Objective To explore the prevalence of thyroid nodules in Guangzhou City in a health physical examination.Methods The data of Doppler ultrasound cases from the department of internal medicine and convalescence,Panyu sanatorium were analyzed.Results ①The detection rates of tiny and non-small thyroid nodule in female individuals [44.1％ (207/469) and 21.7％ (102/469)] were higher than those of males [34.8％ (155/445) and 7.6％(34/445),x2 =8.27,35.88,all P ＜ 0.05]; ②The prevalence of tiny nodules increased gradually in the 21-30-year old people,reached the peak in the 51-60-year old people,and then decreased; ③ The rate of solid and mixed thyroid nodules in females [33.5％(157/469) and 26.2％(123/469)] gradually increased with growing age than those of males [22.0％(98/445) and 14.6％(65/445),x2 =14.89,18.87,all P ＜ 0.05] ; ④ The detection rate of multi-nodule in female[40.1％(188/469)] was higher than that of male[21.3％(95/445),x2 =37.5,P ＜ 0.05].Conclusions The elderly people have a higher risk of thyroid nodular,the detection rate of thyroid nodule in female people was higher than that in males.We should pay more attention to thyroid disease in elderly women.

Objective To evaluate the efficacy of medial femoral tubed skin flap combined with penile elongation for repairing long-segment penile defects.Methods From June 2009 to January 2015,13 cases of long-segment penile defects were treated by medial femoral tubed skin flap with pe nile elongation.Results All cases were followed up for 0.5 to 5.0 years.All flaps survived and all patients had the minor scar in donor areas,with good appearance and feeling of penis.The length of pe nis in flaccid state was 6.3±1.6 cm.The length of penis in erection state was 8.5±1.2 cm;The circumference of penis was 5.3±1.9 cm.1.0 cm × 0.7 cm of necrosis at distal parts occurred in one case early after operation,and healed after dressing changes.Two cases had tumid appearance which influenced penile appearance and sexual intercourse.It was improved by local liposuction.No feeling and e rectile dysfunction developed during the following-up.Except 5 cases who did not married,the other married patients and their partners were satisfied or quite satisfied with sexual intercourse activity.Conclusions Medial femoral tubed skin flap combined with penile elongation is a good method for the treatment of long-segment penile defects.The prosthetic penis could have suitable length,good ap pearance,good feeling and erectile function.

Objective To evaluate the effect of health education combined with lung function test on smoking cessation in smoking sanitation workers. Methods Sixty-nine sanitation workers who smoke were divided into two groups by using the table of random number, routine group (n=35) and lung function test group (n=34). The routine group was given health education. According to the lung function, those in the lung function test group were divided into normal lung function group (19 cases) and abnomal lung function group (15 cases) who received both health education and lung function test. Success rate of smoking cessation and the relapse rate were compared at 2 and 6 months follow-up. Results At 2 and 6 months follow-up, the smoking cessation rates of routine group were [10(29%), 4(11%)], which were lower than those of the normal lung function group [7(37%), 3(16%)], the differences were not statistically significant (P>0.05). The smoking cessation rates of routine group were lower than those in abnormal lung function group[11 (73%), 10(67%)] (P<0.05). The smoking cessation rates of the normal lung function group were significantly lower than those of abnormal lung function group (P<0.05). The relapse rate of routine group[6(17%) and the normal lung function group[4(21%)]at 6 months follow-up were not significantly different. The relapse rate of the normal lung function group and that of abnormal lung function group were not significantly different. Conclusion Health education combined with lung function test could help smokers with abnormal lung function to give up smoking successfully.

