Objective To summery the value of treatment for pancreatic benign tumor following the organ preserve principle.Methods The clinical data of 77 patients with pancreatic benign tumor at the General Hospital of Tianjin Medical University from Jan 2002 to Jan 2012 was analyzed.All patients were divided into traditional pancreatic surgical treatment group (n=24) which include pancreaticduodenectomy(PD) and pancreatic body and tail resection plus spleenectomy(DP) and treatment following organ preserve principle (n =53).Results There are tumor evacuation,segmentectomy,pancreatic head resection with duodenum preserving and pancreatic body and tail resection with spleen preserving in the group of treatment following organ preserve principle.Pathology diagnosis showed insulinoma 30 cases,mucinous cystadenoma 16,serous cystadenoma 10,intraductal papillary mucinous tumor 17,solid pseudopseudopapillary tumor 3 and 1 case of pancreatic intraductal hyperplasia.The rate of pancreatic leakage were 26.3％ (5/19) in traditional surgical treatment group and 24.3％ (9/37) in group of treatment following organ preserving respectively.There was no significant difference between these two groups(P＞0.05).The rate of new development diabetis and aggrasive of the preexist diabetis post the pancreatic surgery were 20.8 ％ (5/24),20 ％ (1/5),13.2(7/53),30 ％ (3/10)respectively.There was no significant difference between these two groups(P=0.485,P=1.000).Conclusions The surgical treatment following the organ preserving is a safe and effective procedure for the patients with pancreatic benign tumor.This new method can preserve the pancreatic parenchymal maximally,avoid the extra-and endo-secrete function loss and preserving the function of spleen.

Objective: To discuss the significance of neoadjuvant chemotherapy followed by surgery in the treatment of local advanced esophageal cancer. Methods:A total of 272 cases of local advanced esophageal cancer were studied in retrospect. Out of the 272 cases, 112 were treated with neoadjuvant chemotherapy followed by surgery (CT-S), whereas the remaining 160 cases underwent surgical treatment (S) only. Complications and survival state after surgery were compared. Results: The rate of complications after surgery was as follows: CT-S: 34.8% (39/112); S: 29.4% (47/160), P=0.50. The five-year survival rate was 35.7% and 29.4%, respectively, P<0.05. The CT-S patients were divided into partial remission (PR) and stable disease (SD)/progressive disease (PD) groups according to the effect of the chemotherapy. The five-year survival rate was 38.5% and 30.1%, respectively, P<0.01. Conclusion: Neoadjuvant chemotherapy is available for local advanced esophageal cancer. Postoperative complications are not increased by chemotherapy, and the survival rate for local advanced esophageal cancer is improved by neoadjuvant chemotherapy. PR has better prognosis compared with SD/PD.

Objective To investigate the micro-anatomical approach to resect both intracranial and extracranial jugular foramen tumors in one-stage. Methods With the aid of surgical microscope, fifteen cadaver heads were used to study the microsurgical anatomy of high cervical part and jugular foramen, measure relative data. Results Detailed dissection was performed on high cervical part between the 1st cervical vertebra and the 4th cervical vertebra, resect foramen processus transversi of the 1st cervical vertebra, free vertebral artery 2nd and 1st cervical vertebra segment and horizontal segment. The jugular tubercle, jugular tunisia and part of the occipital condylus was drilled away as much as possible, total exposure of lateral semicircular canal was completed after the removal of the mastoid revealed labyrinthinem. Then the sigmoid sinus and jugular bulb were skeletonized. The vertical of segment of facial nerve was fully skeletonized to study the necessity of the facial nerve translocation. Full exposure to the sigmoid sinus, open jugular foramen. JF areas expanded, and the measured parameters revealed. The distance was (29.65 ± 3.24)mm from mastoidalec to oncentrated focus of condyle (10.18 ± 0.81)mm from hinder margin of condyle to endostoma of hypoglossal canal. The left distance was (6.8 ± 0.35)mm from jugular foramen to perpendicular part of facial nerve, right was (4.6 ± 0.33)mm. Conclusions Total exposure of JF can be achieved through the approach we described, and will enable the facial nerve, cochlea, and the structure of the vertebral artery to be performed. Both intracranial and extracranial tumors can be removed in a one-stage procedure related to anatomical parameters. Improve the cure, reduce complication and lower mortality.

