Objective To construct a safe,stable and credible system for the running of network system and improve its application effect.Method Starting with the information system construction in Xijing hospital,the existent network system was programmed and rebuilt by establishing a assistant switch core and constructing multi-center redundancy link.Conclusion The rebuilt information system of Xijing hospital attains the anticipated effect,and shows rationality and practicability in use.What's more,combined with actual experience,the rebuild of hospital network system was summarized and suggestions were given.

Objective To realize the integration of PACS and HIS. Methods Powerbuilder was used in designing the electronic application system. Synchronization of PACS and HIS were accomplished by Oracle stored procedures. Results The integration of PACS and HIS were implemented successfully in Xijing Hospital and satisfied results were achieved. Conclusion The successfully integration of diverse systems should be based on the circumstance of hospital,led by information department,and discussed and demonstrated by relative departments. At the same time,the principal of high availability and low dependence among diverse systems should be followed. The alternate periods of old and new work flows should be decreased on the basis of practical software and reasonable procedure.

Objective To study the clinical value of tamsulosin in prevention of urinary retention after radical hysterectomy.Methods Sixty-six patients after radical hysterectomy were enrolled in this study, and divided into two groups in random.Thirty-three cases in the treatment group were treated with tamsulosin 0.2 mg once every night,3 days before the catheter was drawn.While 33 cases in the control group only with placebo.Catheter keeping days, residual urine volume at first extraction,the rate of urinary retention and urinary tract infection,hospitalization time and drug adverse reaction were compared in two groups.Results Catheter keeping days and hospitalization time were shorter in the treatment group than those in the control group(P< 0.05).The residual urine volume at first extraction was(38.2 ± 5.6) ml in the treatment group and (168.5 ± 11.8) ml in the control group,there was significant difference between two groups (P< 0.05).The rate of urinary retention was 18.2%(6/33) in the treatment group and 36.4%(12/33) in the control group,there was significant difference between two groups (P <0.05).There was no adverse reaction resulted from tamsulosin in the treatment group.Conclusion Tamsulosin is an effective drug which could prevent and treat the urinary retention after radical hysterectomy.

Objective To evaluate the efifcacy and safety of hemostatics of injected gelatin matrix (HIGM) under the guidance of contrast-enhanced ultrasound (CEUS) for treating splenic trauma in canine model. Methods A total of 24 commercial hybrid dogs underwent celiotomy with creation of uniformly blunt splenic trauma lesion of 4.0 cm×4.0 cm×2.5 cm (length, width and depth, respectively) by hemostatic clamp. Subjects were prospectively randomized into two groups. The treatment group was treated with HIGM under the guidance of CEUS and the positive control group received thrombin solution. Conventional ultrasound and CEUS were performed to record the ascites and the splenic lesion areas at 1st, 3rd, 7th, 14th and 21st day. The ifne needle biopsy and splenectomy were performed for histopathologic examination. The weight, free intraperitoneal lfuid and injury site were compared with t test between HIGM and postive group. Results All animals in two groups survived. All dogs stopped hemorrhage after injection of HIGM under CEUS guidance. The area of injury site was (12.91±0.89) cm2, (4.45±0.75) cm2 and (1.38±0.23) cm2 at 1st, 3rd and 7th day and splenic lesions were not found at 14th and 21st day in all dogs (n=12) of HIGM group. The splenic lesion was (16.74±0.91) cm2, (11.26±0.99) cm2, (8.02±0.82) cm2 and (1.58±0.36) cm2 in the postive group at 1st, 3rd, 7th and 14th day and splenic lesions were not found at 21st day in all dogs (n=12). At 7th and 14th day post-injection, lesion areas were statistically significant between two groups (t=27.162, P=0.008;t=15.129, P=0.001). Free intraperitoneal lfuid was (0.91±0.05) cm at 1st day detected by conventional ultrasound and free intraperitoneal fluid was not found at 3rd, 7th, 14th and 21st day in all dogs (n=12) of HIGM group. The free intraperitoneal fluid in thepositive group was (1.96±0.17) cm, (1.30±0.11) cm and (0.81±0.12) cm at 1st, 3rd and 7th day and free intraperitoneal lfuid was not found at 14th and 21st day in all dogs (n=12). At 1st, 3rd and 7th day post-injection, free intraperatitoneal lfuid was statistically significant between two groups (t=20.934, P=0.003; t=41.310, P=0.000; t=22.520, P=0.000). Histopathological examination showed that there was no foreign body and foreign body granuloma and the structure of red pulp was recovered at 7th, 14th and 21st day. Gross anatomy showed that the splenic injury site was recovered completely without complications. Conclusion This study explored the value of HIGM for splenic trauma and provided a preliminary experimental evidence for clinical treatment.

