输尿管镜下气压弹道碎石术治疗60例输尿管上段结石

目的探讨输尿管镜下气压弹道碎石术治疗输尿管上段结石的临床疗效。方法置入输尿管镜，经膀胱逆行置入F5输尿管导管，缓慢将输尿管镜进入输尿管后在直视下观察结石，置入气压弹道碎石机进行碎石，取石结束后常规留置F6双J管。结果手术时间30～58min，（45．8±10．1）min；术中出血量7—18ml，（10．9±3．1）ml。8例由于术中结石冲人肾盂，术后改用体外冲击波碎石治疗，一次手术成功率86．7％（52／60）。2例分别于术后7、9d发生脓毒血症，经保守治疗痊愈。43例随访1—6个月，平均3个月，无肾积水及输尿管狭窄发生，术后1个月内结石均排净。结论输尿管镜下气压弹道碎石术治疗输尿管上段较小的结石疗效满意。     

弹性排班模式在我院肾科病房的实践与成效

目的 探讨弹性排班模式在肾科病房实施的效果.方法 在系统调研的基础上,结合病房工作特点,将排班模式分为固定班、弹性班和按需听班3种形式.结果 实施弹性排班后,病房的健康教育、护理满意度、基础护理达标率和护患沟通满意度均提高(P<0.01).结论 科学、合理排班是提高护理质量、确保健康教育落实的有效途径,能够提高护理满意...     

输尿管软镜在上尿路上皮肿瘤诊断中的应用价值

目的：探讨输尿管软镜住上球路上皮肿瘤诊断中的应用价值。方法：收集2006年6月～2012年4月间应用输尿管软镜镜检诊断上尿路上皮肿瘤57例资料。患者术前均行影像学检查（IVP＋泌尿系CT或CTU）。根据影像学俭杏有无肄常，结果分为A、B两组。所仃患者均使用F8输尿管镜检查并取病理活检·活榆标本病理确诊后予患侧输尿管肾全切术，肿瘤分期分级以术后大体手术标本病理为准。比较A、B两组间肿瘤大小、分期、分级的差异。结果：A组患者肿瘤直径为（2．6±1．5）cm显苦大于B组患者的（1．0±0．5）cm（P〈0．01）。A组患者E尿路上皮肿瘤临床分期亦较B组晚（P=0．020）。两组患者病理分级差异无统计学意义（P=0．075）。结论：输尿管软镜能发现传统影像学检查不能发现的甲期较小肿瘤．有望成为诊断上尿路上皮肿瘤常规检杏方式。     

Full-time work for nurses: employers’ perspectives

Aim To examine an employer response to a government employment policy, the Nursing Graduate Guarantee (NGG), over a 2-year period (2008–2009 and 2009–2010). Background Healthcare organizations rely on a stable supply of nurses to meet their staffing needs. However, employment trends have indicated a propensity for part-time employment. The NGG was created to stimulate full-time employment of new graduate nurses in Ontario, Canada. Methods A mixed methods design was used, which included online surveys and focus groups. All healthcare providers (n = 1198) were surveyed in 2008–2009 and 2009–2010. Each year, a sample of NGG employers participated in sector-specific focus groups. Results Approximately 20% of potential healthcare employers participated in the NGG. Reasons for non-participation included lack of awareness of the initiative and lack of full-time jobs. Barriers to offering full-time employment to new graduates included lack of full-time vacancies and budget constraints. Conclusions Employers perceive flexible staffing practices as a way to contain personnel costs but often at the expense of a stable full-time nursing workforce. Implications for Nursing Management This research contributes to an understanding of employers’ perspectives on full-time hiring and participation in a government employment policy.     

F6／7．5输尿管镜钬激光碎石治疗输尿管上段结石（附108例报告）

目的探讨应用F6／7．5输尿管镜钬激光碎石治疗输尿管上段结石的方法和疗效。方法自2008年7月至2011年1月，应用F6／7．5输尿管镜结合钬激光碎石治疗108例输尿管上段结石患者，其中左侧76例、右侧29例、双侧3例。结果所有病例手术均顺利完成，无明显并发症发生。术后2d，32侧结石完全清除；术后2周，另有55侧结石完全清除，结石清除率为78．4％（87／111）。24侧因。肾脏或输尿管结石残留行ESWL治疗，2个月后结石清除，辅助治疗率为21．6％（24／111）。结论利用F6／7．5输尿管镜结合钬激光碎石，具有操作简单、成功率高、并发症低等优点，是治疗输尿管上段结石一种较好的选择。     

Laparoscopic laser lithotripsy inside the endocatch bag: An alternative technique for removal of large post lap pyelolithotomy calculi

Large staghorn calculi in unascended pelvic kidneys and in normally located kidneys with anatomy unsuitable for percutaneous nephrolithotomy have to be treated via pyelolithotomy. When performed laparoscopically, the extraction of these staghorn calculi, without extending skin incision at the port site is challenging. We describe the successful use of laparoscopic laser lithotripsy, intracorporeally, with the entrapped calculus inside the endocatch bag, for fragmentation and retrieval without extension of skin incision.     

Diagnosis of depressed‐type early gastric cancer using small‐caliber endoscopy with flexible spectral imaging color enhancement

Background and Aim: Small‐caliber endoscopy has lower resolution than normal‐caliber endoscopy, limiting its use in routine outpatient practice. Flexible spectral imaging color enhancement (FICE) strengthens the color contrast of depressed‐type early gastric cancer without magnification. The aim of the present study was to evaluate the detection of depressed‐type early gastric cancer using small‐caliber endoscopy with the FICE system. Methods: Eighty‐two patients diagnosed with depressed‐type early gastric cancer by standard endoscopy and biopsy were evaluated by small‐caliber endoscopy. FICE images and conventional images were compared. Color differences in all 82 lesions were measured between malignant lesions and the surrounding mucosa using the Commission Internationale de L'Eclairage (CIE) 1976 color space. Results: Most cancers were readily detected as reddish lesions on FICE images. Lines of demarcation between the malignant lesion and the surrounding mucosa were easily identified with FICE images, as such cancers could be clearly distinguished from the surrounding atrophic mucosa. Greater median color differences between malignant lesions and the surrounding mucosa were present in FICE images compared with conventional images, resulting in images with better contrast (27.2 vs 18.7, P < 0.0001). Conclusions: Small‐caliber endoscopy with the FICE system provides better color contrast of depressed‐type early gastric cancers than conventional small‐caliber endoscopy, and the FICE system may facilitate the diagnosis of this type of cancer as a new endoscopic modality.     

经皮肾镜/输尿管镜取石术中、术后感染性休克15例报告

目的 总结经皮肾镜/输尿管镜取石术中、术后感染性休克的救治经验.方法 回顾分析2004年1月～2009年4月432例微创经皮肾镜取石术及645例输尿管镜碎石取石术中、术后发生感染性休克15例(男4例,女11例)的临床资料,其中11例发生在经皮肾镜取石术,4例发生于输尿管镜碎石术,术中1例,术后14例.感染性休克诊断明确...