Objective To compare the effect of retroperitoneoscopic ureterolithotomy (RPUL) and ureteroscopic lithotripsy (URL) for upper ureteral calculi.Methods One hundred and twenty cases treated by RPUL and 108 cases by URL from January 2002 to October 2012 were reviewed.In RPUL and URL group,the diameter of stone was (1.56 ± 0.52) cm vs (1.44 ± 0.46) cm,ipsilateral hydronephrosis was (2.85 ± 0.86) cm vs (2.76 ± 0.82) cm,body mass index was (23.65 ± 2.80) kg/m2 vs (22.54 ± 2.68) kg/m2.There were no signficant differences.Data on the operation time,the hospital stay after operation,the operation,successsful rate,complication incidence and stone-free rate were compared between the 2 groups.Results Comparisons between RPUL group and URL group included the following:the operation time was (75.5 ± 25.8) min vs (62.5 ± 15.3) min,the hospital stay after operation was (6.2 ± 1.2) d vs (4.0 ± 0.8) d.There were significant differences.The operation successful rate was 95.0％ (114/120) in RPUL group and 85.2％ (92/108) in URL group.The complications incidence rate was 3.5％ (4/114) in RPUL group and 17.4％ (16/92) in URL group.The stone-free rate was 100.0％ (114/114) in RPUL group and 89.1％ (82/92) in URL group.The differences were significant (P ＜ 0.05).Conclusions RPUL and URL had the advantages of less trauma and blood loss and rapid recovery.RPUL had fewer complication and higher success rate than URL,and could be a minimally invasive option for the treatment of ureteral calculi.

Objective To observe the basic rhythm of myoelectrie activities of sphcter of Oddi (SO)and explore its biological significance.Methods Healthy adult rabbits(n=32)were randomized into 4 groups with 8 in each.The first group was for recording of myoelectric activities of SO after keeping fast for 18 hours.The second group was manipulated to observe the myoelectric activities of SO after food infusion through the stoma in stomach.The myoelectric activities of SO in the third group were monitored after the classical Nardi test was performed on these rabbits.The fourth group was used to observe the myoelectric activities of SO after the cholinergic receptors had been blocked.Using the double claw metal electrodes which were put into SO and duodenum through the plasma membrance,the myoelectric signal were recorded with RM6240 multi-channel physiologic recording and signal processing system and non-stop recording was conducted for 120-150 mins.Results 1)Spike Potentials of SO with the frequency was observed in rabbits that had been fasting.2)Myoelectronic activity of SO was observed in rabbits infused with 50 ml milk through stoma.3)After the administration of 1 mg morphine and 1 mg neostigmine i.v,the myoelectric activities of SO were noted as long-lasting persistent MASO.4)Administration of anisodamine 1 mg(i.v.)in the empty abdomen group dismissed SPSO and MASO.This state lasted for 120 min before SPSO gradually reconverted to the state of empty abdomen.Conclusion There are four patterns of myoelectric activities of SO,i.e,tensional waves under empty abdomen indicating a state in which the SO kept a basic tension level.Peristaltic waves under intake of food.Spastic waves under the stimulation of drugs and relaxant waves under the post-ganglionic block of cholinergic receptors were observed in the present study.Correspondingly,their mechanic locomotion is inferred as the basic tensional state to faciliate the deposition and condensation of bile,the peristalsis for the entry of bile into duodenum,the spasmus so that the bile can not be released into duodenum under pathological situation or the effect of drugs.the long lasting relaxant state after effective inhibition of post-ganglionic cholinergic receptors,respectively.The above results indicate that there are more than two states that is ON or OFF in SO and the concepts of contract and peristalsis of SO should be distinguished.

