Objective: To explore the effect of therapeutic application of pneumatic ballistic lithotripsy under percutaneous nephroscope ultrasound and holmium laser lithotripsy for complex kidney stone. Methods: 124 patients with complex renal calculus were selected and divided into observation group (62 cases) and control group (62 cases) as randomly number table. The patients of observation group were cured by pneumatic ballistic lithotripsy under percutaneous nephroscope ultrasound while patients of control group were cured by holmium laser lithotripsy. A series of correlative indicators, such as some correlative indexes in during and post operation, complication situation of post operation and kidney function, were compared. Results:The differences about bleeding volume during operation and postoperative hospital stay between the two groups were significant (t=12.475, t=7.659, P<0.05). For clearance rate of calculus and incidence of complication, the differences between the two groups were significant (x2=6.048, x2=7.159, P<0.05). And the differences of separation index of renal pelvis collective system, creatinine and urea nitrogen post treatment between the two groups also were significant (t=8.529, t=7.058, t=10.596, P<0.05). Conclusion: Comparing with the traditional holmium laser lithotripsy, the clinical better effect of pneumatic ballistic lithotripsy under percutaneous nephroscope ultrasound for complex renal calculi is significant. Its series of advantages, such as shorter operation time, faster recovery, safer and reliable for patients and lower incidence of postoperative complication and so on, can effectively relieve the renal function for patients.

Purpose:To summarize the experences of treating malignant obstructive jaun- dice by percutaneous transhepatic drainage of the bile duct,as well as discussing its clinical effect and practical value.Materials and Methods:Among the 39 patients who were all unsuitable for sur- gical operations,5 were benign,34 were malignant.All patients underwent percutaneous transhep- atic puncture of bile duct.38 cases who were successfully aspirated continued to undergone canal- ization of the obstructive parts 28 be finally successful.Among these patients,metallic stents were placed in 17 cases,balloon dilation in 2 cases,canalization with multi-side-hole catheter in 9 patients.Only external biliary drainage were performed in 10 patients.Results:All of there canal- ization method effected well in verious degrees,but the best result was obtained in the metallic stents group.Conclusion:(1)There is less injury and complication in percutaneous transhepatic drainage,either external or antegrade biliary drainage,and it ts also easy to operate,Interventional treatment is the first choice for patients who suffered from benign or malignant obstructive jaundice unahe undergone surgical operation(2)All the methods amend with each other,but the placement of metallic stent is the best one.

OBJECTIVE: To study the clinical and pathological features of pilomatricoma. METHOD: The authors retrospectively investigated the clinical and pathological materials of 399 patients with pilomatricoma. RESULT: Single lesion occurred in most patients (99%) and 56.39% of them were younger than 30 years. The male-female ratio was 1:1.33. The lesions which sizes average 1.22 cm were commonly emerged in the head, neck, and upper extremity. CONCLUSION Pilomatricoma is a slowly developed benign cutaneous tumour, but it can aggravate sometimes. It's manifestation is diversed and easily misdiagnosed. Early complete excision is recommended for hard or tenacious nodules on head, neck and upper extremity.
Adult ; Extremities ; Female ; Hair Diseases ; pathology ; surgery ; Head and Neck Neoplasms ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Pilomatrixoma ; pathology ; surgery ; Retrospective Studies ; Skin Neoplasms ; pathology ; surgery ; Tumor Burden

OBJECTIVETo evaluate the clinical value of various kinds of interventional techniques in the treatment of Budd-Chiari syndrome (BCS).

METHODSMultiple techniques such as recanalization of the inferior vena cava (IVC) under the guidance of marker and multi-angled fluoroscopy, recanalization of the hepatic vein with a transjugular approach, PTA, Z-expandable metallic stent (Z-EMS) implantation and modified TIPSS were used to treat 103 patients with BCS.

RESULTSOf 103 patients with BCS, 59 patients with obstruction of IVC were treated using recanalization of IVC. Seventeen patients with hepatic vein obstruction had their hepatic veins recanalized. The rest of the patients were given other methods of interventional treatment. Of all the subjects, 101 successfully underwent their procedures, with a success rate of 98.06%; and only 2 failed to recanalization of the IVC. Fifty-three patients were treated using PTA for the first time, with a success rate of 100%. In the 48 patients undergoing Z-EMS implantation for the first time, the success rate was 95.8%. Five patients were treated with modified TIPSS. After these interventional treatments, the success rate was 100%. Two patients died 16 h and 72 h respectively after operation because of DIC and severe hemoptysis. Seventy-two patients were followed up for 1 - 94 months (with a mean of 42.3 months). The mean follow-up of a BCS patient treated with PTA was 52.1 months, resulting in a primary patent rate of 59.4% and a restenosis rate of 40.6%. The mean follow-up of BCS treated with stenting was 33.5 months, with a primary patent rate of 87.5% and a restenosis rate of 12.5%. Eight patients died 7 - 64 months after the interventional procedure.

CONCLUSIONRecanalization of IVC or the hepatic vein transjugularly, PTA, Z-EMS implantation and modified TIPSS can be regarded as safe and effective micro-invasive methods in the treatment of BCS.

Adolescent ; Adult ; Angioplasty, Balloon ; Budd-Chiari Syndrome ; therapy ; Female ; Hepatic Veins ; surgery ; Humans ; Male ; Middle Aged ; Portasystemic Shunt, Transjugular Intrahepatic ; Stents ; Vena Cava, Inferior ; surgery

OBJECTIVETo evaluate the diagnostic value of portable monitor device (PMD) in potential obstructive sleep apnea hypopnea syndrome (OSAHS) patients.

METHODSAll patients met the inclusion criteria were asked to finish the questionniar and underwent anthropometric measurements, and then completed polysomnography (PSG) test and PMD test simultaneously. The correlation between AHI-PMD and AHI-PSG, between MinSaO2-PMD and MinSaO2-PSG were analyzed by Spearman analysis. T test was used to compare the correlation coefficient between the two groups; ROC analysis was used to evaluate the sensitivity and specificity of PMD in diagnosis of OSAHS, and got the Cut-off value between moderate and severe OSAHS and mild OSAHS.

RESULTSThrough PSG test, of all the 111 cases, including 4 simple snoring cases, accounting for 3.6%, OSAHS patients with 107 cases, accounting for 96.4% which including 11 patients (9.9%) with mild, 17 patients (15.3%) with moderate, 79 patients (71.2%) with severe. The correlation of AHI-PMD and AHI-PSG between moderate and severe OSAHS patients was stronger than simple snoring and mild OSAHS patients. The coefficient test between the two groups was statistically significant (P=0.026). The correlation of MinSaO2-PMD and MinSaO2-PSG was statistically significant (P<0.001), the correlation of MinSaO2-PMD and MinSaO2-PSG between moderate and severe OSAHS group and snoring and mild OSAHS group was not statistically significant (P=0.270). A statistically significant correlation between AHI-PMD and AHI-PSG was found (P<0.001). PMD had a sensitivity and specificity of 96.9% and 86.7%, respectively (AUC=0.990, 95%CI 0.970-1.000). The cut-off value between moderate and severe OSAHS and mild OSAHS was AHI-PMD≥12 times/h.

CONCLUSIONPMD had a satisfactory sensitivity and specificity for diagnosing and judging the severity of moderate and severe OSAHS.

Humans ; Monitoring, Physiologic ; instrumentation ; Polysomnography ; ROC Curve ; Sensitivity and Specificity ; Sleep Apnea, Obstructive ; diagnosis ; Snoring