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.

Objective To study the effect of glutamine on hypermetabolism reaction and hormone secretion after severe burn injury. Methods Eighty-eight Wistar rats were inflicted with 30% total body surface area full thickness burns and randomly divided into two groups: namely burned control (B) and glutamine treatment(GLN) group. There was isonitrogenous and isocaloric intake in both groups, and rats of GLN and B groups were given glutamine and glycine at 1 0g/kg d, respectively. The following indices including the resting energy expenditure (REE), the levels of plasma cortisol, insulin and glucagon were determined. Results After burn injury, the REE, plasma cortisol,insulin and glucagons levels were significant increased in both groups. Compared with B group, the level of REE decreased and the ratio of insulin/glucagons increased in GLN group. Correlation analyses showed that REE had a negative correlation with insulin/glucagons ratio (r=-0 78,P

0.05).However,metabolic acidosis and hyperchloremia were observed with feeding arginine hydrochloride for 7 days in severe burned rabbits,and no such significant changes were found in arginine acetate group.CONCLUSION:Arginine acetate is safer than arginine hydrochloride in severe burned rabbits.

Objective: To explore the effects of different nutrition support pathway on enterogenous hypermetabolism after severe burn injury. Methods: Eighty-eight Wistar rats were inflicted with 30% total body surface area full thickness burns and randomly divided into two groups: total parenteral nutrition (TPN) and enteral nutrition(EN) group. The following indices including the resting energy expenditure (REE), the plasma LPS, TNF and IL-1 level were determined. Results: After burn injury, the REE, TNF, LPS and IL-1 were significantly increased in two groups . Comparing with TPN group , the level of REE, TNF, LPS and IL-1 were significantly decreased in EN group (P

OBJECTIVE:To study the effect of L-glutamine granules on protein metabolism and immunofunction in severely burned patients.METHODS:39 severe burn patients(total burn surface areas 30%～60%,full thickness burn areas 20%～50%) were randomly divided into two groups:control group(C group,19 patients) and glutamine treatment group(GLN group,20 patients).GLN group patients were given glutamine granules 0.5g/kg daily for 7 days,and C group were given same weight placebo for 7 days.The concentrations of plasma glutamine,prealbumin,transferrin,immunological globulin and IL-2 were determined.Moreover,the wound healing rate of burn area was observed and then hospital stay days were recorded.RESULTS:After 7 days of taking glutamine,the concentrations of plasma glutamine,prealbumin,transferrin IgG,IgM and IL-2 in GLN group were significant higher than those in before medication and C group(P0.05).The wound healing rate was faster and hospital stay days were shorter in GLN group than those in C group(P

Endoscopy ; methods ; Humans ; Intestinal Diseases ; diagnosis ; diagnostic imaging ; Intestine, Small ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; methods

OBJECTIVE： To evaluate the clinical therapeutic effect of L-glutamine granules on intestinal damage of severe burn patients and the safty of the drug.METHODS： Thirty-nine severe burn patients were randomly divided into two groups： control group（C group， nineteen patients） and L-glutamine treatment group（GLN group， twenty patients） .GLN group patients were given L-glutamine in a dose of 30g per day for 7 days， and C group patients were given the same dosage of placebo for 7 days.The plasma L-glutamine concentration， the degree of intestinal mucosa damage， blood biochemistry and complication were observed and wound healing rate of burn area was determined， then the length of hospital stay was recorded.RESULTS： After 7 days of taking L-glutamine orally， plasma L-glutamine concentration in GLN group was significant higher than that in C group（P<）. The degree of intestine damage and intestinal mucosal permeability in GLN group were lower than those in C group. In addition, the wound healing rate was faster and the length of hospital stay was shorter in GLN group than those in C group. CONCLUSION: Administration of L-glutamine could abate the degree of intestine damage obviously, lessen intestinal mucosal permeability, ameliorate wound healing rate and reduce the length of hospital stay.

