Effect of negative pressure lithotomy on the incidence of infection related complications after percutaneous nephrolithotripsy / 中国医师进修杂志

Objective:To observe the incidence of infection related complications after percutaneous nephrolithotripsy.Methods:One hundred and forty-two patients with renal calculi who were treated in the First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from January 2017 to December 2018 were divided into control group (71 cases) and experimental group (71 cases) by random number method. Among them, the control group was treated with common sheath, the experimental group was treated with negative pressure lithotomy, and the patients were followed up for 1 year after the operation to count the recurrence. The patients in the two groups were compared in terms of perioperative indexes, intraoperative complication rate, postoperative complication rate, recurrence rate in 1 year′s follow-up and quality of life in 1 year′s follow-up.Results:The operation time in two groups had no significant difference ( P>0.05). The amount of bleeding in the experimental group was significantly higher than that in the control group [(12.15 ± 1.06) ml vs. (13.03 ± 1.17) ml], the length of hospitalization was significantly shorter than that in the control group [(5.13 ± 0.67) d vs. (6.02 ± 0.78) d], and the differences were statistically significant ( P<0.01). The incidence of intraoperative complications in two groups had no significant difference ( P>0.05). The incidence of postoperative complications in the experimental group was significantly lower than that in the control group [1.41%(1/71) vs. 11.27%(8/71)], the recurrence rate in the follow-up period of 1 year was significantly lower than that in the control group [1.14%(1/71) vs. 9.86%(7/71)], and the differences were statistically significant ( P<0.05). The scores of postoperative World Health Organization Quality of Life Questionaire BREF (WHOQOL-BREF) of the two groups had no significant difference ( P>0.05). At 1 year′s follow-up, the scores of WHOQOL-BREF in the experimental group were significantly higher than those in the control group ( P<0.01). Conclusions:With the help of vacuum lithotripsy in percutaneous nephrolithotripsy, but the incidence of postoperative complications can be significantly reduced, the length of stay can be shortened, the follow-up recurrence can be reduced, and the quality of life can be improved.

Association of urinary kidney injury molecu le-1 with renal tubulointerstitial lesions and its clinical significance in lupus nephritis patients / 中华风湿病学杂志

Objective To explore the association of urinary level of kidney injury molecule-1 (KIM-1) with renal tubulointerstitial lesions in patients with lupus nephritis (LN). And to find a potential clinical biomarker, which could reflect the specific tubulointerstitial lesions of LN. Methods Sixty cases of biopsy proven new-onset LN patients were enrolled into the study. And 10 normal kidney tissues were collected, which came from 10 patients with kidney trauma or renal tumor nephrectomy. Sixty patients with LN were divided into mild disease group, moderate disease group, severe disease group and the extremely severe disease group according to the criteria of 2000 Hill's morphologic index for the evaluation of renal pathology. Urine and renal tissues specimen were collected. The clinical and pathological data were analyzed retrospectively. Urine level of KIM-1 was detected by enzyme linked immunosorbent assay (-). Immunohistochemical staining was used to observe the expression of KIM-1 in the renal tissue. T-test, One-Way analysis of variance(ANOVA) test or rank sum test and Pearson or Spearman correlation analysis were used for statistical analysis. Results ①With the aggravation of tubulointerstitial lesions, the urinary level of KIM-1 was increased gradually, which was shown in the control group [(0.32 ±0.03) ng/ml], mild group [(2.31 ±0.30) ng/ml], moderate group [(6.12 ±0.51) ng/ml], severe group [(12.51 ±1.83) ng/ml] and the extremely severe group [(15.30 ±2.11) ng/ml] (all P0.05). The expression of KIM-1 in the renal tissue was positively correlated with serum creatinine (SCr), quantity of 24 h UP, SLEDAI, R-SLEDAI, GAI, TLAI and AI (r=0.780, 0.780, 0.812, 0.727, 0.735, 0.910, 0.701, P0.05). Conclusion Urinary KIM-1 enables to assess the tubulointerstitial lesion in LN patients, and it can be a sensitive biomarker to predict the tubulointerstitial damage and to evaluate the degree of tubulointerstitial lesions.

