Bronchoscopy ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Tracheal Neoplasms ; diagnosis ; surgery

BACKGROUND:Surgical treatment for pigmented vil onodular synovitis can maximize the excision of synovial lesions and recovery of joint function.
OBJECTIVE:To investigate the knee joint function and relapse rate fol owing treatment of pigmented vil onodular synovitis with total knee replacement and arthroscopic synovectomy.
METHODS:We retrospectively analyzed 34 cases of knee pigmented vil onodular synovitis admitted for surgical treatment in the Department of Orthopedics, Xiangya Hospital of Central South University, China from December 2006 to December 2011. In these cases, 24 patients received arthroscopic synovectomy and 10 patients were subjected to total knee replacement. Adjuvant radiotherapy was conducted according to postoperative patient’s conditions. Lysholm scoring was employed in the arthroscopic synovectomy group, and American Knee Society scoring was used in the total knee replacement group. Knee function in two groups was compared before and after treatment. Fol ow-up observation was performed to compare knee function recovery and relapse rate between two groups.
RESULTS AND CONCLUSION:Thirty-four patients were effectively fol owed up for 12-66 months, mean 41.3 months. Statistical analysis showed that in the arthroscopic synovectomy group, the postoperative Lysholm score was (86.3± 10.3) points, significantly higher than the preoperative score which was (55.5±13.2) points (t=3.81, P=0.016, P<0.05). In the total knee arthroplasty group, the American Knee Society score was increased from (40.7±2.2) points preoperatively to (90.2±1.1) points postoperatively (t=6.27, P<0.01). In the arthroscopic synovectomy group, the American Knee Society score was increased from (34.2±3.9) points preoperatively to (80.8±1.9) points postoperatively (t=16.58, P<0.01). Arthroscopic synovectomy combined with adjuvant radiotherapy can achieve better outcomes in pigmented vil onodular synovitis patients, while the total knee replacement for advanced with advanced knee diffuse pigmented vil onodular synovitis is better to restore knee function and the recurrence rate is low.

One of the challenges in andrology nowadays is the diagnosis and treatment of external genital abnormalities and defects along with the consequent voiding, sexual, and reproductive dysfunctions, for which no guidelines are yet available. Hitherto, surgical repair and reconstruction are efficient for these diseases. The key to these operations is to individualize surgical strategies according to the specific local lesion and dysfunction, usually involving flap and graft techniques. This article presents our experience in the surgical treatment of penile and scrotal abnormalities and defects with urological and andrological techniques and microsurgical strategies, focusing on the external repair and functional reconstruction. Satisfactory treatment outcomes pivot on a precise evaluation of the disease, a rational design of surgical procedures, and an earnest communication with the patient. Some cases are rather complicated and challenging, usually with complications, and therefore deserve further researches for more effective treatment strategies in clinical practice.
Andrology ; Genitalia, Male ; abnormalities ; surgery ; Humans ; Male ; Penis ; abnormalities ; surgery ; Reconstructive Surgical Procedures ; methods ; Scrotum ; abnormalities ; surgery ; Surgical Flaps ; Treatment Outcome

Child ; Child, Preschool ; Epilepsy ; complications ; diagnosis ; surgery ; Female ; Humans ; Male ; Sleep Apnea, Obstructive ; complications ; diagnosis ; surgery

Child ; Cutaneous Fistula ; surgery ; Female ; Humans ; Neck ; pathology ; Reconstructive Surgical Procedures ; Tracheal Diseases ; surgery

OBJECTIVETo observe the clinical effect and safety of circumcision stapler in the treatment of phimosis and redundant prepuce.

METHODSWe treated 120 patients with redundant prepuce or phimosis using circumcision stapler and another 60 by conventional dorsal-incision circumcision. We observed intraoperative blood loss, operation time, postoperative pain, wound healing time, cosmetic appearance of the penis, and postoperative complications and compared them between the two groups of patients.

RESULTSStapler circumcision showed obvious advantages over the conventional method in intraoperative blood loss ([2. 3 ± 1. 3] vs [15.6 ± 2.9] ml), operation time ([7.1 ± 1.4] vs [22.6 ± 4.6] min), wound healing time ([12.0 ± 2.9] as [16.3 ± 3. 1] d), postoperative pain score (1. 9 ± 1. 3 vs 5. 2 ± 1. 7), incision edema, and cosmetic appearance of the penis (all P <0. 05). Besides, stapler circumcision exempted the patients from stitch-removal pain. However, the incidence rate of postoperative local ecchymosis was significantly higher in the circumcision stapler group than in the conventional circumcision group (20. 8% vs 8. 3% , P <0. 05).

CONCLUSIONCircumcision stapler, with its advantages of easier manipulation, shorter operation time, better cosmetic penile appearance, less pain, and fewer complications, is superior to conventional circumcision in the treatment of phimosis and redundant prepuce.

