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 explore the method and effect of repairing fingertip defect and soft tissue defect in donor area by relay flap with suture nerve.Methods:From January 2017 to May 2019, 11 cases of fingertip defects were repaired with reverse island fascial pedicle flap of dorsal digital artery sutured with nerve, with a flap area of 0.6 cm×1.2 cm-1.6 cm×2.0 cm, and the flap donor area was repaired with dorsal metacarpal artery cutaneous branch flap. The patients were followed-up by outpatient, reexamination and WeChat interviews.Results:Twenty-two flaps of 11 cases survived completely and the wound healed in stage I. The postoperative follow-up ranged from 3 to 36 months, with an average of 13 months. The flap and pedicle were not bloated, the shape of finger was satisfactory, the texture was soft, and the skin color was close to the skin of finger. Sensory recovery≥S 3. The TPD of the flap was 6-11 mm, with an average of 8.4 mm. Hand function was evaluated according to the Trial Standard of Upper Limb Function Evaluation of Chinese Medical Association: excellent in 10 cases and good in 1 case. The patients were satisfied with the repair effect and resumed their daily life and work. Conclusion:This operation is simple, does not need to sacrifice the main blood vessels and nerves, can restore the good shape and sensction of the affected finger, with the activity close to normal. It is an effective method to repair the fingertip defect.

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.

Objective To detect the expressions of interleukin-1β(IL-1β)in peripheral blood and programmed death molecule 1(PD-1)in esophageal cancer tissues and to analyze their influence on clinicopathological features and prognosis of patients.Methods A total of 127 patients with esophageal cancer who underwent surgical treatment at the First Affiliated Hospital of Henan University of Science and Technology from January 2018 to May 2020 were collected and divided into two groups:the survival group(n= 95)and the death group(n= 32),based on their survival status 3 years after surgery.Clinical data of the patients were collected.The expressions of PD-1 and programmed death ligand 1(PD-L1)in esophageal cancer tissues were detected through immunohistochemistry,while the levels of IL-6,IL-1β,and tumor necrosis factor-α(TNF-α)in peripheral blood were measured using enzyme-linked immunosorbent assay(ELISA).Cox regression analysis was performed to identify the risk factors for death 3 years after surgery.The 3-year Kaplan-Meier survival curves of patients with different expressions of IL-1βand PD-1 were plotted,and the survival rates among the three groups were compared using the log-rank test.Results In the death group,the proportions of patients with age≥60 years old,lymph node metastasis,infiltration into the muscle layer,tumor diameter>3 cm,IL-1β high level,TNF-αhigh level,and PD-1 positive expression were higher than those in the survival group.Conversely,the proportions of patients with high IL-6 levels were lower than those in the survival group,with statistically significant differences between the groups(P<0.05).Infiltration into the myometrium,tumor diameter>3 cm,high IL-1β level,and PD-1 positive expression were identified as independent risk factors for postoperative death.The 3-year survival rates were 92.4%,13.3%,and 84.2%for patients in the normal IL-1β+PD-1 negative group,high IL-1β+PD-1 positive group,and normal IL-1β+PD-1 positive group/high IL-1β+PD-1 negative group,respectively.Significant differences existed between the groups(χ2=82.318,P<0.01),with the highest survival rate observed in the normal IL-1β+ PD-1 negative group and the lowest in the high IL-1β+ PD-1 positive group.Conclusion Positive expression of PD-1 and a high level of IL-1βwere identified as independent risk factors for death in patients with esophageal cancer.Notably,patients with positive expression of PD-1+high levels of IL-1βexhibited a low survival rate.

Objective:To study the characteristics and influencing factors of vaginal microbiota in normal pregnant women.Methods:This study was based on a cohort of pregnant women established in Anqing Municipal Hospital Affiliated to Anhui Medical University from February 2018 to February 2020. Vaginal samples of normal pregnant women who met the inclusion and exclusion criteria were ordered by the gestational weeks at sampling. Five samples were randomly selected from each gestational week group and if the samples were less than five, all samples were included. Sequencing of the V3-V4 region of the 16S rRNA gene was performed. Dominant species were analyzed by MicrobiomeAnalyst. Alpha diversity was measured with Chao1, Observed Features, Shannon diversity, Simpson diversity, Faith_pd and Pielou′s Evenness. The dominant status of Lactobacillus was also described and compared. Multiple linear regression and logistic regression were used to analyze the factors influencing vaginal microbiota. Analysis of variance and Kruskal Wallis test were used for statistical analysis of continuous variables, and Chi-square test and Fisher′s exact test were used for categorical data. The differences were considered statistically significant when the P value was less than 0.05. Results:This study enrolled 91 pregnant women (91 vaginal samples) with an average age of (27.37±3.60) years. There were 18, 56 and 17 vaginal samples collected at the median gestational age of 11.93 weeks (the first trimester), 19.43 weeks (the second trimester) and 38.29 weeks (the third trimester), respectively. The relative abundance of Firmicutes and Lactobacillus was 91.30% and 87.67%, respectively. Lactobacillus iners and Lactobacillus crispatus had a relative abundance of 43.95% and 36.33%, respectively. Moreover, Lactobacillus iners-dominated vaginal microbiota was detected in all trimesters. The number of samples with high relative abundance of Lactobacillus iners gradually decreased with gestational age. Lactobacillus crispatus-dominated vaginal microbiota was found in the second and third trimesters and the number of samples with high relative abundance gradually increased during pregnancy. The Alpha diversity of vaginal microbiota had a decreasing trend during the gestation. There were significant differences in Pielou′s Evenness diversity index of vaginal microbiota between different smoking groups ( P<0.05) and in Shannon diversity index between different drinking groups ( P<0.05). There were significant differences in Chao1, Observed Features and Faith_pd diversity index of vaginal microbiota between pregnant women with different education ( P<0.05) and in Shannon and Simpson diversity index between different income groups ( P<0.05). Conclusions:Vaginal microbiota was dominated by Lactobacillus in normal pregnant women. The dominance of Lactobacillus iners gradually decreased, while that of Lactobacillus crispatus increased during gestation. In normal pregnant women, the Alpha diversity of vaginal microbiota was correlated with smoking, drinking, education and family annual income. Smoking cessation and drinking before pregnancy were related to lower Alpha diversity of vaginal microbiota in pregnant women, while lower education and higher family income were associated with higher Alpha diversity.