The comparison of robot-assisted laparoscopic and open pyelolithotomy in the management of nonstaghorn renal calculi larger than 2 cm / 复旦学报（医学版）

Objective To investigate the feasibility and safety of robot-assisted laparoscopic pyelolithotomy (RALPL) as the surgical management for nonstaghorn renal calculi larger than 2 cm. Methods Among the patients admitted to our hospital for nonstaghorn renal calculi larger than 2 cm between Jun. ,2013 and Jun. ,2017, a retrospective analysis was performed on the treatment outcome of patients undergoing RALPL (48 cases) and open pyelolithotomy (OPL) (44 cases). The initial stone-free rate, mean operating time, hemoglobin drop, off-bed activity time and hospital stay were compared between two groups. Results Compared with OPL group, RALPL group had a higher initial stone-free rate (91. 66% vs. 70.45%, P < 0.05), and had significant lesser hemoglobin drop, shorter operating time, off-bed activity time and hospital stay. There was no ClavienⅡ or above complications in RALPL group, but there were 2 cases of ClavienⅡcomplications in OPL group. Conclusions Transperitoneal approach RALPL has a better visual angle to observe renal pelvis and calyces, and can ensure a higher initial stone-free rate under the conditions of low intrarenal pelvic pressure and leaving renal parenchyma and vessels intact. RALPL is a minimally invasive, effective and safe treatment, and is an alternative indication for renal calculi larger than 2 cm (including renal pelvis stones with accompanying renal calyceal stones).

Environmental and psycho-social factors related to prostate cancer risk in the Chinese population: a case-control study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the risk environmental and psycho-social factors associated to prostate cancer (PCa) in Chinese population.</p><p><b>METHODS</b>250 PCa patients and 500 controls were enrolled in this case-control study. Information was collected and logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI) for relationship between lifestyle, eating habits and psycho-social factors with PCa risk.</p><p><b>RESULTS</b>Green vegetables and green tea were associated with a decreased risk of PCa (OR=0.39, 95% CI: 0.28-0.53; OR=0.59, 95% CI: 0.40-0.87, respectively). Family history of PCa (OR=7.16, 95% CI: 2.01-25.49), history of prostate diseases (OR=2.28, 95% CI: 1.53-3.41), alcohol consumption (OR=1.97, 95% CI: 1.33-2.90), red meat consumption (OR=1.74, 95% CI: 1.20-2.52), barbecued (OR=2.29, 95% CI: 1.11-4.73) or fried (OR=2.35, 95% CI: 1.24-4.43) foods were related with increased PCa risk. Negative psycho-social factors including occupational setbacks (OR=1.61, 95% CI: 1.00-2.59), marital separation (OR=1.94, 95% CI: 1.29-2.91), self-contained suffering (OR=2.37, 95% CI: 1.58-3.55), and high sensitivity to the personal comments (OR=1.73, 95% CI: 1.18-2.54) were related to PCa.</p><p><b>CONCLUSION</b>Regular consumption of green vegetables and green tea may suggest protective effects on PCa. Alcohol consumption, red meat consumption and barbecued or fried foods were associated with PCa. Negative psycho-social factors may also play a role in the incidence of PCa in Chinese population.</p>

