Treatment of Symptomatic Ureteral Calculi during Pregnancy / 中国医科大学学报

Objective To present our experience with the management of symptomatic ureteral calculi during pregnancy and to compare the effi?cacy of two treatments:double?J stent insertion and ureteroscopy. Methods In a retrospective study between January 2007 and January 2015,38 pregnant women were treated for symptomatic ureteral calculi in our hospital. The patients were divided into two groups based on whether they re?ceived double?J stent insertion(n=21)or ureteroscopic lithotripsy(n=17). We collected and compared the patients 'characteristics and treat?ment outcomes,such as success ratio,rate of complications,surgical time,medical costs,and hospitalization time. Results In the double?J group, the insertion of a double?J stent was possible for 17 of 21 patients(success rate,81.0%). In the ureteroscopy group,15 of 17 patients had complete calculi fragmentation(success rate,88.2%). Complications in the double?J stent retention group were slightly higher than in the ureteroscopic litho?tripsy group. The medical costs and hospitalization time required to perform ureteroscopic lithotripsy were significantly higher compared to double?J stent insertion. Patients in the double?J group contended with stones after delivery. Conclusion Both of double?J stent insertion and ureteroscopic lithotripsy are effective for the treatment of symptomatic ureteral calculi during pregnancy. The success rate of ureteroscopy ,which can directly dis?rupt stones,was higher. However,double?J stent insertion costs less and is simple and convenient. The technique that is chosen to be performed de?pends on the patient's practical situation and personal preference.

Diagnosis and treatment of ileal conduit urinary diversion stomal varicose bleeding / 中华泌尿外科杂志

Objective To improve the understanding of ileal conduit urinary diversion stomal varicose bleeding.Methods 3 male cases of ileal conduit urinary diversion stomal varicose bleeding were reported.The pathogenic mechanism,clinical features,diagnosis and treatment of this disease were reviewed and discussed with the relevant literature review.The ages were 59,45 and 68.All of them had ileal conduit urinary diversion because of muscle invasive bladder cancer.Ileal conduit urinary diversion stomal varicose bleeding were found at 6 years,6 months and 2 months after surgery.The bleeding was intermittent.All the stomal varicose were found in physical examination.The laboratory examinations showed abnormities of liver functions in all three cases.Image studies showed one with liver metastasis and two with liver cirrhosis.Portal venous hypertension was considered as the cause of bleeding.Results We controlled the bleeding by suturing the first patient's varicose.The patient was died 3 months later because of the advanced cancer.For the second patient,we controlled the bleeding by compressing the varicose.By the meantime,we reduced the portal venous hypertension with medication.The stomal varicose bleeding stopped when the liver function and the portal venous hypertension improved 2 months later.The third patient's stomal varicose were injected with sclerosants.There was no mnore stomal varicose bleeding within half-year follow-up.Conclusions Ileal conduit urinary diversion stomal varicose bleeding is usually found in the patients who have portal venous hypertension because of liver cirrhosis or liver metastasis.To control the bleeding,we can decrease the patient's portal venous hypertension.To control hemorrhage,we can use suturing,compressing,and sclerotherapy,which is an optional treatment.

Effect of end-expiratory positive pressure on contractile function and ultrastructure of diaphragm / 解放军医学杂志

0.05). In comparison to control group (26.5%?14.3%), the fatigue index (FI) decreased remarkably in CMV+PEEP group (12.2%?6.4%, P