Arteriovenous malformation (AVM) recurrence after embolization was rarely reported. This study aimed to explore the potential risk factors of recurrence in angiographically obliterated AVMs treated with endovascular embolization. This study reviewed AVMs treated with embolization only in a prospective multicenter registry from August 2011 to December 2021, and ultimately included 92 AVMs who had achieved angiographic obliteration. Recurrence was assessed by follow-up digital subtraction angiography (DSA) or magnetic resonance imaging (MRI). Hazard ratios (HRs) with 95% confidence intervals were calculated using Cox proportional hazards regression models. Nineteen AVMs exhibited recurrence on follow-up imaging. The recurrence rates after complete obliteration at 6 months, 1 year, and 2 years were 4.35%, 9.78%, and 13.0%, respectively. Multivariate Cox regression analysis identified diffuse nidus (HR 3.208, 95% CI 1.030-9.997, p=0.044) as an independent risk factor for recurrence. Kaplan-Meier analysis confirmed a higher cumulative risk of recurrence with diffuse nidus (log-rank, p=0.016). Further, in the exploratory analysis of the effect of embolization timing after AVM rupture on recurrence after the complete obliteration, embolization within 7 days of the hemorrhage was found as an independent risk factor (HR 4.797, 95% CI 1.379-16.689, p=0.014). Kaplan-Meier analysis confirmed that embolization within 7 days of the hemorrhage was associated with a higher cumulative risk of recurrence in ruptured AVMs (log-rank, p<0.0001). This study highlights the significance of diffuse nidus as an independent risk factor for recurrence after complete embolization of AVMs. In addition, we identified a potential recurrent risk associated with early embolization in ruptured AVMs.

Subsequently to the publication of this paper, an interested reader drew to the authors' attention that western blots featured in Figs. 4B and 5G (representing the 'AR' experiments in both cases) appeared to be the same, albeit that the bands were flipped vertically in Fig. 5G relative to Fig. 4B. The authors have re‑examined their data and realized that Fig. 5 was assembled incorrectly. The results from all the originally performed experiments were presented to the Editorial Office for our perusal. The revised version of Fig. 5, containing the correct data for the 'AR' experiment in Fig. 5G, is shown on the next page. The authors regret the inadvertent error that was made during the preparation of Fig. 5, and confirm that this error did not seriously affect the conclusions reported in the paper. The authors are grateful to the Editor of Oncology Reports for allowing them the opportunity to publish a Corrigendum, and all the authors agree to this Corrigendum. Furthermore, they apologise to the readership for any inconvenience caused. [Oncology Reports 43: 1397‑1412, 2020; DOI: 10.3892/or.2020.7520].

目的:观察姜黄素是否通过下调miR210表达,抑制TLR4/NF-κB信号通路关键因子表达促进人前列腺癌PC3细胞株凋亡.方法:检测人前列腺PC3细胞荷瘤小鼠肿瘤重量;前列腺癌PC3细胞株培养后以姜黄素10、20、40 μmol/L处理48 h,CCK-8法检测PC3细胞株细胞增殖情况;AnnexinV-FITC/PI检测细胞凋亡情况;qRT-PCR检测miR210相对表达量;ELISA检测IL-6和TNF-α含量;Westemblot检测Toll样受体4(TLR4)、核转录因子κB(NF-κB)、B细胞淋巴癌-2(Bcl-2)、Bax蛋白表达及Bcl-2/Bax比值.结果:与荷瘤模型对照组比较,姜黄素50、100、200 mg/kg组显著抑制肿瘤重量,显著升高抑瘤率(P＜0.01).与PC3细胞株模型对照组比较,姜黄素10、20、40 μmol/L能明显抑制PC3细胞增殖,增加肿瘤细胞凋亡率,降低Bcl-2/Bax比值,下调miR210表达,下调TLR4、NF-κB蛋白表达,降低IL-6和TNF-α含量(P＜0.05或P＜0.01).结论:姜黄素能抑制PC3细胞增殖,促进其凋亡,减轻裸鼠鼠移植肿瘤重量,机制可能与下调miR210表达后抑制TLR4信号通路,减少炎症因子表达有关.

