Objective To evaluate the clinical efficacy of percutaneous nephrolithotomy (PNL) in combination with pneumatic and ultrasonic lithotripsy in the treatment of complex renal calculi. Methods Under general anesthesia,an ureteral stent was placed into the patient by cystoscopy. With the prone position,percutaneous access was established by inserting an access needle into the intended calix under the guidance of ultrasonography or fluoroscopy. Afterwards,combined pneumatic and ultrasonic probes were used by nephroscopy for lithotripsy. Results A single tract was used in 137 patients,while two or three tracts were created in the other patients (11 and 2 respectively). One-step procedure to remove the stones was achieved in 119 patients,while a second intervention was performed in 27,and three procedures was carried out in 4. The mean time of the operations were (88?34) min. After the operation,one patient developed infectious shock,and then was cured by anti-shock therapy;two patients showed secondary hemorrhage in two weeks postoperation,and was cured by conservative therapy. In this series,the rate of stone clearance was 84.7% (127/150);23 cases had residual stones,10 of them received ESWL (the stone was removed completely in 7 of the 10 cases),and the other 13 were treated by oral medicines. Six months after the operation,follow-up examination showed a stone-free rate of 89.3% (134/150). Conclusion Combination of ultrasonic and pneumatic intracorporeal lithotripsy is effective and safe for complex renal calculi,which is intractable by open surgery.

Objective To evaluate the indications,complications and efficacy of permanent interstitial brachytherapy in the treatment of clinically localized prostate cancer. Methods Five patients (mean age,73 years;range,59~84 years) with clinically localized stage T 2b to T 3 adenocarcinoma of the prostate were treated with iodine-125 brachytherapy using the transrectal ultrasound guided transperineal implantation technique and Prowess 2.42 treatment planning system.The follow-up period ranged from 12 to 18 months. Results After implantation,the PSA levels of the 5 patients were decreased significantly and were all less than 0.5 ng/ml at 12th post-implant month;and the prostate volume shrunk from the third month. In the early period after the implantation all the patients complained of some voiding problems and had a noticed increase of International Prostate Symptom Score (IPSS),with the decrease of urinary flow rate.But the conditions improved gradually from the third month. No serious complications such as hematuria, bloody stool and rectal ulcer were found in this group. Conclusions Permanent interstitial brachytherapy has better efficacy,fewer complications and more radiation safety in the treatment of clinically localized prostate cancer.

Objective To assess the efficacy and safety of tolterodine on late-onset overactive bladder symptoms after prostate brachytherapy due to prostate carcinoma.Methods Twenty-six prostate cancer patients diagnosed by biopsy,who underwent prostate brachytherapy using iodine-125,were recrui(t)ed in this trial.All cascs complained of overactive bladder symptoms 6 months postoperatively.The 26 patients were divided into 2 groups:14 men in tolterodine group (TR group) who were given tolterodine 2 mg twice a day; 12 men in tamsulosin group (TS group) who were given tamsulosin 0.2 mg once a day.Efficacy was assessed by changes in IPSS,OABSS and nighttime voiding at 2 weeks and 4 weeks after medical treatment respectively.Safety was assessed by postvoid residual (PVR) and acute urinary retention (AUR),dry mouth,constipation and tachycardia at the fourth week after medical treatment.Results The age,tumor staging,GS,PSA,initial prostate volume,IPSS,OABSS,nighttime voiding,iodine-125 seeds implanted and needles punctured of both groups were comparable.IPSS,OABSS and nighttime voiding were significantly improved in TR group after 2 weeks of medical treatment and the above parameters were significantly improved than TS group (14.4 vs 18.3,5.9 vs8.4,1.4 vs2.5).OAB symptoms of TR group were also significantly improved than TS group after 4 weeks of therapy.There were no significant differences of PVR and AUR,dry mouth,constipation and tachycardia between both groups.Conclusions Tolterodine is effective and safe in treating late-onset OAB symptoms after prostate brachytherapy,although the occurence of dry mouth and tachycardia might be increased.

