Objective:To evaluate the safety,feasibility and long-term result of stent placement for vertebral artery (VA) stenosis of outer cranial segment. Methods:40 patients with vertebral artery of outer cranial segment stenosis were treated with stenting. Results:Carotid artery stents were placed in 4 patients and both side vertebral artery stents were placed in 2 patients simultaneously. 46 stents were used in total. The achievement ratio of operation was 100%. During the further follow up period of average 18 months,6 patients accepted recheck of DSA,2 of whom developed restenosis.The stenosis ratios were 10% and 15% respectively. None develop posterior circulation ischemia. Conclusion:Stent placement for treatment of atherosclerotic stenosis of vertebral artery of outer cranial segment is technically feasible and effective,which could be the choice of secondary prevention for cerebrovascular disease.

Antigens, CD34 ; metabolism ; Cysts ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; metabolism ; pathology ; Humans ; Hysterectomy ; methods ; Leiomyomatosis ; metabolism ; pathology ; surgery ; Mesothelioma, Cystic ; metabolism ; pathology ; Middle Aged ; Pelvic Neoplasms ; metabolism ; pathology ; surgery ; Solitary Fibrous Tumors ; metabolism ; pathology ; surgery ; Uterine Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

With the improvement of clinical and scientific research level of pediatric retinal diseases in China,teaching in pediatric retinal diseases for medical students and residents has become increasingly important.Because infants cannot cooperate in ophthalmic examinations,this part becomes a difficult point in clinical teaching and practice.By using the RetCam,a wide-field retinal imaging system,infant's retinal images can display in real time on screen and images and videos can be recorded and reviewed after examination finished.By setting up teaching target reasonably,arranging teaching contents scientifically,and using teaching method properly,we applied multimedia-assisted instruction in teaching pediatric retinal diseases based on RetCam and enhanced teaching effect.

Animals ; Dose-Response Relationship, Drug ; Female ; Humans ; Metals, Heavy ; analysis ; pharmacology ; Placenta ; chemistry ; drug effects ; physiology ; Pregnancy ; Rats

Objective To evaluate the efficacy of α2 adrenergic agonists for the prevention of postoperative adverse cardiac events in patients with coronary disease.Methods MEDLINE,EMBASE,CINHAL,Web of Science,CBM and CNKI were searched to identify all randomized controlled trials on the efficacy of α2 adrenergic agonists for the prevention of postoperative cardiac complications following operation performed under general anesthesia in patients with coronary artery disease.The incidence of myocardial ischemia,myocardial infarction,bradycardia and hypotension were evaluated.Meta-analysis was conducted using the RevMan 5.1 software.Results Fifteen trials included 9 high-quality trials,4 medium-quality trials and 2 low-quality trials.A total of 3422 patients were included in this meta-analysis.1790 patients received α2 adrenergic agonists (clonidine and dexmedetomidine) and 1632 patients received placebo; 724 patients underwent non-cardiac surgery and 2698 patients underwent cardiac surgery.Meta-analysis indicated that α2 adrenergic agonists reduced incidence of myocardial infarction following non-cardiac surgery and myocardial ischemia following non-cardiac surgery and cardiac surgery.Alpha-2 adrenergic agonists significantly increased the incidence of postoperative bradycardia.Conclusion Alpha-2 adrenergic agonists can decrease postoperative cardiac adverse events in patients with coronary disease,but can induce bradycardia,and the efficacy of clonidine is consistent with that of dexmedetomidine.

Objective To discuss the clinical value of transluminal endoscopic surgery (TUES), and to find a simple and safe no-scar surgical approach. Methods A total of 13 cases of TUES, including 1 case of hepatic abscess fenestration, 1 abdominal exploration, 5 appendicectomy, and 6 cholecystectomy, were carried out in our hospital. Among the cases, 3 were accomplished using upper-digestive endoscopy, and 10 were performed using triple-channel catheter technique by modified instruments.Results All the operations were completed successfully without conversion to routine laparoscopic surgery or open surgery. The operation time was 90-150 min in the 6 cases of cholecystectomy, 15-40 min in the 5 cases of appendectomy, 90 min in the hepatic abscess fenestration, and 50 min in the abdominal exploration. The abdominal exploration showed peritoneal abrasion around the bladder, and the hemorrhage was controlled by electric coagulation. No complications including hemorrhage and biliary fistula occurred in this series. No abdominal scar was found after the operation except in the skinfolds around the hilum. Conclusions The TUES is a simple, safe, and feasible technique. Since the TUES for cholecystectomy is difficult, the patients should be selected carefully.

Objective To investigate the feasibility of "non-scar" total laparoscopic cholecystectomy trough the transumbilical approach by using modified instruments.Methods Trocars(5 and 3 mm in diameter respectively)without the proximal seal system on the sleeves were designed for this procedure.The maximum diameters of the trocars were reduced to 8 and 5 mm respectively.The instruments used in this study were 5 cm longer than commercially available instruments.10 cases of total laparoscopic cholecystectomy were performed by using the tools.Results All the gallbladders were removed successfully without massive bleeding during dissection.A mini port was placed on the right upper abdomen to assist retraction in one case because of technical difficulty.The mean operation time was(62?25)minutes(range,45 to 110 minutes)in this series.No intra-and postoperative complications occurred.All the patients were satisfied with the abdominal cosmetic results.They were discharged in 48 hours after the operation,and then back to work in a week.Follow-up was available in the patients for 1 to 5 months.None of them showed complication or recurrence during the period.Conclusions The interference between trocars and surgical instruments can be partially avoided by using the modified tools."Non-scar" total laparoscopic cholecystectomy is feasible by using the technique.

Objective To investigate the diagnosis and treatment for biliary papillomatosis. Methods 23 patients who were pathologically diagnosed as biliary papillomatosis and treated in our hospital from Jan. 2003 to Mar. 2008 were enrolled in this study. Their ages, genders, clinical manifestations, diagnostic approaches,histopathological findings, intraoperative findings, treatments and prognosis were analyzed retrospectively. Recal manifestations were abdominal pain (83.3%) and obstructive jaundice (72.2%). All the patients were diagnosed pathologically through intraoperative frozen section. No patient was diagnosed preoperatively. Anatomically, solitary lesion was observed in 10 patients (43.5%) and multiple lesions in 13 patients (56.5%), with a median tumor size of 2.6 cm. Microscopically, carcinomatous change was found in one patient, mild atypical hyperplasia in three, and medium atypical hyperplasia in one. Therapies mainly included radical excision and palliative external drainage. All but one patient recovered well postoperatively. This patient had anastomotic leak. All 23 patients were followed up with a mean period of 34 months. During the follow-up, three patients died as a consequence of biliary malignancy, one patient had the recurrence and others without recurrence. Conclusions Biliary papillomatosis is very difficult to diagnose preoperatively and the definitive diagnosis mainly depends on intraoperative and postoperative pathologic examination. To obtain a better prognosis, management should be aimed at radical excision. Intraoperative cholangioscopic evaluation and frozen section are strongly recommended to guide the choice of appropriate therapeutic approach.

Cardiovascular Diseases ; Humans ; Magnetic Resonance Spectroscopy

To study the clinical characteristics and surgical treatment of congenital scoliosis with diastematomyelia, four patients were found to have scoliosis with diastematomyelia by CT and MRI.The first step of surgery was to excise the osteal compartion in spinal cord, the second step was the posterior scoliosis correction and fusion after two weeks. All the patients had successful surgery. The body height of the patients increased 4 75cm and the Cobb angle deceased 43? in average. No complication was found in the nervous system. This method is very effective, and is worth popularizing its application.