Objective To evaluate the clinical effectiveness of ureteroscopic pneumatic ballistic lithotripsy for the treatment of ureteral stones.Methods A total of 185 patients with ureteral stones(accompanying renal colic in 96 patients) were treated with ureteroscopic pneumatic ballistic lithotripsy from February 2004 to March 2005 in this hospital. Results The procedure failed in 12 patients,including conversions to open surgery in 6 patients and to extracorporeal shock wave lithotripsy 3 days later in 6 patients.The single-session success rate was 93.5%(173/185),and was 75.0%(24/32) in the upper segment,95.8%(46/48) in the middle segment,and 98.1%(103/105) in the lower segment.The success rate in patients with renal colic was 100%(96/96).The rate of intraoperative ureteral injury was 2.9%(5/173),with conversions to open surgery required in 3 patients(1.7%).Postoperative renal colic occurred in 1 patient.Follow-up checkups in all the patients for 6~12 months(mean,10.2 months) showed no recurrence. Conclusions Ureteroscopic pneumatic ballistic lithotripsy is safe and effective,being the first choice for patients with middle or lower ureteral stones,especially accompanying renal colic.

Objective To evaluate the safety and efficacy of transurethral resection of the prostate(TURP)for high-risk benign prostatic hyperplasia(BPH).Methods Form January 2001 to July 2007,we performed TURP on 303 patients with high-risk BPH.The patients aged form 65 to 89 years with a mean of 76.3.Among them,151 were complicated with cardiovascular diseases,67 had pulmonary diseases,37 had diabetes mellitus,26 had brain disease,16 showed renal inadequacy,and 6 showed abnormal liver function.Results The procedure was completed successfully in all of the 303 cases without death,dysuria,or severe complications.Compared to the examinations carried out before the procedure,the IPSS and QOL scores,and RU decreased significantly,while the Qmax increased 3 months after the prosedure[IPSS:(19.6?7.9)points vs.(6.4?3.3)points,t=26.838,P=0.000;QOL:(4.7?1.5)points vs.(2.3?1.1)points,t=22.459,P=0.000;Qmax:(4.1?2.6)ml/s vs.(13.9?7.1)ml/s,t=-22.561,P=0.000;and RU:(139.0?32.5)ml vs(13.5?8.6)ml,t=55.143,P=0.000].ConclusionsTURP is a safet and effective procedure for high-risk BPH with a low rate of postoperative complications.Proper peri-operative individual management and operation skills are important for the success of the procedure.

Objective To quantify the morphometric characteristics of the pedicles of the infantile thoracolumbar spine and to determine the feasibility and safety of pedicle screw fixation in very young children. Methods A total of 52 patients younger than three years of age underwent standard spiral computed tomography (CT) were enrolled in this study. The patients were grouped according to age, group 1 (0 ～ 18months of age) and group 2 (18 ～ 36 months of age). Images were reformatted, and multiplanar reconstructions were used to attain images of thoracic and lumbar pedicles on sagittal, coronal and transverse planes.The measurements included the inner and outer pedicle diameters on the transverse plane, pedicle sagittal diameter, pedicle length and the pedicle angle on the transverse. Characteristics of the pedicles of the immature thoracic and lumbar spine were studied. Results Pedicle diameters on the transverse plane decreased gradually from T1 to T5 and increased gradually from T6 to L5. The shortest transverse diameter of the thoracic pedicle was T5 or T6. The inner diameter of the segment of L4 in infant (younger than eighteen months) was less than 3.0 mm and the external diameter less than 3.5 mm from T3 to T9. The inner diameter of the segment from T5 to T8 in infant (more than eighteen months) was less than 3.0 mm and the external diameter from T4 to T7 was less than 3.5 mm. The sagittal diameter was significantly more than the transverse diameter. Pedicle diameters on the transverse plane, the sagittal diameter, and the length of the pedicle changed significantly with age, but the pedicle angle did not changed significantly with age. Conclusions The pedicles in the segment from T3 to T9 of less than eighteen months and from T4 to T7 of more than eighteen months were too small, there was no feasibility and safety of pedicle screw fixation. So pedicle screw fixation was feasible and safe for below T9 segment in the infants who are younger than three years old.

Objective:To investigate the risk factors related to urinary tract infection after indwelling ureteral D-J tube in pregnant women with acute renal colic.Methods:Clinical data of 109 pregnant women with acute renal colic undergoing indwelling ureteral D-J tube in emergency department of Taizhou Hospital or Enze Hospital from January 2008 to December 2019 were retrospectively analyzed. There were 31 cases (28.4%) with urinary tract infection after discharge and before delivery (infection group) and 78 cases without infection (non-infected group). Univariate and multivariate logistic regression analyses were used to evaluate the risk factors of urinary tract infection after ureteral D-J tube insertion.Results:In 109 patients the average age was 28 (25,33) years, the average gestational age was 26 (21,31)weeks, and the average body mass index (BMI) was 24.84 (22.60,27.43) kg/m 2. Compared with the non-infected group, the infection group had a higher rate of positive urine culture [38.7%(12/31) vs. 15.4%(12/78), χ2=6.56, P=0.010] and diabetes [45.2%(14/31) vs. 11.5%(9/78), χ2=13.86, P<0.001], and a lower gestational age [23(20,28) vs.27(21,32) weeks, Mann-Whitney U test, P=0.006]. Multivariate analysis showed that diabetes( OR=7.739,95 %CI:2.579-23.223, P<0.001), positive urine culture( OR=3.249,95 %CI:1.131-9.330, P=0.029), and gestational age( OR=0.201,95 %CI:0.042-0.955, P=0.044) were independent risk factors for urinary tract infection in pregnant women with acute renal colic after ureteral D-J tube insertion. Conclusion:History of diabetes, gestational age, and positive preoperative urine culture are risk factors for urinary tract infection after ureteral D-J tube insertion in pregnant women with acute renal colic.

