Comparison of safety and efficacy of 7.5 Fr and 9.5 Fr flexible ureteroscopy in the primary treatment of upper urinary tract calculi with maximum diameter<1.5 cm / 国际外科学杂志

Objective:To compare the safety and efficacy of 7.5 Fr and 9.5 Fr flexible ureteroscopy in the primary treatment of upper urinary tract calculi with maximum diameter<1.5 cm.Methods:Using a prospective randomized controlled study method, 96 patients with upper urinary tract calculi with maximum diameter<1.5 cm admitted to the Department of Urology, Beijing Friendship Hospital, Capital Medical University from August 2020 to May 2022 were selected as the study subjects. The patients were divided into two groups by random number table method: the experimental group and the control group, with 48 patients in each group. The experimental group patients underwent 7.5 Fr flexible ureteroscopic lithotripsy, while the control group patients underwent 9.5 Fr flexible ureteroscopic lithotripsy. Collect preoperative, intraoperative, and postoperative data from these patients, including success rate of ureteral access sheath insertion, surgical time, lithotripsy time, stone-free rate, ureteral injury status, and complications status. The measurement data were expressed as mean±standard deviation ( ± s), Student- t test was used for comparison between groups; the Chi-square test was used for inter-group comparison of count data, and the Mann-Whitney U test was used for inter-group comparison of rank data. Results:The success rate of primary sheath insertion in the experimental group was 93.8% (45/48), and that in the control group was 79.2% (38/48), the difference between the two groups was statistically significant ( P<0.05). There were no statistically significant difference between the experimental group and the control group in terms of surgical time [(52.0±11.0) min vs (55.1±11.4) min, P>0.05] and lithotripsy time [(26.0±9.3) min vs (23.7±8.7) min, P>0.05]. At four weeks after surgery, the stone-free rate in the experimental group was 93.3% (42/45), while that in the control group was 97.4% (37/38), there was no statistically significant difference between the two groups ( P>0.05). In terms of the degree of ureteral injury, there were 17 patients had grade 0 injury, 27 patients had grade 1 injury, 4 patients had grade 2 injury, and no patient had grade 3 injury in the experimental group; there were 9 patients had grade 0 injury, 23 patients had grade 1 injury, 13 patients had grade 2 injury, and 3 patients had grade 3 injury in the control group; the difference between the two groups was statistically significant ( P<0.05). In terms of complications, there were 22 cases of hematuria, 9 cases of pain, 8 cases of bladder spasm, and 2 cases of mild fever in the experimental group; there were 24 cases of hematuria, 12 cases of pain, 9 cases of bladder spasm, and 1 case of mild fever in the control group; there was no statistically significant difference between the two groups ( P>0.05). Conclusion:The application of 7.5 Fr flexible ureteroscopy and 9.5 Fr flexible ureteroscopy in the primary treatment of upper urinary tract calculi with maximum diameter<1.5 cm can achieve good stone-free rates, but the 7.5 Fr flexible ureteroscopy has a higher success rate of sheath insertion and less damage to the ureter.

Research progress on genotype and phenotype of primary hyperoxaluria / 国际外科学杂志

Primary hyperoxaluria (PH) are important causes of kidney stone and chronic kidney stone disease in children. Recurrent kidney stone disease and nephrocalcinosis should alter the physician to the possibility of an inborn error of metabolism as the underlying cause. Unfortunately, the lack of recognition of genotype and phenotype of PH resulted in an unacceptable delay in diagnosis and treatment, sometimes with grave consequences. This paper review the characteristics of genotype and phenotype, genotype-phenotype correlation, current treatment and future gene therapy of PH.

