Objective To investigate the arterial injury in vitro porcine kidney to different size of nephrostomy tracts. Methods The technique of percutaneous nephrostomy was applied to establish 11 groups of different size of nephrostomy tracts from 12 F to 32 F,with 40 tracts in every group.The technique of digital subtraction angiography (DSA) was used to inspect and analyze arterial injury. Results In the range from 12 F to 32 F,the damage of arterial injury increased with the size of the tract diameter.In groups of 20 F and 32 F,the number of nephrostomy tracts with serious arterial injury was 18 (18/40) and 30 (30/40) respectively,and the difference was statistically significant (P＜0.05).There was no statistical difference between groups 18 F、20 F、and 22 F. Conclusions The damage of renal arterial injury increased with the size of the nephrostomy tract.Atract of 20 F reduees arterial injury compared with a tract of 32 F.

Objective To examine supine fulcrum pressurized radiograph to predict spinal flexibility in adolescent idiopathic scoliosis (AIS). Methods 1. Empirical study: put two points (A and B) on one side of the plastic stick and one point on the other side ( C), pressurize on the plastic stick when point C is in the middle of A and B, and then measure the projection shifting of point A. Repeat the pressure test when the distance between A and C doubled. Analyze the effect of increasing distance on diminishing pressure. 2.Clinical study :45 patients ( 16 males and 29 females) underwent standing anteroposterior radiograph ,fulcrum lateral flexion radiograph, supine lateral flexion radiograph. The Cobb's angles were measured and the flexibility ratio was determined on preoperative fulcrum radiograph. Results (1) If the length of A and C was 25 cm, pressurize on point C, when pressure quantitative scale number located 1 scale and 2 scale of the rule, projection shifting of point A were 5 cm and 10 cm. If the length of A and C was 50 cm, pressurize on point C, when pressure quantitative scale number located 1 scale and 2 scale of the rule, projection shifting of point A were 8 cm and 15 cm. The longer the distance, the lesser the pressure force of plastics stick. (2)The Cobb angles and curve flexibility provided by fulcrum lateral flexion radiograph had significant difference from that provided by supine lateral flexion radiograph in male group and female group. Cobb angles of male group was 28. 6°± 4. 1 °, 16. 7°± 4. 6° respectively (t= 7. 438, P ＜ 0. 01 )and curve flexibility was 47. 6% ±8. 1% ,69. 4% ± 8. 5% respectively( t = 7. 438, P ＜ 0. 01 ). Cobb angles of female group was 24.5°± 2. 7°,12. 6°±2. 4° respectively(t = 17. 540,P ＜0. 01 )and curve flexibility was 53.4% ±5.2% ,76. 0% ±4. 7% respectively(t = 17. 54, P ＜ 0. 01 ). The flexibility of spinal main curve of female patients was obviously higher than male patients. Conclusions Supine fulcrum pressurized technique can make up for the insufficiency of supine lateral flexion technique, and provide a convenient, safe, precise and useful method for evaluation of spinal flexibility in AIS.

Objective:To explore the efficacy of tracheotomy and nasal intubation in airways management in treatment of patients with respiratory failure caused by severe tetanus.Methods:A respective case series study was conducted to analyze the data of 92 patients with respiratory failure caused by severe tetanus admitted to Jiangxi Chest Hospital from January 2012 to December 2019. There were 60 males and 32 females, aged 23-81 years [(47.5±14.1)years]. Overall 43 patients underwent tracheotomy (tracheotomy group), and 49 patients underwent nasal intubation (nasal intubation group). The blood gas related indexes (PaO 2, PaCO 2), catheter retention time, incidence of complications such as airway bleeding, nasosinusitis, catheter blockage and ventilator-associated pneumonia (VAP), and clinical outcome were compared between the two groups. Results:After mechanical ventilation, the PaO 2 and PaCO 2 in both groups were significantly improved ( P<0.01), with no significant difference between groups ( P>0.05). Both groups were similar regarding the catheter indwelling time, catheter blockage, airway bleeding and nasosinusitis ( P>0.05). The incidences of VAP and catheter blockage after extubation in tracheotomy group [12%(5/43), 12%(5/43)] were significantly different from those in nasal intubation group [0%(0/49), 31%(15/49)] ( P<0.05). There were 3 deaths in each group, with the mortality rate of 7% (3/43) in tracheotomy group and of 6% (3/49) in nasal intubation group ( P>0.05). Both groups of live tetanus patients were cured. After 3-month follow-up, the tetanus was cured in the two groups. Conclusions:The tracheotomy and transnasal tracheal intubation are optional for severe tetanus patients with respiratory failure. The former has airway and tissue trauma, but it is convenient for mechanical ventilation management, especially indicated for patients with severe convulsions, angular arch reflexes, poor sedation, and continuous application of muscle relaxants. Nasal intubation is relatively non-invasive, simple and fast method, but the prevention and monitoring of VAP requires higher requirements.