Objective To evaluate the feasibility and efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL)in the lateral position.Methods A total of 48 patients with staghorn(12 cases,2.2 to 5.8 cm in diameter)or multiple renal calculi(31)or upper ureteral stones(5)were treated with MPCNL in our hospital between July 2004 to October 2007.The patients were placed in a lateral position with the head 10? lower and the feet 20? lower.The puncture was made under the guidance of X-ray or ultrasonography,and then Holmium laser or EMS lithotripter was used for stone fragmentation.The stone debris was removed by irrigation.Results The procedure was completed in all of the 48 patients except one,who was converted to a supine position because of the difficulty in puncture.Among the 47 cases,41 were cured with the first operation,the other 6 received catheterization in the first procedure,and then underwent calculi removal in a second-stage operation.None of the patients were converted to open surgery.The mean operation time in this series was(137.5?39.6)min.The one-stage cure rate in our patients was 82.9%(34/41).None of the cases had massive blood loss,or injuries to the pleura and other organs.Follow-up was available in 21 cases for 1 to 3 months.During the period,among the 17 patients who had hydronephrosis,11 were cured and 6 were improved;and among the 4 who had residual stones,1 received ESWL in 1 months after the first operation and was cured afterwards;the other 3 were treated by traditional Chinese medicine,2 of them were cured.Conclusions The MPCNL performed on the patients in the lateral position is an effective alternative for renal calculi,and favorable to intra-operative anesthesia monitor.

Adult ; Back Muscles ; physiopathology ; Fasciitis ; physiopathology ; therapy ; Female ; Humans ; Male ; Moxibustion ; Muscular Diseases ; physiopathology ; therapy

Objective To evaluate the effect of sufentanil on autophagy during myocardial ischemia-reperfusion (I/R) in rats.Methods Eighteen adult male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 3 groups (n =6 each) using a random number table:sham operation group (group SH),I/R group,and sufentanil group (group S).Myocardial I/R injury was produced by occlusion of the anterior descending branch of the left coronary artery for 30 min followed by 120 min reperfusion in the rats anesthetized with chloral hydrate in I/R and S groups.Sufentanil 3 μg/kg was injected via the caudal vein at 30 min prior to ischemia in group S.The equal volume of normal saline was given in SH and I/R groups.At 120 min of reperfusion,arterial blood samples were collected for determination of serum creatine kinase-MB (CK-MB) and lactic dehydrogenase (LDH) concentrations,and myocardial specimens were obtained for examination of the ultrastructure of myocardial cells (using transmission electron microscopy) and for determination of autophagy-related proteins microtubule-associated protein 1 light chain 3 Ⅱ (LC3Ⅱ),Beclin-1 and Bcl-2 expression (by Western blot).Results Compared with group SH,the serum CK-MB and LDH concentrations were significantly increased,the expression of LC3 Ⅱ and Beclin-1 was significantly up-regulated,and Bcl-2 expression was significantly down-regulated in group I/R,and the serum CK-MB concentration was significantly increased,the expression of Beclin-1 and Bcl-2 was significantly down-regulated in group S (P＜0.05).Compared with group I/R,the serum CK-MB concentrations were significantly decreased,the expression of LC3 Ⅱ and Beclin-1 was significantly down-regulated,Bcl-2 expression was significantly up-regulated (P＜ 0.05),no significant change was found in serum LDH concentrations (P＞0.05),and the pathological changes were reduced in group S.Conclusion The mechanism by which sufentanil reduces myocardial I/R injury may be related to decreased autophagy in rats.

Objective To make sure the exact curative effect of using Kasai distillate to moderate the dysporia for patients with gynecological operation. Methods Divided 152 patients with dysporia into observation group and control group randomly, each group have 76 cases. Using Kasai distillate 80 ml in observation group, 40 ml in control group. Compare the condition of defecation in these 2 groups after using Kasai distillate 15～30 minutes. Results There were 74 cases and 36 cases in observation group and control group respectively obtain significant curative effect, ?~2=40.7, P

Objective To study the results of laparotomy and Cool-tip radiofrequency ablation to treat large liver tumors.Methods Laparotomy and Cool-tip radiofrequency ablation were carried out on 64 patients with large hepatic cancer.To destroy the tumor completely,for tumors of 3.0～4.0 cm in diameter,7 ablations were required; for 4.0～5.0 cm in diameter 15 ablations; for 5.0～6.0 cm in diameter 19 ablations; for 6.0～7.0 cm in diameter 40 ablations.Result The complete necrosis rate of laparotomy and radiofrequency ablation was 93.75％ (60/64).The short-term results were good.Conclusions Laparotomy and Cool-tip multipoint overlapping radiofrequency ablation for large liver tumors (tumor diameter＞3 cm) could result in a high complete necrosis rate and a low complication rate.It is a good radical treatment for unresectable and large liver cancer.

