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 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.

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 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 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.

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 investigatc the role of phosphatidylinositol 3-kinase (PI3K)/protein-serine-threonine kinases (Akt) signal pathway in ginsenoside Rb1 pretreatment-induced attenuation of myocardial ischemiareperfusion (I/R) injury in diabetic rats.Methods Male SD rats weighing 250-300 g were used in this study.Diabetes mellitus was induced by intraperitoneal streptozotocin and confirmed by fasting blood glucose ≥ 16.7mmol/L.Eight weeks after diabetes mellitus was induced,48 rats were randomly divided into 4 groups ( n =12each):group myocardial I/R (group I/R); group ginsenoside Rb1 (group R); group ginsenoside Rb1 + wortmannin (PI3K inhibitor) (group RW) and group wortmannin (group W).Myocardial I/R was induced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 120 min reperfusion.Ginsenoside Rb1 40 mg/kg was injected iv at 10 min before ischemia in groups R and RW,while in groups RW and W wortmannin 15 μg/kg was injected iv at 20 min before ischemia.Arterial blood samples were collected at the end of 120 min reperfusion for determination of creatine kinase (CK) and lactate dehydrogenase (LDH) activities.The rats were then sacrificed.The infarct size was measured by tetrazolium method.Myocardial apoptosis was detected by TUNEL and apoptotic index (the number of apoptotic myocardial cells/the total number of myocardial cells) was calculated.The expression of Akt and phosphorylated Akt (p-Akt) was determined by Western blotting.Results Ginsenoside Rb1 pretreatment significantly reduced the infarct size,myocardial cell apoptotic index and serum CK and LDH activities and up-regulated p-Akt expression in group R as compared with group I/R.The protective effects of ginsenoside Rbl against myocardial I/R injury were significantly attenuated by wortmannin pretreatment in group RW compared with group R.Conclusion PI3K/Akt signal pathway is involved in the protective effects of ginsenoside Rb1 against myocardial I/R injury in diabetic rats.

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 To investigate the effect of ischemic postconditioning (IPO) on renal injury induced by intestinal ischemia-reperfusion (I/R) and the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) in mice.Methods Thirty-six healthy male C57BL/6J mice,aged 9-12 weeks,were randomly divided into 3 groups ( n =12 each):sham operation group ( S group),I/R group,and IPO + I/R group ( group IPO).Intestinal I/R was produced by occlusion of superior mesenteric artery for 45 min followed by 2 h reperfusion.The mice underwent 3 cycles of 30 s reperfusion and 30 s ischemia at the end of 45 min ischemia before 2 h reperfusion.Blood samples were collected from carotid artery at 2 h of reperfusion and then the mice were sacrificed.The kidney was removed for microscopic examination.The pathological changes of the kidney were scored.The concentrations of serum blood urea nitrogen (BUN),creatinine (Cr) and neutrophil gelatinase-associated lipocalin (NGAL)were detected.The expression of Nrf2 and heme oxygenase- 1 ( HO- 1 ),superoxide dismutase (SOD) activity,and the content of malondialdehyde (MDA),TNF-α,IL-6 and IL-10 were determined in renal tissues.Results The concentrations of serum BUN,Cr and NGAL,MDA content and the expression of Nrf2 and HO- 1 were significantly higher,SOD activity was significantly lower,and the pathological score was significantly higher in group I/R that in group S ( P ＜ 0.05).The concentrations of serum BUN,Cr and NGAL and MDA content were significantly lower,the expression of Nrf2 and HO-1 and SOD activity were significantly higher,and the pathological score was significantly lower in group IPO that in group I/R ( P ＜0.05).There was no significant difference in the content of TNF-αα,IL-6 and IL-10 among all groups(P＞0.05).Conclusion IPO can alleviate the renal injury induced by intestinal I/R through promoting the expression of Nrf2 and up-regulating the expression of HO-1 in mice.