Objective To study the value of transurethral electro-resection for renal pelvic tumor.Methods Transurethral electro-resection was performed on 11 patients after resection of the kidney.A F8 catheter was inserted into the bladder via the distal end of the ureter.The mucosal tissues around the ureter were then cut,and the ureter was fixed to the catheter and removed by pulling out the catheter.Results The operation was completed in all of the cases with a mean operation time of 115 min(65 to 170 min).None of the patients developed infection or hemorrhage after the surgery.11 patients were followed up for 6 to 18 months(mean,11 months),and no one died during the period.No tumor implantation or other intra-bladder masses were found.ConclusionsTransurethral electro-resection is feasible and safe for renal pelvic tumor.

Objective To study the epidemiology of breast diseases based on a vast amount of data collected from a number of hospitals. Methods The pathological data of breast diseases collected from 14 hospitals were statistically analyzed. Grouping was made according to the patients′ age, i.e. every 10 years from 0 to 69 as a group, and the patients aged 70 and over as another group. A database was established using software SPSS (10.0). A statistical analysis was made on the types of breast diseases, the incidence was calculated, and curves were plotted up based on the types of disease and the contribution of patients′ age in different hospitals. Results A total of 35948 cases, including 46 diseases of breast diseases, were analyzed. The common diseases were fibroadenoma, carcinoma, adenosis, hyperplasia of male breast, cystic hyperplasia and accessory-breast, which made up 37.99%, 21.49%, 20.60%, 4.54%, 3.60% and 2.80%, respectively, of the total cases analyzed. Conclusion The number of patients suffering from breast diseases is proportional to the size of the hospital. It has been found that different pathology of the breast had its peak preponderant age of discovery. In all the cases analyzed, tumors were found in 23 167 cases, accounting for 64.45% of all patients, among which benign and malignant lesions constituted 66.13% and 33.74%, respectively. Fibroadenoma was the predominant tumor among benign tumors (89.14%), while the breast cancer constituted 98.82% of malignant tumors. The incidences of the both types of tumor, were similar in different hospitals. No significant difference was found on the peak ages of different breast diseases among the hospitals. 12 781 cases of nontumorous lesions accounting for 35.55% for all the cases showed marked differences in age distribution among hospitals, implying that there were different diagnostic criteria for such lesions.

OBJECTIVE:To observe clinical efficacy and safety of naloxone hydrochloride combined with Danshen injection in the treatment of neonatal hypoxic ischemic encephalopathy(HIE). METHODS:104 patients with HIE were randomly divided into observation group and control group with 52 cases in each group. The control group was treated with Naloxone hydrochloride injec-tion 0.02 mg/kg,ivgtt,qd and conventional symptomatic treatment;while observation group was additionally treated with Danshen injection 4-6 ml+10% Glucose injection 20 ml,ivgtt,qd,on the basis of the control group. Treatment course of 2 groups lasted for 7 d. Clinical efficacy,symptom and sign recovery of 2 groups were compared,as well as levels of serum MMP-9,IL-6 and TNF-α,cerebral hemodynamic parameters and ADR. RESULTS:There was no statistical significance in MMP-9,IL-6,TNF-α and cerebral hemodynamic parameters before treatment(P>0.05). The total effective rate of observation group(92.31%)was signifi-cantly higher than that of control group (75.00%);after treatment,the recovery time of consciousness disturbance,primitive re-flex and muscle tension in the observation group were shorter than those in the control group;the levels of serum MMP-9,IL-6 and TNF-α in observation group were significantly lower than those in control group;peak systolic flow velocity(PSFV),end-dia-stolic flow velocity (EDTV) were higher in the observation group than in the control group,with statistical significance (P<0.05);resistance index (RI) was lower than in control group,but without statistical significance (P>0.05). No ADR was ob-served in 2 groups. CONCLUSIONS:Naloxone hydrochloride combined with Danshen injection can significantly promote HIE and signs recovery,reduce the levels of serum MMP-9,IL-6 and TNF-α,and improve hemodynamic parameters with good safety.