On-demand versus on-time dosing of tadalafil for erectile dysfunction: a prospective multi-center study / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of tadalafil on demand and on time in men with erectile dysfunction.</p><p><b>METHODS</b>We conducted a multi-centered randomized controlled study on 120 ED males, who were assigned to take tadalafil at 10 mg/ 20 mg on demand before sexual activity and at the same dose on time twice a week for 8 weeks. Before and at 4 and 8 weeks after treatment, and 1 month after withdrawal, we obtained the scores on IIEF-5, ED Inventory of Treatment Satisfaction (EDITS) and the short form of Psychological and Interpersonal Relationship Scales (SF-PAIRS) , and compared the safety and efficacy of medication between the two groups of patients.</p><p><b>RESULTS</b>Totally, 110 patients accomplished the trial, 56 in the on-time and 54 in the on-demand group. At 4 and 8 weeks of medication and 1 month after withdrawal, the IIEF-5 scores were improved in both the on-time and on-demand groups, even more significantly in the former than in the latter at 8 weeks of treatment (21.6 +/- 2.9 vs 18.5 +/- 1.7) and 1 month after withdrawal (20.9 +/- 2.1 vs 17.9 +/- 2.3) (P < 0.05). The EDITS scores were significantly higher in the on-time than in the on-demand group at 8 weeks of treatment (31.7 +/- 6.9 vs 28.6 +/- 5.8) and 1 month after withdrawal (30.6 +/- 4.7 vs 27.9 +/- 6.5) (P < 0.05). The scores on the sexual self-confidence, spontaneity and time-concern domains of SF-PAIRS were remarkably improved after medication as compared with the baseline (P < 0.05), even more significantly in the on-time than in the on-demand group at 1 month after withdrawal. Both dosing schedules were well tolerated and no significant differences were observed in safety between the two groups.</p><p><b>CONCLUSION</b>On-time dosing of tadalafil is efficacious and well tolerated in the treatment of ED, and has an even better effect than on-demand dosing at 8 weeks of medication and 1 month after withdrawal.</p>

Causes, location and management of BPH surgery-related urethral stricture / 中华男科学杂志

<p><b>OBJECTIVE</b>To analyze the possible causes of BPH surgery-related urethral stricture and summarize the experience in its clinical management.</p><p><b>METHODS</b>The clinical data of 37 cases of BPH surgery-related urethral stricture were analyzed retrospectively. The patients averaged 68.5 years in age, of whom 12 had the history of open surgery, and 25 transurethral surgery. Anterior urethral stricture was found in 6 cases, and posterior urethra in stricture 31. Thirty-five cases were treated by holmium laser urethrotomy (HLU) or a combination of HLU with transurethral resection of the scar in the stenotic segment, and the results were evaluated based on the maximum flow rate (Qmax).</p><p><b>RESULTS</b>Two cases of full penile urethral stricture were treated by urinary diversion, and all the rest by urethral stricture surgery. Catheters were indwelt in 4 cases of urethral stenosis for 5-7 days post-operatively, and smooth urination was achieved after their removal, with a Qmax of > 15 ml/s. Another 31 cases of membranous urethral stricture received catheter indwelling of 2 -4 weeks and were followed up for 1 - 21 (mean 11. 5) months, of whom 23 experienced satisfactory voiding, with an average Qmax of 14.3 ml/s, and the other 8 poor voiding, with a Qmax of < 8 ml/s.</p><p><b>CONCLUSION</b>HLU or a combination of HLU with transurethral resection of the scar in the stenotic segment is an effective method for the treatment of BPH surgery-related urethral stricture. And conscientiously performed BPH surgery can reduce the incidence of urethral stricture.</p>

The position of bone bridge after alveolar cleft bone grafting / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the outcome of alveolar cleft bone grafting using dental 3D-CT, and identify the position of the bone bridge.</p><p><b>METHODS</b>Eighteen unilateral complete alveolar cleft patients were chosen in this study and using dental 3D-CT to evaluate the position of the bone bridge after thee month bone graft. The alveolar cleft was divided at several section, the bone bridge position were checked, and the position of graft bone bridge were calculated.</p><p><b>RESULTS</b>In mesial and distal direction, there was no difference between mesial and distal bone bridge (P > 0.05). In labial and palatal direction, labial bone bridge was more than palatal bone bridge (P < 0.001). In venial direction, bone bridge which at one third of apical root and middle root of the central incisor root, was more than bone bridge which at alveolar crest and nasal base.</p><p><b>CONCLUSION</b>After secondary alveolar bone graft, bone bridge in alveolar cleft position is most located at labial and apical third and middle third of the central incisor root.</p>

