Objective To investigate the effect of minimally invasive percutaneous nephrolithotomy(MPCNL) in the management of renal or ureteral calculi.Methods MPCNL was performed in 52 patients with renal or ureteral calculi under the localization of C-arm fluoroscopy and/or B-ultrasonography.Results Among the 52 patients,a conversion to open surgery was needed in 1 patient because of perforation of the renal pelvis.The stones were completely extracted on one session in 33 patients,and by a re-operation of MPCNL through the fistulization tube 1 week later in 15 patients.The total stone-free rate was 92.3%.The operation time was 1.5~4 h(mean, 2.5 h).No blood transfusion was needed.Conclusions Minimally invasive percutaneous nephrolithotomy is a safe and effective procedure,especially suitable for basic hospitals.

Objective To explore the way to reduce the absorption of irrigating fluid during PCNL. Methods The amount of absorbed fluid during PCNL in 20 cases (13 males and 7 females)was monitored by ethanol method. The average age was 40 years old. The maximum diameter of calculi by average was 25 mm. Heart rate and mean arterial pressure were monitored during operation.Haemoglobin concentration, serum Na+, K+, Cl-, carbon dioxide-combining power and serum creatinine were measured before and after operation. The amount of irrigating fluid, the duration of operation, and the intrapelvic pressure were recorded. Results The absorbed volume of irrigating fluid in 20 cases was from 50. 2 to 685.0 ml. There was no significant difference in heart rate, mean arterial pressure, serum Na+ , K+ , Cl- and serum creatinine between pre-operation and post-operation(P>0.05), but the postoperative haemoglobin concentration (130.4±16.3 g/L) and carbon dioxide-combining power (24.1±3.2 mmol/L) were lower than that before operation( 142.6±15.6 g/L,26.4±2.0 mmol/L), the differences were significant (P<0. 05). The mean volume of absorbed irrigating fluid in patients with the cumutative time of the intrapelvic pressure higher than 30 mm Hg >10 min,the duration of operation >1 h, or the amount of irrigating fluid >10000 ml was 381. 1, 301.6,261.6 ml respectively, which was higher than that in the other cases (142.9, 136.4, 130.2 mi), the differences were significant (P<0.05). Conclusions The ethanol method is simple, convinent,safe, valid, and is suitable for patients with compromised cardiorespiratory or renal function, who are more likely to develop volume overload because of fluid absorption.

Objective To discuss the surgical treatment of the ankle and the foot soft tissue defects. Methods 41 cases of the ankle and the foot soft tissue defects were treated with different types of pedicle flaps transfer 9 types of flaps were used in all patients. Results 36 flaps of 41 cases were completely survived, 2 ease with superficial necrosis and 3 cases with distal edge partially necrosis and these 5 cases all healed by dressing change. All the easeswere followed up 3 to 36 months(averaged 12 months). The flaps completely survived. Conclusion The study showed that the soft tissue defects in ankle and foot can be constructed satisfactory by selecting a reasonable pedicle flap, especially the sural neurocutaneons island flaps.

Objective To establish the quantitative methods of psoralen and apigenin in Radix Fici Hirtae. Methods The content of psoralen and apigenin in Radix fici Hirtae was determined by HPLC. The chromatographic conditions were as follows:YMC C18 column(250 mm? 4.60 mm,5 ? m),mobile phases of methanol-0.2 % phosphoric acid for gradient elution,flow rate being 1.0 mL? min-1,column temperature at 30 ℃,detection wavelength being 245 nm for psoralen and 338 nm for apigenin,and inject volume being 10 ? L. Results Psoralen showed a good linear relationship in the range of 0.083 6～ 1.045 0 ? g,r=0.999 9,the average recovery was 100.43 % and RSD % was 0.45 % . Apigenin showed a good linear relationship in the range of 0.065 6～ 0.820 0 ? g,r=0.999 9,the average recovery was 100.41 % and RSD % was 0.34 % . Conclusion The established methods are simple and rapid with good reproducibility,and can be used for the quality control of Radix fici hertae.

