Objective To evaluate and analyze the postoperative complications induced from the procedure for prolapse and hemorrhoids(PPH).Methods The data of the third or fourth degree hemorrhoids operated by pro- cedure for prolapse and hemorrhoids were analyzed.Results Total 224 patients with hemorrhoids were operated on by PPH,and the mean operative time was 25 minutes and mean postoperative hospital stay were 3.5 days.Postoper- ative bleeding requiring haemostatic procedures occurred in two patients.Urine retention rate was 30.36%,there were 56 eases pain scores＞5,there of re-prolapse,16 cases of residual skin tags.One case of mucocele.Conclusion The rule of PPH is individual management.

OBJECTIVETo analyze the clinicopathological features and prognosis of colorectal cancer patients with preoperative cancer-related anemia.

METHODSClinical data of 354 patients with colorectal cancer in the Second Affiliated Hospital of Guangzhou Medical College from January 2003 to July 2009 were analyzed retrospectively. Those with hemoglobin(Hb)<120 g/L before surgery were defined as cancer-related anemia.

RESULTSOf the 354 colorectal cancer cases, 195 were males and 159 were females. The median age was 65(range 22-92) years. Preoperative cancer-related anemia tended to be occurred in female(P<0.01) and those with preoperative albumin ≤35 g/L (P<0.01), right colon cancer(P<0.01) and full-thickness invasion(P<0.05). Cox regression analysis showed preoperative cancer-related anemia was an independent unfavorable factor for overall survival (HR=1.60, 95% CI:1.05-2.44; P<0.05), but not for disease-free survival (HR=1.43, 95% CI:0.97-2.12; P>0.05) in colorectal cancer.

CONCLUSIONSPreoperative cancer-related anemia plays an important role in the development and prognosis of colorectal cancer and great attention should be paid to clinical practice.

Adult ; Aged ; Aged, 80 and over ; Anemia ; etiology ; Colorectal Neoplasms ; complications ; surgery ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Young Adult

ObjectiveTo investigate the changes and significance of urine kidney injury molecule-1(KIM-1) in liver transplant recipients concurrent with early-stage acute kidney injury (AKI).MethodsThe clinical data of orthotopic liver transplantation in 50 cases was retrospectively analyzed.According to the Acute Kidney Injury Network (AKIN) criteria and whether there was AKI for recipients after operation,the recipients were divided into AKI group (27 cases) and non-AKI group (23 cases).Serum creatinine (SCr),urine creatinine (UCr) and urine KIM-1were determined at the scheduled time points,and relationship between urine KIM-1and AK1was analyzed.By using the receiver operating characteristic (ROC) and the area under the curve (AUC),the diagnostic accuracy of urine KIM-1for AKI was evaluated.ResultsThe level of SCr reached the highest in two groups at 24 h postoperation,that in AKI group was significantly higher than in non-AKI group (P＜0.05),and then gradually decreased to the preoperative level.The level of urine KIM-1was significantly increased immediately at the time of portal vein reperfusion in two groups,and that in AKI group reached the peak at 2nd h after portal vein reperfusion,significantly higher than in non-AKI group (P＜0.01),which continued 12 h after the portal vein reperfusion.The results showed that the sensitivity was 82.6％ and the specificity was 88.9％ when the urine KIM-114.19 ng/g Ucr was taken as the cutoff to the diagnosis of AKI two h after portal vein repeffusion.ConclusionThe level of urine KIM-1is a reliable biomarker to diagnose AKI after liver transplantation.The intraoperative changes of urine KIM-1may be helpful to early prediction of AKI,for recipients with preoperative normal renal function.

OBJECTIVETo improve the recognition and treatment of Chinese cutis verticis gyrata.

METHODSBased on the review of the etiopathology, clinical features, diagnosis, classification and treatment of the disease in the literatures, six patients with the cutis verticis gyrata were treated with the skin graft or the expanded scalp flap.

RESULTSThe operative effects were satisfactory during 6 months to 5 years of the follow-ups. No recurrence was found in all cases. Two patients treated with skin graft had lead to baldness, four patients treated with the expanded scalp flap had been good appearance.

CONCLUSIONSThe method of the expanded scalp flap is good and effective treatment for the cutis verticis gyrate.

Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Scalp ; abnormalities ; Scalp Dermatoses ; pathology ; surgery ; Tissue Expansion ; methods ; Young Adult

OBJECTIVETo investigate the clinicopathological characteristics, differential diagnosis and prognosis of testicular cellular fibroma.

METHODSWe comprehensively analyzed the clinical presentation, histomorphology and immunohistochemistry of a case of testicular cellular fibroma, reviewed the relevant literature, and discussed its pathological features and differential diagnosis.

