Objective To investigate the influence of brain natrluretic peptide(BNP) in the prognosis of cardiac surgery.Methods Selected 115 cases of pafients with the first cardiac surgery.Their BNP concentration was measured before operation. Observed the relationship between BNP and postoperative atrial fibrillation,mechanical ventilation time,hospital stay,and the mortality of 30 d.Results Whether the patients had hypertension,diabetes,myocardial infarction history,left main stem disease and hemoglobin level or not,showed no definite relationship with BNP (P>0.05).Preoperative lower left ventricular ejection fraction (LVEF)(P=0.002) and European system for cardiac operation risk evaluation [(5±3)scores](P=0.003) were associated with higher BNP level.Postoperative mechanical ventilation time was(15.0±5.4)h,hospital stay was (32±11) d,showed a clear relationship with BNP(P= 0.035,0.001),but postoperative mediastinal infection,atrial fibrillation and mortality of 30 d had no definite relationship with BNP(P>0.05).Conclusion BNP can be used to predict the risk after cardiac surgery.

Objective To evaluate the role of transurethral resection of the prostate(TURP)in early diagnosis of prostate carcinoma.Methods TURP were perforhaed on 16 suspected patients with prostate carcinoma,based on their mean serum PSA level(11.7 ng/ml),negative results of anal touch and needle system biopsies,or with lower urinary tract symptoms,or those biopsy was not fit.6 cases were diagnosed prostate carcinoma by pathology.3 cases underwent double orchieetomy and treated with anti-androgen drugs.2 cases were emasculated by medicines and treated with anti-androgen drugs.1 case underwent radical prostatectomy after neoadjuvant hormonal therapy.Results 6 cases(37.5%)diagnosed prostate carcinoma by pathology were followed up for 3 months to 2 years and were all alive.Lower urinary tract symptoms were relived in 2 patients who underwent TURP. Conclusion TURP play a important role in early diagnosis of prostate carcinoma in certain circumstances.The symptoms could be relieved by TURP in patients with lower urinary tract symptoms.

Combining the functional metabolic imaging and anatomical imaging,PET-CT stands for the highest level of current nuclear medical imaging techniques,and has been applying increasingly in acupuncture studies.However,owning to complexity of the brain function and sensitivity of brain metabolism,the lower reproducibility of cerebral function imaging even may reverse many results.This has been provoked more and more attention by researchers.Its main cause is intimately related to poor experimental methodology.For this reason,the present paper raises the quality control of the research on mechanisms of acupuncture in the process of application of PET-CT techniques from 1) the included standards of participants,2) the preparation of participants during the scanning process of PET-CT,3) the setting of the scanning parameters,4) the used machine and the imaging reagent,5) the analysis of dada,6) the standardization of acupuncture manipulation,and 7) the designs of the acupuncture operation,needling opportunity and scanning opportunity,hoping to offer some beneficial information for the coming researches.

It is important to investigate the mechanical effects of morphology of prostatic urethra (PU) for benign prostatic hyperplasia (BPH). PU and bladder neck transverse diameter ratio (RPU-1), which related to vortex, and their influence on urine flow were observed by CFD. The results showed that vortexes appeared and expanded with increasing RPU on both sides of PU when RPU-1>0.79, and velocity of external urethral orifice decreased gradually. CFD is an available method for urodynamics research. The quantitative simulation of the relationship between RPU-1 and vortex was proposed for the first time, providing a new idea for advancing theory of PU lumen repair in BPH.

Objective To explore the clinical value of transumbilica single-port laparoscopic surgery in the treatment of bilateral varicocele.Methods From Jan. 2010 to Sep. 2010,42 patients with bilateral varicocele underwent laparoscopic high ligation of bilateral spermatic vein.Of these patients,20 were treated with transumbilica single-port laparoscopic surgery,22 with traditional laparoscopic surgery.The two groups of patients were compared for the parameters such as intraoperative blood loss,testicular artery preservation,operating time,time of activities after surgery,time of intestinal function recovery and hospitalization duration.The semen quality 1 year after the surgery was compared with that before treatment.At the out-patient re-examination at 1,3,6months and 1 year after the surgery,the incision,scrotum,spermatic cord,testis were checked for possible complications.The relief of discomfortness in the scrotum was also followed up.Results Both operation procedures were successful,without severe complications.In the single-port laparoscopic surgery produced blood lose ( [ 5 ± 1 ] ml vs.[ 5 ± 1 ] ml,t =- 0.452,P ＞ 0.05 ),the operating time ( [ 41 ± 7 ] min vs.[ 39 ± 3 ] min,t =0.686,P ＞ 0.05 ),postoperative intestinal function recovery time ( [ 11 + 1 ] h vs.[ 11 + 2 ] h,t =- 1.631,P ＞0.05 ) and postoperative hospital stay ( [ 3.1 + 0.7 ] d vs.[ 3.4 + 0.7 ] d,t =- 1.447,P ＞ 0.05 ) which were all comparable to that from conventional laparoscopic surgery.There was significant difference in the population using analgesics,single-port laparoscopic surgery vs.conventional laparoscopic surgery ( 1 case [ 5.0％ ] vs 7case [ 31.8％ ].The difference was statistically significant (x2 =4.886,P ＜ 0.05 ).The single-port laparoscopic surgery produced neglectable scar at the incision.All of the patients were questionaired for their satisfaction with the incision 1 year after the surgery.The difference was statistically significant (x2 =7.636,P ＜ 0.01 )Conclusion Single-port laparoscopic high ligation of bilateral spermatic vein produces comparable outcomes to that of conventional laparoscopic surgery,but it is a more microinvasive procedure producing good aesthetic appearance,representing the trend of laparoscopic technique.

