Objective To observe the clinical effect of adenoidectomy in the treatment of children with chronic rhinosinusitis ,to discuss its postoperative complications and postoperative rehabilitation .Methods Chose 100 children with chronic rhinosinusitis from February 2011 to April 2013 treated in our hospital as observation objects ,the cases were randomly divided into experimental group and control group ,with 50 cases in each group ,patients in experimental group was given drug and adenoidectomy treatment ;patients in control group was given drug orally external treatment only .Observed the postoperative complications and postoperative recovery ,then compared treatment effect of two groups .Results The total efficiency of experimental group was 96% ,control group was 60% ,the difference was statistically significant (P<0 .05);compared with those before operation ,there were significant differ-ence in experiment group in postoperative snoring ,purulence stuff ,sinus patency ,etc(P<0 .05) .Moreover ,experimental group and control group had difference in hospitalization days .The control group not only had high cost and long hospital stay but also had relatively high recurrence rate (P<0 .05) .Conclusion The curative effect of adenoidectomy combined with drugs in the treatment of children with chronic rhinosinusitis was much better than drug treatment only .

Objective To review the clinical features of small cell neuroendocrine carcinoma of the prostate (SCPCa). Methods The ages of 4 cases were 25-77 years. Four cases had progressive dysuria with 2 cases had chronic urinary retention and 2 had upper urinary tract hydronephrosis. On admission, all cases were palpated a hard prostate mass in digital rectal examination. Serum tPSA were 0. 57-6.36 ng/ml with a ratio f/t PSA 0. 26-0.63. B ultrasound, CT and MRI detected 3.9 cm×3. 9 cm×1.6 cm-11.3 cm×7. 9 cm×9. 5 cm irregular shape mass in prostate. 2 cases had seminal vesicle involved, 2 cases had rectum involved, 2 had unilateral ureter involved, and 1 case had sacrum involved. Pelvic lymphonodes metastasis were seen in 3 cases. Bone scan detected multiple bone metastasis in 3 patients. Results The final diagnoses were accomplished by prostate biopsy. Under light microscope, tumor cells were orbivular-ovate or fusiform shape, small volume, and had little cytoplasm. The margin of tumor cells was not clear. Caryokinesis phase could be found with hyperchromatic chromatin. Immunohistochemistry showed positive ChA staining in 4 eases, positive NSE expression in 2 patients and negative PSA in 4 cases. 3 cases were given cisplatin-based chemotherapy, pelvic radiation, or chemotherapy plus radiotherapy. All patients appeared widespread metastasis quickly and died or lost visit within one year. Conclusions SCPCa is a rare, poor prognosis malignancy with early extensive metastasis. The diagnosis is based on pathology.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Catheter Ablation ; methods ; Endoscopy ; Epistaxis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Young Adult

ObjectiveTo evaluate the efficacy of intravenous and intra-arterial thrombolysis with urokinase for acute cerebral infarction.Methods Fifty patients with acute cerebral infarction occurred within 6 hours were divided into two groups by random digits table method with 25 cases each:intravenous and intra-arterial thrombolysis group and intravenous thrombolysis group.The patients in intravenous and intra-arterial thrombolysis group were given 200 000 U urokinase by intravenous infusion for 30 minutes immediately after being hospitalized,and arterial thrombolysis was prepared at the same time.With cerebrovascular angiography,the thrombolytic therapy was carried out in the target vessel blocking points through micro-catheter.Urokinase dissolved in 0.9％ sodium chloride was infused at the rate of 10 000 U per minute,the total volume would not be more than 1 000 000 U.The patients in intravenous thrombolysis group were given 1 000 000 U urokinase in 100 ml 0.9％ sodium chloride by intravenous infusion within 60 minutes.The clinical efficacy after thrombolysis was assessed according to the National Institutes of Health stroke scale (NIHSS) score,the quality of life was judged by Barthel index (BI) score and the prognosis was evaluated by modified Rankin scale (mRS) score of 90 days after thrombolysis.ResultsThere was no significant difference between two groups before thrombolysis according to the NIHSS score (P ＞ 0.05).After thrombolysis,NIHSS scores in two groups showed a downward trend,but they were obviously lower in intravenous and intra-arterial thrombolysis group after 24 h,7 d and 14 d than those in intravenous thrombolysis group [(8.97±4.56) scores vs.(11.01±3.65) scores,(6.88±2.31) scores vs.(8.34±3.05) scores,( 4.06±3.02 ) scores vs.( 6.73±2.15 ) scores ] ( P ＜ 0.05 or ＜ 0.01 ).BI scores before thrombolysis between two groups had no significant difference(P ＞0.05),while BI score of 90 days after thrombolysis in intravenous and intra-arterial thrombolysis group [(79.55±19.64) scores] was higher than that in intravenous thrombolysis group [(69.31±21.35) scores](P=0.0162).The rate of mRS score 0-2 (good efficscy) in intravenous and intra-arterial thrombolysis group [72.0％(18/25) ] was obviously higher than that in intravenous thrombolysis group [ 52.0％ ( 13/25 ) ] (P =0.0198 ).ConclusionsIt is significantly effective to treat acute cerebral infarction by superselective intravenous and intra-arterial thrombolysis.Therefore,it is supposed to be an optimal option for treating acute cerebral infarction in the future.

