Objective To investigate the clinical effects and safety of urethral anastomoses and ureteroscopy urethral realignment in the treatment of urethral straddle injury and catheter placement failure. Methods Ninety patients with urethral straddle injury and catheter placement failure were chosen and divided into A group (45 patients, choosing urethral anastomoses) and B group (45 patients, choosing ureteroscopy urethral realignment). The operation time, intraoperative blood loss, hospital staying time and peri-operation complications in both groups were compared. Results The operation time, intraoperative blood loss, hospital staying time in B group were significantly lower than those in A group: (26.15 ± 10.41) min vs. (71.93 ± 14.50) min, (22.37 ± 7.41) ml vs. (50.70 ± 13.25) ml, (3.22 ± 0.97) d vs. (5.19 ± 1.43) d, P<0.05. After 6 months′follow-up, the clinical indicators in peri-operation period of B group were significantly better than those in A group (P<0.05). The complications incidence in B group was significantly lower than that in A group: 2.22%(1/45) vs. 13.33%(6/45), P <0.05. Conclusions The technology of ureteroscopy urethral realignment in the treatment of urethral straddle injury and catheter placement failure can efficiently shorten the operation time, reduce the degree of trauma and accelerate the rehabilitation process, and it is helpful to reduce the risk of complications in peri-operation period.

Acetaminophen ; therapeutic use ; Ductus Arteriosus, Patent ; drug therapy ; Humans ; Infant ; Infant, Newborn ; Infant, Premature

Objective To summarize clinical features of local and regional failure of salivary gland carcinoma treating by 125I seed,and evaluate the clinical and histologic risk factors for its development.Methods Patients with salivary gland carcinoma treated by 125I seeds between Oct 2001 and Aug 2012 were analyzed retrospectively.The risk factors were analyzed statistically,including age,gender,tumor site,TNM stage,histological differentiation,radiotherapy,treatment,matched peripheral dose and primary or recurrent tumor.Results Ninety-four of 449 patients with salivary gland carcinoma treated by 125I seeds developed local and/or regional area recurrence.Of these,six patients failed in both local and regional area,77 patients failed in local area and eleven patients failed in regional area.The local and regional failure rate was 20.9％.The result of multivariate analysis showed that surgery,radiotherapy and matched peripheral dose were the protective factors(OR =0.458,0.297,0.982,P ＜ 0.05),while age and TNM stage were the risk factors(OR =1.250,1.483,P ＜ O.05).Conclusions The local and regional failure rate was 20.9％.Surgery,radiotherapy and matched peripheral dose were the protective factors;age and TNM stage were the risk factors.

Objective:To explore and evaluate the accuracy, conformity, and clinical application value of digital surgical techniques in guiding 125I seed implantation in the brachytherapy of deep head and neck tumors. Methods:Twelve patients with deep head and neck tumors who received brachytherapy of radioactive 125I seed implantation were selected for the study.The locations of the implantation needles and seeds were designed based on CT images before the operation.A digital positioning model was built according to the treatment plan to accurately import the planned locations of implantation needles into the surgical navigation system.Meanwhile, an individualized puncture guidance template was designed and printed according to the patients′ facial profiles as well as the locations and directions of the implantation needles.During the operation, the template was put in place under the guidance of the navigation system and meanwhile, the implantation needle puncture and radioactive seed implantation were conducted under the joint guidance of the visual needle path and real-time implantation needle locations in the navigation system and template guidance holes.The locations of the implantation needle and the seeds were validated by CT scan and the dose distribution in target areas was calculated.Adverse reactions such as hematoma, pain, infection, nonunion of puncture sites, and tumor cell implantation were observed during and after the operation. Results:All 12 patients successfully received implantation needle puncture and radioactive seed implantation under the guidance of the digital surgical techniques, achieving excellent effects of real-time visualization guidance.Meanwhile, the locations and number of the implantation needles and seeds were consistent with the treatment plan and were distributed evenly.Furthermore, according to postoperative verification, D90 ranged from 83.7 Gy to 131.0 Gy, with an average of 107.5 Gy; V100 was 89.6%-99.3%, with an average of 94.6%, and V150 ranged from 40.2% to 58.9%, averaging 47.8%.No serious adverse reactions were observed during and after the operation. Conclusions:With digital surgical techniques, the surgical navigation system and 3D-printed individualized puncture guidance template jointly guided the implantation needle puncture and 125I seed implantation, improving the accuracy and conformity of the brachytherapy.Therefore, they have clinical application value in head and neck brachytherapy, especially in deep areas with complex anatomical structures.

