Humans ; Perforator Flap

Hearing Loss, Noise-Induced ; diagnosis ; etiology ; Humans ; Noise, Occupational ; adverse effects ; Reference Standards

Female ; Humans ; Laryngeal Diseases ; etiology ; Middle Aged ; Parathyroid Neoplasms ; complications

Objective To explore the clinico-pathological features, immunophenotype, treatment and prognosis of urologic primary primitive neuroectodermal tumor (PNET). Methods The clinical data of 3 patients with urologic PNET were analyzed retrospectively. All patients were male, aged 29, 32 and 75 years respectively. Two of the lesions were located in the kidney, and the third was located in the bladder. The sizes of renal tumors were 7.7 cm×6.2 cm and 12.6 cm×9.4 cm respectively. Imaging examinations revealed a well-defined mass with inhomogeneous echo inside. The size of bladder tumor was 10.0 cm×10.0 cm. CT scan demonstrated irregular thickening of the bladder wall, and the density of the wall was inhomogeneous. In the 2 cases of renal PNET radical surgery was performed, while an emergency palliative surgery to remove a blood clot and biopsy were performed in the bladder PNET case. Results In light microscope, the tumors were characterized by uniform small round or oval cells and nest-like or dense sheet structures surrounded by sparse fibrovascular stroma. Homer-Wright rosettes or pseudorosettes were observed, as well as mitoses. Immunohistochemical study revealed that all cases showed positive staining for CD99, synaptophysin and vimentin. One of the renal tumor cells showed positive for CD56, and the other renal tumor and urocystic tumor cells were focally positive for chromogranin A. Additionally, in 1 of the cases of renal tumor there was a high positive rate of 80% for Ki67 staining while the other case showed less than 5%. All 3 cases were eventually diagnosed as PNET. The first renal tumor case was not treated with radiotherapy and chemotherapy postoperatively, and the patient died of recurrence 14 months after surgery. Both the second renal tumor case and the bladder tumor case underwent chemotherapy postoperatively, and they died 4 and 6 months after surgery respectively. Conclusions The urologic primary PNET is a very rare, highly malignant soft tissue tumor, and the diagnosis must be based on pathologic findings and immunohistochemical phenotypes. The multimodal treatment for urologic primary PNET consists of surgery, chemotherapy and radiotherapy.

Female ; Fluoroscopy ; Humans ; Intubation, Intratracheal ; Male ; Middle Aged ; Tracheotomy ; methods

AIM:To evaluate the efficacy and safety of large sized continuous curvilinear capsulorhexis ( CCC ) involving zonular area in manual small incision cataract surgery ( MSICS) .
METHODS:Totally 1 443 cataract patients ( 1 965 eyes ) underwent MSICS, in which large CCC up to 7-8mm were performed . The related conditions such as success rate of performing CCC, capsule rupture, corneal edema and visual acuity after surgery were recorded and statistically analyzed.
RESULTS:In total of 1 965 eyes, 1 942 eyes ( 98. 83%) had successful CCC, 15 eyes (0. 76%) had a radial tear which could not be saved when performing CCC, 8 eyes (0. 41%) had anterior capsule opened with a cystotome or a scissor due to capsule membrane calcification. No posterior capsule rupture occurred, and intraocular lens was transplanted in all cases. Transient corneal edema was noted in 36 eyes (1. 83%). One day after surgery, 1650 eyes (83. 97%) had visual acuity ≥0. 5, 1867 eyes (95. 01%) ≥0. 3. No unstable intraocular lens was noted in all cases.
CONCLUSION:Large CCC technique for MSICS is safe and reliable, not decreasing stability capsular bag and intraocular lens. It is of high originality despite zonular area is involved so that it is worthy of application in basic medical institutions.

By reshaping the cornea without the creation of a stromal flap, excimer laser corneal surface ablation eliminates flap-related complications and avoids the risk of ectasia that may occur after laser assisted in situ keratomileusis ( LASIK ) . Post-operative pain is one of the most significant disadvantages of surface ablation and thus the management of pain and discomfort following surface ablation is of great importance. We summarize mechanism of corneal pain and current approaches to pain management after surface ablation.

