Triaging patients in the outbreak of COVID-2019 / 中国感染控制杂志

In the outbreak of COVID-19,triage procedures based on epidemiology were implemented in a local hospital in Changsha to control the transmission of SARS-CoV-2 and avoid healthcare-associated infection.This re-trospective study analyzed the data collected during the triage period and found that COVID-19 patients were en-riched 7 folds into the Section A designated for patients with obvious epidemiological history.On the other side,nearly triple amounts of visits were received at the Section B for patients without obvious epidemiological history.8 COVID-19 cases were spotted out of 247 suspected patients.More than 50％of the suspected patients were submi-tted to multiple rounds of nucleic acid analysis for SARS-CoV-2 infection.Of the 239 patients who were diagnosed as negative of the virus infection,188 were successfully revisited and none was reported as COVID-19 case.Of the 8 COVID-19 patients,3 were confirmed only after multiple rounds of nucleic acid analysis.Besides comorbidities,delayed sharing of epidemiological history added complexity to the diagnosis in practice.The triaging experience and strategy will be helpful for the control of infectious diseases in the future.

Research progress of follow-up monitoring design in mega cohort / 中华流行病学杂志

With the increasing demand to study the cause of complex diseases, mega cohort has gradually replaced the traditional small sample cohort and become the hotspot of epidemiological research. Follow-up is the essential step in a cohort study to obtain the information about the onset and death of diseases, migration or loss of follow-up of the cases. Its quality has a direct impact on the conclusions of cohort study. Therefore, it is necessary to develop a reasonable follow-up monitoring program for a mega cohort.In this paper, we summarized the contents and methods of the follow-up monitoring program in the mega cohorts at home and abroad, which aimed to provide suggestions for the new cohort and improve the follow-up program for the existing cohort.

Pedicle Subtraction Osteotomy with a Cage Prevents Sagittal Translation in the Correction of Kyphosis in Ankylosing Spondylitis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Sagittal translation (ST) is an accidental event that surgeons commonly encounter during a spinal osteotomy in the correction of kyphosis in ankylosing spondylitis (AS). However, there is a paucity of effective techniques to prevent ST. The purpose of this study was to propose a pedicle subtraction osteotomy (PSO) with a cage as a method to prevent ST and to explore the efficacy and feasibility of this method in the treatment of kyphosis in AS.</p><p><b>METHODS</b>We retrospectively reviewed 89 consecutive patients with AS kyphosis who underwent a PSO (Group B, 46 patients) or a PSO with a cage (Group A, 43 patients) from February 2009 to December 2013. Pre- and post-operative radiographic results were reviewed. ST and complications were analyzed in both groups. Clinical assessment was performed using the Scoliosis Research Society-22 (SRS-22) outcomes metric. The patients were followed up for at least 2 years.</p><p><b>RESULTS</b>Group A achieved the same re-alignment of the kyphotic spine as Group B. Two (4.7%) of the 43 patients in Group A and 14 (30.4%) of the 46 patients in Group B had intraoperative ST (χ2 = 10.020, P = 0.002). Significant differences were identified between the two groups in the height change of the osteotomized column. SRS-22 scores improved significantly in both groups. Seven patients experienced neurologic complications (1 in Group A and 6 in Group B). Eight patients had cerebrospinal fluid leakage (2 in Group A and 6 in Group B).</p><p><b>CONCLUSION</b>PSO with a cage significantly avoided ST during the osteotomy procedure and might represent a new, safe, and feasible choice for treating patients with AS kyphosis.</p>

