Outcomes of a non-randomised audit of single pigtail suture stents in urolithiasis management of Asian patients in Singapore

Objective:Double-J(DJ)ureteric stents are commonly placed perioperatively for semirigid or flexible ureteroscopic renal surgery.It is believed that lesser stent material within the bladder mitigates stent-related symptoms.This study aimed to evaluate the J-Fil ureteral stent,a single pigtail suture stent compared with conventional DJ stent in relation to stent symptoms in an Asian population undergoing ureterorenal intervention.Methods:Based on internal audit committee recommendation approval,the records of 50 patients retrieved,available data of 41 patients who were prospectively enrolled into two groups(Group 1[J-Fil stent group],n=21 and Group 2[DJ stent group],n=20)between August 2020 to January 2021,were analysed.Parameters compared were nature of procedure,stone location and size,ease of deployment or removal,and complications.A modified universal stent symptom questionnaire was used to assess morbidity of stent symptoms within 48 h of insertion and at removal.Results:Both groups had similar median age,distribution in male to female ratio,and stone size.The overall median universal stent symptom questionnaire score at insertion was similar for bladder pain,flank or loin pain,and quality of life between Group 1 and 2;however,at removal Group 1 fared significantly better than Group 2,especially for flank or loin pain and pain at voiding.Both groups had similar ease in insertion with no hospital readmissions.Conclusion:Our audit favoured the single pigtail suture stent in Asian ureters in mitigating stent-related issues.It showed a good safety profile with easy deployment and removal.It promises a new standard in stenting.

Pigtail的电磁辐射分析及测试

在工程实际中出现的电磁干扰主要是由于设备Pigtail产生的。利用天线原理分析了Pigtail产生电磁辐射干扰的机理,仿真计算出电磁干扰辐射强度随Pigtail长度增加而增强,以及良好的电缆屏蔽能极大地减小电磁干扰辐射强度,提出了正确解决辐射干扰的方法,并通过试验手段验证了该方法的正确性。

Endoscopic treatment of efferent loop syndrome with insertion of double pigtail stent

Efferent loop syndrome is a very rare postgastrectomy syndrome that can occur following Billroth-Ⅱor Rouxen-Y reconstruction.The most common loop syndrome after gastric surgery is afferent loop syndrome;however,efferent loop syndrome has been reported in rare cases.Here,we report a case of efferent loop obstruction that occurred after postoperative adhesiolysis of a small-bowel obstruction.The patient had undergone a partial gastrectomy with BillrothⅡanastomosis and gastric ulcer perforation 30 years prior.The efferent loop obstruction was successfully resolved by the insertion of a double pigtail stent.To the best of our knowledge,this is the first case in the literature describing the treatment of efferent loop obstruction.

Late-onset severe biliary bleeding after endoscopic pigtail plastic stent insertion

Here, we report our experience with a case of severe biliary bleeding due to a hepatic arterial pseudoaneurysm that had developed 1 year after endoscopic biliary plastic stent insertion. The patient, a 78-year-old woman, presented with hematemesis and obstructive jaundice. Ruptured hepatic arterial pseudoaneurysm was diagnosed, which was suspected to have been caused by long-term placement of an endoscopic retrograde biliary drainage(ERBD) stent. This episode of biliary bleeding was successfully treated by transarterial embolization(TAE). Pseudoaneurysm leading to hemobilia is a rare but potentially fatal complication in patients with long-term placement of ERBD. TAE is a minimally invasive procedure that offers effective treatment for biliary bleeding.

Removal of"ruptured"pulmonary artery infusion port catheter by pigtail catheter combined with gooseneck trap:A case report

BACKGROUND Implanted intravenous infusion port(IVAP)is indicated for patients undergoing chemotherapy,total parenteral nutrition and long-term antibiotic treatment.Among their complications,the rupture and migration of the catheter of an IVAP via internal jugular vein represents a very rare but potentially severe condition.CASE SUMMARY A 43-year-old woman was identified with a spontaneous fracture and migration of catheter of an IVAP via right internal jugular vein after adjuvant chemotherapy for left breast cancer.A computed tomography showed the fractured catheter of the IVAP in the pulmonary artery.Therefore,we conducted an emergency procedure to remove the catheter fragment by a pigtail catheter combined with a gooseneck trap.CONCLUSION When the fractured catheter of an IVAP was detected,the special shape of the pigtail catheter in combination with the gooseneck trap successfully facilitated the removal of the dislodged catheter.

