Objective To discuss the feasibility and benefits of staged ureteroscopic laser lithotripsy in complicated cases. Methods From May 2005 to May 2008, the staged ureteroscopic procedure was done in 56 cases for ureteric stricture, kinking, spasm or high mobility of ureteric mucosa. Encountering difficulties, with the guide wire settled in place, the endoscopic procedure was ended and a ureteral stent was set. A second ureteroscopic procedure was carried out two weeks later. Results There was no difficulty for the insertion and the advancing of the ureteroscope two weeks later in all 56 cases. Among the 41 cases previously having the ureteric calculi, the stone was pushed into the kidney by the stent in 16 cases. There was no surgical complication during the second procedure. After three months the complete evacuation rate of the calculus was 96.4%. No patient experienced a fever >39.1 ℃ after the first attempt. Conclusions For complicated cases, such as ureteric stricture, spasm, kinking and high mobility of the ureteric mucosa which hinder the safe advancing of the ureteroscope, staged ureteroscopic procedure might be a safe and effective choice.

ObjectiveTo detect mRNA and protein expression of steroidogenic factor-1 ( SF-1 ) and DAX-1 in human adrenocortical tumors and normal adrenal cortex,and to investigate the effect of SF-1 and DAX-1 on the steroidogenesis and development of adrenocortical tumors.Methods Total RNA and protein was extracted from angiotensin Ⅱ unresponsive aldoterone-producing adenomas ( A Ⅱ -U-APA,n =12 ),angiotensin Ⅱ responsive aldoterone-producing adenomas ( AⅡ -R-APA,n =5 ),cortisol-producing adenomas ( CPA,n =10 ),adrenal nonfunctional adenomas ( NFA,n =10 ),aldosterone-producing carcinoma ( APC,n =2 ) and normal adrenal cortex ( NAC,n =8).To analyze gene expression of SF-1,DAX-1,ACTH receptor(ACTHR),and β-actin by real-time quantitative PCR in different tissues.The protein expression of SF-1,DAX-1,and β-actin in the same tissues by Western blot.To study the relationship of ACTHR,SF-1,and DAX-1 with clinical data in adrenocortical tumors.ResultsThe expression of SF-1,DAX-1 mRNA and protein was different in NAC,AⅡ -U-APA,A Ⅱ -R- APA,APC,CPA,and NFA tissues [ relative expression of SF-1 mRNA:24.58±2.45,23.89±3.17,21.59±3.00,(38.75,44.16),14.17±2.80,and 36.38±3.50; DAX-1 mRNA:0.57±0.06,0.37±0.05,0.43±0.05,( 1.52,1.21 ),0.39 ±0.04,and 0.83 ±0.08 ; SF-1 protein:0.76 ±0.11,0.76 ±0.10,0.73 ±0.07,(1.24,1.40),0.55±0.04,and0.98±0.10; DAX-1 protein:0.65±0.14,0.39±0.13,0.43±0.14,(1.18,1.02),0.56±0.04,and 1.03±0.13 ; all P＜0.05 or P＜0.01 ].There was negative correlation by higher SF-1/DAX-1 ratio and tumor size in AⅡ -U-APA tissues.The mRNA and protein expression of SF-1 was lower in CPA and there was the positive correlation with tumor size.Conclusion SF-1 and DAX-1 might play a key role in the development of the adrenocortical tumorigenesis and steroidogenic tissues.

