Objective:To design a laparoscopic suture guide set based on the principle that the ends of three struts on the arc of the same center, and to explore the rationality and practicability of the device by suture experiment in an isolated human kidney.Methods:⑴ The device was made. The three struts of the device were arranged on the fixed shaft in sequence. The function structure included the direction limitation device and the needle exit site locating device. The direction limitation device included the U-shaped end of the second strut and arc cylinder of the third strut. The needle exit site locating device was the Y-shaped end of the first strut. The ends of the three struts were on the same circular arc with the fixed axis as the center of the circle. When the long round needle of the same radian entered the curved cylinder (the first direction limitation device), it was restricted by the cylinder to travel to the U-shaped end of the second strut (the second direction limitation device), and was guided by the two devices to the Y-shaped end of the first strut (the needle exit site locating device). A built-in torsion spring clamped the kidney to fix the device. The design of the device was drawn into a 3D figure, printed by a metal 3D printer with titanium alloy, polished and then assembled into a finished product. ⑵ Experiment. Four kidneys of patients underwent retroperitoneal laparoscopic radical nephrectomy was cut open, and 8 needle insertion and exit points were designed along the long axis. The kidney sutured with conventional methods was set as the conventional group. Then the laparoscopic suture guide set was used to assist the suture, which was set as the guide group. For effective suture, the distance between the actual insertion point and the preset insertion point was less than 1.0 cm. If the distance was greater than 1.0 cm, re-suture rate and deviation distance were observed. The distance between the actual injection point and the preset injection point was less than 0.5 cm, which means the point is conformant, and the conformance rate was observed. Single needle suture time was observed in 2 groups.Results:In the experiment, 15 stitches deviated more than 0.5 cm, 10 stitches deviated more than 1.0 cm in the conventional group, the re-suture rate was 31.3%(10/32), the conformance rate was 53.1%(17/32), and the deviation distance was 0.6-1.15(0.41±0.48)cm. In the guide group, 5 stitches deviated more than 0.5 cm, 2 stitches deviated more than 1.0 cm, the re-suture rate was 6.3%(2/32), the conformance rate was 84.4%(27/32), and the deviation distance was 0.6-1.10(0.14±0.34)cm. There were statistically significant differences in the above indicators between the two groups ( P<0.05). The single stitch suture time in the conventional group ranged from 3-12(6.00±3.32)seconds, and that in the guide group ranged from 5-11(5.94±1.41)seconds. There was no significant difference in single stitch suture time between the two groups ( P>0.05). Conclusions:The structure design of laparoscopic suture guider is relatively reasonable. The device can ensure the direction of the surgical needle, reduce the number of times to adjust the surgical needle, and the needle position is accurate. It has a good auxiliary effect for suture in vitro, but the guider needs to be operated under laparoscopy to further verify its rationality and practicability.

Objective:To design a laparoscopic partial renal blood flow blocker (LPRB), and to explore the design rationality and effect of LPRB on blocking the blood flow of local renal tissue in rabbit kidney experiment.Methods:⑴ Design.According to the anatomical characteristics of the renal blood flow from the center to the periphery in the human, pig and rabbit, the blood flow at the distal part of the compression area could be blocked by the compression of the medial kidney tissue. LPRB included the first pressure arm, the second pressure arm and shaft. A built-in torsion spring made the two ends of the pressure arm to automatically close. The ends of pressure arm were provided with an arc-shaped compression component, on which, there were multiple adaptive compression plates. ⑵ Fabrication. 3D printer printed the finished product with titanium alloy material. ⑶ Animal experiments. Five New Zealand rabbits were anesthetized and fixed on the operating table in a semi-lateral position, with a lateral abdominal incision. Kidneys were exposed, only the renal pedicle vessels were retained. According to different methods of blocking blood flow, they were divided into conventional group and LPRB group for self-control. The effect of blocking blood flow was observed. The clamping force of LPRB was detected, and the degree of tissue damage at the clamping site was observed by naked eye and pathology.Results:LPRB had been licensed as a utility model and apperance patent. The device was successfully made from titanium alloy by 3D printer. In the experiment, the device was easily placed and removed. The two pressure arms were automatically closed and fixed under the action of torsion spring. The angle of the compression arm could be adjusted according to the position of clamping. The self-adaptive compression plates might be inclined in order to be consistent with the shape of the kidney; The pressure of LPRB was sufficient and the hemostasis was complete.Conclusions:LPRB is basicly rational and safe, and it can realize the partial hemostasis of the excised part and guarantee the blood flow of other parts at the same time. However, the larger size and harder adaptive component need to be improved in the future.

Objective To compare the efficacy of different ultrasound-localizing methods in extracorporeal shock wave litho-tripsy(ESWL)on patients with upper ureteral calculi.Methods One hundred and ninety-two patients with upper ureteral calculi ad-mitted into the Urinary Surgical Department of the hospital for treatment from May 2016 to May 2017 were recruited as research sub-jects.They were divided into the experimental group and the control group in accordance with different ultrasound-localizing methods, each consisting of ninety-six patients.The experimental group was treated with the transabdominal ultrasound-localizing method,while the control group had the transback ultrasound-localizing method.The distance between calculi and skin, the ultrasound-localizing time,the treatment effect and the rate of complications were closely observed and analyzed.Results The success rate of lithotripsy for the experimental group was ≤3 times(90.6%), which was higher than that of the control group(78.1%).In the experimental group,the distance between calculi and skin [(3.7 ±1.4)cm] and the ultrasound-localizing time [(5.1 ±2.5)min] were all signifi-cantly shorter than those of the control group [(8.1 ±2.3)cm,(12.3 ±3.1)min].There were statistical differences, when compari-sons were made between them(P<0.05).However,there was no statistical significance in the rate of complications,when comparisons were made between the 2 groups(P>0.05).Conclusion The transabdominal ultrasound-localizing extracorporeal shock wave lithotripsy could effectively be applied in the treatment of patients with upper ureteral calculi,with the advantages of shorter localizing time,shorter distance between calculi and skin,better accuracy,lower loss of shock wave power and better lithotriptic efficacy.For this reason,it is worth further clinical promotion.

