Objective To discuss the surgical method of resection of petroclival tumors used temporal base transtentorial approach.Methods Analyzed 26 cases of petroclival tumors.All of them were surgically treated under intraoperative neurophysiological monitoring by temporal base transtentorial approach.Firstly the supratentorial part of tumors were resected by pieces,and then the tentorium was cut open,in order to resect residue of the subtentorial part of tumors.This surgical maneuver was applied to reduce the retraction to surrounding vessels,nerves and brain stem,as well to protect important structures and to finally achieve radical removal of the tumors.The efficacy and complications were observed.Results Among 26 cases,19 cases (73.1％,19/26) achieved total removal,5 cases (19.2 ％,5/26) achieved subtotal removal and 2 cases (7.7％,2/26) achieved great partial removal.There was no surgery-related death.Eleven cases suffered from partial neurological deficit.All cases were followed up for 3 months to 4 years,3 cases underwent complete recovery,4 cases underwent partial recovery,and 4 cases underwent permanent deficit.Conclusions Using temporal base transtentorial approach to resect petroclival tumors is convenient,applicable,safe and with minimal injury and with high proportionality of total resection.Under intraoperative neurophysiological monitoring,this approach may be an ideal choice for surgical treatment of these tumors.

OBJECTIVETo evaluate the safety and clinical outcomes of the novel simplified no-flip surgical approach to Shang Ring male circumcision in adults.

METHODSA total of 528 adult males, aged 18 - 58 (mean 35) years, 63 with phimosis and 465 with redundant prepuce, underwent no-flip Shang Ring circumcision with or without removal of the outer ring. The operation time and intraoperative blood loss were recorded and observations were made on such complications as postoperative bleeding, infection, edema, and wound dehiscence.

RESULTSThe operation time, intraoperative blood loss, and 2-hour postoperative pain score were (3.8 +/- 0.3) min, (0.6 +/- 0.1) ml, and 7.3 +/-0.3, respectively. Spontaneous ring detachment occurred at 21.6 +/- 2.1 days postoperatively in 12.7% of the patients (67/528) who had chosen not to remove the rings. Of those who preferred removal of the outer ring (87.3% [461/528]), none experienced any pain at the ring removal 7 days after the operation. Postoperative complications included infection in 3 cases (0.56%) and mild edema in 9 (1.70%), but no bleeding and wound dehiscence. Totally, 518 (98.1%) of the patients felt satisfied with the postoperative penile appearance.

CONCLUSIONNo-flip Shang Ring circumcision, with no need for removal of the inner ring, is a safe and simple approach for adult males, which is superior to conventional Shang Ring circumcision for requirement of fewer surgical instruments, shorter operation time, lower incidence of complications, and better satisfaction with the penile appearance. However, these advantages are to be further demonstrated by more randomized controlled trials.

Adolescent ; Adult ; Circumcision, Male ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Phimosis ; surgery ; Postoperative Complications ; Young Adult

Objective To investigate the pathway and mechanism of neuropeptide Y(NPY)-Y1 receptor agonist,[Leu~(31),Pro~(34)]-NPY,on the cultured cerebrovascular smooth muscle cells(SMCs) in the spontaneously hypertensive rats(SHR) in vitro. Methods The SMCs of the arteries from the brain of SHR were cultured in vitro.Cell cycle was detected with flow cytometry,and the concentration of free intracellular calcium was examined with laser scanning confocal microscopy. Results The percentages of S stage cells of 10~(-5) mol/L and 10~(-6) mol/L NPY was higher than those of the control group(P

The article has studied the application and the student-centered teaching mode in clinic medicine teaching and discussed how to cultivate students' self-learning ability and life-time learning skills by means of internet teaching,problem-base learning,case-studying and question-discussion.It has also pointed out that compared with the traditional teaching mode this teaching mode has advantages in cultivating innovative,pioneering and practical medical talents.

Objective To compare the prescrotal orchiopexy and traditional inguinal orchiopexy in the clinical treatment of children with low cryptorchidism.Methods Seventy-two patients(78 testes)who underwent orchiopexy in our hospital during March 2006 to May 2011 were retrospectively analyzed.And the undescended testis could be manipulated beyond the external inguinal ring under anaesthesia.Matching conditions were age differences among 3 months,same preoperative testicular positioning,same surgeon and same side.Using the paired study of 1 to 1,all the patients were divided into 2 groups: prescrotal orchiopexy(group A)and the traditional inguinal orchiopexy(group B),each group included 36 patients(39testes).Mean age was 5.4 years(group A)and 5.5 years(group B).The time of operation and restore standing,success rate and complications,including hernia,hydrocele,testicular atrophy and ascent were compared between the 2 groups.Results All the patients were successfully operated.The average surgical time for the prescrotal and inguinal groups were 33 and 41 min(P =0.0022),and average time of standing was 1.2 and 5.4 d(P =0.0003).All the patients had no wound infection.Followup ranged from 3 to 65 months.No hernia,hydrocele,testicular atrophy and ascent were identified in either group.The ratios of successful surgery were 100％ in the two groups.Conclusions The prescrotal orchiopexy is simple,safe,and effective in the cases that testis could be pushed down through the external inguinal ring.Compared with traditional inguinal approach,the advantages of prescrotal approach are shorter operative time,fewer traumas,less pain,faster recovery and cosmetic results.

