ObjectiveTo discuss the effect of surgical treatment of varicose vein on primary chronic venous insufficiency(PCVI) in the lower extremities.MethodsBetween August 2007 and August 2008,128PCVIpatients underwenthighligationof the greatsaphenousveinandendovenous electrocoagulation of the varix superficial vein. Spectrum Doppler ultrasound was used to measure the superficial femoral vein blood flow hemodynamic information beneath the first pair of valve including quiet breathing condition and the Valsalva action (reflux time、caliber、reflux velocity). Reflux index (RI) was used as guide line.ResultsClinical sympotoms improved in 54 out of 60 mild PCVI cases, in 29 of 45 moderate PCVI patients, while only in 6 out 23 cases in whom severe preoperative clinical symptom with PCVI was present.The effective rate respectively was 90％, 64％, and 30％.The mild reflux index significantly improved than that before operation ( t = 21. 484, P = 0. 000 ), the moderate reflux index improved than that before operation ( t = 2. 173, P = 0. 035 ), while the serious reflux index were not statistically improved than that before operation( t = 1. 888, P = 0. 078 ). In all cases reflux index improved after the surgery ( x2 = 8. 266,P = 0. 004).ConclusionsMinimally invasive surgical treatment of varicose veins can improve the reflux of the deep vein in PCVI cases with mild to moderate clinical symptom.

Objective To evaluate the clinical presentations,pathologic characteristics,and the diagnosis and treatment of eosinophilic cystitis.Methods Two cases of eosinophilic cystitis were analyzed,and the relevant literature was reviewed.Case 1,a 63-year-old man,complained of voiding urgency and frequency,dysuria,intermittent hematuria,and lower abdominal pain.Cystoscopic examination showed that an about 5cm?3cm abnormal focus was 0.2-0.4 cm above bladder mucosa at the fundus of the bladder.Case 2,a 42-year-old woman,complained of voiding urgency and frequency,dysuria,and suprapubic pain with intermittent hematuria.Cystoscopic examination showed that about 4 cm?3 cm?2 cm abnormal foci of cauliflower-like were 0.3-0.4 cm above bladder mucosa at the fundus and neck of the bladder.Imaging examinations(Bultrasound,CT and IVU) showed diffuse thickening of bladder wall and tumor-like lesions.They both underwent transurethral resection of the lesions and were treated with oral steroids and antibiotics.Results Postoperative pathology confirmed eosinophilic cystitis in both cases.The follow-up was 6 months.The voiding symptoms disappeared,and imaging examinations showed no space-occupying lesions of the bladder in them.Up to now,there has no evidence of relapse.Conclusions Eosinophilic cystitis is a very rare tumor-like inflammatory disease.It is easily misdiagnosed as bladder neoplasm.Cystoscopy and biopsy are gold standard for the diagnosis.Current treatment modalities include transurethral resection of the bladder lesion along with nonspecific medical therapy.

Objective: To investigate the application of one stage otoptasty for congenital atresia of the external acoustic canal and malformations of the middle ear and the auricle. Method: patients with the ear malformations were given surgical reconstruction of one stage otoplasty. The auricle was reconstructed with the rib which was encapsuled with the superthin temporal flap. According to the malformations of the middle ear in patients, Ⅰ style tympanoplasty and Ⅲ style tympanoplasty were carried out respectively. All patients were performed myringoplasty with temporal fascia and reconstructed the external acoustic canal with full thickness skin-grafting. Result:A long term follow-up (4～6 years)demonstrated that 11 ears were survival of which 8 ears figuration were ideal. The hearing improvement was observed in all patients. Conclusion:one stage otoplasty is effective for treatment of the congenital malformations of the external and middle ear.