Radiotherapy (RT) has been used as a therapeutic option for treatment of prostate cancer (PCa) for a number of years; however, patients frequently develop RT resistance, particularly in castration-resistant PCa (CRPC), although the underlying mechanisms remain unknown. Understanding the underlying mechanism of RT resistance in CRPC may potentially highlight novel targets to improve therapeutic options for patients with PCa. In the present study, the expression levels of phospholipase C epsilon (PLC epsilon), androgen receptor (AR) and DNA-dependent protein kinase catalytic subunit (PKcs) were examined in PCa tissue samples and PCa cells, and the effects of PLC epsilon knockdown on AR and DNA damage repair (DDR)-related molecules were determined. The association between PLC epsilon, AR and Poly (ADP-ribose) polymerase 1 (PARP1), as well as their respective roles in radiation resistance, were assessed using gene knockdown and pharmaceutical inhibitors or activators. A chromatin immunoprecipitation assay was used to determine the epigenetic regulatory effects of PLC epsilon on PARP1. Animal experiments were performed to assess whether the mechanisms observed in vitro could be replicated in vivo. The expression levels of PLC epsilon, AR and DNA-PKcs were significantly upregulated in PCa, particularly in CRPC. PLC epsilon knockdown reduced the viability and increased apoptosis of cells subjected to radiation. Additionally, PLC epsilon deficiency suppressed DDR progression by downregulating an AR and PARP1 positive feedback loop and the associated downstream molecules following radiation. PLC epsilon depletion also increased the presence of histone H3 lysine 27 trimethylation in the PARP1 promoter region, suggesting increased methylation of the PARP1 gene and thus resulting in reduced expression of PARP1. In vivo, PLC epsilon knockdown significantly potentiated the effects of radiation on tumor growth. Taken together, the results of the present study demonstrated that PLC epsilon knockdown enhanced the radiosensitivity of CRPC by downregulating the AR/PARP1/DNA-PKcs axis.

Objectives:To explore the feasibility of applying virtual reality (VR) technology to surgical skills training for postgraduate students with VR technology and to evaluate its training effect.Methods:Taking the VR software for nephrectomy as an example, the VR software was applied to the surgical training of the surgery postgraduates, and compared with the traditional teaching methods to evaluate its training effect. Meanwhile the questionnaires about the performance characteristics and technological advantages of VR software were distributed to participators.Results:The examination performances in group with VR training were significantly better than that with traditional teaching methods (92.17±0.38 vs. 87.94±0.43, P<0.001). A total of 35 valid questionnaires were collected back. More than 82% of participators considered that VR surgery teaching had advantages of realistic training mode, strong three-dimensional effect, friendly interface, easy manipulation, favorable interaction, convenient full-scale viewing, splendid and plentiful course content, wonderful training effect and stimulating training interest. All of participators confirmed that VR surgery teaching can replace the traditional surgery training methods. Conclusions:It is feasible to apply VR technology in surgical skills training for postgraduates. The effect of surgical skills training with VR technology for postgraduates is significantly superior to the traditional training methods, which is worth further popularization and application.

