Objective To design and fabricate an integrated optoelectrical fiber to enable the simultaneous transmission of high-power laser and electrical current, thereby developing a novel tool for urological surgery.Methods A miniature metal sleeve was installed at the front end of a medical high-energy optical fiber, and corresponding conductive circuits were configured. The fiber was connected to a fiber thulium laser and a bipolar plasma generator simultaneously. Experiments of simulated vaporization were conducted on ex vivo porcine kidney tissues using thulium laser (50 W), plasma (100 W), and thulium laser + plasma (50 W+100 W), respectively. Tissue removal efficiency was calculated using the weighing method:tissue clearance rate (g/min)=[mass before vaporization (g) - mass after vaporization (g)]/vaporization time (min). Lateral tissue thermal damage was assessed with hematoxylin-eosin (HE) staining. One-way analysis of variance and least significant difference test were used for statistical analysis.Results The integrated optoelectrical fiber was successfully constructed, which could simultaneously and continuously transmit thulium laser and plasma electrocision current. The tissue clearance rate of the thulium laser+plasma group was significantly higher than that of the thulium laser group and plasma group [(0.49±0.13) g/min vs. (0.14±0.02) g/min vs. (0.11±0.04) g/min, P＜0.001]. The average lateral thermal damage depth of the thulium laser + plasma group showed no statistically significant difference compared to the thulium laser group [(985.5±178.5) μm vs.(957.5±197.4) μm, P＞0.05], but both were significantly higher than that of the simple plasma group [(499.6±78.0) μm] (P＜0.001). Conclusion The thulium laser + plasma energy transmitted simultaneously by the integrated optoelectrical fiber can vaporize kidney tissue more efficiently without additional thermal damage.

Objective To study the clinical efficacy and advantages of tip-flexible semirigid ureterorenoscope combined with Holmium laser lithotripsy for the treatment of impacted upper ureteral calculi.Methods We retrospectively analyzed 75 cases of impacted upper ureteral calculi treated in our hospital between September 2015 and December 2017.There were 45 males and 30 females,aged from 35 to 65 years,mean (42.5 ± 3.5)years.All patients were diagnosed by B-ultrasound and CT with impacted upper ureteral calculi.The mean stone diameter was (1.6 ± 0.3) cm.The CT value of stone was (1 025.3 ± 215.4) HU.Tip-flexible semirigid ureterorenoscope combined with Holmium laser lithotripsy were performed in all of the cases,which were under general anesthesia with lithotomy position,to observe the successful rate of lithotripsy,operation time,intraoperative and postoperative complications,postoperative hospitalization time and stone-free rate.Results All 75 cases were successfully operated.The operation time was (38.5 ± 11.2) min.Three cases had postoperative fever.No severe perioperative complications such as septic shock,ureteral perforation or avulsion occurred.The mean hospital stay of the patients was (2.7 ± 0.4) d.A follow up by non-contrast CT scan was done 4 weeks after the procedure to evaluate the result.Sixty seven cases had stone clearances at the primary operation and the stone clearance rate was 89.3％ (67/75).Eight cases undergone ESWL and physical vibration lithecbole,the CT examination showed that the stones were cleared after 1 month.Conclusions Tip-flexible semirigid ureterorenoscope combined with Holmium laser lithotripsy in the treatment of impacted upper ureteral calculi had a definite effect,safe and comfortable for doctors.

In this study, the vaporization ratio of the 2-mum laser in the prostatic tissue with benign prostatic hyperplasia was examined in vitro, to explore a technique to estimate the clearance rate of prostatic tissue during the transurethral vaporesection of the prostate. A total of 9 fresh prostatic tissue specimens were obtained by open surgery and the wet weight of the prostatic tissue were measured immediately after the sample collection. Under the simulated conditions of transurethral vaporesection of the prostate by 2-mum laser, each prostate gland was completely vaporesected into fragments with a diameter of less than 1.0 cm in vitro. After the vaporesection, the whole fragments of prostatic tissue were collected and measured. Then the lost weight of prostatic tissue, the weight of the collected prostatic tissue and the ratio of the lost weight of prostatic tissue to the wet weight of the prostate glandular organ specimen were calculated. The correlation between the weight of collected prostatic tissue and the weight of the whole glandular organ was analyzed. All the experimental procedures were carried out by one operator. Wet weight of the prostatic gland specimen and the weight of the harvested prostatic tissues after the procedure were recorded. With respect to the wet weight of prostate gland specimen, the percentage of the weight of collected prostatic tissue was (34.45+/-1.51) %, and the percentage of the lost weight of prostatic tissue was (65.55+/-1.51)%. Satisfactory linear relationship was observed between the weight of collected prostatic tissue and the wet weight of prostate gland specimen [y=3.245x-6.475 (t=15.097, P=0.000)]. It is concluded that under the simulated conditions of transurethral vaporesection of the prostate by 2-mum laser, the vaporization ratio of prostatic tissue can be calculated on the basis of the weight of collected prostatic tissue, and thereby the clearance of prostatic tissue during the formal operation by 2-mum laser could be quantitatively determined.

In this study,the vaporization ratio of the 2-μm laser in the prostatic tissue with benign prostatic hyperplasia was examined in vitro,to explore a technique to estimate the clearance rate of prostatic tissue during the transurethral vaporesection of the prostate.A total of 9 fresh prostatic tissue specimens were obtained by open surgery and the wet weight of the prostatic tissue were measured immediately after the sample collection.Under the simulated conditions of transurethral vaporesection of the prostate by 2-μm laser,each prostate gland was completely vaporesected into fragments with a diameter of less than 1.0 cm in vitro.After the vaporesection,the whole fragments of prostatic tissue were collected and measured.Then the lost weight of prostatic tissue,the weight of the collected prostatic tissue and the ratio of the lost weight of prostatic tissue to the wet weight of the prostate glandular organ specimen were calculated.The correlation between the weight of collected prostatic tissue and the weight of the whole glandular organ was analyzed.All the experimental procedures were carried out by one operator.Wet weight of the prostatic gland specimen and the weight of the harvested prostatic tissues after the procedure were recorded.With respect to the wet weight of prostate gland specimen,the percentage of the weight of collected prostatic tissue was(34.45±1.51)%,and the percentage of the lost weight of prostatic tissue was(65.55±1.51)%.Satisfactory linear relationship was observed between the weight of collected prostatic tissue and the wet weight of prostate gland specimen[y=3.245x-6.475(t=15.097,P=0.000)].It is concluded that under the simulated conditions of transurethrai vaporesection of the prostate by 2-μm laser,the vaporization ratio of prostatic tissue can be calculated on the basis of the weight of collected prostatic tissue,and thereby the clearance of prostatic tissue during the formal operation by 2-μm laser could be quantitatively determined.

Objective To investigate the influential factors to the prognosis of senile patients with bladder cancer. Methods One hundred and forty-five senile patients with bladder cancer confirmed by pathology from 1998 to 2008 were clinically investigated and analyzed using measuring scales of Functional Living Index-Cancer (FLIC), Functional Assessment of Cancer Therapy-General (FACT-G) and Cancer Rehabilitation Evaluation System short form (CARES-SF). The factors influencing the prognosis were selected and quantified, and the relationship between the factors and prognosis was statistically analyzed. Results By retrospective analysis of clinical data, it was revealed that, suppose every 5 years from 65 were as an age grade, the age-gradient was positively correlated with the survival rates (r=0.687, P