Objective To observe the influence of tumor necrosis factor-alpha(TNFα) on skeletal muscle protein catabolism in rats with chronic obstructive pulmonary disease (COPD) and the effects of indomethacin (IND) on it. Methods Duplicated COPD model rats were divided into two groups: the malnutrition group and the normal nutrition group. The malnutrition group were further divided by randomized block design into four groups. Isotonic physiologic saline was administered to group A, the control and the normal nutrition group, and different doses of oral IND were administered to groups B, C, and D weight, concentrations of TNFα, contents of 3-methyl-histidine ( 3- M H ) and tyrosine (Tyr) in the diaphragm and extensor digitorum longus muscle homogenates were measured before and after the intervention. Results Before the intervention, the concentrations of TNFα in the serum of malnutrition groups were all significantly higher than those of normal nutrition group and the control group. After the intervention: (1) The concentrations of TNFα in the serum of the rats of group B, C and D were significantly lower than the group A, especially in group C. The levels of TNFα in serum and body weight of model group rats were negatively correlated ( r = -0. 846, P ＜0. 01 ), as well as the diaphragm and extensor digitorum longus muscle weights ( r = - 0. 778, P ＜ 0. 01; r = - 0. 772, P ＜ 0. 01 ). (2) The levels of 3-methyl-histidine in the diaphragm and extensor digitorum longus muscles of the intervention group C was lower than the COPD normal nutrition group, as well as the intervention groups B and D. The contents of tyrosine in the diaphragm and extensor digitorum longus muscles of the intervention group C was lower than that of the COPD normal nutrition group,as well as the groups B and D. The body weight growth value of the intervention group B were slightly higher than the group A, without significant difference( P ＞ 0. 05 ), while the group C was significantly higher than the group A ( P ＜ 0. 01 ). Conclusions TNFα is involved in the occurrence of COPD malnutrition and skeletal muscle amyotrophy. IND can reduce the TNFα levels in the serum and the catabolic rates of the skeletal muscle proteins in malnutrition rats with COPD, so as to improve partly the skeletal muscle atrophy.

Carcinoma ; classification ; pathology ; Carcinoma, Papillary ; Female ; Humans ; Middle Aged ; Neoplasm Recurrence, Local ; Thyroid Neoplasms ; classification ; pathology ; Tracheal Neoplasms ; secondary

Objective To investigate the effects of diabetic duration on liver fat content (LFC) in patients with type 2 diabetes,and to explore its relationship with the outcome of liver disease.Methods A total of 435hospitalized patients with type 2 diabetes were recruited.The history data,results of laboratory tests,and hepatic 1 H-MRS were collected,and nonalcoholic fatty liver disease (NAFLD) fibrosis score (NFS) was calculated.Results The prevalence of NAFLD in newly-diagnosed type 2 diabetes mellitus (NT2DM) group was higher than that in predousb-diagnosed type 2 diabetes mellitus (PT2DM) group (92.7％ vs 82.2％,P＜0.05),with higher LFC [(27.97 ± 16.88 vs 19.44± 15.54) ％,P＜0.01].The LFC was reduced with prolonged duration of diabetes.Partial correlation analysis showed that LFC was negatively correlated with duration of diabetes (rs =-0.233,P＜0.01) after adjustment for gender,age,body mass index (BMI),oral anti-diabetic drugs,lipid-lowering drugs,and insulin treatment.Multiple linear regression analysis showed that LFC was positively correlated with BMI,albumin,and alanine aminotransferase while negatively correlated with duration of diabetes.The proportion of patients without advanced fibrosis (NFS＜-1.455) was significantly higher in NT2DM group than that in PT2DM group (26.3％ vs 15.5％,P＜0.05),and the proportion of PT2DM in patients with advanced fibrosis (NFS＞0.676) was significantly higher than that of NT2DM (79.2％ vs 20.8％,P＜0.05).NFS was positively correlated with the duration of diabetes (rs =0.236,P＜0.01).The liver fat content in patients with advanced liver fibrosis decreased significantly,and the LFC was negatively correlated with NFS (rs =-0.164,P＜0.01).Conclusions The duration of diabetes is an independent influencing factor of LFC.With the extension of the duration of diabetes,the decreased LFC in type 2diabetic patients with NAFLD is related to the development of advanced fibrosis.The decrease in LFC in type 2diabetic patient is associated with poor outcome of NAFLD.