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Objective To explore the risk factors of hidden blood loss after UKA.Methods A retrospec-tive study was conducted on 273 patients who underwent UKA from January 2015 to December 2016,including 79 males and 194 females,age between 46 to 87 years old,mean age(67.21± 8.23)years old. The clinical data were collected and the blood volume was calculated according to the Nadler formula. The Gross equation was used to calculate the blood loss and the amount of occult blood loss at 3 days after operation. The risk factors were analyzed statistically. Results The volume of hidden blood loss after operation was(75.36 ± 10.21)mL,and the volume of total blood lost after operation was(187.35± 60.31)mL.Sex,BMI and type of prosthesis were risk factors for hidden blood loss after UKA. Conclusions The volume of hidden blood loss after UKA was related to sex, BMI,and type of prosthesis. For the obese and male patients,we should actively take bleeding management and choose the type of prosthesis reasonably.
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BACKGROUND: A large number of cytokines produce in the periodontium on the tension side during orthodontic tooth movement, participate in periodontal remodeling, and make the tooth move to its normal position, thus achieving alveolar remodeling. Heat shock protein 27 (HSP27) is reported to be involved in the periodontal remodeling. OBJECTIVE: To investigate the expression of HSP27 in the rat periodontium on the tension side during the orthodontic tooth movement.METHODS: The rat models of orthodontic tooth movement were constructed using NiTi coil spring with the force value of 50 g. The periodontal samples were collected at 1, 3, 5, 7, 10 and 14 days after exerting force to detect the expression level of HSP27 in the periodontium on the tension side.RESULTS AND CONCLUSION: Immunofluorescence staining results revealed that the expression level of HSP27 in the periodontal tissues began to increase at the 1st day after exerting force, reached the highest level at the 3rd day, and then fell to the initial level at the 5th day. To conclude, HSP27 is evoked by orthodontic force early, and it may play a role in periodontal remodeling.
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BACKGROUND:Extensive research has been concentrated on the reconstruction of periodontium under orthodontic force. However, there are no reports regarding the expression of heat shock protein 70 (HSP70) in rat periodontium during orthodontic tooth movement. OBJECTIVE:To investigate the expression of HSP70 in rat periodontium during orthodontic tooth movement. METHODS:Rat orthodontic tooth movement models were established using NiTi extension spring with the force of 50 g. The orthodontic periodontium was col ected at 1, 3, 5, 7, 10 and 14 days after exerting force to detect the expression of HSP70. RESULTS AND CONCLUSION:According to immunofluorescence staining, the expression of HSP70 in the periodontal tissues was increased on day 1 after exerting force, and reached the highest level on day 5, then decreased to the initial level on day 14. These results suggest that the expression of HSP70 is evoked by orthodontic force, and it may play a role in periodontal remodeling.
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Objective To compare with the efficiency between X-ray or B ultrasound guided puncture target calyces of treatment of upper urinary calculi in MPCNL.Methods From October 2010 to October 2012,we have a retrospective analysis of the 116 cases in urological department in the second affiliated hospital of Kunming Medical University,it had the sugery that was MPCNL.Selected 116 cases as the research object,(8 patients were lost to follow-up).With X-ray locating (48 cases),B ultrasound locating (53 cases),and compared with preoperative,intraoperative and postoperative clinical objective indicators of two different methods.Results X-ray locating (48 cases),the mean age was (44.86 ± 12.84) years; the mean Stone diameter(1.43 ±0.70) cm; Stone is located in the upper calyx in 1 case,the middle of calyx in 23 cases,under the calyx in 8 cases,the upper ureter in 16 cases.B ultrasonic locating (53 cases),the mean age was(46.36 ± 14.29) years; the mean Stone diameter (1.34 ±0.62) cm; Stone is located in the upper calyx in 2 cases,the middle of calyx in 24 cases,under the calyx in 8 cases,the upper ureter in 16 cases.Compared with preoperative general data of two groups,there was no statistically significant difference (P ＞ 0.05).X-ray group,the mean operation time (130.43 ± 31.63) min ; Intraoperative blood loss(80.42 ± 43.75) mL; Postoperative hospital stay (6.20 ± 2.08) d; Infected with 8 cases (17％) of postoperative,hemorrhage in 2 cases (4％) ; and calculi exhausted rate was 90％ (43/47).B Ultrasound group,the mean operation time(102.45 ± 36.32) min.Intraoperative blood loss(160.07 ± 52.33) mL;Postoperative hospital stay(5.62 ±2.37) d; Infected with 16 cases (30％) of postoperative,bleeding in 9 cases (17％) ; and calculi exhausted rate was 83％ (46/53).By comparison,X-ray and B ultrasound group in operation time,intraoperative blood loss,postoperative infection,a stone exhausted rate was statistically significant (P ＜0.05),and postoperative hospital stay,no statistical significance (P ＞ 0.05).Conclusion X-ray positioning compared with B ultrasound,X-ray is longer than B ultrasonic of operation time,but,blood much less,calculi exhausted rate is higher,and infected rate is lower.