Objective To investigate the clinical features of pedistric Littre hernia.Methods Clinical data of 11 cases of Littre hermia admitted from January 2002 to December 2010 was studied retrospectively.Results The diagnosis of Littre hernia was all established by laparotomy.All of the 11 cases were boys,the median age was 1.2 years (22 days to 3 years and 7 months).The main clinical features were:painful,irregular and nonresetable mass in the groin area (11/11),vomiting in 6 cases (6/11 ),fever (＞38.5 ℃ ) in 4 cases (4/11 );X-ray showed intestinal obstruction in 9 cases (9/11 ),Ultrasound found mixed mass in the groin area in 11 cases ( 11/11 ),pouch-like structure were found in 6 cases (6/11).Eight cases (8/11) presented with elevated WBC ( ＞ 10000).Palpable lobulated structure were fell in 5 cases (5/11).All cases of Littre hernia were successfully operated on,Meckel diverticulum perforation was found in 2 cases ( 2/11 ),Meckel diverticulum adhered to the hernia sac in 8 eases (8/11).All patients were cured by surgery,and postoperative follow-up (10ms-8y) found no recurrence.Conclusions Pediatric Littre hernia is rare,preoperative diagnosis is difficult.Avoiding preoperative violent reduction and intraoperative injuring Meekel's diverticulum or the small bowel helps improve the cure rate of Littre hernia in children.

OBJECTIVETo examine serum concentration of interleukin-18 (IL-18) and IL-18 mRNA expression in peripheral blood mononuclear cells (PBMCs) in children with primary nephrotic syndrome (PNS) and explore the possible role of IL-18 in steroid-resistant nephrotic syndrome (SRNS).

METHODSSixty-six children with newly diagnosed PNS, including 39 cases of steroid sensitive nephrotic syndrome (SSNS) and 27 cases of SRNS, were enrolled. Forty healthy children were used as a normal control group. Blood samples were collected before and 8 weeks after glucocorticoid treatment. Serum concentration of IL-18 was measured using ELISA. IL-18 mRNA expression in PBMCs was detected by the RT-PCR method. The amount of 24-hr urine protein was measured by the biuret method. Serum contents of total cholesterol (T-Ch), triglyceride (TG), low density lipoprotein (LDL), total protein (TP), and albumin (Alb) were measured by the automatic biochemistry analyzer.

RESULTSSerum concentration of IL-18 and IL-18 mRNA expression in PBMCs in the SSNS and the SRNS groups were significantly higher than those in the normal control group before treatment (P< 0.05). The SRNS group had increased serum protein concentration of IL-18 and IL-18 mRNA expression in PBMCs compared with the SSNS group before treatment (P< 0.05). Serum LDL content in the SRNS group was also significantly higher than that in the SSNS group before treatment (P< 0.05). After treatment, serum concentration of IL-18 and IL-18 mRNA expression in PBMCs in the SRNS group were significantly higher than those in the SSNS and the normal control groups (P< 0.05). Serum concentration of IL-18 and IL-18 mRNA expression in PBMCs in the SSNS group were significantly reduced after treatment, but the alterations of IL-18 were not observed in the SRNS group after treatment.

CONCLUSIONSSRNS was associated with increased serum IL-18 concentration and IL-18 mRNA expression in PBMCs. Over-production of IL-18 may play a role in the development of SRNS.

