There is an increasing number of published systematic reviews (SR) of dose-response meta-analyses (DRMAs) over the past decades. However, the quality of abstract reporting of these SR-DRMAs remains to be understood. We conducted a literature survey to investigate the abstract reporting of SR-DRMAs. Medline, Embase, and Wiley online Library were searched for eligible SR-DRMAs. The reporting quality of SR-DRMAs was assessed by the modified PRISMA-for-Abstract checklist (14 items). We summarized the adherence rate of each item and categorized them as well complied (adhered by 80% or above), moderately complied (50 to 79%), and poorly complied (less than 50%). We used total score to reflect the abstract quality and regression analysis was employed to explore the potential influence factors for it. We included 529 SR-DRMAs. Eight of 14 items were moderately (3 items) or poorly complied (5 items) while only 6 were well complied by these SR-DRMAs. Most of the SR-DRMAs failed to describe the methods for risk of bias assessment (30.2, 95% CI: 26.4, 34.4%) and the results of bias assessment (48.8, 95% CI: 44.4, 53.1%). Few SR-DRMAs reported the funding (2.3, 95% CI: 1.2, 3.9%) and registration (0.6, 95% CI: 0.1, 1.6%) information in the abstract. Multivariable regression analysis suggested word number of abstracts [> 250 vs. ≤ 250 (estimated ß = 0.31; 95% CI: 0.02, 0.61; P = 0.039)] was positively associated with the abstract reporting quality. The abstract reporting of SR-DRMAs is suboptimal, substantial effort is needed to improve the reporting. More word number may benefit for the abstract reporting. Given that reporting of abstract largely depends on the reporting and conduct of the SR-DRMA, review authors should also focus on the completeness of SR-DRMA itself.

Accurately predicting storage I/O patterns can help improving performance and endurance of flash memory SSDs. While existing studies made efforts in using machine learning to predict I/O behaviors, long latency limits wide adoption of such techniques. In this paper, we propose an efficient LSTM (Long Short-Term Memory) neural network solution to detect I/O intensities and idle periods inside storage device in real time, referred to as PIPULS (Predicting I/O Patterns Using LSTM in Storage). PIPULS is a supervised learning model that accurately and efficiently predicts I/O behaviors in SSD storage. We have built a prototype PIPULS consisting of an FPGA implementation for testing phase and a software module for training phase. The prototype PIPULS has been deployed in an NVM-express SSD platform for real-time I/O predictions. Extensive experiments have been carried out using real-world I/O traces to demonstrate the feasibility and performance of PIPULS in NVM-e SSD storage. Our experimental results show that PIPULS model can predict future I/O intensities with high accuracy (correlation coefficient = 92%). The run time latency is less than 2us. It takes 0.5MB of FPGA block RAM usage and 5% hardware resource utilization in the Xilinx VU9P FPGA implementation.

Rationale: X-linked dominant chondrodysplasia punctata type 2 (CDPX2) is a condition involving facial, skin, and skeletal dysplasia as a result of a mutation in emopamil binding protein (EBP). It usually presents with mild symptoms in female patients but is fatal in male patients. Patient concerns: A fetus was diagnosed with asymmetrical short limbs and a narrow and small thorax by prenatal ultrasound examination at 24+5 weeks gestation. The pregnancy was terminated at 27 weeks of gestation; gross examination, postnatal X-ray and, whole exome analysis were performed to clarify the diagnosis. Diagnosis: A provisional diagnosis of fatal skeletal dysplasia was given and the definite diagnosis of CDPX2 was based on postnatal X-ray and genetic testing of the aborted fetus. Intervention: The pregnancy was terminated at 27 weeks' gestation after a fetal ultrasound indicated a severe abnormal phenotype. Outcomes: Whole exome analysis of aborted tissue confirmed EBP mutation in this case. Unlike most case reports, this female patient presented a severe phenotype that was considered to be related to X-chromosome inactivation. Lessons: Chondrodysplasia punctata (CDP) should be considered if prenatal ultrasound shows high punctuate echoes at the metaphysis of long bones and asymmetrical short lower limbs. Postnatal X-ray and measurement of sterol levels in the amniotic fluid may aid in the diagnosis of CDP, but the condition can be confirmed with genetic testing of a blood sample or aborted tissue after delivery.