OBJECTIVE: To test the immunoglobulin free light chain (FLC) from nasal secretion and serum of patients with allergic rhinitis(AR)and non-allergic rhinitis(NAR) for the purpose of exploring the possible immunological mechanism. METHOD: Ninety consecutive patients were selected between January 2009 and January 2012, involving 45 patients with AR and 45 patients with NAR diagnosed by symptoms,signs,skin prick tests(SPT) and specific IgE (slgE). Forty-five volunteers were chosen as healthy control (HC). According to the visual analogue scale (VAS) scores,the nasal symptoms of AR and NAR,including sneeze. Nasal discharge. Nasal obstruction and nasal itching were compared. ELISA was used to detect the total IgE, IL-16, IL-17 in nasalsecretion and serum. The data was analyzed by SPSS 17.0 software. RESULT: There was no statistical difference between AR and NAR group in nasal symptoms (P > 0.05); In serum, IL-16 and IL-17 increased in AR group comparared to NAR group (P < 0.05); IL-16 and IL-17 increased in NAR group comparared to HC group (all P < 0.05); In nasal secretion, IL-16 and IL-17 increased in NAR and AR group comparared to HC group (all P < 0.05). CONCLUSION IL-16, IL-17 takes part in the path of physiological process of AR and NAR with the immunological mechanism.
Adolescent ; Adult ; Case-Control Studies ; Female ; Humans ; Interleukin-16 ; blood ; metabolism ; Interleukin-17 ; blood ; metabolism ; Male ; Middle Aged ; Rhinitis ; immunology ; metabolism ; Rhinitis, Allergic ; immunology ; metabolism ; Young Adult

Objective To investigate the effectiveness of Uromentor virtual reality simulator in flexible ureteroscopy training for catechumen.Methods Fifty-one catechumen were selected.After 1 hour training of basic operation in Uromentor virtual reality simulator, all trainees performed special-purpose exercise ( kidney inspection with flexible ureteroscopy ) for 3 hours. Using right kidney inspection, a preliminary assessment for each trainee was made before the special-purpose exercise and data such as total time, number of trauma from the scopes and tools, percentage of kidney surface examined and global rating scale ( GRS ) were recorded.The same assessment was performed once again after the special-purpose exercise ( secondary assessment ) , and data were recorded and compared to the preliminary assessment. Results Each trainee made a significant improvement in flexible ureteroscopic skill after the special-purpose training.The parameters such as total time, number of trauma from the scopes and tools, percentage of kidney surface examined and GRS of all trainees in preliminary assessment were 14.63 ±1.01 min, 8.62 ± 2.67, 51.05%±20.79%and 10.31 ±2.53, respectively;while in secondary assessment, parameters were 7.71 ±1.13 min, 1.67 ±1.23, 98.04% ±5.42% and 29.14 ±3.01, respectively.The differences between the preliminary assessment and the secondary assessment of each parameter were significant ( P<0.01).Conclusions The Uromentor virtual reality simulator can improve the trainee′s skills of flexible ureteroscopy.It is a good instrument of the flexible ureteroscopic training for catechumen.

Objective To set up the methods of establishing rat primary benign prostatic hyperplasic glandular epithelial cell line.Methods Male spontaneously hypertensive rats were raised to 29 weeks,and then evaluated the situation of BPH with HE staining.The prostate tissue from ventral prostate lobe was aseptically removed,dissected,minced,and then dissociated in collagenase type Ⅰ.Isolated cells were collected,seeded in WAJC-404 and PrEGM medium separately,then cultured and passaged.Specificity of primitive cultured prostatic epithelial cells was identified by cell immunochemistry with CK8/18,and the cell growth curves were drawn.Then the situation of growth of the two prostatic hyperplasic glandular epithelial cell lines were analysed and compared.Results The prostatic hyperplasic glandular epithelial cell lines of the spontaneously hypertensive rats in WAJC-404 and PrEGM medium were successfully primarily cultured,purified and passaged in vitro.Cell immunochemistry proved that the cell lines specifically express cytokeratin 8/18.Cell growth curve showed that prostatic epithelial cells in PrEGM,compared with prostatic epithelial cells in WAJC-404,possessed better cell morphology,more exuberant cell vitality,faster growth rate to enter the logarithmic growth period(4 d vs.7 d)and higher peak of cell growth curve(15.3× 104/ml vs.12.8×104/ml).Conclusions Rat primary benign prostatic hyperplasic glandular epithelial cell line can be established conventionally in vitro.PrEGM medium is more suitable for primary culture of the rat benign prostatic hyperplasic glandular epithelial cell line than WAJC-404 medium.