Adult ; Behcet Syndrome ; complications ; Cochlear Implantation ; Cochlear Implants ; Deafness ; etiology ; rehabilitation ; Humans ; Male ; Treatment Outcome

Objective To study the stability of NRT threshold and the correlation between NRT threshold and the value of behavior T ,C in order to instruct mapping in infant cochlear implant ,and to study whether the elic‐itation of NRT waveform can be applied to determine the effects of rehabilitation .Methods There were 159 cases with complete information in data in this study .150 out of the 159 cases coincided with the study requirements of the changes and correlation .We had collected the NRT thresholds of the electrodes of No .1 ,6 ,11 ,16 ,22 in switch-on ,one month after switched -on ,half a year and one year after switched -on .The analysis of variance method was adopted to compare the threshold changes of each electrode in different stages .We had collected the values of behavior T ,C in one year after switched -on .Pearson regression analysis was used to compare the correlation be‐tween NRT threshold in switch -on and this value of behavior T ,C .We applied MAIS assessment scale to make a questionnaire for all 159 patients during the follow -up at one year after switched -on .We had gathered the scores in three aspects ,the average score in questionnaire and the average hearing threshold of every child .All children were divided into four groups according to whether the elicitation of NRT waveform during - operation ,post-op‐eration .Results Regarding the NRT threshold ,there was no significant difference in the pairwise comparison of four time points(P>0 .05) .There was positive correlation between NRT threshold and behavior T ,C(P<0 .01) , but the correlation was wake .The group with no waveform on the during -operation and post -operation had sig‐nificant differences with the other groups in all scores and average hearing threshold (p<0 .01) .And there was no statistical significance among the other three groups (P> 0 .05) .Conclusion The NRT threshold remains steady from switched -on .A positive correlation exists between NRT threshold and the actual T ,C value .The NRT threshold can be used to estimate the T ,C value .But the accuracy of the measured value is less than the behavior method .We still need to use behavior method to measure as soon as possible .The NRT waveform appearance on the post-operation is more significant than that on the during -operation to prognosis of rehabilitation .

Objective To investigate the incidence and risk factors of the complications in perioperative intra-aortic balloon pump (IABP) supported cardiac surgical patients. Methods The clinical data of adult cardiac surgery patients undergoing IABP in Fuwai Hospital from January 2005 to January 2017 were enrolled. The patients were divided into complications group and no complications group. Demographic characteristics, diagnosis, perioperative clinical parameters, IABP related data, and IABP complications (including ischemia, bleeding, vascular injury and mechanical problems) were collected. The incremental risk factors of complications related IABP were analyzed by logistic regression. Results During the 12-year period, 522 patients received IABP support, with 388 male and 134 female; the mean age was (61.79±9.35) years; the complications related to IABP occurred in 25 patients, and overall complication rate was 4.79%; 87 IABP patients were dead in-hospital, the overall mortality was 16.67%, no patient died due to complications. The complications rate was higher in the female patients (40.00% vs. 24.95%), and was more in patients with age ≥ 65 years old (80.00% vs. 38.03%), more with higher body mass index [BMI (kg/m2): 25.45±13.71 vs. 22.95±3.45], diabetes mellitus (44.00% vs. 26.76%), combination treatment with extra-corporeal membranous oxygenation (ECMO: 20.00% vs. 5.03%) and prolonged IABP support time (hours: 134.4±90.3 vs. 109.8±89.1, all P < 0.05). There was no significant difference in the incidence of complications among preoperative IABP support, intra-operative IABP support and post-operative IABP support [3.30% (3/91), 5.46% (10/183), 4.84% (12/248), χ 2 =0.629, P = 0.730]. Bleeding from puncture site occurred in 14 cases (2.68%) without severe bleeding. Limb ischemia occurred in 9 cases (1.72%). One patient (0.19%) was under another surgery because of retroperitoneal hemorrhage caused by vascular injury. One patient (0.19%) was unsuccessful due to a balloon leak. It was shown by logistic regression analysis that presence of age ≥ 65 years [odds ratio (OR) = 2.320, 95% confidence interval (95%CI) = 1.011-1.806, P = 0.047], diabetes mellitus (OR = 2.281, 95%CI = 1.016-5.120, P = 0.026) and combination treatment with ECMO (OR = 4.341, 95%CI = 1.240-15.196, P = 0.040) were found to be the risk factors of complications related to IABP. Conclusions IABP complication rates are generally low. The frequent complications during IABP support is bleeding from site of catheterization and limb ischemia. When patients were treated with IABP, those with older age, diabetes mellitus and combination with ECMO should be monitored closely in order to reduce complications.

