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Objective To investigate the related factors of systemic inflammatory response syndrome after percutaneous nephrolithotomy in the treatment of upper urinary tract stones.Methods The clinical data of 101 patients after percutaneous nephrolithotomy from August 2016 to April 2018 in Miyun Teaching Hospital,Capital Medical University were retrospectively analysed.Screened the independent variable such as gender,with fever or not,with diabetes or not,with hydronephrosis or not,urine leucocyte count,volume of urinary calculi,CT attenuation value of urinary calculi and presence of intraoperative infection,and analyzed the relationship those with systemic inflammatory response syndrome after surgery.Univariate and multivariate logistic regression analysis the factors related to systemic inflammatory response in patients after surgery.Results Of the 101 patients,62 cases was male,and 39 cases was female,12 (11.9％) suffered postoperative systemic inflammatory response syndrome.Univariate regression analysis indicated that the risk factors of systemic inflammatory response syndrome after percutaneous nephrolithotomy were gender,with diabetes or not,urine leucocyte count,volume of urinary calculi and presence of intraoperative infection.Furthermore,multivariate logistic regression analysis revealed that with diabetes,intraoperative infection,urine leucocyte count and volume of urinary calculi were the independent factors of systemic inflammatory response syndrome after percutaneous nephrolithotomy.Conclusion Patients with diabetes,intraoperative infection,urine leucocyte count and volume of urinary calculi could be predicted as the independent factors of systemic inflammatory response syndrome after percutaneous nephrolithotomy,but it has no relationship with gender,with a history of fever or not,with hydronephrosis or not,and CT attenuation value of urinary calculi.
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Objective@#To evaluate the clinical efficacy of percutaneous nephrolithotomy combined with flexible ureteroscopy and holmium laser lithotripsy in the treatment of complicated renal calculi.@*Methods@#Clinical data of 139 patients with complicated renal calculi from March 2013 to March 2019 in Miyun Teaching Hospital, Capital Medical University were retrospectively analyzed. There were 76 males and 63 females, the average was (47.9±3.1) years, aged from 27 to 75 years. The total patients were divided into control group (n=69) and treatment group (n=70) according to different treatment method. The patients in the control group treated with percutaneous nephrolithotorny, the patients in the treatment group were treated with flexible ureteroscopy and holmium laser lithotripsy on the bassis of the control group. Compared the operation time, hospital stays, intraoperative blood loss, effective rate and complication incidence rate between two groups. Measurement data were expressed as mean± standard deviation (Mean±SD), and t-test was used for comparison between groups; count data was compared by Chi-square test.@*Results@#In the control group, the operation time, length of hospital stay and intraoperative blood loss were (65.85±3.83) min and (8.83±4.00) d, (130.72±1.20) ml, respectively, the treatment group were (43.44±3.16) min, (5.72±1.07) d, (96.21±0.98) ml, respectively, the difference between group there was statistical significance (P<0.05); the total effective rate of the control group was 84.0% (58/69), which was significantly lower than that of the treatment group [95.7% (67/70)], and the difference between the groups was statistically significant (P<0.05). The incidence of postoperative complications of the treatment group[2.8% (2/70)] was significantly lower than the control group[14.5% (10/69)], and the difference between the two groups was statistically significant (P<0.05).@*Conclusion@#The complicated renal calculi by percutaneous nephrolithotomy combined with flexible ureteroscopy and holmium laser lithotripsy has the advantage of short operation time, less blood loss, faster recovery and low complication incidence rates, has clinical use and promotion value.