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Recent years found a series of severe incidents of injuring or killing medical workers in several places in China,deteriorating patient-physician relations,and disturbing medical orders.Beijing Administration of Hospitals,since its founding,has attached great importance to the management of medical disputes,as evidenced in the full-process management covering pre-during-post disputes.The administration guided the hospitals in their dispute resolution,and included resolution rate of disputes as an index of municipal hospital performance evaluation.By means of the guidance of such evaluation, medical disputes and major medical accidents have been resolved satisfactorily,and fine management of service quality of such hospitals in terms of medical service,pharmacy,nursing and medical technology has been intensified all the time.
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Objective To raise the awareness of the glandularis ureteritis. Methods Five cases with glandularis ureteritis confirmed by pathological examination from Jan 2001 to Jun 2012 were reviewed. The diagnosis was assessed on histopathologic studies in all. The clinical manifestations, the diagnosis and treatment were discussed. Results Resections of the affected ureter and ureteroplasty were undertaken for 2 patients. Ureteronephrectomy was performed for 2 patients because of serious hydronephrosis due to obstruction. Electrofulguration via-ureteroscopy was carried out for another patient. All patients have been well and without recurrence on following up for 15 to 152 months, with an average of 86.6 months. Conclusion Glandularis ureteritis is not frequently seen and the etiopathogenesis is not yet clear. Biopsy is very important for suspected neoplasm of ureter before performing nephrectomy.
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Clinical bilingual education is an effective method to educate modern senior medical talents.In order to cultivate a group of medical talents with good clinical competence,high professional standard of English,the model of “Bilingual teaching,goal-directed motion and learning by using binding” in combination with modern advanced teaching means is worth discussing.
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The aim of the study is to investigate the effect of salvianolic acid B (SalB) on blood-brain barrier (BBB) in rats after cerebral ischemia-reperfusion, and to illustrate its possible mechanisms. Cerebral ischemia-reperfusion was induced by middle cerebral artery occlusion in rats. The break-down of BBB was indicated by extravasations of immunoglobulin (IgG) monitored with immunohistochemistry. The expression of MMP-9 and NOS2 in the brain was determined by immunohistochemistry, and the expression of p-p38 and p-ERK1/2 was detected by Western blotting. It was shown that on day 2 after ischemia-reperfusion the IgG accumulated around the vascular boundary zone, suggesting the break-down of BBB, and the expression of MMP-9 and NOS2 up-regulated at the same time. The result of Western blotting suggested that the expression of p-p38 and p-ERK1/2 increased. On day 7 after ischemia-reperfusion the. expression of MMP-9 and NOS2 was about the same level as day 2, the expression of p-p38 was higher than that on day 2 and the expression of p-ERK1/2 was slightly lower than that on day 2. SalB (1 and 10 mg x kg(-1)) significantly alleviated the extravasations of immunoglobulin induced by cerebral ischemia-reperfusion (P < 0.05). On day 2 and day 7 SalB attenuated the expression of MMP-9 and NOS2 (P < 0.05). SalB (10 mg x kg(-1)) reduced the expression of p-p38 and p-ERK1/2 apparently on day 2 and 7 after ischemia-reperfusion (P < 0.05). SalB (1 mg x kg(-1)) inhibited the expression of p-p38 on day 7 after ischemia-reperfusion (P < 0.05). The results indicate that SalB protects blood-brain barrier in rats after cerebral ischemia-reperfusion by inhibiting the MAPK pathway.