Classification and surgical treatment of the deviated nose with unilateral cleft lip / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To present a classification of the deviated nose with unilateral cleft lip and the associated surgical correction.</p><p><b>METHODS</b>A total of 176 cases of nasal deformities with unilateral cleft lip treated in Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine & Shanghai Research Institute of Stomatology & Shanghai Key Laboratory of Stomatology from 2007 to 2009 were analyzed. Depending on the relationship between the external pyramid and the facial midline, the nasal deviations with cleft lip were classified into 3 types: I, deviated bony pyramid, II, deviated cartilaginous pyramid; III, deviated lobular. The surgical treatment included surgical correction of deviated bony pyramid, deviated cartilaginous pyramid, deviated lobular and deviated septa.</p><p><b>RESULTS</b>Among the 176 patients, there were 97 males and 79 females, aging from 16 to 42 years with a mean of 20. There were 93 patients without deviated and 83 patients with deviated. Among the 83 deviated patients, deviated bony pyramid was found in 8 (10%), deviated cartilaginous pyramid in 29 (35%), deviated lobular in 46 (55%). Most patients who underwent surgical correction were satisfied.</p><p><b>CONCLUSIONS</b>There were nearly half of the unilateral cleft lip nasal deformity presenting with deviated noses. There was least deviated bony pyramid and most deviated lobular in the unilateral cleft lip deviated nose. The proposed classification for the deviated nose with unilateral cleft lip could serve as a practical guide for surgical planning.</p>

Evaluation of bone volume of alveolar cleft before and after bone graft / 华西口腔医学杂志

<p><b>OBJECTIVE</b>The aim of this study was to evaluate the changing of alveolar cleft bone volume before and after bone graft.</p><p><b>METHODS</b>11 complete unilateral alveolar cleft patients were scanned with dental CT before bone graft surgery and 3 months after surgery. Matlab7.0 software was used to calculate the bone volume of alveolar cleft before bone graft and bone bridge volume after bone graft. The method was clockwise identify the irregular area of alveolar cleft by several points at different vertical level, then calculated the irregular area of alveolar cleft and the volume of alveolar cleft using Matlab7.0 software. The volume of implant bone was evaluated with same method after 3 months surgery. The ratio of graft bone bridge volume and alveolar cleft volume was calculated.</p><p><b>RESULTS</b>The maximum ratio of bone bridge volume and alveolar cleft volume was 114.99%, the minimum ratio was 13.36%. The average ratio was 71.80%, coefficient variation was 47.987.</p><p><b>CONCLUSION</b>Bone bridge volume after bone graft is varying.</p>

The clinical characteristic of adrenal metastatic tumor / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the clinical features of adrenal metastasis.</p><p><b>METHODS</b>From January 1993 to December 2004, 103 cases of adrenal metastasis were reviewed.</p><p><b>RESULTS</b>Lung and hepatocellular carcinoma were the most common primary tumor of adrenal metastatic tumor, which about 36.9% (38/103) and 42.7% (44/103) of all cases, followed by renal carcinoma 6.8% (7/103), colorectal carcinoma 4.9% (5/103), stomach carcinoma 3.9% (4/103), breast cancer 1.9% (2/103), unknown primary tumor 2.9% (3/103). Most of these were low differentiation. The mean diameter of adrenal metastasis was 3.9 cm. The mean interval from detection of primary tumor to adrenal metastasis was 9.5 months. And 79.6% (82/103) were detected as a part of multiorgan metastasis. Only 5 cases (4.9%) were presented with pain in the back. There was little characterization of ultrasonography, CT and MRI, color-Doppler and selective arterial imaging showed little blood supply. All of patients were treated with synthetic methods, 16 cases (15.5%) who had undergone adrenalectomy for metastasis disease had a improved survival compared with those non-adrenalectomy.</p><p><b>CONCLUSIONS</b>There is no particular presentation of clinic and imaging, diagnosis depending on history, follow-up and the pathological presentation of primary tumor. There are no standard treatment guidelines for this group of patients. When the primary tumor could be resected or be well controlled, and there is no other evidence of metastasis, adrenalectomy is recommended. Transarterial chemoembolization (TACE) could not actually be performed.</p>

Evaluation of soft tissue profile in 20 adults with unoperated isolated cleft palate / 上海第二医科大学学报

Objective To evaluate the soft tissue profile in adults with unoperated isolated cleft palate. Methods Twenty patients older than 16 years(median age,18.4) with unoperated isolated cleft palate were enrolled.Soft tissue lateral cephalograms were traced and compared with those of cleft operated patients and class-Ⅰocclusion individuals.The results of various measurements were analyzed with ANOVA by SPSS11.5. Results In adults with unoperated isolated cleft palate,there was restriction at the top of the upper lip,and the antelabrum of upper lip and the lower lip were found normal. Conclusion The soft tissue profile in adults with unoperated isolated cleft palate exhibits almost the same characteristics as the corresponding hard tissue,and there is covering over effect of the soft tissue to some extent.