Objective To compare the role on determining the functional location of primary hyperaldosteronism (PHA)by multi-slice spiral CT (MSCT)and by adrenal vein sampling (AVS),and to discuss the reasonable method to use MSCT and AVS in localization diagnosis of PHA.Methods Clinical data of 78 patients with PHA were analyzed retrospectively.These patients were diagnosed in our department from June 2014 to June 2018.There were 27 male and 51 female patients.With mean age of (47.5 ± 11.2) years old.The mean systolic blood pressure was (190 ± 24)mmHg and mean diastolic blood pressure was (111 ± 16) mmHg.The mean history of hypertension was (6.0 ± 6.0) years.The mean serum potassium was (2.4 ± 0.6) mmol/L.The mean plasma aldosterone concentration (PAC) was (415.7 ± 235.4) pg/ml.The mean plasma renin activity (PRA) was (3.2 ± 5.7) ng/(ml · h).The mean aldosterone/renin ratio (ARR) was 409.0 ± 434.9.All PHA patients underwent MSCT and AVS,the accuracy on determining the functional location of PHA by MSCT and by AVS were evaluated based on the pathological results and clinical outcomes.The influence of adrenal size and character on the accuracy of determining the functional location of PHA by MSCT were analyzed.Results The rate of accuracy of determining the location of PHA by AVS was higher than that by MSCT[100.0％ (78/78) vs.71.8％ (56/78),P ＜ 0.05].When MSCT indicated:adrenal hyperplasia,adrenal tumor volume less than 1 cm,1 cm ＜ adrenal tumor volume ≤ 2 cm,adrenal tumor volume ＞ 2 cm,the rate of accuracy in localization diagnosis with MSCT was 50.0％ (4/8),81.0％ (17/21),92.9％ (26/28),100.0％ (9/9) respectively.Its trend has statistical significance (P ＜ 0.05).The diagnostic accuracy rate of MSCT for aldosterone adenoma was 79.6％ (43/54),while that of adrenal hyperplasia was 58.3 ％ (7/12).There was no statistical significance between two diagnostic accuracy rate of MSCT(P ＞ 0.05).Conclusions AVS is the gold standard for localization diagnosis.When MSCT indicates that there is no obvious abnormality in the adrenal gland,adrenal hyperplasia,small tumor (≤ 2 cm),and bilateral adrenal lesions,AVS should be examined at the same time,which can be considered as the gold standard for localization diagnosis.For isolated adrenal tumor (＞ 2 cm) in PHA,the accuracy of localization diagnosis in MSCT is very high and the AVS is unnecessary.

目的 比较机器人辅助腹腔镜前列腺癌根治术(RLRP)与普通腹腔镜前列腺癌根治术(LRP)治疗局部进展期前列腺癌患者的临床效果,探讨RLRP治疗局部进展期前列腺癌的安全性和可行性.方法 回顾性研究该院2012年2月至2018年5月,37例接受前列腺癌根治术的局部进展期前列腺癌患者的临床资料,其中RLRP组10例,LRP组27例.比较两组患者手术时间 、术中出血量 、术后住院时间 、引流管保留时间 、术后切缘阳性率 、淋巴结阳性率 、术中术后输血 、直肠损伤 、术后吻合口漏尿等情况.结果 37例手术均成功完成,RLRP组 、LRP组平均年龄分别为(68.4±6.9)、(66.4±7.7)岁(P>0.05).两组在手术时间 、住院时间 、引流管保留时间 、输血率 、直肠损伤率 、术后吻合口漏尿率 、淋巴结阳性率 、切缘阳性率方面比较,差异无统计学意义(P>0.05).两组患者术中均无大血管损伤 、输尿管口损伤及严重并发症致患者死亡的病例.RLRP组和LRP组术中平均出血量分别为(210.0±99.4)、(382.6±287.6)mL,差异有统计学意义(P<0.05).结论RLRP治疗局部进展期前列腺癌安全可行,并且在控制术中出血方面优于LRP,但远期疗效有待进一步观察.

