Objective To report the experiences on the diagnosis and treatment of duplication of kidney ureter and bladder. Methods Nine cases of duplication of kidney ureter and bladder from 1996 to 2008 were reviewed.Six cases of duplicated kidney ureter occurred in the left side and 2 cases in the right side,1 case bilateral kidney ureteral duplication.Of 8 cases with unilateral duplicated,duplicated bladders were incompleteness.And the patient with bilateral duplicated,whose duplicated bladder was completeness,was diagnosed with duplication of urethra,uterine,bilateral ovary and oviduet tubes,and also suffered from duplicated uterine prolapse Ⅱ,vaginal anterior wall bulging and duplicated vesicocele.There were two cases whose duplicated kidney losed function because of severe hydronephrosis,and 7 cases existed kidney secretion function. Excision of duplicated kidney ureter and bladder were performed on 2 cases with non-functional duplicated kidney.6 cases had undergone duplicated bladder excision and duplicated ureteral bladder replantation.The special case had undergone duplicated urinary bladder urethra uterine and bilateral annexes excision,and duplicated ureteral bladder replantation. Results The operation was successful in all paients without leakage and ureter stump syndrome.Three months after operation,ureter bladder imaging showed no ureteral reflux in 7 cases of ureteral bladder replantation.IVU were reviewed 12 months after operation:2 cases undergoing duplicated kidney excision showed that the function of residual kidney were normal,7 cases of replantation that the shape and function of sick side kidney and duplicated kidney were good. The patient who suffered from duplicated uterine simultaneously got pregnancy 1.5 years after operation. Conclsions Image examinations may help to diagnose the duplication of kidney ureter and bladder. The main treatment is surgery. Understanding the function of duplicated kidney and the shape of kidney ureter and bladder should be considered before operation. The goal of surgery should be relieving pain,protecting the function of duplicated kidney and minimizing the risk of infection.

Objective To discover,diagnose and treat colorectal cancer in the early period and further improve the survival rate,reduce morbidity and mortality of the colorectal cancer by early screening for colorectal cancer in Jinjiang.Methods According to “The Guide of Cancer Screening and Early Diagnosis and Treatment in China by the Experts Group of Ministry of Health”,the case history was collected while the stool occult blood and FOBT were detected to discover high risk crowd who then inspected by electron enterscope.Results The screening was practiced in Xibin,Zimao and Neikeng town respectively.The crowd of 40-74 years old was 10 116 and 2631 of them accepted screening(acclimation rate,26％).Two hundred and fifty-seven high-risk people were discovered(9.8％ of 2631)and 86 of them(acclimation rate,33％,86/257)were inspected by electron enterscope.Twenty-two cases were detected with colorectal affection(detection rate,8.6％,22/257),20 cases were diagnosed as colorectal adenoma and 2 cases were diagnosed as adenocarcinoma by pathological section.All of them accepted therapy.Conclusion Carrying out early screening for colorectal cancer is important.It can reduce morbidity and mortality of the colorectal cancer and then improve the cure rate and prolong survival in patients with colorectal cancer.

Objective:To explore the application effect of early warning model of chemotherapy complications in nursing care of non-small cell lung cancer during chemotherapy.Methods:By using convenient sampling method, 106 patients with non-small cell lung cancer treated by chemotherapy in the Thoracic Surgery Department of the First Affiliated Hospital of Zhengzhou University from January 2016 to February 2019 were selected as the study objects. According to the time of admission, they were divided into the control group ( n=52) and the observation group ( n=54) . The control group was given routine nursing care during chemotherapy, while the observation group was given nursing care through early warning model of chemotherapy complications during chemotherapy. Hamilton Anxiety Scale (HAMA) , Hamilton Depression Scale (HAMD) and European Organization for the Research and Treatment of Cancer QLQ-C30 (EORTCQLQ-C30) were used to compare the intervention effect of the two groups, and the incidence of complications during chemotherapy was counted. Results:The total incidence of complications was 26.92% (14/52) in the observation group and 46.15% (24/52) in the control group, the difference was statistically significant (χ 2=4.147, P<0.05) . Three months after the intervention, HAMA (9.87±4.25) and HAMD (15.54±3.58) in the observation group were lower than those in the control group; the differences were statistically significant ( t=4.738, 8.296; P<0.05) . The functional score, symptom score, overall quality of life score and single measurement item score of the observation group were higher than those of the control group with statistical differences ( P<0.05) . Conclusions:During chemotherapy for non-small cell lung cancer, nursing through the early warning model of chemotherapy complications can reduce the incidence of chemotherapy complications, alleviate the negative emotions of patients, and improve the quality of life, which is worthy of clinical application.

Objective To investigate the status of exercise autonomy of chronic obstructive pulmonary disease (COPD) patients at stationary phase in community and to analyze the influencing factors of exercise autonomy so as to guide the external hospital control of COPD. Methods Totals of 124 COPD patients at stationary phase from three target communities in the area of the First Affiliated Hospital of Zhengzhou University were investigated by the method of convenience sampling. We analyzed the status of exercise among them. Non-conditional Logistic stepwise regression was used to determine the influencing factors of exercise autonomy. Results A total of 122 valid questionaires were collected. Among 122 patient, 51 (41.80%) patients never carried out, 33 (27.05%) occasionally carried out and 38 (31.15%) persisted in respiratory function exercise. Besides, 44 (36.07%) patients never carried out, 36 (29.51%) occasionally carried out and 42 (34.43%) persisted in all-round exercise. There were 53 patients with the good exercise autonomy. The frequent hospitalization was the independent protective factor of patients' exercise autonomy (P＜ 0.05). Conclusions COPD patients at stationary phase in community have poor exercise autonomy. Patients with more frequent hospitalization tend to carry out exercise more actively.

Objective? To explore the effects of grading health education model on self-care behavior and health behavior among elderly bronchiectasis patients outside hospital. Methods? From March 2015 to March 2017, we selected 120 elderly bronchiectasis patients at the First Affiliated Hospital of Zhengzhou University by convenience sampling. All of the patients were divided into control group and observation group with the method of the random number table, 60 cases in each group. Control group carried out routine health education. Observation group received the grading health education model dividing health education into three stages and pushing education content by WeChat;a total of 12 times of health education were implemented. The interventional cycle was three months between two groups. The Appraisal Self-Care Agency Scale-Reviewed (ASAS-R-C) and the Self-Rated Abilities for Health Practices Scale (SRAHP) were used to assess the self-care behavior and health behavior of patients outside hospital. Results? Before intervention, there were no statistical differences in the score of ASAS-R-C and SRAHP (P＞ 0.05). After intervention, the dimension scores of ASAS-R-C, SRAHP and the total score were higher than those before intervention with statistical differences (P＜0.05). After intervention, the scores of self-care goal, self-care skill, the total score of ASAS-R-C, health responsibility, sport management and the total score of SRAHP of intervention group were (25.62±2.18), (24.52±2.41), (74.72±6.27), (24.78±2.75), (25.21±2.16) and (98.35±8.16) higher than those of control group with statistical differences (P＜ 0.05). Conclusions? Grading health education model is propitious for elderly bronchiectasis patients to clear the nursing goal, improve nursing skills, enhance their health responsibility and improve their sport management abilities which is worthy of popularization and application.

Megalencephalic leukoencephalopathy with subcortical cysts (MLC, OMIN: 604004) caused by mutations in the MLC1 gene, is an rare autosomal recessive disorder. More patients are with infancy and young children onset, whereas adult cases are rare. Only 2 patients from 1 family have been reported in domestic adult cases. Now a 58-year-old female MLC patient is reported. The clinical manifestations of the patient included large head circumference, slow responses, walking difficulties, seizures and paroxysmal loss of consciousness. The result of whole exome sequencing revealed a homozygous insertion mutation c.920_943dup in the MLC1 gene. The mutation in this patient has not been reported in the Human Gene Mutation Database.

Objective To evaluate the safety and perinatal outcomes of thoracoamniotic shunting in the treatment of fetuses with severe primary hydrothorax. Methods 22 cases of suspected severe primary fetal hydrothorax which underwent thoraco-amniotic shunting in Shanghai First Maternity and Infant Hospital,Fetal Medicine Unit and Prenatal Diagnosis Center from January 2012 to December 2017 were analyzed retrospectively. Hydrothorax associated with structural or chromosomal abnormalities, infections and immune fetal hydrops were excluded. Results Totally ,28 shunts were placed in 22 fetuses. The median gestational age at TAS was 31.3 weeks. Preterm membrane rupture within 7 days after the procedure occurred in 9.1％(2/22) cases. Catheter displacement occurred in 18％(4/22) cases. The interval from shunting to delivery was 26.0 days. One fetus ended in induced abortion; 21(95％,21/22) babies were born alive, and their median gestational age at delivery was 34.4 weeks. 62％(13/21)newborns required ventilator supports; 4 neonatal deaths were attributed to pulmonary hypoplasia. The overall perinatal survival rate was 81％(17/21). The perinatal survival rate with hydrops and without hydrops were 10/13 and 7/8 respectively. Conclusion Thoraco-amniotic shunting is a safe procedure for intrauterine therapy and could improve the perinatal outcomes of severe primary fetal hydrothorax.