RESULTSA 30-year-old man presented with complaint of discomfort and painless enlargement in the right testis. The tumor was found to be a testicular fibroma characterized by a solid, thickly or thinly encapsulated, circumscribed and gray-white mass. Microscopically, fusiform cells were arranged into a storiform and herringbone pattern or fascicles. The tumor exhibited a great deal of cellularity and no nuclear polymorphisms, with a mitotic rate of 0-1/10 HP. Immunohistochemistry showed that the tumor cells were positive for Vimentin, patchily positive for S-100 and SMA, but negative for Desmin, alpha-inhibin, CD34 and CD99. The positive rate of Ki-67 was less than 1%.

CONCLUSIONTesticular cellular fibroma is a rare testicular sex cord stromal tumor, pathologically resembling its ovarian counterpart. It can be distinguished from other testicular spindle cell tumors by morphology and immunohistochemical staining. For the treatment of testicular cellular fibroma, surgical resection often has a good prognosis.

Adult ; Fibroma ; pathology ; Humans ; Immunohistochemistry ; Male ; Testicular Neoplasms ; pathology

OBJECTIVETo evaluate the effectiveness and safety of holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TURP)/open prostatectomy (OP) in the treatment of bladder outlet obstruction (BOO) secondary to benign prostatic hyperplasia (BPH).

METHODSWe searched Medline, Cochrane Library, Embase, Wanfang and CBM for randomized controlled trials (RCT) comparing HoLEP with TURP/OP. Comparable data were extracted from eligible studies and pooled for meta-analysis using RevMan5.1.

RESULTSNine RCTs were included in this study, 6 comparing HoLEP with TURP, and the other 3 comparing HoLEP with OP. Meta-analysis showed that, compared with TURP, HoLEP was associated with shorter hospital stay and catheterization time, less hemoglobin loss, longer operative time, and better improvement in international prostate symptom score (IPSS) , peak urinary flow rate (Qmax) and post void residual (PVR) , but the incidences of postoperative urethral stricture and urinary incontinence had no statistically significant difference between the two. Compared with OP, HoLEP showed shorter hospital stay and catheterization time, a lower rate of blood transfusion, longer operative time, and removal of fewer tissues, but the two procedures exhibited no significant differences in either the improvement of IPSS and Qmax or the incidence of urethral stricture.

CONCLUSIONHoLEP is a minimally invasive technique, safe and highly effective for the treatment of BOO secondary to BPH, with its advantages of lower peri-operative morbidity and faster recovery over TURP and OP. However, more high-quality RCTs with larger sample sizes and longer follow-ups need to be carried out to obtain better evidence.

Holmium ; Humans ; Laser Therapy ; Male ; Prostatic Hyperplasia ; surgery ; Randomized Controlled Trials as Topic ; Transurethral Resection of Prostate ; methods

Objective To evaluate the feasibility and safety of a delivery pathway for the performance of percutaneous left atrial appendage (LAA) occlusion in experimental canine models. Methods Transseptal puncture was performed via femoral vein approach under fluoroscopic and angiographic guidance in 12 experimental dogs. A pigtail catheter was advanced into the left atrium (LA), which was followed by LA angiography. The diameters of the neck of LAA were measured on LAA angiogram obtained in appropriate projection. After the delivery sheath was advanced along the wire into LA, a pigtail catheter was inserted into the ostium of the LAA and the sheath was then advanced over the pigtail into the LAA. LAA angiography was then performed through the delivery sheath to confirm the position of the delivery sheath. One hour after the procedure both electrocardiography (ECG) and transthoracic echocardiography (TTE) were carried out in five dogs to check the results, immediately after which the five dogs were sacrificed to macroscopically observe the damages of the puncture site of inter-atrial septum as well as inside the LA and LAA. One hour and 2 weeks after the procedure TTE was conducted in the remaining 7 dogs and these dogs were followed up for one month. Results One dog died of pericardial tamponade during the operation. In 8 dogs the LAA was clearly displayed in the projection position of right anterior oblique (RAO) 30°/cranial (CRA) 20°,while in 3 dogs the LAA was well visualized in the projection position of RAO 30° , and in one dog in the projection position of RAO 30°/caudal (CAU) 20°. The diameter of LAA neck was (13.6 ± 5.2) mm. The delivery sheath was safely advanced into the LAA along the pigtail catheter in all dogs, and no air embolism, thrombus or pericardial tamponade occurred. Hematoma at puncture point of groin occurred in 2 dogs, which was absorbed through pressure dressing. Macroscopic examination of the heart performed immediately after the operation showed that no bloody pericardial effusion was found, and mild hematoma at posterior wall of LA was seen in one dog and mild damage of the upper-margin intima of LAA was noted in 2 dogs. The mean fluoroscopy time was (10.1 ± 2.5) minutes and the mean operation time was (58 ± 12) minutes. TEE showed no pericardial effusion 2 weeks after the procedure. During the follow-up period of one month no sudden death, stroke or infection occurred. Conclusion This method of placing the delivery sheath into the LAA is clinically safe and effective, and it can reliably establish a pathway to advance the LAA occluder into LAA.

