Objective To compare with the efficiency between X-ray or B ultrasound guided puncture target calyces of treatment of upper urinary calculi in MPCNL.Methods From October 2010 to October 2012,we have a retrospective analysis of the 116 cases in urological department in the second affiliated hospital of Kunming Medical University,it had the sugery that was MPCNL.Selected 116 cases as the research object,(8 patients were lost to follow-up).With X-ray locating (48 cases),B ultrasound locating (53 cases),and compared with preoperative,intraoperative and postoperative clinical objective indicators of two different methods.Results X-ray locating (48 cases),the mean age was (44.86 ± 12.84) years; the mean Stone diameter(1.43 ±0.70) cm; Stone is located in the upper calyx in 1 case,the middle of calyx in 23 cases,under the calyx in 8 cases,the upper ureter in 16 cases.B ultrasonic locating (53 cases),the mean age was(46.36 ± 14.29) years; the mean Stone diameter (1.34 ±0.62) cm; Stone is located in the upper calyx in 2 cases,the middle of calyx in 24 cases,under the calyx in 8 cases,the upper ureter in 16 cases.Compared with preoperative general data of two groups,there was no statistically significant difference (P ＞ 0.05).X-ray group,the mean operation time (130.43 ± 31.63) min ; Intraoperative blood loss(80.42 ± 43.75) mL; Postoperative hospital stay (6.20 ± 2.08) d; Infected with 8 cases (17％) of postoperative,hemorrhage in 2 cases (4％) ; and calculi exhausted rate was 90％ (43/47).B Ultrasound group,the mean operation time(102.45 ± 36.32) min.Intraoperative blood loss(160.07 ± 52.33) mL;Postoperative hospital stay(5.62 ±2.37) d; Infected with 16 cases (30％) of postoperative,bleeding in 9 cases (17％) ; and calculi exhausted rate was 83％ (46/53).By comparison,X-ray and B ultrasound group in operation time,intraoperative blood loss,postoperative infection,a stone exhausted rate was statistically significant (P ＜0.05),and postoperative hospital stay,no statistical significance (P ＞ 0.05).Conclusion X-ray positioning compared with B ultrasound,X-ray is longer than B ultrasonic of operation time,but,blood much less,calculi exhausted rate is higher,and infected rate is lower.

Objective:To evaluate the effect of start time of surgery on short-term prognosis in the patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB).Methods:A total of 928 patients of both sexes, aged 18-81 yr, with body mass index of 14.5-37.7 kg/m 2, scheduled for elective cardiac surgery with CPB from November 14, 2019 to May 14, 2020, were selected.Based on the start time of skin incision, the patients were divided into morning group (08: 00-13: 59) and afternoon group (14: 00-20: 00) or into on-hour group (08: 00-15: 59 on weekday) and off-hour group (16: 00-20: 00 on weekday, 08: 00-20: 00 on weekend). Propensity score matching was used to calibrate confounding factors.The primary outcomes were 30-day mortality and serious cardiovascular and cerebrovascular events after surgery.Secondary outcomes included the development of acute kidney injury within 3 days after surgery and development of pulmonary complications within 30 days after surgery, occurrence of surgical site infection, postoperative length of hospital stay, length of intensive care unit stay and duration of mechanical ventilation, and total hospitalization costs. Results:There was no significant difference in 30-day mortality and serious cardiovascular and cerebrovascular events after surgery, development of acute kidney injury within 3 days after surgery, and incidence of pulmonary complications within 30 days after surgery and of surgical site infection, postoperative length of hospital stay, length of intensive care unit stay and duration of mechanical ventilation, and total hospitalization costs between morning group and afternoon group and between on-hour group and off-hour group ( P>0.05). Conclusions:The start time of surgery exerts no effect on short-term prognosis in the patients undergoing elective cardiac surgery with CPB.

Objective    To determine whether there was a clinical relevant association between anesthetic regimen (propofol or inhalational anesthetics) and the occurrence of postoperative delirium (POD) in patients undergoing cardiac surgery. Methods    This retrospective study was conducted on patients with elective cardiac surgery under cardiopulmonary bypass (CPB) at West China Hospital of Sichuan University between October 2018 and March 2019. The patients were divided into a propofol group or an inhalational anesthetics group according to anesthetic regimen (including CPB). The primary outcome was the occurrence of POD during first 3 days after surgery. Logistic regression analysis was used to determine the relationship between anesthetic regimen and the occurrence of POD. Results    A total of 197 patients who met the inclusion criteria were included, with an average age of 53 years, and 51.8% (102/197) were females. POD occurred in 21.3% (42/197) patients. The incidence of POD was 21.4% in the propofol group and 21.2% in the inhalational anesthetics group; there was no significant difference between the two groups (RR=1.01, 95%CI 0.51-2.00, P=0.970). Logistic regression analysis did not find that anesthetic regimen was a risk factor for delirium after cardiac surgery after adjusting risk factors (OR=1.05, 95%CI 0.48-2.32, P=0.900). Conclusion    Anesthetic regimen (propofol or inhalational anesthetics) is not associated with an increased risk for POD in adult patients undergoing elective cardiac surgery under CPB.

Objective    To evaluate the association of anesthesia regime (volatile or intravenous anesthetics) with the occurrence of postoperative pulmonary complications (PPCs) in adult patients undergoing elective cardiac surgery under cardiopulmonary bypass (CPB). Methods    The electronic medical records of 194 patients undergoing elective cardiac surgery under CPB at West China Hospital, Sichuan University between September 2018 and February 2019 were reviewed, including 92 males and 102 females with an average age of 53 years. The patients were classified into a volatile group (n=94) or a total intravenous anesthesia (TIVA) group (n=100) according to anesthesia regimen during surgery (including CPB). The primary outcome was the incidence of PPCs within first 7 d after surgery. Secondary outcomes included incidence of reintubation, duration of mechanical ventilation, ICU stay and hospital stay. Results    There was no significant difference in the incidence of PPCs between the two groups (RR=1.020, 95%CI 0.763-1.363, P=0.896), with an incidence of 48.9% in the volatile group and 48.0% in the TIVA group. Secondary outcomes were also found no significant difference between the two groups (P>0.05). Conclusion    No association of anesthesia regimen with the incidence of PPCs is found in adult patients undergoing elective cardiac surgery under CPB.