Adult ; China ; epidemiology ; Coal Mining ; Humans ; Middle Aged ; Morbidity ; Pneumoconiosis ; epidemiology

OBJECTIVETo evaluate the clinical effect of single-port laparoscopic ligation (SPLL) with suture silk for the management of varicocele.

METHODSWe analyzed the clinical effects of SPLL with suture silk in the treatment of 20 cases of varicocele, and compared them with those of conventional three-port laparoscopic ligation (TPLL) for another 24 varicocele patients.

RESULTSAll the operations were successful. The operation time was 20-35 (mean 28) minutes and the hospital stay was 2 days for SPLL, as compared with 15-28 (mean 20) minutes and 3 days for TPLL. The cure rate was 75% for the former, and 67% for the latter, with no signification difference between the two groups (P > 0.05).

CONCLUSIONSPLL with suture silk for the treatment of varicocele has more advantages over TPLL for minimal invasiveness, faster recovery, and less scarring and extraneous residual.

Adolescent ; Adult ; Humans ; Laparoscopy ; Ligation ; methods ; Male ; Varicocele ; surgery ; Young Adult

Objective To explore the best indication of neuroendoscopic surgery in patients with pituitary tumors by comparing the clinical effects of neuroendoscopic transsphenoidal surgery on patients with different types of pituitary tumors.MethodsA total of 92 patients with different types of pituitary adenoma received transsphenoidal approach under neuroendoscopy in our hospital from June 2016 to October2017 were selected, the surgical results were evaluated by comparing the postoperative hormone levels were normal or not and the tumor were resected or not.The patients were followed up, the physiological function (PF), physiological function (RP), emotional functions (RE) was determined by health measurement scale (SF-36) to evaluated the quality of life of patients.Results There were differences in clinical efficacy of neuroendoscopy for the treatment of different types of pituitary adenoma, the cure rate from high to low in turn was cortical hormone adenomas, growth hormone adenomas, prolactin adenomas, mixed adenoma, non-functional adenomas, the cure rate of functional pituitary adenoma was obviously higher than that of no functional pituitary adenoma, the difference was statistically significant (P＜0.05).At 6 months after surgery, SF-36 result showed that PF scores was (76.30±8.68), RP scores was (78.37±19.05), RE scores was (71.54±21.54), and at 12 months after surgery, PF scores was (87.20±9.24), RP scores was (78.66±15.18) and RE scores was (87.80±17.67), which were higher in patients with functional pituitary adenoma than those in patients with non-functional pituitary adenoma, the differences were significant (P＜0.05).ConclusionThe treatment of functional pituitary tumor by neuroendoscopic surgery, especially corticosteroid adenoma, has the best effect, and can significantly improve the quality of life of patients.

Objective To observe the effect of limited laminectomy combined with foraminal stenosis decompression on preventing C5nerve root palsy and improving neurological function. Methods From March,2014 to May,2016,69 patients with multi-segment cervical spondylotic myelopathy underwent surgical treatment in our hospital were included.Thirty-eight patients(group A)were treated with limited lami-nectomy combined with foraminal stenosis decompression and internal fixation,and 31 patients(group B)under-went routine laminectomy and internal fixation.The postoperative neurological recovery rate,cervical curvature index(CCI)and C5palsy rate were recorded and analyzed. Results No spinal cord and nerve injury occurred during the operation.The width of laminectomy was(16.8±2.1)mm in group A,and was significantly less than(21.7±2.5)mm in group B(t=8.849,P<0.001).There was no significant difference in operation time and intraoperative blood loss between two groups(t<0.439,P>0.05).The Japanese Orthopaedic Association (JOA) score increased continuously after surgery in both groups (F>42.996, P<0.05), and no significant difference was found between them at each time point(t<1.021,P>0.05).The cervical curva-ture index improved after surgery(F>86.379,P<0.05),and no significant difference was found between them at each time point(t<0.943,P>0.05).The spinal cord drift distance was(3.6±0.7)mm in group A,and ws signifi-cantly shorter than(2.5±0.5)mm in group B(t=7.602,P<0.001).There was no significantly difference in the neu-rological recovery rate between two groups(t=0.724,P=0.471).The C5palsy rate was lower in group A(5.2%,2/38)than in group B(22.5%,7/31)(χ2=4.514,P=0.034). Conclusion Limited laminectomy combined with foraminal stenosis decompression could relieve the spinal cord com-pression and restrict the excessive back drift, promote the neurological function recovery and reduce the inci-dence of C5palsy.