Objective To investigate the comprehensive intervention residents health literacy with the thera-peutic efficacy of hypertensive patients on diabetes,and to provide a reference for the implementation of clinical inter-ventions.Methods 1 684 cases of community residents were selected as the research objects.Lectures on health,one on one counseling,health manuals mode on the implementation of comprehensive intervention residents health litera-cy.Comparison of the residents after comprehensive intervention China citizen health literacy questionnairesurvey results,and the awareness rate of diabetes,high blood pressure,diabetes hypertension compared after comprehensive intervention,the awareness rate,treatment rate and control rate of blood pressure,blood glucose were investigated. Results After comprehensive intervention,the basic knowledge and concept healthy residents of the ratio of 81.94%,healthy lifestyle and behavior of the ratio of 82.18%to 81.77%the proportion of health,skills,health liter-acy was 54.98%,which were significantly higher than those of intervention,the difference (χ2 =17.88,90.67, 193.72,413.88,all P<0.05);the number of patients of hypertension in 537 cases,the incidence was 31.89%.The prevalence of hypertension in residents after comprehensive intervention,the awareness rate was 64.06%,the stand-ardized treatment rate was 51.02%and the control rate of hypertension was 35.01%,which were significantly higher than those of intervention(χ2 =67.93,24.85,30.66,all P<0.05);prevalence of diabetes in 269 cases,the inci-dence was 15.97%.The prevalence of diabetes in residents after comprehensive intervention,the awareness rate of diabetes was 78.07%,standardized treatment rate was 60.97%,the blood sugar control rate was 37.17%,which were significantly higher than those of intervention(χ2 =68.78,6.33,17.48,all P<0.05).Conclusion The comprehensive intervention residents health literacy is the effective measures to improve the residents'health literacy and health liter-acy,improve help control blood pressure in patients with hypertension and diabetes,glycemic index,which is of posi-tive significance to promoting the control hypertension,diabetes.

Objective To measure the parameters of ealeaneal quantitative ultrasound(QUS)in nomal Hubei Yichang subjects.which were compared between different age groups after standardization by body mass index(BMI).Methods Calcaneal parameters were measured by UBIS5000 in 2912 normal Hubei Yichang subjects,from 20 to 82 years old women 1450,men 1462).Results The peak values of broadband ultrasound attenuation(BUA)and stiffness(STI)of the calcaneal were both in 45-49 year group for women.The peak value of BUA was in 50-54 year group for men.Standardized by BMI,the peak value of BUA、STI and sound of speed(SOS)were both in 20-24 year groups for women and men.Conclusion BUA、SOS and STI of the calcaneal may change with age.After the influence of body mass is eliminated,the change still exists obviously,and the parameters may gradually reduce with increasing age.

Objective To explore the feasibility of inter-laboratory comparison and trueness evaluation among clinical laboratories, and assess the quality of participants′measurement, by measuring the activity of alanine aminotransferase ( ALT ) in patient serum samples.Methods Method comparison study was used.Five patients serum samples, whose target values were assigned by two international candidate reference laboratory with reference method of ALT without pyridoxal phosphate, were measured by 23 routine laboratories.The bias between measurement result of each participant and the mean of reference laboratories was calculated, and then compared to allowable bias 6%.Calculate the mean value and the relative bias.Results Compared with the mean of reference laboratories, the maximum absolute value of bias among the 23 routine laboratories was 31.27%.The rate range which bias was less than the allowable bias was 26.09%-73.91 %.The bias acceptability of 8 participants were more than or equal to 80%;15 participants were less than or equal to 60%; and 3 participants were 0%.Conclusions Using patient serum samples and values assigned by reference method is an effective way to carry out inter-laboratory comparison and trueness evaluation.It can reflect the quality of measurement more truly.

Objective To investigate the short-term outcome of laparoscopic adjustable gastric banding (LAGB) for morbid obesity complicated with type 2 diabetes. Methods Eight morbidly obese patients with type 2 diabetes underwent LAGB from October 2006 to August 2007. The weight parameters, fasting (FBG) and 2-hour blood glucose (2hBG), medication for diabetes were assessed 1,3, 6 and 9 months after surgery. Results All of the patients lost weight, with a mean body mass index decreased from (38.7±7.5) kg/m2 before LAGB to (30.5±4.3) kg/m2 9 months after LAGB. The FBG and 2hBG were decreased significantly at month 6 and 9 after LAGB, with normal FBG and 2hBG in 4 patients. At month 9 after LAGB, 3 of 5 patients with insulin treatment before LAGB were changed to oral hypoglycemics, 1 was continuously administered with a reduced dose of insulin, and 4 patients stopped any medication. Conclusion LAGB is an effective procedure in the treatment of morbid obesity complicated with type 2 diabetes with a favorable short-term outcome.

