Objective: To summarize our clinical experience on treating bladder transitional cell carcinoma with orthotopic ileal neobladder after radical cystectomy and to report the long-term follow-up results. Methods: From Jan. 1988 to Dec. 2006, 61 patients (49 male and 12 female) with a mean age of 64.0±5.6 years (range 54 to 78) were subjected to orthotopic ileal neobladder construction after cystectomy. The entire length of ileum was opened along the antimesenteric border, placed into a transverse "U" shape, and sutured with a running suture. The lateral borders of the "U" shape bottom were used to surround the urethra and were sutured with the interrupted suture from "inside" the neobladder for the ileourethral anastomosis. The ureters were implanted from inside the neobladder through a-small incision into the ileum at a convenient site, and were embedded in a mucosal sulcus. The perioperation mortality, complications, urinary continence, renal function, image findings, and urodynamic examination were all retrospectively evaluated. Results: One patient (1.6%) died during perioperation period and all the others were followed up for 12-168 months. Totally 13 patients (21.3%) died during follow-up. The complications included renal inadequacy (11 patients), ureteroileal obstruction (9 patients), ureteral reflux (6 patients), urine leakage (5 patients), bleeding (4 patients), incisional hernia (4 patients), urethral stricture (3 patients), and urethral recurrence (1 patient). After 60 months follow-up, 42 patients had a satisfactory urinary continence. Conclusion: After long-term follow-up, we conclude that the ileal neobladder is a satisfactory method for treatment of invasive bladder cancer after radical cystectomy; it has less complication and is clinically valuable.

Animals ; Disease Models, Animal ; Facial Nerve Injuries ; etiology ; Female ; Male ; Rabbits

Objective Differentiation of breast fibroadenoma from breast cancer is of great importance. The purpose of the ar-ticle was to evaluate the diagnostic efficacy of magnetic resonance imaging(MRI) in the differentiation of breast fibroadenoma from breast cancer in DCE-TIC ( dynamic contrast enchancement-time intensity curve) platform type ( typeⅡ) . Methods Between March 2014 and May 2016, 64 patients were included in our study, 19 patients with breast fibroadenoma and 45 patients with breast cancer. All the patients underwent DCE-MRI ( dynamic contrast-enhanced magnetic resonance imaging) examination before operation. Morpho-logic characteristics, hemodynamic characteristics, EER ( early enhancement rate) and ADC ( apparent diffusion coefficient) values were calculated and statistically compared. Results Among 19 cases of breast fibroadenoma, 9 cases were round or ovoid, 8 cases are lobulated, 2 cases were irregular, 15 cases with clear boundary, 14 cases in mammary gland vascular enlargement, 2 cases of slowinflows, 4 cases of moderate inflows, 13 cases of rapid inflows, and the average ADC value was ( 1. 47 ± 0. 38) × 10-3 mm2/s. Low signal separation present in 11 lesions of fibroadenoma. Among the 45 cases of breast cancer, 17 cases were round or ovoid, 7 cases were lobulat-ed, 21 cases were irregular, 11 cases with clear boundary, 38 cases of mammary gland vascular enlargement, 1 case of slow inflows, 5 ca-ses of moderate inflows, 39 cases of rapid inflows, and the averageADC values was (0.98±0.40)×10-3mm2/s. The shape, (χ2=9.176), margin (χ2=16.452), EER(χ2=18.489) and ADC between breast fibroadenoma and breast cancer were of significantly difference. No significant difference was found in the increased and enlarged blood vessels. The success of ADC values in differentation of breast fibroadenoma from breast cancer was statistically significant( P<0.001), and the area under the curve(AUC)of the ROC, sensitivity and specificity of VE were 94.7% and 71.1%. Conclusion Breast fibroadenoma are in fast inflows in the early phase on the DCE-MRI, and there are differences in morphologic characteristics and mass enhancement ways between patients with breast fibroadenoma and breast cancer. Morphologic characteristics combined with inter-nal low signal separation contribute to the differentiation of breast fibroadenoma from breast cancer.