Should a fully covered self-expandable biliary metal stent be anchored with a double-pigtail plastic stent? A retrospective study

BACKGROUND The migration rate of fully covered self-expandable metal stents(FCSEMSs) has been reported to be between 14% to 37%. Anchoring of FCSEMSs using a doublepigtail plastic stent(DPS) may decrease migration.AIM To compare stent migration rates between patients who received FCSEMS alone and those who received both an FCSEMS and anchoring DPS.METHODS We conducted a retrospective analysis of endoscopy reporting system and medical records of 1366 patients who underwent endoscopic retrograde cholangiopancreatography(ERCP) with FCSEMS placement at the University of Kentucky health care. Between July 2015 and April 2017,203 patients with FCSEMS insertion for the treatment of malignant biliary stricture,benign biliary stricture,post-sphincterotomy bleeding,bile leak,and cholangitis drainage were identified. The review and analysis were conducted through our endoscopy reporting system(ProVation~? MD) and medical records. Categorical data were analyzed using Chi-Square and Fischer exact test and continuous data using nonparametric tests. A regression analysis was performed to identify factors independently associated with increased risk of stent migration. We determinedan FCSEMS migration endoscopically if the stent was no longer visible in the major papilla.RESULTS1366 patients had undergone ERCP by three advanced endoscopists over 21-mo period; among these,203 patients had FCSEMSs placed. 65 patients had FCSEMSs with DPS,and 138 had FCSEMSs alone. 65 patients had FCSEMSs with DPS,and 138 had FCSEMSs alone. 95 patients had a malignant stricture,82 patients had a benign stricture,12 patients had bile leak,12 patients had cholangitis,and nine patients had post-sphincterotomy bleeding. The migration rate in patients with anchored FCSEMSs with DPS was 6%,and those without anchoring DPS was 10%(P = 0.35). Overall,migration was reported in 18 patients with FCSEMSs placement out of 203 patients with an overall migration rate of 9.7%. There was no significant association between anchoring the FCSEMSs with DPS and the risk of stent migration. Only patients with the previous sphincterotomy and begin biliary stricture were found to have a statistically significant difference in the migration rate between patients who had FCSEMS with DPS and FCSEMS alone(P = 0.01).CONCLUSION The risk of migration of biliary FCSEMS was 9.7 %. Anchoring an FCSEMS with DPS does not decrease the risk of stent migration.

SolarT60 Pigtail管线烧红故障分析及改造

明珠号FPSO于2010年在渤中25-1油田临时复产后,先后出现3次两台索拉透平T60机组在燃气模式下,燃油pigtail管线烧红的现象。对T60机组燃油pigtail管线烧红的原因进行分析,通过PCD Forward Purge系统改造,保证在燃气模式下燃油管线内有持续的冷却PCD气体,彻底解决机组燃油管线被烧红的安全隐患。

Double pigtail catheter reduction for seriously displaced intravenous infusion port catheter:A case report

BACKGROUND Implanted intravenous infusion port(TIAP)is mainly used for patients who need central venous infusion and poor peripheral vascular conditions.With the advantages of easy to carry,long maintenance cycle,few complications and excellent quality of life,it has been widely used in the fields of malignant tumor chemotherapy,parenteral nutrition support and repeated blood collection.Implanted intravenous infusion port(IVAP)dislocation can have significant complications if not recognised and reinstated immediately.CASE SUMMARY A 24-year-old man was treated with adjuvant chemotherapy for osteosarcoma.Severe displacement of IVAP catheter was found by chest X-ray examination.The IVAP cannot be used normally.Therefore,we conducted an emergency procedure to reset the catheter through double pigtail catheters,the operation was successful and the infusion port was restored.CONCLUSION When IVAP catheter displacement cannot be reset by conventional techniques,two pigtail catheters can be successfully used instead.

Improvement of quality of life in serous cavity inflammation patients underwent pigtail tube drainage

Objective To observe the effect of drainage of pericardium with pigtail tube associated with drainage tube or puncture of pleural cavity. Method Saving cardiac tamponade and treating serious multiple serous cavity inflammation through percutaneous catheterization with pigtail tube infra-xiphoid associating with percutaneous drainage tube or puncture and chemotherapy. Resutls The 4 cases of patients with serous poly serous cavity inflammation were all cured on the whole. They were all not only lived fro 4-6 months longer, but also got better existing mass and they could live on themselves. Conclusion It is a good way to cure patients with serious poly serous cavity inflammation of percutaneous catheterizatin with pigtail tube infra-xiphoid associating with percutaneous drainage tube or puncture and chemotherapy. It can also save pericardiac tamponade patients.It is worth application in clinic.