Retroperitoneal laparoscopic partial nephrectomy has been increasingly applied to treat large renal angiomyolipoma. We hereby propose a target-switching strategy to facilitate this surgery. For this new strategy, the kidney was resected from the angiomyolipoma, rather than resecting the angiomyolipoma from the kidney. The shrunken tumor without blood supply was then taken out. Large angiomyolipoma (>= 6 cm) patients who had retroperitoneal laparoscopic partial nephrectomy between April 2011 and May 2015 were reviewed in this study. Twenty-six patients underwent target-switching strategy. The average tumor size was 8.6 +/- 2.3 cm, and average Nephrectomy score (R.E.N.A.L score) was 7.4 +/- 1.6. Twenty-eight patients underwent traditional surgery. For these patients, the average tumor size was 8.2 +/- 2.1 cm, and average R.E.N.A.L score was 7.8 +/- 1.4. In target-switching group, shorter operation time and less blood loss were observed (p<0.05). The new target-switching strategy is technically feasible and may reduce operation time and blood loss. No major complication was observed in experimental group, and after one year, no tumor recurrence was observed by ultrasound or CT scan. Further randomized studies are needed to confirm our findings.

目的 探讨后腹腔镜辅助经腰小切口肾部分切除术治疗复杂性T1期肾癌的可行性及其疗效.方法 回顾分析2010年7月至2013年12月间我科收治的28例复杂性T1期肾癌患者的临床资料,肿瘤直径(3.76±1.28)cm,其中内生性肾癌13例,T1b期肾癌12例,近肾门肾癌7例,解剖性孤立肾肾癌2例,肾肿瘤解剖学特征PADUA评分为(9.07±1.25)分.所有患者均接受后腹腔镜辅助经腰小切口肾部分切除术治疗.结果 28例患者均顺利完成手术,围手术期无尿漏、大出血等严重并发症,手术时间(213.82±40.04)min,术中肾脏冷缺血时间(23.88±5.98) min,手术出血量(191.07±94.33)mL,手术切口长度(9.48±1.56)cm,患者术后疼痛评分(1.11±0.31)分,2例患者术后出现短暂性高热,经对症处理后体温恢复正常.患者术后平均住院(11.54±3.98)d,均正常出院.术后随访(21.46±12.15)个月,术后第1个月患侧肾脏肾小球滤过率(GFR)平均下降(21.71±11.48)％,随访期间均未发现肿瘤局部复发或远处转移.结论 后腹腔镜辅助经腰小切口肾部分切除术治疗体积较大、内生性生长或靠近肾门的复杂性T1期肾癌疗效满意,技术上安全、可行,便于实施和掌握,其手术切口创伤较小,值得临床推广应用,其远期疗效尚需大样本随机对照研究和长期随访观察.

Objective To explore the severity of acute pancreatitis induced by intraperitoneal injection of 50 μg/kg caerulein at different doses in mice.Methods Acute pancreatitis (AP) was induced by intraperitoneal infection of 50 μg/kg caerulein at 3,6,9,12times,respectively.We evaluated the severity of AP biochemically and morphologically.Results Conventional doses of caerulein (50 μg/kg) were injected with 3,6,9,12 times,the level of serum amylase in experimental group were significantly higher than that in control group (P ＜ 0.05),peaked in the 9 times [(25 966.67 ± 3 787.02) U/L] ;pancreatic water content in the experimental group was significantly higher than that in control group (P ＜ 0.05),peaked in the 6 times [(81.13 ± 1.03) ％] ; pancreatic tissue hematoxylin and eosin (HE) staining showed that pancreas was slightly edema and infiltration of inflammatory cells at 3 times,which showed a large amount of neutrophil infiltration and obvious edema at the 6 times,and pancreatic leaflet margin appeared a small amount necrosis at the 9 times,and the acinar necrosis foci could be seen in large range an the 12 times (histopathological score 8.20 ±0.84),the microscope exhibited altered necrotizing pancreatitis.Conclnsion Conventional caerulein doses (50 μg/kg) may induce acute edematous pancreatitis by 6 times of intraperitoneal injection in mice,and 12 times may induce acute necrotizing pancreatitis.

