in the Department of Dermatology,Ruijin Hospital.Clinical characteristics of these patients were analyzed.Results Of the 11 patients,10 had oral or labial erosions or ulcers,and 6 had obstructive bronchiolitis.Computed tomography (CT)showed solitary internal tumors in all the patients after appearance of skin lesions,and 8 of them were diagnosed with Castleman's disease.All the patients had been treated with corticosteroids before operation,but achieved no obvious improvement.After 2-7 months of postoperative treatment with low-dose prednisone and thalidomide,both cutaneous and mucosal lesions healed with the relief of pulmonary symptoms in 5 patients.Conclusions Oral erosions or ulcers appear to be the most common initial manifestation of PNP with Castleman's disease as the most frequent accompanying tumor.Early detection and timely resection of tumors are keys to successful treatment of PNP,and postoperative treatment with glucocorticoids and thalidomide proves to be effective for PNP.