0.05) ; Compared with group A and B , contents of brain water and MDA were significantly increased at 3 hours after ACCI (P

Objective To investige the risk factors of urosepsis after percutaneous nephrolithotomy (PCNL).Methods We retrospectively analyzed 204 renal calculi or proximally ureter calcui patients,who underwent ultrasound-guided PCNL,from January 2013 to January 2014.Among them,there were 140 men and 64 women,whose mean age was 49 years (range from 29 to 75 years).Eighty-four operations were performed via standard channel and 120 operations were performed via micro channels.Fifty one patients had staghorn stones.Before operation,the urine culture positive rate was 14.7％ (30/204).The creatinine level ranged from 46 to 340 μmol/L [mean (87.9±33.9) μmol/L].Average stone diameter was (2.3±0.8) cm (range 1.0-7.0 cm).Mean operative time was (68.4±26.9) min (range 23-219 min).The chi-square test and a logistic regression model were used to identify key risk factors.Results The operation duration ranged from 23 to 219 min,mean (68.4±26.9) min.Of 204 patients,9 (4.4％) suffered septic shock,including 7 female patients and 2 male patients.Their mean age was (52.6± 15.2) years (20-73 years).Five operations were performed via standard channels and four operations were performed via micro channels.Five patients had staghorn stones.Urine culture positive rate was 77.8％ (7/9).The average stone diameter was (2.5±0.6) cm (range 1.8-3.5 cm).Mean operative time was (86±53) min (range 47-219 min).In univariate analysis,significant associations was observed between female gender (P =0.005),positive urine culture (P＜0.01),staghorn calculi (P =0.035),operative duration＞90 min (P =0.042) and sepsis after PCNL.While in multivariate analysis,female gender (OR=6.001,95％CI=1.190-30.276,P=0.03) and positive urine culture pre-operation (OR=19.647,95％CI=3.918-98.562,P＜0.01) were identified as independent risk factors for post-MPCNL septic shock.Conclusions Female gender and positive urine culture before operation are the key risk factors of urosepsis after percutaneous nephrolithotomy.

The medical engineering department is an important part in modern hospitals,but the status and functions of medical engineers are ignored,which result in the drain of the experts in this field.This paper analyses the reason and gives the countermeasure.

Objective Study on the inhibitory effect of gallnut extract extract on MRSA β-lactamase. Methods Determination of inhibitory effect of gallnut extract on MRSA3002 by TTC method. β-lactamase was repeated by freezing and thawing method . Synergistic effect of gallnut extract and gentamicin was detected by TTC. Results The MIC and MBC of MRSA3002 by gallnut extract were 8mg/mL and 32mg/mL.Gallnut extract can reduce strains of β-lactamase activity,the MRSA300224h 1/2MIC after the effect of gallnut extract, beta lactam enzyme activity inhibition compared with the control group there were significant differences (P<0.01),compared with the positive control group, the difference was not significant. Synergistic effect of gallnut extract and gentamicin can significantly reduce the MIC of MRSA3002. Conclusion Gallnut extract can reduce β-lactamase activity recovery sensitivity of drug-resistant bacteria.

ObjectiveTo study the situation of neural invasion in pancreatic cancer and investigate its related clinical factors. Methods The neural invasion in 73 cases of pancreatic cancer patients was retrospective analysed. The correlation between neural invasion and clinicopathological parameters,and survival rate was investigated.Results In 73 cases of pancreatic cancer,neural invasion occurred in 38(52.1％) patients,among whom intra-pancreatic neural invasion rate was 15.8％ (n =6) ; and both intrapancreatic and external pancreatic plexus invasion rate was 84.2％ ( n =32).Neural invasion was not related with gender,age,and pathological type,degree of differentiation,tumor size and lymph node metastasis (P ＞ 0.05 ).But the presence of abdominal pain,vascular invasion,the expression of EGFR and VEGF in tumor tissue was significantly related with neural invasion (P ＜0.01 ).The median survival of patients in neural invasion group was 8 months,which were significantly shorter than that of in patients without neural invasion (13 months,x2 =4.69,P =0.030).Conclusions Neural invasion has a high incidence in pancreatic cancer,and it can cause obvious abdominal pain.And it is related with vascular invasion and the expression of EGFR and VEGF in tumor tissue.Neural invasion is one of the factors affecting the survival rate.

