Objective To compare the safety and effects of retroperitoneal laparoscopic ureterolithotomy(RLU)and microinva-sive percutaneous nephrolithotomy with lithotomy (MPCNL)for treating complicated upper ureteral calculi and to explore the sur-gical indications and the technical key points.Methods The clinical data in 54 cases of complicated upper ureteral calculi from Mar. 2009 to Sep.2012 were retrospectively analyzed,31 cases adopted the MPCNL therapy (MPCNL group)and 23 cases received the RLU therapy(RLU group).The perioperative complications and the stone clearance rate were compared between the two groups. Results The mean operating time was (69.70±7.73)min in the RLU group and (46.50±7.09)min in the MPCNL group(t=-11.436,P=0.000);the intraoperative blood loss was (21.50±7.23)mL in the RLU group and (66.90±20.00)mL in the MPC-NL group(t=9.94,P=0.000),the MPCNL group was significantly higher than the RLU group;no statistically significant differ-ences were found in the occurrence rate of postoperative hyperpyrexia,the stone clearance rate,the occurrence rate of urinary leak-age and the length of hospital stay between the two groups.Conclusion Both MPCNL and RLU have high safety and satisfactory effects for treating complicated upper ureteral calculi.RLU has less intraoperative blood loss and long operation time.

Objective To detect the serum levels of IL-6 and CRP in patients with acute type A aortic dissection complicated with pulmonary injury and inflammatory response. Methods From January 2007 Month to February 2016,216 patients with acute type A aortic dissection were admitted to our hospital. Among them,there were 120 male and 96 female patients,with a mean age of 52.1 years. All patients underwent cardiac ultrasound and other imaging studies. They were diagnosed and hospitalized immediately after the onset. Treatment lasted for more than 1 week. In a calm state of oxygen ,oxygenation index ≤200 preoperative lung injury is defined as positive. In this study ,according to the definition of the lung injury ,patients were divided into positive and negative lung injury groups. There were 72 positive and 144 negative cases among 216 patients. All patients were hospitalized. Every 4 hours,arterial oxygenation index is calculated. At the same time blood samples were tested for C-reactive protein(CRP)and interleukin-6(IL-6)levels. Data was analyzes by SPSS20.0 statistical software and counted byχ2 test. The results were plotted as the percentage,the measurement data with the t test,with(x ± s) to represent,evaluate serum levels of CRP and IL-6 levels with acute type A aortic dissection complicated by the relationship between lung injury. Results The differences of patients from two lung injury groups in gender,age, smoking,alcohol consumption,and other aspects of common chronic diseases were not significant(P>0.05);the difference between the pre-operative examination of several experimental studies in echocardiography were also no statistically significant(P > 0.05);two groups of patients,serum CRP positive group lung injury peak level and peak IL-6 levels were significantly higher in patients with acute lung injury negative group (P > 0.05). Further study of lung serum CRP in patients with damage to the relationship between IL-6 levels and oxygenation index found after dissection. Patient's oxygenation index decreased ,and serum C-reactive protein and interleukin-6 levels were rising rapidly ,reaching peak levels ,and then ,with the patients with inflammatory response decreased oxygenation index showed an upward trend. Conclusion Inflammatory reaction in acute type A aortic dissection plays a key role in the lung injury. In result ,patients'sicken time is prolonged ,which was closely related to serum C reactive protein(CRP),interleukin 6 levels and hypoxemia. Active anti-inflammation treatment before surgery may improve the patient's oxygenation status.