光纤陀螺仪光纤尾纤装配动力学建模仿真与应力计算方法

光纤陀螺仪(FOG)中光纤尾纤的装配主要依靠工人手工完成,装配应力控制凭借人工经验,一致性难以保障。针对光纤装配应力定量控制的难题,提出一种基于离散微分几何理论的光纤动力学建模仿真方法。首先,基于离散微分几何理论建立了光纤运动学框架,并由弹性势能推导了包含拉伸、弯曲和扭转变形的光纤动力学方程以及应力计算方法。其次,提出了基于Newmark隐式算法的光纤动力学方程数值求解方法,并设计了光纤在装配过程中与周围物体的碰撞检测与响应策略。随后,进行了光纤圆周布设和弯扭变形的仿真测试。结果表明,光纤控制端与固定端之间的自由长度越短,光纤圆周布设的位置越精确;光纤截面半径越大,在同样的扭转角下光纤产生的弯扭变形程度越大。最后,设计了一种光纤陀螺仪装配布局,并通过动力学仿真得到了光纤装配过程的应力分布及最大应力变化,为陀螺仪光路低应力装配与路径规划提供了理论支撑。

平顶猴在HIV/AIDS动物模型中的应用及研究进展

非人灵长类动物模型在HIV-1致病机制研究以及抗AIDS药物和疫苗研发中具有重要作用。由于缺乏HIV-1直接感染的动物,SIV/SHIV猕猴模型是目前AIDS研究中应用最为广泛的动物模型。虽然SIV/SHIV猕猴模型与人AIDS具有一定的相似性,但SIV/SHIV与HIV-1间的遗传差异较大,致使SIV/SHIV猕猴模型存在很多局限性。创建合适的非人灵长类动物模型仍然是HIV/AIDS研究中的热点和难点。平顶猴是目前唯一可以被HIV-1感染的旧大陆猴,在HIV-1静脉传播和性传播模型研究中具有许多优势。该文综述了SIV、HIV、SHIV和HSIV通过静脉和黏膜途径感染平顶猴的特征,并简要介绍了病毒在平顶猴细胞中复制的分子机制以及建立平顶猴AIDS模型的限制因素和前景。

经皮肾碎石取石术后输尿管双J管留置时间和拔管方法的探讨

目的对经皮肾碎石取石术(percutaneous nephrolithotomy,PCNL)后患者输尿管双J管留置时间长短及拔管方法进行探讨。方法 84例行PCNL治疗的上尿路结石患者完全随机分为3组:长期留置组(n=28),术后留置输尿管双J管4～6周,经尿道膀胱镜下拔管;短期留置组(n=28),术后留置输尿管双J管8～12 d,经尿道膀胱镜下拔管;短期留置改良组(n=28),术后留置输尿管双J管8～12 d,经肾穿刺通道用改良方法拔管。3组患者于拔管后和出院后分别填写问卷调查,手术后1个月复查肾功能和利尿肾图。结果患者出院后肉眼血尿、腰胀、膀胱刺激征、泌尿系感染、发热、双J管移位、尿液反流等并发症发生率,长期留置组分别与短期留置改良组、短期留置组间存在显著差异(P<0.05),短期留置组与短期留置改良组间无明显差异(P>0.05)。患者拔管后尿道疼痛、肉眼血尿、尿道损伤、膀胱刺激征、泌尿系感染、发热等并发症发生率,短期留置改良组分别与长期留置组、短期留置组间均存在显著差异(P<0.05),长期留置组与短期留置组间无明显差异(P>0.05)。手术后1个月复查肾功能、利尿肾图,3组间差异无统计学意义(P>0.05)。结论经皮肾碎石取石术后8～12 d,有针对性采用改良方法拔管,可有效缩短双J管的留置时间,避免因带管出院及置管时间过长引起的并发症,减少患者的费用和痛苦,值得临床推广使用。