目的:探讨近似肿瘤实质接触面积与肾部分切除术围手术期参数的相关性.方法:选择第二军医大学附属长海医院泌尿外科2014年l～7月因肾肿瘤入院并接受肾部分切除术治疗的94例患者为研究对象,根据术前CT或MRI图像,并参照球冠面积公式计算肾肿瘤与肾实质接触面积的近似值(estimated tumor contactsurface area,eCSA),以eCSA中位数13 cm2将患者分成≥13 cm2组(n=47)和＜13 cm2组(n=47),比较两组间手术时间、肾缺血时间、术中出血量和术后肾功能等围手术期参数的差异,分析eCSA与肿瘤解剖学R.E.N.A.L.评分、PADUA评分以及上述围手术期参数的相关性.结果:94例患者均顺利完成手术,eCSA≥13 cm2组肿瘤复杂性更高,其肿瘤大小、内生比例、R.E.N.A.L.评分和PADUA评分均高于＜13 cm2组(P＜0.01).eCSA≥13 cm2组开放手术的比例更高(P＜0.05),其肾缺血时间及术中出血量分别长于、多于＜ 13 cm2组(P＜0.01),但两组间手术用时、术后并发症发生率无明显差别(P＞0.05),相关分析提示eCSA与肿瘤大小、肿瘤内生程度、R.E.N.A.L.评分、PADUA评分、肾脏缺血时间、术中出血量以及术后肾功能下降幅度均显著相关(P＜0.01).结论:以近似肿瘤实质接触面积作为参数能够客观地评价肾肿瘤的复杂性.该指标与肾部分切除术的缺血时间、手术出血量以及术后肾功能下降幅度均密切相关,可作为上述围手术期参数的预测因素,其临床应用价值有待进一步研究验证.

Background: Ulcerative colitis-associated colorectal cancer (UC-CRC) is a serious complication of UC. Data on the clinical characteristics of patients in China are scarce. Aims: We aimed to study the incidence, characteristics, treatment, and prognosis of CRC patients with a history of UC. Materials and Methods: We identified patients with UC and followed them until the first occurrence of cancer, death, or emigration in a single study center in China. Results: A total of 4 UC-associated CRC patients were identified among the 642 cases recorded from January 2000 to December 2012. The overall risk of cancer was 0.64%. The overall median duration of UC was 15.5 years (range 6-21 years) in patients with UC-associated CRC. Of these patients, 75% (3/4) were at an advanced stage when they were diagnosed. Longer disease duration and extensive colitis were identified as risk factors for developing CRC, and 5-aminosalicylic acid and steroid therapies were not identified as protective factors against UC-associated CRC. Conclusions: Patients with UC are at an increased risk for CRC. However, the prevalence of CRC in China remains lower than that in the West.

目的探讨超选择性肾动脉分支阻断术在腹腔镜下肾部分切除术中的可行性、安全性及其对患者术后肾功能的短期影响。方法回顾性分析长海医院泌尿外科2013年6月至2014年5月因肾恶性肿瘤入院,并接受同一术者经腹腹腔镜肾部分切除术治疗患者的临床资料,比较超选择性肾动脉分支阻断术（10例）和肾动脉主干阻断术（13例）对手术时间、术中出血量及术后肾功能等临床参数的影响。结果与肾动脉主干阻断术相比,采用超选择分支阻断术者手术时间延长[（257.60±22.03）min vs（199.08±36.70）min,P＜0.05]、术中出血量增多[（220.00±57.01）mL vs（71.54±30.51）mL,P＜0.05]、术后切口平均引流量增加[（113.33±24.82）mL vs（68.08±28.88）mL,P＜0.05],两组患者术后均无大出血、尿漏等严重并发症发生。但在血管阻断时间相当的条件下[（28.60±8.17）min vs（27.85±6.16）min],超选择分支阻断术对肾功能的损害小于肾动脉主干阻断术,接受分支阻断处理的患者术后早期肾小球滤过率（eGFR）的下降程度明显低于后者[（3.14±7.22）%vs（15.26±9.53）%,P＜0.05]。结论超选择性分支动脉阻断术对肾功能损害低于传统的肾动脉主干阻断术,有利于腹腔镜下肾部分切除术后肾功能的早期恢复,值得进一步研究。

