Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Mining ; Noninvasive Ventilation ; Pneumoconiosis ; rehabilitation ; Treatment Outcome

Objective To summarize the pathological and imaging features and treatment of retroperitoneal bronchogenic cyst.Methods The clinical data of 2 cases treated from October 2001 to November 2009 were summarized.The first patient was a 55-year-old woman with the chief complaint of lumbago in the left flank for 10 d.B-ultrasound showed mixed solid and cystic mass in spleen space with a diameter of 3.9 cm with thin wall and without rich blood supply.CT showed the lesion in the left adrenal gland region measured about 4 cm ×4 cm with low density with CT value of 10 HU,and enhanced scan was not obvious with CT value of 20 HU.It was diagnosed as left adrenal tumor and tumor resection was performed.The second case was a 17-year-old young man with the chief complaint of gross hematuria for 3 weeks after strenuous exercise.Ultrasonography found a 8.4 cm × 7.7 cm × 9.0 cm anechoic area surrounding the bladder.CT showed about 9.0 cm × 7.2 cm × 9.0 cm cystic lesion with thin wall,and the center density was uniformity in presacral space with CT value of8 HU.IVU showed visible semi-circular lower edge on the right edge of the bladder.The patient was diagnosed of presacral cyst and cystectomy was performed successfully.Results The pathology report of the first case:organizing wall with fibrous connective tissue,with most of the lining overlying pseudostratified ciliated columnar epithelium,goblet cells and subepithelial basement membrane.Pathological diagnosis was bronchogenic cyst,and the patient was followed up for 9 months without recurrence.The pathology report of the second case:pathological tissue fibers false wall tissue lining ciliated columnar epithelium,goblet cells seen in epithelium,fibrous tissue in the visible structure of mixed glands,a small amount of cartilage and muscle tissue.The diagnosis was bronchogenic cyst,and the patient was followed up for 2 years without recurrence.Conclusions Retroperitoneal bronchogenic cyst is rare and easily misdiagnosed.Radiology imaging can identify cystic features,while a few may be with high density without specificity.Surgical removal of retroperitoneal bronchogenic cyst with symptoms has good prognosis and may prevent malignant transformation and secondary infection.

Objective To observe the curative effect and adverse reactions of intercostals nerve block combined with fentanyl transdermal system in treatment of post-thoracotomy pain syndrome (PTPS). Methods Intercostals nerve block combined with fentanyl transdermal system was used for treatment of 141 patients with PIPS. The degree of pain relief was evaluated by numerical rating scale (NRS),the quality of life of patients was evaluated by the quality of life score standard,and the adverse reactions were also observed. Results The overall remission rate was 97.85%,there were 51 cases (36.43%)with complete remission, 80 cases (57.14%)with significant remission,and 6 cases (42.85%) with moderate remission. The adverse reactions included nausea,vomiting, constipation,dizziness,skin pruritus and dysuria,no serious liver and kidney function damage and respiratory inhibition. The quality of life of all patients was improved. Conclusion Multimodal analgesia has better curative effect and less adverse reactions in treatment of PTPS,so it deserves clinical promotion.

Objective To investigate whether apolipoprotein E (ApoE) genotypes is associated with postoperative delirium in aged noncardiac surgical patients. Methods Two hundreds and twelve inpatients over 65y, undergoing selective noncardiac surgeries were enrolled in the study. The patients were frequently interviewed and evaluated prospectively for delirium with the Confusion Assessment Method (CAM) during the first three postoperative days. APOE genotype was determined using multiplex amplification refractory mutation system pelymerase chain reaction (multi-ARMS PCR) technique. Results Delirium occurred in 45 patients during the first three postoperative days. Of the 212 patients, 18 (8.5%) possessed one or two ApoE 84 allele. There was no significant difference between delirious patients and non-delirious patients(6.7% : 9.0%, P >0.05) in the presence of ApoE ε4 allele. In all four ApoE ε4/4 homozygote patients, one female patient presented a transient delirium status three days be-fore surgery, another male patient presented serious fluctuated delirium symptoms from the second to 17th days after operation. Conclusion The presence of ApoE ε4 allele seems not a predictator of postoperative delirium. ApoE ε4/4 homozygote patients may be more indulgent to delirium than others.

ObjectiveTo discuss the characters and management of renal lymphangiectasia.MethodsThe clinical data of two cases of renal lymphangiectasia were reviewed. The first patient was a 37-year-old woman with the chief complaint of lumbago in the right flank for 8 days.B-ultrasound showed mixed echo in perinephric space. On CT, similar appearances of fluid collections were seen, but not conspicuous. Conservative treatment was taken for three weeks and the symptoms were relieved. Three month later the patient had right lumbago relapse. CT scan revealed a large amount of fluid collection under the capsule of the right kidney. Percutaneous drainage was carried out. Two months later B-ultrasound showed fluid collection in perinephric space and percutaneous drainage again the fluid was sent to pathology. The second case was a 32-year-old woman with the chief complaint of lumbago in the left flank for the past three years. Ultrasonography revealed hyperechoic surrounding the left kidney. CT scan showed a left perinephric collection of fluid attenuation and circumferentially draping around the kidney. Renal lymphangioma was diagnosed and the patient underwent surgery.ResultsNeedle aspiration of the perinephric fluid was carried out, and laboratory analysis showed most leucocytes were lymphocytes. The pathologic diagnosis of the first case was renal lymphangiectasia. There was no recurrence during follow - up of two months. The second case was diagnosed renal lymphangioma pathologically. Follow - up for nine years, revealed no relapse.ConclusionsUltrasonography and CT contributed to the diagnosis of renal lymphangiectasia. Needle aspiration bioposy and histology could confirm it. Treatment of asymptomatic cases is not required. When collections are very large and cause symptoms, percutaneous drainage may be carried out however there is a risk of relapse.

