Objective To investigate the efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL) for impacted upper ureteric calculi.Methods Retro-urethral catheterization was conducted in the diseased ureter under cyctoscope.After a channel from the skin surface into the middle calyx was established under the guidance of X-ray or B ultrasonography,pneumatic lithotripsy was conducted to break up stones under ureteroscopy.Results The success rate of pneumatic lithotripsy was 100%.The rate of postoperative macroscopic hematuria was 55.1%(27/49).The symptom lasted one to three days in 26 cases,and 1 case had apparent hematuria with blood clot flowing out from nephrostomy tube,which lasted 8 days.10.2%(5/49) of cases was complicated with postoperative pyrexia.The stone-free rate in one week and one month postoperatively was 93.9%(46/49) 98.0%(48/49),respectively.Follow-up observations in 49 cases for 1-12 months(mean,5 months) showed no major complications.Conclusions MPCNL for impacted upper ureteral calculi has the advantages of simple performance,less complications and satisfactory efficacy.

Objective To detect the changes of renal hemodynamics, radionuclide renal dynamic imagings were performed in patients with type 2 diabetes millitus (DM) in different stage. Methods Fifty seven patients with type 2 DM were divided into 3 groups according to the value of urinary albumin excretion rate (UAER). (1)GroupDM1:UAER200 ?g/min, 20 cases. 99m Tc DTPA and 99m Tc EC renal dynamic imagings were performed in the type 2 DM patients of 3 groups and 20 normal controls (NC). Glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and renogramweregainedsimultaneously.Results GFR and ERPF were significantly increased in group DM1 than those in NC (P

ObjectiveTo investigate the role of vascular endotheliar growth factor(VEGF),chemokine receptor 4(CXCR4) and stromal cell-derived factor-1(SDF-1) in Wilms tumor as well as their relationship with clinical features by examining the expressions of VEGF,CXCR4 and SDF-1.MethodsThirty cases of Wilms tumor samples and 12 cases of adjacent kidney tissue were collected from the First and the Third Affiliated Hospital of Zhengzhou University from May 2003 to May 2008.Thirteen boys and 17 girls aging from 4 months to 7 years old of whom were 22 favorable histologic types and 8 unfavorable histologic types.By means of cytoplasm to dye buffy for masculine cell,staining intensity and percentage of positive tumor cells serve as the judgment criteria for being positive or negative.All tissues would be tested by hematoxylin and eosin stain at the same time.ResultsThe positive expression rate of VEGF,CXCR4 and SDF-1 in Wilms tumor were 63.33%,70.0% and 53.33%.Those in adjacent normal kidney tissue were 25.0%,8.3% and 16.7%.The 2 groups were statistically significant(Pa

Objective: To analyze the influencing factors for anterior tibial artery atherosclerosis among patients with hyperuricemia, so as to provide insights into the prevention of anterior tibial artery atherosclerosis. Methods: Patients aged 18 years and older with hyperuricemia in Dazhou Integrated TCM & Western Medicine Hospital were enrolled as research subjects from 2020 to 2023. Demographic information and blood biochemistry indicators were collected through electronic medical records. Anterior tibial artery atherosclerosis was evaluated by color Doppler ultrasound. Factors affecting anterior tibial artery atherosclerosis among patients with hyperuricemia were analyzed by a multivariable logistic regression model. Results: A total of 1 105 patients with hyperuricemia were surveyed, including 862 males (78.01%) and 243 females (21.99%). There were 918 cases (83.08%) at the ages of 60 years and older, and 457 cases (41.36%) with a course of disease at 10 years and longer. The median level of blood uric acid was 480.79 (interquartile range, 98.28) μmol/L. There were 314 cases (28.42%) with anterior tibial artery atherosclerosis. Multivariable logistic regression analysis showed that body mass index (≥24.0 kg/m2, OR=1.597, 95%CI: 1.185-2.151), long-term smoking history (yes, OR=1.709, 95%CI: 1.153-2.534), diabetes mellitus (yes, OR=1.517, 95%CI: 1.162-1.981), serum uric acid (≥480.79 μmol/L, OR=1.667, 95%CI: 1.131-2.457), serum creatinine (≥97 μmol/L, OR=1.685, 95%CI: 1.155-2.460), fasting blood glucose (≥6.1 mmol/L, OR=1.528, 95%CI: 1.106-2.112), fibrinogen (>4 g/L, OR=1.589, 95%CI: 1.091-2.315) and triglycerides (≥1.7 mmol/L, OR=1.879, 95%CI: 1.226-2.881) were influencing factors for anterior tibial artery atherosclerosis among patients with hyperuricemia. Conclusion Anterior tibial artery atherosclerosis among patients with hyperuricemia is associated with long-term smoking, diabetes mellitus, serum uric acid, serum creatinine, fasting blood glucose, fibrinogen and triglycerides high level.

Objective: To discuss the rational drug application of Kawasaki disease in children with upper respiratory tract infection in order to provide reference for the therapy of Kawasaki disease suspected of bacterial meningitis.Methods: The medical record of a 2-year-old boy with Kawasaki disease was retrospectively analyzed, and the anti-infection treatment was analyzed and evaluated.Meanwhile, the mechanism of elevated leukocyte count in cerebrospinal fluid (CSF)of children with incomplete Kawasaki disease was discussed.The pharmaceutical care and treatment results in the diagnosis and treatment process were analyzed as well.Results: The anti-infective therapy in early stage was reasonable as the early symptoms of respiratory tract infection in the child were obvious, however, the choice of aztreonam was defective.On the premise of the clinical diagnosis of Kawasaki disease and excluding bacterial meningitis, the medication was timely adjusted.Finally, the symptoms of the child were improved.Conclusion: The application of anti-infection drugs should be reasonable in clinics, and the abnormality in cerebrospinal fluid should be paid more attention in children with Kawasaki disease.It is necessary to strengthen clinical observation and pharmaceutical care in order to guarantee the safety of medication for patients.