Trastuzumab is a humanized monoclonal antibody that targets at human epidermal growth factor receptor 2(Her2)proto-oncogenes,which can act on Her2 over-expression of tumor cells,inhibits tumor cells proliferation, differentiation,migration and other physiological activities,reduces the risk of tumor metastasis and extend the sur-vival time of patients.

Objective To investigate the microsurgical anatomy of white matter fiber tracts and the important structures of the temporal lobe,and analyze its functional and clinical implications.Methods Ten formalin (100 g/L)-fixed human brain hemispheres were dissected using the Klingler fiber dissection technique,with the aid of an operating microscope at 4-25 magnification; the microsurgical anatomy of white matter fiber tracts and the important structures of the temporal lobe was observed.Results In the temporal lobe,a large number of complex white matter fiber tracts were noted locating lateral to the lateral wall of the temporal horn of lateral ventricle and superior to the roof wall.The vertical segment of the superior longitudinal fasciculus,occipitotemporopontine tract,inferior occipitofrontal fascicle,anterior and middle tracts of the optic radiation were located from lateral to the lateral wall of the temporal hom in turn; claustro-opercular and zinsulo-opercular fibers of the external and extreme capsules,auditory radiations,uncinate fasciculus,part of occipitotemporopontine tract,part of inferior occipitofrontal fascicle,anterior commissure,anterior and middle tracts of the optic radiation(including Meyer's loop),the ansa peduncularis and the stria terminalis were located from superior to inferior to the lateral wall of the temporal horn in turn.The lateral wall of the temporal horn of the lateral ventricle was composed of corpus callosum radiation,whose roof wall composed of the tail of caudate nucleus.Furthermore,amygdala composed of the anterior,tip and medial wall of the temporal horn,and the hippocampus constituted the medial wall of the temporal horn.The cerebral foot loop was an important medial structure of the temporal horn.Conclusion It's important in the clinical diagnosis and treatment to improve the knowledge and understanding of white matter fiber tracts and important structures of the temporal lobe.

Objective To observe the clinical efficacy of acupoint injection at Fenglong (ST 40) with Promethazine in treating posterior circulation ischemic vertigo (PCIV) due to turbid phlegm obstructing the middle.Method Sixty-two patients with PCIV due to turbid phlegm obstructing the middle were randomized into a treatment group and a control group, 31 cases each. The two groups both received intravenous infusion of Vinpocetine injection, based on which, the treatment group was intervened by injection at Fenglong (ST 40) with Promethazine, while the control group was given gluteal intramuscular injection of Promethazine. The traditional Chinese medicine (TCM) syndrome score and Dizziness Handicap Inventory (DHI) were observed for the two groups before and after the treatment, and the clinical efficacies were also compared.Result The TCM syndrome and DHI scores were significant changed after the intervention in both groups (P<0.05). After the treatment, the TCM syndrome and DHI scores in the treatment group were significantly different from those in the control group (P<0.05). The total effective rate was 93.5％ in the treatment group versus 80.6％ in the control group, and the between-group difference was statistically significant (P<0.05).Conclusion Injection at Fenglong (ST 40) with Promethazine is an effective method in treating PCIV due to turbid phlegm obstructing the middle.

OBJECTIVETo compare the acute hemodynamic effects and safety of intravenous injection of recombinant human brain natriuretic peptide (rhBNP) versus intravenous nitroglycerin (NIT) in acute myocardial infarction (AMI) patients with heart failure.

METHODSOn top of standard therapy, 42 consecutive patients who suffered from anterior wall AMI with heart failure [pulmonary capillary wedge pressure (PCWP) > 16 mm Hg] within 12 to 24 hours from the onset of chest pain were randomized into rhBNP group (n = 21, 1.5 microg/kg bolus intravenous injection followed by 0.0075 microg.kg(-1).mn(-1) for the first 3 hours and 0.015-0.03 microg.kg(-1).mn(-1) infusion for following 21 hours) and NIT group (n = 21, 10 to 100 microg/mn intravenous infusion for 24 hours). The hemodynamic parameters were monitored by Swan-Ganz catheter at baseline, during drug infusion and 6 hours post infusion withdraw; total urine output was also obtained. The major adverse cardiac events (MACE) were observed up to 1 week after drug infusions.