BACKGROUND: Benign prostatic hyperplasia is a common disease of older males. Although the etiology remains unclear, the factors of life style and habits may have an effect on the disease.OBJECTIVE:To examine the association of cigarette smoking and body mass index with the risk of clinical benign prostatic hyperplasia.DESIGN: A hospital-based case-control study SETTINGS:Department of Epidemiology and Statistics, Public Health School,Tongji Medical College, Huazhong University of Science and Technology; Department of Preventive Medicine, Liaoning Medical College.PARTICIPANTS：Totally 343 males with benign prostatic hyperplasia of 50-82 years old (patient group),who were surgically treated between May 2004 and May 2006,were selected from the Department of Urinary Surgery of the First Affiliated Hospital and Third Affiliated Hospital of Liaoning Medical College (former Jinzhou Railway Central Hospital),Jinzhou Central Hospital and Jinzhou Second People's Hospital．Inclusive criteria：① males above 50 years old；intemational prostatic symptom score(IPSS)＞7；②Digital recta examination (DRE) after miction indicated prostate grade Ⅰ(transverse diameter＞3 cm); ③prostatic volume≥30 g;④maximum unnary flow rate＜15 mL／s；Meanwhile，361 inpatients with diseases irrelative to the risk factors of benign prostatic hyperplasia,prostatic cancer and prostatitis were selected trom the above hospitals as the control group,they were 50-82 years of age with an average of 65 years old．Informed contents were obtained from all the enrolled subjects．METHODS：All the patients and controls were interviewed using an anonymous questionnaire．All participants were asked to report whether they had smoked 20 packs of cigarettes or more in their lifetimes and,if yes,they were smokers,on the contrary they were non-smokers．Based on usual number of cigarettes reported in the questionnaire, men were categorized as 1-10，11-20，21-30 and ＞30 cigarettes per day．Based on duration of smoking,the participants were funher classified as never smoke，1-19,20-29 and ≥30 years．Body mass index(BMI)was assessed from measured body mass and body height，and che standards of BMI in adults in China was 18．5-23．9 for normal,24．0-27．9 for overweight and ≥28．0 for obesity)，then the participants were further classified as BMI＜18．4，18．5-23．9,24．0-27．9 and ≥28．0 subgroups respectively．Years of education(＜7,7-11,and≥12) and occupation(worker,peasant, Intellectual and others) were also investigated．The results of the investigation were input into computer to establish database，the odds ratios (OR) and the 95％ confidence interval(CI)in relation to the various measures were estimated using unconditional multiple logistic regression models, including number of cigarettes smoked per day，BMI,years smoked，years of education,occupation．MAIN OUTCOME MEASURES：Relationships of number of cigarettes smoked per day,years smoked．BMI,years of education and occupation with benign prostatic hyperplasia．RESULTS：Totally 343 cases in the patient group and 361 cases in the control group were involved in the analysis of results．①Patients smoked≥30 cigarettes per day had an elevated risk of benign prostatic hypertrophy as compared with the non-smokers(OR=1．32，95％ CI:0．92-2．58，P＜0．01)．②The risks of benign prostatic hypertrophy in overweight and obesity were significantly increased as compared with non-smokers(OR=1.68,95％ CI: 1．32-3．67；OR=2．35，95％CI:1．83-4．16)，③Manual worker (peasant) was negatively correlated with the risk of benign prostatic hyperplasia (χ2=6．62，P＜0．01)．CONCLUSION:Smoking 30 cigarettes per day was positively related to benign prostatic hyperplasia.For male who were both overweight(BMI 24.0-27.9)and obesity(BMI≥28.0)，smoking was significantly associated the increased risk of surgically treated benign prostatic hyperplasia.

Objective To investigate the expression of six-transmembrane epithelial antigen of the prostate (STEAP) in prostate cancer and its relationship with prostate specific antigen (PSA).Methods A retrospective analysis was performed of 65 consecutive patients verified for prostate canc-er by prostate biopsy or post-operational pathological examination.The clinical stage was classified ac-cording to TNM system and the pathological grade was classified according to Gleason score.STEAP expression in 65 prostate cancer samples (T1 9,T2 14,T3 17,T4 25;high differentiation 37,moder-ate differentiation 12 and low differentiation 16) was studied by using STEAP monoclonal antibody (Santa Cruz Biotech,USA) and SP immunohistochemical staining.Positive staining gray values were introduced to describe the intensity of STEAP expression.STEAP expression level was analyzed with respect to stage,grade,serum total PSA and free/total PSA (f/t PSA) ratio respectively.Results The serum total PSA concentration and f/t PSA ratio in all cases was (27.65±8.34) ng/ml and 0.15～0.04 respectively.STEAP was positively stained in 63 patients (T1 7,T2 14,T3 17,T4 25; high differentiation 37,moderate differentiation 11 and low differentiation 15).The mean STEAP-positive staining gray values in stage T1,T2,T3 and T4 of prostate cancer were 26.8%,45.6%,62.3% and 76.5%,respectively and in high,moderate and low differentiation group were 71.2%,52.8%,and 34.4% respectively.The positive staining gray values of STEAP expression was posi-tively correlated to the clinical stage of cancer and negatively correlated to the Gleason score and the ratio of f/t PSA (P<0.01,respectively).There was no significant relationship between STEAP ex-pression and serum total PSA concentration (P>0.05).Conclusion STEAP expression may act as one of new markers to the invasion degree and pathological grade of prostate cancer.

