Objective To evaluate the efficacy and safety of single-used flexible ureteroscope lithotripsy(FURL)in the treatment of 2.0-3.0 cm non-lower-pole renal stones in elderly patients.Methods A total of 78 elderly patients with non-lower-pole renal stones measuring 2.0-3.0 cm admitted to our hospital were included in this study.Based on the surgical procedure,the patients were divided into the FURL group(42 cases of FURL with holmium laser lithotripsy)and the MPCNL group[36 cases of minimally invasive percutaneous nephrolithotomy(MPCNL)with holmium caser lithotripsy].Various parameters including operation time,stone fragmentation time,postoperative decrease of hemoglobin(Hb)level,postoperative Visual Analog Scale(VAS)for pain,hospitalization duration,stone-free rate(SFR)at 1 week and 4 weeks after surgery,secondary surgery rate,and incidence of complications were compared between the two groups.Results All the patients successfully underwent surgery.The decrease of Hb in the FURL group was(4.4±1.6)g/L,significantly lower than that in the MPCNL group[(24.7±4.6)g/L,t=-25.342,P=0.000].The postoperative VAS scores of the FURL group was(1.6±0.4)points,significantly lower than that of the MPCNL group[(5.6±0.9)points,t=-25.642,P=0.000].The stone fragmentation time in the FURL group was(82.5±10.2)min,significantly longer than that in the MPCNL group[(53.8±8.4)min,t=13.437,P=0.000].The operation time in the FURL group was(98.3±12.5)min,and there was no statistically significant difference compared to the MPCNL group[(96.7±11.8)min,t=0.555,P=0581].The hospitalization time in the FURL group was(3.5±1.5)d,significantly shorter than that in the MPCNL group[(8.6±1.7)d,t=-13.947,P=0.000].The incidence of complications in the FURL group was 26.2％(11/42),and there was no significant difference compared to the MPCNL group[27.8％(10/36),x2=0.025,P=0.875].The proportion of secondary treatment in the FURL group was 19.0％(8/42),and there was no significant difference compared to the MPCNL group[11.1％(4/36),x2=0.938,P=0.333].At 1 week after surgery,the SFR of the FURL group was 54.8％(23/42),significantly lower than that of the MPCNL group[86.1％(31/36),x2=8.943,P=0.003].At 4 weeks after surgery,there was no significant difference in SFR between the FURL group[90.5％(38/42)]and the MPCNL group[91.7％(33/36),x2=0.000,P=1.000].Conclusions Single-used flexible ureteroscope lithotripsy is highly effective in the treatment of non-lower-pole renal stones measuring 2.0-3.0 cm in elderly patients.It offers advantages such as minimal invasion,rapid recovery,minimal bleeding,low incidence of complications,and shorter hospitalization duration,which is worthy of promotion.

Objective:To observe the curative effect of exercise training combined with posture control among patients with displacement of the anterior disc of the temporomandibular joint (TMJ) without reduction.Methods:Forty-four patients with anterior TMJ disc displacement without reduction who had successfully been treated with manual repositioning were randomly divided into a control group and a treatment group, each of 22. Both groups underwent routine exercise training, while the experimental group was additionally provided with posture training five times a week for 4 weeks. After the 4th week of training both groups were evaluated using a visual analogue scale (VAS) and their maximum active mouth opening was compared. Six months later, MRI was performed to observe the disc-condyle relationship of the temporomandibular joint and its position.Results:①After 4 weeks of training, the average VAS scores of both groups were significantly lower than those before the training. The improvement in the treatment group′s average was significantly greater than among the control group. ②After the 4 weeks of training the average maximum active mouth opening of both groups had increased, with the improvement in the treatment group significantly greater. ③Six months later, 19 persons in the treatment group had a normal disc-condyle relationship, significantly more than the 13 in the control group.Conclusions:Posture control training can improve the effectiveness of sports training in maintaining manual repositioning of the TMJ after anterior disc displacement without reduction.