Objective To explore influence and variation of smoking and occupational exposure to air pollution on lung function.Methods Ninety eight sanitation staffs from Panyu District were divided into smoking and non-smoking sanitation groups; and all subject accepted the Chronic Obstructive Pulmonary Disease Assessment Test (CAT) scales,questionnaires,lung function test,and data statistical analysis.Healthy people accepted health examination from Guangzhou Panyu medical health center were used as the control group.Results (1) Forced expiratory volume in the first second (FEV1％),forced expiratory volume in the first second/ forced vital capacity(FEV1/FVC),maximal expiratory flow in 50％ vital capacity (FEF50％),maximal expiratory flow in 75％ vital capacity (FEF75％),maximal mid-expiratory flow (MMEF) of non-smoking sanitation group was significantly lower than non-smoking healthy group (P ＜ 0.01).(2) Abnormal rates of FEF50％,FEF75％,and MMEF of non-smoking sanitation group were significantly higher than non-smoking healthy group (P ＜ 0.01).(3) Abnormal rates of FEF50％,and FEF75％ of sanitation group were significantly higher than healthy group with or without smoking.(4) Abnormal rates of FEV1％ and FEV1/FVC did not have significant difference between non-smoking sanitation group and non-smoking healthy group,but had significant difference between non-smoking and smoking healthy groups.It means smoking and occupational exposure had different impacts on pulmonary function.(5)Moderate score of nonsmoking sanitation group and smoking healthy group were significantly higher than non-smoking healthy group by P =0.049 and P =0.001,respectively.Conclusions Occupational exposure to air pollution and smoking can lead to small airway damage,which was not as obvious as pulmonary function changes.It is necessary to regularly monitor lung function for sanitation staffs who risk occupational exposure to air pollution.Increasing physical exercise would benefit to improve sport lung endurance of the people in our country.

Objective To analyze the clinical features of patients with prostate adenocarcinoma under 50 years.Methods Between January 2008 and April 2014,we reviewed 21 cases with prostate cancer under 50 years old.The mean age in those patients was 48 years old (ranged 42-49 years old).Their tPSA level was elevated,including＞10 μg/L in 17 cases,4-10 μg/L in 4 cases.21 cases were all confirmed by pathology.The results Gleason score showed 6 scores in 3 cases,7 scores in 6 cases (3+4 scores in 5 cases and 4+3 scores in one case),8 scores in 7 cases and 9 scores in 5 cases.In the study,clinical stage was for T2N0M0 in 16 cases,T3N0M0 in 1 case,T4NxM0 in 1 case and T3-4N1M1 in 3 cases.The treatments were hormonal therapy was chosen in 5 cases and radical prostatectomy was performed in 16 cases,including 16 cases with T2N0M0 stage and one case with T3N0M0.Results In those patients who accepted the radical prostatectomy,the duration of follow-up ranged from 3 to 65 months (mean 23 months).During the follow-up,14 patients had a lower incidence of biochemical recurrence.1 patient (T2,PSA 82.8 μg/L,GS 9) had external beam radiotherapy one month after the radical prostatectomy because of tumor invasion into the prostatic capsule.Then his PSA level returned to the 0.2 μg/L.1 patient (T3,PSA 38.9 μg/L,GS 8) had external beam radiotherapy 18 months after the radical prostatectomy because of biochemical recurrence and the tPSA level returned to the 4.0 μg/L.All patients who underwent radical prostatectomy had favourable recovery of urinary continence.In 5 patients who had androgen deprivation therapy,2 patients died after 63 or 65 months and one patient was lost to follow-up.The PSA level in one patient decreased from 71.8 μg/L to 2 μg/L after four months treatment.One patient had castration resistant prostate cancer and the adjuvant external beam radiotherapy was considered,subsequently.Conclusions Men under the 50 years old,who are diagnosed with localised prostate cancer,usually demonstrated the early clinic stage and high Gleason scores.It should not be discouraged from RP.Young men with metastatic prostate cancer have a poor prognosis.