Objective To evaluate the treatment of malignant submandibular gland tumors with surgery combined with 125I radioactive implantation.Methods Thirty-two patients with malignant submandibular gland tumors were treated with surgery combined with 125I seed implantation from December 2005 to December 2012.All of the 32 patients with primary disease were treated by excision of the submandibular gland and neoplasm.None of the patients received wide excision or neck dissection without the evidence of the neck metastases.The planning targets was based on computerized tomography (CT)images,tumors site,extent and pathologic type.The matched peripheral dose (mPD) was 90-110 Gy.Recurrence-free survival (RFS),overall survival (OS) rates and side effects were retrospectively reviewed.Results Totally 32 patients received 1394 radioactive seeds implantation,radioactive seeds and dose distributed were well in all patients.All patients were followed for 15-126 months (mean of 64 months),with 5 recurrence,5 distant metastases,and 4 patients who died of disease.The 3-and 5-year RFS were 93.1％ and 87.9％,and OS rates were 93.3％ and 84.5％,respectively.No severe complications were observed during follow-up.Conclusions The excision of the neoplasm and the submandibular gland,combined with 125I seed implantation brachytherapy was an effective modality for the treatment of malignant submandibular gland tumors.

Objective To evaluate the efficacy of 125Ⅰ brachytherapy alone for the treatment of recurrent parotid gland carcinoma.Methods Recurrent parotid gland carcinoma patients (n =24) treated by 125Ⅰ brachytherapy alone between 2006 and 2013 at Peking University Hospital of Stomatology were enrolled in this retrospective study.All patients underwent surgery or radiotherapy.The local control rate,survival rate,and side effects were evaluated.Results The median follow-up time was 21 months (range,4-59 months).Among the 24 patients,6 had local failure and 10 died during the follow-up period.The 1-and 3-year overall survival rates,progression-free survival rates,local control rates were 74.8％ and 39.3％,74.8％ and 31.5％,82.0％ and 69.4％,respectively.No grade 3 or over radiation injury was found.Conclusions 125Ⅰ seed brachytherapy alone could provide an ahernative treatment method for inoperable recurrent parotid gland carcinoma patients.

Objective To discuss key points of prevention and treatment of perioperative pulmonary hypertensive crisis in patients with serious pulmonary arterial hypertension associated with ventricular septal defect. Methods Retrospectively analyzed the nursing experience of perioperative pulmonary hypertensive crisis on 31 patients with serious pulmonary arterial hypertension associated with ventricular septal defect from March to December during 2016.Among these patients,7 patients occurred pulmonary hypertensive crisis.The prevention contained avoiding oxygen lack,keeping pH alkaloid in the body, application of pulmonary vasodilator, deep sedation. Results A total of 30 cases survived the perioperative period, and were discharged from the hospital, one died. Conclusions The patients with serious pulmonary arterial hypertension had more risks during the perioperative period,the main cause of death was pulmonary hypertensive crisis during this time.So prevention of pulmonary hypertension crisis is the key point of postoperative nursing.

