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Objective: To explore the effects of glandular differentiation (GD) on the prognosis of bladder urothelial carcinoma (BUC) in pT1. Methods: We retrospectively analyzed the clinical and pathological data of 248 BUC patients in pT1, 82 of them with glandular differentiation as UCGD group and the other 166 patients with pure BUC but without histological variants as control group. Results: The prognosis was significantly worse in UCGD group than in the control group (P=0.007). In univariate analysis, lymphovascular invasion (HR 1.416,95% CI 1.120-2.254, P=0.013) and glandular differentiation (HR 1.367, 95% CI 1.115-1.853, P=0.038) were significantly related to the prognosis of the patients. In multivariate analysis, glandular differentiation (HR 1.462, 95% CI 1.138-2.393, P=0.007) and lymphovascular invasion (HR 1.348, 95% CI 1.052-1.944, P=0.022) were independent factors related to the prognosis of PT1 BUC patients. Conclusion: The prognosis of PT1 UCGD patients is significantly worse than that of pure PT1 BUC patients. Therefore, UCGD patients should be regularly followed up and reviewed after the operation and should receive radical cystectomy if necessary.
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Objective:To investigate the application of 3D printing technique in percutaneous nephrolithotomy (PCNL) of patients with complicated kidney stones.Methods:From January 2015 to December 2017, 60 patients with complicated kidney stones were enrolled in the First Affiliated Hospital of Hebei North University for prospective study, and PCNL was proposed.All the patients were randomly divided into 3D print group (30 cases) and conventional image inspection group (30 cases, control group). Before operation, CT urography (CTU) was used in both groups.In 3D printing group, digital imaging and communications in medicine (DICOM) files of CT were extracted for 3D image postprocessing, and thermoplastic materials were used to print 3D model.In the 3D printing group, the digital imaging and communications in medicine (DICOM) files of CT were extracted for 3D image post-processing, and the 3D model was printed with thermoplastic materials.According to the comprehensive planning of 3D kidney model, a virtual safe and reliable percutaneous renal access was established for each patient, and PCNL was executed.The patients in the two groups were compared before, during and after operation.Preoperative: age, sex, body mass index, blood creatinine, stone size and CT value.During the operation: (1) the target renal calices location time; (2) the conformity between the preoperative planning and the actual operation; (3) the operation completion time.After operation: (1) stone removal rate; (2) hemoglobin reduction level; (3) postoperative recovery.Results:All the 60 patients successfully completed the operation, 30 patients successfully printed out the 3D model, which can accurately express the relationship between the stone and the adjacent anatomical structure, the internal renal artery and the collecting system.Positioning time of 3D printing group in target renal calices((2.9 ± 1.5) min vs.(5.8 ± 1.7) min, P=0.023), coincidence between simulated and actual puncture calices((89.5 ± 3.5)% vs.(60.2 ± 5.7)%, P=0.005), postoperative stone removal rate ((89.9 ± 4.5)% vs.(75.9 ± 5.2)%, P=0.009), and hemoglobin levels((1.4 ± 0.5) g/L vs.(2.9 ± 1.4) g/L, P=0.032) were superior to the control group, and the difference was statistically significant.But there was no significant difference between the two groups (all P>0.05). Conclusion:The 3D printed kidney model truly restores the anatomical details around the kidneys and stones, providing a stereoscopic and intuitive way to perform surgery, so it maybe has a significance guidance for percutaneous nephrolithotomy.
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Objective To design a system that is many X-ray machines automatic operation,timely exposure to realize the sharing of power supply. Methods A circuit is designed based on the normal hospital conditions and go with proper control algorithm. The fifty-one series SCM were made use of in the hardware circuits,and validated by X-ray machine simulation tests which simplify the X-ray exposure to the process of relay controlling,which software is based on interrupt mechanism. Results The program could effectively control the exposal of many X-ray machines and the priority was indicated by the experiments. Conclusion Under the prerequisite of the system does not affect the exposure parameters of X-ray machine accuracy,the system can realize a number of X-ray machine's power-sharing,at the same time allow only a single X-ray exposure and use of the interrupted source. And it can make exposure many original X-ray machines can become closely related with high security,proper order and high performance,which has prominent benefits on areas with bad power and equipment conditions.