Objective To improve the diagnostic level of on pelvic nodal metastases of prostate cancer. Methods Thirty-three cases of prostate cancer underwent instep lymphangiography to find out if there were pelvic nodal metastases.The results of lymphangiography were compared with the pathologic results of fine needle aspiration biopsy of lymph nodes. Results In the 9 cases testing positive for nodal metastases 7 were identified by cytology of fine needle aspiration biopsy and 6 were confirmed by pathology;while in the 24 cases with negative results,4 were false negative(17%). Conclusions The lymphangiography plays an important role in diagnosis of nodal metastases of prostate cancer.Fine needle aspiration for suspected lymph nodes can minimize false positive result,nevertheless there is still false negative result in lymphangiography.

A HPLC method for the determination of berberine in Phellodendron amurense processed by four different procedures has been established. The method is simple, specific and accurate. The recovery is 102.7% and coefficient of variation is 0.69%.

Objective To evaluate the therapeutic effects of low tension,anti-reflux Roux-y sigmoid neobladder. Methods Using modified ureterocolostomy and colorectostomy,low tension Roux-y sigmoid neobladders were formed on 12 cases of bladder cancer and 1 case of vesicovaginal fistula.The surgical procedures involved making an “inversive valve” into the bowel lumen about 1.5 cm above the Roux-y anastomotic stoma and anastomosing the ureter and colon by Leadbetter method;then the reservoir was made by detubularization of sigmoid.Postoperatively,blood electrolytes and acid-base balance, and urination were monitored. Results During the follow-up of 0.5~5 years,only 2 cases had occasional fever;no hydronephrosis, no disorder of acid-base balance occurred.The blood electrolytes were within the normal range.And no one had incontinence. Conclusions The low tension,anti-reflux Roux-y sigmoid neobladder is a surgical technique of less trauma and with less complications.

Objective To summarize the experience of microsurgery for repair on urethrovaginal and vesicovaginal fistula. Methods Five cases of complex urethrovaginal or vesicovaginal fistula underwent repair procedure with thin suture under surgical magnifier.The defect of vesical neck was sutured in several layers and the urethra was renovated by using vaginal wall tissue. Results The operations were successful in all the 5 cases with no obvious incontinence.Their course of coition was not influenced. Conclusions Suturing the defect of the vesical neck in several layers can restore the function of the sphincter.Microsurgery may align the tissue well and cause less tissue reaction,thus it is beneficial to the concrescence of the fistula.

l 1H-MRS was good for clinical purpose.

Objective To evaluate the diagnostic value of in vivo 1H-MRS in the hyper acute reaction stage of radiation-induced brain injury after nasopharyngeal carcinoma radiotherapy. Methods Eighteen patients with nasopharyngeal carcinoma accepted radiotherapy for the first time. Bilateral temporal lobes in all cases were examined by conventional MRI and 1H-MRS before and after radiotherapy with radiation dose of 20 Gy, 40 Gy, and 60 Gy, respectively. MR image was performed with T_1-weighted gradient- and spin-echo, T_2-weighted spin-echo, fluid-attenuated inversion-recovery, and point resolution spectroscopy. The change of the spectroscopic morphology and the ratios of the metabolites were observed. Results There were no changes of signal in the temporal lobes with conventional MRI, but the peak height of NAA and Cho decreased obviously in the anterior half of the temporal lobes with 1H-MRS after radiotherapy. The post-radiotherapy changes of different metabolic peak in the anterior temporal lobes presented as two types: one type was that Cho and NAA peak were of the same height simultaneously. There were 20 locations (56%) of the 36 reaching the peak when accepting 20 Gy, 22 (61%) when accepting 40 Gy, and 13 (36%) when accepting 60 Gy, respectively. The other type was that Cho peak became the highest, whereas NAA peak was obviously lower and decreased to be the second highest. There were 4 locations(11%) of the 36 reaching the peak when accepting 20 Gy, 10 (28%) when accepting 40 Gy, and 23 (64%) when accepting 60 Gy, respectively. The ratio of Cho/Cr, NAA/Cr, and NAA/Cho decreased in the same position too. In addition, there was positive correlation between the ratios of the metabolites and the dose of radiotherapy.Conclusion 1H-MRS can be used to diagnose the radiation-induced injury of the brain in early acute reaction stage after nasopharyngeal carcinoma radiotherapy through reflecting histiocytic metabolism, and provide objective basis for pathology development and cellular metabolism study, also it can provide feasible projects for the clinic.

