ObjectiveTo assess the effectiveness and prognosis of different radical surgery for Hirschsprung disease (HD).MethodsThe bowel function of HD patients undergoing the anus modified Soave operation (84 cases,modified Soave group),modified Swenson operation (60 cases,modified Swenson group),modified Duhamel operation (76 cases,modified Duhamel group) was followed up by 3,6 months and 2 years after surgery.Long-term bowel function,clinical type,removal length,anorectal manometry,barium enema were analyzed and compared among three groups.ResultsThe occurrence rates of bowel dysfunction 3,6 months and 2 years after surgery in modified Soave group[17.9％(15/84),7.1％(6/84),4.8％ (4/84)] were significantly lower than those in modified Swenson group[41.7％ (25/60),21.7％(13/60),18.3％(11/60) ] and modified Duhamel group [ 36.8％ (28/76),18.4％ (14/76),13.2％(10/76) ].There was significant difference between modified Soave group and modified Swenson group,modified Duhamel group(P＜ 0.05 ).There was no significant difference between modified Swenson group and modified Duhamel group (P ＞ 0.05).When the removal length ≤35 cm,the occurrence rate of bowel dysfunction after surgery in modified Soave group [ 18.7％ (14/75)] was lower than that in improved Swenson group [ 39.5％ ( 17/43 ) ] and modified Duhamel group [ 34.4％ (21/61 ) ].There was significant difference between modified Soave group and modified Swenson group,modified Duhamel group (P ＜ 0.05).There was no significant difference between modified Swenson group and modified Duhamel group (P ＞ 0.05).When the removal length ＞ 35 cm,there was no significant difference in the occurrence rate of bowel dysfunction after surgery among three groups (P ＞ 0.05 ).The occurrence rates of bowel dysfunction in short-segment type and common type in modified Soave group was lower than those in modified Swenson group and modified Duhamel group.There was significant difference between modified Soave group and modified Swenson group,modified Duhamel group(P ＜ 0.05).There was no significant difference between modified Swenson group and modified Duhamel group (P＞ 0.05).The anorectal angle 2 years after surgery in modified Soave group [(93.67 ± 10.50)° ] was less than that in modified Swenson group [(110.20 ± 11.88)° ] and modified Duhamel group [(106.33 ± 12.21)° ].There was significant difference (P ＜0.05).ConclusionThe complication and trauma are significantly lower in the anus modified Soave operation than the modified Swenson operation and modified Duhamel operation,but the choice of surgery should be strictly controlled according to the anal HD treatment indications.

Objective To analyze the clinical features of differentiated thyroid cancer diagnosed during pregnancy or one year after delivery.MethodsA total of 234 women with differentiated thyroid cancer were treated from January 2001 to January 2011.Cases were divided into three groups according to the time of tumor diagnosis( group 1,no pregnancy history; group 2,during pregnancy or in the first year after delivery;group 3,longer than 1 year after the delivery).ResultsThe thyroid nodule was asymptomatic and discovered on routine examination more often in group 2(78.7％ ) than other two groups (P =0.02).There were no significant difference among three groups in age,hospitalization time,operation time,operation method,tumor type,primary tumor stage and mortality. But more patients in group 2 were suffering from extrathyroid invasion ( P =0.024 ),multi-focal cancer ( P =0.023 ),larger cervical lymph node ( P =0.021 ),later regional lymph node stage (P =0.020 ) and higher local recurrence (P =0.001 ).By stepwise logistic regression analysis,pregnancy is one of the factors impacting on local recurrence rate ( P =0.045 ).ConclusionsPregnancy does not affect the mortality of the differentiated thyroid cancer,but the incidence of extrathyroid invasion,multi-focal cancer,cervical lymph node metastasis,local recurrence is higher in patients with differentiated thyroid cancer diagnosed during pregnancy.