Objective To evaluate the differential diagnostic value of dynamic contrast enhanced magnetic resonance imaging(DCE-MRI) and diffusion weighted imaging(DWI) in adenosis of the breast and breast cancer.Methods 30 cases of adenosis and 45 cases of breast cancer with pathological verification were scanned with DCE-MRI and DWI.The MRI features of the lesions were analyzed, including shape,margin,T2WI singal, features of enhancement, time intensity curve(TIC) type, early enhancement rate(EER),peak time, background enhancement and ADC value.Results The irregular margin with or without spiculation and the heterogeneous enhancement were mostly seen in breast cancer (P=0.002,P=0.009, respectively).The TIC type Ⅲ, EER larger than 100% and peak time within 2 minutes were mostly seen in breast cancer(P<0.001).The ADC of breast cancer and adenosis were (1.03±0.24)×10-3mm2/s and (1.34±0.30)×10-3mm2/s respectively(P<0.001).The features of shape,T2WI singal and background enhancement had no statistical significance between adenosis and cancer(P>0.05).Conclusion DCE-MRI combined with DWI will be helpful to the diagnosis of breast lesions.

Objective　To evaluate the safety and primary outcomes of transumbilical laparoendoscopic single-site radical nephrectomy (LESS-RN) by using home-made single-port device.　Methods From July 2010 to November 2011,we had performed transumbilical LESS-RN on eleven renal cell carcinoma patients by using the home-made single-port device.There were 5 males and 6 females in this group.The mean age was 49 (37 -68) years and mean body mass index was 24.2 (18.4 -30.4) kg/m2.Ultrasound and CT scan revealed 11 renal tumors (7 on left and 4 on right),with 3 on the upper pole,4 in the middle and 4 in the lower pole.There were 2 cases with suspicious lymph node metastasis and one case with renal cyst.There was no distant metastasis.The intracorporal procedure was similar to conventional laparoscopic radical nephrectomy.　Results　Except two cases converted to conventional laparoscopic RN and one case converted to hand-assisted laparoscopic RN,the other procedures were completed successfully without open conversion.The mean operative time was 225 min (155 -297 min) and mean estimated blood loss was 271 ml (50 -900 ml).Postoperative results showed that all cases were renal cell carcinoma and there were 3 cases in T1a,5 cases in T1b and 3 cases in T2a.The mean visual analog pain scale (VAPS) was 4 (3 -6),and mean hospital stay was 10 d (5 -15 d).With the mean follow-up of 17 months (8 -24 months),all patients were alive with no evidence of local recurrence or metastasis.Patients were satisfied with the cosmetic results of the wound recovery.　Conclusions　Transumbilical LESS-RN using home-made single-port device is a safe approach in selected patients and has excellent cosmetic results. Primary oncologic outcomes are good.However,we will still need large clinic trials to further evaluate the efficacy and safety of LESSRN.

OBJECTIVE: To analyze the case characteristics of poisoning by exhaust gas of the imperfect combustion of natural gas and provide references for forensic identification and prevention of such accidents. METHODS: Twenty-two cases of poisoning by exhaust gas of the imperfect combustion of natural gas in Minhang District during 2004 to 2013 were collected. Some aspects such as general conditions of deaths, incidence time, weather, field investigation, and autopsy were retrospectively analyzed. RESULTS: In the 22 cases, there were 15 males and 16 females. The age range was between 2 and 82 years old. The major occurring time was in January or February (8 cases in each) and the cases almost occurred in small area room (21 cases). There was wide crack next to the exhaust port when the gas water heater was been used in all cases. CONCLUSION There are more prone to occurrence of exhaust gas poisoning of imperfect combustion of natural gas in small area room with a ventilation window near the exhaust port of gas water heated. It shows that the scene of combustion exhaust gas poisoning should be more concerned in the cold season.
Accident Prevention ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Autopsy ; Carbon Monoxide Poisoning/prevention & control* ; Child ; Child, Preschool ; Death ; Female ; Humans ; Male ; Middle Aged ; Natural Gas/poisoning* ; Retrospective Studies ; Young Adult

Factor Analysis, Statistical ; Health Policy ; Leadership ; Occupational Health Services ; organization & administration

Accidents, Occupational ; Humans ; Work Schedule Tolerance

Pseudomonas aeruginosa is one of the most common causes of nosocomial infection due to its intrinsic resistance to antibiotics. In the host,glutathione(GSH) ,one of the most important intracellular antioxidants,provides protection against high levels of oxidative stress. A decrease in GSH levels in tissues infected with P. aeruginosa has been observed while interactions between pyocyanin and GSH maybe partially attribute to P. aeruginosa infection. In this review,the relationship between GSH and the pathogenicity of P. aeruginosa has been discussed based on the author's own research results and the latest literature.

According to the requirement of simulated actual combat,based on the traditional contents of sanitary reconnaissance of water source,this paper introduced some practical knowledge and skills in drinking water under emergency,including water source search,utilization,drinking principles and some measures to reduce the loss of body water.These practices enriched and consum- mated the subject of sanitary reconnaissance of water source.