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Objective To discuss the long term clinical effect of ileal orthotropic neobladder.Methods From 1991 to 1998,79 patients,mean age 55(41～75)years,male 74,female 6,were followed up.The serum creatinine and urea,electrolytes,blood routine,B ultrasonic scan of the neobladder residual urine and IVU or MRU of the patients were followed up.The max transverse diameter of renal pelvis and the max verticaI/level diameter of neobladder were measured in 5,10 to 14,15 years of postoperative when IVU or MRU.All results of different time were compared by the multiple comparisons.The local or distant cancer recurrence and the complications of the operation Were evaluated. Results Sixty-four cases,58 male,6 famle,were long term followed up:mean time was 167 (range,121～216)months.Seven cases died of other diseases.Seven cases had pelvic recarrence.Two cases had urethral recurrence.Three cases died of tumor metastasis.One case had ureter recurrence.Forty-eight patients were alive more than 10 years.The value of the serum creatinine,urea,electrolytes and bloods routine of the patients were normal after 5,10 to 14 and 15 vears postoperative (P＞0.05).The max transverse diameter of the renal pelvis in 5,10 to 14 and 15 years Dostoperative were 14.0 mm,14.1 mm and 13.7 mm,respectively,P＞0.05.The max vertical/level diameter of the neobladder in 5,10 to 14,15 years of postoperative were 110.4 mm/90.4 mm,111.5 mm/95.3mm and 127.0 mm/97.0 mm,respectively,P＞0.05.The residual urine of 5 cases was more than 50 ml and had not increased during follow up.Eight cases with neobladder stone were cured by the intracavitary lithothrypsis.Two cases with uretheral stricture were cured by the intracavitary therapy.Twelve cases of 14 cases with inguinal hernia were cured by reoperation,2 cases accepted conservative treatment.Only 17 cases had no complication involve of the cancer and the operation. Conclusion The upper urinary tract and neobladder of the ileal orthotopic neobladder could be stable for long time,the cure rate of tumor is satisfactory and the lifetime follow up is necessary.
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OBJECTIVE: To discuss the application of E-commerce system in Hospital drug management. METHODS: It analyzed the defects existed in current Hospital Information System (HIS), introduced hospital E-commerce system and evaluated comparatively the drug management information before and after the application of the e-commerce system. RESULTS & CONCLUSIONS: E-commerce system has effectively made up the functional insufficiency of HIS and changed the traditional drug purchase mode; therefore, its application has a bright future.
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Objective To study the application of transurethral bipolar plasma kinetic vaporization of the distal ureterectomy in radical nephroureterectomy for renal pelvic or ureteral carcinoma. Methods A total of 6 patients with renal pelvic or ureteral carcinoma without involvement in ipsilateral distal ureter,ureteral orfice,and the bladder were included.Radical nephroureterectomy was performed by using transurethral bipolar plasma kinetic vaporization combined with either flank incision nephrectomy (5 patients) or retroperitoneal approach laparoscopic nephrectomy(1 patient). Results The operation was completed smoothly in the 6 patients with comparatively little blood loss.The operation time was 120~210 min(mean,150 min).Obturator nerve reflex happened in no patients during the operation.Postoperative bladder irrigation found no bleeding in the bladder.The time of indwelling the catheter was 7~9 d(mean,8 d).Hypogastralgia and fever occurred in 1 patient on the 5th postoperative day.And the patient was confirmed as having mild urinary extravasation and was given catheter indwelling for 5 days. Transuretheral cystography found no leakage and a full recovery of voiding function was achieved.Postoperative pathological findings showed negative margins in all the patients.One patient died of myocardial infarction 3 months after operation,while follow-up in the remaining 5 patients for 7~21 months(mean,16 months) showed no tumor recurrence. Conclusions Application of transurethral bipolar plasma kinetic vaporization of the distal ureterectomy is micro-invasive,with little hemorrhage and few complications.It is an effective assistant option in radical nephroureterectomy.
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Modern medicine has a double characteristics of techniques and humanity in clinics especially in urology for new techniques and materials can be simply utilized by means of physical channel of urinal system.In the clinical practice of Uuology,we should consciously practice the medical ethics,such as autonomy right and respecting right,and offer humane care to patients indeed.These contributes to improving the quality of medical service,alleviating the contradictions between docters and patients,reducing medical disputes.
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Objective To investigate the applied perineal anatomy of the pudendal nerve of female and its direction to perineal operation.Methods The gross anatomy were done on 20 female cadaver(ensuring the pelvic,the hip and the perineum were intact).In each cadaver,the dissection proceeded from intrapelvic,the pudendal canal(Alcock'canal) and the ischiorectal fossa.The composition,track,abut,ramus and domination area of female pudendal nerve were examined.Results The gross anatomy showed that the pudendal nerve was composed of the ventro-branches of sacral nerve 2~4(S_2~S_4).The pudendal nerve sends off anal branch at level of the ischial spine.And the trunk courses in the internal pudendal canal forwardly and inwardly send off the perineal nerves and dorsal nerve of clitoris.The perineal nerves sends off branches to back lunar labium,muscle and urethra.The dorsal nerve of clitoris sends off the nerve to skin of clitoris,and some to the urethra simultaneously.The pudendal nerve has different abut in different anatomical position.Conclusions The perineal anatomy of the pudendal nerve has the meaningful direction to the perineal operations.