Pancreatic cancer with liver metastases (PCLM) is a refractory malignant tumor characterized by insidious onset, rap-id progress, and poor prognosis. Only a few patients had the opportunity of receiving surgical treatment. PCLM is primarily treated by systemic chemotherapy. The chemotherapeutic regimen of 5-fluorouracil, oxaliplatin, irinotecan, and leucovorin has become the first-line therapy for PCLM patients with good performance status. Gemcitabine-based chemotherapy is still very important in treating PCLM. Nab-paclitaxel plus gemcitabine, which has been found to increase survival, is recommended as a new standard for treating PCLM patients. However, still no breakthrough has been established in the study of gemcitabine plus molecular-targeted therapy. Sys-temic chemotherapy combined with trans-catheter arterial chemoembolization is valuable and may be effectual in prolonging survival. Further investigation of prospective and randomized controlled clinical trials is necessary. Radio frequency ablation and brachy-thera-peutic embolization with yttrium-90 microspheres are still in the exploratory stage. Multimodality treatment of PCLM using chemother-apy, radiation therapy, and Chinese herbal medicine is gaining wide acceptance. This article reviews the recent progress in the treatment of PCLM.

Objective To evaluate the diagnosis and treatment of left renal vein entrapment syndrome. Methods The clinical data of 10 cases of left renal vein entrapment syndrome were retrospectively analyzed.Their mean age was 24 years (range,14-37 years).Of them 7 cases presented with non-glomerular origin hematuria;2,with orthostatic proteinuria;1 with hematuria accompanied by proteinuria.Color Doppler sonography showed that the dilated segment of the left vein was three-fold than the strictured segment in diameter,and magnetic resonance angiography (MRA) showed that the left renal vein was compressed in 9 cases. Results Stent placement across the left renal vein was performed in 7 cases.Superior mesenteric arteriectomy and replantation were performed in 3 cases.The operations were all successful.Follow-up of 1-5 years showed that the clinical symptoms were improved and urine tests were normal. Conclusions Non-glomerular hematuria or orthostatic proteinuria is frequently found in left renal vein entrapment syndrome.Left renal vein entrapment syndrome can be diagnosed by Doppler sonography,MRA and cystoscopy in the presence of hematuria or proteinuria.Generally,conservative treatment and careful follow-up are conducted in these patients.Surgical and radiologic interventional procedures are effective alternatives for those with glomerular dysfunction and complications.

Objective To discuss the appearances of focal nodular hyperplasia(FNH) of the liver on the muhiphase helical CT scanning, and to improve its diagnostic accuracy with CT. Methods Helical CT scanning of pre- and post- contrast arterial phase,portal venous phase and delayed phase was performed in 10 cases with surgically and pathologically proved FNH. Results On pre- contrast scans,9 of 11 FNH lesions were hypodense(either homo-geneous or non-homogeneous), the other two lesions were isodense. On the arterial phase scans, all lesions were markedly and homogeneously enhanced,except for the central scar area. Tortuous and dilated arteries were seen at the center or peripheral area in 3 out of 11 lesions. On the portal phase and delayed phase scans ,4 of 11 lesions turned to isedanse of slightly hypodense,7 lesions remained slightly hyperdense. Central scar was found in 8 FNH lesions ,2 of them showed no enhancement while the other six demonstrated late enhancement. Conclusion Mulfiphase helical CT scanning can fully reflect the blood supplying and pathologic features of FNH, and it is of great value in diagnosing and differentiating FNH.

Objective: To explore the coping strategies of the elderly with Impaired Glucose Regulation(IGR), to compare the differences of coping strategies among the groups of different prognosis and to provide some advice on psychological intervention. Methods: Fasting Plasma Glucose (FPG)and two-hour postprandial Plasma Glucose of OGTT(OGTT2hPG)of 220 old persons with IGR were tested, and they were assessed by TCSQ. Results: 27.73%～78.64% of old people with IGR chose active strategies when facing stress, 4.09%～18.18% of them adopted negative strategies. There were no significant differences of coping strategies among the groups of different prognosis. Conclusion: It was better to pay more attention to those who mainly selected negative strategies in psychological intervention on the elderly with IGR.

Objective To evaluate the efficiency of nutrition support in critical ill patients. Methods A retrospective analysis was made to the efficiency of the nutrition support applied to 233 critical ill patients PN+EEN→EN+per os→per os was employed as the model of nutrition support, and a nasal feeding pump was used for enteral nutrition. Results During the period of nutrition support, in the 233 patients, 26 dead, the mortality was 11.16%. Early enteral nutrition significantly decrease the mortality in critical ill patients. There existed significant differences in complications in three kinds of enteral nutrition may methods. Conclusion It is feasible to give the critical ill patients, it might help to reduced the mortality in ICU patients.