Objective:To compare the clinical effects of Percutaneous nephrolithotomy lithotripsy (PCNL) and transurethral ureteroscopy (URL) in the treatment of impacted upper ureteral calculi.Methods:Since 2008, There were 144 cases with incarcerated upper ureteral calculi in hospital, all patients were divided into two groups according to the different ways of treatment, the PCNL group with 72 cases and the URL group with another 72 cases. Monitor and record the rate of overall fragment, and the stone clearance rate of 3d and a month after the operation, average length of stay and total costs of the two groups. Through the Analysis to the data obtained, compare the clinical results of PCNL and URL in the treatment of impacted upper ureteral calculi.Results: For PCNL group, the rate of overall fragment, and the stone clearance rate of 3d and a month after the operation was 95.8% (69/72), 93.1% (67/72) and 98.6% (71/72), while for URL group, the data was 84.7% (61/72), 83.3% (60/72) and 86.1% (62/72), the difference was statistically significant (x2=5.18,x2=5.85,x2=6.49;P<0.05); The operation time, average length of stay and total costs for PCNL group are greater than the URL group, and the difference was statistically significant(t=3.80, t=4.87,t=5.34;P<0.05).Conclusion: PCNL compared with the URL in the treatment of impacted upper ureteral calculi has a better performance on stone clearance, but there are problems of higher costs and longer hospital stay. Accordingly, patients need a comprehensive comparison and choose the appropriate way.

Objective To investigate the distribution of pathogenic of nosocomial infections in intensive care unit (ICU) and the tendencies of its drug-resistances.Methods All of 130 patients of nosocomial infection from March 2009 to March 2013.Results Of all the nosocomial infection pathogens,gram-negative(G-) bacteria was the main(53.76％).The first five pathogens were E.coli(13.9％),E.faecalis (11.3％),A.baumannii (10.3％),S.aureus (9.8％) and K.pneumoniae (8.3％).The lower resistant to pseudomonas aeruginosa were amikacin (5.3％).A.baumannii increases rapidly and its resistances was severe.Two trains of E.faecalis were resistant to vancomycin.Conclusion G-bacteria is the main pathogens in ICU,fungal has upward tendency.The multidrug resistances of A.baumannii and E.faecalis were severe; Target monitoring is an effective surveillance method to reduce the prevalence of the nosocomial infection in ICU.

Objective:To compare the clinical effects on new bone formation and foot-ankle function between proximal tibial bone transport and distal tibial bone transport in the treatment of massive bone defects after tibial osteomyelitis debridement.Methods:From July 2012 to July 2017, 42 patients with chronic tibial osteomyelitis received bone transport surgery at Department of Orthopaedics, Nanfang Hospital.According to the Cierny-Mader classification for chronic osteomyelitis, all of them belonged to diffusive tibial osteomyelitis (type IV).Of them, 32 were treated by proximal tibial bone transport after tibial osteomyelitis debridement.In the proximal group, there were 27 males and 5 females, aged from 17 to 65 years and involving 20 left and 12 right sides. The other 10 cases received distal tibial bone transport. In the distal group, all of them were male, aged from 25 to 63 years and involving 6 left and 4 right sides. The 2 groups were compared in terms of external fixation index (EFI) and American Orthopaedic Foot & Ankle Society(AOFAS) Ankle and Hindfoot Scale.Results:There were no significant differences between the 2 groups in the preoperative general data such as gender, age or osteomyelitis site, indicating the 2 groups were comparable ( P>0.05). Both groups obtained complete follow-up. The proximal group was followed up for 590.1 d ± 287.3 d and the distal group for 615.6 d ± 130.6 d, showing no significant difference between groups ( P>0.05). In the proximal group 2 cases developed talipes equinovalgus after bone transport while in the distal group 3 cases did, and surgical intervention was needed for them. Surgical intervention was also carried out for16 cases of non-union at the docking site in the proximal group and for 2 ones in the distal group. The EFI was 76.2 d/cm±50.0 d/cm for the proximal group and 84.3 d/cm ± 59.9 d/cm for the distal group, showing no significant difference between groups ( P>0.05). The AOFAS scores were 81.4±10.1 for the proximal group and 60.0±5.9 for the distal group, showing a significant difference ( P<0.05). Conclusion:In the treatment of massive bone defects after tibial osteomyelitis debridement, no significant difference has been observed in the effect on bone formation between proximal tibial bone transport and distal tibial bone transport, but the former transport may have a less adverse effect on foot-ankle function.

Objective:To investigate the effect of psychological support during perithrombotic period on post-stroke depression (PSD) in patients with acute ischemic stroke (AIS).Methods:Patients with AIS received intravenous thrombolysis in the Affiliated Lianyungang Hospital of Xuzhou Medical University from January 1, 2021 to July 31, 2021 were enrolled prospectively. The intervention group received one-to-one individual psychological support therapy in the perithrombolytic period on the basis of receiving standard intravenous thrombolytic therapy. At 30 d after onset, Hamilton Depression Scale was used to assess whether PSD occurred. Multivariate logistic regression analysis was used to evaluate the independent influencing factor of PSD. Results:A total of 126 patients with AIS were enrolled, and 86 of them were male (68.25%). Their age was 63.65±10.46 years; 65 were in the intervention group and 61 were in the control group. The incidence of PSD in the intervention group was significantly lower than that in the control group (20.00% vs. 36.07%; χ2=4.049, P=0.044). Multivariate logistic regression analysis showed that psychological intervention (odds ratio [ OR] 0.333, 95% confidence interval [ CI] 0.132-0.838; P=0.020] was an independent protective factor for PSD, while ischemic heart disease ( OR 4.510, 95% CI 1.181-17.217; P=0.028), alcohol consumption ( OR 3.421, 95% CI 1.317-8.888; P=0.012), anticoagulation therapy ( OR 3.145, 95% CI 1.155-8.567; P=0.025) and modified Rankin Scale score before thrombolysis ( OR 1.627, 95% CI 1.142-2.317; P=0.007) were the independent risk factors for PSD. Conclusion:Perithrombolytic psychological support may reduce the incidence of PSD.