Objective To explore the clinical efficacy of transurethral vaporization combined with resection in the treatment of benign prostatic hyperplasia(BPH) and prevention of complications. Methods Under low position continuous epidural anesthesia, 83 cases of BPH were treated by transurethral vaporization and resection with Stabilized loop, roller-shape and spade electrodes. Results The mean operative time was 58 min and blood loss 80ml. No blood transfusion was required and no transurethral resection syndrome(TURS) occurred. All patients had been followed up for 2 months～2 years. IPSS decreased from(26 4?5 7)points to(8 4?3 9) points( t =20 31, P

Objective To investigate the effect of pelvic autonomic nerve preservation (PANP) for urinary function and sexual dysfunction after total mesorectal excision (TME) of rectal cancer in male patients. Methods A total of 147 patients, hospitalized from March 2009 to March 2010,were enrolled into this study and received TME plus PANP combination treatment. The clinical data of these cases were analyzed retrospectively. Results There were no operative deaths. The 0. 5 - 1.0 years follow-up data showed that 9 cases (6. 12% ) had voiding dysfunction, 11 cases (7.48%) had sexual dysfunction, 12 cases ( 8.16% ) had local recurrence. Conclusion TME plus PANP combination treatment can improve the urinary and sexual function,without increasing the postoperative local recurrence rate.

Objective To evaluate the clinical value of laparoscopic renalcyst unroofing as compared with open surgery.Methods The clinical data of 30 cases(group A) receiving glaparoscopic renalcyst unroofing from February 2002 to March 2005 and 15 cases(group B) receiving open renalcyst unroofing from February 2002 to February 2004 were retrospectively analyzed.The rating of depression and anxiety before operation,operating time,amount of bleeding during operation,recovery of intestinal function after operation,ambulation and normal activities after operation,the time of using intravenous after operation,the times of using analgesic after operation,the operation cost,total cost of hospitalization,the hospital stay and complications were compared between group A and group B.Results In group A,the amount of bleeding during renalcyst unroofing operation,the recovery of intestinal function after operation,ambulation after operation,the hospital stay,the resume of normal activities after operation and the occurrence of complications the time of using intravenous after operation,the times of using analgesic after operation were all better than those in group B(P

Objective To assess the cause of iatrogentic urethral stricture,prevention methods.Methods A total of 21 cases of iatrogentic urethral stricture patients were retrospectively analyzed. Results 2 cases of corpus glandulare prostatae extraction on ospectinis,2 cases of urethrolithotomy, 12 cases of transurethral resection of the prostate foe the treatment of symptomatic BPH, 5 cases of exelcymosic UCL all gained urethral sounding and urethra sliver and electrotomy. Conclusion Iatrogentic urethral stricutre can be prevented by iatrogentic urethral catheterization operation technical,reconstruction the time size quality of urethral catheterization, using intravenous. By urethral sounding and intracavitary operation,iatrogentic urethral stricture all gained satisfaction.

Objective To investigate the outcome of free posterolateral leg perforator flap in the reconstruction of soft tissue defects of oral and maxillofacial area.Methods From February,2014 to August,2016,16 patients were performed defect reconstruction following oral cancer ablation with free posterolateral leg perforator flap including 3 cases of sequamous cell carcinoma of the tongue,6 cases of carcinoma of the buccal mucosa,7 cases of sequamouse cell carcinoma of the floor of mouth.The flap ranged from 5.0 cm×3.0 cm to 13.0 cm ×9.0 cm in size,and were adjected to the soft tissue defects of oral and maxillofacial area.The outcome of reconstruction was evaluated by considering the facial appearance,the swallowing and the speach function,the ranges of mouth opening and patient prognosis.Results All 15 transplanted flaps survived well and only 1 survived after disposing in time,because of vascular crisis.The donor sites were closed directly without donor-site morbidity.All patients were satisfactory with their facial appearance,the ranges of mouth opening and swallowing and speech function.Conclusion The free posterolateral leg perforator was an ideal free tissue for repairing functionally oral and maxillofacial defects,sinceit including some beneficial characteristic such as constant blood vessel,flexible and divese design,abundant and position-latent donor site tissues,small operation loss,flexible preparation and loss of major vascular nerves.

Adult ; Female ; Humans ; Liver ; pathology ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; pathology ; Obesity ; pathology ; Young Adult

