OBJECTIVETo investigate the intra- and postoperative hemorrhage of percutaneous nephrolithotomy via the standard nephrostomy tract.

METHODSA retrospective analysis was conducted among 1578 patients undergoing percutaneous nephrolithotomy. During the operations, all the nephrostomy tracts were dilated to F24 size after successful puncture. The stones were shattered and removed by EMS lithotrity system.

RESULTSAll the patients showed intra- and postoperative hemorrhage, and in 121 cases, blood transfusion was needed. In 18 patients, the operation had to be terminated for severe hemorrhage. The 8 patients with repeated bleeding were managed and cured by blood transfusion and medication. In another 2 cases, severe hemorrhage was found to result from false aneurysms by renal arteriography and managed by superselective embolization.

CONCLUSIONPercutaneous nephrolithotomy through standard nephrostomy tract is safe and does not increase the risk of bleeding with careful operation.

Adolescent ; Adult ; Aged ; Blood Loss, Surgical ; Female ; Humans ; Kidney Calculi ; surgery ; Male ; Middle Aged ; Nephrostomy, Percutaneous ; methods ; Postoperative Hemorrhage ; Retrospective Studies ; Young Adult

Objective To analyze the manifestation,reason,the processing method of the steel wire implantation with the sereotactic mammography to improve the accuracy of the preoperative positioning.Methods Seventy-nine cases which got the stereotactic steel wire implantation.In 96 lesions, 13 had steel wire displacement.Among them,5 cases got steel wire displacement during the sereotactic process,5 cases got steel wire displacement after the stereotactic process,2 cases got steel wire displacement during the operation,one case did not show the calcification on the postoperative radiography.Results The steel wire displacement occurred in 5 cases during the stereotactic process came from the patients and doctors respectively and the repositioning was needed.The steel wire displacement after the stereoscopic positioning was attributed to the overdose injection of local anesthesia,which led to the mismatch between the depth of Z axis of the mammary gland and the actual depth the computer given,the incorrect method for needle placement,and,neglecting whether the steel wire have got the lesion anchored when pulling out the needle set of steel wire hood,besides,these three kinds of instances above were all exaggerated by the accordion effect.For the displacement within 2 cm,the lesion can be excised toward the pathological change direction according to the position that steel wire prompted and re-place the second steel wire,putting the J-shaped steel wire into the needle hood and taking it out of the body.After repositioning,2 cases had the steel wire prolapse during operation,which resulted from the over-lifting of the steel wire.After placing the steel wire, the radiologist should give an accurate description on the depth and direction to the surgeon and the notch should be taken for incision from the steel wire head end which is proximate to skin.The postoperative specimen from one case had no calcification,which might be related to the condition that the calcification was located in the gland body,which got destruction from the surgical electrical electrotome.The excisionscope should be extended and the short term reexamination is recommended to make sure the complete excision of the calcification.Conclusion It is the gold standard method that implanting the steel wire with the stereotactic mammography to guide the surgical dissecting technique to diagnose non-palpable breast lesion(NPBL).Thorough understanding of the displacement manifestation of implanting steel wire with stereotactic technique and the treatment methods will be helpful in the surgical dissecting guidance.

Objective To investigate the characteristic and clinical significance of airway inflammation in children with acute asth-ma. Methods Underwent sputum induction and sputum induction in children (n=34) with acute asthma was repented in recovered children ( n = 24).Induced sputum were also taken from 15 healthy children as controls.Total and differential cell counts were per-formed. Interleukin(IL)-8、IL-6 were measured,The relationship between inflammatory cells and IL-8、 IL-6、peak expiratory (PEF) were analyzed.Results The inflammatory cell infiltrate was mixed including eosmophilic granulocytes, neutrophils, and macrophages. They decreased significantly, but eosinophilic granulocyte remained a higher percentage compared with healthy subjects. There was low-er percentage of lymphocytes at acute exacerhation.Eosinophilic granulocytes were correlated with the degree of airflow obstruction. Levels of IL-8、IL-6 were elevated during the acute exacerbation and decreased at resolution.IL-8 was correlated significantly with neutrophils at acute exacerhation and resolution.IL-6 was correlated signifficantly with eosinophilic granulocytes at acute exacerbation. Conclusions Airway inflammation is chataeterized by infiltration of eosinophils, neutrophils and macrophages.IL-8、IL-6 possibly is the important cytokines of airway inflammation in children with acute asthma. Increased eosinophils in induced sputum correlates with asthma severity. Therapy to the cytokines may have potential values.J Appl Clin pediatr,2004,19(12): 1023-1025

Bronchoscopy ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Tracheal Neoplasms ; diagnosis ; surgery

OBJECTIVETo explore how obstructive sleep apnea syndrome (OSAS) affects children's sleep architecture.