OBJECTIVE:To investigate the expression pattern of a novel long noncoding ribonucleic acid (RNA), RCCRT1, in renal cell carcinoma (RCC) tissues among the patients with various clinicopathologic features and to detect the role of RCCRT1 in migration and invasion of RCC in vitro. MATERIALS AND METHODS:We found out a novel long noncoding RNA, RCCRT1, that expressed differently between high-grade (Fuhrman grade III-IV) and low-grade RCC tissues (Fuhrman grade I-II) by gene chip analysis, then verified it with quantitative polymerase chain reaction. The expression of RCCRT1 was diminished by transfecting with small interfering RNA. RCCRT1 effects were assessed by cell proliferation, cell apoptosis, transwell assay, and wound-healing assay. RESULTS:Compared with adjacent noncancerous tissues, RCCRT1 is upregulated remarkably in RCC, particularly in high-grade RCC tissues. After analyzing the relative expression of RCCRT1 in various tissues by quantitative reverse transcription polymerase chain reaction and clinicopathologic characteristics of patients, we drew the conclusion that RCCRT1 is associated with clinicopathologic findings such as tumor size, pathologic T stage, tumor grade, lymph node metastasis, and distant metastasis. Furthermore, small interfering RNA-induced depletion of RCCRT1 expression suppressed migration and invasion in RCC cell lines. CONCLUSION:The results of the present study suggest that RCCRT1 promoted migration and invasion of RCC and that RCCRT1 may offer a biomarker to verdict prognosis as well as an attractive new target for prognostic and therapeutic intervention for RCC patients in the future.

BACKGROUND:Deleted in breast cancer 1 (DBC1) was initially cloned from a region homozygously deleted in breast cancers, but its role in colorectal cancer remains unknown. The present study aims to examine the expression level of DBC1 and assess its prognostic value in human colorectal cancer.METHODS:Immunohistochemical staining was performed to detect the expression level of DBC1 in a series of 186 colorectal cancer patients. Immunohistochemical staining results were analyzed and compared statistically with various clinicopathological characters and overall survival.RESULTS:Compared with the corresponding non-tumor tissues, a higher expression level of DBC1 was detected in colorectal cancer (P < 0.01). Tissue microarray analysis revealed that DBC1 expression is significantly associated with tumor histological grade, TNM stage and metastatic status (P < 0.01). Importantly, Kaplan-Meier analysis showed that DBC1 expression is associated with shorter overall survival (P < 0.01). Univariate Cox regression suggested that DBC1 expression, poorly differentiation status and the presence of lymph node metastasis predict shorter overall survival in colorectal cancer (P < 0.05). Multivariate Cox regression analysis indicated that DBC1 acts as an independent prognostic factor in colorectal cancer (P < 0.01).CONCLUSIONS:These results suggest that DBC1 is over-expressed in colorectal cancer and that it might serve as a predictor for selecting patients at high risk of poor prognosis.