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Objective To evaluate the clinical efficacy of percutaneous nephrolithotomy combined with flexible ureteroscopy and holmium laser lithotripsy in the treatment of complicated renal calculi.Methods Clinical data of 139 patients with complicated renal calculi from March 2013 to March 2019 in Miyun Teaching Hospital,Capital Medical University were retrospectively analyzed.There were 76 males and 63 females,the average was (47.9 ±3.1) years,aged from 27 to 75 years.The total patients were divided into control group (n =69) and treatment group (n =70) according to different treatment method.The patients in the control group treated with percntaneous nephrolithotorny,the patients in the treatment group were treated with flexible ureteroscopy and holmium laser lithotripsy on the bassis of the control group.Compared the operation time,hospital stays,intraoperative blood loss,effective rate and complication incidence rate between two groups.Measurement data were expressed as mean ± standard deviation (Mean ± SD),and t-test was used for comparison between groups;count data was compared by Chi-square test.Results In the control group,the operation time,length of hospital stay and intraoperative blood loss were (65.85 ± 3.83) min and (8.83 ± 4.00) d,(130.72 ± 1.20) ml,respectively,the treatment group were (43.44 ± 3.16) min,(5.72 ± 1.07) d,(96.21 ± 0.98) ml,respectively,the difference between group there was statistical significance (P ＜ 0.05);the total effective rate of the control group was 84.0％ (58/69),which was significantly lower than that of the treatment group [95.7％ (67/70)],and the difference between the groups was statistically significant (P ＜ 0.05).The incidence of postoperative complications of the treatment group[2.8％ (2/70)] was significantly lower than the control group[14.5％ (10/69)],and the difference between the two groups was statistically significant (P ＜ 0.05).Conclusion The complicated renal calculi by percutaneous nephrolithotomy combined with flexible ureteroscopy and holmium laser lithotripsy has the advantage of short operation time,less blood loss,faster recovery and low complication incidence rates,has clinical use and promotion value.
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ObjectiveTo observe the relationship between neuronal function score,brain edema and aquaporin4(AQP4) expression of fluid percussion brain injury in rats.MethodsThe fluid percussion models of brain injury of rats were established by using the improved device.Nervous function score,brain water content,histological changes,AQP4 expression were observed by Shapira and Wahld method,dry-wet measure,light microscopy,immunohistochemistry and western blot at 1 h,6 h,12 h,24 h,3 d and 7 d after operation respectively.ResultsNervous function score in TBI group decreased at 12 h( 11.17 ± 1.32),reached its minimum at 24 h( 10.17± 0.75),and recoved partially at 3rd day( 10.66 ± 1.37 ).The water content obviusly increased in those of TBI group at 12h( (80.27 ±1.47)％ ),reached its peak at 24h( (82.19 ±0.97)％ ),and then began to drop at 3d ( (8 1.74 ± 1.69 ) ％ ),while Western blot showed that AQP4 immunoreactive expression obviusly increased at 12 h (OD:0.65 ±0.05),reached its maximum at 24h( OD:0.72 ±0.08),and decreased at 3d( OD:0.56 ±0.07),and immunohistochemistry showed the same trendency of AQP4 expression as that of Western blot.The linear regression analysis indicated that nervous function score had a negtive correlation with expression of AQP4 in edematous brain and change of brain water content respectively ( r =- 0.615,P ＜ 0.01 ; r =- 0.605,P ＜ 0.05 ).ConclusionNervous function score of fluid percussion brain injury in rats decrease,has negative relationship with brain edema and AQP4 expression,and possible mechanisms is that AQP4 is indirectly involed in nerve function impairment by mediating brain edema.
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ObjectiveTo observe the relationship between neuronal function score and pathological changes of fluid percussion brain injury in rats and to explore their clinical significances.MethodsThe fluid percussion models of brain injury in rats were established by using the improved device with three kinds impact pressure such as 0.1 MPa,0.2 MPa,0.3 MPa,and vital signs and mortality rate were observed.Behavior changes,brain water content,histological changes were observed by Shapira and Wahld method,dry-wet measure,light microscopy at 1 h,6 h,12 h,24 h,3 d and 7 d after operation respectively.ResultsThe animals accepted impact pressure of 0.1 MPa showed temporary hypopnea with mortality rate of 2.08％,those of 0.2 MPa suffered apnoea of ( 10.88 ±2.69 ) s with mortality rate of 4.17％ and those of 0.3 MPa suffered apnoea of ( 20.60 ± 3.02 ) s with mortality rate of 16.67％.As the impact pressure increased,nervous function score minimumly decreased to (7.17 ±0.75) of 0.1 MPa group,(4.83 ± 0.75 ) of 0.2 MPa group and (2.67 ± 0.52) of 0.3 MPa group respectively,and recovered more slowly.Brain water content maximumly reached to (81.12 ± 0.03 )％,(82.74 ± 1.11 )％ and (83.89± 0.04) ％ at time point of 24 h respectively.The brain injury was involved in the outer layer of cerebral cortex,hippocampal formation and brain stem respectively and histological observation verified above findings.Conclusion Light,moderate and heavy fluid percussion brain injury in rats have more and more low nervous function scores,which have positive relationship with more and more serious pathological changes.