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Objective:To explore the effect of postoperative stent placement time on flexible ureteroscopy lithotripsy (FURL) in the treatment of kidney calculi.Methods:A retrospective analysis of 126 patients with kidney calculi admitted to Guangyuan Central Hospital from April 2017 to November 2018. All patients were treated with FURL. The patients were divided into two groups according to the time of stent placement after FURL: conventional tube placement group ( n=91) and short-term tube placement group ( n=35). The postoperative stent placement time of patients in the conventional tube placement group was 4 weeks, and the postoperative stent placement time of patients in the short-term tube placement group was 2 weeks. The postoperative outcome indicators (hospitalization time and stone-free rate), postoperative complication indicators (postoperative hematuria, renal hematoma, urinary tract infection and fever) and postoperative pain were compared between the two groups. The measurement data was expressed as mean±standard deviation ( Mean± SD), and the Student′s t test was used for comparison between groups; the Chi-square test was used for comparison between counting data. Results:There were not significant differences in hospitalization time [(7.22±1.02) d vs (7.26±1.22) d], stone-free rate 1 month after surgery (84.6% vs 82.8%), stone-free rate 2 month after surgery (93.4% vs 88.5%), postoperative hematuria (10.9% vs 11.4%), renal hematoma (3.3% vs 0) and fever (2.2% vs 0) between the conventional tube placement group and short-term tube placement group ( P>0.05). Compared with the conventional tube placement group, the short-term tube group had lower urinary tract infection rates (17.6% vs 2.9%), the difference was statistically significant ( P<0.05). There was not significant difference in the average use rate of opioids [(1.05±0.45) vs (1.00±0.50), P>0.05], acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) [(1.52±0.55) vs (1.45±0.45), P>0.05] between the two groups during hospitalization. There was not statistically significant difference in the incidence of abdominal pain after discharge from the hospital [(1.25±0.55) vs (1.15±0.45)]. The number of applications of acetaminophen and NSAIDs in the conventional tube placement group was greater than that in the short-term tube placement group [(1.45±0.46) vs (1.25±0.30)] after one month, the difference was statistically significant ( P<0.05). Conclusions:Short-term tube placement after renal FURL surgery is as effective as traditional long-term stenting, achieving the same stone-free effect and reducing early postoperative complications. For the reduction of postoperative infection and postoperative pain, short-term stenting has certain advantages.
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Objective:To study and analyze the relationship between slow coronary flow (SCF) and vascular endothelial func‐tion .Methods:A total of 88 patients ,who received coronary angiography in our hospital from Jan 2014 to Dec 2014 ,were selected .TIMI blood flow classification was used to assess coronary flow velocity of all patients .The CTFC (corrected TI‐MI frame count ) >27 frames was regarded as slow flow .The patients with slow flow were regarded as SCF group (n=43) , and those with normal blood flow were regarded as normal control group (n=45) .Levels of blood pressure ,blood glucose and blood lipids ,and vascular endothelial function were measured and compared between two groups .Logistic regression a‐nalysis was used to analyze the relationship between SCF and vascular endothelial function .Results:There were no signifi‐cant difference in levels of blood pressure ,blood glucose and blood lipids between two groups , P>0. 05 all .Compared with normal control group , there were significant reductions in fore brachial artery flow‐mediated vascular diastolic function [FMD ,(8. 33 ± 2. 04 )% vs . (7. 06 ± 1. 78 )% ] and nitroglycerin mediated vasodilation [NMD , (20. 39 ± 4. 13 )% vs . (16.10 ± 5.22)% ] in SCF group ,P<0.01 both .Logistic regression analysis indicated that reduced FMD (OR=1.069 ,P=0.011) and NMD (OR=1.183 ,P=0.014) were risk factors for SCF .Conclusion:The vascular endothelial dysfunction is a risk factor of slow coronary flow .
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Objective:To study the predictive value of red cell distribution width (RDW)on poor myocardial perfu- sion in patients with acute myocardial infarction(AMI)treated by percutaneous coronary intervention (PCI).Meth-ods:From August 2013 to August 2015,a total of 212 ACS patients undergoing PCI in our hospital were selected. According to RDW of blood analyzer,patients were divided into RDW50% were regar- ded as good myocardial perfusion group (n=134).Clinical data were compared between two groups,and single fac- tor and multi-factor analysis were used to analyze influencing factors for myocardial perfusion.Results:Compared with RDW<13.0% group,there were significant rise in age [(62.85±5.23)years vs.(67.33±6.17)years],and significant reductions in left ventricular ejection fraction [LVEF,(52.37±6.14)% vs.(50.55±5.53)%]and STR [(0.73±0.26)vs.(0.57±0.39)]in RDW≥13.0% group,P<0.05 or <0.01. Compared with good myocardial perfusion group,there were significant reductions in percentage of RDW<13% (59.70% vs.44.87%)and LVEF [(52.25±3.81)% vs.(50.29 ± 4.08)%],and significant rise in age [(63.29 ± 1.93)years vs.(66.42 ± 2.15) years]in poor myocardial perfusion group,P<0.05 all.Multi-factor Logistic regression analysis indicated that age, LVEF and RDW were independent predictors for poor myocardial perfusion (r=3.826~6.525,P<0.01 all).Con-clusion:Red cell distribution width possesses good predictive value for poor myocardial perfusion in patients with a- cute myocardial infarction undergoing percutaneous coronary intervention,which is worth extending in clinic.
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Objective To evaluate the value of international normalized ratio (INR) in predicting and diagnosing hemorrhagic events in patients with nonvalvular atrial fibrillation (NVAF)receiving wafarin, to determine the optimal cut-off value of INR for predicting hemorrhagic events by receiver operator characteristic (ROC) curve. Methods The data of 231 patients with NVAF receiving wafarin were retrospectively analyzed, including 93 patients with hemorrhagic events and 138cases without hemorrhagic events as control group. The PT and INR were detected by Sysmex CA-500 with Medcalc software plotting ROC curve. Results The area under the ROC curve for INR was 0. 822 (95%CI: 0. 717-0. 900), the analysis of ROC curve revealed the optimal cut-off value of INR was 2.71, which presented a sensitivity of 77.40% and a specificity of 78.30%. Conclusions Through evaluation by ROC curve, the new cut-off value provides substantial improvement in sensitivity, with an acceptable loss of specificity. The value on predicting hemorrhagic events is better, the discriminative power of INR between hemorrhagic events and nonhemorrhagic events is satisfactory. The cut-off value of INR can guide the clinical physicians to predict the risks of hemorrhagic and promote proper use of clinical medications.