ITS2 sequence was used as a barcode to identify herbal tea ingredient Plumeria rubra and its adulterants. Genomic DNAs from forty eight samples were extracted, the ITS2 sequences were amplified and sequenced bi-direstionlly, and then assembled and obtained using CodonCode Aligner. The sequences were aligned using ClustalW, the genetic distances were computed by kimura 2-parameter (K2P) model and the Neighbor-joining (NJ) phylogenetic trees were constructed using MEGA5.0. Results showed that the length of ITS2 sequence of P. rubra were 244 bp. The intra-specific genetic distances (0-0. 016 6) were much smaller than inter-specific ones between P. rubra and its adulterants(0.320 8-0.650 4). The NJ tree indicated that P. rubra and its adulterants could be distinguished clearly. Therefore, Using ITS2 barcode can accurately andeffectively distinguish herbal tea ingredient P. rubra from its adulterants, which providesa new molecular method to identify P. rubra and ensure its safety in use.
Apocynaceae ; classification ; genetics ; DNA Barcoding, Taxonomic ; methods ; DNA, Plant ; genetics ; DNA, Ribosomal Spacer ; genetics ; Drug Contamination ; prevention & control ; Drugs, Chinese Herbal ; chemistry ; classification ; Flowers ; chemistry ; classification ; Molecular Sequence Data ; Phylogeny ; Quality Control

OBJECTIVETo analyze the characteristics of atrial tachycardia originating from the atrioventricular cingulum.

METHODThe electrophysiological mechanism, ablation site graph and nerve distribution of 16 cases of atrial tachycardia originating from the atrioventricular cingulum or adjacent atrial muscle which were proved by electrophysiological monitoring and radiofrequency ablation.

RESULTSAtrial tachycardia from peri-cingulum represented 23.2% of atrial tachycardia treated by radiofrequency ablation during the same period. The ratio of left to right atrioventricular cingulum was 3:16. There was no difference of the surface ECG characteristics and electrophysiological mechanism between the atrial tachycardia originating from atrioventricular cingulum and that from other positions. Both A and V components were recorded at all the successful ablation sites. The ratio of amplitude of A to V was between 2:3 and 6:1. Atrial potential in the target site was 20-46 (38.6 +/- 6.7) ms earlier than P'wave in surface ECG. The success rate of ablation was 87.5% and the recurrent rate 7.1%.

CONCLUSIONSPeri-cingulum atrial tachycardia accounts for a certain proportion in all atrial tachycardia. The exciting sites originating from right cingulum are more common than those from left cingulum. Its electrophysiological mechanism has no difference from other positions. Cingulum mapping and ablation have important practical meanings.

Adolescent ; Adult ; Aged ; Catheter Ablation ; Child ; Electrophysiologic Techniques, Cardiac ; Female ; Humans ; Male ; Middle Aged ; Tachycardia, Ectopic Atrial ; physiopathology ; surgery ; Young Adult

A printed polymer for selective identification of levofloxacin was synthesized on the surface of silica gel with levofloxacin as template molecule. The polymer was characterized by elemental analysis and infrared spectroscopy, and the properties of the polymer were determined by dynamic adsorption and selective adsorption. The results showed that the maximum adsorption capacity of the imprinted polymer was 56.33 mg/g and the imprinting factor was 2.62. The imprinted polymer was applied to quantitative analysis of levofloxacin with molecular imprinted solid phase extraction spectroscopy (SPES). The SPES was carried out in an elaborately designed device with which the interested analyte was extracted by the solid phase extraction medium and the diffuse reflectance spectrum was measured directly on the solid medium without elution. SPES has simplified the operation process and improved the sensitivity. The regression equation of the standard curve was A=0. 0496C+0. 2412, the correlation coefficient (R2) was 0. 9924, the linear range was 0. 25-9.0 mg/L,and the detection limit was 0.24 mg/L. The recoveries of determination of levofloxacin in Pork samples were 89.1%-92.0%, and the relative standard deviations (RSDs) of the three parallel tests were 3.4%-7.9%. Compared with the traditional enrichment and separation technique, this method developed here had some advantages such as miniaturization and integration, high sensitivity and selectivity, low cost, simple operation and rapid detection.