Humans ; Neck Dissection ; methods

Objective To analyse the characteristics of fundus fluorescein angiography(FFA)of iatrogenic retinal vascular occlu- sion.Design Retrospective case series.Participants 9 eyes of 9 patients with iatrogenic retinal vascular occlusion and 16 eyes of 16 patients with non-iatrogenic retinal vascular occlusion in Beijing Tongren Hospital in 2002-2005.Methods All patients were examined with FFA.The difference of circulation time of retinal vessels both in iatrogenic and non-iatrogenic retinal vascular occlusion patients was compared.Main Outcome Measures The starting perfusion time and the finishing time of retinal artery or vein.Results In pa- tients with iatrogenic(4 cases)and non-iatrogenic(12 cases)central retinal artery occlusion,the finishing perfusion time was separately 79.33?87.04s and 19.20?4.61s; the finishing time of retinal vein was separately 128.07?149.11s and 33.16?15.34s.In iatrogenic(4 cas- es)and non-iatrogenic(4 cases)central retinal artery together with central retinal vein occlusion patients,the finishing perfusion time of retinal artery was separately 211.67?371.26s and 30.07?17.26s;the finishing perfusion time of retinal vein was 232.43?358.52s and 48. 81?11.64s.One patient was ocular artery occlusion.FFA showed that choroidal background fluorescence and central artery were perfused slowly,the vascular fluorescence perfusion was interrupted before it came out of optic disk and the perfusion interruption continued until late stage with extensive peripheral non-perfusion areas.Conclusion The perfusion time of the retinal artery and vein in iatrogenic reti- nal vascular occlusion may be much longer than that in non-iatrogenic retinal vascular occlusion.

With increasing demands and recognition, emergency medicine has advanced rapidly in China in recent decades. The education and training of professionals in this field are important for the further development of emergency medicine. With an attempt to investigate the way to strengthen residency training system in emergency medicine, this article reviews its potential development direction, training modes, learning materials, and quality control.
China ; Emergency Medicine ; education ; organization & administration ; Internship and Residency ; methods ; standards ; trends

Objective To investigate the effect of the percutaneous autologous bone marrow stem cell transplantation for the treatment of nonunion of tibial fracture. Methods From 2007 to 2011,the data of 11 patients with tibial nonunion who received autologous bone marrow stem cell transplantation was analyzed retrospectively. Taking bone marrow,examine,isolation,cultivation and expansion marrow mesenchymal stem cells( MSCs) ,and then marrow needle was inserted into the site of the nonunion under the X-ray,the MSCs were injected into the site of nonunion. Compression bandage was applied after operation. X-rays following-up were reviewed. Results All 11 patients were followed up from 4~27 months,with average of 13 months,X-ray showed:fracture healed well,no adverse events happen. Conclusion Satisfactory out-come can be obtained by percutaneous autologous bone marrow stem cell transplantation in treatment of tibial nonunion. Clinical application value is high,especially to patients who had suffered from severe skin and soft tissue injury with keloids healed.

Objective To study the relationship between insulin induced gene 2 (INSIG2) variant and obesity or lipid metabolism in Chinese children and adolescents. Methods A total number of 2030 school students at the age from 7 to 18 years were selected in Beijing. Physical indicators, serum lipids and the rs13428113 polymorphism in INSIG2 gene were examined for all the subjects. Results The overall mutation rate of the rs13428113 polymorphism (T>C) was 49.3%.The differences of genotype and allele frequencies were not statistically significant among normal-weight, overweight and obesity groups (P>0.05). Among the overweight students, those with CC genotype had higher body mass index, waist-hip ratio, bronchial triceps skin-fold, and anterior superior lilac spine skin-fold than TT/TC carriers. Among the obese group, those with CC genotype had higher total cholesterol level than TT/TC careers (P<0.05). Conclusion The rs13428113 polymorphism in INSIG2 gene was associated with abnormal lipid metabolism in overweight and obese children, which increasing the degree of obesity and abnormal serum lipids.

Objective: To observe the clinical efficacy of DZWJY-1 type electronic moxibustion apparatus and traditional moxibustion in treating knee osteoarthritis (KOA). Methods: A total of 76 eligible patients were randomized into an electronic moxibustion apparatus group and a traditional moxibustion group, with 38 cases in each group. The electronic moxibustion apparatus group was intervened by DZWJY-1 type electronic moxibustion apparatus, and the traditional moxibustion group received moxa stick moxibustion for treatment. Neixiyan (EX-LE 4), Dubi (ST 35), Xuehai (SP 10) and Liangqiu (ST 34) were selected for both groups and the treatment was conducted 3 times a week for a total of 12 times. The visual analog scale (VAS) and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores were observed before treatment and after 6 and 12 sessions of treatment, respectively. Results: There were 4 dropout cases in the traditional moxibustion group. Therefore, this trial had 72 valid cases, including 38 cases in the electronic moxibustion apparatus group and 34 cases in the traditional moxibustion group, the differences in the baseline data between the two groups were statistically insignificant (P>0.05). After 6 and 12 sessions of treatment, the VAS scores decreased significantly with the increase of treatment sessions in both groups (all P<0.01), and the betweengroup differences were statistically insignificant at the same time points (both P>0.05). The pain intensity was evaluated using the weighted value of VAS score. The markedly effective rate was 47.4％ and the total effective rate was 89.5％ in the electronic moxibustion apparatus group, versus 50.0％ and 94.1％ in the traditional moxibustion group, and the betweengroup differences were statistically insignificant (both P>0.05). After 6 and 12 sessions of treatment, the total score and the component scores including pain, stiffness and difficulty moving in the WOMAC decreased significantly with the increase of treatment sessions in both groups (all P<0.01), and the between-group differences were statistically insignificant (all P>0.05). Conclusion: Electronic moxibustion apparatus and traditional moxibustion both are effective in reducing joint pain and improving joint function in KOA patients, and they are equivalent comparing the clinical efficacy.

