Adult ; Barotrauma ; diagnosis ; surgery ; Hand Injuries ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Paint

Objective To evaluate the safety and efficacy of photoselective vaporization of prostate (PVP) for the treatment of benign prostatic hyperplasia (BPH). Methods A total of 161 patients with symptomatic bladder outlet obstruction due to BPH underwent PVP via transurethral with Niagara PV TM system.The therapeutic results were assessed using following variables:the safety and efficacy of sacral anesthesia,blood loss,operative time,indwelling catheterization,mean Qmax,IPSS,QOL and the sexual function. Results The PVP was successfully performed on all the 161 patients with BPH.There were 160 patients under sacral anesthesia and only 1 under epidural anesthesia.The mean operative time was (44.5?22.4)min (range,15～210 min).All patients had minimal or no blood loss and no patients required blood transfusion.No postoperative catheterization was needed in 21 patients. The mean catheterization time was (34.4? 20.8 )h (range,24-72 h).Postoperatively 2 cases had transient dysuria and 2 experienced delayed hematuria.All cases were followed up for 3 to 6 months after treatment.The mean Qmax increased from (6.5? 2.4 )ml/s to (19.8?2.1)ml/s;mean IPSS and QOL decreased to 5.8?1.6 and 1.7?0.4,respectively,which showed significant improvement,compared with those before operation( P

AlM:To study and investigate the change situation of trace elements and body comprehensive immune state of patients with viral keratitis.METHODS:Sixty-two patients with viral keratitis in our hospital from December 2011 to February 2014 were selected as observation group, 62 healthy persons with health education at the same time were the control group, then the serum and tear Zn, Cu, cellular immunity and erythrocyte immunity of two groups were compared, and the detection results of observation group with different types and severity degree were compared.RESULTS:The serum and tear Zn of observation group was all lower than that in control group, serum and tear Cu was higher than that in control group, cellular immunity and erythrocyte immunity indexes were all worse than that in control group, the detection results of observation group with mild, moderate and severe infection had significant differences (P<0. 05), while the detection results of observation group with herpes simplex keratitis and herpes zoster keratitis had no significant differences (P>0. 05).CONCLUSlON: The change of trace elements and body comprehensive immune state of patients with viral keratitis are obvious, and the severity degree for the detection levels of keratitis are greater.

Aged ; Female ; Humans ; Immunophenotyping ; Leukemia, Large Granular Lymphocytic ; classification ; immunology

Objective To explore clinical and radiographic outcomes of unstable distal clavicle fractures (Neer ⅡB) fixed with lateral clavicle anatomic locking compression plate (LCP).Methods Between January 2009 and October 2010,eleven consecutive patients with unstable fractures of the distal clavicle (Neer ⅡB) were treated using lateral clavicle anatomic LCP.There were 9 men and 2 women,with the mean age of 37.2 years (range,23-43 years).The right shoulder was involved in 6 patients and the left in 5 patients.The interval between injuries to operation was 24-72 h (mean,48 h).After fracture reduction,the plate was place on superior of the distal clavicle.According to the distal fragment length,3 to 6 locking screws were carefully inserted,3 locking screws were used to fix proximal fractures.Coracoclavicular ligament was not repaired.Functional recovery of the shoulder joint was assessed using the American Shoulder and Elbow Surgeons (ASES) rating scale score.Plain radiographs of clavicles were used to assess bony union.Results All the patients were followed up for 9 to 12 months (mean,10.3 months).Solid bony union was eventually achieved in all patients.The mean ASES scores were 89.1 (range,84-91) on the injured side versus 96.2 (range,94-100) on the contralateral side.No implant-related fracture,fixation failure and rotator cuff injury occurred.Conclusion Lateral clavicle anatomic LCP fixation in the treatment of distal clavicular fractures is a reliable and simple technique.

This study aims to investigate the preparation process and in vitro release behavior of artesunate polylactic acid microspheres, in order to prepare an artesunate polylactic acid (PLA) administration method suitable for hepatic arterial embolization. With PLA as the material and polyvinyl alcohol (PVA) as the emulsifier, O/W emulsion/solvent evaporation method was adopted to prepare artesunate polylactic acid microspheres, and optimize the preparation process. With drug loading capacity, encapsulation efficiency and particle size as indexes, a single factor analysis was made on PLA concentration, PVA concentration, drug loading ratio and stirring velocity. Through an orthogonal experiment, the optimal processing conditions were determined as follows: PLA concentration was 9. 0% , PVA concentration was 0. 9% , drug loading ratio was 1:2 and stirring velocity was 1 000 r x min(-1). According to the verification of the optimal process, microsphere size, drug loading and entrapment rate of artesunate polylactic acid microspheres were (101.7 +/- 0.37) microm, (30.8 +/- 0.84)%, (53.6 +/- 0.62)%, respectively. The results showed that the optimal process was so reasonable and stable that it could lay foundation for further studies.
Artemisinins ; chemistry ; Calibration ; Drug Compounding ; methods ; Lactic Acid ; chemistry ; Microspheres ; Polyesters ; Polymers ; chemistry ; Polyvinyl Alcohol ; chemistry

Objective To investigate methods and clinical effects of limited open reduction of ankle articular surface and locking compression plate (LCP) placement using minimally invasive plate osteosynthesis (MIPO) in managing tibial Pilon fractures.Methods Twenty-one patients with tibial Pilon fractures treated between August 2009 and August 2011 were involved in the study,including 16 males and 5 females,at age of 21-68 years (average 42.3 years).According to AO/OTA classification,12 patients were with type 43B fractures and nine with type 43C fractures.There were two patients with open fractures (both Gustilo-Anderson type Ⅰ fractures).Limited open reduction of ankle articular surface plus LCP placement using MIPO were performed.Early functional training without weight-bearing was carried out postoperatively.Results Nineteen patients were followed up for 12-24 months (average 14 months).According to Burwell-Chamley' s radiological evaluation system,17 patients obtained anatomical reduction of articular surface and two patients obtained moderate reduction,but they all had bony healing.Ankle function evaluated by Mazur' s criterion were excellent in seven patients,good in 10 and fair in two,with excellence rate of 89％.Conclusion Limited open reduction combined with LCP internal fixation can successfully construct articular anatomic relationship,decrease soft tissue dissection and attain solid fixation in treatment of Pilon fractures and further facilitate functional recovery of the affected extremity in coordination with early functional exercise.