Effect of calcium sodium phosphosilicate and potassium nitrate on dentin hypersensitivity: a systematic review and Meta-analysis / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This systematic review and Meta-analysis aimed to compare the efficacy of calcium sodium phos-phosilicate (CSPS) and potassium nitrate as desensitizing agents for the treatment of dentin hypersensitivity (DH).</p><p><b>METHODS</b>A thorough search in The Cochrane Library, PubMed, Embase, Chinese WanFang Data, CBM, and CNKI were conducted for studies published up to June 2017. Randomized controlled trials (RCTs) of the treatment of DH with CSPS and potassium nitrate toothpaste were included. Quality assessment and data extraction were performed by two reviewers independently, and Meta-analysis was performed by using RevMan 5.3 software.</p><p><b>RESULTS</b>Eight RCTs involving 411 patients were included. Experimental group comprised 203 and control group had 208 patients. The Meta-analysis indicated the superior effect of CSPS dentifrice on air blast sensitivity at 2, 4, 6, and 8 weeks of follow-up [SMD=-1.85, 95%CI (-2.89, 
-0.81), P=0.000 5, I²=93%], [SMD=-1.61, 95%CI (-1.96, -1.26), P<0.000 01, I²=49%], [SMD=-3.79, 95%CI (-7.18, -0.40), P=0.03, I²=98%], and [SMD=-2.13, 95%CI (-2.69, -1.58), P<0.000 01] , respectively. No significant effects were seen at 12 weeks [SMD=-0.63, 95%CI (-1.47, 0.20), P=0.14, I²=71%]. CSPS dentifrice showed a better desensitizing effect at 2, 4, 6, 8, and 12 weeks of follow-up on cold water sensitivity [SMD=-1.07, 95%CI (-1.48, -0.66), P<0.000 01, I²=69%], [SMD=
-1.29, 95%CI (-1.81, -0.76), P<0.000 01, I²=64%], [SMD=-1.20, 95%CI (-1.57, -0.83), P<0.000 01, I²=86%], [SMD=-1.30, 95%CI (-2.51, -0.08), P=0.04, I²=82%], and [SMD=-0.79, 95%CI (-1.27, -0.31), P=0.001], respectively. No significant effects at 1 week of follow-up [SMD=0.00, 95%CI (-0.62, 0.62), P=1]. The favorable effect of CSPS dentifrice on tactile sensitivity was more obvious than the control group at 2, 4, and 8 weeks of follow-up [SMD=-1.31, 95%CI (-2.00, -0.62), P=0.000 2, I²=67%], [SMD=-1.37, 95%CI (-1.74, -0.99), P<0.000 01, I²=23%], and [SMD=-1.33, 95%CI (-1.82,-0.84), P<0.000 01], respectively. No significant effects at 1 week of follow-up [SMD=-0.32, 95%CI (-0.94, 0.31), P=0.32] were observed.</p><p><b>CONCLUSIONS</b>Current evidence indicated that CSPS was more effective than potassium nitrate at reducing DH. The evidence generated by this review was based on a small number of individuals. High-quality and large sample size as well as ideally-designed clinical trials are required in the future before definitive recommendations can be made.</p>

Histological structure of the trabecular meshwork in the eyeball: challenging the traditional concept and preliminary findings in rabbits, rats and mice / 南方医科大学学报

<p><b>OBJECTIVE</b>To verify that the trabecular meshwork (TM) in the wall of the eyeball consists of smooth muscle fibers instead of collagen fibers or endothelial cells.</p><p><b>METHODS</b>Eighteen fresh eyeballs from 3 rabbits, 3 SD rats and 3 mice were sectioned along the sagittal plane and sliced after paraffin embedding for HE staining, VG staining, Masson staining, α-SMA immunohistochemistry or CD31 immunohistochemistry. These slices were observed under microscope and the structure of the TM was compared with those of scleral collagen fibers, ciliary muscles and endothelial cells.</p><p><b>RESULTS</b>HE staining of the eyeball slices from the 3 animal species resulted in purplish red staining of the TM, which was highly consistent with ciliary muscle fibers. The cell?like structures on the surface of the TM were not clearly outlined, with flat nuclei showing a dark purple staining; these structures did not show obvious boundaries from the TM. Ciliary muscle fibers, which were smooth muscle cells in nature, were aligned in bundles in various directions. The longitudinally sectioned cells were flat and contained purplish cytoplasm and highly flattened nuclei. Scleral collagen fibers were stained dark red with a few fibroblasts sandwiched among them. The long axis of the fibroblasts was in parallel with that of the collagen fibers. The outline of the fibroblast was not clear and the nucleus was flat in dark blue. The vascular endothelial cells presented with different morphologies and contained light purplish cytoplasm and dark nuclei, protruding into the vascular cavity. VG staining of the TM revealed a pale red filamentous structure, and the collagen fibers were stained bright red. Masson staining of the TM showed a reticular structure consisting mainly of dark red fibers intermingled with thin green fibers. Scleral collagen fibers presented with a cord?like green wavy structure. The endothelial cells were green and flat, while the ciliary smooth muscle fibers were purple. In immunohistochemistry for α?SMA, the TM and the ciliary smooth muscle fibers showed a strong positivity in the cytoplasm, while the scleral collagen fibers and vascular endothelial cells showed negative staining; immunohistochemistry for CD31 showed no obvious positive staining in the TM, collagen fibers or ciliary smooth muscle cells from all the animals in spite of slight differences among them.</p><p><b>CONCLUSION</b>The TM consists mainly of smooth muscle fibers with a thin layer of peripheral endomysium without endothelial cells.</p>

