Objective To investigate the complications of minimally invasive percutaneous nephrolithotomy (PCNL) and their countermeasures.Methods The datum of 265 cases who underwent PCNL in our hospital.Among the 265 cases of PCNL,serious complications occurred in 13 cases.Of the 13 cases,4 cases had massive hemorrhage,2 case had colon perforation,1 case had serious urinary extravasation,6 cases had febricity.Results The incidence of serious complications was 4.91％(13/265),all patients were cured by corresponding treatment and no death in the cases.Conclusions Adequate preoperative preparation in PCNL and strict surgical indications were good for complications reduction.Serious complications should be detected early and treated correspondingly.

Objective To explore the experience in diagnosis and treatment ot primary transitional cell carcinoma of prostate for the early and accurate to diagnosis and treatment.Methods The clinical data and features of 3 cases were retrospectively reviewed.Results All patients were diagnosed as primary transitional cell carcinoma of prostate.Two cases were advanced tumor.The preoperative examinations (ultrasound and serum,PSA) have failed to accurately indicate the diagnosis.All of them were confirmed by pathological examination.1 case lost follow-up,1 case performed TURP + chemotherapy through intravesical administration have survived 17 months respectively till today.The other case has already survived 2 months postoperatively but with lumbar spine bone metastasis.Conclusions Early diagnosis of primary transitional cell carcinoma of prostate is difficult.The diagnosis of the disease depends on the transrectal needle biopsy of the prostate or the specimens of the prostate after the Urethroscopy.Because of the prognosis is bad,and prone to pathological missed diagnosis or misdiagnosis.Need to exclude multicentric lesions and mixed tumor and choice of treatment method.

Objective Investigating for the standardization of serum enzyme determination by using enzyme calibrator in lab tests Methods 150 laboratories were involved in this program. One enzyme calibrator and three patient samples were send to each participate lab The calibrator was tested using routine method and record the results The patient samples were analyzed before and after calibration Record the results All lab data was processed with computer Results Compare with the target values, the bias of alanine aminotransferase (ALT), aspartate aminotransferase (AST), amylase (AMY) and lactate dehydrogenase (LD) assays were 3 8%, -1 8%, 2 3% and -5 2% respectively, the bias of alkaline phosphatase (ALP), gamma glutamyltransferase (GGT) and creatine kinase (CK) assays were 13 7%, -13 9 and -19 2% respectively The precision of the enzyme assays were improved by using calibrators Conclusions The traceability of ALT, AST, AMY and LD assays were reasonable Calibrating by using enzyme calibrator can improve the assay precision among laboratories

Objective Little is known about the role of low oxygen concentration in the formation of the capsule of Cryptococ -cus neoformans .This study was to investigate the effect of hypoxic condition on the capsule size of Cryptococcus neoformans . Methods We cultured 39 Cryptococcus neoformans strains in liquid Sabouraud medium and then incubated them at the normoxic (21%) and hypoxic concentration (1%), respectively.After 72 hours of incubation, we observed the capsules formed at different ox-ygen conditions under the Olympus microscope and the measured their sizes using the Axiovision software . Results Of the total number of Cryptococcus neoformans strains , 30 showed larger capsules in the normoxic than in the hypoxic condition , 17 with statisti-cally significant differences in their diameters (P<0.05), while the other 9 strains exhibited just the opposite results , 4 with statisti-cally significant differences in their diameters ( P<0.05). Conclusion Hypoxia might inhibit the growth of the Cryptococcus neoformans capsule.However, further studies are needed on its correlation with the serum or gene types of the Cryptococcus neofor-mans strain.

Objective To establish neuropathic pain models,explore the effects and mechanisms of dexmedetomidine on neuropathic pain.Methods Wistar rats were randomly divided into four groups (n =9):0.9％ sodium chloride solution CCI group (N),dexmedetomidine CCI group (D),ZD7288 CCI group (Z) and sham-operated group (Sham).Sciatic nerve ligation was performed in group N,D and Z.The sciatic nerve in group Sham was exposured without ligation.7 d after surgery,the rats in group D were intraperitoneal injected with dexmedetomidine (40 μg· kg-1),and the rats in group Z were intraperitoneal injected with ZD7288 (10 mg·kg-1)once a day for 3 d.The same volume of 0.9％ sodium chloride solution was given at the same time in group N.The behavioral test was performed before and 7 d after operation,as well as 3 d after injection treatment.Mechanical allodynia was assessed by paw withdrawal mechanical threshold (PWMT) to von Frey filaments.Thermal hyperalgesia was assessed by paw thermal withdrawal latency (TWL) to radiant heat.Dexmedetomidine block of HCN channels in dorsal root ganglion (DRG) neurons were confirmed by whole-cell recording.Results 7 d after surgery,the PWMT and TWL of rats in group N,D and Z were decreased significantly (P ＜ 0.05).The PWMT and TWL in group Sham were no significant difference before and after operation.Dexmedetomidine significantly increased the levers of PWMT and TWL in group D and Z after treatment for 3 d,and group Z was greater than group D (P ＜ 0.05).Dexmedetomidine (0.1,1,10 μmol· L-1) caused a concentration-dependent decrease in the amplitude of Ih in DRG neurons from (-844.43 ± 386.34) to (-215.99 ± 63.90) pA (P ＜ 0.05),and the inhibition rate of Ih was (11.87 ± 1.80) ％,(35.26 ± 3.65) ％ and (52.02 ± 5.56) ％,respectively(P ＜0.05).Dexmedetomidine produced a dose-related shift to the left of the Ih activation,and a negative shift in V1/2 (P ＜ 0.05).V1/2 shifted from (-86.21 ± 1.68) to (-103.54 ± 2.01) mV (P ＜ 0.05).The slope values were not altered by dexmedetomidine.Conclusion Dexmedetomidine produces a dose-dependently analgesic effect on neuropathic pain after peripheral never injury,which is likely due to the inhibition of Ih and reduction of ectopic spontaneous discharge in DRG neurons.