目的 通过对比腹膜后腹腔镜下肾上腺全切术与腹膜后腹腔镜下肾上腺肿瘤切除术治疗醛固酮腺瘤患者的相关指标,为临床应用后腹腔镜下肾上腺肿瘤切除术治疗醛固酮腺瘤患者提供依据.方法 回顾性分析2014年1月～2018年9月重庆医科大学附属第一医院收治的103例醛固酮腺瘤患者的临床资料,32例行后腹腔镜下肾上腺全切术,71例行后腹腔镜下肾上腺肿瘤切除术.术后随访1～41个月,平均15.7个月.比较两组患者手术时间、术中术后并发症发生率,术后皮质醇不足发生率、引流管留置时间、术后住院时间,术后血压缓解率及复发率.结果 肾上腺全切组手术时间为(117.00±47.00)min,术中术后并发症发生率为9.37％,术后住院时间为(5.20±3.10)d,均高于肾上腺肿瘤切除组的(78.00±32.00)min、0、(4.00±1.10)d,差异有统计学意义(P<0.05);两组患者术中出血量及引流管留置时间,术后皮质醇不足发生率比较,差异无统计学意义(P>0.05).全切组和肿瘤切除组术后血压缓解率分别为90.63％和81.69％,组间比较差异无统计学意义(P>0.05),全切组复发率为0,低于肿瘤切除组的4.23％,但二者间差异无统计学意义(P>0.05).结论 鉴于后腹腔镜下肾上腺肿瘤切除术的良好的手术效果,技术上安全可靠,虽然有较小概率复发可能,仍是醛固酮腺瘤患者的一个良好选择.

Objective: We discussed the accuracy and reliability of computed tomography perfusion (CTP) before and after revascularization in ischemic cerebrovascular disease (ICVD). Method: Siemens Somatom Sensation 64 CT Scanner was used to collect the images of CTP before and after revascularization in 30 cases of ICVD using our method for delineating region of interest (ROI); the results were interpreted using our method of CTP parameter evaluation alongside statistical analysis of the changes before and after surgery. Results: ROI was delineated for each case, and CTP parameters were detected semi-quantitatively before and after surgery. The CTP imaging coincided with the changes of clinical symptoms before and after surgery. Conclusion: CTP evaluation of cerebral blood flow provides important indications for cerebral revascularization in ICVD. CTP has a high value for outcome evaluation after revascularization for ICVD. An accurate delineation of ROI is a guarantee of accurate CTP. The CTP parameters can be evaluated based on the relative value between the affected side and the healthy side.

自媒体是一种迅速 、便捷的信息传播方式.以微信 、QQ、微博为代表的自媒体平台具有内容丰富 、形式多样 、突破时空限制 、交互性强等特点,能够为师生交流提供便利,也为知识拓展提供新的途径.但目前在医学教育活动中,自媒体的应用还处于初始阶段.该文结合相关文献,分析了自媒体应用于医学教育的可行性及相关教学方法,有利于医学教育方式改革和提高医学教育质量.

目的:探讨影响原发性输尿管癌预后及其术后继发膀胱癌的危险因素.方法:回顾性分析58例2010年6月至2017年9月于重庆医科大学附属第一医院行手术治疗,病理诊断为输尿管癌患者的临床资料,对可能影响输尿管癌预后的7个临床及病理因素进行单因素和多因素Cox模型分析,对可能影响输尿管癌术后继发膀胱癌的5个临床及病理因素进行单因素和多因素Cox模型分析.结果:单因素分析表明:临床分期(x2=16.441,P=0.000)、组织学分级(x2=6.941,P=0.008)、术后是否化疗(x2=4.934,P=0.026)与输尿管癌预后显著相关.性别(x2=0.414,P=0.520)、年龄(x2=2.013,P=0.156)、肿瘤是否多发(x2=0.029,P=0.865)、手术方式(x2=0.243,P=0.622)与预后无关.浸润深度(x2=5.314,P=0.021)、术后膀胱灌注(x2=3.919,P=0.048)、组织学分级(x2=7.025,P=0.008)、手术方式(x2=6.565,P=0.010)与输尿管癌术后继发膀胱癌显著相关.肿瘤是否多发(x2=1.291,P=0.256)与输尿管癌术后继发膀胱癌无关.多因素分析表明:临床分期(RR =6.037,95％CI=1.708 ～21.333,P=0.005)及组织学分级(RR=10.032,95％CI=1.161～86.695,P=0.036)是影响输尿管癌预后的显著因素,高级别组织学分级(RR=8.942,95％CI=1.175～68.056,P=0.034)及非根治手术(RR=3.819,95％CI=1.424～10.244,P=0.008)是输尿管癌术后继发膀胱癌的危险因素(RR＞1).结论:输尿管癌的临床分期及组织学分级是决定预后的显著影响因素;组织学分级及手术方式是影响输尿管癌术后继发膀胱癌的显著独立危险因素.

