Acupuncture is an important method to cure diseases in TCM.which has been extensively accepted.Acupuncture manipulation is a key point for good clinical curative effect because different manipulations can bring out different organic reactions.The author summarized clinical experience on acupuncture manipulations for acupuncturists to improve medical effects.

OBJECTIVE:To analyze the factors in the causation of cefradine-induced hematuria.METHODS:The material in CHINESE BIBLIOGRAPHIC DATA BASE OF BIOLOGY & MEDICINE(from 1980 to February 2001)and PHARMACEUTICAL ABSTRACTS(1990～2000)was reviewed and the data were analysed on patients'age and sex,route of drug administration,beginning of hematuria,prognosis and time of recovery.RESULTS:18 reports on cefradine-induced hematuria(108 cases) were found,which indicated that hematuria was mainly associated with renal hypoplasia in childhood and intravenous administration of cefradine.CONCLUSION:Intravenous administration of cefradine in children should be very careful.

Objective To utilize the PBL method for the teaching reform of pedodontics lesson in Zhengzhou University. Methods Dental students of 2004 grade of Zhengzhou University were divided into 2 groups randomly,one group of which were taught with PBL method while the other group with traditional teaching method. The teaching effect was measured with questionnaire survey and examination. Result The PBL method was welcomed by undergraduate students and there was statistical significant difference between the examination scores of the two groups (P

Objective To report the safety and efficacy of partial nephrectomy (PN) in 56 patients with renal tumors. Methods A retrospective analysis was performed for 56 patients who were treated with PN.Patients were divided into two groups according to the occlusion time.The occlusion time for Group 1 was≤30 min in 28 cases,and Group 2＞30 min in 28 cases.All patients underwent pre-and post-operation 99Tcm-diethylenetriamine pentoacetic acid renal scintigraphy, to determine the renal glomerular filtration rate (GFR).The GFR values, amount of blood loss during operation,operative time,postoperative hospital stay and the complications rate were compared between the two groups prior to surgery and one week and six months post-surgery.All patients were followed-up.Results The average follow-up time was 36 (30-48) months.The overall survival rate and tumor recurrence-free survival rate were 100% and 98%.There was no significant difference between vessel clamp time≤30 min and＞30 min in the amount of intraoperative blood loss,operative time,postoperative hospital stay and complications rate,P values were 0.266,0.487,0.879 and 1.000.The preoperative and 1 week postoperative GFR values of the two groups were (42.9±4.9) and (34.2±4.9),(42.8±5.6) and (30.4±5.2) ml/min.The difference was significant(P=0.007).The GFR values were (41.2±4.3)ml/min at 6 months after surgery for Group 1,compared with that before surgery,but the difference was not significant (P＞0.05).While the GFR values were (38.1±5.0) ml/min for Group 2,and the GFR for Group 2 did not recover to the preoperative level (P=0.001). Conelusions PN for renal tumors could be a safe and effective treatment option.The damage on renal function could be minimal when the renal artery clamping time is controlled to within 30 min.

Purpose:To study the pathological and clinical characteristics of different subtypes of cyst-associated renal cell carcinoma and summarize the experience in diagnosis and therapy. Methods:39 cases with cyst-associated renal cell carcinoma underwent urological operations in our hospital from 1991 to 2000. Their medical data were analyzed and then divided into different subtype according to pathological characteristics. Results:The data included 2 patients with renal cell carcinoma on the background of polycystic kidney, 20 cases with renal cell carcinoma originating in a cyst and 17 cases with cystic renal cell carcinoma.3 patients underwent partial nephrectomy and 36 cases unilateral radical nephrectomy.16 patients were Robson stage Ⅰ and 23 were RobsonⅡstage.The pathological diagnosis was 38 cases of clear cell carcinoma and one of chromophobe cell carcinoma. The survival rates at 1,3,5 years are 100%、100%、94.8%(37/39) respectively after follow-up. Conclusions:The cases with renal cyst need periodical health check-up.Most of cyst-associated renal cell carcinomas belong to low stages. Contrast-enhanced computed tomography and selective digital subtraction angiography of renal artery are the main methods for preoperative clinical diagnosis. The long-term effect of operations of cyst-associated renal cell carcinoma is better.