Adolescent ; Adrenal Cortex Hormones ; therapeutic use ; Child ; Child, Preschool ; Drug Resistance ; Female ; Humans ; Interleukin-18 ; blood ; genetics ; physiology ; Leukocytes, Mononuclear ; metabolism ; Lipoproteins, LDL ; blood ; Male ; Nephrotic Syndrome ; blood ; drug therapy ; RNA, Messenger ; blood

Objective:To investigate the clinical safety and efficacy of robot-assisted laparoscopic ventral onlay lingual mucosal graft ureteroplasty for ureteral stricture.Methods:The clinical data of 6 patients with ureteral stricture admitted to the Guizhou Provincial People's Hospital from December 2020 to August 2022 were retrospectively analyzed. There were 3 males and 3 females, with an average age of (40.2±11.5) years old. The status of ureteral stricture and hydronephrosis was measured by ultrasonography, CT urography and ureteral retrograde angiography. There were 2 cases of left ureteral stricture and 4 cases of right ureteral stricture, including 4 cases of upper segment stricture and 2 cases of middle segment stricture. The separation of the renal pelvis on the affected side was 3.2 (2.1, 4.2) cm. The length of ureteral stricture was 3.8 (2.5, 4.3) (1.0-5.0) cm, and the preoperative blood creatinine was 90(71, 97)μmol/L. Robot-assisted laparoscopic ventral onlay lingual mucosal graft ureteroplasty was performed in all cases under general anesthesia. The strictured ureter segment was separated and longitudinally cut during the operation. The lingual mucosal grafts 2.5-5.0 cm in length and 1.0-1.5 cm in width was cut according to the stricture. Then the lingual mucosal grafts were harvested and placed in the strictured ureter as a ventral onlay. One double J tube was placed in the affected side in all cases during operation. The perioperative outcomes and complications were analyzed. The blood creatinine and renal pelvis separation on the affected side after surgery were compared with the preoperation.Results:All the surgeries were successfully completed. The average operative time was (190.8 ± 59.0) min, median blood loss was 40 (20, 63) ml, postoperative indwelling time of the drainage tube was 6 (4, 6) days, gastrointestinal function recovery time was 3 (2, 3) days, postoperative hospital stay was 6 (6, 7) days. The patients had clear pronunciation and lingual incision recovered 1 week post-operatively. The urine tube was removed 2 weeks after surgery, and the double J tube was removed 8 (6, 10) weeks post-operatively. Radiological examination revealed significant difference in hydronephrosis on the affected side 3 months post-operatively compared with the preoperation, and the separation of the renal pelvis on the affected side was 1.2 (1.2, 1.4) cm after surgery. The blood creatinine was 79(71, 104)μmol/L at 3 month after surgery, which was also improved compared with preoperative.Conclusions:Robot-assisted laparoscopic ventral onlay lingual mucosal graft ureteroplasty is a feasible and safe option for the treatment of ureteral stricture with less trauma, rapid recovery, and less complications.

OBJECTIVETo study serum concentration and mRNA expression of interleukin-13 (IL-13) in children with steroid-responsive nephrotic syndrome (SRNS) and the effect of methylprednisolone pulse therapy (MPT) on IL-13 expression.

METHODSTwenty-eight children with SRNS were enrolled in this study. Serum protein level of IL-13 was measured using ELISA and IL-13 mRNA expression in peripheral blood mononuclear cells (PBMC) was detected with RT-PCR before MPT, 2 and 5 days after MPT, and 2 weeks after disappearance of proteinuria following MPT. Twenty-four urinary protein was measured with the biuret assay. Twenty healthy children were used as controls.

RESULTSSerum IL-13 levels (38.48 +/- 13.01 pg/mL vs 5.18 +/- 2.71 pg/mL) and PBMC IL-13 mRNA expression (1.31 +/- 0.23 vs 0.36 +/- 0.07) before MPT in SRNS patients were significantly higher than in the controls. After 5 days of MPT and 2 weeks after disappearance of proteinuria following MPT, serum IL-13 levels (15.33 +/- 7.81 and 5.35 +/- 2.12 pg/mL respectively) and PBMC IL-13 mRNA expression (0.89 +/- 0.26 and 0.33 +/- 0.08 respectively) were significantly reduced (P < 0.01). Serum IL-13 levels and PBMC IL-13 mRNA expression in SRNS patients 2 weeks after disappearance of proteinuria following MPT were reduced to control levels, but remained at a higher level than controls 5 days after MPT. A positive correlation was found between serum levels of IL-13 and 24-hour urinary protein in SRNS patients before (r=0.75, P < 0.01) and after 2 and 5 days of MPT (r=0.68, r=0.71 respectively; P < 0.05).