目的:探讨补体C5a关键受体C5L2表达抑制后,对小鼠肾移植急性排斥反应模型中Th17细胞功能以及急性排斥反应的影响.方法:构建特异性C5L2干扰腺病毒,通过小鼠尾静脉注射入小鼠急性肾移植排斥模型,检测其血肌酐,ELSA检测Th17相关细胞因子白细胞介素(interleukin,IL)-6、IL-17以及肿瘤坏死因子(tumor necrosis factor,TNF)-γ的变化,同时检测小鼠肾组织病理改变.结果:成功建立小鼠急性肾移植排斥模型,将构建的C5L2干扰腺病毒尾静脉注射后,小鼠血清Cr水平下降,IL-6、IL-17以及TNF-γ水平下降,急性排斥反应减轻.结论:特异性C5L2干扰腺病毒可以抑制Th17细胞功能,减轻肾移植急性排斥反应.

Objective To discuss whether the content and method of pre-job training meet the need of medical trainees and to give some advice on its reformation. Methods 350 trainees enrolled by The First Affiliated Hospital of Chongqing Medical University attended the two-day standardized pre-job training in September, 2016. The self-designed satisfaction questionnaires on contents and method of pre-job training were distributed to all trainees after training, and then the statistical analysis was completed by SPSS 11.0 software. The satisfaction rate higher than80% was deemed as satisfactory, and the satisfaction rate lower than80% was regarded as unsatisfactory. Results 350 questionnaires were distributed in total, with 335 valid responses returned.. The result showed that the number of trainees who were satisfied with the training contents of medical law and rules and regulations, writing norms of medical documents, infection control, medical information technology, medical insurance policy, fire control and personal security and the use of library resources were 321(95.82%), 318(94.93%), 310(92.54%), 302(90.15%), 251(74.93%), 234(69.85%) and 220 (65.67% ) respectively. There were 254 (75.82% ) trainees who were satisfied with the training methods. Conclusions All medical trainees were satisfied with most contents of current pre-job training. However, the trainings on the extension of clinical expertise and the improvement of clinical skills should be added. Almost all trainees were dissatisfied with the training method, which should be diversified. Fur-ther improvement on contents and methods for current pre-job training will be conducive to enhancing the quality of medical trainees.

目的 总结和分析输尿管癌的典型临床表现及影像学特点,提高输尿管癌的诊疗水平.方法 回顾性总结2008年7月至2017年3月该院术后病理证实为输尿管癌28例,分析其典型临床表现、影像学特点及治疗方案.结果 28例中8例仅表现为无痛性全程肉眼血尿,4例仅表现为腰痛,12例表现为全程肉眼血尿伴腰痛,血尿皆出现于腰痛之前,4例无任何临床表现均于体检时发现.泌尿系B超的检出率为66.7％;CT尿路造影(CTU)的检出率为85.7％;静脉尿路造影(IVU)+尿路平片(KUB)的检出率为71.4％;逆行肾盂造影检出率为75.0％;输尿管镜检的检出率为92.9％,所取组织病理活检检出率为57.7％;荧光原位杂交技术(FISH)检出率为64.3％.28例皆行腹腔镜联合下腹部切口输尿管癌根治性切除术,术后病理检查皆证实为输尿管癌,其中浸润性高级别尿路上皮癌20例,浸润性低级别尿路上皮癌8例.结论 肉眼血尿是输尿管癌的主要临床表现,可伴或不伴有腰痛.影像学检查常提示患侧肾积水、梗阻部位以上输尿管扩张积水等表现.输尿管镜检对输尿管癌的检出率最高,但由此方法所取的组织病理活检阳性率并不理想;CTU、逆行肾盂造影的检出率也较高,但均稍低于输尿管镜检+病理活检,泌尿系B超、FISH、IVU+K UB可作为输尿管癌的术后复查及初筛手段.联合运用CT U和输尿管镜检+病理活检可有效提高输尿管癌的正确诊断率.目前输尿管癌以手术治疗为主,标准术式为腹腔镜联合下腹部切口输尿管癌根治性切除术,切除范围包括患侧肾脏、全长输尿管及膀胱袖状切除.