Objective To study the effect of continuous subcutaneous insulin injection(CSII) in treatment of type two diabetic patients with pulmonary infections. Methods From January 2001 to December 2005,83 type two diabetic patients with pulmonary infections were randomized to group CSII (42 cases) and group MSII(41 cases). The period of normalization of the blood glucose and cure of the pulmonary infections, cost and morbidity of low blood glucose were observed. Results Blood glucose of all patients in two groups reduced significantly. Significant difference was observed in the period of cure of the pulmonary infections, usage amount of insulin and morbidity of low blood glucose. In group CSII HbA1c, CRP and CHOL reduced significantly. Fasting CRP and high density lipoprotein-C (HDL-C) were remarkably increased. Conclusions Consecutive subcutaneous insulin pump injection is able to control the blood glucose better, to correct metabolic disorder, reduce the cost and hospital day and decrease the morbidity of low blood glucose. CSII is a better of method.

OBJECTIVETo investigate the diagnosis and treatment of hypotelorism.

METHODSFrom Jan. 2000 to Jan. 2014, 6 cases with hypotelorism were retrospectively studied. Among them, 3 cases had craniosynostosis, 2 had holoprosencephaly, and 1 had cleft lip. All the cases were diagnosed and treated by bone graft or spring distraction to correct the hypotelorism.

RESULTS2 cases were treated by none graft and 4 cases were treated by external spring distraction. All the patients completed the treatment successfully with obvious improvement in appearance. No complication happened. 4 cases were followed up for 2 years with an average fronto-orbital axis angle as (50 ± 8) °.

CONCLUSIONSHypotelorism can be successfully corrected by bone graft as fronto-orbital bridge or spring distraction.

Bone Transplantation ; Cleft Lip ; Craniofacial Dysostosis ; diagnosis ; surgery ; Craniosynostoses ; complications ; Humans ; Osteogenesis, Distraction ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo discuss the treatment and diagnosis of congenital median perineal cleft in children.

METHODSBetween January 2009 to February 2013, 7 cases were diagnosed as congenital median perineal cleft according to the symptoms. Among them, 4 cases underwent surgery to correct cleft with double triangular perineal flaps. The other 3 cases with minor cleft did not receive surgery management.

RESULTSThere is an median cleft from the perineum to the anus with mucosa on the cleft surface. Primary healing was achieved in all the four patients with satisfactory appearance. The patients were followed up for 1-4 years with almost normal perineal appearance.

CONCLUSIONSCongenital perineal median cleft can be diagnosed according to the symptoms. Double triangular perineal flaps can be effectively correct the cleft to attain normal perineal appearance.

Adolescent ; Anal Canal ; Child ; Humans ; Perineum ; abnormalities ; surgery ; Surgical Flaps ; Treatment Outcome ; Wound Healing

Objective Negative pressure aspirator clogging ( OSAC) frequently occurs in orthopedic surgery .This study was to investigate the frequency , location , and mechanisms of OSAC in China by analysis of the current status and clinical observation of OSAC so as to provide evidence for the solution of the problem . Methods Using the two-stage random sampling method , we conduc-ted a questionnaire survey on OSAC among 738 clinical orthopedists during the 16th and 17th Chinese Orthopedic Association Confer-ences.Totally, 160 out 1200 orthopedic surgeries were randomly selected in the time order of operation , including 38 cases of total hip arthroplasty ( THA) , 39 cases of total knee arthroplasty ( TKA) , 43 cases of extremity and spinal fractures surgery , and 40 cases of other orthopedic surgeries .We also obtained the satisfaction scores with the existing aspirators from related medical professionals . Results Among the 738 respondents included into the analysis , 706 (95.7%) thought that OSAC often occurred during surgery , 631 (85.5%) considered THA to be the leading cause of OSAC , and 714 (96.7%) regarded the tip and hose joint of the aspirator as the common causes . The mean satisfaction score with the existing aspirators was 7.62 ±0.74.Clinical observation showed the mean frequency of OSAC to be 2.55 ±1.62 in THA, 1.95 ±1.33 in TKA, 1.52 ±1.18 in extremity and spinal fracture surgeries , and 0.95 ± 0.68 in other orthopedic surgeries , and the satisfaction score to be 7.36 ±0.84. Conclusion OSAC has a high incidence rate during orthopedic surgeries in China , thus affecting orthopedic surgery and reducing orthopedists'satisfaction with the aspirators . The current negative pressure aspirator system demands prompt improvement .