OBJECTIVETo evaluate the potential correlations between parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and clinical stages of nasopharyngeal carcinoma (NPC).

METHODSEighty-one newly diagnosed NPC patients received MRI examination. Clinical TNM stages and corresponding overall stages based on Chinese 2008 Staging System were determined. Pearson correlation coefficients were obtained to evaluate the potential correlations between DCE-MRI parameters of primary NPC lesions and clinical stages.

RESULTSSix cases were excluded from the study due to poor quality of images or too small tumor samples. The Ktrans,Kep, Ve, fPV, PeakT, Maxslop, CER, WoutSI, AUC90 and AUC180 values of 75 primary NPC tumors were (0.336 ± 0.133) min⁻¹, (1.419 ± 0.441) min⁻¹, 0.256 ± 0.100, 0.018 ± .010, (64.879 ± 15.975)s, (21.181 ± 5.507)s⁻¹, 1.348 ± 0.998, 0.515 ± 0.383, 16.177 ± 5.141 and 28.891 ± 9.511, respectively. Ktrans showed a positive correlation with overall stage (r=0.240, P=0.038), T stage (r=0.257, P=0.026) and M stage (r=0.438, P<0.001). A significant positive correlation was revealed of Ve with overall stage (r=0.418, P<0.001), T stage (r=0.466, P<0.001) and M stage (r=0.269, P=0.020). Negative correlation was found between Kep and T stage (r=-0.288, P=0.012). PeakT had positive correlation with overall stage (r=0.231, P=0.046) and T stage (r=0.318, P=0.005). AUC90 was revealed to have a positive correlation with overall stage (r=0.362, P=0.001), T stage (r=0.380, P=0.001) and M stage (r=0.446, P<0.001). AUC180 showed a positive correlation with overall stage (r=0.380, P=0.001), T stage (r=0.405, P<0.001) and M stage (r=0.423, P<0.001). No significant correlations for N stage with any DCE-MRI parameter were found. NPC in M1 stage had higher Ktrans, Ve, AUC90 and AUC180 values than NPC in M0 stage. There were significant (P<0.05) differences in Ktrans, Ve, PeakT, AUC90 and AUC180 values among different overall stages. Significant (P<0.01) differences in Ve, PeakT, AUC90 and AUC180 values were observed among different T stages.

CONCLUSIONSDCE-MRI parameters of primary NPC lesions have significant correlations with clinical stages. DCE-MRI parameters may act as imaging biomarkers for non-invasive assessment of the tumor microstructure, disease progression and aggressiveness of NPC.

Area Under Curve ; Carcinoma ; Contrast Media ; Humans ; Magnetic Resonance Imaging ; Nasopharyngeal Neoplasms ; pathology ; Neoplasm Staging

To investigate the magnetic resonance imaging (MRI) features for primary brain lymphoma and improve its diagnosis and differential diagnosis.
 Methods: The clinical and MRI data from 14 patients with primary brain lymphoma were retrospectively reviewed.
 Results: Fourteen patients, including 5 males and 9 females, were (55±8) years old. There were 9 patients with single lesion and 5 patients with multiple lesions (2-6 lesions). A total of 26 lesions were identified. All lesions located in supratentorium, such as the cerebral hemisphere, the basal ganglia, and the corpus callosum. Most of them deeply located in the brain. The lesions presented slightly low or equal signal on T1-weighted image (T1WI), slightly high or equal signal on T2-weighted image (T2WI), and slightly high or equal signal on disffusion-weighted imaging (DWI), in which 2 lesions showed central necrosis and 2 lesions included hemorrhage. All of them showed significant enhancement, 3 of them showed annular enhancement, and the rest showed nodular and mass enhancement. The degree of para-tumorous edema for different lesions was different, including 20 lesions with marked edema, 4 with moderate edema, and 2 with slight edema.
 Conclusion: MRI features for primary brain lymphoma are specific. The tumors mostly locate in supratentorium and deep brain, showing multifocal growth, isointense to grey matter at T1WI and T2WI, marked enhancement, restricted diffusionon DWI, rare necrosis, and obvious space occupying effect.
Brain ; diagnostic imaging ; Diagnosis, Differential ; Female ; Humans ; Lymphoma ; diagnostic imaging ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies