Objective To investigate the management of severe haemorrhage following minimally invasive percutaneous nephrolithotomy.Methods A retrospective study was accomplished on 3857 patients of minimally invasive percutaneous nephrolithotomy from Jan 1995 to Feb 2004.Fourteen patients,11 males and 3 females with a mean age of 45 years,developed severe haemorrhage requiring a haemostasis procedure(0.4%).Results Three cases of nephrectomies for haemostasis were performed at the beginning of our experience.Renal arteriography was performed in 11 patients,and the results showed that 5 patients were suffered with arteriovenous fistulas,4 cases with false aneurysms,1 case with arteriovenous fistulas and false aneurysms,and 1 case with arteriolar injury.All the patients with vascular abnormalities were successfully treated by highly selective embolization.Conclusion The severe haemorrhage following minimally invasive percutaneous nephrolithotomy is a rare complication,but impossible to be predicted.Renal arteriography and selective embolization is a safe and effective procedure for the management of severe haemorrage following minimally invasive percutaneous nephrolithotomy.

OBJECTIVETo observe the effect of fluoroacetamide on cardiomyocytes of rat and the antidotal effect of acetamide.

METHODS4 groups of SD rats were treated with various dosages of fluoroacetamid(p.o.) and 2 groups of them were treated with acetamide(i.p.). The changes of cardiomyocytes and serum AST, LDH, CK, CK-MB and HBDH were measured at different intervals after poisoning.

RESULTSIn the group treated with fluoroacetamid 8 mg/kg. bw, serum AST[(589.58 +/- 821.72) U/L], CK[(916.78 +/- 343.55) U/L], HBDH[(504.47 +/- 148.88) U/L] raised obviously compared with control[(187.70 +/- 46.87), (755.65 +/- 498.90), (347.25 +/- 228.40) U/L respectively] (P < 0.01), and the pathological findings such as degeneration, liquefactive necrosis and filtration of inflammatory cells in cardiac muscles were observed 24 hours later, while all the male dead within 3 days. In the group treated with fluoroacetamid 4 mg/kg. bw, serum LDH and HBDH rose significantly compared with control(P < 0.01) 5 day later. On the day of 10, myocardial enzymes restored in all experiment groups with some interstitial fibroblastic proliferation. The pathological changes were reduced in the group treated with acetamide synchronously (100 mg/kg. bw).

CONCLUSIONAcute intoxication of fluoroacetamide could damage cardiomyocytes while acetamide could reduce the injury of them, but the injury was reversible. The levels of serum myocardial enzymes could be a usable index for early diagnosis.

Acetamides ; pharmacology ; Alanine Transaminase ; blood ; Animals ; Antidotes ; pharmacology ; Creatine Kinase, MB Form ; blood ; Fluoroacetates ; toxicity ; L-Lactate Dehydrogenase ; blood ; Myocytes, Cardiac ; drug effects ; pathology ; Rats ; Rats, Sprague-Dawley