Objective To evaluate the safety and efficacy of percutaneous nephrolithotomy (PCNL) with B ultrasound-guided renal access in the lateral decubitus flank position for complex renal calculi. Methods From June 2004 to August 2009, 650 patients with renal stones≥20 mm underwent PCNL with B ultrasound-guided renal access in the lateral decubitus flank position. 512 men and 138 women,with a mean age of 38 years(range 11 - 78 years)and a mean stone size of 31 mm(range 20 - 58 mm). Results Successful access was achieved in 650 patients (100%). Minimally PCNL and PCNL were performed in 493 and 157 patients. Complete stone clearance rate was 86. 6% (563/ 650). The mean operative time was 72 min(range 35 - 145 min), and the mean hospital stay was 18d (range 9 - 32 d). There were no visceral injuries. Conclusions PCNL with B ultrasound-guided renal access in the lateral decubitus flank position is safe and convenient, and prevents harmful effects of radiation for the surgeon, the surgical team, and the patient.

Objective To study the anticoagulation therapy of lower molecular weight heparin in the treatment of patients with acute pancreatitis.Methods Seventy-three patients with acute pancreatitis were divided into anticoagulation group(n=38)and control group(n=35).The serological indexes and prognosis of patients were detected.Results Anticoagulation treatment with lower molecular weight heparin significantly decreased the white blood cell count,increased the oxygen partial pressure in arterial blood,shoaened the duration of hospitalization,and reduced the aggravation rate,secondary operation rate and mortality of patients with acute pancreatitis.Conclusions Anticoagulation treatment with lower molecular weight heparin is safe,effective and can improve the prognosis of patients with acute pancreatitis.

Objective To investigate the value of 18F-FDG,11C-MET and 11C-CHO PET/CT in the differentiation of C6 glioma from different kinds of inflammation in experimental rat models.Methods (1) A total of 48 male SD rats were randomly divided into 6 groups by the random number table:group 1 and 2 consisted of 8 rats bearing both C6 glioma and turpentine oil-induced acute inflammation;group 3 and 4 consisted of 8 rats bearing both C6 glioma and turpentine oil-induced chronic inflammation;group 5 and 6 consisted of 8 rats bearing both C6 glioma and BCG-induced granuloma.(2) 18F-FDG and 11C-MET PET/CT were performed on rats of group 1,3 and 5;18F-FDG and 11C-CHO PET/CT were performed on rats of group 2,4 and 6.The lesion-to-muscle ratios and tumor selectivity index (SI) were calculated.(3)After the PET/CT imaging,the lesions were excised.Immunohistochemical staining was used to demonstrate the situation of Glut-1,HIF-1α and CD98.(4)Two-sample t test,Nemenyi test and nonparametric Kruskal-Wallis H test were used for statistical analyses.Results (1) 18 F-FDG and 11 C-MET uptake in C6 glioma were higher than those in different inflammatory tissues(t--1.425-3.901,all P＜0.05).The 11 C-CHO uptake among different lesions were not significant (t =0.031-3.901,all P＞0.05).In group 1 and 5 models,SIMET(4.22±2.96 and 4.89±2.08) was significantly higher than SIFDG(1.77±0.86 and 1.72±0.77;t =2.717and 2.490,both P＜0.05);but iu group 3 models,SIMET(3.84±2.71) was not significantly higher than SIFDG(2.28± 1.14;t =2.082,P＞0.05).(2) Immunohistochemical study showed that there were significant differences in the expression of HIF-1 α,CD98 among different lesions (H =17.810,26.540,both P ＜ 0.05),and no significances of expression of Glut-1 among different lesions (H=5.940,P＞0.05).Nemenyi test showed that there was significant difference for CD98 expression between C6 glioma and acute inflammation,C6 glioma and granuloma (x2=5.504,9.345,both P＜O.05),and for HIF-1α and CD98 expression between C6 glioma and chronic inflammation (x2 =-5.938,2.128,both P＜0.05).Conclusions Compared with 18F-FDG and 11 C-CHO,11 C-MET has better tumor specificity.11 C-CHO PET/CT is not suitable for the differentiation of tumor and inflammation because of its lowest specificity.