Correlation between integrin subunits alpha5 and beta1 expressions in prostate cancer and its clinical implication / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the correlation between the expression of integrin subunits alpha5 and beta1 in prostate cancer (PCa) and its clinicopathological data including tumor grade and clinical stage.</p><p><b>METHODS</b>Expressions of integrin subunits alpha5 and beta1 were examined in 30 cases of PCa and 30 cases of normal prostatic tissues by immunohistochemical assay.</p><p><b>RESULTS</b>Expressions of integrin subunits alpha5 and beta1 in PCa were lower than those in normal prostatic tissues (P <0.05) respectively.</p><p><b>CONCLUSION</b>Compared with normal prostatic tissues, expressions of integrin subunits alpha5 and beta1 in PCa were rather weaker or even faded. Expressions of integrin subunits alpha5 and beta1 revealed an positive correlation with tumor's Gleason grade and negative with clinical TNM stage. The results indicate that integrin subunits alpha5 and beta1 have potential values in the diagnosis and are predictable indices in the proliferation of PCa.</p>

Effect of epidermal growth factor signal pathway on integrin alpha5 beta1 in prostate cancer cell line DU145 / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the molecular mechanism of epidermal growth factor (EGF) signal pathway on the expression of integrin alpha5 beta1 in prostate cancer cell line DU145.</p><p><b>METHODS</b>Using flow-cytometry, the effects of EGF and the mitogen-activated protein kinase (MAPK) signal pathway inhibitor PD98059 on the expression of integrin alpha5 and beta1 subunits on DU145 cell surface were analyzed. RT-PCR and Western blot methods were used to examined the expression of mRNA and cell total protein of integrin alpha5 and beta1 subunits. And the metastatic phenotypes in DU145 cell were investigated.</p><p><b>RESULTS</b>The expression levels of integrin alpha5 beta1, which was the receptor for fibronectin, were changed. EGF up-regulated the protein and mRNA expression of beta1 subunit on DU145 cell surface, 231% and 248% (P < 0.01) compared to the control respectively, and it could significantly promote the ability of DU145 cell adhesion to fibronectin and migration. However PD98058, which was the inhibitor of MAPK signal pathway, down-regulated the protein and mRNA expression of beta1 subunit, 60% and 63% (P < 0.01) compared to the control respectively, and it had the contrary function on the adhesion and migration ability of DU145 cell. But both had no effect the expression of alpha5 subunit.</p><p><b>CONCLUSIONS</b>EGF might promote the metastatic ability mainly by up-regulating the expression of beta1 subunit by activating MAPK signal pathway in DU145 cells. Their regulation effects are on the mRNA transcriptional level.</p>

Prostate sarcoma: a report of 14 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To discuss the diagnosis and effective treatment of prostate sarcoma.</p><p><b>METHODS</b>We analysed the clinical materials of fourteen patients with prostate sarcoma treated in our hospital from Jan. 1991 to Jun. 2004.</p><p><b>RESULTS</b>Prostate sarcoma accounted for 3.21% of all the prostatic malignant tumors treated in our hospital during that period. The average age was 39.5 years old (ranging from 17 to 62). Twelve cases came to our hospital because of dysuria. Large soft prostate tumors were found in all the patients in physical examination. The serum AKP, ACP and PSA levels were normal in all the 10 patients who had received the test. Pathological test revealed: 7 cases leiomyosarcoma, 1 case rhabdomyosarcoma, 4 cases fibrosarcoma, 2 cases spindle cell sarcoma. Different kinds of prostate sarcoma each his its own immuno-histochemical staining features. Two cases were at Ghavimi Stage I, 5 at Stage II, 3 at Stage III, and 4 at Stage IV. All the patients received surgery, chemotherapy and/or radiotherapy. One case failed to be followed up, 11 died 2 approximately 12 months after diagnosis. Two patients are still alive, 1 for 18 months without recurrence, and the other for through with relapse.</p><p><b>CONCLUSION</b>Dysuria is always the first symptom of prostate sarcoma. DRE test may suggest prostate sarcoma but needle biopsy contributes to a definite diagnosis. The immuno-histochemical dyeing helps to differentiate the disease. The prognosis of prostate sarcoma is very poor and the main treatment is surgery followed by chemotherapy and/or radiotherapy.</p>