METHODSEighty-three children with OSAS were reviewed; every patient was monitored with polysommography for 7 hours at night for 11 parameters, including the number of arousal, snoring index, nadir O(2) desaturation, stage I %, stage II %, show wave sleep (SWS)% and rapid eye movement (REM)%. The basis for diagnosis of OSAS was the widely accepted pediatric diagnostic criteria of apnea/hypopnea index, apnea/ hypopnea index of > 1 episode/hour, nadir O(2) desaturation < 92%. Sleep was scored manually according to the standard set by Rechtschaffen.

RESULTSIn OSAS group, the number of arousal was 22.5 +/- 1.4, snoring index was 70.6 +/- 16.5, and/or SaO(2) was (73.8 +/- 1.9)%. OSAS group had increased stage I : (45.8 +/- 2.0)% vs. (2.3 +/- 1.1)%, t = 22.46, P < 0.01 and decreased stage II : (23.9 = 1.7)% vs (47.9 = 4.4)%, t = - 14.18, P < 0.01, SWS (15.6 +/- 1.8)% vs. (21.1 +/- 5.0)%, t = - 3.123, P < 0.01, REM (14.7 +/- 1.5)% VS. (28.2 +/- 4.1)%, T = -8.923, p < 0.01.

CONCLUSIONThe severity of OSAS relates to changes of sleep architecture in children. Intermittent nocturnal hypoxia secondary to apnea/hypopnea, and frequent electroencephalogram arousals from sleep may result in significant sleep fragmentation. Children with OSAS had learning problems and failure to thrive.

Child ; Child, Preschool ; Female ; Humans ; Male ; Monitoring, Ambulatory ; Polysomnography ; Severity of Illness Index ; Sleep Apnea, Obstructive ; classification ; pathology ; physiopathology ; Sleep Stages ; physiology

Syl948 is a synthesized selective S1P1 agonist with novel structure. HTRF-IP1 test indicated that Syl948-P, the active form of Syl948 in vitro, has strong activity against S1P1 (EC50: 83 +/- 16 nmol x L(-1)), but its effect on S1P3 was very weak (EC50: 1 026 +/- 90 nmol x L(-1)). In SD rats, oral administration of Syl948 10 mg x kg(-1) significantly decreased the peripheral blood lymphocytes (PBL), with the maximal PBL inhibition rate of 63%, which was as similar as equal dose of fingolimod (FTY720). Oral administration of Syl948 10 mg x kg(-1) had no effect on heart rate of SD rats, which was better than FTY720. Daily oral administration with Syl948 (2 or 4 mg x kg(-1)) significantly prolonged the survival time of the allografts of skin slice on mice. In summary, the above results demonstrated that Syl948 has great selectivity in vitro and good activity in vivo, which indicated its potential use as an anti-rejection drug in skin transplantation.
Animals ; Fingolimod Hydrochloride ; Graft Survival ; drug effects ; Immunosuppressive Agents ; pharmacology ; Lymphocytes ; drug effects ; Mice ; Propylene Glycols ; pharmacology ; Rats ; Receptors, Lysosphingolipid ; agonists ; Skin Transplantation ; Sphingosine ; analogs & derivatives ; pharmacology ; Transplantation, Homologous

The NF-kappaB pathway regulates the expression of over 150 target genes, e.g., cytokines, chemokines, leukocyte adhesion molecules and inducible effector enzymes. Consequently, it plays a crucial role in innate and adaptive immune responses, inflammatory response, stress responses, apoptosis and so on. IkappaB kinase (IKK) is the key of this pathway, and it owns a special structure which consists of catalytic subunit and regulatory subunit. Naturally, the activation of IKK needs the interaction of the two subunits and phosphorylation by its upstream kinases. Actually, there are two methods of activation of the NF-kappaB pathway, and both of the methods need the IKK complex. Given to the crucial role of IKK, researchers have isolated and synthesized amounts of IKK inhibitors, and these provide a great convenience to develop novel anti-inflammatory and anti-tumor drugs.
Animals ; Anti-Inflammatory Agents ; pharmacology ; Antineoplastic Agents ; pharmacology ; Enzyme Activation ; Enzyme Inhibitors ; metabolism ; pharmacology ; Humans ; I-kappa B Kinase ; antagonists & inhibitors ; chemistry ; metabolism ; physiology ; NF-kappa B ; metabolism ; Phosphorylation ; Signal Transduction