The value of combined application of both ECG-gated cine MRA and 3D-CEMRA in the detection of large intracranial aneurysms was evaluated and the findings were compared with those of conventional MRA and DSA. Twenty-four patients with 26 large intracranial aneurysms underwent MRI and DSA. All these aneurysms, diameter from 15 to 39 mm, were located at internal cerebral artery (n=12), vertebral artery (n=3), basilar artery (n=4), anterior cerebral artery (n=2), middle cerebral artery (n=2), anterior communicate artery (n=2) and posterior communicate artery (n=1). Thirteen cases of hematoma or cavernoma were studied as control group. All patients were examined on GE 1.5T MR system. ECG-gated cine MRA was performed with 2D multi-phase fast gradient-recalled echo sequence in a single section. All the images were analyzed with signal intensity VS time curve for differentiating intraaneurysmal blood flow from static tissue. The results were analyzed by statistic "t" test. 3D-CEMRA was performed with spoiled gradient-recalled echo and one dose of Gd-DTPA. All data was processed with multi-plannar reformat (MPR) and tomography for the demonstration of aneurysms in detail. All 26 aneurysms were demonstrated successfully by combined application of both cine MRA and 3D-CEMRA. Compared to DSA and conventional 3D-MOTSA, its sensitivity and specificity figures were both 100%. Cine MRA could differentiate the blood flow from the static tissue. The intensity VS time curves of intraaneurysmal blood flow offered fluctuating form and average signal change between systole and diastole period was about 89.8 +/- 37.4; However, under the control group, intraaneurysmal thrombus or cerebral hemorrhage or cavernomas had no significant signal change and the curves offered steady form with the average signal change being about 8.2 +/- 6.3. There was statistically significant difference between the intraaneurysmal blood flow and static tissue (P=0.025, <0.05). 3D-CEMRA was very useful in demonstrating the aneurysmal size, intraaneurysmal thrombus formation, neck and the detailed relationship of the aneurysm to the surrounding structures. It was concluded that the combined application of both cine MRA and 3D-CEMRA might be a valuable clinical tool for the detection of large intracranial aneurysms.
Angiography, Digital Subtraction ; Contrast Media ; Evaluation Studies ; Image Enhancement ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional/methods ; Intracranial Aneurysm/*diagnosis ; Magnetic Resonance Angiography/*methods ; *Magnetic Resonance Imaging, Cine

Objective To improve the recognition in the diagnosis and treatment of basaloma of the prostate gland.Methods A case of basaloma of the prostate gland was reported,and the relevant litera- ture was reviewed to investigate the histogenesis,diagnosis and treatment of this disease.A 67-year-old male patient suffered from intermittent gross hematuria for 3 years.He hadⅡ?hyperplastie prostate gland,and the right lobe of the prostate was elevated obviously in hard texture.The PSA level was 5 ng/ml.The prostate biopsy result showed glandnle-like basaloma of the prostate gland with low potential malignancy.After chemo- therapy with of Flutamine for 45 d,the patient underwent radical prostatectomy.Results Postoperative pa- thology showed that the tumor had intact capsule and was lobulated.The tumor cell was small in volume with ovoid karyomegaly and seldom caryokinesis.Some of the cells arranged like fruit nest,and infihratively grew. Proliferated basilar cells of the prostate were found in marginal part of the tumor.The pathological diagnosis was basaloma(adenoid cystic carcinoma)of the prostate gland.Postoperatively,the patient recovered well with no urinary incontinence or hematuria.During a follow-up of 2 years,the patient had no recurrence. Conclusions Adenoid basal cell carcinoma/adenoid cystic carcinoma is a clinically rare subtype of adenoid carcinoma of the prostate with low PSA level,low potential malignancy,slow growth,late metastasis and better prognosis.Radical prostatectomy is recommended for this disease.