目的:评估加速康复外科(enhanced recovery after surgery,ERAS)在肾上腺和肾脏肿瘤手术中应用的效果.方法:将2017年3月至2018年2月我院收治的拟行手术治疗的肾上腺肿瘤、肾脏肿瘤按随机数字表法随机分为ERAS组和常规组,按照预设的纳入排除标准,最终ERAS组纳入89例,其中肾上腺肿瘤38例、肾癌15例、肾囊肿36例.常规处理组纳入100例,其中肾上腺肿瘤49例、肾癌16例、肾囊肿35例.ERAS组按照预设的加速康复外科措施进行围手术期处理,比较2组围手术期相关指标.结果:与传统组相比,ERAS组的术后首次饮水时间[(3.1±1.7)h vs.(7.8±3.5)h,t'=-11.419,P=0.000]、术后首次进食时间[(7.6±3.7)h vs.(13.0±6.9)h,t'=-6.611,P=0.000]和术后首次下床时间[(9.1±4.9)h vs.(26.9±16.3)h,t'=-10.449,舟0.000]明显提前;术后留置尿管时间[(10.1±4.5)h vs.(23.2±15.4)h,t=-8.165,P=0.000]、术后肛门排气时间[(10.0±7.6)h vs.(15.0±9.0)h,t'=-4.157,P=0.000]和术后住院天数[(2.7±1.8)d vs.(3.6±2.1)d,t'=-3.128,P=0.002]明显缩短;术后2 h VAS疼痛评分[(3.3±0.8)vs.(4.3±0.8),t=-8.925,P=0.000]和术后首次下床时VAS评分[(2.5±0.6)vs.(3.4±0.7),t=-8.662,P=0.000]降低;手术时间[(55.8±32.5) min vs.(58.5±31.8) min,t'=-0.557,P=0.578]、术中出血量[(48.2±39.2) mL vs.(48.3±34.6) mL,t'=-0.008,P=0.994]、术后并发症(3/89 vs.6/100,x2=0.712,P=0.398)、引流管留置时间[(24.4±16.2)h vs.(27.0±15.3)h,t'=-1.143,P=0.255]两组对比差异无统计学意义.结论:ERAS理念运用于肾上腺和肾脏肿瘤手术的围手术期是安全有效的,能够明显加速患者术后康复,提高患者舒适感,缩短住院时间.

目的:了解重庆地区睾丸扭转的流行病学特点及诊治现状.方法:采用病案资料回顾性分析法,对重庆市50家医疗机构2012年1月至2016年12月间451例睾丸扭转病例进行调查,结果采用统计描述和Cochran-Armitage趋势检验.结果:疾病流行病学特点:发病年龄以18岁以下为主(65.9％),季节以冬季常见(43.2％),首发症状主要为阴囊疼痛(69.6％)和睾丸疼痛(25.7％),左右侧睾丸比为1.79∶1,扭转类型以鞘膜内型常见(88.1％).疾病诊治方面:首诊误诊率为32.8％,医生职称和医疗机构等级越低,误诊率越高;发病至就诊时间越长,睾丸切除率越高;差异有统计学意义.患者未及时就诊原因主要为患方未重视(52.6％)及首诊误诊(45.5％).结论:睾丸扭转诊治水平有待提高,提高基层医院、初级医务人员的诊治水平及公众对该病的认识是提高睾丸挽救率的关键.