Treatment status of noninfective nonunion / 国际外科学杂志

Nonunion is the interruption of fracture healing process for a variety of reasons.The cause of the disease is different,and the treatment method is also different.Non-infective nonunion is that there are no local infection factors when nonunion occurs after wound and fracture,and it is most common in all nouunion.However,it is still a difficult problem for clinical orthopaedics.With the development of medical technology orthopaedics attach great importance to this kind of nonunion and study it deeply,its incidence is getting lower and lower.Despite brilliant results,the treatment for this kind of nonunion remains tricky.The treatment of non-infective nonunion can be divided into conservative treatment and surgical treatment,and the latter is still the main treatment.This article gives a systematic review of the treatment of non-infective nonunion.

Application of BMP-2 bone graftting material in nonunion after femoral intramedullary nail / 国际外科学杂志

Objective To investigate the clinical efficacy of bone grafts containing bone morphogenetic protein 2 (Bone Conduction) treating of nonunion of femoral fracture after intramedullary nailing.Methods The clinical data of 49 patients with nonunion of femoral fracture after intramedullary nailing from August 2008 to August 2016 were analyzed retrospectively.They were divided into experimental group and control group according to different bone grafting methods.The experimental group (n =23) was treated with Bone Conduction combined with allograft bone grafting.The control group (n =26) was treated with autogenous bone grafting.The autogenous bone was taken from the ipsilateral ilium.The two groups were compared operative time,intraoperative blood loss,postoperative wound complications,hospitalization time,postoperative visual analog scale,mean image healing time and the score for distal femoral fractures after the operation.All patients were followed up for 12 to 24 months.Follow-up methods were divided into telephone follow-up and outpatient follow-up.The patients were followed up for outpatients before fracture healing.The patients were followed up by telephone after fracture healing.The healing time of fracture,the flexion and extension activities of the knee joint at 9 months after operation were recorded.SPSS19.0 statistical software was used to analyze the data.Measurement data were expressed as ((x) ±s).The independent sample t test was adopted in measurement data and the counting data was tested by Chi-squared test.Result In the experimental group,operative time was (138.7 ± 34.6) minutes,intraoperative blood loss was (315.4 ± 52.8) ml,postoperative wound complications was 0 case,hospitalization time was (8 ± 3) days,postoperative visual analog scale was 5 scores,but in the control group,operative time was (170.5 ± 32.5) minutes,intraoperative blood loss was (367.2 ± 56.4) ml,postoperative wound complications was 3 cases,hospitalization time was (13 ± 2) days,postoperative visual analog scale was 8 scores.There were significant differences between the two groups,P ＜0.05.All patients who followed up for 12-24 months were recovered,with an average follow-up of 15 months.Mean image healing time in the experimental group and control group was separately(4.9± 2.5) months,(5.2 ± 2.8) months.The excellent and good rates ofthe score for distal femoral fractures 9 months after the operation was separately 95.7％,96.2％,there was no significant difference between the two groups,P ＞ 0.05.Conclusions Bone graft material containing bone morphogenetic protein 2 (Bone Conduction) has the advantages of simple operation,less trauma,less complications,high osteogenic activity and good bone graft effect are equalled with iliac bone graft,the bone graft material containing bone morphogene protein is an effective method to treat nonunion of femoral fracture after intramedullary nail.

Clinical analysis of 13 cases of urachal carcinoma / 国际外科学杂志

Objective To summarize the author' s clinical experiences in the diagnosis and treatment of urachal carcinoma.Methods Thirteen cases with urachal carcinoma from 1990-2011 at Beijing Friendship Hospital affiliated to Capital Medical University were retrospectively reviewed and analyzed.Results The most common complaint was hematuria;B ultrasonic or CT scan demonstrated a parenchyma or vesica between the bladder dome and abdominal wall.Nine patients underwent extensive pattical excision of the bladder,3 paitents underwent radical resection,and 4 patients received comprihensive chemotherapy.The five-year survival rate was 30.7％.Conclusion Extensive partial excision of the bladder is recommended for urachal carcinoma.