Objective To compare the outcomes of standard laparoscopic radical prostatectomy (SLRP) and retropubic radical prostatectomy (RRP) via meta-analysis.Methods A systematic literature search of articles from January 1992 to April 2015 was conducted via Pubmed,Web of Science,Cochrane Library,and EMBASE databases,and the references of the retrieved articles.Fixed-or random-effect models were used to summarize the estimates to evaluate operation time,blood loss,transfusion,catheterization time,hospital stay,surgical margin status,perioperative complications,postoperative erectile dysfunction,and postoperative urinary incontinence in these two approaches.Results A total of 17 articles were included in this study.Compared with RRP group,the operation time was longer in SLRP group (SMD =1.20,95％ CI 0.83,1.58).On the contrary,the SLRP group held advantages in blood loss (SMD =-2.02,95％ CI -2.67,-1.37),transfusion (RR =0.22,95％ CI 0.16,0.30),catheterization time (SMD =-1.44,95 ％ CI-2.34,-0.54),hospital stay (SMD =-0.97,95 ％ CI-1.29,-0.66) (P ＜ 0.05).Moreover,these two approaches showed no difference in surgical margin status (RR =0.94,95 ％ CI 0.84,1.05),perioperative complications (RR =0.78,95％ CI 0.60,1.02),postoperative erectile dysfunction (RR =1.13,95 ％ CI 0.97,1.31),and postoperative urinary incontinence (RR =0.85,95 ％ CI 0.57,1.28) (P ＞0.05).Conclusions Compared with RRP,SLRP could be a more suitable approach to treat localized prostate cancer.Random clinical trials are needed in the future to better evaluate these two approaches.

Objective To investigate the application of artificial neural network analysis on computerized transrectal ultrasound (ANNAcTRUS) in early detection of prostate cancer.Methods Sixty men with or without prior biopsies, either due to elevated PSA or abnormal digital rectal findings, were included in this study from January 2014 to July 2015.Patient's mean age was (65.6 ± 8.9) years (51-89 years).Their PSA level was (9.8 ± 4.9)μg/L.The patients received the ANNAcTRUS targeted 6-core biopsy.Each patient received six targeted biopsies of suspicious regions, which was identified by ANNAcTRUS online system.Histopathologic examination was further carried out to confirm the result of the targeted biopsies.Results According to the results of ANNAcTRUS,52 of 60 patients received biopsy in ANNAcTRUS group.ANNAcTRUS targeted 6-core biopsy was able to detect prostate cancer in 24 (46.2％) of 52 patients.The distribution of Gleason Score was as follows : 3 + 3 (n =9), 3 + 4 (n =8), 4 + 3 (n =4), 4 +4 (n =2) and 5 +4 (n =1).For patients without prior negative biopsy,ANNAcTRUS targeted 6-core biopsy was able to detect prostate cancer in 17 (51.5％) of 33 patients.Conclusions ANNAcTRUS targeted 6-core biopsy illustrates a higher detection rate of prostate cancer.Furthermore, ANNAcTRUS targeted 6-core biopsy tends to detect low-grade prostate cancer.

Objective To investigate the diagnosis and treatment of cystic renal cell carcinoma.Methods The clinical data of 67 cases of cystic renal cell carcinoma treated from January 2005 to April 2013 were analyzed retrospectively.Preoperative imaging procedures indicated masses of renal cysts in 67 cases,including malignant tumors in 59 cases.Intraoperative pathological examination was performed in 59 cases and the pathological results showed malignant tumors in 56 cases,renal cyst in 2 cases and multilocular cyst of kidney in 1 case.The surgical procedures included radical nephrectomy (n=19),partial nephrectomy (n =12),retroperitoneal laparoscopic radical nephrectomy (n =9),retroperitoneal laparoscopic partial nephrectomy (n =20),retroperitoneal laparoscopic cyst unroofed then transferred to radical nephrectomy (n =6),and retroperitoneal laparoscopic partial nephrectomy transferred to radical nephrectomy (n =1).Results The 67 cases were diagnosed as renal carcinoma,including clear renal cell carcinoma with cystic changes in 31 cases and multilocular renal cell carcinoma in 36 cases.Sixty-two cases were followed up for 10-110 months (median 56 months),and there was no recurrence or metastasis,among which 7 cases diagnosed as benign pre-operation or intra-operation but malignant by pathological examination after surgery were followed up for 61-103 months (median 82 months).Conclusions Imaging plays an important role in the early diagnosis of cystic renal cell carcinoma.Intraoperative pathological examination should be performed in suspected cases.Nephron-sparing surgery is preferred with good outcome.

