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 observe dynamic responsive regularity of specific IgM and IgG antibodies in SARS patients. Methods 145 specimens of plasma from 25 cases of clinically diagnosed SARS patients were examined in the study. ELISA was employed to detect IgM and IgG antibodies against SARS coronaviral antigens. Nested RT-PCR was used to qualitatively determine SARS coronavirus (SARS-CoV). Results 49.0% (71/145) and 54.5% (79/145) of the samples were positive for IgM and IgG antibodies, respectively. Both antibodies were found to be detected in 84.0% of the patients. The antibodies were found to be detectable from the 2nd to 4th week after the onset of disease in most patients, and there was a fendeney of sising in positive rate until the 5th week after the onset. Thereafter, the detectable rate of IgM antibody began to decline, while that of IgG antibody remained to rise. Positive rate for serum SARS-CoV was 15.8% (18/114) for all samples or 40.0% (10/25) of patients. Most virus-positive samples were those which were collected within 4 weeks after disease onset. Conclusions Anti-SARS-CoV IgM/IgG antibody and detection of virus in plasma could serve as practical diagnostic indicators for SARS. In most cases, when the serum was pasitive for antibody the serum virus positive rate would soon declined. However, concomitant existence of antibody and viral sequence in plasma was observed in a few patients.

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

Objective: To explore the feasibility and safety of comprehensive staging surgery via laparoscopic operation and its clinical significance. Methods: A retrospective analysis of medical records was conducted in 35 inpatients diagnosed of ovarian cancer (stage I, n = 29; stage II, n = 4; stage III, n = 2) in Department of Gynecology of Fourth Hospital of Hebei Medical University between January 2010 and January 2013. Of the 35 patients, 15 underwent comprehensive staging operation via laparoscopic operation and 20 via open operation. The general conditions during and after operation and the postoperative survival were observed and compared between the two groups. Results: All operations completed successfully in 15 patients in the laparoscopic operation group, and no perioperative complications were observed. The intraoperative blood loss and the rate of postoperative analgesia in the laparoscopic operation group were both less than those in the open operation group (P < 0.05), but the differences in duration of operation, number of abdominal and pelvic lymph nodes resected, recovery time of gastrointestinal function, rate of postoperative complications, rate of postoperative recurrence, rate of increase in pathological stage, hospitalization expenses, duration of hospital stay after operation and the rate of chemotherapy after operation were not statistically significant between the two groups (P > 0.05). There was also no significant difference in the cumulative survival rate between the two groups (P > 0.05). Conclusion: Comprehensive staging operation for ovarian cancer especially for early-stage cancer is feasible and safe. It has the merits of smaller wound, less blood loss during the operation and more rapid recovery. Copyright© 2014 by TUMOR.

Objective To evaluate the safety and effectiveness of immunosuppression regimens,postoperative complications,dead causes and risk factors of lung transplantation (LTx).Methods The immunosuppression regimens and clinical data of 100 patients with end-stage lung diseases receiving LTx in our hospital were retrospectively analyzed between Sept.2002 to Dec.2010.There were 72 patients subject to single LTx and 28 patients to bilateral LTx,amongst them 61 patients received LTx under circulation support,including 5 cases of cardopulmonary bypass (CPB) support and 56 cases of extracorporeal membrane oxygenation (ECMO) support.The immunosuppression regimens including Cyclosporin,mycophemolate Mofeil and corticosteroids were utilized in 53 recipients before the year of 2007,and Cyclosporin was switched to Tacrolimus in 47 patients after 2007.All the patients received Daclizumab or Basiliximab as immunosuppression induction regimens.Results The 1-,2-,3-and 5-year survival rate after LTx was 73.3％,61.6％,53.5％ and 40.7％ respectively.The mean survival time post-transplant in the patients who received Cyclosporin-based regimens and Tacrolimus-based regimens were (36.57 ± 3.44) months and (35.00 ± 2.33) months,repectively,with no significant differences (P＞0.05).The main causes of mortality included primary graft dysfunction (PGD),acute rejection (AR),bronchiolitis obliterans (BOS) and sepsis.The incidence of AR and BOS in Tacrolimus group was significantly lower than that in Cyclosporin grou (P ＜0.05),but the incidence of diabetes mellitus was significantly higher in Tacrolimus group.Analysis of Spearman rank correlation revealed that there was a direct correlation between the incidence of AR and BOS (r =0.340,P＜0.01).The use of circulation support,diagnosis of IPF,postoperative complications such as AR,BOS and infection were associated with decreased survival time postoperatively,in both univariate and multivariate proportional hazards regression models (P＜0.05).Conclusion Cyclosporin-and Tacrolimus-based regimens were both effective immunosuppression strategies postoperatively,Consummate follow-up surveillance and prompt treatment of complications were the key points in prolongation of survival time and improving quality of life after LTx.

This article analyzed the types and causes of clinical research misconduct including the definition and background.We then set up the research management system to control and prevent such misconduct behavior.Our strategy includes using various technical tools to actively carry out clinical research integrity related education and training program,establishing integrated control model,and clinical research misconduct handling mechanism to jointly cope with the problems,to promote a good atmosphere for clinical research and to establish the integrity of the research.Our goal is to promote the medical technology development and to improve the patient care.

Specialization development of nursing has increasing demand for nursing staff. Competency model is a professional way for the person-post matching, which may replace the job analysis as a new research direction in nursing human resource management. In this paper, the validation and application of nursing competency model were reviewed from the perspectives of competency model, to discuss the thought and method of verifying competency model, so as to lay the foundation for the clinical application of nursing competency model, and promote the rapid development of nursing.

Objective To evaluate the charateristics of biliary stricture after orthotopic liver transplantation(OLT) by ultrasound. Methods Diametes,thickness,characteristic echo of bile were observed by ultrasound in 41 patients with biliary stricture after OLT,and the results were compared with those of 46 patients without biliary complication after OLT.Results The diameter of intrahepatic bile,thickness of bile,incidence of intrahepatic bile dilation or hyperechogenicity in biliary stricture patiens were higher than those in patients without biliary complication,there were significant differences between two groups(P＜0.05).Conclusions The series of ultrasonographic character such as bile dilation,thickeness or hyperechogenicity of biliary wall,thin of bile duct are available to diagnose biliary stricture.