Objective To investigate the value of narrow-band imaging (NBI) cystoscopy in the diagnosis of interstitial cysti-tis (IC).Methods From Sep.2009 to Mar.2014, 65 patients highly suspected of having IC were included in the study .First, con-ventional white-light imaging(WLI)cystoscopy was performed under spinal anesthesia by a senior urologist .Then, NBI cystoscopy was conducted independently by a junior urologist .Following hydro-distention test , the above two urologists made conventional observation by WLI cystoscopy , and biopsy was performed to see if abnormal bladder mucosa could be detected .Results Conventional WLI cysto-scopy before hydrodistention revealed that 5 patients out of 65 had ulcerative pathological lesion and 23 patients had non-ulcerative capil-lary-rich area .When NBI cystoscopy was administered , 28 WLI-positive cases were detected , and another 31 WLI-negative cases were found to have non-ulcerative capillary-rich area.WLI cystoscopy after hydrodistention revealed that 5 cases with ulcerative lesion had mucosa rupture with bleeding at the site of ulcer , and all the 54 cases with non-ulcerative capillary-rich area under NBI cystoscopy and 2 NBI-negative cases were found to have petechial hemorrhage and glomerulus -like erythema.Biopsies performed in 61 cases with ab-normal bladder mucosa revealed that 59 cases had chronic inflammation and 2 cases were diagnosed to be carcinoma in situ .Thus, 59 were confirmed to be IC cases.In the diagnosis of IC under the WLI mode before hydrodistention , the sensitivity, specificity and Kappa values were 44.1%, 66.7% and 0.032 respectively, while under NBI mode, the sensitivity, specificity and Kappa values were 96.6%, 66.7%and 0.633 respectively.Conclusion Compared with WLI cystoscopy, NBI cystoscopy seemed to be more sensitive in the diagnosis of IC before hydrodistention .The NBI-positive area was highly identical to the positive area after hydrodistention .It had good application value in IC diagnosis .

Objective To explore the correlation between IL-22 expression levels in serum and FOLFOX resistant status and to examine weather IL-22 could promote chemoresistance in colorec-tal cancer cells.Methods ELISA were preformed to detect IL-22 expression levels in 60 patients who received FOLFOX adjuvant chemotherapy after radical excision.The chemoresistant effect of IL-22 in colorectal cancer cells with treatment of chemotherapeutic drugs was investigated.Results IL-22 serum levels increased in chemoresistant patients compared with chemosensitive patients.In addi-tion,IL-22 could confer resistance to 5-FU and OXA of SW480 and SW620 cell lines.Conclusion Elevated serum IL-22 levels correlate with FOLFOX chemoresistant condition of colorectal cancer and may be an important factor for chemoresistance.

Objective To explore the correlation between IL-22 expression levels in serum and FOLFOX resistant status and to examine weather IL-22 could promote chemoresistance in colorec-tal cancer cells.Methods ELISA were preformed to detect IL-22 expression levels in 60 patients who received FOLFOX adjuvant chemotherapy after radical excision.The chemoresistant effect of IL-22 in colorectal cancer cells with treatment of chemotherapeutic drugs was investigated.Results IL-22 serum levels increased in chemoresistant patients compared with chemosensitive patients.In addi-tion,IL-22 could confer resistance to 5-FU and OXA of SW480 and SW620 cell lines.Conclusion Elevated serum IL-22 levels correlate with FOLFOX chemoresistant condition of colorectal cancer and may be an important factor for chemoresistance.

Objective To evaluate the safety of simultaneous transurethral green laser vaporization therapy in benign prostatic hyperplasia (BPH) and nonmuscle-invasive bladder transitional cell carcinoma (NMIBT).Methods The clinical data of 27 patients (observation group) who had undergone simultaneous transurethral green laser vaporization therapy in BPH and NMIBT between May 2004 and October 2010 were analyzed retrospectively.Meanwhile 27 patients(control group) only had undergone green laser vaporization therapy in NMIBT during the same period were selected.Clinicopathologic parameters,rate of recurrence and progression,rate of recurrence in the bladder neck and prostatic urethra were determined and compared.Results The time of follow-up in observation group and control group were (28.61 ± 19.53) and (30.20 ± 21.46) months.The rates of recurrence,progression and recurrence in the bladder neck and prostatic urethra between observation group and control group had no significant differences [ 18.5％ (5/27) vs.25.9％ (7/27),3.7％ (1/27) vs.0,0 vs.0] (P ＞0.05).Conclusion Simultaneous transurethral green laser vaporization of NMIBT and BPH can be safely performed without increasing the risk of tumor recurrence in the prostatic urethra.