Objective To analyze the main causes for unplanned re-operation of pheochromocytoma (PCC) and explore the countermeasures on reducing the re-operation rate.Methods The clinical data of 6 patients with pheochromocytoma who underwent an unplanned re-operation were analyzed retrospectively between September 2011 and December 2016 in our hospital.There were 4 males and 2 females with a mean age of 46 years,ranged from 24 to 60 years.Only 1 patient had paroxysmal hypertension and headache,and the other 5 patients had no symptoms or atypical symptoms.Tumors of 3 cases were located in adrenal,and 3 were extra-adrenal PCCs.The average size of tumors was 5.25cm,ranged from 3 to 10 cm.Among the 6 cases,2 cases were diagnosed as PCC preoperatively and underwent adequate preparationwith stable hemodynamics during the first operation,who encountered post-operative bleeding soon after the surgery.Four cases were misdiagnosed,with poor preoperative preparation and operation was aborted.One case was misdiagnosed as bladder carcinoma and underwent transurethral resection.Results All 6 re-operations were performed by urologists.The main causes for unplanned re-operation were as follows:perioperative hemodynamic unstability (50％,3/6),post-operative bleeding (33.3％,2/6),uncertainty of surgical outcome (16.7％,1/6).Conclusions A precise diagnosis and an adequate preoperative preparation are the key to prevent a second-look surgery.An appropriate surgical approach and a complete surgical hemostasis could help lowering the re-operation rate.

目的:建立一种操作简便、手术时间短、效果确切的小鼠肾移植模型.方法:静脉采用套扎式吻合,将供肾下腔静脉穿过导管,外翻套扎于导管,将其插入受体肾静脉内,套扎受体肾静脉于腔静脉外,完成静脉端端吻合;动脉采用供体腹主动脉与受体腹主动脉端侧吻合,供体膀胱瓣与受体膀胱吻合.结果:开放血管后供肾颜色正常,动脉搏动正常,静脉充盈好,成功建立小鼠肾移植模型,静脉吻合(10±5) min,动脉吻合(10±5) min,膀胱瓣吻合2～5 min,总手术时间40～60 min.结论:采用改良的套扎式原位静脉吻合和膀胱瓣吻合,可以降低手术难度,缩短手术时间,成功建立小鼠肾移植模型.

There nearly have 1 year for the medical postgraduate exempted from admission examination to enjoy the postgraduate life,meanwhile to finish the clinicalpractice task as a medical undergraduate.For students,supervisors and the university,analysis of opportunities and difficulties faced by the medical postgraduate exempted from admission examination in this stage can be made,feasible training plan can be developed,in advance to allow students to avoid the psychological confusion,change the way of learning,lay the foundation for scientific research and improve their clinical skills.These measures will contribute to improve the quality of the medical postgraduate exempted fmm admission examination and the education quality.

Objective To analyze the typical clinical manifestations and imaging characteristics of renal pelvic carcinoma.Methods The clinical data in 69 cases of renal pelvic carcinoma verified by postoperative pathology in this department of the hospital from July 2013 to November 2016 were retrospectively summarized to analyze its typical clinical manifestations,imaging features and treatment regimens.Results All the cases were hospitalized due to hematuria and presented gross hematuria.The detectable rate of B-ultrasonic examination was 71.43 ％,which of computed tomography urography(CTU) was 84.21％ and which of intravenous urography(IVU) + kidney ureter bladder(KUB) was 70.27 ％,which of retrograde pyelography(RP) was 90.32 ％,which of flexible ureteroscope(FU) was 91.67 ％,the pathological detection rate of biopsy tissue by this method was 58.33 ％ and detection rate of fluorescence in situ hybridization was 79.07 ％.Sixty-nine cases all were performed the retroperitoneal laparoscopy combined with hypogastric incision renal pelvic carcinoma radical operation,postoperative pathological examination verified renal pelvis carcinoma.Conclusion Flexible ureteroscope examination has the highest definite diagnosis rate of renal pelvic carcinoma,but the pathological positive rate of biopsy tissue by this method is not ideal;the definite diagnosis rate of RP and CTU were secondary,urinary system B-ultrasonic examination,FISH and KUB+IVP can serve as the preliminary screening and postoperative re-examination means of renal pelvic carcinoma.