Objective To analyze the clinical effect of minimally invasive percutaneous nephrolithotomy titanium laser lithotripsy(MPCNL)on upper ureteral calculi.Methods According to digital table,68 patients with upper ureteral calculi were randomly divided into the study group and control group,cach group in 34 cases.The study group received the MPCNL treatment,the control group received extracorporeal shock wave lithotripsy(ESWL)therapy. The therapeutic effects were compared.Results The success rate of gravel,stone clearance rates of the study group were 91 .1 8% and 91 .1 8%,which were higher than 70.59%,67.65% of the control group,there were significant differences between the two groups(χ2 =4.660,5.757,P =0.031 ,0.0164).Conclusion Percutaneous nerve titanium laser lithotripsy for upper ureteral stones can achieve good therapeutic effect.

Objective To evaluate the efficacy and clinical significance of partial laparoscopic resection of renal pedicle without renal pedicle vascular resection in the treatment of low renal complex tumors.Methods Retrospective analysis of retroperitoneal laparoscopic renal artery clamping without partial nephrectomy in the treatment of the patients with low-grade complex renal tumors in 10 cases(observation group) and the clinical data of retroperitoneal laparoscopic renal pedicle occlusion of renal vascular resection in 10 patients (control group) were analyzed.The amount of bleeding,operation time,the average hospitalization time,drainage tube placement after operation,the hemoglobin (Hb),serum creatinine(Ccr) and glomerular filtration rate(GFR) changes were observed in the two groups.Results The operation time,bleeding volume,postoperative drainage tube placed time,postoperative hospitalization time of the observation group were (103.0 ± 42.7) min,(100.0 ± 70.4) mL,(3.5 ± 1.2) d,(5.0 ± 1.2) d,respectively,which of the control group were (129.2 ± 57.5) min,(89.2 ± 9.5) mL,(6.5 ± 9.7) d,(6.3 ± 3.4) d,respectively,there were statistically significant differences between the two groups (t =4.23,3.23,1.57,4.24,all P ＜0.05).Before operation,the Hb,Ccr and GFR between the two groups had no statistically significant differences(all P ＜0.05).After operation,the Hb,Ccr and GFR of the control group were (85.7 ± 18.2) g/L,(77.9 ± 22.1) μmol/L,(61.4 ± 50.9) mL · min-1 · 1.73 (m2)-1,respectively,which of the observation group were (95.6 ± 13.5) g/L,(70.2 ± 10.5) μmol/L,(85.5 ± 5.1) mL · min-1 · 1.73 (m2)-1,respectively,there were statistically significant differences between the two groups(t =9.34,7.44,7.34,all P ＜0.05).Conclusion Retroperitoneal laparoscopic renal partial nephrectomy without blocking renal pedicle vessels is a safe and effective method for the treatment of low complexity renal tumors.It has advantages of simple operation and is beneficial to the recovery of patients'function.

OBJECTIVEWe designed a multi-center, double-blind, randomized, parallel, with metformin controlled clinical trial to evaluate the efficacy and safety of low dose rosiglitazone combined with sulphonylurea therapy in type 2 diabetic patients who were inadequately controlled with sulphonylurea alone.

METHODSPatients were treated with 4 mg rosiglitazone once daily plus sulphonylurea (test group) or 0.5 g metformin twice daily plus sulphonylurea (control group) for 12 weeks. The mean levels of HbA(1c), fasting and postprandial plasma glucose were recorded and compared between the two groups.

RESULTSThe mean levels of HbA(1c) decreased by 1.09% and 0.95% in the test group (n = 102) and control group (n = 96) respectively. Fasting and postprandial plasma glucose levels in the test group decreased by 25.0% and 35.6%, and in the control group, decreased by 17.7% and 23.8% as compared with the baseline (both P < 0.01). No liver damage was found.

CONCLUSIONCombination treatment of rosiglitazone and sulphonylurea can effectively improve glycemic control in type 2 diabetic patients inadequately controlled with sulphonylurea alone.

Adult ; Aged ; Blood Glucose ; analysis ; Diabetes Mellitus, Type 2 ; drug therapy ; Double-Blind Method ; Drug Therapy, Combination ; Humans ; Hypoglycemic Agents ; administration & dosage ; Metformin ; administration & dosage ; Middle Aged ; Sulfonylurea Compounds ; administration & dosage ; Thiazoles ; administration & dosage ; Thiazolidinediones