Objective To evaluate the effects of temperature of the irrigation fluid on body temperature and cardiovascular performance during transurethral surgery. Methods 87 cases were randomly divided into two groups according to the temperature of irrigation fluid used: the ambient (21～ 24 ℃) and the isothermic (35～36 ℃). Body temperature, blood glucose, ECG, HR, SaO 2, cardiac output (CO), mean arterial pressure (MAP) and systemic vascular resistance (SVR) were monitored during the transurethral surgery. Results Body temperature was decreased 2.1 ℃, MAP elevated, CO decreased and SVR increased in the ambient group, while body temperature was decreased only 0.3 ℃ and cardiac performance was maintained relatively stable in the isothermic group. Conclusions Hypothermia, resulted from the use of large amount of low temperature irrigation fluid during transurethral surgery has detrimental effects on body temperature and cardiovascular performance. Isothermic irrigation fluid would stablize the cardiovascular performance and so increases the safety of transurethral surgery.

Objective To enhance the function of picture archiving and communication systems (PACS) and the efficiency of medical imaging by adjusting dataflow. Methods About 9500 examinations consecutive data in July of 2003 were analysed and and followed. The dataflow was adjusted by adding digital radiology servers and temporal servers. Results The network bottleneck was resolved and the system load balanced, then the function of the system was enhanced. The secure running of the system was ensured in condition of urgency or increasing of patients and image data. Conclusion Adjustment of dataflow in PACS makes full use of all resources, reduces unnecessary time-wasting , further improves the working efficiency in our department.

Objective To compare the clinical efficacy between continuous and intermittent androgen deprivation in high risk prostate cancer.Methods Sixty-four patients with high risk prostate cancer were treated from January 2008 to April 2009,36 cases who accepted goserelin and bicalutamide were taken as intermittent hormonal therapy (intermittent treatment group),while 28 cases who accepted bilateral orchiectomy in addition to flutamide were regarded as continuous hormonal therapy (continuous treatment group).The comparison of tumor specific mortality,time of prostate specific antigen (PSA) to nadir,tine to PSA recurrence,serum testerone and quality of life score were assessed between the two groups.Results In continuous treatment group and intermittent treatment group,follow-up period was (26.4 ± 10.3) and (28.1 ± 8.7) months,the time of PSA to nadir was (3.8 ± 2.1 ) and (4.0 ± 3.6) months,the time to PSA recurrence was (20.1 ± 12.3) and (24.5 ± 14.6) months,respectively.There was no significant difference between the two groups.At the time of 18,24 and 30 months after therapy,serum testerone was 0.85,0.88,0.89 μg/L in continuous treatment group,while 1.21,1.36,1.48 μg/L in intermittent treatment group,respectively (P ＜ 0.05 ).Similarly,quality of life score was 38.7,40.5,39.8 scores in continuous treatment group,while 49.2,51.4,52.3 scores in intermittent treatment group at the time of 12,18 and 30 months after therapy,respectively (P ＜ 0.05 ).Conclusions Clinical efficacy could not been found between continuous and intermittent endocrinic therapy of prostate cancer.During intermittent,quality of life seems to be better and increases in accordance with serum testerone recurrence at given time.

Objective To explore the operative methods and clinical outcomes in emergency or sube- mergency repair for the complicated tissue defects in hand in first stage applying microsurgical technique. Methods From Jan.,2000 to Aug.,2005,49 emergency cases of complicated hand tissue defects were re- paired in the first stage with replantation,reconstruction,free flaps,combined finger reconstruction and flap transplantation,including 21 cases in mini tissue mass replantation or reconstruction,15 cases in replantation combined with free flap transplantation,8 cases in replantation and reconstruction combined with free flap transplantation,5 cases in combined multiple digits reconstruction with free flap transplantation.The free flap transplantation included the anterolateral femoral flap,the latissimus dorsi myocutaneous flap,the dorsalis pe- dis flap,the media pedis flap and the instep flap.Results All the flaps,the replanted and reconstruceted finger survived uneventfully except for one replanted finger necrosis.45 cases healed in the first stage and the other 4 cases healed in the second stage.During a follow-up from 6 months to 3 years postoperatively,a satis- factory appearance and function of the reconstructed hand was achieved.The excellent and good rate was 85.7% assessed with provisional functional assessment criterion for upper limbs issued by Chinese Society of Hand Surgery.Conclusion The emergency or subemergency repair for the complicated tissue defects in hand has the advantage of short-term treatment and desirable functional outcome.The emergency replantation and reconstruction combined with various flaps or tissue mass can be applied to repair tissue defect in hand in the first stage according to the position and area of the defect along with the technique level of the surgeon, having been proved to achieve desirable clinical outcomes.And the key points leading to a successful operation is the correct treatment for the raw surface of the defects,suitable choice for various flaps,logical design of combination pattern and prevention and timely treatment for vessel crisis.

OBJECTIVETo investigate the clinical effects of anterior cervical intervertebral space decompression under microscope in treating cervical spondylotic myelopathy in elderly patients.

METHODSFrom June 2009 to March 2012, 43 patients with cervical spondylotic myelopathy were treated with anterior cervical intervertebral space decompression and intervertebral fusion under microscope. There were 26 males and 17 females, aged from 60 to 72 years old with an average of (64.9±3.7) years. Japanese Orthopaedic Association System (JOA) score was from 7 to 12 points with an average of (9.5±1.8) points before operation. The function of nerves was assessed before and after operation according to JOA.

