Objective To evaluate the relationship between the early incidence of postoperative complications and renal pelvic pressure during minimally invasive percutaneous nephrolithotomy. Methods 133 renal calculi patients were monitored during MPCNL. Then the patients were separated into two groups according to the renal pelvic pressure,and the postoperative fever,the perirenal fluid and impairment of renal function were analyzed. Results The average body temperature was higher in high pelvic pressure group than that in low pelvic pressure group from the first day to the fourth day after operation(P<0. 05). The urinary protein of all patients raised obviously after the op-eration while it decreased gradually afterward. The urinary protein of the high pelvic pressure group was much higher than that of the low pel-vic pressure group in same day with a significant difference (P<0. 05). The incidence of perirenal fluid was much higher in high pelvic pres-sure group than that in low pelvic pressure group (P<0. 05). Conclusion The incidence of early postoperative complications was related to renal pelvic pressure during MPCNL.

The effects of continuous occlusion of thoracic or abdominal aorta (OTA or OAA) via intra-aortic balloon inflation on coronary perfusion pressure (CPP) were observed in 12 dogs after 10 min of cardiac fibrillation in comparison with those of different doses of epinephrine (0.02~0.14 mg/kg). The results showed that OTA could not increase CPP. However, during 30 min of cardiopu-Imonary resuscitation(CPR), every 3 min of OAA was followed by markedly increased CPP, 067 ~ 12kPa higher than the value in balloon deflation peritxl right before(P

Objective To explore the application and assess the cosmetic effect of mammaplasty with volume-displacement technique(VDT)following breast conserving surgery.Methods Breast conservation therapy(BCT) was performed in 77 patients of early breast cancer(EBC).Of the patients,42 cases received oncoplastic VDT (onco-plastic group)and 35 cases had only direct skin closure without treatment of the postresection defect (regular group) following BCT.The cosmetic results of the two groups were evaluated after operation and radiotherapy,respectively. Results All patients were followed up for 1 -36 months with median follow -up of 22.3 months,and no recurrence or metastasis occurred in one of the patients.1 month after surgery,the excellent or good cosmetic outcome were achieved in 31 cases (73.81%)in oncoplastic group and 17 cases (48.57%)in regular group respectively,and there was statistical difference between the two groups (χ2 =5.442,P =0.021);1 month after radiotherapy,the cos-metic excellent or good result were obtained in 27 cases (64.29%)in oncoplastic group and 6 cases (17.14%)in regular group respectively,and the difference between the two groups reached statistical significance (χ2 =9.045,P =0.008).Conclusion VDT can improve the cosmetic effect of mammaplasty following BCT in EBC and does not affect curative effect,it is worthy of promoting.

Objective To investigate the distribution of pathogens and the results of drug sensitivity test in patients with intra-abdominal infection, and to provide theoretical basis for the rational selection of anti-infective programs. Methods The pathogenic bacteria culture and drug sensitivity test results of peritoneal fluid or drainage fluid in hospitalized patients with intra-abdominal infection were retrospectively analyzed. Results 405 cases of positive culture results were obtained in 3 509 cases of intra-abdominal infection specimens. A total of 436 strains of pathogens, including 268 strains of Gram-negative bacteria (61.47％), 151 strains of Gram-positive bacteria(34. 63％), 17 strains of Fungi (3. 90％). The top five were Escherichia coli (22. 25％), Acinetobacter baumannii (10. 09％), Klebsiella pneumoniae (9. 86％), Enterococcus faecium (7. 80％), Staphylococcus aureus(4. 13％). The extended spectrum β-lactamas rates of Escherichia coli and Klebsiella pneumoniae were 58. 76％ and 16. 28％, respectively. The multi-drug resistant strains of Acinetobacter baumannii were 79. 55％. Vancomycin resistant strains were detected in Enterococcus faecium (8. 82％), the detection rate of methicillin-resistant Staphylococcus aureus (MRSA) in Staphylococcus aureus was 72. 22％, and the detection rate of methicillin-resistant Staphylococcus aureus (MRCNS) in coagulase-negative Staphylococci was 51. 92％. Conclusion The main pathogens of intra-abdominal infection is Escherichia coli, followed by Acinetobacter baumannii, Klebsiella pneumoniae, Enterococcus faecium and Staphylococcus aureus, the detection rate of MRSA and MRCNS is high. The overall drug resistance of intra-abdominal infection is serious.

