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Objective:To evaluate the clinical efficacy and safety of using the F4.8 Visual Puncture Micro-percutaneous nephrolithotomy to treat the female distal calculi associated with stricture.Methods:From June 2017 to December 2019, 32 female patients with distal ureteric calculi associated with stricture, aged(35.0±10.3) years ( range from 16 to 75 years)old, were enrolled into this retrospective study. They were diagnosed by colour doppler ultrasound, IVU(intravenous Urography), or CT, et al. The average stone size was (13.0±3.6)mm in diameter(range from 3 to 20 mm), and the stone obstruction duration was from 2 to 35 days, with average of(5±17) days. Twenty-seven cases were on the unilateral ureter and 5 cases were on the bilateral ureters. There were 17 cases undergoing ESWL 2 weeks before. Six cases of stone diameter less than 6 mm were administered medical therapy for more than 7 days. All the 32 case underwent ureteroscopic lithotripsy but failed because of the ureter stricture. They all suffered from hydronephrosis, with the diameter of renal collecting system from 15 to 45 mm, with(23±15)mm on average. The lithotomy position was taken, and the F4.8 Visual Micro-percutaneous nephrolithotomy using 0.9% Sodium chloride was applied to enter into ureter through urethra. There were 21 cases of ureter orifice stricture, including 8 cases associated with avulsion or perforation, 9 cases associated with intramural ureter abnormality and stricture, the zebra guidewire being failed to enter. The F4.8 Visual Micro-percutaneous nephrolithotomy cooperated with water pressure modulation was used to flush and open the ureter orifice and intramural ureter for entering. Holmium lase was used for lithotripsy. Two cases stone were infective and obstructed seriously. F4.8 Visual Micro-percutaneous nephrolithotriptor entered the ureter and destroyed the stones, and the stone fragments were discharged. Stone migrated upward and escaped occurred in 1 case, then the zebra guidewire was indwelled and ureteroscope was used for lithotripsy successfully. All cases were indewelled F4.7 doubld-J tube and urethral catheter after operation.Result:All the 32 patients underwent lithotripsy successful by one-stage. The operation time was 15-43 min [averaged (35.0±8.7)min]. All patients were recovered and discharged 4-7(averaged 5.3) days after operation. Three patients occured fever, T>38.5℃, and they recovered by using sensitive antibiotics according to the blood and urine culture. No severe complications occurred, such as ureteral perforation or extravasation. All patients were reviewed by ultrasound and KUB 3 days after operation, finding 24 cases with stone free, and 8 cases of a little residual stone, with the stone free rate of 75%. One month later, ultrasound and IVU was performed, and no residual stone was detected, with the stone free rate of 100%. The hydronephrosis alleviated by varying degrees. The diameter of the renal collecting system was from 0 to 35 mm, with(12±9)mm on average. The IVU showed the ureter was unobstructed. Conclusions:The F4.8 Visual Micro-percutaneous nephrolithotomy is safe and effective for the female distal calculi associated with stricture, when routine ureteroscopic lithotripsy failed.
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Objective To analyse the etiology,clinical features and prognosis of drug-induced liver disease(DILD),in order to draw more attention to this problem.Methods 332 cases of DILD admitted to the First Affliated Hospital of Zhejiang Universitv from 2000-2006 were retrospectively analysed.Results A variety of drugs.including herbal medicines(27.1% of our total cases),anti-tuberculosis drugs (13.3%)and immunosuppressive drugs(10.8%)caused drug-induced liver damage.The hepatocellular type(43.1%)was the most common type seen clinically and the mixed type(32.5%)and eholestatic type (24.4%)were somewhat less.Conclusions A variety of medicines may cause DILD;herbal medicines,anti-tuberculosis drugs and immunosuppressive drugs were frequently found to be responsible, the hepatocellular type was the most common.while the mixed type and cholestatic type were somewhat less.Serum albumin,total bile acids,direct bilirubin and blood prothrombin time are important predictors of the prognosis of DILD.
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Objective To compare the consistency of 2 methods,RUCAM and CDS,for assessment of drug-induced liver injury and their sensitivity and specificity.Methods A total of 332 patients with drug-induced liver disease,who admitted to the first hospital of Zhejiang university from January 2000 to December 2006,were retrospectively evaluated.The data were collected from patients including clinical presentation,liver function,etc.The liver function and the outcome of the patients after treatment were also observed.The probability of the diagnosis was classified as definitive,probable,possible,unlikely,or excluded.The consistency,the specificity and sensitivity of two methos were evaluated with Spearman correlation analysis.Results Absolute agreement between the 2 scales was observed in 91 cases(27.41%),with disagreement of 1 level in 219 cases(65.96%),and of 2 levels in 22 cases(6.63%),which showed a positive correlateion(r=0.485,P=0.001).Absolute agreement between the 2 scales was observed in 12 cases of severe drug-induced liver disease(18.46%)(r=0.578,P=0.001)and in 79 cases of minor drug-induced liver disease(29.59%)(r=0.382,P=0.001).The specificity of CDS was 100%,and the sensitivity was 57%and 25%in diagnosis of severe and minor drug-induced liver disease,respectively.Conclusions The best correlation between the 2 scales was obtained for drug-induced liver injury.The RUCAM scale showed better sensitivity,especially in diagnosis of server drug-induced liver disease.
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OBJECTIVE To assess the relationship among the genes types ureA,cagA,vacA,gene vacA subtypes and Helicobacter pylori(Hp)-related upper gastrointestinal diseases in this study.METHODS Eighty-four Hp strains were identified from bacteria isolated and cultured from the gastric mucosa tissue.Genes ureA,cagA,vacA,and gene vacA subtypes were typed using PCR with specific primers.RESULTS In 84 identified Hp strains,the positive ratio of gene ureA was 100.00%,of gene cagA was 90.48%,and of gene vacA was 95.24%.The positive ratio of genes cagA and vacA was lower in gastric cancer than in gastritis and peptic ulcer(P0.05).CONCLUSIONS ure+,cagA+ and vacAm2 subtypes of Hp are predominant in patients with upper gastrointestinal diseases in Zhenhai District,Ningbo,Zhejiang Province.They are more common in patients with gastric ulcer and gastritis.
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Objective To investigate the correlation of changes in peripheral natural killer T(NKT) cells and fatty liver disease(NAFLD).Methods Peripheral blood samples were obtained from 60 NAFLD patients and 60 age and gender matched healthy controls.The frequency of peripheral NKT cells was detected by flow cytometry.The differences of clinical presentation and laboratory data in two groups were analyzed.The risk factors of NAFLD were screened by Logistic regression analysis. Results NAFLD patients had lower frequency of peripheral NKT cells than healthy controls [median fre- quency was 1.12%(IQR0.87%～1.54%)in patients vs.1.48%(1.23%～1.98%) in controls,P
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Objective The objective of digitalized patient records control is to meet some new demands set on patient records control under the new circumstances. Methods A computer system for digitalized patient records control and supporting processing, management and applications setups were established. Results The system put the contents of the patient records into various categories with difierent standards and designed relatively strict means of authorization. It rendered patient records easier to use and their control more strict, making it possible to make general use of the records without access to the original documents. As a result, data loss was avoided, authority over the data was put under control, data sharing was provided, and full and convenient use of data was realized. Conclusion Digitalized patient records control, a form of shaping computer-based patient records before the latter fully comes into being, enhances the efficiency of patient records application and reduces the pressure of paper records storage. It is a practical and effective way of controlling patient records.