OBJECTIVE To analyze the status of concomitant or combined infection in patients presented with hepatitis B for investigation of the nosocomial infection control. METHODS We determined the serum virus marker of hepatitis A,C,D,E and G from 786 cases infected with hepatitis B virus. RESULTS Double and multiple infections accompanied by hepatitis B were found to be 16.67%(131/786) and 1.78%(14/786),respectively,especially with hepatitis C which amounted to 45.52%(66/145) of those with concomitant infections(double or multiple). CONCLUSIONS It is commonness that the patient of hepatitis B to preexist other kinds of hepatitis virus infections.We determine other hepatitis markers in patients of hepatitis B to be probative for nosocomial infection.

Risk management is derived from industry.In recent years,risk management is introduced by many medical laboratories their process management abroad.However,the concept of risk management is still very new for laboratories in China.Therefore,the establishment of the project for risk detection,classification,correction,prevention and supervision could help medical laboratories improve their service quality.

Objective To evaluate the effectiveness and safety of MRI-navigation system EMT-100 in assisting the performance of precise percutaneous puncture biopsy.Methods With the help of MRI-navigation system EMT-100,percutaneous puncture biopsy of thoracic and abdominal lesions was performed in 42 patients.The puncture success rate was used as the main index to evaluate the effectiveness of MRI-navigation system EMT-100.The success rate of puncture biopsy,the total time used for procedure,the average number of puncturing,the average number of scanning,and the incidence of complications were recorded.Results In the 42 patients,the success rates with single and twice puncturing were 86％ (36/42) and 14％ (6/42) respectively.The success rate of puncture biopsy was 100％.The mean time used for locating puncture site was (11.5±5.5) min;the average number of puncturing was (1.4±0.5) times,and the average number of scanningwas(4.2±0.8) times.Among the 32 patients with pulmonary lesions,bloody sputum occurred in 2 patients (6.2％) and small amount pneumothorax in one patient (3.1％),and no serious complications occurred in other patients.Conclusion In performing percutaneous puncture biopsy of thoracic and abdominal lesions,the use of MRI-navigation system is safe.This technique has certain advantages,such as accurate positioning,high puncture success rate,wide range of application,radiationless,etc.It can help precisely obtain the lesion tissue and get pathological diagnosis.Therefore,it is really a valuable guiding technology.(J Intervent Radiol,2017,26:263-265)

Objective Trichophyton rubrum strains can cause superficial infection and also deep tissue infection, but relevant animal model has not been reported yet.The aim of this study was to construct an animal model of granuloma infected by T.rubrum. Methods Three T.rubrum strains isolated from clinical granuloma tissues, 2 T.rubrum strains isolated from tinea infection and a standard strain of ATCCMYA4438 were selected.Corticosteroids were given to the Balb/C mice before and after the injection of the T. rubrum and mucin suspension and the mice model of granuloma was established.Direct microcopy, culture and histopathologic method were adopt to verify the infection effects. Results The mice inoculated with the T.rubrum granuloma strains with mucin suspension were examined after 21 days in the condition of applying appropriate dose of glucocorticoids.Direct microscopic examination showed the slender mycelium, fungal culture showed the growth of colony and histopathology showed excessive keratinization of foot tissue, formation of granuloma in the dermis with inflammatory cell infiltration of neutro-philic granulocyte and lymphocytes.However, the mice inoculated with the T.Rubrum tinea strains with mucin suspension showed the negative result. Conclusion The rubrum granuloma mice model can be es-tablished using the clinical isolates of T.rubrum granuloma strains with the mucin and glucocorticoids interventions.

Objective To investigate the molecular mechanism of resistance to carbapenems in Pseudomonas aeruginasa from 5 teaching hospitals in Beijing. Methods A total of 213 non-duplicate imipenem-resistant Pseudomonas aernginosa (IRPA) isolates were collected from 5 hospitals in Beijing from June 2004 to December 2005. The minimal inhibitory concentrations (MICs) of meropenem, imipenem and others antibiotics were determined by agar dilution method. Disk diffusion test was used for screening metalloenzymes. The bla IMP,bla VIM and OprD2 genes were amplified by PCR and only sequenced. Results Out of 213 isolates, OprD2 loss was detected in 84 isolates and IMP-1 enzyme was detected in 6 isolates simultaneously. Thirteen IRPAs only produced IMP-1 and 2 isolates only produced VIM-2. Conclusion OprD2 loss and metallo-β-lactamuse production are the parts of the mechanisms of resistance to carbapenems in Pseudomonas aeruginosa in Beijing.