Objective To investigate the feasibility and efficacy of laparoscopic orchiopexy for inguinal palpable undescended testes. Methods Ninety patients with 103 inguinal undescended pal-pable testes were treated by laparoscopic orchiopexy performed by the same surgeon. There were 24 (26.7 %) left and 53 (58. 9%) right palpable cryptorchidism cases, plus 13 cases (14.4 % ) with bilat-eral undescended testes. The mean age of the patients was 17 months (range 8 months-6 years). The surgical procedures were described as following. First, the peritoneum was opened at the anterior sur-face of the spermatic vessels and vas deferens before the testis was pulled into the abdominal cavity so that the spermatic vessels and vas deferens were released and easily manipulated. Second, the inter-space between internal spermatic fascia (transversalic fascia) and processus vaginalis was divided so, that the testis could be pulled into the abdominal cavity. Finally, the trocar which was inserted from scrotum was placed through the outer ring. Finally, the testis was placed at position and fixed. Re-suits The mean operative time was 32.7±5.2 min. The processus vaginalis unclose was found in 93 (90.3%) cases; and contralateral process us vaginalis unclose were found in 12 (15.6%) cases of 77 unilateral undescended testes. The complication rate was 3(3.3%)cases, all in bilateral cases. All 103 testes were descended by laparoscopy. On follow-up ranging 6-12 months, all testes maintained good size and a proper position. Conclusions The laparoscopic approach may be a safe way to descend the inguinal palpable testes. Orchiopexy of palpable undescended testes can be done with advantages in the laparoscopic approach.

Co-processed excipients withgelatinized or non-gelatinized starch were prepared by spray drying. Powder and tablet properties of corocessed excipients prepared were compared with those of physical mixtures and spray-dried lactose. Their applicability in traditional Chinese medicine (TCM) powder tableting was tested on two TCM extracts, i.e., the gardenia extract and the Herba Sedi extract. It was shown that gelatinizing starch before co-spray drying with lactose could improve the performance and efficiency of starch as a binder, resulting in remarkable improvement in physicomechanical properties of co-processed excipients prepared. Conpared to self-made and commercially available spray-dried lactose, co-processed excipients achieved better compactability and higher drug loading for TCM extracts. In conclusion, the lactose-gelatinized starch co-processed excipient, with excellent physicomechanical properties, is promising to be explored as a new excipient for direct tableting.
Excipients ; chemistry ; Lactose ; chemistry ; Medicine, Chinese Traditional ; methods ; Powders ; chemistry ; Starch ; chemistry ; Tablets ; chemistry

Adult ; Cutis Laxa ; complications ; diagnosis ; Emphysema ; diagnosis ; etiology ; Female ; Humans ; Male ; Middle Aged

Objective To assess the clinical outcomes of glutamine supplementation in neonates.Methods The study was designed as a double-blind randomized controlled trial.Totally 100 infants were randomly divided into 5 groups with 20 infants in each group:control group:standard parenteral nutrition (PN);PNI group:PN supplemented with 0.3 g/ (kg·d) glutamine;enteral nutrition (EN) 1 group:EN supplemented with 0.3 g/ (kg·d) glutamine;PN2 group:PN supplemented with 0.3 g/ (kg·d) glutamine;and EN2 group:EN supplemented with 0.3 g/ (kg·d) glutamine,The primary endpoints were the time to establish full enteral nutrition [defined as receiving 120 ml/ (kg·d) enterally],episodes of gastric residuals,total duration of PN,and mortality.The second endpoints were weight gain and head circumference gain,liver function,renal function,days on ventilator,and length of hospitalization.Results Time to achieve full enteral nutrition,incidence of gastric residuals,duration of PN,weight gain (g/d) ,head circumference gain (cm/w),liver function,renal function,and length of hospitalization were not significantly different among all five groups.Days of mechanical ventilation were significantly decreased in PN1 group and PN2 group when compared with the control group (P ＜ 0.05).Intention-totreat analyses showed that,when compared with the control group,PN1 group:RR:1.053;95% CI:0.952-1.164;ENI group:RR:1.333,95% CI:1.035-1.717;PN2 group:RR:1.053,95% CI:0.952-1.164;EN2 group:RR:1.25,95% CI:1.004-1.556.Conclusions Glutamine supplementation may not be able to decrease the time to achieve full enteral nutrition,the incidence of gastric residuals,and the duration of PN.However,pareneral glutamine supplementation does reduce the days on ventilator in neonates.Also,parenteral glutamine supplementation has no obvious influence on mortality.

Objective To compare the computed orthopantomography(COPT)with Sh?ller radiography(SR),film orthopantomography(FOPT)and other traditional radiographic techniques in the radiography of temporomandibular joint(TMJ).Methods Ninty-eight cases were randomly divided into 3 groups,and the open and close positions of TMJs of both sides were examined with SR,FOPT,and COPT, respectively.The satisfactory rates of the X-ray pictures were statistically analyzed with Pearson chi-square in SPSS10.0,and the satisfactory rates were analyzed with q test between the groups.Results One hundred and forty-four of the open and close positions of 144 TMJ pictures of the COPT group,128 of 128 of the FOPT group,and 6 of 120 of the SR group were satisfactory in the mandible ramus of the TMJ,with satisfactory rate being 100%,100%,and 5%,respectively(P0.01),respectively between FOPT and COPT groups.The difference was not statistically significant.The exposure was as follows:COPT,99—113 mAs;FOPT,210—225 mAs;and SR,48—75 mAs.Therefore,COPT and FOPT were superior to SR in the pictures of the mandible ramus,coronoid process,and incisure,but inferior in the joint space pictures.The satisfactory rates of the condylar process and articular tubercle were same in the 3 groups.The exposure of the FOPT group was greater than that of the COPT and SR groups.Conclusion COPT is superior to SR and FOPT in TMJ radiography,and should be applied widely in the clinic.