Objective To study the dynamic changes of serum concentration of soluble cell adhesion molecule (sCAM) in patients with aneurysmal subarachnoid hemorrhage.Methods Serum concentrations of sCAM in 30 patients with aneurysmal subarachnoid hemorrhage were detected using ELISA method before surgery and at 1~3 d, 7~9 d and 11~13 d after surgery. Transcranial Doppler sonography was used to measure the velocity of middle cerebral artery (VMCA). The results were compared with 20 healthy controls.Results Serum concentrations of sCAM at 1~3 d and 7~9 d in patient group were significantly higher than that in control group (all P

Objective:To present the learning curve of robotic assisted laparoscopic partial nephrectomy by a single surgeon.Methods:The clinical data of 100 patients with renal tumor who underwent robot assisted laparoscopic partial nephrectomy in Peking Union Medical College Hospital from February 2016 to April 2018 were retrospectively analyzed. There were 64 males and 36 females. The average age was 51.5(18-79) years. The average body mass index (BMI) was 24.9(19-31)kg/m 2. TNM stage was T 1N 0M 0, which indicated partial nephrectomy. The tumors were located on the left in 38 cases and on the right in 62 cases. The average maximum diameter of tumor was 3.9(1.0-6.7) cm, and the average R. E.N.A.L. score was 6.7(4-11). All operations were performed by a single surgeon. This group of operations were the first 100 robot cases for this surgeon. The mean machines docking time was 14(10-30) min, the mean operation time was 119.2(60-240) min, the mean warm ischemia time was 16.7(0-45) min, and the estimated mean blood loss was 105.2(30-500) ml. There was no conversion to open surgery or laparoscopic radical nephrectomy. No serious complications occurred (Dindo calvein grade ≥ grade Ⅲ). There were 1 case of lower extremity intramuscular venous thrombosis, 1 case of urinary fistula, 1 case of pulmonary infection and 1 case of peri-kidney hematoma after operation. All patients were cured after conservative treatment without further operation or intervention. Cumulative Sum (CUSUM) test was used to fit the learning curve of docking time and operation time, and to judge the three different learning stages of robot surgery according to the inflection of the curve (CUSUM stop rising, and CUSUM begin to decline). The characteristics of patients and perioperative data of different learning stages were compared. Result:According to the CUSUM, the learning curve of robot assisted laparoscopic partial nephrectomy was 19 cases. According to the inflection point of operation time learning curve, 100 cases could be divided into three stages, 1st-19th cases were learning stage, 20th-43rd cases were mastering stage and 44th-100th cases are proficient stage. There were no significant differences in age, gender, tumor side, intraoperative bleeding volume, postoperative pathological type, total cost of hospitalization and incidence of complications among the three stages ( P>0.05). The median BMI in the learning stage was significantly lower than that in the mastery stage and the proficiency stage (23 kg/m 2, 26 kg/m 2, 25 kg/m 2, P=0.02). The median docking time(20 min, 12 min, 12 min), median operation time (150 min, 120 min, 100 min) and median warm ischemia time (21 min, 18 min, 15 min)were gradually shortened in the learning stage, mastering stage and proficient stage ( P<0.001). The median length of postoperative hospital stay in mastering stage and proficient stage was shorter than that in learning stage (7 d, 6 d, 6 d, P=0.011). The median maximum diameter of tumor (3.7 cm, 3.9 cm, 4.0 cm)and median R. E.N.A.L. score (6, 7, 7)increased gradually in learning stage, mastering stage and proficient stage, but the difference was not statistically significant( P=0.75, P=0.16). Conclusions:The learning curve of robotic assisted laparoscopic partial nephrectomy for an experienced surgeon is about 19 cases. After the completion of the learning curve, the docking time, operation time, warm ischemia time and postoperative hospital stay of patients can be significantly shortened than the initial period, and more difficult renal tumor operations can be accomplished.