Aged ; Coal Mining ; Electrocardiography ; Heart Rate ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; physiopathology ; Tachycardia ; etiology

Objective: To investigate the correlation between serum melatonin level and cardiac function, blood lipid in patients of heart failure with preserved ejection fraction (HFpEF). Methods: One hundred and seventy patients with HFpEF (HFpEF group) in Ninth Hospital of Xi′an City from May 2016 to May 2018 were selected. According to the cardiac function grading of New York Heart Association (NYHA), Ⅱ grade (cardiac function Ⅱ grade) was in 98 cases, and Ⅲ grade (cardiac function Ⅲ grade) was in 72 cases. Then, 32 healthy volunteers were selected as control group. The 2 groups were sampled at 2:00 and 7:00, and the level of melatonin was detected by enzyme-linked immunosorbent assay. The correlation between serum melatonin level and cardiac function, blood lipid were analyzed (Pearson correlation), including triglyeride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), N-terminal precursor brain natriuretic peptide (NTproBNP), hypersensitive C reactive protein (hs-CRP), ejection fraction, left ventricular end-diastolic volume index (LVEDVI), miral diastolic early and end-diastolic maximum blood flow velocity ratio (E/A) and peak value of early diastolic blood flow velocity in the mitral valve and peak value of the early diastolic velocity of the mitral annulus (E/e′). Results: The TG, TC, LDL-C, NTproBNP and hs-CRP in cardiac function Ⅲ grade patients were significantly higher than those in cardiac function Ⅱ grade patients: (1.51 ± 0.69) mmol/L vs. (1.15 ± 0.75) mmol/L, (4.03 ± 1.02) mmol/L vs. (3.47 ± 0.94) mmol/L, (1.42 ± 0.33) mmol/L vs. (1.17 ± 0.31) mmol/L, (3 438.54 ± 553.58) ng/L vs. (3 034.58 ± 557.35) ng/L and (4.26 ± 2.54) mg/L vs. (3.12 ± 2.13) mg/L, the HDL-C, ejection fraction and E/A were significantly lower than those in cardiac function Ⅱ grade patients: (2.44 ± 0.88) mmol/L vs. (2.97 ± 0.94) mmol/L, (56.23 ± 5.26)% vs. (61.11 ± 5.33)% and 0.82 ± 0.18 vs. 0.91 ± 0.17, and there were statistical differences (P<0.01). The melatonin levels at 2:00 and 7:00 in control group and cardiac function Ⅱgrade patients of HFpEF group were significantly higher than those in cardiac function Ⅲ grade patients of HFpEF group: (454.24 ± 123.54) and (432.68 ± 155.68) ng/L vs. (368.85 ± 98.52) ng/L, (483.25 ± 90.54) and (418.54 ± 103.57) ng/L vs. (345.85 ± 98.52) ng/L, the melatonin level at 7:00 in control group was significantly higher than that in cardiac function Ⅱ grade patients of HFpEF group, and there was statistical difference (P<0.01). In cardiac function Ⅱ grade patients of HFpEF group, the melatonin level was correlated with TG, TC, LDL-C and HDL-C (P<0.01); In cardiac function Ⅲ grade patients of HFpEF group, the melatonin level was correlated with NTproBNP, hs-CRP, ejection fraction, LVEDVI, E/A, E/e′, TG, TC, LDL-C and HDL-C (P<0.01 or <0.05). Conclusions The melatonin level is correlated with the level of blood lipid in HFpEF patients. Melatonin level is correlated with cardiac function Ⅲ grade patients, but this phenomenon is not observed in cardiac function Ⅱ grade patients.

A 56-year-old female was admitted to Department of Gastroenterology at Peking Union Medical College Hospital with diarrhea for seven months, and abnormal liver function for six months. She had a history of type 1 diabetes. The main clinical manifestations were recurrent fatty diarrhea and abnormal liver function, accompanied by abdominal and retroperitoneal lymphadenopathy, elevated CA19-9 and CEA. Progressive impairment of hepatic synthetic function and shrinkage of liver developed in a short period of time. The pathology of liver biopsy suggested that nodular regeneration of hepatocytes was followed by hyperplasia of thin bile ducts after submassive necrosis. Intestinal mucosa biopsies were performed twice. The pathology showed that the intestinal villi were completely blunt, accompanied with crypt hyperplasia. Goblet cells disappeared with reduced mucin. Paneth cells were barely seen without intraepithelial infiltration of lymphocytes. Rifaximin was not effective, while glucocorticoids improved clinical situation. The diagnosis of autoimmune enteropathy was finally confirmed by multidisciplinary team including departments of gastroenterology, pathology, endocrinology, hematology, infectious diseases, and rheumatology. With the administration of glucocorticoid and sirolimus, diarrhea relieved and liver function returned to normal.