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Objective To access the practicality and safety of a new type Balloon dilatation combined with flank supine position in percutaneous nephrolithotomy.Methods Clinical data of 60 kidney stones patients were collected and retrospectively analyzed.This group of patients had been admitted and selected according to the inclusion criteria in our institute from July.2012 to Sep.2013.There was no obvious difference in sex,age,body mass index (BMI),stone location and size.According to the surgery approaches,this group of patients was divided into ballon group (dilated by balloon dilatation) and Amplatz group (dilated by Amplatz fascial dilation) and in each group there were 30 cases.All these patients received the surgery by the same group of surgeons.We collected the data of one-time success puncture rate,success puncture time,puncture complications (kidney calices fracture,perinephric fluid collection and postoperative delayed hemorrhages etc.),removing stones time and stone free rate.Results Compared with Balloon group,Amplatz group had a significant difference (P＜0.05) in one-time success puncture rate [100％ (30/30) vs 90％ (27/30)],success puncture time [(6.1±2.3)min vs (13.3±3.6)min],puncture complications [3％(1/30) vs 13％(4/30)] and removing stones time [(11.7±2.0)min vs (21.5±3.1)min]; but no significant difference (P＞0.05) in stone free rate [87％ (26/30) vs 83％ (25/30)].Conclusions Balloon dilatation combined with flank supine position in percutaneous nephrolithotomy is easy for surgery.It can establish the surgery access more accurately and faster,decreases removing stones time and reduces operative complications.
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Objective To analyze the clinicopathologic characteristics and treatment of primary and secondary bladder mucosa lymphoma. Methods From June 1996 to September 2011,8 cases of bladder mucosa lymphoma patients including primary bladder mucosa lymphoma patients (2 males and 3 females)and secondary bladder mucosa lymphoma patients ( 1 male and 2 females) were treated in our institute.The patient's mean age was 68 years (ranged from 57 to 78 years),and the other 3 secondary bladder mucosa lymphoma patient's mean age was 61 years (ranged from 41 to 81 years).7 of 8 patients accepted transurethral resection of bladder tumor combined with CHOP chemotherapy and radiotherapy,and 1 patient abandoned treatment.CHOP chemotherapy and radiotherapy were performed at 2 weeks post-operatively.Secondary bladder mucosa lymphoma patients accepted 3-dimensional conformal 6000 cGy radiotherapy.Urinary CT examination showed that there were round or oval irregular tumors in the wall of urinary bladder,whose diameters were 1 to 4 cm.Tumor edges were glossy and tumor density were uniform.In addition,the bladder wall with tumor was uneven.In contrasted CT,the tumors appeared obviously enhanced.7 cases had cauliflower-like tumors found by cystoscope,and there were necrosis-calcification area in the center of tumors.1case appeared multiple tumors,which consisted of one big tumor and three smaller ones. Results There were 5 cases of primary bladder mucosa lymphoma, including 3 bladder mucosa associated lymphoma (MAL) cases and 2 diffuse large B cell lymphoma cases.There were 3 secondary bladder mucosa lymphoma cases including 2 diffuse large B cell lymphoma cases and 1 generalized follicular cystic central lymphoma case,which belongs to the tuberous sclerosis Hodgkin lymphoma.Immunohistochemical analysis showed that CD20,CD21,CD43 staining were positive in low grade MAL (3 cases).However,CD3,CD20,CD31 staining were positivein high grade MAL (5 cases). All patients were followed up 3 to 44 months.3 cases of secondary malignant lymphoma patients died after diagnosed after 3 to 13 months.5 cases of primary malignant lymphoma patients were all survived. 1 case recurred 14 months after surgery and accepted TURBT and CHOP chemotherapy again.Pathologic diagnosis showed the transformation from peripheral zone of bladder mucosa associated lymphoma to diffuse large B cell lymphoma.The patient was free of recurrence. Conclusions MAL and diffuse large B cell lymphoma are the most common type of bladder mucosa lymphoma.Primary and secondary diffuse large B cell lymphoma have similarities in histological analysis,but the former prognosis is better than the latter's. Transurethral resection of bladder tumor combined with chemotherapy and radiotherapy can prevent the relapse of MAL in short term and long term with good tolerance,and can be used as ideal treatment of MALT.
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Objecfive To observe the effects of combined acupuncture and point injection in the treatment of diabetic ophthalmoplegia patients.Methods 40 patients with diabetic ophthalmoplegia were randomly recruited into a control group and a treatment group,with 20 patients in each group.The control group was treated with acupuncture,and the treatment group was additionally treated with point injection.Therapeutic effects were observed after the treatment.Results Effective rate was 85% and 55%in the treatment group and the control group respectively,showing significant difference(P=0.0384<0.05).Conclusion Acupuncture combined with point injection is effective in treating patients with diabetic ophthalmoplegia.
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Objective To evaluate the relationship between intraocular pressure (IOP) and anterior chamber angle in patients with different types of acute angle-closure glaucoma after phacoemulsification and intraocular lens implantation. Design Retrospective case series. Participants 173 cases of acute angle-closure glaucoma coexisting cataract (173 eyes) in Mingren Eye Hospital from January, 2005 to June, 2007. Methods All patients with acute angle-closure glaucoma underwent phacoemulsification and intraocular lens implantation, and were examined with high-frequency ultrasound biomicroscopy (UBM). Anterior chamber depth (ACD), intraocular pressure (IOP) and anterior chamber angle (ACA) were measured. Follow-up was 1-48 weeks after surgery. Main Outcome Measures Intraocular pressure, phacoemulsification complications, re-open rate of anterior chamber angle. Results At 8th week after surgery, the rate of IOP control in pupillary block group, non-pupillary blocking group, and multimechanism group was 88.9%, 52.0%, 83.4%, respectively and there was a statistically significant between these groups (?2=7.13, P=0.022). At 48th week, the rate of IOP control was 54.2%, 33.3%, 35.8%, respectively(?2=12.56, P=0.003). Fifty patients were follow up with UBM, and 66.7% in pupillary block group, 33.3% in non-pupillary blocking group and 33.3% in multimechanism group in 48 weeks postoperatively showed evidence of the widened anterior chamber angle. No specific postoperative complications were found in this study compared with those with phacoemulsification without glaucoma. Conclusions The use of phacoemulsification and intraocular lens implantation for acute angle-closure glaucoma coexsiting cataract can get best IOP-controlled rates in pupillary block group. It is related to the degree of widened anterior chamber angle.