Objective To evaluate the efficacy and safety of one-step dilation technique in minimally invasive percutaneous nephrolithotomy (MPCNL). Methods Clinical data of 2813 patients who underwent MPCNL by one-step dilation technique from February 2011 to March 2015 was retrospectively analyzed. Results 2813 patients were successfully underwent MPCNL by one-step dilation, including 2383 cases who were accessed by single tracts (84.71%) and 430 (15.29%) cases by multiple tracts. The mean operating time was (78.6 ± 41.1) min, the mean tract accessing time was (2.3 ± 0.8) min.The stone-free rate after one session operation was 78.59%. It improved to 91.50% one month after operation. During and after operation, 93 cases needed transfusion, 21 underwent selective renal artery embolization. Adjacent viscera damage: 9 cases with pleural lesions and 1 case with colon injury, 13 cases with urinary extravasation, perirenal hematoma in 15 cases, without liver and spleen injury. Septic shock in 2 cases, who was recovered after anti-infection treatment. Conclusion One-step dilation is safe and effective technique to establish tracts in MPCNL, which can reduce X-ray exposure and operation time, but does not increase the risk of bleeding.

Objective To investigate the safety and efficacy of ureteral access sheath (UAS) with vacullm suction during flexible ureteroscopy lithotripsy in treatment of renal stones. Methods 96 cases of renal stones patients who received flexible ureteroscopy lithotripsy were retrospectively analyzed and divided into two groups:control group with 50 cases and treatment group with 46 cases. The stones free rate, operation time, intrapelvic pressure, renal colic, formation of steinstrasse, SIRS, Calcitonin Zymogen, leukocyte count, hospitalization time, hospitalization costs and treatment efficiency were evaluated after one month. Results The average, maximum and minimum intrapelvic pressure of treatment group was much lower than that of control group (P < 0.05); After one month, the treatment efficiency and stones free rate of control group was 70.0% and 82.0%, lower than that of treatment group (P < 0.05); The operation time of control group and treatment group was(108.6 ± 3.5) min, (86.3 ± 5.2) min (P < 0.05); The cases of renal colic, steinstrasse and SIRS of control group after treatment was 13 cases, 11 cases, 10 cases which was more than that of treatment group with 2 cases respectively (P < 0.05); The hospitalization time, hospitalization costs of control group and treatment group was (8.8 ± 1.1) d, (23 067.5 ± 392.8) RMB and (7.7 ± 1.2) d, (21 957.3 ± 378.6) RMB (P < 0.05); The Calcitonin Zymogen, leukocyte count of control group and treatment group was (1.5 ± 0.3) and (0.3 ± 0.1) ng/ml, (14.6 ± 0.5)×109/L and (6.4 ± 0.6)×109/L (P < 0.05). Conclusion The application of ureteral access sheath with vacullm suction during flexible ureteroscopy lithotripsy in treatment of renal stones was simple, safe and effective, and can shorten the operation time, improve the rate of clearing stone and treatment efficiency, reduce the incidence of adverse reactions. The application can be extended.

Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme 2 ; Betacoronavirus ; COVID-19 ; Cardiovascular Agents/pharmacology* ; Cardiovascular Diseases ; Coronavirus Infections/physiopathology* ; Humans ; Pandemics ; Peptidyl-Dipeptidase A/physiology* ; Pneumonia, Viral/physiopathology* ; SARS-CoV-2