Update on perivascular epithelioid cell tumors of the urinary system / 国际外科学杂志

The perivascular epithelioid cell (PEC) is a cell type constantly present in a group of tumors called PEComas(perivascular epithelioid cell tumors). PEC expresses myogenic and melanocytic markers,such as HMB45. PEComa is a widely accepted entity now. PEComas are related to the genetic alterations of tuberous sclerosis complex (TSC), an autosomal dominant genetic disease due to losses of TSC1 or TSC2 genes. PEComas are rare in the urinary system and there are some open questions about PEComas regarding its histogenesis, the definition of epithelioid angiomyolipoma and the identification of the histological criteria of malignancy. This review provides an update on PEComas of the urinary system.

Pure laparoscopic radical nephrectomy and thrombectomy for renal tumors with renal vein and vena caval thrombus / 中华泌尿外科杂志

Objective To evaluate the feasibility of using pure laparoscopic radical nephrectomy and thrombectomy to treat renal tumor with renal vein and vena caval thrombus. Methods Two ca-ses o{ right renal tumor with renal vein and vena caval thrombus were reported. Contrast-enchanced CT showed renal tumor extended into renal vein and vena cava in 1 case, and filling defect was found in right renal vein and extended to vena cava in the other. Both patients received pure laparoscopic ra-dical nephrectomy and thrombectomy through retroperitoneal approach. Four trocars were placed du-ring the operation, and the renal artery was dissected before the vena cava was mobilized circumferen-tially above and below the renal vein, a faparoscopic vessel blockage clamp was used to partly occlude the vena cava containing the thrombus. The vena cava was repaired after the intact tumor thrombus was extracted. Results The tumor thrombus extended 0.3 cm and 1.0 cm above the renal vein, re-spectively. Both patients were discharged 5 d after operation. Pathological examinations showed that tumors were epithelioid renal angiomyolipoma and grade Ⅰ-Ⅱ clear cell carcinoma separately. Both patients were free of local recurrence and metastasis 5 months after operation. Conclusion Pure la- paroscopic radical nephrectomy and thrombectomy for renal tumor with vena caval and renal vein thrombus is feasible in carefully selected patients.

Application of complexity sequence in sleep staging based on sleep EEG data / 生物医学工程学杂志

In this paper an approach of time-window complexity sequence is applied to sleep EEG analysis. This approach can reduce the loss of state information due to the nonstationarity of EEG signal and the unevenness of state space, and can overcome certain limitations of the complexity itself to some extent. It will help to extract the state features of EEG in different sleep stages. In addition, we preprocess EEG by adopting ICA and wavelet transform (WT). The results show that some physiological artifact in EEG can be eliminated effectively by these methods, and the sleep staging based on sleep EEG data will be more exact.

The diagnosis and treatment of juxtaglomerular cell tumors (report of 5 cases) / 中华泌尿外科杂志

Objective To study the juxtaglomerular cell tumor. Methods The clinical characteristics,diagnosis,surgical teratment and the prognosis of 5 patients were retrospectively studied with review of the literature. Results All the patients had hypokalemia.Peripheral serum renin levels were recorded in 4 patients and 3 of them had high levels of peripheral serum renin activity and hyperaldosteronism while these were normal in the other 1.1 patient had been preoperatively diagnosed as a right adrenal tumor with a concurrent right kidney tumor while the post-operative histopathological studied revealed normal adrenal tissue and a juxtaglomerular cell tumor of the right kidney.All patients underwent simple tumor resection.The peripheral serum renin activity,hyperaldosteronism,hypokalemia,and hypertension became normal after the tumor resection.At a mean follow-up of 58 months (range 15 to 120 months ) no tumor recurrence and hypertension has been documented. Conclusions Juxtaglomerular cell tumor is a begin tumor of kidney,being a rare, curable cause of high levels of peripheral serum renin activity,hyperaldosteronism, hypokalemia and hypertension.Differential diagnosis includes primary hyperaldosteronism and renal artery stenosis.The prognosis is good with tumor resection.