Objective To analyze the risk factors of subclavian venous catheter-related infections in patients with traumatic hemorrhagic shock (THS) and provide a basis for prevention and control of the infection. Methods A retrospective study was conducted. 357 patients with THS and indwelling of subclavian vein catheter admitted in the Department of Emergency of Affiliated Hospital of Sichuan Provincial Luzhou Medical College were enrolled, and according to the infection state, they were divided into infection group (56 cases) and non-infection group (301 cases). The patients' data of gender, age, history of underlying disease, catheter position, catheter indwelling time, time staying in hospital, situation of antimicrobial drug used, application of tracheotomy or not, white blood cell count (WBC) levels, etc were collected for univariate analysis. The resulting indexes with statistical significance were applied for carrying out the multivariate logistic regression analysis, and then the independent risk factors involved in the development of subclavian venous catheter-related infections in the shock patients could be screened out.Results In 357 patients with THS, 56 were infected (15.7%). Univariate analysis showed: age ≥ 60 years (χ2 = 19.839,P < 0.001), with diabetes mellitus in past history (χ2 = 6.252,P = 0.012), catheter indwelling time ≥ 7 days (χ2 = 19.261,P < 0.001), time staying in hospital ≥ 7 days (χ2 = 4.315,P = 0.038), time for use of antimicrobial drug≥ 7 days (χ2 = 16.161,P < 0.001), tracheotomy (χ2 = 40.969,P < 0.001), WBC < 4×109/L (χ2 = 39.451,P < 0.001) and the disease severity grade 4 - 5 (χ2 = 8.345,P = 0.004) were the risk factors of subclavian venous catheter-related infections in patients with THS. Multivariate analysis showed: catheter indwelling time ≥ 7 day [odds ratio (OR) = 16.713, 95% confidence interval (95%CI) 3.651 - 76.624), tracheotomy (OR = 6.861, 95%CI 2.377 - 18.246), WBC < 4×109/L (OR = 4.903, 95%CI 1.887 - 12.643) were the independent risk factors of subclavian venous catheter-related infections in THS patients.Conclusion The strict implementation of aseptic catheterization, shortening the time of catheter indwelling as much as possible and the rational use of antibiotics can effectively reduce and prevent the incidence of venous catheter-related infection in THS patients.

OBJECTIVETo study the effects of alltrans retinoic acid (ATRA) on airway responsiveness, airway remodeling and expression of matrix metalloproteinase-9 (MMP-9) protein in rats with asthma.

METHODSForty rats were randomly divided into five groups: asthma model, normal saline (control), ATRA treatment, cotton oil treatment and budesonide treatment (n=8 each). Asthma was induced by ovalbumin sensitization and challenge in the asthma model, and the ATRA, cotton oil or budesonide treatment groups. ATRA (50 μg/kg), cotton oil (1 mL) or budesonide (0.32 mg/kg) was administered before ovalbumin challenge in the three treatment groups. Airway responsiveness was assessed. The lung tissues were sampled to detect airway remodeling and the expression of MMP-9 protein by immunohistochemistry.

RESULTSThe expression of MMP-9 in lung tissues in the ATRA treatment group was significantly higher than that in the control group, but the airway responsiveness in the ATRA treatment group was not significantly different from that in the control group. The airway responsiveness and the expression of MMP-9 in lung tissues were significantly reduced in the ATRA treatment group compared with the asthma model group. The airway remodeling was significantly improved in the ATRA treatment group compared with the asthma model group.

CONCLUSIONSATRA may alleviate airway hyperresponsiveness and airway remodeling possibly through decreasing the protein expression of MMP-9 in rats with asthma.

Airway Remodeling ; drug effects ; Animals ; Asthma ; drug therapy ; pathology ; physiopathology ; Bronchi ; drug effects ; pathology ; physiopathology ; Lung ; enzymology ; Matrix Metalloproteinase 9 ; analysis ; Rats ; Rats, Sprague-Dawley ; Tretinoin ; pharmacology

Objective To explore the theory of mind (TOM) between adolescent with schizophrenia and normal adolescent from hot TOM and cool TOM.Methods 37 adolescent schizophrenias and 25 normal adolescents were interviewed with the Chinese version of YONI task, Reading the Mind in the eyes test and series of tests,then analyzed with adolescent schizophrenias cognitive features.Results ① Compared with the control group (83.16± 10.07),the scores of YONI task in the adolescents with schizophrenia (74.30 ± 11.44) had statistically significant difference (t=-2.983,P＜0.05),mainly the statistically significant difference existed in the groups in cool and hot TOM.②The differences between positive subtype (69.85± 12.66) and negative subtype (78.18±8.92) in scores were significant(t=-2.104,P＜0.05),especially in the hot TOM.③In Reading the Mind in the eyes test,there was no statistically significant difference in scores(t=0.982,P＞0.05) between the control group (17.59±3.13) and the group of adolescents with schizophrenia(18.42±2.98).Conclusion The adolescents with schizophrenia damage in hot TOM and cool TOM.The adolescents with schizophrenia in positive subtype are worse than the negative subtype,especially in the hot TOM.

Objective Investigate the effect of EC50 of propofol target-injection in the different TCM (traditional Chinese medicine) physique types of patients who are in unconscious phase. Methods Depend on the standard protocol of TCM physique types sort and determination, we sorted 60 patients into three groups:Ping He (group A), Yang Xu (group B) and Yin Xu (group C), 20 patients per group. We applied the sequential experiment to measure the minimal EC50 and NI values of propofol when the patients were in the unconscious phase. Results The EC50 of propofol of group A, B and C are 3.85 μg/mL, 4.12 μg/mL and 3.43 μg/mL respectively. 95% confidence intervals of group A, B and C are 3.64 ~ 4.07 μg/mL, 3.92 ~ 4.33μg/mL and 3.26 ~ 3.60 μg/mL respectively. Conclusion There is a correlation between the different TCM physique types and the dosage of propofol target-injection.

Adult ; Aged ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Knee Injuries ; surgery ; Male ; Middle Aged ; Postoperative Care