RESULTSCentral venous pressure and systolic blood pressure remained unchanged after rhBNP or NIT infusion. Compared to baseline level, PCWP was significantly reduced by 48.9% (P < 0.01) at 30 minutes after rhBNP infusion and this effect remained up to 6 hours post infusion withdraw; PCWP reduced by 28.7% (P < 0.05) at 2 hours after NIT infusion and this effect remained to 6 hours before infusion withdraw. Cardiac index (CI) was increased by 27.1% (P < 0.05) at 1 hour after rhBNP infusion and remained till 6 hours post infusion withdraw; CI was significantly increased at 3 hour after NIT infusion and this effect disappeared after infusion withdraw. The PCWP and CI values were significantly higher in rhBNP group than that of NIT group at 30 minutes and 2 hours (P < 0.05). Heart rate was significantly reduced at 30 minutes (95.3 +/- 7.4 vs. 118.0 +/- 8.2 bpm, P < 0.05) and at 2 hour (92.8 +/- 6.8 vs. 109.2 +/- 7.6 bpm, P < 0.05) in rhBNP and NIT group, respectively and heart rate remained reduced during the whole infusion period in both groups. The total urine output for 30 hours in rhBNP group (1870 +/- 535 ml) tended to be higher than that in NIT group (1538 +/- 620 ml, P > 0.05). There was no symptomatic hypotension or other adverse events during drug infusion in both groups and MACE up to 1 week post drug infusion was also similar between the two groups.

CONCLUSIONIntravenous injection of rhBNP results in more rapid and long-lasting hemodynamic improvements than that of NIT in AMI patients with heart failure and it is also feasible and safe for clinic use in AMI patients with heart failure.

Aged ; Female ; Heart Failure ; complications ; drug therapy ; physiopathology ; Hemodynamics ; drug effects ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications ; drug therapy ; physiopathology ; Natriuretic Peptide, Brain ; therapeutic use ; Recombinant Proteins ; therapeutic use

OBJECTIVETo study the clinical outcomes of stage I testis teratoma, including pure teratoma, and to provide information on the treatment options for this disease.

METHODSWe retrospectively analyzed 27 cases of orchiectomy for stage I testis teratoma, excluding epidermoid cyst, and investigated its recurrence associated with treatment methods and clinicopathological factors.

RESULTSFour of the 27 cases relapsed, all in the orchiectomy group and confined to the retroperitoneal region, 3 with and the other 1 without risk factors, but with no death. No recurrence was found in those treated by orchiectomy followed by chemotherapy with bleomycin, etoposide and platinum (BEP). The total rate of recurrence was 15.8%. No severe side effects were observed in the 9 patients undergoing adjuvant BEP chemotherapy.

CONCLUSIONRisk factors may increase the recurrence rate of stage I testis teratoma, while postoperative adjuvant chemotherapy can reduce it, including that of pure teratoma, though surveillance policy remains the most popular option after orchiectomy.

Adolescent ; Adult ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; pathology ; Neoplasm Staging ; Retrospective Studies ; Teratoma ; pathology ; therapy ; Testicular Neoplasms ; pathology ; therapy ; Young Adult

BACKGROUND AND OBJECTIVEHypopharyngeal carcinoma has a high risk for early regional lymphatic dissemination. However, reports about regional lymph node metastases, especially retropharyngeal lymph node metastases, are rare. This research explored the spread of hypopharyngeal carcinoma, especially metastases of the retropharyngeal lymph nodes by studying computed tomography (CT) and magnetic resonance imaging (MRI) images.

METHODSThe CT/MRI images of 88 patients with pathologically confirmed hypopharyngeal carcinomas that were performed at our hospital between August 2000 and March 2009 were analyzed retrospectively. The interrelations among local stage and lymph nodes in various regions were analyzed by Chi2 test and multivariate logistical regression.

RESULTSThe rate of regional lymph node metastasis for all patients was 73.9%, and the highest rates of positive lymph nodes were at levels IIa (61.4%), IIb (44.3%), and III (37.5%). Metastases to levels I, IV, V, and VI were rare, as were retropharyngeal lymph-node metastases, which were always combined with metastases at levels II and III. Univariate analysis showed that level-IV metastases correlated to metastases at levels Ib and III; retropharyngeal lymph node metastases were correlated to level IIb and bilateral cervical lymph node metastases. Multivariate analysis showed that level-VI metastases correlated to level IV and that retropharyngeal lymph-node metastases correlated to bilateral cervical lymph node metastases.

CONCLUSIONSRegional lymph node metastases in patients with hypopharyngeal carcinoma follow some regulations, and skip metastasis is rare. The highest rates of positive lymph nodes are at levels II and III. Bilateral lymph node metastases may be a risk factor for retropharyngeal lymph node metastases.

Adult ; Aged ; Carcinoma in Situ ; diagnosis ; diagnostic imaging ; pathology ; Carcinoma, Squamous Cell ; diagnosis ; diagnostic imaging ; pathology ; Female ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Lymph Nodes ; diagnostic imaging ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck ; Neoplasm Staging ; Pharynx ; Retrospective Studies ; Tomography, X-Ray Computed