Objective To explore the efficacy and safety of one-stage flexible ureteroscopic lithotripsy for bilateral kidney stones.Methods Retrospectively analyzed 112 patients with bilateral kidney stones treated by flexible ureteroscopic lithotripsy from January 2018 to October 2023.Based on the treatment procedure,the participants were divided into an observation group and a control group.The observation group(60 cases)underwent one-stage lithotripsy using flexible ureteroscopy for bilateral kidney stones,the control group(52 cases)received staged lithotripsy for bilateral kidney stones.The operation time,intraoperative blood loss,stone clearance rate one month after operation,postoperative hematuria time,duration of lumbar and abdominal pain,creatinine level one day after operation and incidence of postoperative complications were compared between the two groups of patients.Results Findings indicated that the observation group had a mean operation time of(103.68±27.46)min,which was significantly shorter compared to the control group's mean operation time of(132.51±39.74)min,the difference was statistically significant(P<0.01).Additionally,the stone clearance rate after one month post-operation was 91.67%in the observation group and 90.38%in the control group(P=0.920);The average blood loss of the observation group was(15.29±5.15)mL,and the duration of postoperative lumbar and abdominal pain was(6.18±1.40)d,while the average blood loss of the control group was(12.00±3.62)mL,and the duration of postoperative lumbar and abdominal pain was(4.56±1.12)d,with significant difference(P<0.01);The duration of postoperative hematuria in the observation group was(3.07±0.92)d,the incidence of postoperative irritation sign of bladder was 65.00%,the incidence of postoperative moderate and low fever was 25.00%,and the creatinine level on the first day after surgery was(73.47±17.80)μmol/L,while the duration of postoperative hematuria in the control group was(2.73±1.28)d,the incidence of postoperative irritation sign of bladder was 53.85%,the incidence of postoperative moderate and low fever was 17.31%,and the creatinine level on the first day after surgery was(68.61±17.38)μmol/L,the differences were not statistically significant(P>0.05).Conclusion One stage flexible ureteroscopic lithotripsy for bilateral kidney stones is safe and effective,moreover,the surgical outcome is close to that of staged surgery,but postoperative nursing and pain management should be strengthened in order to improve the effect of comprehensive treatment.

Objective To explore the efficacy and safety of one-stage flexible ureteroscopic lithotripsy for bilateral kidney stones.Methods Retrospectively analyzed 112 patients with bilateral kidney stones treated by flexible ureteroscopic lithotripsy from January 2018 to October 2023.Based on the treatment procedure,the participants were divided into an observation group and a control group.The observation group(60 cases)underwent one-stage lithotripsy using flexible ureteroscopy for bilateral kidney stones,the control group(52 cases)received staged lithotripsy for bilateral kidney stones.The operation time,intraoperative blood loss,stone clearance rate one month after operation,postoperative hematuria time,duration of lumbar and abdominal pain,creatinine level one day after operation and incidence of postoperative complications were compared between the two groups of patients.Results Findings indicated that the observation group had a mean operation time of(103.68±27.46)min,which was significantly shorter compared to the control group's mean operation time of(132.51±39.74)min,the difference was statistically significant(P<0.01).Additionally,the stone clearance rate after one month post-operation was 91.67%in the observation group and 90.38%in the control group(P=0.920);The average blood loss of the observation group was(15.29±5.15)mL,and the duration of postoperative lumbar and abdominal pain was(6.18±1.40)d,while the average blood loss of the control group was(12.00±3.62)mL,and the duration of postoperative lumbar and abdominal pain was(4.56±1.12)d,with significant difference(P<0.01);The duration of postoperative hematuria in the observation group was(3.07±0.92)d,the incidence of postoperative irritation sign of bladder was 65.00%,the incidence of postoperative moderate and low fever was 25.00%,and the creatinine level on the first day after surgery was(73.47±17.80)μmol/L,while the duration of postoperative hematuria in the control group was(2.73±1.28)d,the incidence of postoperative irritation sign of bladder was 53.85%,the incidence of postoperative moderate and low fever was 17.31%,and the creatinine level on the first day after surgery was(68.61±17.38)μmol/L,the differences were not statistically significant(P>0.05).Conclusion One stage flexible ureteroscopic lithotripsy for bilateral kidney stones is safe and effective,moreover,the surgical outcome is close to that of staged surgery,but postoperative nursing and pain management should be strengthened in order to improve the effect of comprehensive treatment.