BACKGROUND:Interleukin-1 receptor-associated kinase 4 activity-induced inflammations and infection have been extensively accepted. However, there was no report concerning its effects on flap ischemia-reperfusion injury. OBJECTIVE:To explore the significance of interleukin-1 receptor-associated kinase 4 activity in flap ischemia-reperfusion injury. METHODS:A total of 36 adult male Sprague-Dawley rats were randomized into sham-operated group (n=12), ischemia-reperfusion group (n=12) and interleukin-1 receptor-associated kinase 4 group (n=12). The models of right lower abdominal island flap ischemia-reperfusion injury were set up. Interleukin-1 receptor-associated kinase 4 group was intraperitoneal y injected with 1 mL of interleukin-1 receptor-associated kinase 4 (100μmol/L) before reperfusion. The flaps were col ected at 1, 2, 4, and 6 hours after ischemia-reperfusion injury for histopathhological observation. At 1 hour after ischemia-reperfusion, protein expression of interleukin-1 receptor-associated kinase 4 was detected in flaps. The proportion of flap survival was calculated at 7 days after surgery.RESULTS AND CONCLUSION:Histopathological observation demonstrated that compared with the ischemia-reperfusion injury group, neutrophil infiltration and edema was evidently improved, and the protein expression of interleukin-1 receptor-associated kinase 4 was gradual y reduced in the interleukin-1 receptor-associated kinase 4 group. Flap survival proportions were respectively (51.70 ±7.62)%and (86.56±12.23)%in the ischemia-reperfusion injury group and interleukin-1 receptor-associated kinase 4 group at 7 days after surgery. There were significant differences in the flap survival proportion between the two groups (P<0.01). These results showed that after flap ischemia-reperfusion injury, the inhibition of interleukin-1 receptor-associated kinase 4 activities could elevate the survival rate of transplanted flap.

Objective To investigate the effect of body mass index (BMI) on laparoscopy and the open radical prostatectomy.Methods A retrospective analysis of 226 cases of radical prostatectomy from 2012 January to 2013 May was performed.106 patients underwent laparoscopic surgery,with aged 66.5±0.7,height (167.7±0.5) cm,weight (66.8±0.9) kg; 120 patients underwent open surgery,with aged (65.8±0.7) year,height (168.1±0.5) cm,weight (66.5±0.8) kg.Non-obese (BMI ＜25 kg/m2) and obese (BMI ≥ 25 kg/m2) were divided in each group.The preoperative serum PSA level,the operation time,the blood loss during operation,the preoperative and postoperative hemoglobin,Gleason score,and the postoperative indwelling catheter time were compared between non-obese group and obese group.In the laparoscopic surgery group including 76 non-obese cases (71.7％) and 30 obese cases (28.3％),no difference showed in PSA values and age before operation between the two sub-groups.In the open surgery group,including 84 non-obese cases (70.0％) and 36 obese cases (30.0％),no statistical difference of preoperative PSA values and age showed in the two sub-groups.Results In the laparoscopic group,the operation time is (nonobese 169.4±37.8 min and obese 188.5±42.3 min),and the blood Hb decrease(non-obese-22.8± 11.0g/L,obese-30.9±15.9 g/L) and the blood loss(non-obese 115.9±68.9 ml,obese 178.3±126.4 ml)showed significant difference in the two sub-groups (P＜0.05).The two sub-groups showed no statisticaldifference in postoperative indwelling catheter time and Gleason score (P＞0.05).In the open surgery group,the intraoperative hemorrhage (non-obese 413.7±289.4 ml,obese 594.4-±534.9 ml) and the hemoglobin decrease (non-obese-27.2± 13.3 g/L,obese-34.9± 15.8 g/L) showed significant difference (P＜0.05).The two sub-groups showed no significant difference in the preoperative hemoglobin,postoperative indwelling catheter time,Gleason score and operation time (P＞0.05).Conclusions For the patients who underwent prostatectomy,no matter by laparoscopic or open surgery,the blood loss was greater in obese subgroup than non-obese subgroup,and the operation time was much longer in obese group than non-obese group.