Circulating-free DNA Mutation Associated with Response of Targeted Therapy in Human Epidermal Growth Factor Receptor 2-positive Metastatic Breast Cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The addition of anti-human epidermal growth factor receptor 2 (HER2)-targeted drugs, such as trastuzumab, lapatinib, and trastuzumab emtansine (T-DM1), to chemotherapy significantly improved prognosis of HER2-positive breast cancer patients. However, it was confused that metastatic patients vary in the response of targeted drug. Therefore, methods of accurately predicting drug response were really needed. To overcome the spatial and temporal limitations of biopsies, we aimed to develop a more sensitive and less invasive method of detecting mutations associated with anti-HER2 therapeutic response through circulating-free DNA (cfDNA).</p><p><b>METHODS</b>From March 6, 2014 to December 10, 2014, 24 plasma samples from 20 patients with HER2-positive metastatic breast cancer who received systemic therapy were eligible. We used a panel for detection of hot-spot mutations from 50 oncogenes and tumor suppressor genes, and then used targeted next-generation sequencing (NGS) to identify somatic mutation of these samples in those 50 genes. Samples taken before their first trastuzumab administration and subsequently proven with clinical benefit were grouped into sensitive group. The others were collected after disease progression of the trastuzumab-based therapy and were grouped into the resistant group.</p><p><b>RESULTS</b>A total of 486 single-nucleotide variants from 46 genes were detected. Of these 46 genes, phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), proto-oncogene c-Kit (KIT), and tumor protein p53 (TP53) were the most common mutated genes. Seven genes, including epidermal growth factor receptor (EGFR), G protein subunit alpha S (GNAS), HRas proto-oncogene (HRAS), mutL homolog 1 (MLH1), cadherin 1 (CDH1), neuroblastoma RAS viral oncogene homolog (NRAS), and NOTCH1, that only occurred m utations in the resistant group were associated with the resistance of targeted therapy. In addition, we detected a HER2 S855I mutation in two patients who had persistent benefits from anti-HER2 therapy.</p><p><b>CONCLUSION</b>Targeted NGS of cfDNA has potential clinical utility to detect biomarkers from HER2-targeted therapies.</p>

The Expression of Cav1.3 Calcium Channels in Adult Rat Cochlea / 听力学及言语疾病杂志

Objective To investigate the expression of Cav 1.3 calcium channel in adult rat cochlea and study its role in auditory physiology and pathology.Methods The sprague-dawley rats were used as experimental subjects.The distribution of Cav1.3 calcium channel in the cochlea was detected by immunofluorescence technique.The expression of Cav1.3 was measured with Western blot (WB) and RT-PCR.Results Immunofluorescence photographs revealed that Cav 1.3 calcium channel localized in the lateral wall membrane,hair cells,stria vascularis,spiral ganglion cell,spiral ligment,spiral prominence,and limbus laminae spiralis.The results of WB and RT-PCR inform Cav1.3 calcium channel gene (CACNA1D) were measured in the cochlea and kidney.The expression of Cav1.3was mainly in the basilar membrane.Moderate expression was observed in the spiral ganglion and stria vascularis.Conclusion The preliminary study revealed the distribution of Cav 1.3 calcium channel gene(CACNA1D)in adult rat cochle possesses tissue specificity,providing a theoretical basis for further research in auditory physiology and pathology.

