ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the factors affecting the efficacy of extracorporeal shock wave lithotripsy (ESWL) and establish a model for predicting the success rate of a single ESWL session in the treatment of single renal calculus.</p><p><b>METHODS</b>Between January 2008 and February 2010, 325 patients underwent ESWL monotherapy and were followed up for at most 3 months. The correlations between the outcome of a single ESWL session and the patients' age, gender, body mass index (BMI), disease duration, pretreatment renal colic, hematuria, urinary irritation symptoms, stone location, stone laterality, stone length and stone width were analyzed. The statistically significant factors identifies were further analyzed by multivariate logistic regression, and the predictive model was established.</p><p><b>RESULTS</b>The stone-free rate of ESWL was 76.9%. Univariate analysis found that the patients' age, stone laterality, stone location, disease duration, pretreatment hematuria, stone length and width all significantly affected the outcome of the treatment. Logistic regression analysis indicated the factors including disease duration, pretreatment hematuria, stone length and stone width determined the success rate of the treatment. Hosmer and Lemeshow Test showed a good fitting of the predictive model (Χ(2)=18.144, df=8, P=0.168) with an overall accuracy of 87.4%.</p><p><b>CONCLUSION</b>Disease duration, pretreatment hematuria, stone length and width are independent factors affecting the outcome of a single ESWL session for single renal calculus.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Kidney Calculi , Therapeutics , Lithotripsy , Logistic Models , Treatment OutcomeABSTRACT
Objective To explore the outcome for kidney transplant recipients who suffered from cancers after transplantation. Methods De novo cancer data in 59 transplant recipients were collected. 6 cases of native renal cell carcinomas, 4 cases of native pelvo-ureteral carcinomas, 14 cases of bladder cancers, 7 cases of prostate cancers, 9 cases of hepatocellular carcinomas, 3 cases of gastric carcinomas, 2 cases of colon cancers, 1 case of pancreatic cancer, 4 cases of breast cancers, 3 cases of cervical cancers, 2 cases of skin cancers, 2 cases of non-small cell lung cancers, 1 case of thyroid cancer and 1 case of post-transplant lymphoproliferative disease. These data were compared with those from 59 patients in general population with the same gender, age and tumor stage. Results Overall incidence rate for de novo malignancy post-transplantation was 1. 9 % (59/3150). Urinary cancers were the most common. Compared to the general population, the overall survival was significantly worsened in transplant recipients (P<0. 01), and 5-year survival rate in transplantation group and control group was 30 % vs 75 0 %. Multivariate analyses demonstrated cancer stage to he a negative risk factor for survival of transplant recipients with de novo cancer, and surgery and functioning graft to be the positive survival predictors. Conclusion Transplant recipients experience worse outcomes than the general population for these cancers. These data suggest that cancers in transplant recipients are more aggressive biologically at the time of diagnosis.
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Objective To explore the outcomes of kidney transplant recipients who developed urinary and male genital cancers after transplantation. Methods Data of 31 kidney transplant recipients developed de novo urinary and male genital cancer were compared with data of 31 patients in general population with the same age and same tumor stage. Results Compared with the general population, the overall survival was significantly worse in the transplant recipients (P=0. 02) , 5-year survival rates for each group were 50% vs 68%. Multivariate analyses demonstrated cancer stage to be a negative risk factor for survival for transplant recipients with de novo urinary and male genital cancer, and surgery and functioning graft to be the positive survival predictors. Conclusions Transplant recipients experience worse outcomes than the general population from urinary and male genital cancers. Cancers in transplant recipients are more biologically aggressive at the time of diagnosis.
ABSTRACT
Clinical practice is quite important transition phase for medical students to become qualified doctors,and development of surgerical skills is the diffficult and key point in the clinical practice.Intensive training of surgerical skills before clinical practice can enhance the confidence and efficiency of medicine students during the course of clinical practice.Whihin limited time,the key of intensive training of surgerical skills is the training of aseptic technique and basic skills of surgery,and during the course of training,attention should be paid to both principle and details.