Objective To compare the curative effect of ultrasound guided mammotome minimally invasive biopsy system and open operation in the treatment of benign breast mass .Methods 60 benign breast mass patients with total 115 phymas were selected as treatment group , and were given the mammotome minimally invasive biopsy treatment .60 benign breast mass patients with total 105 phymas who were given traditional open operation at the same time,were selected as control group .The treatment effect and satisfaction condition of patients in the two groups were compared.Results The phymas of patients in two groups were all removed by operation .The operation time,blood loss,healing time and scar size after operation in the treatment group were all shorter than those in the control group (t=2.41,3.87,2.44,9.84,P<0.05 or P<0.01).The incidence rate of postoperative complication in the treatment group (6.66%) was significantly lower than that in the control group (20.00%)(χ2 =4.62,P<0.05).The postop-erative satisfaction of patients in the treatment group (95.00%) was significantly higher than that in the control group (20.00%)(χ2 =5.26,P<0.05).Conclusion Compared with open operation ,ultrasound guided mammotome min-imally invasive biopsy system in the treatment of benign breast mass has advantages of shorter operative time ,smaller operative trauma ,shorter postoperative healing time ,less operative complication ,higher satisfaction of patients .

AIM To test the hypothesis that intravenous liposomal prostaglandin E 1 (Lipo PGE 1) would attenuate reperfusion injury in a rabbit ischemia reperfusion model. METHODS Twenty four open chest rabbits were randomized to receive a 10 minute intravenous infusion of either liposome diluent (placebo), free PGE 1 (2 ?g?kg -1 ), or Lipo PGE 1(2 ?g?kg -1 PGE 1) after 60 minutes of left anterior desending (LAD) ligation just before reperfusion. Carotid arterial pressure and electrocardiogram were monitored and recorded continously throughout the whole experiment. After 2 hours reperfusion, infarct size and region at risk were measured by postmortem dual dyes with triphenyl tetrazolium chloride (TTC) and Evans blue. Myocardial leukocyte infiltration by myeloperoxidase (MPO) assay was performed. RESULTS Infarct size as a ratio of weight of infarcted tissue to weight of region at risk (MI/RISK) was significantly reduced with Lipo PGE 1 32.20%?4.70% compared with PGE 1 42.09%?6.93% or placebo 44.57%?5.46% ( P

Objective To explore the predicting value of plasma asymmetric dimethylarginine (ADMA) in cardiac structure and function of patients with chronic kidney diseases (CKD).Methods A total of 100 CKD patients were enrolled in this cross-sectional study.According to staging of the K-DOQI guideline,CKD patients were divided into five groups.Twenty healthy people were enrolled as control.Plasma level of ADMA was determined by reversed-phase high performance liquid chromatography.Cardiac structure and function were detected by color echocardiography.Results Plasma levels (μmol/L) of ADMA in CKD stage 3 to 5 patients (1.3318±0.4684,1.5712±0.4210,2.1093±0.7714) were significantly higher than those in CKD stage 1,2 patients (0.4387±0.2575,0.4809±0.2846) and healthy control (0.4611±0.1615) (all P＜ 0.01).Meanwhile,ADMA level of CKD stage 5 was significantly higher as compared to CKD stage 3-4.The left ventricular mass index (LVMI) was significantly higher in stage 4-5 patients than that in stage 1-3 and healthy control.Plasma ADMA was positively correlated with LVMI (r=0.476,P=0.028) and negatively correlated with left ventricular ejection fraction (EF) (r=-0.327,P=0.041).Multivariate stepwise Logistic regression analysis revealed plasma ADMA level was an independent predictors for EF (OR=0.984,P＜0.01).Conclusions Plasma level of ADMA begins to increase in CKD patients of stage 3 and rises proportionally to the decline of renal function.Plasma ADMA level is useful in predicting the cardiovascular complications of CKD patients.

Objective To evaluate the safety, efficacy and morbidity of transurethral electrovaporization of superficial bladder tumor (TVBt). Methods TVBt was performed in seventy-three pat iens (mean age 66 years) with superficial bladder carcinoma,twelve of them trans urethral electrovaporization of the prostate (TVP) was carried out simultaneousl y for concomitant BPH. Results The tumor was resected in one-stage for 72 cases,in two-stage for multiple tumors in one patient. The mean operative time was 29 minutes in simple TVBt group, and 78 minutes in the group performing both TVBt and TVP. Intraoperative bladde r perforation occurred in 1 case, No patient need blood transfusion for bleeding . The mean duration of an indwelling urethral catheter was 46h. All patients wer e followed up for twenty-four months, and the recurrence rate was 21% within t wo years after the operation. Conclusions TVBt is a simp le, effective and safe surgery for the treatment of superficial bladder cancer.

Objective To evaluate the effects of temperature of the irrigation fluid on body temperature and cardiovascular performance during transurethral surgery. Methods 87 cases were randomly divided into two groups according to the temperature of irrigation fluid used: the ambient (21～ 24 ℃) and the isothermic (35～36 ℃). Body temperature, blood glucose, ECG, HR, SaO 2, cardiac output (CO), mean arterial pressure (MAP) and systemic vascular resistance (SVR) were monitored during the transurethral surgery. Results Body temperature was decreased 2.1 ℃, MAP elevated, CO decreased and SVR increased in the ambient group, while body temperature was decreased only 0.3 ℃ and cardiac performance was maintained relatively stable in the isothermic group. Conclusions Hypothermia, resulted from the use of large amount of low temperature irrigation fluid during transurethral surgery has detrimental effects on body temperature and cardiovascular performance. Isothermic irrigation fluid would stablize the cardiovascular performance and so increases the safety of transurethral surgery.