Objective To evaluate the efficacy and safety of rivaroxaban on anti -deep venous thrombosis for patients with hip arthroplasty. Methods A total of 63 cases who scheduled for hip arthroplasty were recruited and were randomly divided into treatment group ( n=31 ) and control group ( n =32 ) .Patients in treatment group were administered with rivaroxaban 10 mg? d-1 6 h after surgery orally qd for 35 days, and patients in the control group were injected with low molecular heparin 4100 U 12 h after surgery for 14 days.The data of blood loss, blood transfusion rate and deep venous thrombosis risk were compared between the two groups.Results There were 30 patients finishing the treatment of 3 months follow -up in treatment group with the incidence of deep venous thrombosis being 13.3%.There were 31 cases finishing the 3 months follow-up in the control group with the incidence of deep venous thrombosis being 16.2%.There was no statistical difference between the two groups (P>0.05).The platelet and coagulation function change of the two groups were not statistically different before and after the treatment ( P>0.05 ) .The blood loss was ( 1320.6 ±202.4 ) mL and (1301.1 ±232.6) mL in treatment group and control group respectively with no statistical difference ( P>0.05 ) .Conclusion Rivaroxaban can significantly decrease the risk of deep vein thrombosis in patients undergoing hip arthroplasty without increasing the risk of bleeding, similar to the efficacy of low molecular heparin.

The purpose of this study was to assess the factors affecting caudal screw loosening after spinopelvic fixation for adult patients with spinal deformity. This meta-analysis calculated the weighted mean difference (WMD) and odds ratio (OR) using Review Manager ver. 5.3 (RevMan; Cochrane, London, UK). The loosening group was older than the control group (WMD, 2.17; 95% confidence interval [CI], 0.48–3.87; p=0.01). The S2 alar-iliac (S2AI) could prevent the caudal screw from loosening (OR, 0.43; 95% CI, 0.20–0.94; p=0.03). However, gender distribution (p=0.36), the number of fusion segments (p=0.24), rod breakage (p=0.97), T-score (p=0.10), and proximal junctional kyphosis (p=0.75) demonstrated no difference. Preoperatively, only pelvic incidence (PI) in the loosening group was higher (WMD, 5.08; 95% CI, 2.71–7.45; p<0.01), while thoracic kyphosis (p=0.09), lumbar lordosis (LL) (p=0.69), pelvic tilt (PT) (p=0.31), pelvic incidence minus lumbar lordosis (PI–LL) (p=0.35), sagittal vertical axis (SVA) (p=0.27), and T1 pelvic angle (TPA) demonstrated no difference (p=0.10). PI–LL (WMD, 6.05; 95% CI, 0.96–11.14; p=0.02), PT (WMD, 4.12; 95% CI, 0.99–7.26; p=0.01), TPA (WMD, 4.72; 95% CI, 2.35–7.09; p<0.01), and SVA (WMD, 13.35; 95% CI, 2.83–3.87; p=0.001) were higher in the screw loosening group immediately postoperatively. However, TK (p=0.24) and LL (p=0.44) demonstrated no difference. TPA (WMD, 8.38; 95% CI, 3.30–13.47; p<0.01), PT (WMD, 6.01; 95% CI, 1.47–10.55; p=0.01), and SVA (WMD, 23.13; 95% CI, 12.06–34.21; p<0.01) were higher in the screw loosening group at the final follow-up. However, PI–LL (p=0.17) demonstrated no significant difference. Elderly individuals were more susceptible to the caudal screw loosening, and the S2AI screw might better reduce the caudal screw loosening rate than the iliac screws. The lumbar lordosis and sagittal alignment should be reconstructed properly to prevent the caudal screw from loosening. Measures to block sagittal alignment deterioration could also prevent the caudal screw from loosening.

Objective To explore the factors associated with the complications of cranioplasty, infection and local epidural hematoma, such as age, sex, primary disease, skull defect and concomitant hydrocephalus. Methods 211 patients after cranioplasty were reviewed. Results 8 cases (3.8%) complicated one of them, in which 6 cases with local epidural hematoma and 2 cases with infection. The infection was more likely related with the areas of skull defect (P=0.003). No factor was found related with the local epidural hematoma. Conclusion It is necessary to focus the size of the frontal sinus when repairing the the frontal bone, to avoid the screw into the frontal sinus caused infection.