Objective:To explore risk factors of skin pruritus in peritoneal dialysis patients and the effect of individualized care intervention, to provide guidance for clinical practice.Methods:The total of 87 patients with peritoneal dialysis who were followed-up with pruritus in the Beijing Anzhen Hospital from January 2017 to June 2020 were selected. The Visual Analogue Scale (VAS) was used to evaluate the degree of pruritus, and the patients were divided into two groups: mild-to-moderate skin pruritus group (VAS≤6 points) and severe skin pruritus group (VAS>6 points). The risk factors of severe skin pruritus were analyzed by single factor and multivariate Logistic regression. The improvement of skin pruritus after 3 months of individualized nursing intervention was observed.Results:Among the 87 patients, the mild-to-moderate skin pruritus group and the severe skin pruritus group accounted for 64.4%(56/87) and 35.6%(31/87), respectively. Single factor analysis showed that the age, prevalence of diabetes, serum albumin, serum phosphorus, intact parathyroid hormone and C-reactive protein levels were (61.8 ± 11.5) years old, 33.3%(19/56), (36.3 ± 5.3) g/L, (1.6 ± 0.5) mmol/L, 328.4(144.9, 494.5) ng/L, 2.8(0.6, 8.3) ng/L in the mild-to-moderate skin pruritus group, and (67.0 ± 9.2) years old, 61.1%(19/31), (33.9 ± 4.8) g/L, (1.9 ± 0.3) mmol/L, 397.0(300.0,758.6) ng/L, 7.2(2.6, 17.2) mg/L in the severe skin pruritus group, the differences were significant between the two groups ( t values were -2.17, 2.14, -2.32, Z values were -2.28, -2.90, χ 2 value was 6.07, P<0.05). Logistic multivariate regression analysis showed that low albumin, high blood phosphorus and high C-reactive protein were independent risk factors for severe skin pruritus in peritoneal dialysis patients ( P<0.05). After 3 months of individualized care,18.4% (16/87) patients had complete remission,19.5% (17/87) patients significantly relieved, 55.2% (48/87) relieved, 6.9% (6/87) were ineffective, and the total response rate was 93.1%(81/87). Conclusions:More than one-third of peritoneal dialysis patients with pruritus are severe. Lower serum albumin, higher serum phosphorus and higher C-reactive protein are independent risk factors for severe pruritus in peritoneal dialysis patients. Individualized care can effectively improve pruritus in peritoneal dialysis patients.

OBJECTIVETo analyze and evaluate the clinical efficacy of heat-sensitive moxibustion for symptoms of large intestine cancer.

METHODSSixty patients with large intestine cancer were randomly divided into an observation group and a control group, 30 cases in each one. FOLFOX chemotherapy regimen was used in the two groups,and heat-sensitive moxibustion was added in the observation group. The acupoints were Zusanli(ST 36), Sanyinjiao (SP 6) Xuehai (SP 10) and Geshu (BL 17), etc. The treatment was applied once a day,five-day treatment as one course. Four courses were required. The reaction rates of uncomfortable symptoms by the Chinese version of the M. D. Anderson symptom inventory (MDASI-C) scale and clinical effects were analyzed and evaluated in the two groups.

RESULTSAfter treatment, the MDASI-C reaction rate of uncomfortable symptoms in the observation group was 50.4% which was lower than 53.3% in the control group (P < 0.05). The total effective rate of symptom improvement in the observation group was 83.3% (25/30), which was higher than 60.0% (18/30) in the control group (P < 0.05).

CONCLUSIONHeat-sensitive moxibustion can improve symptoms of chemotherapy for large intestine cancer.

Aged ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Colorectal Neoplasms ; drug therapy ; Drug-Related Side Effects and Adverse Reactions ; etiology ; therapy ; Female ; Fluorouracil ; adverse effects ; therapeutic use ; Humans ; Intestine, Large ; drug effects ; Leucovorin ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Moxibustion ; instrumentation ; Organoplatinum Compounds ; adverse effects ; therapeutic use ; Treatment Outcome