Standardized Research and Analysis about Integrated Traditional and Western Treatment Programs of Lower Urinary Infection / 浙江中医药大学学报

[Objective] To standardize integrated traditional and western treatment programs of lower urinary infection and evaluate its effect and to insure the safety. [Methods] TCM syndrome type of lower urinary tract infection is divided into Xuelin type, gaolin type, laolin type, qilin type, relin type. Each type col ects separately 60 patients. Every 60 patients are randomly divided into experimental and control groups.The way to treat the patients for the con-trol group must be in accordance with the norms of western medicine treatment of anti-infection. By contrast, the way that the patients from the experi-mental group should be based on the western medicine treatment, simultaneously what is to be emphasized is that the treatment must also be according to Chinese medicine syndrome type plus Chinese herb. The three elements efficacy, cost-effectiveness and security analysis are used to evaluate the differences between the two groups. [Results]The experimental group of relin type and qilin type has no statistical y significant difference in the efficacy of the control group.The efficacy of experimental group of xuelin type, gaolin type and laolin type is better than the control group,and cost-effectiveness ratio has no significant difference.There is no serious adverse reaction. [Conclusion] Screening of lower urinary tract infection patients with blood type, cream drench type, combination of traditional Chinese and western medicine treatment, can improve the curative effect.

Effect of Third Sacral Nerve Root Electro-acupuncture Therapy on Acontractile Detrusor / 中国康复理论与实践

@#ObjectiveTo observe the effect of third sacral nerve root electro-acupuncture on acontractile detrusor. Methods84 patients with acontractile detrusor were divided into 2 groups received urethral catheterization alone (control) or electro-acupuncture on third sacral nerve (treatment) respectively. The voiding diary (including urination times, nocturia times and urinary volume) and urodynamics test (including maximum bladder volume, maximum systolic pressure detrusor, the effective time of detrusor contraction, maximum urinary flow rate, average urinary flow rate and residual urine volume) were observed before and 8 week after treatment. ResultsCompared with those before treatment, the urination times, nocturia times and residual urine volume decreased (P<0.05) in treatment group, while maximum systolic pressure detrusor, the effective time of detrusor contraction, maximum urinary flow rate, average urinary flow rate and residual urine volume improved (P<0.05), but the maximum bladder capacity showed no significant difference (P>0.05). ConclusionElectro-acupuncture on third sacral nerve is an effective intervention for acontractile detrusor.

Experimental Study on Yinhuang Solution on Bladder Mucosal Injury in Rat / 中国康复理论与实践

@#ObjectiveTo investigate the effects of Yinhuang solution on the bladder mucosal before and/or after mucosal injury.Methods32 SPF female SD rats were randomly divided into 4 groups with 8 rats in each group. Group A was used for the normal control group, group B for the model control group, group C for preventive group, group D for preventive and therapeutic group. Injured rats were created by hydrochloric acid applied on bladder mucosa. After the models were established or before and after the models were established, bladders were perused with Yinhuang solution. Severity of inflammatory infiltration were observed by HE staining, histological score and heat shock protein 70 (HSP70) expressed in the mucosa.ResultsEndoscopic pathological change showed that group B had a large number of inflammatory cell infiltration, significant expansion of capillary, epithelial cell necrosis. Group C had a small amount of expansion of capillary, inflammatory cell infiltration. Group D scattered in expansion of capillary, a small amount of inflammatory cell infiltration. Concerning the results of histological score and HSP70 expression, there was a significant difference between group A and groups B, C or D (P<0.01); there was a significant difference between group B and groups C or D (P<0.01); there was a significant difference between group C and group D (P<0.05).ConclusionYinhuang solution can evidently improve the repair capability of bladder mucosa after injury.