Objective To compare the diagnostic efficacy and complications of transperineal prostate biopsy for<10 cores biopsy vs≥10 cores biopsy. Methods Nine hundred transrectal ul-trasound-guided transperineal prostate biopsies were performed. Patients were divided into 2 groups, <10 cores group and ≥10 cores group. Patient numbers of the 2 groups were 759 and 141, respec-tively. Cancer positive rate and complications were compared between the 2 groups retrospectively. Results Cancer positive rates were 41.6%(316/759) and 51.8%(73/141) in 2 groups (P<0.05). In patients of PSA≤10.0 ng/ml, cancer positive rates were 6.8% (16/235) and 17.8% (8/45) in 2 groups (P<0.05). Gross hematuria was the most common complication associated with biopsy. There was no statistical difference between the 2 groups in post-biopsy gross hematuria rate. Conclu-sions The diagnostic efficacy is higher in≥10 cores prostate biopsy than that in <10 cores prostate biopsy, There is no difference in biopsy related complications regarding biopsy core numbers.

ObjectiveTo evaluate the relationship between metabolic syndrome (MS) and benign prostatic hyperplasia ( BPH ) in men over 50 years old.Methods Male participants over 50 years old form a community in Beijing were randomly selected.Age,blood pressure,past history,and the international prostate symptom score (IPSS) were recorded.Plasma glucose,triglyceride,high density lipoprotein,prostate specific antigen (PSA),prostatic volume,and Qmax were measured.The morbidity and severity of BPH were compared with statistical analysis.ResultsFour hundred and forty men were enrolled,and were divided into 2 groups:MS group (n =105) and non-MS group (n =335).Compared to the non-MS,non-obesity,and non-hyperlipidemia group respectively,the morbidity of BPH was higher in MS,obesity and hyperlipidemia group (33.3％ vs.11.9％,P ＜ 0.05 ; 20.4％ vs.11.8％,P ＜ 0.05 ; 25.0％ vs.14.1％,P =0.007).The morbidity of moderate and severe LUTS in MS group was higher than non-MS group (61.9％ vs.31.3％,P ＜ 0.05).Significant differences were found in IPSS,prostate volume and PSA between the MS and non-MS groups ( P ＜ 0.05 ),but not found in Qmax ( P =0.069).Obesity,hyperlipemia and diabetes mellitus were risk factors of BPH (OR 1.75,95％ CI 1.40 -21.82,P =0.041 ; OR 3.36,95％ CI 2.34-48.13,P=0.037; OR 2.08,95％ CI 1.32-13.67,P=0.045). Conclusions There is higher morbidity of BPH in MS patient.MS could increase IPSS and prostate volume,and reduce PSA in BPH patient.Obesity,hyperlipemia and diabetes mellitus are risk factors of BPH.MS should be considered when treating BPH.

OBJECTIVE:To determine the therapeutic effect of transpedicular instrumentation without fusion on patients with thoracolumbar burst fractures.METHODS:A total of 63 patients with thoracolumbar burst fractures (the inclusion criteria was neurologically intact spine with a kyphotic angle >20° and/or decreased anterior vertebral body height > 50%) who were treated with transpedicular instrumentation without fusion were studied,including 40 cases treated by AF internal fixation,16 cases by Tennor screw-rod fixation system and 7 cases by Diapason screw-rod fixation.All patients underwent a radiological and clinical assessment (including the loss of kyphotic angle,decreased anterior vertebral body height,the midsagital diameter of the canal and the Low Back Outcome Score) preoperatively,postoperatively and after 24 months.The deformity of angulation was measured by Cobb angle.RESULTS:All pstients were followed for a 24 months,with average stay of 13.4 days.There were averaged 3.8 days from admitted to operation,and the internal fixation was removed within 8-12 months in 51 cases,followed a 9.4-day hospital stay.According to low back outcome score,46 patients achieved excellent,9 good,5 fair and 3 poor,with excellent and good rates of 88%.The Cobb's angle was 20.1° preoperatively,6.2° postoperatively,and 11.9° after 24 months.The average lose of anterior vertebral body height was changed from 49.1% preoperatively to 17.4% postoperatively,which was 20.4% after 24 months.The midsagittal diameters was 49.8% (n=63) preoperatively,78.1% (n=28) postoperatively,and 91.7% (n=25) after 24 months.The implant failure occurred in 5 patients.The radiographic parameters had no associativity to the outcome of LBOS.CONCLUSION:Transpedicular instrumentation without fusion is conductive to treating burst fractures of the thoracolumbar spine without nerve injury.The routine posterior or posterolateral fusion is unnecessary in the operative management of these fractures.