Objective To study the key points and preliminary experience in the application of laparoscopic pelvilithotomy combined with percutaneous nephrolithotomy(PCNL)surgery in multiple renal calculi. Methods Eight patients,accepted laparoscopic pelvilithotomy combined with PCNL surgery in our hospital from January 2008to December 2009,were enrolled into the study. Retroperitoneal approach were performed in all operations. The biggest stone was 3.3 cm ×2.3 cm,the smallest one was 0.5 cm ×0.5 cm. All patients had renal pelvis cast stone along with multiple small renal calyceal stones. The stones were removed under laparoscopic operation at the first step. If it was difficult to remove the pelvis cast stone,nephroscope were settled into the pelvis through incision,and then the shattered stone smashed by lithotripsy were removed under the observation of nephroscope. Further exploration and removal of the remaining stones in every calices was necessary for the patients. Results The operations were successful in all cases and all stones were removed thoroughly and get satisfactory effects. The average operation time was 90 minutes. No serious complications happened,such as bleeding,urine leakage or ureteral stricture. The average length of hospital stay was 5 days. Conclusions Our treatment combines the advantages of both laparoscopic pelvilithotomy and percutaneous nephrolithotomy to reduce the incidence of complications and improve the therapeutic effects.

Circular RNA (circRNA) is a widely present endogenous noncoding RNA that is covalently bonded at the 3' and 5' ends via trans-splicing to form a closed-loop structure with high stability, biological evolutionary conservatism,and tissue expression specificity. CircRNA has important biological functions, such as playing the role of microRNA (miRNA) sponge, regulating the expression of a par-ent gene, and improving transcription and translation levels. In gastrointestinal tumor, circRNA mainly plays the role of miRNA sponge, which affects the proliferation, differentiation, apoptosis, and invasion of cancer cells. In addition, circRNA was specifically expressed in the tumor, and the expression level significantly differs from that of paracancer. Therefore, a highly conserved and stable circRNA se-quence is expected to be an early diagnosis and prognostic marker for gastrointestinal tumor. In this study, we review research advanc-es on circRNA and its relationship with gastrointestinal cancers (esophageal, gastric, colorectal, and liver cancers).

Objective To investigate the performance of MicroScan WalkAway 96 Plus (MSW) system in detection of carbapenem-resistant Enterobacteriaceae (CRE).Methods A total of 81 stock CRE strains were used in this study. Bacterial identification and antimicrobial susceptibility test were performed by MSW system. Beta-lactamases genes blaKPC,blaIMP,blaVIM, blaOXA-48 and blaNDM were amplified by PCR and subjected to sequencing analysis. Disk diffusion method and PCR were used as gold standard to evaluate the performance and reliability of MSW system in identifying carbapenem-resistant and carbapenemase-producing Enterobacteriaceae.Results Overall, 69.1 % (56/81) of the Enterobacteriaceae strains were identified as CRE by the MSW system. The results of PCR showed that 48 strains were carbapenemase-producing Enterobacteriaceae. When carbapenemase-producing Enterobacteriaceae strains were identified by the instrument using an advanced expert system, the sensitivity was 93.8 % and specificity was 42.4 %. The positive predictive value was 70.3 %, the negative predictive value was 82.4 % and the predictive accuracy value was 72.8 %.Conclusions The MicroScan WalkAway 96 Plus system has shown good performance in detection of CRE.

Objective To investigate the risk factors,clinical and coronary angiographic characteristics in women less than 50 years with coronary heart disease(CHD).Methods One hundred and twenty-six women less than 50 years were divided into CHD group and non-CHD group according to the result of coronary angiography(CAG).Risk factors,clinical and coronary angiographic characteristics were investigated retrospectively.Results In 6395 cases who were given CAG in the corresponding time period,126(1197%)women were less than 50 years,and 44 cases were confirmed as having CHD by CAG[CHD group,mean age(46.8±3.6)years)].Meanwhile 82 cases were in non-CHD group[mean age(45.4±4.3)years)].The incidence rate of hypertension[77.3%(34/44)vs 26.8%(22/82)],diabetes mellitus[34.1%(15/44)vs 4.9%(4/82)],hyperlipidemia[43.2%(19/44)vs 7.3%(6/82)],family history of CHD[43.2%(19/44)vs 7.3%(6/82)],and risk factors of family history of CHD[52.3%(23/44)vs 12.2%(10/82)]had significant difference between CHD group and non-CHD group(P<0.01).88.6%(39/44)CHD palients were acute coronary syndrome,50.0%(20/44)lesion was one-vessel lesion.Left anterior descending coronary was involved most easily.The degree of calcification was lighter.The type.of lesion was mostly localized and segmented.Conclusions Hypertension,hypedipidemia,diabetes mellitus,family history of CHD,and risk factors of family history of CHD are the major risk faetom in women less than 50 years with CHD. The possibility of CHD is higher when having classical angina and multiple risk faetom.

