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 compare the safety and clinical effect of laparoscopic partial nephrectomy ( LPN) on small renal cell carcino-ma. Methods The records of 65 patients who underwent partial nephrectomy in our hospital from March 2008 to March 2013 were retrospec-tively analyzed. 35 patients were given open partial nephrectomy and the other 30 patients were given LPN. Compared the operative time,blood loss,warm ischemia time,length of stay,positive marginrate,and occurance rate of complications between the two groups. Results There was no statistical difference in the mean size of tumor in the two groups. Compared to the OPN group,there was less blood loss,operative time, hospital stays and warm ischemia time in the LPN group. There was neither positive surgical margin nor renal function damage in the two groups. And during the follow-up period ranged from 6 to 18 months,there was no local recurrence. Conclusion Laparoscopic partial ne-phrectomy has a shorter operation time,less blood loss,shorter length of hospital stay compared with open partial nephrectomy,and it wouldn 't extend the time of warm ischemia,while the clinical effect of the two methods are similar.

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

Objective To analyze and summarize the clinical manifestations,diagnosis and treatment of patients with primary limitations bladder amyloidosis. Methods Combined with literature,the clinical data of l patient of primary localized amyloidosis of urinary bladder in our hospital was analyzed. Results Histological examination revealed urinary bladder amyloidosis,the patient recovered well,no recurrence occurred during 18 months' follow-up. Conclusion The primary localized amyloidosis of urinary bladder is rare,which occurs mainly in middle-aged men. The main clinical symptoms are painless and hematuria,which is similar to bladder cancer and often misdiagnosed as blad-der cance. So the final diagnosis should be based on pathology. The main treatment is surgery. There are recurrent and malignant potential,the patients need a long-term follow-up after operation.

Objective To analyze and summarize the clinical manifestations,diagnosis and treatment of testicular epidermoid cyst pa-tients.Methods Combined with literature,the clinical data of 7 patients with testicular epidermoid cyst in our hospital from July 2005 to Au-gust 2015 were analyzed.Results Histological examination showed testicular epidermoid cyst,postoperative recovery was good,no recurrence during 12 to 36 months’follow-up.Conclusion The testicular epidermoid cyst is rare in clinic,the clinical manifestations is similar to tes-ticular cancer,so it is often misdiagnosed as testicular cancer,which should be diagnosed by pathology,treated by testis preserved testicular tumor resection,and the prognosis is good.

OBJECTIVE: To summarize advances in clinical application of ureter stent and its biocompatibility. METHODS: A computer-based online search of CNKI (1989/2009) and Medline (1989/2009) was performed with the key words of "ureter, biocompatibility, stent, treatment, complications" in Chinese and English respectively. A total of 51 articles were collected. and 21 were included. The treatment advances and its biocompatibility of ureter stent were summarized, and clinical application advances, biocompatibility and complication prevention of ureter stent were explored. RESULTS: Ureter stent includes polymerizer, metal and degradable material stents. As the common implants in treatment of upper urinary tract diseases, ureter stent functions as stent and internal drainage, and relieve ureteral obstruction, prevent leakage of urine postoperatively and ureterostenosis. Complications following ureter stent implantation include stent shifting, urine reflux, irdtative symptoms of bladder, fouling and stone formation as well as infection. However, these complications can be relieved through positive treatment. CONCLUSION: Ureter stent is an effective approach to treat urologic disease, but the biocompatibility required improvement. Rigorous operation during stent implantation and positive treatment of complication can effectively prevent complications.

