Objective To discuss a new method on treatment of the nephroptosis. Methods Seven patients of nephroptosis were treated with polypropylene ventrofixation on the twelfth rib.There were 2 male cases and 5 females.The patients aged from 14 to 46 years old.Height were a-mong 150 and 183 cm and weight from 45 to 68 kg.There were 5 cases with right side lesions,l case left and 1 case bilateral.The operation was performed through the lumbar incision.A polypropylene net string was put betw,een the fibrous capsule of the kidney and the adipose capsule,across the lower pole of the kidney.After adj usted the tension,the string was fixed by silk suture or by rivet after the silk running around the twelfth rib.IVU(intravenous urogram)was performed to compare the posi-tion of kidney pre-and post operation. Results The operations were successfully done.Averagc time of the operation was 65 min(from 50 to 90 min)and average hospital stay was 8 d(from 7 to 9 d).Average time lying in bed was 7 d(between 6 and 8 d).The symptoms of waist soreness.1umbo-dynia,hematuria,frequent micturition relieved.The follow up time was from 1 2 to 3 6 months with an average of 24 months. In 4 cases of hydronephrosis and calculus,3 cases were cured and 1 case was lightened.One case of repeated urinary tract infection,urinary sediment was normal and irritation symptoms disappeared.For l case with Dietl syndrome,the symptoms of nephric colic,nausea,pal-lor,exhaustion,hematuria disappeared. Conclusion The Polypropylene ventrofixation on twelfth rib might be alternative treatment choice for nephroptosis.

OBJECTIVETo discuss the diagnosis and treatment of multiple trauma with mainly thoracic and abdominal injuries.

METHODSA retrospective analysis was performed on data of multiple trauma cases with mainly thoracic and/or abdominal injuries.

RESULTSOf 1166 cases, 72.3% were found with shock. The operation rates of thoracic and abdominal injuries were 14.8% (119/804) and 83.5% (710/850) respectively (X(2) equal to 780.683, P less than 0.01). The operation rates of blunt and penetrating thoracic injuries was 6.8% (42/617) and 40.6% (76/187) respectively (X(2) equal to 131.701, P less than 0.01). The operation rates of blunt and penetrating abdominal injuries were 77.1% (434/563) and 96.1% (276/287) respectively (X(2) equal to 50.302, P less than 0.01). The operation rates of blunt thoracio-abdominal injuries were 6.8% (42/617) in thoracic region and 77.1% (434/563) in abdomen respectively (X(2) equal to 544.043, P less than 0.01). Among the cases of abdominal injuries, 41 received arteriography embolism, with the efficacy of 95.1% (39/41). Total mortality rate was 6.1%. The mortality rates of blunt and penetrating injuries were 7.3% (62/854) and 2.9% (9/312) (X(2) equal to 6.51, P less than 0.005). The deaths were mainly due to large volume of blood loss.

CONCLUSIONSWhen both thoracic and abdominal injuries exist, laparotomy is frequently required rather than thoracotomy. Laparotomy is seldomly used for blunt thoracic injuries, but usually used for penetrating thoracic and abdominal injuries. Mortality rate of penetrating thoracic and abdominal injuries is markedly lower than that of blunt injuries. Surgical operation is still important for those patients with penetrating thoracic or abdominal injuries.

Abdominal Injuries ; surgery ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Male ; Middle Aged ; Multiple Trauma ; surgery ; Retrospective Studies ; Thoracic Injuries ; surgery ; Wounds, Nonpenetrating ; surgery ; Wounds, Penetrating ; surgery ; Young Adult

PURPOSE: Hrd1 has recently emerged as a critical regulator of B-cells in autoimmune diseases. However, its role in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) remains largely unexplored. This study aimed to examine Hrd1 expression and B-cell accumulation and their possible roles in CRSwNP. METHODS: Quantitative real-time polymerase chain reaction, immunohistochemistry, enzyme-linked immunosorbent assay and Western blotting were used to assess gene and protein expression in nasal tissue extracts. Cells isolated from nasal tissues and peripheral blood mononuclear cells were characterized by flow cytometry. Local antibody production was measured in tissue extracts with a Bio-Plex assay. Additionally, changes in Hrd1 expression in response to specific inflammatory stimuli were measured in cultured dispersed polyp cells. RESULTS: Nasal polyps (NPs) from patients with eosinophilic CRSwNP (ECRS) had increased levels of Hrd1, B-cells and plasma cells compared with NPs from patients with non-eosinophilic CRSwNP (non-ECRS) or other control subjects (P < 0.05). The average Hrd1 levels in B-cells in NPs from ECRS patients were significantly higher than those from non-ECRS patients and control subjects (P < 0.05). NPs also contained significantly increased levels of several antibody isotypes compared with normal controls (P < 0.05). Interestingly, Hrd1 expression in cultured polyp cells from ECRS patients, but not non-ECRS patients, was significantly increased by interleukin-1β, lipopolysaccharide and Poly(I:C) stimulation, and inhibited by dexamethasone treatment (P < 0.05). CONCLUSIONS: Differential Hrd1 expression and B-cell accumulation between the ECRS and non-ECRS subsets suggests that they can exhibit distinct pathogenic mechanisms and play important roles in NP.
Antibody Formation ; Autoimmune Diseases ; B-Lymphocytes* ; Blotting, Western ; Dexamethasone ; Enzyme-Linked Immunosorbent Assay ; Eosinophils* ; Flow Cytometry ; Humans ; Immunity, Innate ; Immunohistochemistry ; Nasal Polyps* ; Plasma Cells ; Polyps ; Real-Time Polymerase Chain Reaction ; Tissue Extracts

The number of investigator initiated research (IIR) is increasing. But the recognition and management of IIR in China is still in its infancy, and there is a lack of specific and operable guidance for the implementation process. Based on our practical experiences, previous literature reports, and current policy regulations, the authors took prospective IIR as an example to summarize the implementation process of IIR into 14 steps, which are as the following: study initiation, ethical review, study registration, study filing, case report form design, database establishment, standard operating procedure making, investigator training, informed consent, data collection, data entry, data verification, data locking and data archiving.

Telephone follow-up is one of the important ways to follow up patients. High-quality follow-up can benefit both doctors and patients. However, clinical research-related follow-up is often faced with problems such as time-consuming, laborious and poor patient compliance. The authors belong to a team that has been committed to the study of patient-reported outcomes for a long time. The team has carried out long-term follow-up of symptoms, daily function and postoperative complications of more than 1 000 patients after lung cancer surgery, and accumulated certain experience. In this paper, the experience of telephone follow-up was summarized and discussed with relevant literatures from the aspects of clarifying the purpose of clinical research follow-up, understanding the needs of patients in follow-up, and using follow-up skills.