目的 总结B超定位ESWL治疗尿路结石的临床经验. 方法 回顾性分析1995年8月至201 1年7月采用B超定位电磁冲击波体外碎石一体机治疗的20 625例尿路结石患者的临床资料.肾结石8659例，输尿管结石11 712例，膀胱结石 254例.阴性结石 1965例. 结果 结石总粉碎率97.04％( 20 014/20 625)，其中肾结石粉碎率96.27％( 8336/8659)，输尿管结石粉碎率97.56％(11 426/1l 712)，膀胱结石粉碎率99.21％ (252/254).术后3个月结石总排净率91.69％(18 912/20 625)，其中肾结石排净率86.63％(7501/8659)，输尿管结石排净率95.32％ (11 164/11 712)，膀胱结石排净率97.24％(247/254).阴性结石总粉碎率为97.91％(1924/1965)，术后3个月排净率为94.40％ (1855/1965).结论 B超定位ESWL治疗尿路结石安全有效，但需要严格掌握其适应证，以提高治疗效果.
Background Pain has a substantial impact on patients' activities and overall quality of life， but current conventional drugs have debilitating side effects， including gastrointestinal disorders. Thus there is a pressing need for new therapies with fewer side effects to alleviate cancer pain. We recently developed a topical herbal formula Xiaotan Tongluo analgesic gel (XTTL gel) based on the principles of traditional Chinese herbalism， and we have received positive feedback from bone cancer pain patients. The aim of this study was to determine the analgesic effects and explore the mechanisms of XTTL gel in a rat model of bone cancer pain. Methods The rat model of bone cancer pain was established by inoculating Walker-256 rat carcinoma cells directly into the right tibial medullary cavity of Wistar rats. The rats were randomly assigned to three groups (n=10 per group)： (1) sham bone cancer control (sham group)： vehicle (PBS) inoculation without carcinoma cells plus topical administration of blank gel; (2) Sham treatment control (vehicle group)： Walker-256 cell inoculation plus topical administration of blank gel; (3) XTTL gel treatment (treatment group)： Walker-256 cell inoculation plus topical administration of XTTL gel. XTTL gel treatments were applied daily for 7 days starting on day 14 following inoculation. Outcomes were assessed 21 days after inoculation by mechanical allodynia， histological staining， and by measuring concentrations of type I collagen carboxy-terminal telopeptide (ICTP) and bone-specific alkaline phosphatase (BAP) in serum. Results Fourteen days after cancer cell incubation， significant mechanical allodynia in the ipsilateral hind paw and tumor growth in proximal end of the tibia were observed in the vehicle and treatment groups but not in the sham group. At day 21， mechanical withdrawal thresholds in treatment group rats were significantly higher ((4.8557±0.8336) g) compared with those of the vehicle group ((1.8630±1.4369) g， P 0.05). Conclusion Topical use of XTTL gel may have an analgesic effect on bone cancer pain， an effect mediated by lowering of ICTP levels and inhibiting bone resorption.
New insights into arterial structural-functional interactions and the implications for pressure augmentation in humans: a meta regression analysis in 8336 subjects
Regional differences in haemoglobin values and process care measures were examined using data from the Centers for Medicare & Medicaid Services' End-Stage Renal Disease (ESRD) Clinical Performance Measures Project. It was posited that regional differences in haemoglobin values are consequent upon differences in components of clinical practice.A national random sample of 8336 adult， in-centre haemodialysis patients， stratified by the 18 regional ESRD Networks， was drawn. Information was collected for October-December 1998. Multivariable stepwise linear and logistic regression analyses were performed to identify variables associated with haemoglobin. Linear regression analysis was used to identify variables associated with Epo/Hb index (mean weight-adjusted treatment level erythropoietin (Epo) dose divided by mean haemoglobin).The percentage of patients with haemoglobin concentration < 11 g/dl ranged from 34 to 52% across ESRD Networks. In addition to haemoglobin there was significant， non-random variation among ESRD Networks with regard to prescribed Epo dose and administration route， intravenous (IV) iron prescription and dialyser flux (high flux = KUf > or = 20 ml/mmHg/h) (all P-values < 0.001). Higher haemoglobin was associated with older age， male gender， higher serum albumin， higher transferrin saturation， higher Kt/V， lower serum ferritin and lower prescribed Epo dose (all P-values < 0.01). Diabetes mellitus as cause of ESRD， high-flux dialyser use， IV iron prescription or subcutaneous Epo prescription were not associated with haemoglobin. Male gender， diabetes as cause of ESRD， older age， higher transferrin saturation and higher albumin concentrations were associated with lower Epo/Hb index. Prescription of IV iron and IV Epo were associated with higher Epo/Hb index.Regional mean haemoglobin levels vary considerably across the US and the variation in haemoglobin is explained by both non-modifiable factors and modifiable clinical practice-derived variables.