Objective:To assess the effectiveness and characteristics of intratumoral radioactive seed implantation in low rectal cancer with anal sphincter preservation.Methods:Clinical data of 8 patients (not willing or can not to undergo radical resection of rectal carcinoma) with low rectal cancer receiving radioactive seed implantation with anal sphincter preservation were retrospectively analyzed.Results:All the 8 patients successfully completed intratumoral radioactive seed implantation. Preoperative clinical symptoms of discomfort were significantly improved, and CEA levels decreased significantly. Colonoscopy and CT examination showed that tumor disappeared in 4 cases, anal function was successfully preserved in all patients. The mean survival time was 32.4 months.Conclusions:Intratumoral radioactive seed implantation in low rectal cancer with anal sphincter preservation can effectively improve the quality of life of patients.

Objective To investigate the opportunity and skill of surgery for pancreatic sinistral portal hypertension.Methods Clinical data were retrospectively analyzed on 15 cases of pancreatic sinistral portal hypertension admired from Dec 2015 to Dec 2017.Results All fiften cases underwent surgical treatment,among them three cases were initially treated conservatively in the early stage and treated surgically for gastrointestinal bleeding,12 cases with definite pancreatic disease and pancreatic sinistral portal hypertension treated in the first stage.Three patients underwent second surgery for recurrent gastrointestinal bleeding.The patients were followed up for 6 to 18 months with symptoms significantly impioved without deaths.Conclusions Splenectomy combined with esophagogastric devascularization is the basic surgical treatment for pancreatic sinistral portal hypertension.

Objective:To investigate the effects of transaxillary endoscopic and traditional open radical thyroidectomy on the levels of inflammatory factors in patients with thyroid cancer.Methods:The clinical data of 102 thyroid cancer patients underwent radical thyroidectomy from October 2019 to October 2021 in Xinjiang Medical University Hospital of Chinese Medicine were retrospectively analyzed. Among them, 50 cases underwent transaxillary approach endoscopic radical thyroidectomy (study group), and 52 cases underwent open radical thyroidectomy (control group). The operation related indexes were compared between two groups, including operation time, intraoperative blood loss, postoperative drainage, lymph node clearance and hospital stay; the pain scores 1, 3 and 7 d after operation were recorded; the levels of interleukin-6 (IL-6), interleukin-10 (IL-10), galectin-3 (Gal-3) and tumor necrosis factor-α (TNF-α) before operation and 1 d after operation were measured by enzyme-linked immunosorbent assay; the postoperative complications were recorded, including hoarseness, limb numbness, cough after drinking water and hypocalcemia; and the cosmetic satisfaction was followed up 3 months after discharge, and the recurrence was observed by CT 6 months after discharge.Results:The operation time in study group was significantly longer than that in control group: (88.69 ± 15.16) min vs. (61.47 ± 15.48) min, while the intraoperative blood loss, postoperative drainage and hospital stay were significantly lower in control group: (51.21 ± 10.06) ml vs. (85.46 ± 11.37) ml, (98.29 ± 30.61) ml vs. (117.47 ± 30.25) ml and (5.35 ± 0.54) d vs. (7.72 ± 0.61) d, and there were statistical differences ( P<0.01); there was no statistical difference in lymph node clearance between two groups ( P>0.05). The pain score 1 and 3 d after operation in study group was significantly lower than that in control group: (5.13 ± 1.07) scores vs. (7.87 ± 1.46) scores and (4.22 ± 1.35) scores vs. (6.42 ± 1.28) scores, and there were statistical differences ( P<0.05); there was no statistical difference in pain score 7 d after operation between two groups ( P>0.05). There were no statistical differences in IL-6, IL-10, TNF-α and Gal-3 between two groups ( P>0.05); the IL-6, IL-10, TNF-α and Gal-3 1 d after operation in study group were significantly lower than those in control group: (26.27 ± 3.14) ng/L vs. (29.22 ± 4.52) ng/L, (7.54 ± 2.31) ng/L vs. (10.92 ± 2.54) ng/L, (14.98 ± 3.76) μg/L vs. (23.65 ± 2.46) μg/L and (3.54 ± 0.48) μg/L vs. (4.48 ± 0.63) μg/L, and there were statistical differences ( P<0.01). There was no statistical difference in the incidence of total complications between two groups ( χ2 = 1.73, P>0.05). The total satisfaction rate in study group was significantly higher than that in control group: 94.0% (47/50) vs. 78.8% (41/52), and there was statistical difference ( χ2 = 4.94, P<0.05). The patients were followed up for 6 months after discharge, and there was no recurrence. Conclusions:The transaxillary approach endoscopic radical thyroidectomy can reduce intraoperative blood loss, length of stay, postoperative drainage, postoperative pain, and to some extent inhibit inflammatory response. It can improve the postoperative cosmetic satisfaction, reduce the incidence of postoperative complications, and does not increase the recurrence rate