The effect of miR-124 on homocysteine-induced atherosclerosis via promoter region DNA methylation in ApoE(-/-) mice / 生理学报

The aim of the present study is to explore the role of miR-124 and its promoter region DNA methylation in homocysteine (Hcy)-induced atherosclerosis. ApoE(-/-) mice were fed with hypermethionine diet for 16 weeks to duplicate hyperhomocysteinemia model. Meanwhile, a normal control group (C57BL/6J mice fed with normal diet, N-control) and a model control group (ApoE(-/-) mice fed with normal diet, A-control) were set. The degree of atherosclerosis was observed by HE and oil red O staining. Automatic biochemical analyzer was used to detect the serum levels of Hcy. Foam cell model was duplicated and oil red O staining was used to confirm whether the model was successfully established. And foam cells were stimulated with 0, 50, 100, 200, 500 μmol/L Hcy and 50 μmol/L Hcy + 10 μmol/L AZC respectively. Real-time quantitative PCR (RT-qPCR) was used to detect the expressions of miR-124 in mice aorta and foam cells; Nested landing methylation specific PCR (nMS-PCR) was used to detect the levels of miR-124 promoter DNA methylation in mice aorta and foam cells. Meanwhile, the effects of DNA methylation inhibitor AZC on miR-124 expression were observed at the cellular level. The effect of miR-124 promoter DNA methylation status on lipid accumulation in foam cells was observed by oil red O staining. The results showed that compared with model control group, the serum levels of Hcy in high methionine group were significantly increased (P < 0.01) and developed aortic atherosclerotic plaque, the expression of miR-124 was markedly decreased (P < 0.01), while the levels of miR-124 promoter DNA methylation were significantly increased (P < 0.01). Given different levels of Hcy, the expression of miR-124 in foam cells was decreased, while the levels of miR-124 promoter DNA methylation were increased in a dose-dependent manner (P < 0.05, P < 0.01). AZC reversed the results of mentioned indices as above markedly (P < 0.05). Downregulation of miR-124 may play a role in Hcy-induced atherosclerosis and its promoter DNA methylation status may be an important mechanism in this process.

Risk of Trastuzumab-Related Cardiotoxicity in Early Breast Cancer Patients: A Prospective Observational Study / 한국유방암학회지

PURPOSE: In the present study, we investigated the incidence of cardiotoxicity within 5 years of trastuzumab treatment and evaluated potential risk factors in clinical practice. METHODS: The study cohort included 415 patients diagnosed with early breast cancer (EBC). Cardiotoxicity incidence was evaluated in patients receiving trastuzumab and those who did not. Multivariate Cox proportional hazards regression models were used to estimate hazard ratios and 95% confidence intervals of potential risk factors for trastuzumab-related cardiotoxicity after appropriate adjustments. RESULTS: Incidence of cardiotoxicity in patients treated with trastuzumab was significantly higher than that in controls (23.7% vs. 10.8%, p<0.001). This result was adjusted for factors that might increase the risk of cardiotoxicity, such as history of coronary artery diseases or the use of anthracyclines for more than four cycles. CONCLUSION: Our findings indicated that treatment with trastuzumab was strongly associated with cardiotoxicity in EBC patients.