Objective:To investigate the effect of free wrist crease flap based on the superficial palmar branch of radial artery in the treatment of compound tissue defect of dorsal finger.Methods:From January 2015 to June 2019, the clinical data of patients admitted to the Department of Hand Surgery, Xuzhou Renci Hospital with skin, soft tissue and tendon defects of dorsal fingers, with or without bone exposure, were retrospectively analyzed. The free wrist crease flap based on the superficial palmar branch of radial artery was used. For patients with dorsal finger wounds less than 2.5 cm in length, palmaris longus tendon was used in the flap to repair, and the direction of flap incision and dorsal finger repair was consistent. If the length of dorsal finger defect was more than 2.5 cm, the palmaris longus tendon was not carried in the flap. The wrist crease flap based on the superficial palmar branch of the radial artery was harvested, and the free palmaris longus tendon was used to repair the defect along the same incision. The flap was selected according to the left and right wrist donor site flap and rotated 90° counterclockwise or clockwise to cover the dorsal finger wound. The flap survival and texture were followed up after operation. The total active movement(TAM) of fingers was evaluated according to the trial standard for the evaluation of the upper limb function of the Hand Surgery Society of the Chinese Medical Association.Results:A total of 17 patients were enrolled in this study, including 12 males and 5 females. The mean age was 39.5 years (range, 21-65 years). There were 10 cases of left finger and 7 cases of right finger. The area of dorsal finger skin defects ranged from 1.5 cm×1.3 cm to 3.8 cm×2.0 cm, and the area of flap ranged from 1.8 cm×1.5 cm to 4.0 cm×2.2 cm. The patients were followed up for 3 to 48 months, with an average of 16.5 months. All the flaps survived and healed well. The texture of the flap was good, and no obvious swelling was observed. Venous crisis occurred in 1 case 18 hours after operation. The stitches were removed, the edge of the flap was bled, and the flap survived after 10 days. All wrist donor sites were sutured directly and healed well after operation. There was no abnormality in wrist flexion and extension function. The TAM of fingers was rated as excellent in 12 cases, good in 4 cases, and fair in 1 case.Conclusions:The free wrist crease flap based on the superficial palmar branch of radial artery is an alternative method for repairing compound tissue defect of dorsal finger. The recipient flap has no bloated appearance. Finger extension function could be reconstructed. The wound at the donor site is small and could be closed directly.

Objective:To investigate the effect of free wrist crease flap based on the superficial palmar branch of radial artery in the treatment of compound tissue defect of dorsal finger.Methods:From January 2015 to June 2019, the clinical data of patients admitted to the Department of Hand Surgery, Xuzhou Renci Hospital with skin, soft tissue and tendon defects of dorsal fingers, with or without bone exposure, were retrospectively analyzed. The free wrist crease flap based on the superficial palmar branch of radial artery was used. For patients with dorsal finger wounds less than 2.5 cm in length, palmaris longus tendon was used in the flap to repair, and the direction of flap incision and dorsal finger repair was consistent. If the length of dorsal finger defect was more than 2.5 cm, the palmaris longus tendon was not carried in the flap. The wrist crease flap based on the superficial palmar branch of the radial artery was harvested, and the free palmaris longus tendon was used to repair the defect along the same incision. The flap was selected according to the left and right wrist donor site flap and rotated 90° counterclockwise or clockwise to cover the dorsal finger wound. The flap survival and texture were followed up after operation. The total active movement(TAM) of fingers was evaluated according to the trial standard for the evaluation of the upper limb function of the Hand Surgery Society of the Chinese Medical Association.Results:A total of 17 patients were enrolled in this study, including 12 males and 5 females. The mean age was 39.5 years (range, 21-65 years). There were 10 cases of left finger and 7 cases of right finger. The area of dorsal finger skin defects ranged from 1.5 cm×1.3 cm to 3.8 cm×2.0 cm, and the area of flap ranged from 1.8 cm×1.5 cm to 4.0 cm×2.2 cm. The patients were followed up for 3 to 48 months, with an average of 16.5 months. All the flaps survived and healed well. The texture of the flap was good, and no obvious swelling was observed. Venous crisis occurred in 1 case 18 hours after operation. The stitches were removed, the edge of the flap was bled, and the flap survived after 10 days. All wrist donor sites were sutured directly and healed well after operation. There was no abnormality in wrist flexion and extension function. The TAM of fingers was rated as excellent in 12 cases, good in 4 cases, and fair in 1 case.Conclusions:The free wrist crease flap based on the superficial palmar branch of radial artery is an alternative method for repairing compound tissue defect of dorsal finger. The recipient flap has no bloated appearance. Finger extension function could be reconstructed. The wound at the donor site is small and could be closed directly.