No abstract available.
China* ; Escherichia coli* ; Escherichia* ; Prevalence*

Objective To explore the effect of selective beta-1 adrenoreceptor blocker on exercise tolerance in patients with hyperten-sion. Methods From May, 2015 to May, 2016, 72 patients with hypertension were divided into two groups, according to whether taking the selective beta-1 receptor blocker. Group A (n=35) took the selective beta-1 receptor blocker two weeks before cardiopulmonary exercise, while group B (n=37) did not take anything at the same time. The exercise tolerance was compared between two groups. Results The maxi-mal systolic blood pressure, peak heart rate, one-minute heart rate after exercise (HR1) and rate-pressure product were lower in group A than in group B (t>2.012, P<0.05), however, the recovery value of HR1 was higher in group A than in group B (t=2.100, P<0.05). There was no difference in both peak power and peak oxygen uptake between two groups (t<0.689, P>0.05). Conclusion The selective beta-1 adrenore-ceptor blocker could reduce myocardial oxygen consumption, and improve vagus nerve activity, but did not reduce exercise tolerance in pa-tients with hypertension.

Objective To analyze the molecular characteristics of qnrS-positive Escherichia coli ( E. coli) strains resistant to quinolone. Methods A total of 57 qnrS1-positive clinical isolates were collect-ed from Fujian Medical University Union Hospital. Plasmid-mediated quinolone resistance ( PMQR) genes [qnrA, qnrB, qnrC, qnrD, aac(6′)-Ib-cr, qepA and oqxAB] andβ-lactamase genes (blaCTX-M-1, blaCTX-M-2, blaCTX-M-8 , blaCTX-M-9 , blaSHV and blaTEM ) were detected by PCR and then sequenced. Agar dilution method was used to analyze the antimicrobial susceptibility of the qnrS1-positive strains. Phylogenetic analysis was conducted using PCR. Multilocus sequence typing ( MLST) was performed for phenotyping. Enterobacterial repetitive intergenic consensus-polymerase chain reaction ( ERIC-PCR) was used to evaluate the genetic sim-ilarity between those isolates. Transferability of the qnrS1 genes carried by the 57 strains was examined by conjugation test with the sodiumazide-resistant E. coli J53 as the recipient strain. Mutations in the quinolone resistance-determining regions ( QRDR) in those strains were analyzed by PCR. Results All of the qnrS1-positive E. coli strains showed high resistance to quinolones. PMQR genes were harbored by 14 (24. 6％) isolates. Extended spectrum β-lactamases (ESBLs)-producing isolates accounted for 68. 4％. Mutations in the QRDR of gyrA, gyrB, parC and parE genes were found in 56 (98. 2％) strains and the most frequent point mutations were S83L (89. 5％) in gyrA gene, S80I (54. 4％) in parC gene and P415V (28. 1％) in parE gene. The qnrS1 gene was successful transferred from 13 (22. 8％) isolates to E. coli J53 by conjuga-tion. Five plasmid incompatibility groups were detected. Phylogenetic analysis showed that there were 36 (63. 2％), 13 (22. 8％), 1 (1. 8％) and 7 (12. 3％) isolates belonging to groups A, B1, B2 and D, respectively. The 57 qnrS1-positive E. coli strains were assigned to 50 ERIC types and 39 sequence types ( ST) based on the results of ERIC-PCR and MLST. Conclusions Mutations in the QRDR in E. coli strains were associated with qnrS1 gene and might play a critical role in the dissemination of quinolone-resistant bacteria.

Objective To discuss the application effect of nurser ’ stress management in clinical nursing.Methods We selected 100 nurses and they were randomly divided into observation group (n=50) and control group (n=50).In control group, nurses were asked to deal with the job stress by the traditional way of self-regulation, while in observation group , stress management was used to improve the situation by the method of the specific psychological health training , which would assist the nurses to build up the mental response mechanism and the strategic thinking of seeking for help .Meanwhile , stress management training for the head nurses was arranged and stress management center was built , the education for the nurses was operated . Compared the nursing quality of two groups .Results The incidence of nursing risk and defects , physical and mental illness of observation group was lower the control group , the differences were statistically significant (2.0%vs 16.0%,34.0% vs 78.0%;P<0.05).At the same time, the self-satisfaction of the nurses, the satisfaction from nursing service recipients , leaders of the hospital and cooperation partners in observation group was higher than that in control group , the differences were statistically significant (96.0%vs 76.0%,72.0%vs 40.0%,100.0%vs 80.0%;P<0.05).Conclusions Stress management of nurses is observationly verified to be useful for decreasing the incidence of nursing risk, defects, disputes and physical and mental illness of the nurses, and increasing the self-satisfaction of the nurses , as well as the satisfaction from nursing service recipients, leaders of the hospital and cooperation partners .

One of critical technologies in a non-invasive positive airway pressure respirator is to output the airflow for meeting the requirement of respiratory patient in breath. In order to develop a safe and reliable blower driving system, a circuit based on the special chips MC33035 and MC33039 was designed. The linear relationship between the input control voltage and the output air flow was achieved. This designed circuit will be embedded in the non-invasive ventilator system as a module. And based on this circuit, the secure and controllable ventilation flow can be performed.
Humans ; Lung ; Respiration ; Ventilators, Mechanical