Objective To discuss the relations between optimal surgical margin and local recurrence and the impact of preserving segment of sacral nerve root on neural functions based on the clinical and pathological features of giant cell tumor(GCT).Methods From August 1996 to August 2008,48 patients with sacral GCT undergoing tumor resection were respectively analyzed,including 20 males and 28 females with an average of 34.7 years(range,19-74).The tumors were located in S1-S5 in 4 patients,S1-S4 in 7,S1-S3 in 15,S1,2 in 12,S2-S5 in 8,and S3-S5 in 2.Surgical methods included single posterior approach in 29 cases,combined anterior-posterior approach in 19.The surgical margins adopted were en-bloc in 2 patients,marginal in 15,marginal and curettage in 25,and curettage in 9.Results Forty-one of 48 cases were successfully followed up,the average time was 43.5 months(range,18-115).The average blood loss during surgery was 3560 ml(range,550-12 000).Benign lung metastasis occurred in one case 6 years after operation,2 patients died of malignant transformation.Local recurrence occurred in 15 cases.The recurrence rates in patients with en-bloc resection,marginal resection,marginal resection combined with curettage,and curettage were 0,18.2%,40.9%,66.7%,respectively.The recurrence rate of marginal group was significantly lower than that of the curettage group.Of 27 cases with bilateral S3 nerve root preservation,2 sufiered from urine or fetal dysfunction.with an incidence rate of 7.4%.While 4 of 12 patients with unilateral S3 nerve root preservation suffered from sphincter disturbance,with an incidence rate of 33.3%.The significant difference between groups in nerve root preservation was confirmed.Conclusion Optimal surgical margin for sacral GCT is of great importance to local control of tumor recurrence,the surgical procedure of sacral GCT should aim at the marginal resection on the basis of rational sacral nerve roots preservation;preservation of bilateral S3 nerve roots contributes to the recovery of sphincteral function in most patients.

Objective To explore the value of applying personalized medicine in the clinical teaching of gastrointestinal surgery. Methods Totally 100 undergraduates in grade 2008 were ran-domly assigned to experimental class (EC) and control class (CC), with 50 cases in each group. The experimental class accepted personalized medical teaching through introducing idea and method of personalized medicine. The control class accepted conventional teaching. The effect of teaching was evaluated by questionnaire survey and examination. The data were analyzed through t-test and Chi-square test. Results Questionnaire survey of satisfaction showed that 88 students (88%) were inter-ested in the new course, 91 students (91%) thought that the new mode of teaching was better than the old one. Questionnaire survey of teaching effect showed that in EC:44 students (88%) thought that the new course could increase interests of clinical question;43 students (86%) thought that the new course could optimize the process of diagnosis and treatment of gastric cancer;40 students (80%) thought that the new course could strengthen the communication between doctors and patients; 42 students (84%) thought that the new course could widen the minds in diagnosis and treatment;45 students (90%) thought that the new course could enhance the ability of dialectical thinking;while in CC, the proportions of the above issues were 24(48%), 23(46%), 26(52%), 25(50%) and 26(52%) (all P<0.05). Furthermore, there were statistical difference in auerage scores bertween EC and CC [(86.26 ±5.72) vs. (77.00 ±6.16)] (P=0.000). Conclusions Personalized medicine is suc cessfully practiced in the teaching course of gastric cancer, which not only meets the requirement of personal-ized medicine, but also guides the reformation of clinical teaching to certain extent.

Objective To evaluate the application and initial experience of laparoscopy in kidneypreserving surgery for savage giant hydronephrosis. Methods This series included 6 cases of savage gianthydronephrosis (2 men and 4 women;age range,15 -57 years;mean age,28 years).Of them 5 cases weredetected when visiting doctors due to flank pain,abdominal mass,and the rest one by B-ultrasound duringpregnancy.Four cases had hydronephrosis on the left;and 2 cases,on the right.The quantity of hydronephro-sis was 2250 -8300 ml,respectively.None had development on IVU examination.Of them,3 cases had con-genital ureteropelvic junction (UPJ) obstruction;2 had multiple stones in infracalices secondary to UPJ ob-struction;1 had stones in pelvis with polyp formation.Relieving obstruction,pyeloplasty,nephroplication andnephropexy were performed via laparoscope. Results All the operations were successful.The operativetime was 2.5 -5.0 h;the blood loss was 50 -150 ml,and the mean postoperative hospital stay was 7.2 d.The postoperative follow-up ranged from 3 to 24 months. Three months after operation,B-ultrasound showedthat giant hydronephrosis was markedly relieved in 5 cases (the renal sinus separation was 1.8 m,2.0 cm,2.5 cm,2.5 cm and 2.8cm,respectively),and in the rest 1 case the kidney was slightly smaller than nor-mal.IVU examination was performed every 3 months after operation, and different degrees of developmentappeared in all cases.During the follow-up,no obvious ureteropelvic anastomotic stricture was found on retro-grade pyelography (RGP). Conclusions The protective renal treatment via laparoscopy for savage gianthydronephrosis is a feasible and minimally invasive technique that provides the same clinical and radiograph-ic results as open operation.