Objective To evaluate the efficacy and safety of double-J stents in extracorporeal shock wave lithotripsy for the treatment of middle and upper ureteral calculi, and to explore the reasonable application of double-J stents. Methods 511 patients with middle and up-per ureteral calculi in our hospital were selected as the statistical objects. 161 patients of the catheter group were indwelled double-J stent be-fore extracorporeal lithotripsy while the other 350 patients in the no-catheter group underwent extracorporeal shock wave lithotripsy directly. The satisfaction rate of X-ray display location, gravel effect, and rate of adverse reaction were compared. Results The satisfaction rate of X-ray display location in the catheter group was higher than the no-catheter group (P=0. 025). And the gravel effect of the two groups were of statistical significance (P=0. 041). The incidence of hematuria and lower urinary tract symptoms in the catheter group was significantly high-er than that in the no-catheter group (P<0. 05). The incidence of renal colic in catheter group was lower than that in no-catheter group (P=0. 001). Conclusion Indwelling double-J stents is useful for stones display and localization, and it can improve the stone clearance rate. For ureteral stones whose diameter were less than 1 cm, double-J stents has little influence on the rate of stone clearance, but it can reduce the occurrence of severe renal colic.

Female ; Humans ; Hyperkeratosis, Epidermolytic ; pathology ; Infant, Newborn

Concurrent chemoradiotherapy is the optimal regimen for patients with inoperable locally advanced non-small cell lung cancer (LA-NSCLC).The application of new technologies such as positron emission tomography (PET)/CT and four dimensional CT (4D-CT) enhances the accuracy of radiotherapy and decreases adverse reaction.Induction chemotherapy and consolidation chemotherapy do not show benefit to survival.The targeted therapy and immunotherapy have the potential of improving the outcomes of inoperable LA-NSCLC.

To explore the value and attentive problems of the innovative practical teaching reform of dermatology staff room,the author constructed a new practical teaching system by carrying out advanced teaching methods,gradually establishing the on-line test system and setting up the evaluation and feedback system. The result showed that the innovative practical teaching reform of dermatology staff room had strong applicability and operability.

Objective To analyze the survival statistics and perioperative parameters of clinical stage Ⅰ non-small cell lung cancer patients who received systemic or selective mediastinal lymphadenectomy,and explore the value of selective mediastinal lymphadenectomy for clinical stage Ⅰ non-small cell lung cancer.Methods The clinical data of 984 patients with clinical stage Ⅰ non-small cell lung cancer who underwent lobectomy and systemic/selective lymph node dissection in Zhongshan Hospital from January 2005 to December 2010 were analyzed retrospectively.There were 581 males and 403 females with an average age of(59.6 ± 10.2) (24-84) years.786 patients received systemic mediastinal lymphadenectomy,and 198 patients received selective mediastinal lymphadenectomy.Results Average operation time of selective mediastinal lymphadenectomy group was(132.3 ±30.3) minutes,and that of systemic mediastinal lymphadenectomy group was(150.7 ±41.8) minutes with significant difference(P ＜ 0.01).Average amount of intraoperative bleeding of selective mediastinal lymphadenectomy group was (96.2 ± 53.5) ml,and that of systemic mediastinal lymphadenectomy group was (124.4 ± 65.4) ml with significant difference(P ＜0.01).There was no significant difference in overall survival rate between two groups(P =0.844).Recurrence rates were 25.3 ％ and 27.5 ％,respectively (P =0.533).Subgroup analysis showed no significant difference of 5-year survival rates between the two groups.Conclusion For patients with clinical stage Ⅰ non-small cell lung cancer,selective mediastinal lymphadenectomy can reduce operation time and amount of intraoperative bleeding.Survival of patients who received selective mediastinal lymphadenectomy was no worse than that of patients who received systemic mediastinal lymphadenectomy.

Objective To explore the pathogenesis and diagnosis of chronic granulomatous disease. Methods Clinical features and laboratory examination results of a child with chronic granulomatous disease were retrospectively analyzed. Genome DNA was extracted from peripheral blood of the child and his parents. The high-throughput sequencing was performed by Illumina sequencing platform, using the Agilent SureSelect exome capture method. Results The child had recurrent infections along with liver enlargement and dysfunction. The anti-infection and symptomatic treatment were unsatisfactory. Gene sequencing analysis revealed a homozygous point mutation (c.7C?>?T, p.Gln3*) in CYBA gene. His mother had the same heterozygous mutation in this locus, and his father had a large fragment heterozygous deletions. No other candidate gene mutations were identiifed. Conclusions The diagnosis of chronic granulomatous disease is conifrmed in this child. It is caused by CYBA gene mutation.

Objective To investigate the selection of flaps for the reconstruction of facial skin defects.Methods A total of 40 patients with facial skin defects were treated from February 2011 to February 2015 in our hospital,and they were given different surgery methods ac-cording to the different facial skin defect sizes.Minor defects were primarily treated by direct suturing;medium-sized defects were treated by local skin flap transposition or island skin flap;and larger defects were treated by expanded skin flap.Results All patients were followed up for 1 to 2 years.All the flaps survived with good color and texture match.All the scars healed well which were almost invisible.There was no obvious deformity in the donor and recipient sites.In addition,there was no lesion recurred.Conclusion Select suitable flaps for the recon-struction of facial skin defects according to the face defect area could get reliable blood supply of the flap,inapparent incision scar and a high level of satisfaction.