Objective:To investigate the therapeutic efficiency of multiple forms of microdissected perforator flaps in the reconstruction of limb defect.Methods:The data of patients treated in the Department of Hand Surgery of Xuzhou Renci Hospital from June 2020 to June 2022 for repairing wound of hands, feet, limbs and popliteal fosses with microdissected perforator flap were retrospectively analyzed. CT angiography and color Doppler ultrasound were performed in all patients before surgery to locate perforator vessels, design the donor flap, and cut the flap retrograde according to the design line. After confirming good blood supple, the flap was harvested under the microscope, and fat particles were cut around the vascular pedicle by "insect eating" technique. After that, the flap was transferred to the recipient area, completed the vascular anastomosis, and placed the drainage tube. The donor site was closed directly. The blood circulation of the flap was observed closely after operation. Regular follow-up visits were conducted in outpatient clinics, door-to-door visits and WeChat to record sensory recovery and complications. Postoperative wound healing, flap shape, flap sensation, flap temperature and scar in donor area were evaluated using the efficacy satisfaction scale, which was divided into four grades: excellent (2 points), good (1 point), fair (0 point) and poor (-1 point). The total score of 5-10 was satisfactory, 0-4 was average, and -1--5 was unsatisfactory.Results:A total of 16 patients were included, including 8 males and 8 females. The age ranged from 26 to 65 years, with an average age of 45.9 years. There were 2 cases of upper limb soft tissue defect, 2 cases of hand degloving injury, 11 cases of hand skin soft tissue defect, and 1 case of popliteal soft tissue defect. The wound size ranged from 3.0 cm×4.5 cm to 13.0 cm×30.0 cm. Free medial sural artery perforator flap was used in 4 cases, interosseous dorsal artery perforator flap in 1 case, anterolateral femoral perforator flap in 6 cases, thoracic umbilical flap in 1 case, anterolateral femoral perforator flap combined with superficial circumflex iliac artery perforator flap in 1 case, and superficial circumflex iliac artery perforator flap in 3 cases. The size of the skin flap was 3.5 cm×5.0 cm - 9.5 cm×30.0 cm. After operation, 15 cases of flaps successfully survived, 1 case of venous crisis occurred 1 day after operation, and successfully survived after exploration and re-anastomosis of blood vessels. The wounds in the donor area healed in one stage without wound infection, delayed healing and other complications. All patients were follow-up for 7 to 18 months (mean 12.1 months), the skin flap survived well, no pigmentation, bloated appearance, and no patients requested secondary thinning treatment. The skin flap sensation recovered light touch in 1 case, protective sense in 9 cases and deep touch only in 6 cases. No significant thickening of skin flap was observed in the later period of follow-up, and skin flap wear was observed in 1 patient. There were only linear scars left in the donor area, and there were no obvious abnormalities in appearance and function. Efficacy satisfaction evaluation showed that all patients were satisfied with the therapeutic effect, scoring 6-9 points, with an average of 7.8 points.Conclusion:Microdissected perforator flap technique provides a one-stage surgical solution for aesthetic and functional areas with high requirements, and satisfactory clinical efficiencies can be obtained.

Objective: To observe the therapeutic effect of acupuncture therapy for treatment of chronic atrophic gastritis. Methods: According to the theory of TCM, 36 cases of chronic atrophic gastritis were differentiated and treated by acupuncture. Gastroscopy and electrogastrograph (EGG) of the body surface, gastric acid and pepsin, blood gastrin, blood prostaglandin E (PGE), gastric mucosal cells and G cells are recorded. Results: Acupuncture therapy had a better effect in improving clinical symptoms, the markedly effective rate was 97.2% and the disappearing rate of clinical manifestations 97.02%;after acupuncture treatment,blood PGE concentration increased; gastric acid secretion increased; gastric dynamics was enhanced and the amplitude of EGG rose; acupuncture could significantly facilitate secretion of gastrin. Conclusion: Acupuncture is a convenient treatment method for atrophic gastritis with quick effect and without side effects.