双J管置入术后的并发症

目的探讨双J管置入术后的并发症原因和对策。方法对双J管置入术后出现并发症134例临床资料进行分析。结果出现的并发症有:腰痛43例;肉眼血尿28例,输尿管梗阻24例,膀胱刺激症状29例,双J管移位11例,泌尿系感染5例。经相应处理后,并发症均获消除。结论双J管置入术后可能出现各种并发症,应积极观察和早期处理。

猪尾巴导管引流联合药物治疗恶性腹腔积液47例临床观察

目的:观察猪尾巴导管留置引流联合顺铂及白细胞介素-2(IL-2)控制恶性腹腔积液的近期疗效及毒副反应。方法:47例恶性腹腔积液患者,先于彩超定位处将猪尾巴导管留置腹腔中,引流至排尽腹腔积液,再通过导管注入顺铂40mg、IL-2 200万IU,2次/周,共4次。结果:47例中完全缓解15例(31.9%),部分缓解21例(44.7%),无效7例(14.9%),进展4例(8.5%),总有效率76.6%(36/47),生活质量明显改善,无明显毒副反应。结论:应用猪尾巴导管引流联合顺铂及IL-2控制恶性腹腔积液有较好的疗效,能改善患者生活质量,毒副反应轻。

输尿管镜置取双J管的体会

目的 :引流尿液防止和减少外渗 ,避免粘连 ,暂时缓解梗阻 ,降低肾内压 ,保护肾功能 ,减轻感染 ,防止粘连和狭窄。方法 :经输尿管镜或膀胱镜置入。结果 :用输尿管镜 ,膀胱镜置取管 1 960例。结果 :全部患者取管 1月后静脉肾盂造影输尿管通畅。结论 :上尿路术后置入双J管对防止输尿管术后并发症的发生有不可替代的作用。

不同术式胸腔闭式引流术治疗自发性气胸的疗效观察

目的观察4种不同术式胸腔闭式引流术治疗初发自发性气胸的疗效及并发症。方法初发自发性气胸146例,根据不同术式胸腔闭式引流分为4组,开花引流管组、带针胸导管组、中心静脉导管组及猪尾巴引流导管组,进行回顾性对比分析,比较各组临床疗效、肺膨胀时间、疼痛程度及并发症。结果中心静脉导管组疗效较低,但与其他组比较差异无统计学意义(P>0.05)。肺膨胀时间特别在<36 h、>120 h时间段,猪尾巴引流导管组与开花引流管组、带针胸导管组比较差异无统计学意义(P>0.05),与中心静脉导管组比较差异有统计学意义(P<0.05)。疼痛程度比较,疼痛程度≥7的小口径引流管组(中心静脉导管组与猪尾巴引流导管组)与大口径引流管组(开花引流管组与带针胸导管组)比较差异有统计学意义(P<0.01)。并发症发生率猪尾巴引流导管组较其他各组明显减少,差异有统计学意义(P<0.05)。结论采用猪尾巴引流导管组做胸腔闭式引流术治疗初发自发性气胸,具有微创、效优,并发症少等特点,值得临床推广应用。

猪尾导管行胸腔闭式引流的疗效评价

目的探讨微创方法行胸腔闭式引流的疗效及安全性。方法对56例胸腔积液、31例自发性气胸和2例液气胸的患者,采用猪尾导管行胸腔闭式引流,观察其治疗效果及并发症发生情况。结果全部病例均顺利完成胸腔穿刺并行闭式引流,其中3例病人因导管堵塞行第2次引流,80例病人引流成功,肺复张或胸水明显减少,9例无效,总有效率89.9%。结论应用猪尾导管行胸腔闭式引流操作方便,创伤小,并发症少,具有较高的临床应用价值。

C-lens准直器回波损耗的理论计算与分析

用矩阵光学和几何光学的方法计算了C-lens准直器的回波损耗,分析了影响回波损耗的各主要因 素,并绘出了回波损耗对各影响因素的响应曲线,对C-lens光纤准直器的设计和优化具有一定指导意义.

利用全光纤自外差系统研究光纤光栅半导体激光器的线宽

以带光纤尾纤引出式微体声光移频器(AOFS)为基础,用全光纤结构的延迟自外差激光器线宽测量系统(分辨率为50kHz),其中声光移频器插入损耗仅为29dB,大大提高了信噪比。采用该系统对窄线宽13μm光纤光栅半导体激光器(FBG-LD)进行了测量,测得激光器线宽的典型值为15MHz,同时分析了测量系统近端反射光对线宽测量精度的影响以及FBG-LD的线宽压窄特性。