A resonance light scattering(RLS) method for the determination of critical micelle concentration(CMC) of sodium dodecyl benzene sulfonate(SDBS) was proposed. Under room temperature, the RLS intensity of the SDBS system increased with increasing SDBS concentration. And when the concentration of SDBS approached CMC, the RLS intensity had increased sharply. The RLS peaks were appeared at 330 nm and 396 nm, respectively. The plot of the RLS intensity at 396 nm versus SDBS concentration was S-Curve. The concentration of SDBS at the intersection point of two tangents to S-curve was considered as SBDS CMC. This result was consistent with the results of the pyrene probe fluorescence spectrometry and electrical conductivity method. The influences of the concentration of Ca2+ on the aggregation behave of SDBS and SDBS-emulsion OP(OP) systems were studied by the RLS method. The results indicated that the mixed

A series of 29 cases of esophageal stenosis or obstruction caused by chemical burn or malignancy in the cervical or upper thoracic segment were treated by resection, and its continuity was re-established by a vascularized free or pedicled jejunal graft. It was successful in 28 cases, with only one failure. The age of these cases ranged from 4 to 65 years old. Among them, 4 children were between 4 and 6. Sixteen cases of pedicled jejunal grafts had their vessels anastomosed to cervical vessels at the upper end. The lengths of the grafts varied from 40 to 60 cm. In the 13 free jejunal grafts, jejunal blood vessels were anastomosed to the right gastroepiploic vessels and cervical vessels at the lower and upper ends, respectively, to re-establish circulation for long jejunal segments, while for the short jejunal grafts anastomosis was made to the cervical vessels only. The vascularized jejunal patch graft is an effective measure for repairing anastomotic fistula or localized wall defect. A regime of monitoring blood circulation of the jejunal transplant is described.

BACKGROUND:The method of ligating or resecting rat lower limb femoral or iliac artery has been widely used to make rat models of lower limb ischemia, but there have been no stable and efective methods used to establish diabetic models of chronic atherosclerotic occlusive diseases and to evaluate the ischemic status of hindlimbs of models. OBJECTIVE: To establish type 2 diabetes rat models of lower limb ischemia by feeding with high-fat diet and to evaluate them. METHODS:Twenty rats were randomly and evenly divided into diabetes group (n=10) and control group (n=10). Rats in the diabetes group were fed with high-fat diet for 6 months, and were intraperitonealy injected with streptozotocin (50 mg/kg) to induce diabetes. Rats in the control group were fed with normal diet for 6 months. Rats in these two groups were subjected to ligation of femoral artery to establish right lower limb ischemia models. RESULTS AND CONCLUSION:At the first day of modeling, color Doppler flow imaging and CT angiography showed obviously decreased blood flow suggesting the success of establishing ischemia model. At 7 and14 days after modeling, the blood flow of rats in these two groups showed a gradual recovery as detected by color Doppler flow imaging. At 28 days after modeling, blood flow of rats in the diabetes group was significantly slower than that in the control group (P < 0.05). CT angiography showed that at 28 days after modeling, only a smal amount of compensatory increase in blood flow of the blood vessels at the ligation position of proximal right lower limb femoral artery was seen in the diabetes group, while no obvious blow was observed in the distal part. Histopathologic and immunohistochemical staining showed that at 28 days after modeling, destroyed tissue structure and inflammatory cel infiltration were observed in the ischemic region and capilary density on the affected side was lower than that on the healthy side. The protein expression of vascular endothelial growth factor in the ischemic muscle tissue of rats in the diabetes group was significantly increased compared with that in the control group (P < 0.05). These results show that diabetic rat models of lower limb ischemia can be successfuly established by long term high-fat diet feeding and femoral artery ligation and they can be validated by CT angiography.