Structure-based identification of drug-like inhibitors of p300 histone acetyltransferase / 药学学报

A growing body of evidence suggests that p300 histone acetyltransferase plays important roles in cancer cell differentiation and proliferation. Here, we employed structure-based hierarchical virtual screening method to identify novel lead compounds of p300 histone acetyltransferase. From a screening library containing approximate 100 000 diverse druglike compounds, 33 compounds were chosen for experimental testing and one compound, 4-acetyl-2-methyl-N-morpholino-3,4-dihydro-2H-benzo[b][1, 4]thiazine-7-sulfonamide (17), showed as micromolar inhibitor. Based on its predicted binding pose, we investigated its binding characteristics by designing two series of structural modifications. The obtained structure-activity relationship results are consistent with the predicted binding model. We expect that the identified novel p300 histone acetyltransferase inhibitors will serve as starting points for further development of more potent and specific histone acetyltransferase inhibitors.

Molecular mechanism of FGF8b regulation of epithelial-mesenchymal transition in prostate cancer cells / 中南大学学报(医学版)

OBJECTIVE@#To explore the molecular mechanism of fibroblast growth factor 8b (FGF8b) in promoting epithelial-mesenchymal transition in prostate cancer DU145 cells.@*METHODS@#Cells were selected in three groups as follows: a block control group (DU145 cells), a negative control group [DU145 cells transfected with empty plasmid (pcDNA3.1/DU145)], and an experimental group [DU145 cells transfected with FGF8b (FGF8b/DU145)]. The activity of extracellular regulated protein kinases1/2( ERK1/2) pathway was detected by western-blot in the three groups. The FGF8b-DU145 cells and DU145 cells were cultured with PD98059 (an ERK kinase inhibitor) to observe microscopically the morphology changes within the cells. The experimental samples were also divided into four groups: FGF8b/DU145 cells cultured with 2% FBS (Group A); FGF8b/DU145 cells cultured with 2% FBS+PD98059 (50 μmol/L) (Group B); DU145 cells cultured with 2% FBS (Group C); DU145 cells cultured with FBS+PD98059 (50 μmol/L) (Group D). The expression of epithelial- mesenchymal transition (EMT) markers (E-cadherin, vimentin) were detected by western-blot analysis and the cell's mobility were detected by the Transwell chamber.@*RESULTS@#The activity of ERK1/2 in the experimental group was significantly higher than that in the other two control groups; when ERK kinase inhibitor PD98059 was added to FGF8b/ DU145 cells, the expression of epithelial marker E-cadherin protein was significantly increased in group B compared with that in the group A (P<0.05). The expression of mesenchymal marker vimentin protein was significantly reduced in group B compared with that in group A (P<0.05). The cell migration assay suggested that cell migration was markedly decreased in group B (P<0.05) compared with that in group A.@*CONCLUSION@#EMT in prostate cancer induced by FGF8b can be mediated by ERK kinase pathway, in which mitogen-activated/extraceluer signal regulated kinase 1 (MEK1) may be a key factor. MEK1 could be an effective target in regulating the invasion and migration of prostate cancer.

Retroperitoneal laparoscopic dismembered pyeloplasty in pediatric ureteropelvic junction obstruction / 中华泌尿外科杂志

Objective To discuss the efficacy of retroperitoneal laparoscopic dismembered pyeloplasty for pediatric ureteropelvic junction obstruction(UPJO). Methods Retroperitoneal laparoscopic dismembered pyeloplasty was performed on 24 patients with UPJO.The age of the patients ranged from 3 to 14 years(mean,7 years).The diagnosis was set up by ultrasonography,IVU,CT or magnetic resonance urography.All the patients had hydronephrosis,with 4 cases mild,10 cases moderate and 10 severe ones. Results All operations were completed laparoscopieally,without conversions to open surgery during operation.The mean operative time was 180 min(range 150 to 200).The mean blood loss was 60 ml(range 40 to 100)and the mean postoperative hospital stay was 7 d (range 5 to 9).All 24 patients were followed-up for 6 to 24 months(mean,1 4 months).There was no stricture at UPJ.Eighteen patients had complete resolution of hydronephrosis and 6 patients showed obvious alleviation in hydronephrosis. Conclusion Retroperitoneal laparoseopie dismembered pyeloplasty could be a mini-invasive,safe,and effective procedure for the treatment of UPJO in pediatric patients.