Objective To investigate the effects and mechanisms of median nerve electrical stimulation on synaptic plasticity in ischemic stroke rats.Methods 18 healthy male SD rats were randomly divided into Sham group(n = 6),ischemic stroke group(MCAO group,n = 6)and median nerve electrical stimulation group(MNES group,n = 6).The left middle cerebral artery occlusion model of rats was established by thread plug method.Thread plug was not inserted in sham group.The median nerve electrical stimulation group was given median nerve electrical stimulation intervention on the 3rd day after modeling,and intervention on the next day.After intervention for 7 times,behavioral detection,HE staining was used to detect median nerve injury.Nissl staining was used to detect cerebral infarction volume.Western blot was used for detection of the expression level of proteins related to synaptic plasticity,and electron microscopy was performed.Results HE staining showed that median nerve electrical stimulation did not cause damage to the median nerve in stroke rats,and the median nerve membrane was intact without obvious inflammatory cells.Compared with MCAO group,the neural function,motor function and coordination of the injured forelimb in MNES group were significantly improved(P<0.01).Compared with MCAO group,cerebral infarction volume in MNES group was significantly reduced(P<0.05),the pyknosis of Nissl bodies in ischemic penumbra decreased.Compared with MCAO group,the expression levels of synaptic plastication-related proteins PSD95 and synI in the cortex of MNES group were significantly up-regulated after median nerve electrical stimulation(P<0.05),the number of synapses in the ischemic cortex increased significantly(P<0.01).Conclusion Median nerve electrical stimulation is a safe and effective therapeutic measure to improve nerve function after stroke,and its mechanism is related to promoting synaptic plasticity.

Objective:To investigate the clinical application value of enhanced recovery after surgery using the LEER model in patients subjected to laparoscopic cholecystectomy in basic hospitals of Yi nationality area.Methods:Twenty-six patients who underwent laparoscopic cholecystectomy based on the concept of enhancing recovery after surgery using the LEER model in People's Hospital of Jinkouhe District of Leshan from January to October 2021 were included in the observation group. An additional 20 patients who concurrently underwent laparoscopic cholecystectomy and conventional intervention were included in the control group. Clinical efficacy, postoperative complications and postoperative pain were compared between the two groups.Results:Postoperative fasting time, length of hospital stay, and total hospital days in the observation group were 6 (6, 6) hours, 2 (2, 3) days and 4 (4, 6) days respectively, which were significantly shorter than 24 (24, 36) hours, 5 (5, 6) days, 7 (7, 9) days in the control group ( H = 351.00, 407.50, 458.00, all P < 0.05). Hospitalization cost in the observation group was 5 454.58 (5 014.11, 6 016.58) yuan, which was significantly lower than 6 611.91 (6 192.68, 7 841.73) yuan in the control group ( H = 420.00, P < 0.05). There were no significant differences in operative time and postoperative complications between the two groups (both P > 0.05). At postoperative 6 hours, Visual Analogue Scale score in the observation group was 3 (3, 4) points, and patients with mild pain accounted for 73.07% (19/26). At postoperative 24 hours, Visual Analogue Scale score in the observation group was 2 (2, 3) points, and patients with mild pain accounted for 92.31% (24/26). Overall pain was well controlled after surgery. Patient satisfaction rate in the observation was 96.15% (25/26). All patients recovered and were discharged. Conclusion:Application of enhanced recovery after surgery using the LEER model in patients subjected to laparoscopic cholecystectomy in basic hospitals of Yi nationality area can promote postoperative recovery, contribute to changing the theory of diagnosis and treatment, and improve overall medical quality. The enhanced recovery after surgery protocol using the LEER model has a good application value.

