3.Three cases failed to respond to treatment.Two cases had recurrence 7 and 9 months after treatment.The effective rate was 82%. The ICSI score was decreased to 6.1?3.4 at 1 month,6.3?3.5 at 2 months (P

Objective To explore the feasibility of B-ultrasound guided ureteroscopic holmium laser nephrolithotomy via percutaneous nephrostomy for the treatment of complex renal calculi. Methods A total of 32 cases of complex renal calculi was included in the study. Under local anaesthesia and B-ultrasound guidance, a percutaneous nephrostomy was performed untill a F_ 16 catheter could be introduced, with the sheath indwelling in the tract. Then under a F_ 8/9.8 ureteroscopy, holmium laser nephrolithotomy was conducted for 1~3 fractions with an interval of 3~5 d. Results The renal puncture was successfully accomplished in all the cases. The stone-free rate was 75% (24/32) at 4 weeks, and 94% (30/32) at 12 weeks after procedure. No serious hemorrhage or infection happened. No conversion to open surgery was required. Conclusions Under local anaesthesia and B-ultrasound guidance, ureteroscopic holmium laser nephrolithotomy via percutaneous nephrostomy for the treatment of complex renal calculi is safe, effective, and feasible.

0 05) The overall incidence of adverse effects was between 12 9% and 28 8% There were no significant differences between these two groups Rivastigmine had no influence on vital signs and laboratory indexes Conclusion Rivastigmine may significantly improve the symptoms of the patient with AD and have a good safety and tolerability,being an ideal choice in treating AD

Objective To investigate the early and long-term effects of enhanced ischemia/reperfusion injury on the transplanted abdominal aorta. Methods Abdominal aorta grafts from Sprague-Dawley (SD) rats were cold stored for 1 or 24 hours, and they were orthotopically transplanted to SD or Wistar recipients. The pathohistological changes and the expression of TGF-? 1 in the grafts were observed. The levels of serum lipid peroxides before and after transplantation were also measured. Results The intima was significantly thicker in aorta transplants which was cold stored, both in SD→SD and SD→Wistar groups 10 weeks and 6 weeks after transplantation, whereas grafts which were cold stored for 24 hours showed pronounced thickening as early as 2 weeks after transplation. Serum lipid peroxides levels were elevated significantly 2 hours post-transplantation in all groups, but they were lowered 4 and 24 hours post-transplantation. The expression of TGF-? 1 in 24 hours of ischemia became stronger 1 week after transplantation regardless the difference in strains of the animal. Conclusions The enhanced ischemia/reperfusion injury can aggravate the infiltration of inflammatory cells, intensify the expression of TGF-? 1, accelerate the thickening of intimal layer.

AIM and METHOD:To determine the production of nitric oxide(NO) and change of NO synthase(NOS) activity in mitochondria isolated from the rat brains of the ischemia/reperfusion rat model produced by transient occlusion of middle cerebral artery on the following the points: 2 h after occlusion of artery and 30 min, 2h, 4h after reperfusion. RESULTS: After the occlusion of middle cerebral artery, the respiratory control rate(RCR) of mitochondria significantly decreased and slightly increased at 4h after reperfusion. Meantime, the production of NO in mitochondria increased significantly. But with the increase of perfusion, production of NO gradually decreased and reached normal level as in the control group. It also shows that cerebral ischemia increased NOS's activity significantly in the mitochondria and still kept a higher level than the control group although it decreased gradually after reperfusion. But the iNOS's activity did not show obvious change. The change of total NOS's activity depends on the change of cNOS's activity. CONCLUSION: The activation of NO/NOS system in the mitochondria might play an important role in the reperfusion injury during reperfusion of ischemic brain.

The etiological factor, diagnosis, as well as therapeutic results of 23 cases with urinary fistula following renal transplantation, at the Chengdu Military General Hospital, from December 1998 to December 2008, were analyzed retrospectively, including 21 cases with a renal transplantation, 2 cases with retransplantation; 9 cases adopt renal artery, renal veins to external lilac artery, external lilac vein anastomosis, 14 cases with renal artery to internal lilac artery, renal veins to external lilac vein anastomosis. 23 cases were followed-up for 6-12 months, 17 cases suffered urinary fistula at days 3-7 after transplantation, 6 cases occurred at days 7-10; there were 17 stoma fistulae, 4 distal end necrosis of ureter, 2 ureteral fistulae. 11 cases were received conservative treatment, and 12 cases with operation. Among the surgery patients, 9 cases received conventional operation and 1 of them returned with urinary fistula and then was cured by second operations; 3 patients received pedicled omentum transplantation and no recurrence or hydronephrosis happened with normal renal function. The one-time success rate was 92% (11/12), of which the repair success rate using pedicled omental was 100%. The results demonstrated that prevention plays an important role in urinary fistula, and ureter should be protected during the surgery. Meanwhile, stoma fistula should be avoided. Promptly treatment following urinary fistula is also necessary to reduce the damage of urinary fistula to the renal function.