Objective To evaluate the significance of CT assessment for extraarticular anatomy in treatment of displaced intraarticular calcaneal fractures.Methods(1)Measurement of normal calcaneum 40 pieces of adult calcaneum specimen were measured,items of measurement included height of culmination of posterior facet and tuberosity,width of posterior edge of sustentaculum and tuberosity.(2)CT measurement of calcaneum.Transverse(axial)and coronal CT scanning were obtained from 20 feet with displaced intraarticular calcaneal and 20 normal feet as control.Following items were measured in CT scanning:the height of culmination of posterior facet and tuberosity,the coronal talocalcaneal angle,in coronal scanning,the width of posterior edge of sustentaculum and tuberosity,the axial calcaneocuboid angle,in axial scanning.Results(1)Measurement of height of calcaneum height of culmination of posterior facet and tuberosity of calcaneal specimen were(43.07?2.85)mm and(44.69?3.67)mm respectively,and these two items from CT scanning of normal feet were(42.84?1.66)mm,(43.40? 3.01)nun,and from CT scanning of feet with calcaneal fractures were(34.76?3.24)mm,(40.41? 3.69)mm.There was a statistically significant different between these two items for normal calcaneal specimen and for CT scanning of feet with ealcaneal fractures(P

Along with the wide application of cadaveric donor kidney transplantation (CDKT), most transplantation centers face the shortage of cadaveric donors. Living donor kidney transplantation (LDKT) has been successfully applied with remarkable advantages over CDKT. Human leukocyte antigen matching generally is not an important problem in non-related LDKT. Even with 6-locus mismatch, the effectiveness of LDKT is still superior to non-mismatch CDKT. Although LDKT donor has extremely low mortality and incidence of complications, the safety of LDKT donor is becoming a research highlight. In addition, many social problems are involved in LDKT, which should be deliberately considered during clinical practice.
Adolescent ; Adult ; Aged ; Graft Survival ; immunology ; Humans ; Kidney Transplantation ; adverse effects ; ethics ; methods ; psychology ; Living Donors ; Middle Aged ; Young Adult

One of the challenges in andrology nowadays is the diagnosis and treatment of external genital abnormalities and defects along with the consequent voiding, sexual, and reproductive dysfunctions, for which no guidelines are yet available. Hitherto, surgical repair and reconstruction are efficient for these diseases. The key to these operations is to individualize surgical strategies according to the specific local lesion and dysfunction, usually involving flap and graft techniques. This article presents our experience in the surgical treatment of penile and scrotal abnormalities and defects with urological and andrological techniques and microsurgical strategies, focusing on the external repair and functional reconstruction. Satisfactory treatment outcomes pivot on a precise evaluation of the disease, a rational design of surgical procedures, and an earnest communication with the patient. Some cases are rather complicated and challenging, usually with complications, and therefore deserve further researches for more effective treatment strategies in clinical practice.
Andrology ; Genitalia, Male ; abnormalities ; surgery ; Humans ; Male ; Penis ; abnormalities ; surgery ; Reconstructive Surgical Procedures ; methods ; Scrotum ; abnormalities ; surgery ; Surgical Flaps ; Treatment Outcome

Objective To study the diagnosis and surgical treatment of adrenal cavernous hemangi -oma. Methods The data of one case with adrenal cavernous hemangioma was retrospectively reviewed .A 62-year-old female patient admitted in out hospital on 18th June, 2013 due to the paroxysmal hypertension for 10 years and finding the left adrenal mass for 2 months.Her highest blood pressure was 175/55 mmHg and the response for the drug treatment was poor .In recent 6 months, her blood pressure was unstable .Ab-dominal ultrasound showed a hypoechoic mass in left adrenal .Enhanced CT examination showed an irregular mass in the left adrenal gland , with the size of 4.5 cm ×2.5 cm ×3.9 cm,peripherally enhanced in arterial phase , contrast agent filling in portal venous phase , and high density in delay phase .Abdominal MR exami-nation showed a mass before abdominal aortic , with clear and smooth edge .The mass showed low signal in T1WI phase and high signal in T 2WI phase, which was considered as pheochromocytoma .24h urinary cate-cholamines showed that norepinephrine was 103.0 nmol, epinephrine was 9.8 nmol and dopamine was 18.9 nmol.Octreotide (99Tcm-TOC) showed slight high expression of somatostatin receptor .Preoperative diagnosis was left pheochromocytoma . Results After the preoperative medical preparation of phenoxybenzamine for 3 weeks, her blood pressure was maintained at 120-132/50-70 mmHg, with stuffy nose, warm hand and foot, and the weight gain of about 1 kg.The patient was undergone laparoscopic resection of left adrenal tumor under general anesthesia on June 24, 2013.The postoperative blood pressure returned to normal .And the left adrenal pathology was cavernous hemangioma .Following up for 5 months, the patient had normal blood pressure without the tumor recurrence . Conclusions The adrenal cavernous hemangioma is extreme-ly rare with high rate of misdiagnosis .For adrenal tumor with typical hemangioma imaging , the diagnosis of cavernous hemangioma should be considered .For tumors larger than 6 cm, surgery is recommended .The first choice of operative approach is laparoscopic resection of adrenal tumor , and normal adrenal tissue should be retained as far as possible.