Objective To explore the method and clinical value of sentinel lymph node biopsy for penile carcinoma guided by multispectral separate-merge guided surgery device (MGS).Methods The clinical data of 7 patients with sentinel lymph node biopsy of penile cancer guided by MGS from April 2017 to April 2018 were analyzed retrospectively at First Hospital of Shanxi Medical University.They were 62-78 years old,with an average age of 65 years.All of carcinoma was located in the glans or coronal sulcus,which diameter was 1.0-3.5 cm,with an average of 2.5 cm.Three cases of inguinal lymph nodes could be non-palpable and the others palpable.All patients were injected 0.25 ml (2.5 mg/ml) of indocyanine greensolution with 1 ml syringe at 12,4,6 and 9 points in the proximal normal skin of penile tumors.Immediately,the imaging probe was aligned with the injection point to observe the dynamic changes of fluorescence image on MGS display.Results There were 14 sides of groin in 7 patients,except for 1 side without images,other 13 sides developed well.The images displayed by MGS include visible image,fluorescent image and merged image,and the merged image was green pseudo color.According to the dynamic changes of the image,it could be divided into five parts:injection point,penile body,pubic symphysis,inguinal region and sentinel lymph node.In 13 well-developed sides,fluorescence gradually disappeared in other parts about 15 minutes after injection,and the location of sentinel lymph nodes was determined in vitro by gradually consolidating and fixing the fluorescence images in the inguinal region.The lymph node-like tissue with strong fluorescence intensity was observed immediately after the skin incision.There was a clear boundary between the lymph node-like tissue and the surrounding tissue.Along this boundary,lymph nodes were separated,ligated,excised.No lymph nodes were found on the undetected side.Postoperative pathology confirmed that lymph nodes were located by fluorescence imaging in vitro and traced by fluorescence imaging in vivo,the coincidence rate was 100％.There were residual fluorescent tissues on three sides and lymphatic vessels were removed.Conclusions MGS-assisted intraoperative fluorescence imaging could improve the doctor's visual depth so that physicians can real-time,dynamic,accurate in vitro location and in vivo tracking of sentinel lymph nodes of penile cancer.

BACKGROUNDThe prognosis of R1-resection at the bronchial stump in patients with non-small cell lung cancer (NSCLC) remains unclear. This study intends to identify the prognostic factors and to optimize treatments for these patients under update conditions.

METHODSThe data of 124 NSCLC patients who underwent R1-resection at the bronchial stump was reviewed. There were 41 patients in the surgery group (S), 21 in the postoperative radiotherapy (PORT) group (S+R), 30 in the postoperative chemotherapy (POCT) group (S+C), and 32 in the PORT plus POCT group (S+R+C). The constitute proportion in different groups was tested using the χ(2) method, univariate analysis was performed using the Kaplan-Meier and log-rank method, and multivariate analysis was done using the Cox hazard regression with entry factors including age, sex, pathological type and stage, classification of the residual disease, and treatment procedure. The process was performed stepwise backward with a maximum iteration of 20 and an entry possibility of 0.05 as well as an excluded possibility of 0.10 at each step.

RESULTSIn univariate analysis, survival was more favorable for patients with squamous cell carcinoma, early pathological T or N stage, and chemotherapy or radiotherapy. There was no significant difference in the survival for patients with different types of the residual disease, except for the difference between patients with carcinoma in situ and lymphangiosis carcinomatosa (P = 0.030). The survival for patients receiving chemoradiotherapy was superior to that for those undergoing surgery alone (P = 0.016). In multivariate analysis, the pathological type (HR 2.51, 95% CI 1.59 to 3.96, P = 0.000), pathological T (HR 1.29, 95% CI 1.04 to 1.60, P = 0.021) or N stage (HR 2.04, 95% CI 1.40 to 2.98, P = 0.000), and chemotherapy (HR 0.24, 95% CI 0.13 to 0.43, P = 0.000) were independent prognostic factors.

CONCLUSIONPatients with squamous cell carcinoma, early pathological T or N stage, or receiving chemotherapy had a more favorable prognosis.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; radiotherapy ; surgery ; Female ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; radiotherapy ; surgery ; Male ; Middle Aged ; Prognosis