Objective To investigate the influence of the radical resection and the optic canal unroofing on the postoperative vision in the patients with tuberculm region meningeal tumors.Matheods A retrospective analysis was made in 44 patients with tuberculm region meningeal tumors,from January 2010 to October 2012.The clinical data including the Simpson grades,adhesion between tumor and the surrounding structures,optic canal decompression,and postoperative vision were studied,and followed-up.Results In all 44 cases,there were 31 patients with Simpson grade Ⅰ resection,their postoperative vision of 17 patients were improved,eleven unchanged,and 3 worse.Out of them,tumors showed more adhesive in 9 cases,unroofed the optic canal in 17 cases.There were 13 cases in the other group including 8 cases with Simpson grade Ⅱ and 5 cases with Simpson grade Ⅲ,their postoperative vision of 8 patients were improved,four unchanged,and 1 worse.Out of them,tumors showed more adhesive to the surroundings in 10 cases,unroofed the optic canal in 3 cases.There were no different postoperative vision among the Simpson grades by the Chi-Square test (P ＞ 0.05).The less adhesive of the meningeal tumors,the better resection grade would be (P ＜ 0.05).And unroofed the optic canal group showed better postoperative vision than the not unroofed ones (P ＜ 0.05).Conclusion In the tuberculum region meningeal tumors,the Simpson resection grade was related to adhesion between the meningeal tumors and the surroundings,not to postoperative vision.The optic canal decompression can improve their visual outcome in some cases.

Objective To investigate the relationship between the expression ofα1-antichymot-rypsin (α1-ACT)in plasma and postoperative cognitive dysfunction(POCD).Methods The cognitive function of 64 patients undergoing operation under general anesthesia was evaluated by a battery of cognitive assessment instruments(BCAI)and the levels ofα1-ACT were measured at the time 1 d pre-operatively and 7 d and 3 months postoperatively.The patients were randomly divided into two groups:30 patients in ulinastatin group (group U)were injected with 10 000 U/kg ulinastatin,which was dissolved in 100 ml saline,within 20 min at the time of 30 minutes before induction;while control group (group C)were injected with the same volume saline.Results There was no significant differ-ence between the expression of α1-antichymotrypsin in patients with POCD and in control patients at the time before operation.Compared with control patients,the levels of α1-ACT in patients with POCD at the time of 7 d and 3 months postoperation were significantly higher (P <0.05).The levels of α1-ACT at 7 d postoperation were significantly higher than that preoperatively in both groups (P <0.05).The incidence of POCD in group U were significantly lower than that in group C,at the time of 7 d and 3 months after surgery (P <0.05).Conclusion POCD is associated with high expression of plasma α1-ACT.

ObjectiveTo study the treatment and prognosis of the breast phyllodes tumors.MethodsKG1Clinical data, and the results of follow-up in 203 cases of breast phyllodes tumors were analyzed using Logistic analysis and Cox regression in SPSS statistic software.ResultWT5”BZLocal recurrence and tumor mortality were in direct proportion to the pathologic grade of the tumor. There was a direct proportion between local recurrence and tumor infiltration; and between tumor caused-mortality and tumor mitosis and necrosis.Mitotic activity and tumor necrosis were the independent prognostic factors. After surgical resection 21 1% of patients with benign tumor, 45 2% of patients with borderline tumor, 64 3% of patients with malignant tumor suffered recurrence. The 5-year survival rate was 100% in patients with benign phyllodes tumor, 92 0% with borderline tumor, and 33 3% with malignance.KG2Conclusion Local excision is not the appropriate treatment for phyllodes tumor. Patients with benign or borderline phyllodes tumor should undergo wide local excision including a margin of uninvolved tissue, and that with local recurrent borderline and malignant phyllodes tumor receive mastectomy.

OBJECTIVETo study the relationship between pathological features and classification criteria of the breast Phyllodes tumor.

METHODS203 cases of breast phyllodes tumor diagnosed in 22 hospitals since 1956 were analyzed and reappraised by a retrospective study.

RESULTS133 cases were benign, 42 cases were borderline and 28 were malignant. The follow-up (6 to 372 months) showed that 28/133 benign, 19/42 borderline and 18/28 malignant cases recurred, and 17 patients (2 borderline and 15 malignant) died. The statistic cluster analysis demonstrated that stromal cellar atypia, margin involvement, mitotic activity and tumor necrosis were retained in the variable group, and no error distinguish were showed.

CONCLUSIONSThe breast phyllodes tumor can be classified as the following three types: benign, borderline and malignant. It is important to diagnose and classify the breast phyllodes tumor according to the involvement of tumor margin, stromal cellar atypia, mitotic activity, stromal overgrowth and tumor necrosis. There are significant differences of 5 years survival rates, recurrent rates and death rates between the benign, borderline and malignant breast phyllodes tumor. With wide excision the recurrence of the tumor decreased suggesting that broad excision is preferred for the benign phyllodes tumor and mastectomy is indicated for recurred borderline and malignant tumors.