Primary study of pharyngeal flap surgery in congenital velopharyngeal insufficiency / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study effective operation method of congenital velopharyngeal insufficiency by reviewing clinical data of 29 patients with pharyngoplasties.</p><p><b>METHODS</b>29 patients (9 male and 20 female, ranged from 4 to 25 years old, mean age was 13.5) with congenital velopharyngeal insufficiency were available for this study. All cases received Chinese speech intelligibility test and blowing test before and after the pharyngeal flap surgery.</p><p><b>RESULTS</b>Chinese speech intelligibility of 29 cases who underwent pharyngoplasties was improved from 33.86% to 43.13%, and the blowing time was increased from 4.60 to 17.72 seconds, the degree of abnormal speech was reduced.</p><p><b>CONCLUSION</b>The pharyngeal flap surgery is an effective method for congenital velopharyngeal insufficiency, which reduces hypernasality and increases oral pressure, improves the velopharyngeal function.</p>

The evaluation of the Chinese intelligibility of patients with velopharyngeal incompetence / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To study the Chinese intelligibility of patients with velopharyngeal incompetence (VPI).</p><p><b>METHODS</b>100 patients with VPI and 32 normal students were selected for this study. Of 10 patients, 15 with cleft palate, 21 with congenital velopharyngeal incompetence, 56 with post-palatoplasty VPI and 8 with post-pharyngoplasty VPI. Chinese intelligibility was measured by three speech pathologists and relation between degree of abnormal articulation and Chinese intelligibility were studied.</p><p><b>RESULTS</b>Chinese intelligibility of the controls was 99.0% and the patients with VPI were 35.2%. Of the patients, the cleft palate was 19.9%, the congenital velopharyngeal incompetence was 32.8%, the post-palatoplasty VPI was 40.3% and the post-pharyngoplasty VPI was 35.2%. The data showed obvious difference among the controls and sub-types of VPI (P < 0.01).</p><p><b>CONCLUSIONS</b>(1) Chinese intelligibility of VPI accompanied with hypernasality is worse. (2) Of misarticulation of VPI, the cleft palate is the worst, in turn the others are the congenital velopharyngeal incompetence, the post-pharyngoplasty VPI and the post-palatoplasty VPI.</p>

CT assist in surgical design for the posterior pharyngeal flap / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To establish a method for assist design of the posterior pharyngeal flap (PPF).</p><p><b>METHODS</b>The width, length of velopharyngeal space in repose and phonation of "i" in 26 cases with VPI were measured with CT. The width and length of PPF needed, the location of the pedicle and the contact position with the soft palate were analyzed.</p><p><b>RESULTS</b>The width of velopharyngeal space in repose ranged from 15.10 to 37.25 mm, with the average of 27.01 mm, the length was 12.54 to 30.39 mm, with the average of 22.10 mm. The width in phonation of "i" was 9.11 to 34.06 mm, with the average of 17.69 mm, the position of the pedicle wasall located at the level of the first cervical vertebra or above and the contact area of the flap with the soft palate was in the middle posterior 1/3 mostly.</p><p><b>CONCLUSION</b>As a method to quantitatively evaluate velopharyngeal function, CT can assist in design for the PPF.</p>

An experimental study on high intensity focused ultrasound combined with mitomycin treatment of bladder tumor / 中华外科杂志