Objective To perform partial nephrectomy via combined transgastric and transvesical approach in porcine and to use V-loc suture for suturing the renal defect,so as to further assess the safety and feasibility of combined transgastric and transvesical approach.MethodsThree female pigs were used in this study.The transvesical access was established by incising the anterior wall of the bladder under ureteroscope,and a self-designed Trocar was inserted.Under the guidance of ureteroscopy,the transgastric access was established by a needle knife with cautery,and the gastroscope was introduced after balloon dilation.Under the guidance of gastroscope,laparoscopic ultrasonic scalpel was introduced via the bladder Trocar;the kidney artery and vein were separated,the arteries were blocked and some lower part of renal parenchyma was resected;and the wound was closed by 2-0 V-loc suture which was introduced percutaneously.The specimens were collected from the bladder.ResultsSix partial nephrectomy procedures were done in the 3 pigs.The first case was transferred to traditional laparoscopy due to incompleted blocking of the artery,bleeding and loss of vision.The rest 5 cases were successfully completed,with a mean operation time of 174 min(140-220 min),a warm ischemia time of 21 min(17-28 min),and with no significant bleeding.The average size of incised tissue was 1.5 cm×1.5 cm.ConclusionPartial nephrectomy via combined transgastric and transvesical approach is extremely difficult,but it can be done by using the V-loc suture and auxiliary needle laparoscopic instrument;however,its clinical prospect still needs further verification.

Background Studies have demonstrated the implication of HOXB9 in tumorigenesis, but its role in gastric carcinoma remains unknown. Aims To investigate the expression and prognostic value of HOXB9 in patients with gastric carcinoma. Methods The localization and expression of HOXB9 in gastric cancer cells lines were detected by immunofluorescence and western blot. The mRNA and protein expression level of HOXB9 was detected in subjects with gastric carcinoma and paired non-cancerous tissues. Correlation between HOXB9 expression and clinicopathological parameters, the association of HOXB9 expression with the patients' survival rate was also assessed. Results HOXB9 was predominantly localized in the cell nucleus. A significant decrease in HOXB9 intensity in poorly differentiated gastric cancer cells is evident (P < 0.01). A lower mRNA and protein expression level of HOXB9 was detected in gastric carcinoma (P < 0.01). Decreased expression of HOXB9, poorly differentiation status and the presence of lymph node metastasis predict shorter overall survival (P < 0.05). Patients without HOXB9 expression had a lower overall survival rate (P < 0.01). Multivariate Cox regression analysis showed HOXB9 was an independent prognostic factor in gastric carcinoma (P < 0.01). Conclusions HOXB9 is down-regulation in gastric carcinoma and may be a novel prognostic marker for poorer clinical outcome for patients with gastric carcinoma.

Objective To investigate the clinical benefits and role of robot-assisted laparoscopic partial nephrectomy(RAPN) by comparing the clinical data of patients receiving the RAPN or conventional laparoscopic partial nephrectomy(CLPN).MethodsA retrospective analysis was performed for 67 patients who underwent either RAPN(n =24) or CLPN (n =43) between January 2011 and December 2012 at our institution.Preoperative clinical stages of both groups were T1N0M0.Univariate analysis and logistic regression model were used to detect factors affecting indication selection in RAPN.The intraoperative parameters and postoperative outcomes were compared between RAPN and CLPN groups matched for DAP score.ResultsUnivariate and multivariate logistic regression analysis revealed that DAP score(β =1.987,P =0.022,95%CI[1.34,39.79]) was the only predictor of RAPN approach in logistic regression analysis.Only 38 DAP matched cases in RAPN(n =19) and CLPN(n =19) were included for analysis,and the demographics were comparable between the matched two groups except for the preoperative estimated glomerular filtration rate(eGFR).One open conversion was required in the RAPN group due to intra-operation bleeding,and all the cases were smoothly completed in the conventional laparoscopic group.There were no significant differences between the matched two groups regarding the estimated blood loss,time off oral-intake,highest visual analog pain scale,length of stay,complication rate or transfusion rate(all P 0.05).Patients undergoing RAPN had a significantly shorter warm ischemia time([27.0±5.3] min vs [34.2±7.3] min,P 0.05) and a longer operative time([249.5±49.6] min vs [212.9±57.11] min,P 0.05) compared with CLPN group.The surgical margins were negative in both groups.During a mean follow-up of(5.6±2.2) months and(6.6±2.6) months,only one tumor recurrence was notice in the CLPN group.At the last follow-up,the decrease percentage of eGFR was(12±8)% in the RAPN group versus(17±15)% in the CLPN group(P 0.05).ConclusionRAPN requires a shorter warm ischemia time and provides a more rapid learning curve,good surgical safety and good short-term efficacy.For surgeons with experienced CLPN technique,they can use RAPN to treat high-complexity tumors which are beyond the conventional laparoscopic technique.