Objective: To assess the status of handgrip strength of elderly population from longevity areas in China, and to analyze the correlative factors of handgrip strength of elderly people. Methods: Data from Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2012 was used, from which1 967 participants aged ≥60 years old with valid data of grip strength value from 8 Chinese longevity areas were included. Information on demographics characteristic, life style and health status was collected using questionnaires. The handgrip strength of both left and right hands were measured by grip dynamometer. The different characteristics of group of participants with different grip strength were compared and then analyzed by adopting the Cumulative odds Logistic regression model to identify main factors associated with hand grip strength. Results: The P₅₀ (P₂₅-P₅₀) of hand grip strength of elderly people from the eight longevity areas was 20 (11-28) kg; The hand grip strength of males was 26 (18-34) kg, which was higher than that of females(14 (9-20) kg) (P<0.001). Cumulative odds Logistic regression model showed that the hand grip strength of females was lower than males, whose β value (95%CI) was-1.22 (-1.43--1.00). The elderly who was at a higher age, smoking, drinking or with anemia, had a comparatively lower handgrip strength, whose β (95%CI) value were separately-0.08(-0.09~-0.07),-0.29(-0.56~-0.02),-0.54(-0.80~-0.28), and-0.41(-0.62~-0.20). And the elderly who had a higher boby mass index, drinking tea and outdoor activities, had a comparatively higher handgrip strength, whose β(95%CI) value were separately 0.28 (0.15-0.40), 0.25(0.03-0.47) and 0.51(0.30-0.71). Conclusion Age and gender were the main correlative factors, lifestyles and physical conditions might also be correlative factors of hand grip strength of the elderly from longevity areas in China.

Objective: To discuss the relationship between body mass index (BMI) and cognitive impairment among elderly adults aged ≥65 years old from longevity areas of China. Methods: A total of 2 439 elderly adults from 8 longevity areas were included in our baseline survey by answering questionnaire and taking body measurements and blood biochemical examinations in 2012. In the follow-up study in 2014, we studied the cognitive impairment status among the 1 135 elderly adults aging ≥65 years old. Multivariate logistic regression model was used to analyze the relationship between BMI and cognitive impairment risk. Results: 113 participants were defined as cognitive impairment, with a positive rate at 10.0%. The positive rate in group of underweight, normal weight, and overweight and obese elderly were 22.2% (51/230), 7.5% (47/629), 5.4% (15/276). The rate of cognitive impairment in groups of low BMI (<19.7 kg/m²), middle BMI (19.7-23.1 kg/m²) and high BMI (>23.1 kg/m²) were separately 17.7% (66/372), 7.1% (27/379) and 5.2% (20/384) (P<0.001). Every 1.0 kg/m² increase in BMI, the risk of cognitive impairment would significantly decreased by 7% (RR(95%CI): 0.93(0.87-0.99)). Compared with participants with middle BMI level, the group of low BMI participants was associated with a significantly increased risk of cognitive impairment (RR (95% CI): 1.98(1.14-3.44)); while there was no significant association was observed in the high BMI group (RR(95%CI): 1.15(0.57-2.32)). Compared with elderly in normal weight, the elderly with under weight was in higher risk of cognitive impairment (RR (95%CI: 2.19(1.31-3.66)) and there was no significant association found between the elderly with overweight (RR(95%CI): 1.18(0.58-2.38)). Conclusion Among the elderly ≥65 years old from longevity area, low BMI level and underweight were associated with the increased risk of cognitive impairment.

Objective: To explore the relationship between successful aging (SA) index and the survival status among elderly from longevity areas of China. Methods: A total of 2 296 old people aged ≥65 years old from 8 longevity areas were enrolled in our baseline survey in 2012. The information of demographics characteristic, life style, self-assessed health and mood or emotional state, cognitive function, abilities of daily living and physical activity were collected by questionnaire. There were 891 SA people in total, whose SA score was 4-5. 891 SA and 1 396 non-SA participated in the follow-up study in 2014. Finally, 860 SA and non-SA people were matched by orientation analysis. A Cox proportional hazards model was used to explore the relationship between successful aging index and survival status. Results: After 2 years of follow-up, a total of 1 442 elderly survived, with an average baseline age at (83.69±10.81) years old and 278 elderly people died, with an average baseline age at (93.41±9.05) years old. The mortality rate was 16.16% (278/1 720) in total, and it was 13.14% (113/860) in SA group, which was lower than it in non-SA group (19.19%, 165/860), and the difference was statistically significant (P=0.001). The analysis of the multivariate Cox regression showed that SA was the protective factor of the survival of the elderly after age and sex adjusted. Compared to the non-SA group, the risk of mortality rate in SA group decreased by 38%, the HR (95% CI) was 0.62 (0.49-0.79). Conclusion The mortality rate in the SA group was low in the longevity areas in China; compared with non-SA group, the death rate in SA group reduced by 38%.