After ischemic stroke, the key to reduce the mortality and disability rate is to restore the blood supply of brain tissue as soon as possible. However, the cerebral ischemia-reperfusion injury (CIRI) caused by blood flow restoration is also an important cause of brain tissue structural damage and dysfunction. Studies in recent years have shown that the activation of mitophagy at CIRI stage can reduce the volume of cerebral infarction and protect neurons from CIRI, while excessive or insufficient mitophagy can aggravate CIRI. This suggests that inducing moderate mitophagy may be a potential therapeutic target for neuroprotection after stroke. However, the neuroprotective mechanism of mitophagy has not yet been fully elucidated. This article reviews the neuroprotective mechanism and potential application of mitophagy in stroke, and discusses some problems of mitophagy as a therapeutic target for stroke.

BACKGROUNDLaparoscopic cholecystectomy has been widely used in clinical practice during the recent decades; however, the effects of pneumoperitoneum and the surgery on the coagulation system are largely unknown. This clinical study aimed to observe any possible effects of pneumoperitoneum and the surgery on the coagulation system of patients.

METHODSThis was a prospective observational study. The inclusion criteria included (1) patients with chronic cholecystitis and/or cholecystic polyps and (2) patients in the relief stage of acute cholecystitis. The exclusion criteria included (1) patients in the episodic stage of acute cholecystitis and those complicated with cholangiolithiasis; (2) patients with concomitant hematologic diseases, damages to the liver function, malignant tumors or immune system diseases, or patients complicated with thrombotic or hemorrhagic disorders; and (3) patients who had taken anticoagulant medication within a week before surgery. Fifty patients who were hospitalized into our department for elective laparoscopic cholecystectomy between November 2011 and February 2013 were eligible and enrolled into this study. Of the 50 patients, 22 were male and 28 female. The age of the patients ranged from 29 to 78 (mean 56.7±11.5) years. The surgery for each of the 50 patients was performed with the same equipment and conditions. The surgeries for all the patients were performed under general anesthesia with the patients in a 30-degree head-up tilted posture, and the pressure of pneumoperitoneum was maintained at 13 mmHg. Venous blood specimens were taken from each patient before and at the end of pneumoperitoneum (i.e., 0 hour after surgery) and at 8 hours after surgery for determination of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), thrombin time (TT), and D-dimer (DD). The results of the determinations of these parameters were compared.

RESULTS(1) All the patients recovered well without any complications. (2) The pre-pneumoperitoneum values of the parameters of coagulation had normalized. (3) The PT values slightly increased (P > 0.05) at the end of pneumoperitoneum (i.e., 0 hour after surgery) and decreased by 0.5 seconds at 8 hours after surgery as compared to the pre-pneumoperitoneum values (P < 0.05). (4) APTT at 0 and 8 hours decreased by 1.4 seconds (P > 0.05) and 3.7 seconds (P < 0.05) respectively as compared to pre-pneumoperitoneum values, while the difference between the APTT values at 0 and 8 hours after surgery was not statistically significant (P > 0.05). (5) FIB determined at 0 hour post-operation increased by 0.1 g/L as compared to pre-pneumoperitoneum values (P > 0.05); however, the FIB values at 8 hours after operation increased by 1.2 g/L as compared to the pre-pneumoperitoneum values (P < 0.05), and increased by 1.1 g/L as compared to 0 hour post-operation (P < 0.05). (6) The TT values obtained at 0 and 8 hours post-operation were not significantly different as compared to the pre-pneumoperitoneum values (P > 0.05). (7) The DD values gradually increased after operation; as compared to pre-pneumoperitoneum values, DD at 0 and 8 hours after operation increased by 210.8 ng/ml and 525.9 ng/ml respectively (P < 0.05) and DD at 8 hours after operation increased by 315.1 ng/ml as compared to 0 hour post-operation (P < 0.05).

CONCLUSIONSThe pneumoperitoneum for laparoscopic cholecycstectomy may lead to postoperative hypercoagulation in the patients, and thereby may increase the risks for development of postoperative thrombosis; Patients may have risks for occurrence of thrombosis within 8 hours after the operation, to which attention should be paid in favor of preventing thrombosis.

Adult ; Aged ; Aged, 80 and over ; Blood Coagulation ; physiology ; Cholecystectomy, Laparoscopic ; Female ; Humans ; Male ; Middle Aged ; Partial Thromboplastin Time ; Pneumoperitoneum ; surgery ; Prospective Studies