Treatment of renal calyceal stricture and atresia through antegrade percutaneous nephrostomy by Holmi-um laser / 中华泌尿外科杂志

Objective To evaluate the clinical efficacy and safety of Holmium laser in the treat ment of calyceal stricture and atresia through antegrade percutaneous nephrostomy. Methods Ante grade percutaneous nephrostomy was performed in 68 patients with calyceal stricture and atresiathrough a rigid 8/9.8 F ureteroscope. The stricture and atresia was incised in a linear fashion by theHolmium laser with a 550 mm fiber. After completion of the incision,a double J ureteral stent wasplaced for 6-8 weeks and nephrostomy tube was kept for 7 days thereafter. Patients were then fol lowed up with IVU and/or ultrasound at 3-6 month intervals. Results The mean operative timewas 90 min,ranged from 80 to 120 min. The mean postoperative hospital stay was 8 d(7-9d). Hy dronephrosis was significantly improved in 38 cases in an average follow up of 9 months (4-26 months). Repeated laser incision was performed to 4 treatment failures and all turned out to be suc cessful. Conclusions The Holmium laser treatment through antegrade percutaneous nephrostomyfor calyceal stricture and atresia has characteristics of minimal invasion,short hospital stay,good effi cacy in short term and repeated cases. This procedure to be used as the first choice for patients withgood renal function and mild hydronephrosis,especially accompanied with renal calculus.

Mini-percutaneous nephrolithotomy in the treatment of un-hydronephrotic cata-staghorn renal calculi / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the surgical techniques and clinical effects of mini-percutaneous nephrolithotomy (mini-PCNL) in the treatment of un-hydronephrotic cata-staghorn renal calculi.@*METHODS@#The clinical data of 46 cases (31 males and 15 females) treated by mini-PCNL were retrospectively analyzed. There were mono-renal calculi in 38 patients (3 patients were the isolated renal calculi) while the other 8 combined opposite side upper urinary tract calculi. The diameter of calculi ranged from 4.2 to 6.4 (mean=5.2) cm. Puncturation was guided by B-type ultrasound. Lithotripsy by air pressure path lithotripter and/or holmium laser was done when the pervium was established.@*RESULTS@#The pervium in the 46 patients was successfully established by one-session puncturation with B-type ultrasonography guidance. The operative time ranged from 140 to 280 (mean=190) min. The amount of blood ranged from 50 to 200 (mean=100) mL and no one needed blood transfusion. Calculus was completely removed in 18 patients (39.1%). Calculi in 10 patients (21.7%) were completely removed among the 20 patients who underwent second-look mini-PCNL. Calculi in 1 of the 3 cases were completely removed by third-look mini-PCNL. Left-over calculi in 17 patients (8 patients after the first time mini-PCNL, 7 patients after second-look, and 2 patients after third-look) were treated by extracorporeal shock-wave lithotripsy (ESWL) and 8 were removed completely. All the 46 patients were followed up for 4 to 48 months. None of them had nephro-hydrops or stenosis. Renal function re-investigation showed that 8 patients recovered and 2 improved in the 10 patients who had azotemia before. Two (5.4%, 2/37) had calculus recurrence in 37 cases which calculi were completely removed before. The size and amount of left-over calculi in 3 patients (33.3%, 3/9) were increasing.@*CONCLUSION@#Mini-PCNL is effective and causes less trauma for un-hydronephrotic cata-staghorn renal calculi. Mini-PCNL combined ESWL may substitute the open operation and is the preferred method for un-hydronephrotic renal cata-staghorn calculi.

The Practice of Clinical Teaching Reform in Urology / 中华医学教育探索杂志

With the development of clinical education,Urology Department in Xiangya Hospital has identified teaching object and scheme,and improved the condition and modality of teaching and the level and development of clinical teaching.

