Objective To evaluate the effects and complications of percutaneous nephrolithotomy (PCNL) in the treatment of renal stone after repeated extracorporeal shockwave lithotripsy (ESWL).Methods Forty-four patients who had a history of repeated ESWL (treatment group) and 50 patients with-out surgical intervention (control group) were submited to PCNL,and clinical data was documented in details and analyzed.Results The time to establish access in treatment group and control group was (11.8 ± 4.1) min and (10.9 ± 2.5) min,respectively,and there was no significant difference (t =1.308,P =0.194).The time to extract stone in both groups was (92.0 ± 13.5) min and (66.6 ± 17.6) min,respectively,and there was significant difference (t =7.776,P =0.000).The operative time in treatment group was (113.9 ± 12.0) min,which was longer than that in control group with (87.6 ± 13.6) min (t =8.354,P =0.000).The clearance in both groups was 81.8％ and 94.0％,and there was no significant difference (x2 =3.361,P =0.067).The was no death or other severe complication in both groups.Conclusions The operation time in treatment group was longer than that in control group,and there was no significant difference in clearance and complication rate.Thus it was safe and effctive to perform PCNL in these patients with a history of failed repeated ESWL.

Objective To explore a feasible and effective method of purse-string suture and traction in proce- dures for prolapse and hemorrhoids(PPH)with circular stapler.Methods Width of resected mucosal band and ex- tent of residual hemorrhoid mucosal lifting were compared between two groups of patients with hemorrhoids receiv- ing PPH with“two-point retraction”method(group one,110 cases)and other retraction methods(group two,40 cas- es).Results For group one of 110 cases with“two-point retraetion”,resected mucosal band of all cases were intact and and average width ranged from 3.5 to 5cm.There was a completely residual hemorrhoid mucosal lifting(com- plete return of prolapsed hemorrhoid into the anal canal)in 100 cases of group one(91%).But in group two with other retraction methods,average width of resected mucosal bands ranged from 0.2 to 3.5cm and there was an in- complete band in 10 cases(25%).The rate of mucosal lifting in this group was only 62.5%(19/40).Conclusion Two-point retraction is a feasible,effective and simple method in PPH,resulting in an intact resected mucosal band and sufficient hemorrhoid mucosal lifting.So the two-point retraction PPH is worth to be extended for application.

Objective To investigate the feasibility, safety and clinical efficacy of staged endo-scopic treatment for refractory ureteral calculus. Methods Eighteen refractory ureteral calculus ea-ses (11 males and 7 females) treated with staged endoscopic treatment were retrospectively analyzed. The mean age of the patients was 32 years (range 2-65 years). Of the 18 cases, 2 had bilateral ure-teral calculi. Of the 20 ureteral calculi, 11 were in the upper, 6 were in the middle and 3 in the lower part of ureter. The mean diameter of the calculi was 0.9 cm (range 0.4-1.6 cm). Staged endoscopic treatment was offered to patients because of failure of ureterscopic lithotripsy or extracoporeal shock-wave lithotrispy caused by uretreal twist or eongential narrow. For all the cases, it was hard to com-pletely clear all the stone load and ureteral stents or percutaneous nephrostomy were performed to drain the kidney in the first session. Then, the calculi were removed by endoscopic manipulations in the second or third session. Results Thirteen patient's calculi were completely cleared in the second sessions 40-50 d after the first operation. The other 5 cases had to accept the third session 50-60 d after the second operations. There was no intra- or post-operative complication in all cases. During the 6 months' follow-up, there was no sign of recurrence. Conclusion Staged endoscopic treatment is a feasible and safe method and has high efficiency in the management of refractory ureteral calculi.