Objective: By modeling ischemic foot ulcers in experimental rabbits, the mechanism of healing in animal models was investigated. Methods: Sixty healthy male clean grade New Zealand rabbits were 3 months. The weight range was 2.1-2.5 kg. Randomly draw auording to the number, the experimental rabbits were randomly divided into 4 groups, namely, no ischemia-no ulcer-no intervention group (group A), no ischemia-no ulcer-no intervention group (group B), no ischemia-no ulcer-no intervention group (group C) and no ischemia-ulcer-intervention group (group D), with 15 rabbits in each group. Ischemic foot ulcers experimental rabbit building complete after 24 h, will naturally exposed ischemic foot ulcers in the low frequency electromagnetic field on experimental rabbit 7 d feeding experiment, the experimental rabbits ischemia crus muscle and the ulcer base were collected, and plasma by enzyme-linked immunosorbent assay (ELISA) verification tests in experimental rabbit plasma hypoxia-inducible factor 1 alpha subunit (HIF-1α), matrix metalloproteinases 9 (MMP-9) and soluble leukocyte differentiation antigen 40 ligand 1 (sCD40L1) expression level, while detecting ulcer healing area change, hematoxylin-eosin staining was used to detect and analyzed the pathological changes of ulcerated skin. Measurement data were expressed as mean±standard deviation (Mean±SD), one-way analysis of variance was used for comparison between groups, and LSD method was used for pairwise comparison. Results: The concentration of MMP-9 and sCD40L1 in group D were (40.510±10.155) ng/ml and (44.580±19.138) ng/ml, respectively. Concentrations in group C were (93.210±17.838) ng/ml and (318.500±52.680) ng/ml, respectively. Group D was significantly lower than group C, and the difference was statistically significant (P< 0.000 1). The concentrations of HIF-1α in group D was (249.700±71.824) ng/ml, and that in group C was (124.830±20.110) ng/ml. The concentration in group D was significantly higher than that in group C, and the difference was statistically significant (P< 0.000 1). The concentrations of HIF-1α, MMP-9 and sCD40L1 in group B were (181.590±31.927), (78.950±16.652) and (173.670±43.048) ng/ml, respectively. The concentrations of group A were (35.420±9.916), (32.700±6.449) and (47.440±11.831) ng/ml, respectively. The concentration in group B was significantly higher than that in group A, the difference was statistically significant(P<0.000 1). The concentration of HIF-1α in group D was (249.700±71.824) ng/ml, and the concentration of group A was (35.420±9.916) ng/ml. The concentration of group D was significantly higher than that of group A, and the difference was statistically significant (P=0.000 1). The concentration of the MMP-9 in the group D was compared with the concentration of group A, and the difference was not statistically significant (P=0.207). The concentration of sCD40L1 in group D was (44.580±19.138) ng/ml, and that in group A was (47.440±11.831) ng/ml. The difference between group D and group A was not statistically significant(P=0.858). The healing area of ulcer was (1.855±0.394) cm² in group D and (0.653±0.269) cm² in group C. Group D was significantly higher than group C, and the difference was statistically significant (P<0.000 1). Hematoxylin-eosin staining results of ulcer skin showed that the epithelial of ischemic foot ulcer was significantly atrophied, hyperkeratinized, and the acinous cell layer was atrophied with a small amount of obvious inflammatory cell infiltration and hyperplasia of small vessels. After intervention, the symptoms were relieved. Conclusion Low frequency electromagnetic fields can promote the expression of HIF-1α in experimental rabbits, inhibit the expression of MMP-9 and sCD40L1, and promote the healing of ischemic foot ulcer.