Objective To analyze the recovery of the renal function in the severe hydronephrosis children after percutaneous nephrostomy.Methods 50 cases of uretero-pelvic junction obstruction (UPJO) children were retrospectively studied from January 2013 to January 2016.There were 25 boys and 25 girls,and the mean age was 3.0 years (ranged from 2 months to 9 years and 7 months).The children were taken the percutaneous nephrostomy in the first stage and pyeloplasty or nephrectomy in the second stage according to the recovery of renal function.Split renal function,urine osmotic pressure,urine pH and urine β2-microglobulin (β32-MG) were compared between pre-operation and post-operation.The recovery of the renal function after the operation were evaluated by the single photon emission computed tomography (SPECT) and superb micro-vascular imaging (SMI) to analysis the feasibility of the pyeloplasty surgery in the severe hydronephrosis children.Result The postoperative renal function of 49 patients in the group recovered after percutaneous nephrostomy,only one child showed unrecoverable.After the first stage management,the renal cortical thickness [(5.9 ± 1.0)mm vs.(2.9 ± 0.9) mm,P =0.03],the separate renal function mmo]/L vs.(126.5 ± 100.5) mmol/L,P ＜ 0.001] were significantly improved compared with preoperation,andRI [(0.72 ±0.03) vs.(0.79 ±0.04),P=0.021],urine pH [(6.18±0.21) vs.(7.38 ± 0.32),P =0.039] and urine β2-MG [(562.16 ± 49.78) mg/L vs.(954.28 ± 69.45) mg/L,P ＜0.001] significantly reduced.Conclusions The renal function of the severe hydronephrosis children could be recoverable after the surgery of the percutaneous nephrostomy and pyeloplasty.Most children's kidneys suffered the severe hydronephrosis could be spared by surgery.SMI technology could provide reliable quantitative basis to evaluate renal function.

ObjectiveTo study the clinicopathological features of endometrial cancer patients diagnosed during or after tamoxifen (TAM)treatment for breast cancer and to evaluate the relevance between the clinicopathological features and the cessation time of TAM treatment. Methods42 TAM-related endometrial cancers patients in the Affiliated Hospital of Medical Collage of Qingdao University were divided into 2 groups according to the cessation time of TAM.Group B were 20 past TAM users who were diagnosed as endometrial cancer 12 or more months since the cessation of TAM.Group A included the rest 22 patients.The clinicopathological features of the 2 groups were analyzed retrospectively.ResultsThe age of patients was ranging from 32 to 85 years when they were diagnosed endometrial cancer.There was no significant difference in terms of the age at which breast cancer was diagnosed, BMI, HRT, single dose of TAM, duration and cumulative dose between the 2 groups.However, the difference of the age at which endometrial cancer was diagnosed, menopausal status, the interval between diagnostic date of the 2 cancers, histological types, pathological stage, myometrial invasion, and cervical invasion had statistical significance between the 2 groups ( P ＜ 0.05 ). Conclusion Compared with group A, group B have a higher pathological stage and more invasive histological features, which may be because group B include more elderly and postmenopausal patients.

Objective To recognize the relationship between high cutantous artery branches and descending branch of lateral femoral circumflex artery artery,and to investigate the blood supply of anterolateral thigh flap in clinical.Methods Retrospective analysis 152 cases of anterolateral thigh flap from November,2003 to December,2016.It contains cutting with descending branchs in 99 cases,cutting with lateral branchs in 43 cases,the union of them in 8 cases and high cutantous artery branches in 2 cases.Results The flaps survival in 147 cases,cutting necrosis in 3 cases and partly necrosis in 2 cases.Descending and lateral branchs were both dominance neurovascular bundle of vastus lateralis muscle,independently or commonly dominate the skin of anterolateral thigh,occurrence rate was 33.5％.Conclusion The descending branch of lateral femoral circumflex artery include lateral branch,all of which are the neurovascular bundles,supply the anterolateral thigh muscle,and divid into some perforator branches crossing the musle to the anterolateral thigh skin subsequently,which constitute "the anatomical functional unit".High cutantous artery branche is the one of all of the branches,its origin lies hight and arise from lateral branch.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.