Objective To evaluate the therapeutic effects and to summarize the clinical experience of benign prostatic hypertrophy(BPH) with inguinal hernia in the elderly 70-89 years. Methods Clinical data of 32 patients 70-89 years old simultaneously undergone transurethral resection of prostate (TURP) and plug-mesh tension-free hernia repair from July 2000 to May 2005 were retrospectively analyzed and followed up. Results The average operating time was (85.0?12.8)minutes, the average blood loss was (90.0? 18.7 )ml. No postoperative death or life threatening complications were revealed. By 7-40 months of following up reported that there were no recurrence of hernia as well as no incontinence and urethral stenosis or other complications. IPSS,maximal flow rate and residual urine were evidently improved after operation. Conclusion Combined TURP and plug-mesh tension-free hernia repair is a safe and effective procedure for the elderly patients.

OBJECTIVETo analyze the complications of percutaneous kyphoplasty except bone leakge for the treatment of osteoporotic thoracolumbar vertebral compression fractures.

METHODSFrom October 2008 to October 2012,178 patients with 224 osteoporotic vertebral compression fractures were treated with percutaneous kyphoplasty under local anethsia. There were 72 males and 106 females,ranging in age from 58 to 92 years old,with an average of 75.3 years,including 93 thoracic vertebrae and 131 lumbar vertebrae. The complications except bone cement leakage were analyzed during operation and after operation.

RESULTSAll operations were successful and all patients were followed up from 12 to 60 months with an average of 26.2 months. No death was found. Bone cement leakage occurred in 27 cases, about 15.1% in 178 cases; and complications except bone cement leakage occurred in 15 cases. There was 1 case with cardiac arrest,was completely recovery by cardiopulmonary resuscitation (CPR) immediately; and 1 case with temporary absence of breathing,was recovery after treatment. There were 3 cases with fall of blood pressure and slower of heart rate; 1 case with intestinal obstruction; 2 cases with local hematoma and 1 case with intercostal neuralgia. Vertebral body fractures of 2 cases were split by bone cement and the fractures of adjacent body occurred in 4 cases.

CONCLUSIONIt's uncommon complication except bone cement leakge in treatment of osteoporotic thoracolumbar vertebral compression fractures with percutaneous kyphoplasty. The complication of cardiopulmonary system is a high risk in surgery; and cytotoxicity of bone cement,nervous reflex,fat embolism and alteration of intravertebral pressure may be main reasons.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; surgery ; Humans ; Kyphoplasty ; adverse effects ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Postoperative Complications ; etiology ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery

OBJECTIVETo explore the effect of uvulopalatopharyngoplasty with uvula preservation and radiofrequency tongue base reduction for obstructive sleep apnea hypopnea syndrome (OSAHS).

METHODSForty six patients with OSAHS were enrolled. One group (n = 22) of patients only received uvulopalatopharyngoplasty with uvula preservation, while the other group (n = 24) had both uvulopalatopharyngoplasty with uvula preservation and radiofrequency tongue base reduction. Polysomnography and distance between anterior pillars (DBAP), distance between posterior pillars (DBPP), length of roft palate, distance between tongue base and posterior pharyngeal wall (DBTP) were measured before and 6 months after surgery.

RESULTSThe pre-operation apnea hypopnea index (AHI), x +/- s, lowest SaO2 (LSaO2) of first group were (56. 5 +/- 6. 0)/h, and 0.626 +/- 0.060 respectively, and 6 months after surgery, AHI was (23.7 +/- 2.7)/h, LSaO2 was 0.797 +/- 0.053. The pre-operation AHI, LSaO2 of second group were (58.4 +/- 5.1)/h, and 0.650 +/- 0.057 respectively, and 6 months after surgery, AHI was (15.5 +/- 3.2)/h, LSaO2 was 0.864 +/- 0.064. After surgery AHI and LSaO2 have changed in both groups (P<0.001). Six months after operation, DBAP and DBPP became withy, length of soft palate became short (P<0. 001). In one group the validity ratio is 72.7% (16/22), the other group the validity ratio is 87.5% (21/24) (P< 0.05), and pharyngeal posterior airway width (PPAW) became withy (P <0.001).

CONCLUSIONSFor OSAHS patients, the obstructive regions should be evaluated. The combined surgery of uvulopalatopharyngoplasty with uvula preservation and radiofrequency tongue base reduction could have a better result.