Objective To investigate the influence factors of degrees of Virchow-Robin Spaces (VRS) in patients with acute first-ever lacunar stroke.Methods Two hundred and thirty-eight patients with first-ever lacunar stroke whose infractions were found in the basal ganglia (n=131) or the central semiovale (n=107) were recruited from our hospital from January 2016 to June 2017.The demographic and clinical characteristics of these patients were collected and magnetic resonance imaging was used to identify the presence and degrees of VRS in the basal ganglia (BG-VRS) and central semiovale (CSO-VRS).Logistic regression models were constructed to identify the influence factors for BG-VRS and CSO-VRS.Results The VRS scores were not statistically different between patients whose infractions were found in basal ganglia and patients whose infractions in central semiovale (P＞0.05).Univariate survival analysis indicated that gender,hypertension percentage,systolic pressure level,and body mass index (BMI) in patients from mild BG-VRS group were significantly different as compared with those in patients from severe BG-VRS group (P＜0.05);hypertension percentage,diabetes mellitus percentage,and BMI in patients from mild CSO-VRS group were significantly different as compared with those in patients from severe CSO-VRS group (P＜0.05).Multivariable Logistic regression analysis showed that hypertension and BMI could significantly influence the severity of BG-VRS (odds ratio [OR] =6.272,95％ confidence interval [CI]:1.931-20.365,P=0.002;OR=0.757,95％CI:0.619-0.927,P=0.007),and BMI could significantly influence the severity of CSO-VRS (OR=0.775,95％CI:0.655-0.918,P=0.004).Conclusion Hypertension is the independent risk factor of degrees of BG-VRS,and BMI is the protective factor of degrees of BG-VRS and CSO-VRS.

OBJECTIVE:To investigate the effects of paroxetine on depression symptoms and neurological function recovery in patients with post-stroke depression. METHODS:A total of 108 patients with post-stroke depression in our hospital were analyzed retrospectively and divided into observation group(51 cases)and control group(50 cases). Both groups received routine therapy as dehydration,activating blood circulation to dissipate blood stasis,anticoagulation,defibringen. Based on it,observation group was additionally given Paroxetine hydrochloride tablet 20 mg,once a day;control group was additionally given Sertraline hydrochloride tablet 50 mg,once a day. Treatment courses of 2 groups lasted for 4 weeks. The depression symptom relief and the recovery of neu-rological function were observed in 2 groups before and after treatment. HAMD score and MESSS score were compared before and after treatment,and the occurrence of ADR was recorded during treatment. RESULTS:Total response rate of depression symptom relief(70.37% vs. 38.89%)and the recovery of neurological function(66.67% vs. 40.74%)in observation group were significant-ly higher than control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in HAMD score and MESSS score between 2 groups(P>0.05);after treatment,HAMD score and MESSS score of 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). During treatment,no obvious ADR was found in 2 groups. CONCLUSIONS:Paroxetine has good therapeu-tic efficacy for post-stroke depression and can effectively relieve the depression so as to promote the recovery of neurological func-tion,which has a positive effect on the prognosis of patients with acute cerebral infarction and doesn't increase the occurrence of ADR with good safety.

Objective To study the anticoagulation therapy of lower molecular weight heparin in the treatment of patients with acute pancreatitis.Methods Seventy-three patients with acute pancreatitis were divided into anticoagulation group(n=38)and control group(n=35).The serological indexes and prognosis of patients were detected.Results Anticoagulation treatment with lower molecular weight heparin significantly decreased the white blood cell count,increased the oxygen partial pressure in arterial blood,shoaened the duration of hospitalization,and reduced the aggravation rate,secondary operation rate and mortality of patients with acute pancreatitis.Conclusions Anticoagulation treatment with lower molecular weight heparin is safe,effective and can improve the prognosis of patients with acute pancreatitis.