Objective:To provide chemical basis for processing of leech through investigating the variations of composition of leech scalded with talc powder. Methods: Amino acids were determined by HPLC post column derivatization and steroids by GC MS. Results: The results showed the total contents of amino acids in scalded leech were reduced and the steroids of it were changed. Conclusion: The processing method of leech used at the moment has a great influence in chemical components of leech.

Objective To investigate the relationship between metabolic syndrome (MS) and recurrence of urolithiasis.Methods A retrospective analysis was performed in urinary stone patients from March 2008 to February 2012.Patients were divided into MS group and non-MS group according to the diagnose criteria of metabolic syndrome (2007 version) by the joint committee for developing Chinese guidelines on prevention and treatment of dyslipidemia in adults.The patients were followed up for 24-72months (median 47 months) since operation.The difference of stone recurrence was compared between the 2 groups.Results Two hundred and eighteen patients with urinary stone disease were enrolled.Of them,52 patients were diagnosed with MS.Stone recurrence occurred in 29 patients (55.8％) of MS group,whereas 66 patients (39.8％) of non-MS group suffered stone recurrence.It demonstrated the median recurrence free survival of group MS and non-MS was 36 months and 59 months by Kaplan-Meier analysis,respectively (Log-rank test,P =0.019).Multivariate Cox regression analysis results revealed that MS was significantly associated with stone recurrence (HR 1.817,95％ CI 1.105-2.988,P =0.011),however,the gender (P =0.336),age (P =0.246) and recurrence urolithiasis at first visit (P =0.051) were not associated with stone recurrence.Conclusions MS is an independent risk factor for urinary stone recurrence.It is suggested that the treatment of MS may have a important role in prevention of stone recurrence in MS patients with urolithiasis.

Objective To investigate the effect and safety of topical tranexamic acid (TXA) plus cocktail analgesic for reducing blood loss during total knee arthroplasty (TKA).Methods A prospective case control study was made on 60 patients scheduled to undergo TKA because of knee injuries between August 2015 to June 2016.There were 13 males and 47 females,with the mean age of 65.5 years (range,51-80 years).Traumatic arthritis occurred in 44 patients and degenerative arthritis in 16 patients.The patients were assigned to separate cocktail analgesic group (Group A,n =30) and topical TXA plus cocktail analgesic group(Group B,n =30),according to the random number table.Patients in Group A received multiple-point intra-articular cocktail analgesic injection before implantation of the prosthesis in TKA.While patients in Group B received multiple-point intra-articular TXA plus cocktail analgesic injection before implantation of the prosthesis.Between-group differences were compared with respect to intraoperative blood loss,hemoglobin change (Hb),haematocrit (Hct),postoperative drainage,total blood loss,hidden blood loss,blood transfusion rate,Hospital for Special Surgery (HSS) score,incidence of deep venous thrombosis (DVT) and other complications.Results All patients were followed up for 3 months.Perioperative Hb reduction in Group B was 18.5 (13.0,26.0) g/L,less than 23.0 (21.0,35.5) g/L in Group A (P ＜ 0.05).Hct was reduced by 5.6 (4.1,7.8) ％ in Group B,while 7.2 (6.1,10.7) ％ in Group A (P ＜ 0.05).Postoperative drainage volume,total blood loss and occult blood loss in Group B were 105.0(60.0,223.8) ml,596.0(426.1,795.3) ml,422.3 (228.9,624.0) ml respectively,decreased compared to Group A [162.5 (118.8,245.0) ml,788.3 (583.0,1 082.4) ml,603.2 (435.2,884.7)ml respectively] (P ＜0.05).There were no significant differences in intraoperative blood loss,blood transfusion rate,HSS score and DVT incidence between the two groups (P ＞0.05).Conclusion Topical TXA plus cocktail analgesic can reduce blood loss during perioperative period in TKA,without increasing the risk of DVT.

