Objective To investigate the effect of three-level network of vaccination on immunization rates of planned immunization vaccine,and provide science basis for planned immunization work.Methods Immunization rates of children in 131 villages under administration of Xiaolan People's Hospital of Zhongshan were investigated according to PPS from 2007 to 2010,and were compared before and after the establishment of three-level network of vaccination.Results After the establishment of three-level network of vaccination,rates of certification,and vaccination rates of OPV,DPT,and HBV were all increased significantly,vaccination rates of BCG were not raised obviously.Conclusions The establishment of three-level network of vaccination can increase immunization rates of planned immunization vaccine.

Background and purpose: Systemic reports about the prognosis of patients with renal cell carcinoma (RCC) of stage T_(1-3a)N_0M_0 combined with inflammatory enlargement of hilar lymph nodes have not been observed in the literature. This study was to investigate the prognostic role of inflammatory enlargement of hilar lymph nodes in the patients with RCC of stage T_(1-3a)N_0M_0 and its association with clinical features. Methods; Forty-nine patients with RCC of stage T_(1-3a)N_0M_0 combined with inflammatory enlargement of hilar lymph nodes were reviewed and all these patients underwent radical nephrectomy from January 1995 to January 2000. Results: The duration of follow-up was 8-14 years with the average of 7.5 years. Seven patients were lost to follow-up. Seventeen patients without RCC and four with RCC metastases are alive at present. Eighteen patients died of RCC relatad complications and three died of cerebro-cardiovascular disease. Metastases occurred in twenty-two patients one year after surgery. The 5- and 10- year survival rates were 53.1% and 42.9%, respectively. Conclusion: Most of the enlarged hilar lymph nodes in RCC were diagnosed as lymphadenitis. The rate of inflammatory enlargement of hilar lymph nodes in the long-term survival patients with RCC of stage T_(1-3a)N_0M_0 were comparatively low. Regional lymphadenectomy or resection of enlarged inflammatory lymph nodes could not protect the patients from metastasis completely. It is advised that limited lymphadenectomy with resection of enlarged inflammatory lymph nodes should be performed for the patients in RCC combined only with inflammatory enlargement of hilar lymph nodes.

Background and purpose:Laparoscopic partial nephrectomy has been one of the surgery options for patients with single renal carcinoma of T1 stage. Under the effect of some factors, intraoperative renal blood lfow clamping somtimes exceeds the safe limit of 30 minutes of warm ischemia time (WIT) for renal tissues, that might results in warm ischemia-reperfusion injury to severe extent. However, there still remains controversy about the depth of this warm ischemia-reperfusion injury. So this study aimed to evaluate the effects of longer WIT on ipsilateral residual renal tissues. Methods:Forty-four patients underwent retroperitoneal laparoscopic partial nephrectomy from Jan. 2012 to Jan. 2014. All of them were divided into observe group (WIT>30 min) and control group (WIT≤30 min). The differences of glomerular filtration rate (GFR) of operative kidney Pre- and post-operatively between two groups were analyzed. Results: The pre- and post-operative GFRs of operative kidney in observe group were 29.3-53.0 mL/min[(33.1±5.2) mL/min], 23.1-40.5 mL/min[(27.3±5.9) mL/min] respectively (P=0.054). The pre-and post-operative GFRs of operative kidney in control group were 27.4-49.6 mL/min[(32.3±4.1) mL/min], 23.8-44.4 mL/min[(29.1±5.0) mL/min], respectively (P=0.07). There was no statistically differences of the depth of the decrease of GFRs after surgery between the two groups (P=0.051). Conclusion: WIT of 30-60 min does not result in statistically signiifcant injury for ipsilateral residual renal function. However, it is still necessary to reserve more ipsilateral residual renal function through minimizing WIT under the premise of ensuring the safety of surgery.

Animals ; Animals, Newborn ; Female ; Hippocampus ; physiopathology ; Hypoxia-Ischemia, Brain ; physiopathology ; Long-Term Potentiation ; Male ; Maze Learning ; Memory ; Rats ; Rats, Wistar

Objective To evaluate the clinical value of holographic image navigation in urological laparoscopic and robotic surgery.Methods The data of patients were reviewed retrospectively for whom accepted holographic image navigation laparoscopic and robotic surgery from Jan.2019 to Dec.2019 in Beijing United Family Hospital and other 18 medical centers,including 78 cases of renal tumor,2 cases of bladder cancer,2 cases of adrenal gland tumor,1 cases of renal cyst,1 case of prostate cancer,1 case of sweat gland carcinoma with lymph node metastasis,1 case of pelvic metastasis after radical cystectomy.All the patients underwent operations.In the laparoscopic surgery group,there were 27 cases of partial nephrectomy,1 case of radical prostatectomy,2 cases of radical cystectomy and 2 cases of adrenalectomy.In the da Vinci robotic surgery group of 54 cases,there were 51 cases of partial nephrectomy,1 case of retroperitoneal lymph node dissection,1 case of retroperitoneal bilateral renal cyst deroofing and 1 case of resection of pelvic metastasis.There were 41 partial nephrectomy patients with available clinical data for statistic,with a median age of 53.5 years (range 24-76),including 26 males and 15 females.The median R.E.N.A.L score was 7.8 (range 4-11).Before the operation,the engineers established the holographic image based on the contrast CT images and reports.The surgeon applied the holographic image for preoperative planning.During the operation,the navigation was achieved by real time fusing holographic images with the laparoscopic surgery images in the screen.Results All the procedures had been complete uneventfully.The holographic images helped surgeon in understanding the visual three-dimension structure and relation of vessels supplying tumor or resection tissue,lymph nodes and nerves.By manipulating the holographic images extracorporeally,the fused image guide surgeons about location vessel,lymph node and other important structure and then facilitate the delicate dissection.For the 41 cases with available clinical data including 23 cases of robotic-assisted partial nephrectomy and 18 cases of laparoscopic nephrectomy,the median operation time was 140 (range 50-225) min,the median warm ischemia time was 23 (range 14-60) min,the median blood loss was 80(range 5-1 200) ml.In the robotic surgery group,the median operation time was 140 (range 50-215)min,the median warm i schemia time was 21 (range 17-40)min,the median blood loss was 150(range 30-1 200)ml.In the laparoscopic surgery group,the median operation time was 160(range 80-225)min,the median warm ischemia time was 25 (range 14-60)min,the median blood loss was 50 (range 5-1 200) ml.All the patients had no adjacent organ injury during operation.There were 2 cases with Clavien Ⅱ complications.One required transfusion and the other one suffered hematoma post-operation.However,the tumors were located in the renal hilus for these 2 cases and the R.E.N.A.L scores were both 11.Conclusions Holographic image navigation can help location and recognize important anatomic structures during the surgical procedures..This technique will reduce the tissue injury,decrease the complications and improve the success rate of surgery.