Objective To investigate risk factors for postoperative complications after percutaneous nephrolithotomy (PCNL) according to the modified Clavien scoring system. Methods The clinical data of 523 patients who underwent PCNL from 2008 to 2015 were retrospectively analyzed, and the risk factors of the complications of PCNL were analyzed. Results There were 417 patients without postoperative complications and 106 patients with postoperative complications, among whom 25 patients had major complications. After multivariate Logistic regression analysis, elder (P = 0.002), previous PCNL (P=0.035), two or more comorbidities (P=0.001), staghorn calculi (P=0.031), longer operative time (P = 0.000) had association with the postoperative complications. Two or more comorbidities (P =0.013), multiple tracts (P=0.008), and longer operative time (P=0.003) had association with the major postoperative complications. Conclusions Elder, previous PCNL, two or more comorbidities, staghorn calculi, multiple tracts, longer operative time have association with the major postoperative complications.

Antineutrophil cytoplasmic antibody-associated vasculitis (AAV) refers to the groups of potentially life-threatening autoimmune disease.Antithyroid drug is one of the causes.Usually the involved organs are skin,kidney,and (or) lung.Early diagnosis and treatment of AAV is essential.Timely cessation of antithyroid drugs is the first step.If necessary,glucocorticoids and (or) immunosuppressive agents should be used to delay the progression of the disease.

Objective To investigate the prevention and management strategies of in-hospital complications in the hip replacement in elderly patients(≥80 years old) Methods The data of 42elderly patients with hip replacement between Oct.2004 and Dec.2006 were collected and analyzed.Their age ranged from 80 to 96 years with an average of 84.6 years.Twenty-four cases were associated with severe osteoporosis(Dorr Ⅲ),13 with coronary heard disease,10 with arrhythmia,7with diabetes,5 with cerebral paralysis.Twenty five cases had a cemented stem bipolar femoral head replacement,2 had uncemented stem bipolar femoral head replacement,7 had cemented total hip replacement,3 had revision of total hip replacement. Results No death occurred during operations,1 died postoperatively due to dislocation at the 5th day postoperation.One case had coma for 1 week after general anaesthesia.5 had temporary cognitive handicap,38(90.5%)were able to walk at the aid of walker with easement of pain before discharging. Conclusions To gain good results in elderly patients with hip arthroplasty,less invasive and quick anaesthetic technique and operative procedures are encouraged.Meticulous preoperative preparation.active preventing and treating the intraoperative and postoperative complications should be emphasized.

Objective To explore the significance of core-needle biopsy ( CNB) in the diagnosis of thyroid lymphoma. Methods A case of Hashimoto's thyroiditis for several decades, showed a thickening of the neck for several months, and no abnormalities were found by the method of fine-needle aspiration( FNA), then we performed CNB and flow cytology. Results Thyroid lymphoma was finally diagnosed through CNB and flow cytology. Conclusion Thyroid lymphoma should be considered when the neck became thickened in short time in patients with chronic Hashimoto's thyroiditis. Core-needle biopsy accompanied with flow cytometry and immunohistochemistry analysis should be suggested as routine diagnostic method especilly when fine-needle aspiration was negative.

Sulfur compounds in the diesel were selectively derived into methylsulfonium salts by reacting with iodomethane in the presence of silver tetrafluoroborate, and characterized by positive-ion electrospray ionization (ESI) fourier transform ion cyclotron resonance (FT-ICR MS). The conversion ratios and react selectivities of the methylation for various sulfur compounds were investigated by gas chromatograph coupled with pulse flame photometric detector (GC-PFPD). Result shows that the sulfur compounds in the diesel can react with iodomethane easily at room temperature, the most of sulfur compound derived into methylsulfonium salts;the homologue of benzothiophene get the higher conversion ratio and react selectivity than the homologue of dibenzothiophene (DBT). It is found that primarily sterically hindered alkylated DBT, for example, 4- or 4-, 6- DBT, is recalcitrant to be methylated. Other than benzothiophenes and dibenzothiophenes, one- and two-ring sulfides, as well as other sulfur compounds with a double bond equivalent (DBE) value ranged from 1 to 12 are identified in the diesel.

Objective To observe the changes of cardiac rhythms in a swine model of adult asphyxia! cardiac arrest. Method Sixteen Pigs were aphyxiated by endotracheal tube clamping until 8 min after loss of aortic pulsations. Resuscitation was then provided and swinds were assigned to received 0.045 mg/kg epinephrine intravenously after 3 min of basic life support. The animals with restoration of spontaneous circulation within 20 min from CPR were defined as successfully resuscitated, while the rest were identified as unresuscitation. Electrocardiogram ( EGG) were monitored from the start of asphyxia to the start of the CPR. Results When loss of pulsations occurred, 2 of 16 animals had ventricular fibrillation; 10 pigs exhibited pulseless electrical activity, and 4 pigs had asystole. During the 8 min after the loss of aortic pulsations, pulseless electrical activity converted to VF in 7 pigs. Immidiatedly prior to resuscitation, VF occurred in 9 pigs, asystole in 4 pigs, and PEA in 3 pigs. Conclusions Most of animals in this swine model of asphyxial cardiac arrest presented PEA, but most of them converted to VF especially late in the asphyxial process.

