Objective To investigate the causes of postoperative severe infection and other complications of percutaneous nephrolithotomy,and to study the principles of prevention and treatment.Methods Five hundred and sixty three cases of patients underwent percutaneous nephrolithotomy from September 2008 to December 2011 in our hospital,after operation,22 patients were found with serious infection.Data of these 22 cases were analyzed retrospectively according to the causes of the infection,corresponding prevention and treatment.Results The occurrence rate of severe postoperative infection was 3.9％ ( 22/563 ) in this group.The condition of 21 patients improved through adjusting antibiotics and taking other necessary measures in time;the condition of 1 case of septic shock patient was under control by giving anti-infective and anti-shock treatment measures.Conclusion Percutaneous nephrolithotomy is a safe and effective minimally invasive surgery,with a certain incidence of postoperative infection which should be timely and effectively controlled.

Objective:To analyze the effect of levonorgestrel releasing intrauterine system ( Mirena) on endometrium in the pa-tients with anovulatory uterine bleeding. Methods:Totally 67 cases of anovulatory uterine hemorrhage were treated with Mirena. The menstrual blood volume, uterine endometrial thickness, hemoglobin, endometrial ET content and complications were recorded before and after the treatment. Results:After the 12-month treatment, the menstrual blood volume and endometrial thickness were significant-ly decreased, and hemoglobin was significantly increased (P<0. 01). The percentage of abnormal uterine bleeding was significantly decreased, the ET content in endometrium was significantly decreased (P<0.05), and the ET content was decreased significantly with the prolongation of the treatment time. The complication rate was reduced from 50. 74% to 7. 46%. Conclusion:Mirena is nota-bly effective in the treatment of the patients with anovulatory uterine bleeding.

Objective To discuss the prevention and management of complications of transurethral electrovaporization of the prostate(TUVP).Methods A total of 820 patients underwent TUVP from June 1998 to August 2005.A Wolf electrovaporization system and a F_(24) 12? resectoscope were used.After the seminal colliculus was identified for making a reference plane,the prostatic tissues were removed untill the surgical envelope,and the bladder neck and the apex of prostate were surgically shaped.Results Complications occurred in 124 patients(15.1%,124/820).There were 17 cases of intraoperative complications(2.0%),including massive haemorrhage in 6 patients(0.7%),presymptoms of transurethral resection syndrome in 6 patients(0.7%),and perforation on the juncture of the bladder and the prostate in 5 patients(0.6%).There were 107 cases of postoperative complications(13.0%), including urethral stricture in 18 patients(2.2%),spasm of the bladder in 32 patients(3.9%),secondary hemorrhage in 3 patients(0.4%),retrograde ejaculation in 11 patients(1.3%),temporary incontinence in 13 patients(1.6%),infection of the urinary tract in 24 patients(2.9%),and acute pulmonary thromboembolism in 6 patients(0.7%). Conclusions Preoperative precautions and clear intraoperative exposure are essential to prevent the incidence of complications of TUVP.

Objective To investigate the expressions of survivin and bcl-2 and their relationships in transitional cell carcinoma of the bladder.Methods The expressions of survivin and bcl-2 in 40 cases of transitional cell carcinoma of the bladder were detected with streptavidin-biotin peroxidase(SP) method,with 15 cases of normal bladder specimens as controls.Results Survivin was expressed in 25 of 40(58.149%) cases of bladder carcinoma tissues,and normal bladder specimens did not express survivin(P

Objective To discuss the causes and management of the complications of the transurethral electrovaporization of prostate(TVP) to improve the effect.Methods All 820 cases took TVP.3～6 months follow-up was taken to investigate the complications and their disposal.Results No patient died,6 cases had massive haemorrhage during operation,6 cases had presymptom of TUR syndrome,5 cases had perforation of juncture of bladder and prostate,6 cases had acute pulmonary thromboembolism(PTE) after TVP,32 cases had spasm of bladder,18 cases had urethral stricture,3 caess had postoperative bleed,11 cases had retrograde ejaculation,13 cases had temporary incontinence,24 cases had infection of urinary tract.Conclusion Pre-operational precautions are essential,the complications of TVP may be decreased by accurate operation and reliable management of infection.

Objective To retrospec the efficacy of percutaneous nephrolithotomy on treatment of urinary tract stones in solitary kidney.Methods From June 2008 to April 2011,percutaneous nephrolithotomy technique was used to treat 20 cases of urinary tract stones,with kidney stone or cast form staghorn calculi in 4 cases,single pelvis,calyceal stones 10 cases,6 cases of upper ureteral calculi;Fourteen cases used the standard channel F24;6 cases used F16 Micro Channel.Among the 20 patients,16 cases performed stage Ⅰ single channel surgery;2 cases performed dual-channel surgery in Ⅰ stage;2 patients with severe infection performed stage Ⅱ single channel surgery.Results The average duration of the operation was 66mins.The stone clearance rate was 88.36％ on average(18/20),without laceration or bleeding of pelvis or renal calyces mucosa or any other complications.Postoperative indwelling nephrostomy tubes were removed 6 -7 days later,without complications found during the follow-up period.For the 6 cases with preoperative renal dysfunction before surgery,the levels of blood Cr decreased at 2 weeks after surgery.Conclusion Compared to open surgery,percutaneous nephrolithotomy is safe and effective with small wound in treatment of solitary kidney with invasive upper urinary tract calculi.