Adult ; Catheter Ablation ; Cleft Palate ; surgery ; Female ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Palate, Soft ; surgery ; Polysomnography ; Sleep Apnea, Obstructive ; surgery ; Tongue ; surgery ; Uvula ; surgery

Objective To investigate the diagnostic value of matrix gamma carboxy glutamic acid protein(MGP) for coronary heart disease(CHD) .Methods Enzyme linked immunosorbent assay was performed for the detection of serum MGP level in health‐y subjects and CHD patients with different coronary artery calcium score(CACS) .Receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of MGP for CHD .Results Between CHD patients and healthy subjects ,and CHD patients with different CACS ,the difference of serum MGP level was significant ,and serum MGP level was positively correlated with CACS (P<0 .05) .ROC curve of showed that the area under ROC curve was 0 .667 ,the diagnostic threshold was 70 .69 pg/mL ,the diag‐nostic sensitivity was 58 .80% ,the specificity was 83 .70% and the Youden index was 0 .425 .Conclusion CHD patients might be with abnormal serum MGP level ,which could be positively correlated with CACS .MGP might be with significant value for the diag‐nosis of CHD ,could be useful for the clinical prevention and early diagnosis of CHD .

Objective To investigate the clinical outcomes of minimally invasive percutaneous nephrolithotomy(MPCNL)in the treatment of lower caliceal calculi.Methods We retrospectively re- viewed the clinical outcomes and complications of 33 patients who underwent MPCNL for lower caliceal cal- culi from March 2001 to April 2005.The average diameter of the calculi was 2.8 cm.Single tract nephrosto- my was performed in all 33 cases;among them renal access was obtained through a middle calyx in 10 cases and a lower calyx in 23.Nine cases had F14 renal access;and 24 cases,F16.Results Of 33 cases,28 (85%)achieved stone-free at 1 session.A second-look was needed in 3 cases due to intraoperative bleed- ing;ESWL,in 1 case with residual,calculi;no treatment,in 1 case with residual calculi＜4 ram.The mean operative time was 93 min;mean blood loss was 113 ml;mean hospital stay was 11 d.Blood transfusion was needed in 1 patient who suffered from hepatic cirrhosis preoperatively;another experienced severe bleeding 7 d after operation and was cured with hyperselective spongia gelatinosa embolization of the renal artery.Fol- low-up was available in 19 cases for 2-48 months,and no recurrence of renal calculi was noted.Conclu- sions Minimally invasive percutaneous nepbrolithotomy has advantages of safety,less invasion,and easy re- covery for the treatment of lower caliceal calculi.

Acquired Immunodeficiency Syndrome ; complications ; pathology ; Antigens, CD34 ; metabolism ; Gastrectomy ; methods ; Humans ; Male ; Middle Aged ; Sarcoma, Kaposi ; metabolism ; pathology ; surgery ; virology ; Stomach ; pathology ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; virology ; Vimentin ; metabolism

OBJECTIVETo in vestigate the chemical constituents of Sarcandra glabra and obtain a more comprehensive understanding on its effective components.

METHODThe constituents were isolated by various column chromatographic method and their structures were elucidated by physico-chemical properties and spectroscopic analysis.

RESULTFive flavonoid glycosides were isolated and identified as kaempferol-3-O-beta-D-glucuronide (1), quercetin-3-O-alpha-D-glucuronide (2), quercetin-3-O-beta-D-glucuronopyranoside methyl ester (3), 5, 7, 4'-trihydroxy-8-C-beta-D-glucopyranosyl flavanone (4), neoastilbin (5), 5-O-caffeoylquinic acid methyl ester (6), 3, 4-dihydroxybenzoic acid (7), isofraxidin (8).

CONCLUSIONCompounds 1-6 were isolated from the genus Sarcandra for the first time. The glucuroide compounds compounds 1-3, were first isolated from the genus Sarcandra.

Caffeic Acids ; chemistry ; Coumarins ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Flavonoids ; chemistry ; Glucuronides ; chemistry ; Glycosides ; chemistry ; Magnetic Resonance Spectroscopy ; Magnoliopsida ; chemistry ; Spectrometry, Mass, Electrospray Ionization