الملخص
@#Objective To evaluate the efficacy of mechanical thrombectomy under the guidance of multi-mode computed tomography in the treatment of acute anterior circulation cerebral infarction caused by cardiogenic embolism.Methods We retrospectively analyzed the baseline and follow-up data of patients with cardiogenic acute anterior circulation ischemic stroke treated with mechanical thrombolectomy.According to the preoperative evaluation,the patients were divided into MMCT group and NCCT group.The efficacy was analyzed by comparing the vascular revascularization rate,NIHSS score and 3-month Modified Rankin Scale (mRS) score of the two groups,and the safety was analyzed by comparing the conversion risk and mortality of symptomatic bleeding.Multivariate logistic regression was used to analyze the factors affecting the prognosis of patients.Results A total of 118 eligible patients were finally included,including 58 in MMCT group and 60 in NCCT group.There was no significant difference in the proportion of functionally independent patients between the two groups 3 months after surgery (58.9% vs 31.7% P=0.034),and no significant difference in symptomatic intracranial hemorrhage transformation and mortality (P>0.05).Multivariate regression analysis showed that MMCT and baseline NIHSS score were independent prognostic factors. Conclusion Mechanical thrombectomy under the guidance of multi-mode CT evaluation does bring better clinical prognosis for patients with acute anterior circulation cerebral infarction caused by cardiac embolism.MMCT and baseline NIHSS score are closely related to the prognosis of patients with acute anterior circulation cerebral infarction caused by cardiac embolism.Future studies are needed to further verify the above conclusions.
الملخص
Objeetive To explore the clinical application value of new modified paracalculous ureteral catheter in ureteroscopic holmium laser lithotripsy for the treatment of large middle and lower ureteral stone.Methods From January 2014 to January 2017,86 patients with unilateral middle and lower ureteral large stone were treated in Jingzhou Central Hospital.By adopted to random digital table,86 patients were randomly separated into two groups,all of whom were treated with ureteroscopic holmium laser lithotripsy.Forty-three cases were underwent new modified laser lithotripsy with ureteral catheter inserted beneath the stone.Normal saline was injected continuously through the catheter during lithotripsy procedure (modified lithotripsy group).Forty-three cases were underwent direct ureteroscopic holmium laser lithotripsy (direct lithotripsy group).The outcome data were compared between the two groups,such as the operation time,stone clearance rate,ureteral perforation,transit to open surgery,postoperative urinary sepsis,perirenal hematoma,ureterostenosis and other complications.Measurement data were expressed as ((x) ± s),and t test was used for comparison between groups.Results All the patients in the modified lithotripsy group were completed successfully without ureteral perforation,rupture,loss of lithotripsy channel,transit to open surgery,perirenal hematoma,and urinary sepsis and so on.In the direct lithotripsy group,there were 5 cases of ureteral perforation,4 cases of lithotripsy channel loss,6 cases of transit to open surgery,2 cases of perirenal hematoma,1 case of urinary sepsis.The operation time of the two groups was (39.5 ± 7.2) min and (47.2 ± 11.6) min,respectively,t =-4.975,P =0.001.Stone clearance rate was 100％,91.1％.The patients in both groups received an average of 1 year out-patient follow-up.There were 3 cases of mild ureterostenosis in the modified lithotripsy group,which were not re-operated.In the direct lithotripsy group,there were 5 cases of mild ureterostenosis,and 2 cases of severe ureterostenosis,which were re-operated.Conclusion It is safe and effective to use the new modified paracalculous uteteral catheter in the ureteroscopic holmium laser lithotripsy of large middle and lower ureteral stone,which can shorten the total operation time and reduce the occurrence of complications.It has a higher clinical value.
الملخص
Objective To investigate the change of AQP1 and AQP2 before and after the release of obstruction and explore the relationship between reabsorption dysfunction of renal tubule and the change of AQPs. Methods The model of unilateral ureter obstruction (UUO) was established by surgery. Western blot and immunohistochemistry were used to study the expression of AQPs before and after obstruction. Results In UUO model, both AQPs began to down-regulate one day after obstruction, the expression of both AQPs became lower one day after the release of obstruction. And they started to up-regulate 7 day after the release of obstruction. AQP2 became normal since 14 days after the release of obstruction, and AQP1 became normal since 21 days after the release of obstruction. Conclusion The expression of AQP1 and AQP2 were descended in hydronephrosis. The dysfunction of renal tubule and the osmotic-dependent polyuria after the release of obstruction in UUO were caused by the down - regulation of AQPs.