CONCLUSIONSSerum IL-13 levels and PBMC IL-13 mRNA expression in children with SRNS increase. MPT can inhibit the expression of protein and mRNA of IL-13 in these patients.

Adolescent ; Child ; Female ; Humans ; Interleukin-13 ; blood ; genetics ; Male ; Methylprednisolone ; administration & dosage ; Nephrotic Syndrome ; blood ; drug therapy ; Proteinuria ; drug therapy ; RNA, Messenger ; analysis

OBJECTIVETo demonstrate the ablation of segmental glissonian pedicle by ultrasound-guided radiofrequency in precision liver resection in porcine model.

METHODSThe study was carried out on 6 Bama miniature pigs. Coagulative desiccation of the vessels feeding the segment to be resected was induced by introduction of a "cooled-tip" radiofrequency electrode under intraoperative ultrasound guidance at the level of the vessels. Then, an area of marked discoloration on the surface of the liver became obvious. Liver parenchymal transection followed without any form of hepatic inflow occlusion. Three segments (segment 3, 5, and 6) were resected on each pig. The criteria studied the local and general tolerance, the change of blood flow parameters of each segmental arterial and portal branches, and the microscopic appearance of the segmental arterial, portal and biliary tract branches. Using t test as the statistical methods.

RESULTSPostoperative mortality and morbidity were 0 and all serum parameters had normalized by 14 days. Demarcation area was obtained in 15 segments. The flow rate of the resected segmental portal branches was 0 cm/s after radiofrequency and the value of the arterial branches was (28 ± 18) cm/s which was significantly lower than pre-radiofrequency, which were (10.2 ± 3.0) cm/s and (60 ± 17) cm/s (t = 14.439, 5.502; P = 0.000). There was no significant difference in the flow rate of the remnant segmental arterial and portal branches among pre-radiofrequency, post-radiofrequency and 14 days after operation. On microscopic observation, the mean ablated length of segmental portal, arterial and biliary tract branches were (1.6 ± 0.4) cm, (1.2 ± 0.4) cm, and (1.7 ± 0.3) cm respectively.

CONCLUSIONSThe ablation of the segmental glissonian pedicle by ultrasound-guided radiofrequency is quick, safe and effective. The probe needs to be away from vessels feeding segments 1.5 cm at least to avoid thermal injuries.

Animals ; Catheter Ablation ; methods ; Female ; Hepatectomy ; methods ; Male ; Swine ; Swine, Miniature ; Ultrasonography

OBJECTIVETo investigate a patient featuring a complex neuromuscular disease phenotype.

METHODSA comprehensive analysis integrating clinical investigation, electrophysiological testing, pathological analysis and mutation screening was carried out.

RESULTSThe patient has presented clinical and pathological manifestations mimicking Duchenne muscular dystrophy. However, genetic analysis has identified no deletion in 21 exons of Dystrophin gene, no pathologic expansion of CTG repeats in DMPK gene or CCTG repeats in ZFN9 gene. Instead, a homozygous deletion of exons 7 and 8 in SMN gene was discovered.

CONCLUSIONA rare case of spinal muscular atrophy (SMA) was verified by genetic diagnosis. SMA is a group of neuromuscular disorders with great phenotypic heterogeneity and sometimes cannot be diagnosed by clinical manifestations, electrophysiological and pathological changes alone. Genetic diagnosis has become indispensable for accurate diagnosis for patients suspected to have the disease.

Adult ; Diagnosis, Differential ; Humans ; Male ; Muscular Atrophy, Spinal ; diagnosis ; genetics ; pathology ; Myotonic Dystrophy ; diagnosis ; genetics ; pathology ; Myotonin-Protein Kinase ; Phenotype ; Protein-Serine-Threonine Kinases ; genetics ; SMN Complex Proteins ; genetics ; Young Adult