<p><b>OBJECTIVE</b>To study the therapeutic effect and synergistic inhibition effect of high intensity focused ultrasound in combination with mitomycin on T739 mice bladder tumor.</p><p><b>METHODS</b>BTT739 tumor-bearing mice receiving HIFU and/or mitomycin in two weeks, were divided into control group, low dose chemotherapy group, high dose chemotherapy group, HIFU group and HIFU combined chemotherapy group. The growth of mice tumor volume was observed in two weeks, by which we counted tumor volume doubling time and performed the growth curve. All specimens were analysed histologically.</p><p><b>RESULTS</b>HIFU combined mitomycin has significant synergistic inhibition effect. Tumor tissue damage such as huge coagulation necrosis was observed using light microscopy. However, there were still some remaining alive cells. The apoptosis of tumor cell in HIFU group and HIFU combined chemotherapy group obviously increased in comparison with other groups.</p><p><b>CONCLUSIONS</b>HIFU group, HIFU combined chemotherapy group can distinctively inhibit tumor growth; HIFU combined with mitomycin has notable synergistic inhibitory effect. HIFU may induce the apoptosis of tumor cell.</p>

Applied anatomy of the path of retroperitoneal laparoscopy surgery / 中华外科杂志

<p><b>OBJECTIVE</b>To discover the anatomical basis of retroperitoneal laparoscopic surgery.</p><p><b>METHODS</b>Twenty Chinese adult cadavers including 12 and 8 woman were anatomized. The relationship between nerves, vessels of the lateral abdominal wall, retroperitoneal structures and the path of retroperitoneal laparoscopic surgery were measured.</p><p><b>RESULTS</b>In male cadavers, the distance between the iliac crest and lumbar trigonum was 4.02 +/- 1.26 cm on the left, and 3.83 +/- 0.90 cm an the right. The distance between the iliac crest and ilio-hypogastric nerve was 0.82 +/- 0.13 cm on the left and 0.84 +/- 0.08 cm on the right. The distance between the subcostal nerve and XII rib in the posterior axillary line and midaxilla line was 0.79 +/- 0.26 cm, 1.65 +/- 1.12 cm on the left and 0.78 +/- 0.30 cm, 1.59 +/- 1.07 cm on the right respectively. The distance between the ureter of inferior pole of kidney and extra-border of psoas was 2.24 +/- 0.67 cm on the left and 2.19 +/- 0.73 cm on the right. The distance between crossing of the ureter and iliac vessels and extra-border of psoas was 3.91 +/- 0.59 cm on the left and 3.76 +/- 0.53 cm on the right. In female cadavers, the distance between the iliac crest and trigonum lumbale was 3.90 +/- 0.37 cm on the left and 3.87 +/- 0.37 cm on the right. The distance between the iliac crest and ilio-hypogastric nerve was 0.94 +/- 0.06 cm on the left and 0.93 +/- 0.10 cm on the right. The distance between the subcostal nerve and XII rib in the posterior axillary line and midaxilla line was 0.61 +/- 0.14 cm and 1.37 +/- 0.89 cm on the left and 0.64 +/- 0.13 cm, 1.32 +/- 0.95 cm on the right respectively. The distance between the ureter of inferior pole of kidney and extra-border of psoas was 2.00 +/- 0.23 cm on the left and 1.91 +/- 0.13 cm on the right. The distance between crossing of the ureter and iliac vessels and extra-border of psoas was 3.43 +/- 0.31 cm on the left and 3.85 +/- 0.43 cm on the right.</p><p><b>CONCLUSIONS</b>The top of the lumbar trigonum which is 2 cm above the iliac crest selected as the first point and 2 cm inferior to the XII rib in the posterior axillary line selected as the second point is the anatomical basis for retroperitoneal laparoscopic surgery. It can reduce the opportunity to injury nerves, vessels and retroperitoneal structures while making retroperitoneal laparoscopic surgery easy.</p>

The recent study and key technologies of an aided endoscopic surgical robot system / 中国医疗器械杂志

This paper introduces the recent study and development of an aided endoscopic surgical robot system, and discusses its future trends--teleoperative robot system and telesurgery system. In addition, their key technologies are analyzed here in the paper.