Blood Loss, Surgical ; Circumcision, Male ; instrumentation ; methods ; Ecchymosis ; etiology ; Humans ; Male ; Pain, Postoperative ; Penis ; abnormalities ; Phimosis ; therapy ; Postoperative Complications ; Postoperative Period ; Surgical Staplers ; adverse effects ; Wound Healing

Objective To observe the sequence of fat deposit and its relationship with insulin resistance in SD rats fed by high fat diet.Methods Normal 8-week-old male SD rats were randomly divided into normal chow (NC,n=40)and high fat diet(HF,n=40)groups.Triglyceride(TG)in serum,liver and muscle were measured;glucose infusion rate(GIR)and the mRNA level of genes related to lipid metabolism in liver and muscle were determined in different stages.GIR was detected by eugiyeemic-hyperinsulinemic clamp for evaluating the insulin sensitivity.Gene expression was determined by real-time PCR.Results(1)As compared with NC group,serum TG was not increased after high fat feeding for4 and 8 weeks,it began to increase after 12 weeks [0.52(0.15-1.00) mmol/L vs O.31(0.09-0.53)retool/L, P0.05)in skeletal muscle.After 8 weeks,the expression of ACC1 in liver in HF group was increased by 20.6%,CPT-1 was decreased by 27.1%(P

Hydroxyapatite (HA) is one of ideal materials for bone substitutions due to its intrinsic biocompatibility. However, its relatively poor mechanical properties such as brittleness and low strength have hindered its use in high-load applications. Biotic bones themselves are nanocomposites mainly composed of nanohydroxyapatite (n-HA) and collagen. From biomimetic point of view, nanocomposites of HA could potentially improve both biocompatibility and mechanical properties of bone grafting materials. Recent progress in this field branched into nanocomposites of HA with nonbiodegradable and biodegradable polymers, the latter including collagen, gelatin, chitosan, polylactides as well as polyanhydrides. In this paper, the preparation, biological reactions and mechanical properties of different nanocomposites are reviewed in detail.
Biocompatible Materials ; chemistry ; Bone Substitutes ; chemical synthesis ; chemistry ; Durapatite ; chemistry ; Humans ; Nanocomposites ; chemistry ; Nanoparticles ; chemistry ; Particle Size

OBJECTIVETo evaluate the efficacy and safety of long-term on-demand use of vardenafil in the treatment of erectile dysfunction (ED).

METHODSWe conducted a questionnaire investigation among 891 ED patients treated by on-demand use of oral vardenafil at 20 mg every 3 days from March 2007 to January 2010, covering the general information of the patients, their need for and attitudes towards the treatment, clinical efficacy and adverse events of the drug, and satisfaction of the patients and their partners after 12 weeks of treatment.

RESULTSTreatment and follow-up were completed in 700 patients, of whom 504 (72%) achieved sufficient hardness and duration of penile erection and overall sexual satisfaction, 84 (12%) admitted to improvement of erectile hardness and duration but not adequate satisfaction, and the other 112 (16%) experienced no significant changes. Significant differences were found in IIEF-5 scores, Rigiscan test results and partners TSS scores before and after the treatment (P < 0.05). Most frequent adverse events included flushing (15%), dizziness and headache (10%), dyspepsia (3%), and nasal congestion (1%).

CONCLUSIONLong-term on-demand use of oral vardenafil, in addition to its safety and good tolerance, can effectively improve the erectile function of ED patients, their success rate of sexual intercourse, and overall quality of sexual life.

Adult ; Erectile Dysfunction ; drug therapy ; Follow-Up Studies ; Humans ; Imidazoles ; adverse effects ; therapeutic use ; Male ; Piperazines ; adverse effects ; therapeutic use ; Sulfones ; adverse effects ; therapeutic use ; Treatment Outcome ; Triazines ; adverse effects ; therapeutic use ; Vardenafil Dihydrochloride ; Vasodilator Agents ; adverse effects ; therapeutic use ; Young Adult

OBJECTIVETo explore how obstructive sleep apnea syndrome (OSAS) affects children's sleep architecture.

METHODSEighty-three children with OSAS were reviewed; every patient was monitored with polysommography for 7 hours at night for 11 parameters, including the number of arousal, snoring index, nadir O(2) desaturation, stage I %, stage II %, show wave sleep (SWS)% and rapid eye movement (REM)%. The basis for diagnosis of OSAS was the widely accepted pediatric diagnostic criteria of apnea/hypopnea index, apnea/ hypopnea index of > 1 episode/hour, nadir O(2) desaturation < 92%. Sleep was scored manually according to the standard set by Rechtschaffen.

RESULTSIn OSAS group, the number of arousal was 22.5 +/- 1.4, snoring index was 70.6 +/- 16.5, and/or SaO(2) was (73.8 +/- 1.9)%. OSAS group had increased stage I : (45.8 +/- 2.0)% vs. (2.3 +/- 1.1)%, t = 22.46, P < 0.01 and decreased stage II : (23.9 = 1.7)% vs (47.9 = 4.4)%, t = - 14.18, P < 0.01, SWS (15.6 +/- 1.8)% vs. (21.1 +/- 5.0)%, t = - 3.123, P < 0.01, REM (14.7 +/- 1.5)% VS. (28.2 +/- 4.1)%, T = -8.923, p < 0.01.

CONCLUSIONThe severity of OSAS relates to changes of sleep architecture in children. Intermittent nocturnal hypoxia secondary to apnea/hypopnea, and frequent electroencephalogram arousals from sleep may result in significant sleep fragmentation. Children with OSAS had learning problems and failure to thrive.

Child ; Child, Preschool ; Female ; Humans ; Male ; Monitoring, Ambulatory ; Polysomnography ; Severity of Illness Index ; Sleep Apnea, Obstructive ; classification ; pathology ; physiopathology ; Sleep Stages ; physiology