Objective To explore the efficacy and safety of greenlight photoselective vaporization of prostate (PVP) in high-risk elder patients with benign prostatic hyperplasia (BPH). Methods A total of 120 high-risk elder patients with BPH underwent PVP procedure. The operating time, blood 1oss, indwelling catheterization and operation-related complications were monitored. The variables such as international prostate symptom score (IPSS), Quality of life (QOL) score, maximum urinary flow rate (Qmax) and residual urine volume (RUV) were recorded and compared pre- and post-operatively. Results All the 120 patients had a good peri-operative condition. The mean operating time was (52. 6 ± 5.8 )min, intraoperative blood loss was (20.4 ±9.5) ml. Among the 120 cases,26 did not received postoperative catheterization. In the other 94 cases received postoperative catheterization, the mean catheterization time was (24. 5 ± 15.9) hour. IPSS and QOL scores decreased from (28.5 ± 3.8) and (5.0 ± 0.8) preoperatively to (7.2 ± 1.8) and (1.5 ± 0.6)postoperatively. Qmax increased from ( 5.2 ± 3.1 ) ml/s to ( 15.2 ± 4.3 ) ml/s, and RUV decreased from ( 118.6 ± 15.2) ml to ( 16. 5 ± 4. 6) ml. There was significant difference for these parameters before and after the operation (Ps ＜ 0. 05 ). Conclusion The PVP is considered to be a safe, effective and minimally invasive procedure to treat BPHin high-risk elder patients. It is easy to manipulate, with advantages of shorter operating time,less blood loss, better tolerance and rapid recovery, especially for high-risk elder patients with BPH.

ObjectiveTo investigate the clinical effect of endoscopic dense ligation in the treatment of esophageal variceal bleeding. MethodsA total of 156 patients who underwent endoscopic ligation for the first time due to esophageal variceal bleeding caused by cirrhotic portal hypertension in Shijiazhuang Fifth Hospital from July 2015 to June 2016 were enrolled, and according to the treatment method, they were divided into dense ligation group with 76 patients and non-dense ligation group with 80 patients. The patients were followed up for 1-2 years, and a statistical analysis was performed for the eradication or disappearance rate of varices, the number of times of ligation, early rebleeding rate, late-onset rebleeding rate, and the incidence rate of adverse reactions. The t-test was used for comparison of continuous data between two groups, and the chi-square test or Fisher′s exact test was used for comparison of categorical data between two groups. ResultsThere were significant differences between the dense ligation group and the non-dense ligation group in the eradication or disappearance rate of varices (71.05% vs 55.00%, χ2=4.300, P=0.038) and number of times of ligation (χ2=8.511, P=0.014), and there were no significant differences between the two groups in early rebleeding rate (5.26% vs 2.50%, P＞0.05), late-onset rebleeding rate (7.89% vs 10.00%, P＞0.05), recurrence rate of varices (13.16% vs 18.75%, P＞0.05), and incidence rate of adverse reactions (26.32% vs 21.25%, P＞0.05). There was a significant difference in the time to recurrence of varices between the two groups (11.90±1.89 months vs 7.07±1.17 months, t=2.295, P=0.031). Of all 156 patients, 2 (1.28%) died during follow-up, with 1 patient in the dense ligation group and 1 in the non-dense ligation group. There was no significant difference in mortality rate between the two groups (P＞0.05). ConclusionEndoscopic dense ligation is a safe technique for the treatment of esophageal variceal bleeding and is better than non-dense ligation in terms of the disappearance rate of varices and number of times of ligation. Endoscopic dense ligation also allows a longer time to recurrence of varices than non-dense ligation.

Objective:To explore the clinical and genetic characteristics of four children with Kabuki syndrome (KS) due to variants of KMT2D gene. Methods:Four children with KS diagnosed at the Children′s Hospital of Shanxi Province between January 2020 and December 2022 were selected as the study subjects. Whole exome sequencing was carried out for the children and their family members. Candidate variants were verified by Sanger sequencing and pathogenicity analysis.Results:The KS phenotype scores for the four children were 7, 8, 6, and 6, respectively. Child 2 also presented with a rare solitary kidney malformation. Genetic testing revealed that all children had harbored novel de novo variants of the KMT2D gene, including c. 16472_16473del, c. 858dup, c. 11899C>T, and c. 12844C>T, respectively. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), all of the variants were classified as pathogenic. Conclusion:For children showing phenotypes such as distinctive facial features, intellectual disability, developmental delay, cardiac abnormalities, and urinary system anomalies, KS should be considered. Early diagnosis and intervention can be achieved through genetic testing, especially in the presence of KMT2D gene mutations.