Objective To investigate the protective effects of G CSF on lungs of rats with acute cholangitis and changes in blood TNF and TXA 2/PGI 2 by treating the rats with G CSF. Methods Seventy two Wistar rats were randomized into the control, infected and treated groups. We established the model of cholangitis in the rats with injection of E. coli 25922 into the bile duct. The animals in the treated group were pretreated with G CSF 500 ng/day bid) for 5 days before the E. coli injection. The levels of blood TNF and TXA 2/PGI 2 were measured at the 3rd, 6th and 12th h after the injection. Meanwhile, the morphological changes in lungs of the rats were observed. Results The morphological changes in lungs were milder and levels of blood TNF and TXA 2/PGI 2 were significantly lower in the treated group than in the infected one (P

0. 5) in the patients with nephritis, uretericcalculi and other diseases. The renogram methodis simple, inexpensive, without blood samplingand is useful in clinical application.

Objective To observe the effect of conventional therapy plus trimetazidine on alcoholic cardiomyopathy (ACM) and plasma brain natriuretic peptide (BNP).Methods Eighty-six cases of ACM patients were divided into control group and observation group by random digits table method with 43 cases each.Control group was treated with conventional therapy,while observation group was added trimetazidine.Course of treatment was 3 months.The left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD),6 min walk distance,plasma BNP before and after treatment and the efficiency in two groups was observed and compared.Results LVEF,LVEDD,6 min walk distance,BNP before treatment in control group were respectively (37.2 ±7.4)％,(57.6 ±7.4) mm,(312.8 ±21.6) m,(846.2 ±63.7)μg/L,and the indicators in observation group were respectively (38.5 ±8.1)％,(57.1 ±6.8) mm,(316.5 ± 23.9) m,(857.6 ± 61.4) μ g/L.All indicators between two groups was no statistically different (P＞0.05).LVEF,LVEDD,6 min walk distance,BNP after treatment in control group were respectively (43.5 ±8.6)％,(54.3 ± 6.4) mm,(511.6 ± 26.7) m,(679.4 ± 51.3) μg/L,and there were significant difference compared with those before treatment (P ＜ 0.05).LVEF,LVEDD,6 min walk distance,BNP after treatment in observation group were respectively (51.6 ± 9.2)％,(51.2 ± 6.3) mm,(579.3 ± 25.1) m,(536.5 ± 50.6)μ g/L,and there were significant difference compared with those before treatment (P ＜ 0.05).There were significant difference in LVEF,LVEDD,6 min walk distance and BNP after treatment between two groups (P ＜ 0.05).The total effective rate in observation group was 90.7％ (39/43),which was significantly higher than that in control group [72.1％ (31/43)] (x2 =4.914,P ＜ 0.05).Conclusion Adding trimetazidine on the basis of conventional therapy can improve the cardiac function and myocardial remodeling of ACM patients and improve clinical efficacy.

Objective To observe the therapeutic effect of rhubarb combined with Probiotics for treatment of patients with severe acute pancreatitis (SAP) accompanied by acute lung injury (ALI). Methods A prospective randomized controlled trial was conducted. Sixty patients with SAP and ALI were randomly divided into a rhubarb group and a combination of rhubarb and Probiotics group (combined group), 30 cases in each group. Both groups were treated with conventional therapy. On that therapeutic base, the patients in rhubarb group were treated with rhubarb 3 g·kg-1·d-1 (Raw rhubarb in boiling water 200 mL was cooked for 30 minutes, then the decoction was divided into two parts to be infused through nasal jejunal tube, retaining for 1 hour);while in the combined group, beside the above rhubarb therapy, the patients were additionally given Probiotics [Clostridium butyric acid:Chang Lekang capsule, once 1 grain (0.42 g), twice a day] through nasal jejunal tube. The therapeutic course was 14 days in the two groups. The plasma endotoxin levels, oxygenation index, and acute physiology and chronic health evaluationⅡ(APACHEⅡ) score were observed before and after treatment for 7 days and 14 days, respectively. After treatment for 30 days, the time of intestine functional recovery and mechanical ventilation, number of damaged organs, number of infectious sites, number of pancreatic pseudocysts, length of intensive care unit (ICU) stay and 30-day fatality rate were observed in the two groups. Results With the prolongation of treatment, the plasma level of endotoxin and APACHEⅡscore in the two groups were gradually reduced, and the oxygenation index was gradually increased after treatment for 7 days and 14 days in the two groups compared with those before treatment, and there were statistically significant differences in above indexes on the 14th day after treatment between combined group and rhubarb group [endotoxin (μg/L): 19.16±1.90 vs. 21.20±1.05, oxygenation index (mmHg, 1 mmHg = 0.133 kPa): 369.50±5.45 vs. 341.50±7.36, APACHE Ⅱscore:11.84±0.60 vs. 13.00±0.86, P<0.05 or P<0.01]. The length of intestine functional recovery in the combined group was longer than that in the rhubarb group (days: 5.63±1.75 vs. 5.02±1.54), the number of damaged organs (2.08±0.74 vs. 2.70±1.11), the number of infectious sites (1.93±0.64 vs. 2.23±0.83), the number of pancreatic pseudocysts (1.22±0.34 vs. 1.63±0.11) and the mortality rate [10.0%(3/30) vs. 13.3%(4/30)] in the combined group were lower than those of the rhubarb group, but there were no statistically significant differences between two groups (all P > 0.05). The times of mechanical ventilation (days: 13.40±1.76 vs. 15.60±1.28) and the length of ICU stay (days:16.13±1.25 vs. 17.63±1.30) were significantly shorter in combined group than those in rhubarb group (both P<0.05). Conclusion Rhubarb combined with Probiotics for treatment of patients with SAP and ALI can promote their recovery of lung function and shorten their length of ICU stay.