Objective To summarize the experience of ultrasound-guided percutaneous nephrostomy during percutaneous nephrolithotomy(PCNL) under B-ultrasound guidance. Methods A ultrasound-guided percutaneous nephrostomy was performed in 43 cases by using a 18-gauge needle.Then the percutaneous puncture was expanded for establishing a working tunnel. Under nephroscope,stone fragmentation was completed in the renal pelvis and the upper segment of the ureter.Results The success rate of percutaneous puncture was 100%.Of the 43 cases,the percutaneous working tunnel was successfully established in 42 cases(97.7%),while a conversion to open surgery was needed in 1 case because of uncontrolled hemorrhage after puncture.The overall stone clearance rate was 100%(42/42),including 38 cases of stone removal on one session and 4 cases of two-staged clearance.No serious complications,such as massive hemorrhage or neighboring organ injuries,were encountered.Re-examinations with B-ultrasonography or KUB at 1 month after operation showed no residual stones.Conclusions Ultrasound-guided percutaneous nephrostomy is minimally invasive,safe,and reliable.Proper use of this technique is crucial for a successful performance of percutaneous nephrolithotomy in the treatment of upper urinary tract calculus.

Objective To investigate the correlation between atherosclerotic renal artery stenosis and hypertension.Methods One hundred and seventy-nine patients underwent renal artery angiography after coronary artery angiography. Results Among the 179 patients, 56.4% patients were detected as renal artery normal, 24% as renal artery disease, and 19.6% as renal artery stenosis. Compared with hypertensive patients with normal renal artery, ARAS patients had higher systolic blood pressure (148?23 mm?Hg vs 136?18 mm?Hg, P

Objective To explore the application and effect of scene imitation method in the education of patients before fiberoptic bronchoscopy.Methods 264 elective bronchoscopy patients between March 2007 and Decembet 2007 were randomly divided into control group(120 patients)and the experiment group(144 patients)Traditional health education was applied in the control group before bronehoscopy.Scene imitation method in health education was applied in the experiment group before bronchoscopy.Results The examination succes rate in the experiment group was significantly improved(P＜0.05).The medical order obeying behavior(MOOB)of the patients was significantly different between the two group(P＜0.01).Conclusion Before the use of fiberoptic bronchoscopy,the new scene simulation method Can help patients on the list obtain more cognitive ability about the testing.Comparing the traditional education,it establishes a sound relationship between doctors and patients,reduces complication and leads to more accurency of testing,thus helping patients to recover soon.

Objective To find out about the utilization of health resources by rural pulic health centers in Hubei Province in the Ninth Five-Year Plan period so as to provide primary information for the better use of rural health resources. Methods The issues of Hubei Health Statistics and Hubei Almanac in 1990 and from 1996 to 2000 were collected and statistial analyses were conducted by means of the spss software. Results In the Ninth Five-Year Plan period, the human resources and fixed assets of rural public health centers in Hubei Province kept increasing whereas the volume of services dropped year by year. The reduction in the average number of outpatient visits and discharged patients per annum was respectively 4. 42% and 4. 09%. The efficiency of the health personnel in delivering medical services has been decreasing, with the average number of patients treated by each person per annum, the annual number of beds utilized, and the annual number of discharged patients in 2000 dropping respectively by 27.54% , 30.22% and 26.36% , as compared with 1996. The annual ratio of bed utilization was around 30% and the number of bed turnovers was about 20 times, evidencing, moreover, a tendency of going down. Conclusion The input of health resources in the rural public health centers in Hubei Province in the Ninth Five-Year Plan period increased while the rate of utilization dropped. It is suggested that integrated management in the rural areas be adopted, better utilization of health resources made, reform of the public health centers deepened, and internal management improved; greater stress be laid on improving the quality of rural health personnel; and the rural cooperative medical and health system be perfected.

Objective to observe the efficacy and application value of PFNA and Gamma in the treatment of intertrochanteric fractures in elderly. Methods 100 patients with intertrochanteric fractures were divided into PFNA group and Gamma group, who received PFNA treatment and Gamma treatment respectively. And the operation status of patients at different ages,postoperative recovery,and complications were observed. Results The operation time,intraoperatve blood soss of PFNA group were lower than those of Gamma group(P<0. 05). There was no significant difference in fracture healing time. The Harris score of the over 75s in PFNA group was higher than that in Gamma group(P<0. 05),and the complications were less than Gamma group(P<0. 05). Conclusion PFNA was suitable for the patients at differ-ent ages with the advantages of more rigid fixation,good anti-rotation,fewer trauma and fewer complications.