Objective To introduce the technique of metal-on-metal hip resurfacing arthroplasty,evaluate its preliminary clinical results and review the factors which affect the results.Methods From January 2006 to October 2010,104 patients (116 hips) with osteonecrosis of the femoral head,hip osteoarthritis,hip dyplasia,or ankylosing spondylitis were treated with the total hip resurfacing arthroplasty.Among them,59 patients (66 hips) were male,and 45 patients (50 hips) were female,with an average age of 39.7 years (range,16-67 years).Standard operation technique was performed for all patients with Conserve Plus prosthesis.Each patient was followed up at 1 month,3 months,6 months,1 year postoperatively.Results Three patients (4 hips) were lost,so 101 patients (112 hips) were followed up for an average period of 33 months (range,9-66 months).The average Harris hip score was improved significantly from 37.6±6.3 preoperatively to 91.3±5.3 at final follow-up; 104 hips were excellent,7 hips were good,1 hip was poor,and the excellent and good rate was 99.1％.At final follow-up,the average abduction angle of the acetabutar cup was 42.7°(range,36°-55°); the average femoral prothesis stem-shaft angle was 138.5° (range,132°-146°).Two patients presented with heterotopic ossification (Brook Ⅲ and Brook Ⅱ ).One patient presented with prothesis dislocation,which healed after being treated with manual reduction.There was no femoral neck fracture,infection,or prosthesis loosening.Conclusion With strict patient selection criteria and optimized technique,the short-term results of metal-on-metal hip resurfacing arthroplasty are satisfactory.

Angiomyfibroblastoma (AMF)is a kind of rare benign tumour. The clinical and imaging findings of AMF are nonspecific. In October 2019, 1 case of Angiomyfibroblastoma of perineum was admitted to Heze Municipal Hospital for surgical treatment. Final pathological diagnosis was AMF. So far, neither recurrence nor metastasis has been detected for 5 months.

Objective:To compare the effect of the frequency of transcatheter arterial chemoembolization (TACE) on preventing tumor recurrence after hepatectomy. Methods:A total of 45 post-operative patients who had received prophylactic TACE once or thrice were retrospectively examined between January 2008 and June 2009. Of the 45 patients, 23 underwent TACE once, and the others un-derwent it thrice. TACE was administered to all patients via the hepatic artery one to two months after operation and was repeated every two to four months with patients who underwent TACE three times. All cases were followed up for 36 to 40 months after surgery. The rates of cumulative recurrence between the two groups were compared. Results:In the group that underwent TACE once, the 1-, 2-and 3-year cumulative recurrence rates were 30.43%, 47.83%, and 47.83%, respectively. In the group that underwent TACE thrice, the 1-, 2-and 3-year cumulative recurrence rates were 4.55%, 27.27%, and 36.36%, respectively. Statistical analysis showed that the relapse rate within one year was lower in the group that underwent TACE thrice than in the group that underwent TACE only once (P=0.022). How-ever, no significant difference in the cumulative recurrence rate was found between the two groups in two and three years (P=0.086, 0.225). Conclusion:Hepatocellular carcinoma patients who undergo preventive TACE three times after hepatectomy exhibit reduced re-currence rates during the peak time of tumor recurrence and extended disease-free survival intervals.

Objective To investigate characteristics of cage migration after transforaminal lumbar interbody fusion (TLIF) and related risk factors.Methods A retrospective study was conducted to review cage migration in 512 patients who had undergone TLIF procedure from January 2010 to June 2011 in 5 spinal research centers.There were 255 males and 257 females,aged from 37 to 77 years (average,54.7 years).All patients were followed up at 3,6,12 months after operation.The clinical outcomes were evaluated using the visual analogue scores (VAS) and Oswestry disability index (ODI).X-rays and 3D CT scans were used to analyze the incidence and related risks factors of cage migration in these patients.Results Cage migration was found in 6 of 512 patients,the total incidence was 1.17％.Significant difference was found between each center.Cages with different shapes had different incidence.The analysis showed that the incidence of migration of rectangular-shaped cage (3.11％,5/161) was significantly higher than that of kidney-shaped cage (0.28％,1/351).The cage in double-segment TLIF (5.75％,5/87) was easier to migrate than that in monosegment TLIF (0.24％,1/425); furthermore,linear type endplate(3.50％,5/143) was remarkably easier to migrate than concave-concave one (0.27％,1/369).Conclusion Difference in operative skills,cage shape,number of fused segments,adjacent endplate shape,and lumbar spondylolisthesis might be risk factors for cage migration after TLIF.