A canine model of electro-physiologic-electropharmacologic testing on ischemic ventricular tachyarrhythmias were established in the open-chest dogs subjected to programmed electrical stimulation (PES) on 5~8days after acute my-ocardial infarction produced with two -stage occlusion of left anteriol decending coronary artery (LAD) followed by partly reperfusion. The electrophysiologic -electropharmacologic effects of pro-cainamide (PA ) were observed in this canine model. pA distinctly lengthened the QTc interval and the effective refractory period ( ERP) of normal and infarct myocardium in both ventricles and decreasedthe dispersion of ERP in infarct myocardium (IDR) as well as the dispersion of ERP in left ventricle (VDR). The PES - induced ventricular tachycardia (VT) or ventricular fibrillation (VF) was prevented in 5 out of 6 PA treated dogs (n = 6),Normal saline (NS) did not prevented PES- induced VT/VF. The results suggest that PA may be effective in preventing the onset of reentrant ventricular tachyarrhythmias after myocardium ischemic damage.

Objective To obtain a lasting and purified cell line of vascular smooth muscle cells (VSMCs) by primary culture, and to provide these test materials related research. Methods The primary and transfer culture was done by tissue - piece inoculationand trypsin digestion,respectively. The cells were frozen in liquid nitrogen,and cultured cells were identified by phase contrast microscopy and immunohistochemical SP kit. Results 85% of inoculated tissue pieces survived. More than 90% of VSMCs regrew in transfered culture. The frozen cells could recover their proliferation by several culture transfers. The VSMCs showed the typical "peak and valley" characteristics under microscopy. Immunohistochemical staining with antibody against SM - a - actin expression in these cells was positive. Conclusion The tissue - piece inoculation is a simple method for obtaining satisfactory VSMCs in short term.

Objective To evaluate ultrasound-guided posterior approach to intercostal block for herpetic neuralgia. Methods Forty-eight patients with herpetic neuralgia after appearance of rashes on the back of chest (the coursc ＜ 30 days) aged 56-84 yr received intercostal block performed via posterior approach under the guidance of ultrasound with a mixture of 0.75% ropivacaine, glucocorticoid and methylene blue. Pain was assessed with visual analogue scale (VAS) before block and at 1, 2, 4 and 8 weeks after block. Pain relief (PAR) was cal-culated (PAR= (VAS score before block- VAS score after block) ÷ VAS score before block × 100%). Results No patient developed dyspnea and pneumothorax. VAS scores were reduced significantly, quality of life was improved and PAR increased at 1, 2, 4 ancl 8 weeks after block ( P ＜ 0.05 or 0.01). Concluslon Ultracound-guided posterior approach to intercostal block is safe and effective for the treatment of herpetic neuralgia.

Objective To compare outcomes of laparoscopic radical prostatectomy (LRP) and open radical prostatectomy (ORP) performed in our hospital.Methods A non-randomized,retrospective comparative study was performed to analysis 302 prostate cancer patients from January 2011 to June 2014.One hundred and ten patients underwent LRP and 192 underwent ORP.There were no significant differences between the LRP and ORP groups with respect to patient age,body mass index,PSA level,Gleason Score,clinical T stage and transrectal ultrasonography prostate volume (P ＞ 0.05).The operating time,estimated blood loss,catheter retaining time,hospital stay time,positive surgical margin rate and urinary control rate were compared between the 2 groups.Results The median operative time of the ORP group and the LRP group was 95 min and 120 min,the difference between groups was significant (P ＜ 0.01).The median duration of hospitalization of the 2 groups was 9 d and 6 d,the difference between groups was significant (P＜0.01).ORP group and LRP group's estimated blood loss was 350 ml and 250 ml.Days of tube drainage were 3 d in both groups.Days of urinary catheterization drainage after surgery were 16 d and 15 d,respectively.Positive margin rate was 10.4％ and 12.7％.Urinary continence recovery rates at 3 month were 80.2％ and 70.8％.Urinary continence recovery rates at 6 month were 85.9％ and 87.3％.No significant difference was observed in the above index (P ＞ 0.05).Conclusions Compared with ORP,LRP has shorter hospital stay time and longer operating time.Both LRP and ORP have good outcomes in oncological control and function rehabilitation.Both of them are important procedures to treat localized prostate cancer.