0.05),the escape latency was longer(P

Cochlear Implantation ; HIV Infections ; Humans

Objective We will discuss the related factors affecting the rehabilitation efficacy after the opera-tion of adults cochlear implantation .Methods Nijmegen Cochlear Implant Questionnaire'was adopted .There were questionnaire surveys on 29 adult patients with cochlear implantation .The individual scores and total scores of all subjects were collected together with the personal information ,including age ,bilateral effects and other factors . They were grouped in accordance with different grouping standards of different affecting factors .Results Compared to the communication manner of long -term hearing loss ,the rehabilitation efficacy of the group using lip -reading preoperatively was greater than the group using sign language or writing ;the rehabilitation efficacy of the group with the aggregate time of using CIs more than two years was superior to that similar group of less than two years , and the average P within the group of these two factors was <0 .05 .There was no statistical significance among group comparisons for other factors as the P was >0 .05 .Conclusion Ages ,the bilateral deafness ,and auditory dep-rivation have no obvious effects on the rehabilitation efficacy after the operation .The patients with postlingual deafness can improve their hearing with proper rehabilitation .Lip-reading preoperatively has positive effects on the rehabilitation effica-cy after the operation ;the length of using CIs has become the major factor affecting the rehabilitation efficacy .

Objective To discuss the perioperative nursing measures for patients with osteoporotic vertebral compression fractures who are receiving percutaneous vertebroplasty (PVP) treatment by using high viscosity bone cement.Methods A total of 30 patients with osteoporotic vertebral compression fractures were included in this study.All patients were treated with PVP by using high viscosity bone cement.Preoperative routine nursing,psychological intervention,dietary intervention,postoperative guidance of rehabilitation exercise of limbs,close observation of bone cement leakage were strictly implemented,and the corresponding nursing measures were promptly taken when needed.Results Through strict implement of the nursing intervention all 30 patients could actively cooperate with PVP treatment,and after PVP the pain was significantly relieved in all patients.Conclusion Adequate preoperative preparation,proper postoperative guidance,careful observation and effective nursing can help the patients resume their daily life activities as soon as possible,relieve the pain,and improve the quality of life as well.(J Intervent Radiol,2017,26:274-276)

Objective: To investigate the risk factors affecting the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), and establish a new scoring model to predict the short-term prognosis of patients. Methods: This study enrolled 222 patients with HBV-ACLF. According to their clinical outcomes during hospitalization and 90 days after discharge, they were divided into survival and death group. Clinical data were collected to calculate the Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD), albumin-bilirubin (ALBI), and age-bilirubin-international normalized ratio-creatinine (ABIC) scores for prognosis. Multivariate logistic regression analysis was used to analyze the independent risk factors affecting 90-day mortality in HBV-ACLF patients. Cox regression model was used to establish a new prediction model. Area under the receiver operating characteristic curve was used to calculate short-term prognostic value of the models. K-M survival curve was used to predict the prognosis of patients. Results: CTP and ABIC scores were independent risk factors for 90-day mortality in HBV-ACLF patients, and the risk of death from liver failure had increased with increase of score. Cox regression model established a new predictive model CTP-ABIC = 0.551 × CTP + 0.297 × ABIC. Area under the receiver operating characteristic curve of all three scoring models (CTP, ABIC and CTP-ABIC) were 0.878, 0.829, 0.927, respectively. CTP-ABIC score was superior to the CTP and ABIC score (P value < 0.001). Patients with CTP-ABIC score ≥9.08 had higher mortality rate than patients with CTP-ABIC score < 9.08, and the difference was statistically significant (P < 0.001). Conclusion All three scoring systems can predict short-term prognosis in patients with HBV-ACLF, but the accuracy of CTP-ABIC is superior.