Objective To investigate the correlation between atherosclerotic renal artery stenosis and the severity of coronary lesions in patients with confirmed coronary artery disease and the impact of renal artery stenosis on serum inflammation related factors.Methods 163 patients from Peking University First Hospital with confirmed coronary heart disease by coronary angiography underwent selective renal artery angiography from Dec 2002 to Sep 2003.Serum hypersensitive C reactive protein(hs-CRP)and Interleukin-6(IL-6)were measured.Results Patients combined with coronary disease and renal artery stenosis were presented with more acute coronary syndrome(ACS)and triple-vessel CAD.Serum hs-CRP and IL-6 levels were also higher in this group.Conclusion Renal artery stenosis is correlated with severe coronary disease.Inflammation state could be one of the reasons for this connection.

This article has shown the experiences to achieve more effective teaching results by integration of multiple teaching patterns,including case-based,problem-based learning,in the teaching of water-electrolyte metabolism and acid-base balance disorders.

Acupuncture Therapy ; Adult ; Aged ; Bloodletting ; Female ; Gout ; therapy ; Humans ; Male ; Middle Aged

Anthocyanin biosynthesis is one of the thoroughly studied enzymatic pathways in biology, but little is known about the molecular mechanisms of its final stage: the transport of the anthocyanins into the vacuole. A clear picture of the dynamic trafficking of flavonoids is only now beginning to emerge. So far four different models have been proposed to explain the transport of anthocyanins from biosynthetic sites to the central vacuole, and four types of transporters have been found associated with the transport of anthocyanins: glutathione S-transferase, multidrug resistance-associated protein, multidrug and toxic compound extrusion, bilitranslocase-homologue. The functions of these proteins and related genes have also been studied. Although different models have been proposed, cellular and subcellular information is still lacking for reconciliation of different lines of evidence in various anthocyanin sequestration studies. According to the information available, through sequence analysis, gene expression analysis, subcellular positioning and complementation experiments, the function and location of these transporters can be explored, and the anthocyanin transport mechanism can be better understood.
Anthocyanins ; metabolism ; Biological Transport ; Glutathione Transferase ; metabolism ; Membrane Transport Proteins ; metabolism ; Multidrug Resistance-Associated Proteins ; metabolism ; Plants ; metabolism ; Vacuoles ; metabolism

Objective To evaluate the accuracy of point-of-care testing (POCT) for blood glucose monitoring in critically ill patients.Methods Two hundred and forty critically ill patients,of both sexes,aged 20-88 yr,with Acute Physiology and Chronic Health Evaluation Ⅱ score of 1-45,were enrolled.The venous,arterial and capillary blood samples were collected to determine the real-time blood glucose level using glucose oxidase (GOD) and glucose dehydrogenase (GDH) methods.The blood glucose level measured by central laboratory hexokinase method simultaneously was served as standard level.Error Grid analysis (EGA) and Bland-Altman analysis were used to determine accuracy and consistency,respectively.The accuracy of real-time blood glucose levels within the consistent limits was evaluated.Results 1.The results of EGA showed that 98.7 ％,98.3 ％,98.3 ％(GDH method) and 96.2％,96.6％,96.7％ (GOD method) of the difference between venous,arterial and capillary blood glucose levels measured and the standard level were located in the A and B zones,respectively,and 1.2％,1.7％,1.7％ (GDH method) and 2.9％,3.3％,3.3％ (GOD method) in the D zone.0.8％ (GOD method) of the difference between venous blood glucose levels and the standard level were located in the C zone.2.Bland-Altman analysis showed that the difference between the standard level and glucose level measured in blood samples from the vein,artery and capillary.was-0.1,-0.3,-0.2 mmol/L (GDH method) and-0.9,-1.0,-0.9 mmol/L (GOD method),respectively,and the incidence beyond the upper and lower limits of consistency zone was 4.5 ％,6.7 ％,6.6 ％ (GDH method) and 4.6 ％,5.0 ％,7.1％ (GOD method),respectively.The accuracy of venous,arterial and capillary blood glucose levels within the consistent limits was 94.3 ％,92.1％,93.7％ (GOD method) and 96.6％,95.1％,95.5％ (GDH method),respetively.Conclusion The accuracy of POCT for blood glucose monitored by GOD and GDH methods is good in critically ill patients,but it is possible to overestimate the patient's real glucose level.