Objective To explore the safety and effectiveness of early microsurgical removal of low-grade (Spetzler-Martin Ⅰ-Ⅱ) bleeding arteriovenous malformations. Methods The clinical data of 31 patients with low-grade AVM by microsurgical treatment in our hospital from October 2009 to December 2015 were retrospectively reviewed in the acute stage of bleeding (within the first week after bleed). All patients showed a cerebral AVM on DSA or CTA at admission, 18 of whom underwent intraoperative ultrasound. Neurological outcomes were assessed with Glasgow outcome scale (GOS) after operation. According to the GOS scores, the patients were divided into good prognosis group (scores of 4-5) and poor prognosis group (scores of <4); the differences of preoperative clinical data between the two groups were compared. After operation, cerebral DSA or CTA was performed. According to the postoperative brain AVM with or without residual, the patients were divided into residual group and no-residue group; the differences of the clinical data and use of ultrasound in operation were analyzed statistically between the two groups. Results A favorable functional outcome was observed in 27 patients (87.1%); as compared with that in the poor prognosis group, the proportion of Glasgow coma scale (GCS) scores>8 and young patients in the good prognosis group was significantly higher (P<0.05). In 31 patients, there were 5 with residual brain AVM (total residual rate 16.1%); the proportion of patients with Spetzler-Martin grading (SMG) I in the residual group was significantly lower than that in the no-residue group (P<0.05). There was no statistically significant difference in the proportion of intraoperative ultrasound use between the two groups (P>0.05). Conclusions Early microsurgery for grade Ⅰ-Ⅱ bleeding AVMs is a safe and definitive treatment with intraoperative ultrasound, achieving both immediate cerebral decompression and protection against rebreeding, reducing hospital stays and allowing a more rapid rehabilitative course whenever necessary. Patients who are younger or with GCS scores>8 may have a better prognosis and high complete resection is achieved in those with SMG Ⅰ.

OBJECTIVE: To investigate the prevalence of vertigo and related risk factors in middle school students in the city of Xi'an. METHOD: A cross-section study was used to investigate on vertigo among middle school students. Questionnaire ,ear examination and auditory tests were carried out by the staff who received special training. Multiple Logistic regression models were used to analyze the relative influential factors about vertigo. RESULT: There were 1567 middle school students who underwent a complete investigation. The participants comprised 793 males (50.6%) and 774 females (49.4%). The overall prevalence of vertigo was 5.6%. No significant difference of the prevalence was found between males (4.7%) and females (6.5%) (P > 0.05). The use of MP3 or MP4, insomnia and history of middle ear infections or ototoxic drugs ingestion were the main risk factors for vertigo (odds ratio: 2.837, 5.582, 2.808 and 1.695, respectively). CONCLUSION Vertigo has an influence on the study and living of the students. More researches are urgently needed on prevention and treatment of vertigo.
Adolescent ; Child ; China ; epidemiology ; Female ; Humans ; Logistic Models ; Male ; Prevalence ; Schools ; Students ; Vertigo ; epidemiology ; Young Adult

OBJECTIVE: To understand the usage of MP3 and effects on hearing of middle school students in Xi'an, and discuss controlling strategies. METHOD: Stratified random cluster sampling method was used in the 1567 middle school students in Xi'an through questionnaire survey, ear examination and hearing examination, data were analysed by the SPSS13.0 statistical software. RESULT: 1) The rate of holding MP3 in the middle school students was 85.2%. Average daily use time was (1.41 +/- 1.11) h. 2) The noise group of pure tone hearing threshold was significantly higher compared with the control group (P<0.01), and increased the detection rate of hearing loss with the increasing use of MP3. 3) The detection rate of symptoms increased with the increasing use of MP3. CONCLUSION The usage of MP3 can harm hearing in middle school students, which can result in neurasthenic syndrome.
Adolescent ; Audiometry, Pure-Tone ; Auditory Threshold ; Data Collection ; Female ; Hearing Loss ; etiology ; Hearing Tests ; Humans ; MP3-Player ; Male ; Students ; Surveys and Questionnaires