Objective To assess the value of endoscopic ultrasonography (EUS) and abdominal CT scan on preoperative T and N staging of advanced gastric cancer.Methods A total of 188 patients with advanced gastric cancer received EUS and CT scan to evaluate the T and N staging and lymphatic metastasis before surgical operation.The postoperative pathologic results acted as gold standard for comparison of the two methods.The results consistent with pathologic results were considered as correct otherwise were incorrect.The accuracy of EUS and CT and the each consistency of two methods with pathology were analyzed.Results For T staging, the accuracy of EUS and CT was 87.2%(164/188), 76.6%(144/188), respectively, and Kappa value of EUS and CT was 0.726 and 0.509, respectively.There was a statistical difference between the two methods(χ2=7.181,P=0.007).For lymph node metastasis, the accuracy of EUS and CT was 72.9%(137/188) and 79.8%(150/188), respectively, and Kappa value of EUS and CT was 0.397 and 0.487, respectively.No statistical difference was found between them(χ2=0.963,P=0.326).The consistency test between the two methods for T and N staging and lymph node metastasis revealed that the Kappa value was 0.507 and 0.649, respectively.The accuracy of EUS on T staging was 93.0%, 93.3%, 96.8% and 91.5% in cardiac cancer, gastric fundus cancer, gastric corpus cancer, and gastric antrum cancer, respectively.Corresponding Kappa value in the 4 different positions were 0.843,0.881,0.940 and 0.710, respectively according to consistency tests.The accuracy of gastric antrum cancer with pylorus invasion was 63.2% and the consistency test Kappa value was 0.340.Conclusion EUS is an accurate method for T staging and lymphatic metastasis of advanced gastric cancer, but there is a lower accuracy for T staging of gastric antrum cancer with pylorus invasion.

Objective To preliminarily investigate the effect and possible mechanisms of Senecio cannabifolius Less.Ⅱ(FHC-Ⅱ) on perfluoroisobutylene (PFIB) inhalation-induced acute lung injury. Methods Totally 156 rats were randomly assigned to three groups: the control group, the PFIB group and the FHC-Ⅱ prevention group, with 32, 62 and 62 rats in each group respectively. The FHC-Ⅱprevention group were given FHC-Ⅱthree times per day at the dosage of 340 mg/kg before PFIB exposure. 1 h after the last time of FHC-Ⅱ administration, the FHC-Ⅱ prevention group were exposured to gaseous PFIB (0.2 mg/L) for 10 minutes in a static whole-body exposure inhalation system. The survival rate of the rats were recorded at 1, 2, 4, 8, 16, 24, 48 and 72 h post PFIB exposure;the lung index and total protein content in bronchoalveolar lavage fluid (BALF) were measured at 1 h, 2 h, 4 h, 8 h, 16 h and 24 h; IL-1β and IL-8 in sera were assayed by enzyme-linked immunosorbent assay (ELISA) at 1, 2, 4, 8 and 16 h post PFIB exposure and the histopathological examination of the lung tissue was performed at 8 h post PFIB exposure. Results FHC-II significantly reduced the content of the total protein in BALF, lung index and the levels of IL-1β and IL-8 in aera as well, and dramatically alleviated the histopathological changes in the lung tissue. Conclusion FHC-Ⅱ demonstrates some preventive effect on PFIB inhalation-induced acute lung injury in rats.

Objective To analyze the safety, feasibility and operative technique details of non-grasping en bloc mediastinal lymph nodes dissection technique in uniportal video-assisted thoracic surgery(VATS) for lung cancer.Methods From April, 2014 to March, 2015,46 patients with lung cancer received non-grasping en bloc mediastinal lymph nodes dissection after uniportal VATS lobectomy.Clinical data of the cases were analyzed retrospectively.There were 19 males and 27 females.The age was(57.2 ± 9.0) (38-73) years.The first 6 cases were performed in the lateral decubitus position while the later 40 cases were all performed in the semiprone position.Results All cases accepted uniportal VATS non-grasping en bloc mediastinal lymph nodes dissection successfully.Arm fatigue of surgeon and assistant was obviously relieved when the patient was placed in the semiprone position.The thoracic drainage time was(3.2 ± 2.1) (1-12)days and the postoperative length of hospital-stay was(6.0 ± 4.5) (2-27) days.The number of dissected mediastinal lymph nodes stations was (4.3 ± 0.8) (3-6)and the number of dissected mediastinal lymph nodes was (11.8 ± 4.9) (4-30).There were 42 cases with stage No , lease wit stage N1, and 3 cases with stage N2 in pathological examination.Five patients developed minor postoperative complications.No perioperative death occurred.Conclusion Uniportal VATS non-grasping en bloc mediastinal lymph nodes dissection for lung cancer was safe and feasible, which could decrease the interference of the instruments and help to keep the surgical field clear.Non-grasping en bloc mediastinal lymph nodes dissection would be performed more smoothly in the semiprone position with less damage to lung and better ergonomics.