Objective To discuss the mid?to long?term results and possible prognostic factors of Bernese periacetabu?lar osteotomy for adolescents and young adults with developmental dysplasia of the hip. Methods Bernese periacetabular os?teotomy was performed on 162 patients (171 hips) with hip dysplasia from August 1997 to July 2009. Follow?up data was ac?quirable completely in 123 cases (137 hips), including 30 males (33 hips) and 93 females (104 hips). Age of surgery was 12-48 years (average 27.1 years). The X?ray radiographs and Harris scores were recorded preoperatively and at the last follow?up. The lateral center?edge angle (LCE), acetabular incline angle (AI), continuity of Shenton's line were also recorded. The grades of the hip osteoarthritis were classified by T?nnis classification. Insufficient corrections of osteotomy, excessive corrections of osteotomy, nonunion of the pubis, nerve injuries, and vascular injuries were recorded as complications. Results All the con?tactable cases was followed up again in June and July in 2014. Follow?up duration was 5-17 years (mean, 8.1 years). The LCE angle improved from 7.13° ± 8.86° preoperatively to 30.17° ± 14.98° at the final follow?up. The T?nnis acetabular incline angle decreased from 27.84° ± 12.85° preoperatively to 7.06° ± 10.58° at the final follow?up. The continuity of Shenton's line was in?tact in 106 cases postoperatively, compared with 87 cases preoperatively. Harris score improved from 83.34±9.82 preoperative?ly to 92.79±7.05 at the last follow?up. There was significant correlation between preoperative Harris score and Harris score at the last follow?up. Early complications were observed in 15 cases (15 hips), along with 17 cases (17 hips) of progressions of hip osteoarthritis. Survival rate of the hip at the last follow?up was 97.8%. Conclusion Bernese periacetabular osteotomies can significantly improve bone coverage and joint function of hip dysplasia patients with low rate of short?term complications. Further?more, there was little osteoarthritis progression observed, with good survival rate of the joint in mid?to long?term follow?up. Lower pre?operative Harris scores and higher pre?operative T?nnis classifications are important prognostic factors for post?operative pain.

It is a tough challenge treatment of complete dislocation from developmental dysplasia of the hip at the age of 8-25 patients. Although the procedure of total hip arthroplasty (THA) can improve joint function significantly, the failure rate still remains high. Hip arthrodesis remains a sensible and safe option. A stable and painless hip joint can be obtained without multiple operations. Ganz et al.had described a modified Colonna capsular arthroplasty and surgical hip dislocation with well joint functions, radiographic findings and the less complications of the femoral head osteonecrosis. There is a obvious advantage in postponing THA, and subsequent THA could be technically easier and safer in a dislocated hip. The procedure of pelvic support osteotomy, which is proposed by Ilizarov, combined two steps of femur osteotomy and femur lengthening, provides an effective treatment option for adolescent hip dysplasia or dislocation. By this procedure, the hip could be reserved, the limb length recovered and the gait improved significantly. Resection arthroplasty is a reliable method, by which 90% dysplasia patients received a painless joint and good functional outcomes. In view of certain drawbacks, it is used only as a salvage operation currently. This article reviews some alternative nonarthroplasty methods for developmental dysplasia of the hip with complete dislocation. Good clinical results can be obtained through strict indications and nice surgical skills.
Adolescent ; Arthrodesis ; Arthroplasty, Replacement, Hip ; Child ; Femur ; Femur Head ; Gait ; Hip Dislocation ; Hip Dislocation, Congenital ; therapy ; Humans ; Osteonecrosis ; Osteotomy ; Treatment Outcome ; Young Adult

OBJECTIVETo observe the distribution law and study the factors related to the femoral neck anteversion angle among the patients with developmental dysplasia of the hip of Hartofilakidis type I.

METHODSAmong the patients with hip dysplasia of Hartofilakidis type I who was admitted to Department of Orthopaedic Surgery, the First Affiliated Hospital of People's Liberation Army General Hospital from June 2010 to June 2013, a total of 340 hips (25 male and 161 female) were included in the study. The average age was 28.3 years, ranging from 13.5 to 49.9 years. The observation index included: femoral neck anteversion angle, lateral center-edge angle, acetabular index angle, lateral displacement of the femoral head, superior displacement of the femoral head, continuity of Shenton's line and Calve's line. The correlation between different factors was analyzed, and the factor closest to femoral neck anteversion angle was analyzed further by regression analysis.

RESULTSAmong the patients of developmental dysplasia of the hip of Hartofilakidis type I, the femoral neck anteversion angle increased, with an average of 28°±13°. Correlation and regression analysis showed significant negative correlation with treatment age (r=-0.158, P=0.003; t=-6.892, P=0.000); positive correlation with gender (r=0.332, P=0.000; t=-4.376, P=0.000); significant positive correlation with lateral displacement of the femoral head (r=0.092, P=0.000; t=3.766, P=0.000); significant negative correlation with central-edge angle (r=-0.122, P=0.024; t=2.031, P=0.043). The femoral neck anteversion angle showed correlation with acetabular index angle, continuity of Calve's line and superior displacement of the femoral head in correlation analysis, not in regression analysis, however, it did not show correlation with side and continuity of Shenton's line.

CONCLUSIONAmong the patients of developmental dysplasia of the hip of Hartofilakidis type I, the increasing of the femoral neck anteversion angle may not only lead to early onset and therefore early treatment of pain in the hip joint but also the lateral displacement of the femoral head that requires immediate medical attention.

Acetabulum ; Adolescent ; Adult ; Female ; Femur Head ; Femur Neck ; pathology ; Hip Dislocation, Congenital ; pathology ; surgery ; Hip Joint ; Humans ; Hyperplasia ; Male ; Middle Aged ; Orthopedic Procedures ; Orthopedics ; Regression Analysis ; Tomography, X-Ray Computed ; Young Adult

High frequency ultrasound can clearly show the integrity of Achilles tendon and evaluate the site of the injuried tendon.What’more it can assess the separated and internal indications of the ruptured tendon.It has the advantages of noninvasive,economical and convenient.With all these advantages,high frequency ultrasound can be the first choice to evaluate the injured tendon among all the imaging techniques and provide reliable evidence for clinical diagnosis.