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 .

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.

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

ObjecfiveTo compare the sensitivity of diffusion weighted imaging(DWI)with dynamic contrast enhanced(DeE)MRI for the detection of small breast caJlcers and to evaluate the clinical value of DWI.MethodsForty-eight patients with benign(n=25)and malignant(n=45)small breast lesions(≤2 cm)proved by pathology underwent DWI and DCE MRI.The DCE MRI was performed using FLASH sequence and the time-signal intensity chive was drawn.The DWl was performed using GRAPPAEPI sequence with different b values(800,1000 s/mm2) and the ADC values of lesions were measured.The sensitivity and specificity of DWI for the detection of small breast cancers were compared with DCE MRI. ResultsForty of 45 small breast cancers and 19 of 25 small benign breast lesions were corrlectly diagnosed using DCE MRI.The sensitivity and positive predictive value of TIC were 88.9%(40/45)and 87.0%(40/46).With b values of 800 s/mm2 and 1000 s/mm2,the avemge ADC values of small breast cancers were(1.153±0.192)× 10-3 and(1.079±0.186)× 10-3 mm2/s,while those of benign ones were (1.473±0.252)×10-3 and(1.419±0.255)×10-3 mm2/s,respeetively. There was no significant difference for the ADC values with different b values in the same group(P＞0.05),while there was a signiticant difference between the malignant and the benign lesions(P＜0.05)Thirty-nine of 45 small breast cancers and 19 of 25 small benign breast lesions were correctly diagnosed using DWI with b value of 1000see/mm2.Both the sensitivity and positive predictive value of diagnosis were 86.7%(39/45).The abilities of DWI and DCE MRI for the diagnosis of small breast cancers werle the same. The sensitivity(93.3%)and positive predictive value(91.3%)were improved with the combination of DCE MRI and DWI. Conclusion DWI has a high sensitivity for the detection of small breast cancers,the ADC value can provide valuable information in the differential diagnosis.

Objective To assess the role of helical CT in the long-term follow-up of patients with malignant hepatic tumors treated with RFA. Methods CT findings of patients with liver malignant tumors (29 hepatocellular carcinomas and 7 metastases) were reviewed retrospectively, who underwent percutaneous ultrasound-guided radiofrequency ablation (RFA). CT images consisted of nonenhanced and dual-phase contrast-enhanced helical CT scan, the effect of ablation therapy and tumor recurrence were detected. Results The major patterns of tumor residual or local recurrence were the lesions with thick rim or nodular peripheral enhancement in arterial phase or the lesions with gross enlargement on follow-up CT images. The complete necrosis lesions in 28 cases (77.8%) were seen on the initial postablation CT scans after a single session RFA. On the subsequent follow-up CT examination, the local intra-hepatic tumor recurrences were seen in 2 cases (5.6%) as well as the remote intra-hepatic tumor recurrences were seen in 4 cases (11.1%).Conclusion For certain patients with hepatic malignant tumors, RFA is an effective therapeutic method, and dual-phase contrast enhanced helical CT scans play a important role in long-term assessment and follow-up of patients.