Meta regression analysis of aortic reflection timing to locate the site of reflection and to identify its relationship with arterial stiffness and age in 8336 subjects
摘 要： 目的：Vita In-Ceram渗透氧化铝陶瓷、氧化锆陶瓷和Ivoclar Vivodent EmpressⅡ铸瓷材料相对透明率的对比测定.方法：采用分光光度计分别测量4种颜色的Vita In-Ceram渗透氧化铝、4种颜色的渗透氧化锆陶瓷、3种颜色的EmpressⅡ铸瓷底层材料的可见光积分透射率.结果：牙本质瓷和遮色瓷的相对透明率范围从0.5958～0.8336，而核瓷材料相对透明率的范围从EmpressⅡ的0.8089到渗透氧化锆陶瓷的1.00.结论：3种全瓷系统底层材料的相对透明率组间具有显著性差异，按数值高低排序为EmpressⅡ＞In-Ceram氧化铝和In-Ceram氧化锆.
摘 要： 目的：探讨规范化早孕期超声结构筛查在胎儿中枢神经系统畸形诊断中的临床价值。方法：对6902例（8336胎）孕11～13＋6周胎儿（单胎妊娠5468例，双胎妊娠1434例）行规范化早孕期超声结构筛查，并追踪妊娠过程和临床结局。结果：6902例（8336胎）11～13＋6孕周胎儿中产前超声检出中枢神经系统畸形13例（单胎妊娠10例，双胎妊娠 3例），其中露脑畸形5例，无脑儿 4例，前脑无裂 2例，脑膜膨出1例，开放性脊柱裂1例。合并其他结构异常 4例，染色体核型异常 3例。13例胎儿随访结果：除 3例双胎畸形胎儿经选择性减胎术后正常胎儿继续妊娠，余胎儿引产前超声与引产后尸检结果相符合。结论：规范化早孕期超声结构筛查可及早发现胎儿中枢神经系统畸形，对降低畸形胎儿的出生率及指导产科处理均有重要临床价值。
AbstractWe evaluated the impact of total prostate volume (TPV) on the international index of erectile function-5 (IIEF) and the premature ejaculation diagnostic tool (PEDT). A cross-sectional study was conducted that included 8336 men who had participated in a health examination. PEDT， IIEF and transrectal ultrasonography were used. A full metabolic work-up and serum testosterone level checks were also performed. The median age of participants was 51.0 years. In total， 40.1% had IIEF scores ≤16. Additionally， 24.7% were classified as demonstrating premature ejaculation (PE) (PEDT > 10). The severity of erectile dysfunction (ED) significantly increased with the TPV (p trend < 0.001). After adjusting for potential confounding factors， the odds ratio (OR) for IIEF scores ≤ 16 significantly increased in the group with TPVs of 30–39 cm3 and the group with TPVs ≥ 40 cm3 compared with the group with TPVs ≤ 19 cm3 (TPV 30–39 cm3， OR： 1.204， 95% confidence interval： 1.034–1.403; TPV ≥ 40 cm3， OR： 1.326： 95% confid...
Ureteral avulsion is an uncommon yet severe complication of ureteroscopy. Among 8336 patients who received ureteroscopic procedures in our hospital from December 2001 to December 2011， we encountered two cases of ureteral avulsion. The first of these experienced disruption at the ureteropelvic junction due to extraction of the tubular ureter from the urethra， which was corrected by immediate open surgery to reposition and anastomose the ureter. The second patient sustained a proximal ureteral disruption following retrieval of the ureteroscope， which was wedged in the narrow lumen of the proximal ureter， and led to simultaneous extraction of the distal ureter. Immediate surgical intervention was performed to maintain ureteral continuity. Mild hydronephrosis was observed in kidneys that were ipsilateral to the ureteral avulsion in both patients. However， no physical discomfort or loss of renal function was indicated after 12 months.