Objective:To investigate the safety and efficacy of domestic Kangduo robotic surgery system in adrenalectomy.Methods:This study summarized the clinical data of patients with adrenal adenoma who were operated by domestic kangduo robot from November 2020 to April 2021. This study was approved by the hospital ethics committee, and the clinical trials of medical devices were filed. Inclusion criteria: age 18-75 years old; all of them in accordance with the indication of adrenalectomy; tumor volume≤6 cm; agree to sign the informed consent, follow the doctor's advice and follow up regularly. Exclusion criteria: patients with ipsilateral upper abdominal surgery history; patients with severe uncontrolled disease or acute infection; patients with cardiovascular and cerebrovascular diseases, blood system diseases and immune system diseases that are not controlled and can not reach the operation standard; pregnant or lactating women. All patients underwent robot assisted adrenalectomy. The general information and perioperative data of the patients were summarized.Results:Five patients were included in this study, including 1 male and 4 female. The average age was 49 (34-61)years old. There were 2 cases on the left and 3 cases on the right. The average diameter of tumor was 2.2 (1.1-3.7) cm. All patients showed adenoma by CT examination. Two cases were diagnosed as primary aldosteronism, one as Cushing's syndrome, and two as nonfunctional adenoma. All the operations were successfully completed in 5 cases, including 4 cases via retroperitoneal approach and 1 case via peritoneal approach. The average docking time was 3.8 (3-6) min, the average operation time was 56.2 (21-92) min, and the average blood loss was 34 (20-50) ml. The postoperative pathology was adrenal cortical adenoma. The average postoperative hospital stay was 3.6 (3-5) days. No postoperative complications occurred in 5 cases. Two patients with primary aldosteronism had hypertension and hypokalemia before operation, and they needed oral antihypertensive drugs to control them. They did not need medication after operation, and their blood pressure and potassium were maintained at normal levels. All patients were followed up for average 1.5(0.5-5.0)months.Conclusions:Domestic robot assisted laparoscopic adrenalectomy has the advantages of few blood loss, short operation time, few complications. It’s a safe and effective operation, but the conclusion needs to be further verified by large sample and multi-center study.

Objective To study the initial experience and outcomes of laparoscopic enucleation with preoperative selective arterial embolization ( PSAE) for the treatment of renal angiomyolipomas. Methods A total of 43 patients with sporadic renal angiomyolipomas from July 2013 to November 2014 underwent laparoscopic nephron-sparing surgery ( NSS) .The patients were divided into either PSAE group ( n =19 ) or non-PSAE group ( n =24 ) .The data of patient demographics, success rate of surgery, perioperative complications rate, operating time ( OT ) , warm ischemia time ( WIT ) , estimated blood loss ( EBL ) , length of hospitalization, kidney estimated glomerular filtration rate (eGFR) and serum creatinine (Scr) level over 3 months, and ipsilateral recurrence were collected and compared between the two groups. Results Enucleation was successful in 100%patients (19/19) of the PSAE group and in 62.5%patients (15/24) of the non-PSAE group,with no significant difference ( Fisher' s test, P=0.105) The EBL was (46.4 ±20.6) ml in the PSAE group, which was significantly less than the non-PSAE group [(89.5 ±30.4) ml, t=-5.287, P=0.000].The OT and WIT were significantly shorter in the PSAE group than those in the non-PSAE group [(90.3 ± 21.1) min vs.(131.7 ±18.6) min, t=-6.831,P=0.000;(9.5 ±5.7) min vs.(24.2 ±4.8) min, t=-9.181, P=0.000]. The length of hospitalization was significantly longer in the PSAE group than that in the non-PSAE group [(7.7 ±1.1) d vs.(6.3 ± 1.3) d, t=3.748, P=0.000].No severe complications occurred in the PSAE group, whereas the non-PSAE group had 1 case of urinary leakage and 1 case of hematoma.The Scr level over 3 months after surgery was more ideal in the PSAE group [(70.1 ±13.7)μmol/L vs.(84.2 ±9.1) μmol/L, t=-4.045, P=0.000].No statistically significant difference was found in the eGFR between the PSAE group and the non-PSAE group [(72.6 ±12.8) ml· min-1· 1.73 m-2 vs.(68.0 ±10.7) ml· min-1· 1.73 m-2, t=1.284, P=0.206].No evidence of recurrence was found during follow-up period in both groups. Conclusions Laparoscopic enucleation with PSAE is a safe and effective minimally invasive procedure for the treatment of renal angiomyolipomas.As compared to traditional laparoscopic partial nephrectomy, it has advantages of less WIT, less EBL, and better protection of renal functions.It can be recommended in well-selected patients.

6 cm AVMs(57.1%)were much higher than that with 0.05).Seizure was found in forty-three patients.After embolization the seizure in 20 patients disappeared,11 patients had been improved greatly.The total effective power was 72.1%.Conclusions The size and location of AVM is significantly associated with the onset of seizure.The number of feeding artery has no relation with the seizure.Endovascular embolization for the AVMs has got better cure effect.