Objective:To explore the effect of standard channel ultrasonography-pneumatic lithotripsy on kidney function and prognosis of patients in the treatment of complex kidney calculi.Methods:A total of 60 patients with complex kidney calculi admitted to Suixi County Hospital of Anhui Province from October 2017 to September 2020 were selected and divided into the observation group (29 cases, received ultrasound-pneumatic lithotripsy operation) and the control group (31 cases, received pneumatic lithotripsy operation) according to different treatment methods. The perioperative indexes, stone clearing rate, recurrence rate, complication rate, the renal function changes and quality of life(QOL) changes before and after the operation were compared between the two groups.Results:The operation time, intraoperative blood loss, postoperative decrease in hemoglobin(Hb), postoperative hematuria time and times of postoperative using analgesic in the observation group were lower than those in the control group: (80.86 ± 16.95) min vs. (94.31 ± 13.11) min, (60.52 ± 9.17) ml vs. (69.34 ± 10.06) ml, (8.58 ± 2.05) g/L vs. (10.11 ± 2.42) g/L, (3.02 ± 1.09) d vs. (3.65 ± 1.27) d, (4.59 ± 1.62) times vs. (6.43 ± 1.39) times, there were statistical differences ( P<0.05). At 4 weeks post operation, the levels of renal function indexes urinary N-acetyl-glucosaminidase (NAG), urinary β2 microglobulin (β2-MG), serum neutrophilic gelatinase-associated apolipoprotein (NGAL), serum creatinine (SCr) in the observation group were lower than those in the control group: (5.13 ± 2.14) U/L vs. (7.08 ± 2.35) U/L, (0.14 ± 0.07) mg/L vs. (0.22 ± 0.09) mg/L, (2.06 ± 1.01) μg/L vs. (2.71 ± 1.06) μg/L, (97.05 ± 20.97) μmol/L vs. (110.64 ± 20.32) μmol/L, there were statistical differences ( P<0.05). The clearing stone rate in the observation group was higher than that in the control group, and recurrence rate was lower than that in the control group: 93.10%(27/29) vs. 70.97%(22/31), 0 vs. 19.35%(6/31), there were statistical differences ( χ2 = 4.90, 4.27, P<0.05).The incidence of complication in the two groups had no significant difference ( P>0.05). The length of stay in the observation group was shorter than that in the control group: (5.54 ± 2.06) d vs. (7.01 ± 2.13) d; the scores of QOL at 3 and 6 months after operation in the observation group were higher than those in the control group: (82.55 ± 6.36) scores vs. (78.98 ± 5.32) scores, (87.03 ± 7.21) scores vs. (83.46 ± 6.05) scores, there were statistical differences ( P<0.05). Conclusions:Standard channel ultrasonography-pneumatic lithotripsy can effectively treat patients with complex kidney stones, improve renal function and promote surgical recovery. Its safety is guaranteed to some extent.

Objective To compare the effect and prognosis outcome of open reduction internal fixation and primary arthrodesis in treatment of Lisfranc injuries combined with the first tarsal jointdislocation.Methods A retrospective case control study was conducted on the clinical data with complete follow up data of 126 patients with Lisfranc injuries combined with the first tarsal joint dislocation in nine ankle surgery centers of China from January 2009 to June 2015.There were 76 males (60.3％) and 50 females (39.7％) with an average age of 45.5 years (range,20-87 years).Among the 126 cases,simple dislocation occurred in 41 cases (32.5％),and fracture dislocation in 85 cases (67.5％).The duration from injury to surgery was 11.7 days (range,4-26 days).According to surgery method,the patients were divided into open reduction internal fixation group (n =92) and primary arthrodesis group (n =34).The outcomes were evaluated by American Orthopedic Foot and Ankle Society(AOFAS) score,36-items short form health survey (SF-36),and visual analogue score (VAS).Complications were also followed up.Results All patients were followed up for 18-80 months,with an average of 29.5 months.Primary union was seen in all the patients.At the last follow up,the mean AOFAS midfoot score was (79.4 ± 6.7) points in open reduction and internal fixation group and (85.1 ±8.3) points in primary arthrodesis group (P ＜ 0.05).The mean VAS was (3.1 ± 0.6) points in open reduction and internal fixation group and (2.2± 0.3)points in primary arthrodesis group(P ＜ 0.05).The physiological function of SF-36 was (80.3 ± 5.3) points in open reduction and internal fixation group and (83.5 ± 6.9) points in primary arthrodesis group(P ＞ 0.05).The body pain score of SF-36 was (76.1 ±4.6) points in open reduction and internal fixation group and (84.6 ± 8.7) points in primary arthrodesis group (P ＜ 0.05).In open reduction and internal fixation group,there were five cases (5％) with internal fixator loosening or fracture,16 cases (17％) with redislocation,36 cases (39％) with obvious pain of the middle foot during walking,and eight cases (6％) with tarsal joint traumatic arthritis which was given phase Ⅱ arthrodesis.In primary arthrodesis group,two patients (6％) reported pain due to internal fixation,and the pain was relieved after fixator removal.No re-dislocation,loosening of internal fixation,or traumatic arthritis were found (P ＜ 0.05).Conclusion For Lisfranc injuries combined with first tarsal joint dislocation,primary arthrodesis can stabilize the first tarsal joint and avoid complications or adverse consequences such as redislocation,pain,internal fixation failure,or reoperation.