Objective To evaluate endoscopic management of bladder neck obstruction (BNO). Methods 44 patients suffering from BNO have been treated by transurethral resection of bladder neck (TURN). Results All patients have been followed up for 6～84 months with a mean of 48 months.The success rate has been 84%.Recurrence was observed in 4 (11%) for all of which TURN was carried out twice or three times with success.The causes of the 7 failures were neurogenic bladder, detrusor-extra-sphincter dyssynergy, BNO with chronic prostatitis (CP) or BNO with chronic cystitis in female patients. Conclusions Endoscopic management is a safe and efficient treatment for BNO.Careful consideration should be undertaken in case there is CP or for female patients.Postoperative adjunctive hormone supplement therapy and long-period urethral dilatation might be needed for preventing recurrence.

ObjectiveTo evaluate clinical-pathological features, diagnosis and therapy of gestational trophoblastic tumor (GTT) misdiagnosed as ectopic pregnancy. MethodsFrom 1999 to 2003, a total of 13 patients with GTT misdiagnosed as ectopic pregnancy were retrospectively analyzed. ResultsThe main symptoms were amenorrhea, abdominal pain, irregular vaginal bleeding. Serum beta-human chorionic gonadotrop in(hCG) was measured in 10 patients. Eight had hCG values above 10 000 IU/L; 3 had hCG values above 50 000 IU/L. The lesions of GTT misdiagnosed as ectopic pregnancy were fallopian tube, horn of uterus, peritoneal cavity, greater omentum, recto-uterine pouch. According to standards of the International Federation of Gynecology and Obstetrics(FIGO) the 13 patients were categorized as 6 of stage Ⅰ, 2 of stage Ⅱ, 3 of stage Ⅲ and 5 of stage Ⅳ. Histologically they included 10 cases of choriocarcinoma and 3 of invasise mole. All patients were treated by complete surgical resection combined with subsequent adjuvant chemotherapy. ConclusionsMisdiagnosis leads to delay in therapy with resultant increased morbidity of GTT.Analysis on serial hCG is helpful to differential diagnosis between ectopic pregnancy and GTT.

OBJECTIVE To sum up the cases of hospital infection,in order to further improve the experience of the work of hospital infection.METHODS The investigation of hospital infection situation among inpatients 2005-2007 was reviewed.RESULTS The hospital infection rates in 2005-2007 were 1.81%,1.65% and 1.52%,respectively,mainly in the lower respiratory tract infection and surgical incision.CONCLUSIONS Hospital infection is closely related with the age,the underlying diseases,the antibiotic misuse and the environment.

Objective To investigate the influence of hypoxia-reoxygenation on the myocardin gene expression of cultured rats' vascular smooth muscle cells(SMC).Methods The SMC were isolated from the media of the thoracic aorta vessel of Sprague-Dawley rats,and cultured with attachment-block manner.The morphology and cell counting of the cultured cells under hypoxia conditions were observed and comparedto that under normal culture condition.Total RNA extracted from the cultured cells,the expression of myocardin mRNA in SMC were measured at hypoxia status and at various time after reoxygenation through RT-PCR.Results The rats' vessel SMC was successfully cultured and showed a "peak-valley" shape.Self-made hypoxia equipment can produce a lower oxygen partial pressure without significant variation of pH value which met the experiment requirements in 2 4 hours .However,in the hypoxia conditions,the expression level of myocardin was lowest at the 12th hours,then increased.After 24 hours of hypoxia,the expression levels of myocardin began to increase at the 6th hour of reoxygenation and reached a normal level at the 12th hour of reoxygenation.Conclusions Hypoxia-reoxygenation has an effect on the expression of myodardin gene.

Objective To discuss the technical feasibility and clinical effectiveness of using complex tissue flap pedicled with inferior gluteal artery perforator for repair giant sacrococcygeal pressure sore.Methods Thirty embalmed lower limbs of adult cadavers perfused with red latex were used for anatomical study,and the followings were observed:①The course,branche and distribution of gluteal artery.②The course and distribution of the posterior femoral cutaneous nerve.③Anastomosis between the posterior cutaneous branch of gluteal artery and nutrient vessels of the posterior femoral cutaneous nerve.8 cases aging from 17 years to 56 years were completed during May 2007 to July 2013,6 cases were males and 2 cases were females.The sizes of pressure sore with the depth to Ⅳ degree were ranged from 16 cm × 9 cm to 22 cm × 10 cm.The sizes of flaps were harvested from 32 cm × 10 cm to 25 cm × 9 cm.Results The gluteal artery crossed the edge of the piriformis,the main stem was (3.1 ± 0.4) mm in diameter and gave out 2-5 muscular branches to supply the gluteus maximus.The posterior femoral cutaneous nerve crossed the edge of gluteus maximus and descended between biceps femoris and semitendinosus.Perforating deep fascia point located was (5.9 ± 0.8) cm above the line between medial and lateral femoral epicondyle.The constant anastomosis were formed by the posterior cutaneous branch of gluteal artery,the obturator artery perforator and the direct popliteal artery perforator around the posterior femoral cutaneous nerve.The complex flap survived successfully in all patients.Sutures were removed at 14 days postoperatively and the wounds healed well.All supplied areas were closed by directly suturing.Recurrent sacrococcygeal pressure sore was not observed in all cases with satisfied appearance and normal color during the outpatient follow-up period from 5 months to 5 years.Conclusion The united flap of gluteal myocutaneous flap and the posterior femoral cutaneous neurovascular flap pedicled with inferior gluteal artery perforator can be used to primary repair giant sacrococcygeal pressure sore.Rich blood supply,simple operation technique and high rate survival rate was considered as advantages of the flap.The lower recurrence of pressure sore was due to nice wear resisting with rich layer of anatomical structure in the flap and strong ability of anti-infection.The clinical effect was satisfied.