Objective To explore the function of specialized training course in training singleport laparoscopic skills.Methods The specialized training course for single-port laparoscopy included cutting rubber bands into‘Z’shape,cutting‘petaloid’folded slips and peeling oranges.Twelve residents were enrolled into traditional laparoscopy training for one week and then randomized into two groups:6 trainees performed the specialized training course for 2 h daily and the others as the control group continued to practice the traditional course for 2 h daily.One week later,the trainees were tested on performing porcine single-port laparoscopic nephrectomy.Operation time and performance was compared.T test were performed using SAS 9.1.3 statistics software,and a P＜0.05 was considered to be statistical significance.Results Operation time of the specialized group was decreased significantly(59.2±17.3)min vs.(87.0±25.5)min,P=0.049,and the total global rating scale score increased significantly(26.3±2.2 vs 18.2±2.8,P=0.000 17).Conclusion The specialized course is beneficial to the training of single-port laparoscopic skills.

Purpose: To evaluate the feasibility of a novel transvesical port (TVEP) for natural orifice translumenal endoscopic surgery (NOTES) in the porcine model. Materials and Methods: The TVEP consisted of an internal guide core and external sheath design using computer-aided design software. Transvesical peritoneoscopy, renal biopsy, as well as combined transvesical/transgastric nephrectomy were performed through the TVEP in a porcine model. Operative parameters and port performance were measured. Results: Twelve procedures were successfully performed by four surgeons. No complications occurred with introduction of the TVEP. The mean time for placement was 5.6 minutes. Steady pressure controlled CO2 pneumoperitoneum up to 15 mm Hg with a flow of 2 L/min was achievable. The average scoring by physician of the TVEP was 4.75 for ease of placement, 5 for ability to maintain pneumoperitoneum, 4.25 for convenience of inserting instruments, and 4.5 for overall satisfaction. The average score regarding instruments exchangeability, however, was relatively low: 3.25. Conclusions: Real surgery using a novel TVEP is feasible in performing transvesical NOTES.

Objective To summarize the surgical experience in robotic-assisted laparoscopic partial nephrectomy,and to investigate the efficacy and safety of this surgery.Methods The clinical data of 12 patients who underwent robot-assisted laparoscopic partial nephrectomy in Changhai Hospital from March to July in 2012 were analyzed.All the patients were male and the age range was 43-66 years.In 4 cases the tumors were in the left kidney,and 8 in the right.In 7 cases the tumors were in the dorsal part of the kidney,and 2 in the ventral part.There were 3,5 and 4 cases in the upper,middle and lower pole of the kidney respectively.Preoperative GFR test was normal in all cases.Kidney CT scan showed the maximum diameters of the tumors were 2.0-5.8 cm,with an average of 3.3 cm.The pre-operative stages in all cases were T1N0M0.Results The surgery was successfully completed in all cases.The mean duration of the surgery was 160-310 min,with an average of 242 min.The blood loss was 30-300 ml,with an average of 135 ml,and the intraoperative blood transfusion was unnecessary.The warm ischemia time was 20-49 min,with an average of 31 min.There was no intraoperative morbidity,and no conversion to open surgery.The postoperative length of hospitalization was 9-31 d,with an average of 14 d.Gross hematuria arose in 1 patient at 1 week after the surgery.The post-operative pathology showed renal clear cell carcinoma with Furhman Grade Ⅱ in 11 cases,and renal angiomyolipoma in 1 case.The maximum diameters of the tumors were 2.0-5.0 cm,with an average of 3.5 cm.The tumor resection margin was negative in all cases.Conclusions Robot-assisted laparoscopic partial nephrectomy is safe and effective for local renal tumors.This surgery has significant advantage over traditional laparoscopic partial nephrectomy,in terms of the resection of the renal tumors and the reconstruction of the kidney.