Objective:To study the application effect of carotid-subclavian artery blood vessel prosthesis bypass grafting in the reconstruction of cerebral blood supply.Methods:The clinical data of 14 patients undergoing carotid-subclavian artery blood vessel prosthesis bypass grafting to reconstruct cerebral blood supply in the Department of Vascular Surgery, Beijing Tiantan Hospital, Capital Medical University from March 2019 to March 2022 was retrospective collected. And the surgical indications, clinical effect and complications were analyzed.Results:There were 12 males and 2 females, aged from 47 to 74 years, with an average age of 60.5 years. Of 14 patients, 2 patients suffered from common carotid artery stenosis with posterior dilatation, 12 patients suffered from subclavian artery occlusion with vertebral artery steal. All the procedures were successfully performed without intraoperative cerebral infarction, cardiovascular accident, lymphatic leakage or artificial vascular infection. Phrenic nerve injury occurred in 1 patient after operation. During the follow-up of 3-27 months, average 14 months, there were no artificial vascular stenosis, anastomotic stenosis, vertebral artery steal, new cerebral infarction, upper limb ischemia or cerebral ischemia.Conclusion:Carotid-subclavian artery blood vessel prosthesis bypass grafting can be used in reconstructing the blood supply of both the anterior circulation, and the posterior circulation safely and effectively.

Objective To evaluate the effect of surgical treatment on extracranial supra-aortic aneu-rysms and summarize the experience.Methods The clinical data of 10 patients undergoing surgical treatment of extracranial supra-aortic aneurysms from May 2019 to November 2023 in the Department of Vascular Surgery of Beijing Tiantan Hospital affiliated to Capital Medical University were collected.The 10 patients included 5 pa-tients with internal carotid artery aneurysm,2 patients with subclavian artery aneurysm,2 patients with vertebral artery aneurysm,and 1 patient with internal carotid artery aneurysm combined with ipsilateral subclavian artery aneurysm.The surgical indications,surgical regimens,clinical efficacy,and complications were retrospectively analyzed.Results All the 10 patients underwent surgery successfully,with the surgery duration range of 60-420 min and the median surgery duration of 180.0(121.5,307.5)min.Intraoperative bleeding volume varied with-in 30-400 mL,with a median of 90(50,125)mL.The time of carotid artery blocking and vertebral artery bloc-king varied within the ranges of 10-20 min and 20-30 min,with the medians of 15.0(11.5,16.3)min and 25.0(15.0,22.5)min,respectively.No cardiac accident,cerebral infarction,or cerebral hemorrhage oc-curred during the perioperative period.The 10 patients were followed up for 3-58 months,with the median follow-up time of 8.5(5.3,17.0)months.One patient with subclavian artery aneurysm developed artificial vessel oc-clusion 20 months after surgery.One patient with internal carotid artery aneurysm developed distal carotid artery stenosis 6 months after surgery.Conclusion Surgical treatment should be actively adopted for extracranial supra-aortic aneurysms,and individualized surgical regimens should be designed according to patient conditions.

In this review, development and application of the minimally invasive esophagectomy(MIE) for esophageal cancer are discussed including the types of MIE procedures, short- and long- term outcome after MIE; as well the future of MIE is forecasted. Main procedures of MIE performed currently include esophagectomy via thoracoscopy and laparoscopy and cervical esophagogastrosty, Ivor-Lewis MIE via thoracoscopy and laparoscopy, and hiatal MIE. Ivor-Lewis MIE gradually becomes a standard surgical option for the cancer of distal esophagus or esophagogastric junction while the solution of intrathoracic anastomosis via thoracoscopy has achieved. Several methods of intrathoracic anastomosis are reported such as hand-sewn, circular stapler, side-to-side and triangular anastomosis. MIE could decrease operative blood loss, shorten hospital stay and ICU stay, reduce postoperative especially pulmonary complications, and harvest more lymph nodes compared to open esophagectomy. The long-term survival has been proved similar with that after open esophagectomy for esophageal cancer. MIE has developed rapidly in recent years with some aspects in future prospectively: individual MIE treatment and quality of life, fast track after surgery, and robot-assisted MIE, as well the endoscopic submucosal dissection for esophageal cancer is mentioned.