0.05), but there were significant differences after the operation (P

Objective To explore the related prognostic factors of the patients with thyroid microcarcinoma.Methods Clinical data,including clinical,pathologic,and therapeutic factor of 203 patients with thyroid microcarcinoma admitted were analyzed retrospectively.Results The cause specific survival and locoregional failure free survival rates at 10 years were 100.0% and 91.4% , respectively.Univariate analysis showed that multifocality, cervical lymph node metastasis and radioiodine treatment was associated with prognosis.Multivariate analysis revealed that cervical lymph node metastasis was the only independent prognostic factor for locoregional failure free survival.The risk of locoregional recurrence increased 2.5 folds when lymph nodes metastasis occurred at presentation.Conclusion The ratio of thyroid microcarcinoma to thyroid carcinoma increased yearly and the overall survival rate of thyroid microcarcinoma was excellent.Of all the prognostic factors,lymph node metastasis was the most important one related to survival.

Objective To explore the incidence rate and the risk factors of deep vein thrombosis (DVT) in patients with traumatic fractures so as to provide references for prevention of DVT.Methods All of 534 Patients with fresh four extremities or pelvic fracture between January 2010 and December 2013 were involved in this study.The incidence of DVT under 5 risk factors including general state, injury type, fracture condition, operation and laboratory examination were analyzed.Each patient underwent three Doppler ultrasound exams in actions as the epidemiology diagnostic criterion for DVT.Results The total incidence rate of DVT in 534 patients was 11.99％.The univariate analysis showed that male patients with age≥60 years, BMI≥25 kg/m2, history of smoking, lack of exercises, history of diabetes, hypertension and coronary artery disease had higher incidence rate of DVT.In different injury types, the fall injury caused the highest incidence rate of DVT (45.71％).There were different DVT rates for different fracture sites, with the highest incidence rate of DVT for femur shaft fracture (20.69％).The incidence rate of DVT was 50.00％ for fractures of more than three parts, 15.29％ for fractures of two parts and only 3.98％ for sole part.The incidence rate of DVT for comminuted fractures was higher than others.The operation duration, massive transfusion during operation and general anesthesia were related with the increase of incidence of DVT.Positive ACA and enhancement of D-dimer, Fib and CRP were related with the increase of incidence of DVT.Conclusion The incidence of DVT in patients with traumatic fractures approaches a considerable level.It has relationships with age≥60 years, BMI≥25 kg/m2, history of smoking, fall injury, fracture of femoral shaft and hip, more than three parts of fractures, comminuted fractures, operation duration≥2 hours, largely blood transfused, massive transfusion during operation, general anesthesia, positive ACA, enhancement of D-dimer, Fib and CRP.The surgeons should recognize the importance to prevent DVT and PE in the traumatic patients.

Objective By analyzing the clinical and radiographic manifestations of calcium pyrophosphate deposition disease (CPDD) to improve the recognization of the disease.Methods Clinical features,diagnosis and treatment of an old female patient with CPDD was reported with literature review.Results An old female patient presented with swollen and pain on the right knee without obvious causes eight years ago,which was characterized by slightly reddness of joint surface,warm of local skin.Thcn she gradually developed swollen and pain in left knee,right ankle,both wrists,bilateral meta-carpophalangeal (MCPJ) and right elbow joints with few joint symptoms and the joints swollen and pain could relieved spontaneouslyitself in about one week.X-ray showed the thin strip of cartilage calcifications in wrist triangular fibrocartilage disc,meniscus of knee and the pubic symphysis were parallel to the surface of cartilage.Examination of microscopy with refractive filter demonstrated that short rod crystals refraction in joint fluid.CPDD was diagnosed and treated with flushing of joint cavity and injections of betamethasone as well as nonsteroidal anti-inflammatory drug orally.Symptoms relieved after therapy.Conclusion Understanding the disease characteristics of CPDD is beneficial to for accurate diagnosis and treatment.

Objective To observe the protective effect of meicha protein on the heart of spontaneously hypertensive rats(SHR),and explore its mechanism.Methods Fourty healthy SHR rats were randomly divided into 4 groups:model control group,Meicha protein low dose group(70 mg·kg-1)、Meicha protein high dose group(140 mg·kg-1),Compound Kendir Leaves Tablets group(50 mg·kg-1),n=10.The rats were orally administered twice daily by gavage for seven weeks,measuring blood pressure in each group fort nightly.1 h after the last administration,drawing off the blood from carotid,stripping off the heart tissue,and the organ index was calculated;Taking a part of the tissue with 4% paraformaldehyde for Pathological histology.Detection of serum NO,ET-1 levels as well as the organization of the ACE and Ang II mRNA expression to explore the mechanism of its buck.Results Meicha protein could significantly reduce the blood pressure of SHR;The impact on the rat organ coefficient was not obvious,but had a protective effect on heart tissue.Compared with the model control group,the contents of NO an ET-1 were significantly increased(P<0.01).Compared with the model group,the high dose of Meicha protein could induce ACE,AngⅡ,CYP11B2.The expression of mRNA was significantly decreased(P<0.01).Conclusion The possible mechanism of Meicha protein antihypertensionis relevant to increase the content of NO in serum,reduce the content of ET-1 in serum,reduce mRNA expression of ACE and AngⅡin cardiac tissue.