Objective:To investigate the predictive value of cerebroplacental ratio (CPR) for adverse perinatal outcomes of induction of labor in prolonged pregnancy.Methods:This retrospective study recruited 315 singleton pregnant women who had induced labor due to prolonged pregnancy (≥41 gestational weeks) in the First Affiliated Hospital of Chongqing Medical University from January 1, 2019 to April 30, 2020. Based on the occurrence of adverse perinatal outcomes (emergency delivery due to persistent abnormal fetal heart rate monitoring, umbilical artery blood pH at birth <7.2, 5 min Apgar scores<7, transferring to neonatal intensive care unit after birth, chorioamnionitis and vaginal delivery converted to cesarean section), they were divided into two groups: case group ( n=76) and normal group ( n=239). Clinical features and umbilical artery blood flow, middle cerebral artery (MCA) flow and CPR measured in the last ultrasound scan before induction were compared between the two groups using student's t-test, Mann-Whitney U test and Chi-square test. Receiver operating characteristic (ROC) curve was used to analyze the predictive values of umbilical artery blood flow, MCA flow and CPR for the adverse perinatal outcomes. Multivariate logistic regression analysis was used to screen the meaningful predictors. Results:Compared with the normal group, the umbilical artery pulsatility index (PI) (0.9±0.1 vs 0.8±0.1, t=-5.458, P<0.001) and the percentage of abnormal CPR (<1.0) increased significantly [21.1%(16/76) vs 6.3%(15/239), χ2=14.190, P<0.001] in the case group, while the MCA-PI and CPR decreased significantly (1.1±0.2 vs 1.3±0.3, t=5.658, P<0.001; 1.2±0.3 vs 1.6±0.5, t=8.940, P<0.001). The areas under the ROC curves of umbilical artery PI, MCA-PI and CPR for predicting adverse perinatal outcomes were 0.71, 0.71 and 0.77, respectively. CPR had the highest sensitivity (0.74) compared with umbilical artery PI (0.68) and MCA-PI (0.71), but the specificity of them were similar (0.67, 0.66 and 0.66). Multivariate logistic regression analysis showed that only CPR was the independent risk factor for adverse perinatal outcomes ( OR=0.028, 95% CI: 0.010-0.080, P<0.001). Conclusions:As an indicator for early prediction of adverse perinatal outcomes of induction of labor in prolonged pregnancy, CPR was more sensitive but less specific.

Objective: To analyze the association between physical activity and screen time with overweight and obesity in preschool children, and to provide evidence for childhood obesity prevention and control. Methods: Using a case control study design, 109 overweight or obese children (the case group) were recruited from four kindergartens from a community of Chaoyang District, Beijing, and 117 children with normal weight in the same kindergarten (the control group) were recruited as control. Gender and age were matched between the case and the control group. Univariate analysis was used to compare the demographics, physical activity time, screen time, sleep and diet characteristics between the two groups. Logistic regression was used to analyze the association of physical activity and screen time with overweight and obesity in preschool children with adjustment for covariates. Results: After adjusting for age, gender, average daily sleep time, the total score of Children s Sleep Habits Questionnaire (CSHQ), Chinese diet balance index for preschool children (DBI-C), children with <3 h of daily physical activity had an increased risk of overweight and obesity compared with those with ≥3 h of physical activity ( OR=2.55,95%CI=1.16-5.64，P =0.02), and the risk of overweight and obesity increased with each additional quartile of daily screen time in children ( OR=2.44,95%CI=1.69-3.52, P <0.01). Conclusion Insufficient physical activity and excessive screen time are independent risk factors of overweight and obesity in preschool children. Comprehensive intervention measures should be taken to effectively increase physical activity and reduce screen time for overweight and obesity prevention and control in preschool children.

Objective:To explore the clinical efficacy ofendoscopic retrograde cholangiopancreatography (ERCP) plus percutaneous transhepatic cholangiodrainage (PTCD) of biliary reunion in the treatment of biliary occlusion after liver transplantation.Methods:From May 2018 to August 2019, clinical data were retrospectively analyzed for 9 patients with biliary tract occlusion after an initial liver transplantation. All of them underwent biliary reunion. An endoscopist performed ERCP while an interventional physician completed PTCD with bilateral guide wire under the same anesthetic period so that bilateral guide wire completed a reunion at biliary occlusion for re-opening biliary tract or establishing a new bile duct outflow path. Postoperative follow-ups were performed for observing the treatment outcomes and various factors of biliary stricture factors analyzed.Results:All of them received PTCD or T-tube sinus angiography and interventional treatment. The diagnosis of complete biliary occlusion was definite. After treatment, 7 cases of biliary tract reunion were successful. During operation, three reunion types of guide wire biliary, intestinal cavity and intra-abdominal cavity were employed. Two failed cases received continuous PTCD drainage after operation. The influencing factors of biliary tract stenosis were retrospectively analyzed after operation. Among them, there were non-anastomotic stenosis ( n=2), biliary leakage ( n=2) and anastomotic stenosis and long tortuous biliary tract ( n=5). Conclusions:Rapid, mini-invasive and safe, ERCP plus PTCD biliary tract reunion may be employed as a first choice for biliary occlusion after liver transplantation.