BACKGROUND:Although the renal transplantation technology has been quite mature, vascular complications during and after transplantation inevitably occur.
OBJECTIVE: To investigate the diagnosis and management of vascular complications during and after renal transplantation.
METHODS: A retrospective analysis was performed in 11 patients suffering from vascular complications during and after renal transplantation. During the transplantation, there were two cases of arterial anastomotic stenosis, one case of renal vain transverse, three cases of atherosclerosis plaque of the external iliac artery blocking the transplant renal artery, one case of twisted renal vein. After transplantation, there were two cases of extra renal pseudoaneurysm, one case of arterial anastomotic stenosis, and one case of renal artery obstruction.
RESULTS AND CONCLUSION: Two cases of arterial anastomotic stenosis during operation had good recovery, and renal alograft dysfunction occurred after 6 and 11 years, respectively. In the case of renal vain transverse, the renal alograft functioned for 12 years. Among the three cases of atherosclerosis plaque of external iliac artery blocking the transplant renal artery, 1 case presented with renal alograft dysfunction immediately, the other two patients,renal function recovered wel during the folow-up of 6 and 2 years respectively. In the case of twisted renal vein, delayed graft function occurred, and the patient died of severe pulmonary infection 1 month later. The renal alograft dysfunction occurred in the two cases of post-transplantation extra renal pseudoaneurysm. The case of post-transplantation arterial anastomotic stenosis was treated by baloon angioplasty and metalic stent placement via femoralartery, and the renal function became normal during 18 months of folow-up. The case of post-transplantation renal artery obstruction appeared to have delayed graft function, and died of severe pulmonary infection 3 weeks later. These findings indicate that patients with vascular complications during and after renal transplantation can obtain satisfactory outcomes if receiving accurate diagnosis and timely treatment.

Report a case sustained Gustilo type III C open fracture of the left humerus with brachial artery injury who has limb ischemia and wound infection after operation in June, 2014. To salvage the limb, performed cross limb vessel transfer to restore blood supply at one-stage. After multiple debridement, Flow-through flap transfer was performed for definitive reconstruction of the arterial injury and repair the wound in secondary stage. In the 3rd stage, cutting the pedicle of transposition vessels. Follow-up at 1 year after surgery, the patient's left upper limb had survived with limited movement and confirmed Flow-through the vessel reconstruction using CTA.

Objective To explore clinical value of intraoperative extra strong electrical stimulation in the treatment of birth brachial plexus palsy. MethodsFrom July 2008 to September 2011,intraoperative extra strong electrical stimulation was applied in 9 cases of incomplete birth brachial plexus palsy after neurolysis.The latency and amplitude of compound muscle action potentials before and after electrical stimulation were recorded and the extent of improvement was compare.ResultsThe latency was improved in 7 cases with 8.02％ in average,amplitude in 8 cases with 185.97％ in average.The related nerve recover partial motor function in 8 cases in 2 weeks after operation.ConclusionIntraoperative extra strong electrical stimulation is a effective assistant technique to promote motor functional recovery of birth brachial plexus palsy.

Objective To investigate the short-term outcome of vascularized supraclavicular lymph nodes flap transplantation to treat the lower extremity lymphedema.Methods From June,2014 to June,2016,6 cases of stage Ⅱ-Ⅲ lower extremity lymphedema received vascularized supraclavicular lymph nodes flap transplantation in this study.Flap size ranged from 2.5 cm×8.0 cm to 3.5 cm×10.0 cm.The anterior tibial artery and accompanying vein were detached for anastomosis.Results One case suffered flap necrosis and then received lymphatic-venous anastomosis instead;2 cases suffered vascular crisis and partial flap necrosis,but transplanted lymph node survived and the wound were closed with skin graft.The other 3 flaps survived without any complication.Follow-up time ranged from 0.5 to 2.0 years.The affected limb circumference and the incidence of lymphangitis decreased significandy,with no complications observed in donor site.Conclusion Using vascularized supraclavicular lymph nodes flap transplantation to treat lower limb lymphedema,it has satisfactory short-term outcome and no obvious complications.It is a promising treatment choice for patients with lower extremity lymphedema in the early and mid stage.