目的完善相关术前评估并取得患者知情同意后,在国内首次尝试进行单孔多通道后腹腔镜下肾脏肿瘤冷冻消融术,探讨该手术的可行性和安全性,总结操作经验。方法 2012年3月14日和19日我科先后完成单孔多通道（TriPort TM）后腹腔镜下肾肿瘤冷冻消融术2例。例1为79岁男性,Charlson合并症指数（Age-weighted）为4,肿瘤最大径2.7cm,R.E.N.A.L.评分为2+2+3+p+3=10p,术前eGFR为61.5ml/（min.1.73m2）;例2为43岁女性,Charlson合并症指数（Age-weighted）为3,肿瘤最大径2.6cm,R.E.N.A.L.评分为1+1+1+a+2=5a,术前eGFR为187.8ml/（min.1.73m2）。手术方法:于腋中线水平,髂嵴最高点与第12肋下缘连线中点处取一2cm纵行皮肤切口,充分游离暴露肿瘤表面,腹腔镜监视下将两把2mm直角冷刀经皮穿刺后置入瘤体内,按照EndoCare冷刀手术操作系统完成两个循环后退出冷冻刀头。结果 2例手术均顺利完成,手术时间、冷冻时间、术中出血分别为:185/170min,30/30min,50/30ml;术后第1、2、3天患者视觉疼痛模拟评分分别为:2/1,1/1,0/0;术后住院时间分别为:6/5d;无任何术中、术后并发症。术后病理组织学评估2例均为透明细胞癌,Furhman分级分别为Ⅱ和Ⅰ。术后1个月复查肾功能分别为:60.2和144.3ml/（min.1.73m2）;术后1周、1个月复查肾脏增强CT提示肿瘤已完全消退,无局部复发。结论初步经验表明单孔多通道后腹腔镜下肾脏肿瘤冷冻消融术切口小、肾功能损害小,术后患者疼痛轻、恢复快,肿瘤治疗近期疗效确切,但需严格把握临床适应证。远期疗效有待前瞻性大样本的长期随访对照研究。

Laparoendoscopic single-site surgery(LESS)and natural orifice transluminal endoscopic surgery(NOTES)are gaining the momentum of mini-invasive surgery,but many technical problems remain to be solved;difficulties in learning the technique hamper its popularization.A satisfactory training system can greatly promote the development of the new technique.In this paper,we introduce the current status of training for LESS and NOTES,and also introduce some valuable experience in our training courses.

OBJECTIVE To investigate the role of stenting after uncomplicated ureteroscopy. METHODS This was a systematic review and meta-analysis of randomized controlled trials from MEDLINE, the Cochrane Central Search Library, and the EMBASE database. All of the studies reported various outcomes with or without stenting after ureteroscopy. RESULTS Fourteen trials were identified. As there was significant heterogeneity in pain assessment, difference in postoperative pain between the stent and nonstent groups was not clear. The incidence of dysuria, frequency, and hematuria was statistically significantly higher in stent group (relative risk [RR] 1.91, 95% confidence interval [95% CI] 1.18-3.08, dysuria; RR 2.23, 95% CI 1.48-3.36, frequency and urgency; RR 2.26, 95% CI 1.20-4.24, hematuria). There was no statistically significant difference in the postoperative analgesia requirement, urinary tract infections, postoperative fever, stone-free rate, and ureteral stricture between groups. There was a decreased tendency toward unplanned medical visits or hospital readmission in the stent group (RR 0.60, 95% CI.33-1.11), but the difference was not statistically significant. Combined analysis of the trials only used holmium laser or pneumatic lithotripsy showed no statistically significantly difference in unplanned medical visits between groups. Five studies found that ureteral stenting increased the expenses. Operation duration was significantly longer in the stent group (weighted mean difference 4.25, 95% CI 1.10-7.40). CONCLUSIONS A meta-analysis of the present literature revealed much benefit in the nonstent patient group. However, considering different outcome measures, marked clinical heterogeneity and various quality of, including trials, the place of stenting after uncomplicated ureteroscopy remains unclear. UROLOGY 78: 1248-1256, 2011. (C) 2011 Elsevier Inc.