Objective To investigate the clinical features,diagnosis and treatment experience of idiopathic calcinosis of the scrotum(ICS).Methods We report 5 cases with a 4-month to 20-year history of ICS.The related literatures were reviewed.Results The multiple scrotum masses in these patients were increased slowly in size and number.The levels of blood calcium and phosphorus were normal.Histopathologically,nodules were composed of basophilic calcified material and located in the dermis.There was no epithelial lining around the calcified nodules.Conclusion ICS is a rare localized benign disease.The diagnosis of the tumor relies largely on the histopathology.Surgical excision is the best choice for treatment.

Objective To investigate the effectiveness of three-drug (Relingqing, Prostant and Antibiotic) therapy to chronic prostatitis. Methods One hundred and twenty patients were randomly divided into 2 groups: three-drug treatment group (n=80) and antibiotic only group (n=40). After treated for 12 weeks, 120 cases of chronic prostatitis were evaluated with the pre- and post-massage test (PPMT) and chronic prostatitis symptom index (CPSI). Results In three-drug treatment group, 15 patients in 21 patients of type Ⅱ and 41 patients in 59 patients of type ⅢA were normal evaluated by PPMT. From the results of CPSI, the cure rate was 13.8% (11 cases), the symptoms of 48 patients (60.0%) were improved significantly whose CPSI decreased more than 15, and only 16 patients(20.0%)felt a little better whose CPSI decreased from 5 to 15, and the symptoms of 5 patients were not improved. There was statistical difference among three-drug treatment group and antibiotic only group. Conclusion The three-drug treatment is more effective in treating chronic prostatitis than the therapy of antibiotic only.

Onset with fever and back pain, an 81-year-old man had sudden oliguria and progressively elevated serum creatine from normal range to 660 μmol/L within 1 week after receiving contrast agents, various antibiotics, and several nonsteroidal anti-inflammation drugs. Urine output recovered after supportive treatment. However, his serum creatinine level rose again soon after a temporary decline accompanied by gross hematuria with almost normal morphology, nephrotic proteinuria, and hypoalbuminemia. Renal biopsy revealed necrotizing glomerulonephritis. Methylprednisolone was intravenously administrated 500 mg per day for 3 days, followed by oral glucocorticoids and cyclophosphamide. Gradually the patient′s serum creatinine descended to 144 μmol/L.

Objective To evaluate the CT and MRI characteristics of Primary Central Nervous System Lymphoma(PCNSL)in immunocompetent patients,and enhance its diagnosis level.Methods CT and MRI data of 20 patients with PCNSL confirmed by histo-pathology were analyzed retrospectively.MRI scans were performed with and without Gadolinium contrast.Two of them had contrast-enhanced CT scan;six had CT scan without contrast administration;1 had CT scan with both non-contrast and contrast enhancement.Re- suits Totally,38 lesions were found in all patients:14 lesions of them were single and 24 lesions were found in 6 patients.Generally,the lesions were located in the surface and/or midline of the brain.The signal features and density were similar to meningioma,and strongly enhancing after contrast administration.Thirty-six of the 38 lesions had spicular sign peripheral to the lesion.Conclusion Although the manifestations of the PCNSL are variety,there are still many characteristics in the medical imaging,especially in the locations,the signal features,and spicular sign in the edge of the lesions after contrast material injection.

Objective To analyze common postoperative complications after autologous liver transplantation in patients diagnosed with hepatic alveolar echinococcosis (HAE)from plateau area. Methods Clinical data of 6 patients with advanced HAE undergoing ex-situ or partially ex-situ hepatectomy combined with autologous liver transplantation were retrospectively analyzed. Clinical characteristics of postoperative complications were analyzed. Results Postoperative complications mainly included biliary tract complications (n=4),intra-abdominal hemorrhage (n=1 ),infection (n=3). Two cases presented with bile leakage complicated with intra-abdominal infection and died from infectious shock and multiple organ dysfunction syndrome. One patient had intra-abdominal hemorrhage and died from hemorrhagic shock and disseminated inravascular coagulation. Biliary tract complication and intra-abdominal hemorrhage were primary causes of mortality. Conclusions Biliary tract complication,intra-abdominal hemorrhage and infection are the main prognostic factors for HAE patients undergoing autologous liver transplantation.