Objective To investigate the feasibility and safety of helix hydro-jet lithotrity in treatment of calculus of intrahepatic duct and to establish its basic parameters.Methods The parameter of hydro-jet Was set at different levels of pressure(5000-9000 kPa)and different nozzle directions,and the effect of different parameter wag observed and analyzed in three groups.including 32 ex vivo intrahapatic gallstones.thirty-two ex vivo swine bile ducts and 31 ex vivo bile ducts obtained from patients with hepatolithiasis.Results Lithotrity was successful in all groups with a jet pressure of 5000-9000 kPa.The multiple regression analysis showed that the time of procedure depended linearly on the minimal stone diameter,stone weight andjet pressure.The time of procedure and the time needed to damage the bile duct decreased with the increase in jet pressure.At same jet pressure,the smaller the angle between nozzle and bile duct,the longer the time needed to cause damage in bile duct.The technique was successfully performed in 60 patients,with no severe complications,including bile duct injury.Conclusion It is feasible to treat hepatolithiasis with hydro-jet lithotrity.The most optimal operation condition was hydro-jet pressure of 6000-7500 kPa and frequency of 1 Hz.

Objective To evaluate the curative effect,safety,advantages and disadvantages of helix hydro-jet and holmium laser lithotripsy in the treatment of intrahepatic bile duct stones.Methods 158 patients of intrahepatic bile duct stones were divided into helix hydro-jet group (n =82) and helix hydro-jet group (n =76).Time of lithotripsy,frequencies of lithotripsy,residual stone,intraoperative hemorrhage,postoperative hemorrhage,stone recurrence rate,postoperative fever,and therapeutic efficacy were compared between the two groups.Results There was no significant difference between the two groups on frequency of lithotripsy,residual stone rate and stone recurrence rate (P ＞ 0.05) ; whereas intraoperative washing normal saline (2 300 ± 275) ml vs (2 850 ± 331) ml,(P =0.002),the time of lithotripsy (54.2 ± 15.3) min vs (38.1 ± 12.7) min,P =0.041,intraoperative hemorrhage (19 cases vs 29 cases,P =0.041),Intraoperative analgesia (2 cases vs 9 cases,P =0.032),postoperative hemorrhage (11 cases vs 21 cases,P =0.037),and postoperative fever (30 cases vs 62 cases,P =0.027) had significant differences(P ＜ 0.05).Conclusions Both helix hydro-jet and the holmium laser lithotripsy is safe and effective for the treatment of intrahepatic bile duct stones.Holmium laser is more efficient than Helix Hydro-jet,while helix hydro-jet is safer than holmium laser in lithotripsy.

Objective To investigate the risk factors of pancreatic cancer in Wenzhou area.Methods A case control study was conducted on 220 cases with pancreatic cancer and 220 matched controls using conditional logistic regression analysis.Results Univariate analysis showed BMI ＞ 30 kg/m2,smoking,reproductive history,diabetes,cholecystitis,chronic pancreatitis,history of appendectomy,history of partial gastrectomy,history of cancer and familial history of cancer were associated with pancreatic cancer,while multivariate conditional logistic regression analysis showed that the risk factors of pancreatic cancer included smoking (OR =3.624,95％ CI i.474 ～ 8.907),BMI ＞ 30 kg/m2 (OR =1.789,95％ CI 1.030 ～ 3.108),diabetes (OR =3.191,95％ CI 1.094 ～ 9.309),chronic pancreatitis (OR =4.972,95％ CI 1.593 ～ 14.898),and cholecystitis (OR =2.289,95 ％ CI 1.024 ～5.116).Conclusions BMI ＞ 30 kg/m2,smoking and diabetes are risk factors for pancreatic cancer in Wenzhou area.

Objective To investigate the clinical imaging features and immune manifestations of clear cell carcinoma and papillary renal cell carcinoma at the same time in one side of the kidney,in order to increase the awareness of the disease and improve the clinical diagnosis and treatment.Methods This study retrospectively analyzed the clinical data of 7 patients with unilateral renal clear cell carcinoma combined with papillary cell carcinoma admitted to the Department of Urology,People's Hospital of Xinjiang Uygur Autonomous Region from January 2007 to June 2017.The general data,images performance,surgical methods,immunohistochemical results of the patients were observed.Results In 7 patients with multiple tumors of ipsilateral kidney,6 were males,accounting for 85.71％ (6/7);1 female,accounting for 14.29％ (1/7).Ages 45-78 years old,average 63 years old;4 cases were found by physical examination,accounting for 57.14％ (4/7);2 cases were admitted to hospital with obvious oncological symptoms,accounting for 28.57％ (2/7);1 case of renal nonfunction,accounting for 14.29％ (1/7).The tumor was located in 6 cases of left kidney,accounting for 85.71％ (6/7),and the tumor was located in 1 case of right kidney,accounting for 14.29％ (1/7).Preoperative imaging examination clearly indicated multiple tumors in 3 cases,and the remaining 4 cases only showed placeholders.Lesions,of which the maximum diameter of the tumor 7.5 cm,2 patients with a diameter of ＞ 4 cm;4 cases of radical renal resection and partial nephrectomy;3 cases of clear cell carcinoma Fuhrman Ⅰ grade,Fuhrman Ⅱ grade 5 cases postoperative pathology report There were 4 cases of papillary renal cell carcinoma in Fuhrman grade Ⅰ and 3 cases in Fuhrman grade Ⅱ,all of them were type Ⅰ cell carcinoma.Conclusions Ipsilateral kidney associated with papillary renal cell carcinoma and clear cell carcinoma is rare clinically,its formation is unknown.Readings should be repeated before surgery.If you can identify multiple tumors,you will be able to choose the surgical procedure.Partial nephrectomy or radical nephrectomy may be performed depending on the size of the tumor.Radical nephrectomy is recommended.

Objective To investigate the effect of rebamipide on chronic non-atrophic gastritis (NAG) with erosion and its protection of gastric mucosa from Helicobacter priori(Hp) associated lesions.Methods Patients(n=452)with endoscopically confirmed NAG with erosion from 11 hospitals in China were enrolled and randomly assigned at a ratio of 3:1 to receive either rebamipide(100 mg t.i.d.)or sucralfate(1.0 t.i.d.)for 8 weeks.Hp infected patients received eradication treatment before randomization.Symptoms,endoscopic scores and histological changes were recorded before and after therapy.Concentrations of serum prostaglandin E(PGE:)and oxygen free radical(MDA)were measured in patients from 2 centers.Results Per-protocol analysis(n=415)showed that the dyspeptic symptom score in rebamipide group decreased significantly after eight weeks of treatment. The endoscopic inflammation score in rebamipide group also decreased from 2.65 ±0.09 to 0.60±0.10(P<0.001),which was,significantly better than that of sucralfate group(P<0.001).Histological findings were consistent with the endoscopic findings.There Was a significant elevation(P=0.002)in PGE2 concentration in mucesa from rebamipide-treated subjects [(225.4±18.3) pg/g vs.(266.7±14.7)Pg/g] compared with that in sucralfate group.The concentration of MDA significantly decreased from(325.9±65.6)mmoL/g to(216.5±61.5)mmol/g,which is markedly different from that of sucralfate group(P=0.046).No statistical difference was found between Hp eradication group,Hp infection group and Hp negative group,regarding the effect of Rebamipide.Conclusion Compared to sucralfate,Rebamipide demonstrates a superior effect on improvement of dyspepsia symptom and endoscopic findings in erosive NAG,which is not influenced by Hp infection.