Clinical observation of hand-assisted laparoscopic live donor nephrectomy / 中南大学学报(医学版)

OBJECTIVE@#To investigate the feasibility and advantage of hand-assisted laparoscopic live donor nephrectomy in renal transplantation.@*METHODS@#Six living relative donors received retroperitoneal left-side laparoscopic nephrectomy. The operating time of nephrectomy, the warm ischemic time, the recovery time of allograft and donors were recorded and analyzed.@*RESULTS@#The mean operating time of nephrectomy was 150 minutes, the mean warm ischemic time was 3.5 minutes, and the mean time of micturition after graft reperfusion was 82 seconds. The donors recovered rapidly and returned to normal within 30 days . The urine volume and renal function of the 6 recipients were normal without complications in the following 3 months.@*CONCLUSION@#Hand-assisted laparoscopic live donor nephrectomy is feasible with short operating time and warm ischemic time; the donors experience less pain, and recover rapidly. This technique may be widely used in living donor nephrectomy.

Retroperitoneal laparoscopic pyelolithotomy and ureterolithotomy (report of 25 cases) / 中华泌尿外科杂志

Objective To evaluate the surgical technique and clinical application of retroperitoneal laparoscopic pyelolithotomy and ureterolithotomy with no suture of the incision. Methods Twenty-five patients who had upper urinary tract calculi with the course from 10 months to 6 years were enrolled.The size of the calculi was 1.2 to 3.1 cm in diameter.ESWL was ineffecative in 14 of the patients and ureteroscopic lithotomy failed in 2 of them.Then the 25 patients underwent retroperitoneal laparoscopic pyelolithotomy and ureterolithotomy.Details of the procedure were presented. Results All the operations were successful in the 25 patients. The operations took 60 to 190 min with a mean time of 105 min.All the patients fully recovered with no complication observed during the 9～12 months' follow-up. Conclusions Retroperitoneal laparoscopy surgery with no suture of the incision has advantages of minimal invasive,safe,effective and rapid postoperative rehabilitation.The surgical procedure has a good prospect in the urologic clinical practice.

Treatment of renal calculi with percutaneous nephrolithotomy / 中华泌尿外科杂志

Objective To evaluate the feasibility and efficacy of percutaneous nephrolithotomy (PCNL)in treating renal calculi.Methods The data of 118 patients with renal calculi who had underg- one PCNL from July 2002 to August 2004 were retrospectively analyzed.There were 86 men and 32 women. The mean age was 39 years(range,7-68 years).Of the 118 cases,11 had pelvic calculi,16 had calyx cal- culi,35 had pelvocalyceal calculi,54 had staghorn calculi,and 2 had bilateral renal calculi.The mean stone size was 2.5 cm?1.5cm(ranged from 2.0 cm?1.0 cm to 4.5cm?4.0cm).Results Of the 118 ca- ses,112 underwent one-stage PCNL,and 6,two-stage PCNL.The procedure was performed by single tract in 114 cases,and by two tracts in 4 cases.Lithotomy was done by one session in 60 cases,by 2 sessions in 42 cases,and by 3 sessions in 16 cases.The total stone clearance rate was 81.4%.The mean operative time was 120 min,and mean hospital stay was 15 d.No blood transfusion was needed during operation,and only one patient experienced bleeding(about 500 ml)after 4 d postoperatively,and was cured by conservative treat- ment such as blood transfusion and anti-inflammation.No major complications were observed in other pa- tients.Conclusions PCNL has advantages of minimal trauma,less blood loss,fewer complications,and is safe and effective in treating renal calculi,especially for patients who will have the second procedure.

Diagnosis and treatment of congenital giant megaureter(report of 6 cases) / 中华泌尿外科杂志

Objective To present and evaluate the diagnosis and treatment of congenital giant megaureter. Methods From 1992 to 1999, 6 cases of congenital giant megaureter were diagnosis and treated, the pathogenesis, diagnosis and treatment of congenital giant megaureter were discussed. Results Resection of the kidney and ureter were carried out in all the 6 with satisfaction. Conclusions The diagnosis may be confirmed on B ultrasonography, CT, or intravenous urography. Nephroureterectomy is the principal method of treatment for congenital giant megaureter.