RESULTSAll patients were followed up from 10 to 18 months with an average of (14.7±1.6) months. Postoperative JOA score was (13.81±1.44) points (ranged, 10 to 16), had significantly higher than preoperative (P<0.01). According to the rate of the improved JOA score, 9 cases got excellent results, 26 good, 7 fair, 1 poor.

CONCLUSIONAnterior cervical intervertebral space decompression under microscope for cervical spondylotic myelopathy in elderly patients is safe and effective.

Aged ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; methods ; Female ; Humans ; Male ; Microscopy ; Middle Aged ; Spondylosis ; surgery

OBJECTIVETo explore mid-term follow up results of distal fixation prosthesis in treating unstable intertrochanteric fractures in elderly patients.

METHODSFrom May 2008 to March 2014,58 elderly patients with unstable intertrochanteric were treated with distal fixation prosthesis, among them, there were 15 males and 43 females aged from 75 to 87 years old with an average of 83.2 years old. Fracture were classified according to Evans classification, 39 cases were type I c and 19 cases were type I d. Surgical risk was evaluated before operation, 9 patients were performed total hip arthroplasty and 49 patients were performed prosthetic replacement hip joint function of patients with different age period, Evans classificaton, prothesis type, fixation method were evaluated respectively by using Harris score.

RESULTSFifty-six patients were followed up from 13 to 36 months with an average of 21.6 months. Harris score was 83.51 ± 6.40, 5 cases got excellent results, 38 cases good and 13 cases moderate. Harris score of patients aged from 75 to 80 years old was 88.64 ± 2.35, 81.64 ± 6.40 in patients aged more than 80 years old, and had significant differences between two groups; Harris score in patients with type Evans I c was 83.64 ± 6.53, and 83.11 ± 6.08 in type Evans I d, while there was no significant differences between two groups. There was no obvious meaning in Harris score between patients with tension band (83.63 ± 6.15) and without tension band (82.41 ± 6.57). There was no significant meaning in Harris score between patients with normal distal fixation prosthesis (83.34 ± 6.43) and femoral moment reconstruction distal fixation prosthesis (83.92 ± 6.51). There was 1 patient occurred hip joint dislocation on the operative side and re-dislocation after manual reduction, then received open reduction. Two patients occurred femoral osteolysis without clinical symptoms, and treated conservative treatment.

CONCLUSIONArtificial joint replacement for unstable intertrochanteric fractures in elderly patients, hip joint function in patients aged more than 80 years old is worse, while there was no obvious market effect in fracture classification, whether to use tension band and type of distal fixation prosthesis, moreover, proximal femoral osteolysis should be focused on.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; Female ; Femur ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip Fractures ; surgery ; Hip Joint ; surgery ; Hip Prosthesis ; Humans ; Male ; Treatment Outcome

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Environmental Exposure ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Rabies ; epidemiology ; prevention & control ; Rabies virus ; Risk Factors ; Rural Population ; Young Adult

OBJECTIVETo confirm diagnosis of a special case with chief complaints of abdominal pain and dyskinesia of lower extremities.

METHODSThe clinical symptoms, signs, MRI, pathological findings and the results of blood test for microfilaria were analyzed.

RESULTSThe patient was a 6-year old girl who had abdominal pain for 10 days dyskinesia of lower extremities for 6 days accompanied by difficulty in urination and defecation. There was tenderness on T7-9 spinous process, sensory dullness below the umbilicus. Babinski's and Oppenheim's sign were bilaterally positive, and ankle clonus was positive. MRI showed space occupying change in the vertebral canal at T7-9 level. The mass of 2 cm x 1 cm x 1 cm size was removed by surgical operation and histopathological study showed obvious fibrous tissue proliferation accompanied by eosinophil, lymphocyte and neutrophil infiltration around a worm-like structure. Night time blood test performed at 23:00 confirmed the presence of microfilaria.

CONCLUSIONThe diagnosis of filariae in vertebral canal could be confirmed.

Animals ; Child ; Female ; Filariasis ; blood ; cerebrospinal fluid ; complications ; Filarioidea ; Humans ; Spinal Canal ; parasitology ; pathology ; Spinal Diseases ; etiology ; parasitology

Objective To investigate the gene mutations of human immunodeficiency virus (HIV)‐1 drug resistance among anti‐retrovirus (ARV ) treated‐naive men who have sex with men (MSM ) in Shanghai to provide evidence‐based data for optimized treatment .Methods All 669 treatment‐nave cases of HIV‐1 infection identified among MSM in 2013 were recruited and their plasma was collected .RNA was extracted and amplified by nest reverse transcription‐polymerase chain reaction ,and DNA was sequenced and then phylogenetically analyzed .Finally ,subtypes were identified and drug resistance was analyzed in comparison with International HIV Drug Resistance Database .Results The pol gene fragments of 645 cases were obtained .Primary drug‐resistance rate was 2 .48% (16/645) ,including mutations conferring resistance to protease inhibitor (PI) (0 .31% ,2/645) ,nucleoside reverse transcriptase inhibitors (NRTI) (0 .16% ,1/645) ,non‐nucleoside reverse transcriptase inhibitors (NNRTI) (1 .70% ,11/645) and both NRTI and NNRTI (0 .31% ,2/645) ,respectively .Mutations conferring resistance to CRF01_AE were 12 cases (2 .99% ) ,while mutations conferring resistance to CRF07_BC and CRF_01B were 0 .61%(1/163) and 4 .65% (2/43 ) including 1 case of CRF52_01B and unidentified CRF_01B , respectively . Resistance to NNRTI in B subtype were 2 .70% (1/37) .Conclusion The prevalence of HIV‐1 drug resistance‐associated mutations among MSM in Shanghai ,2013 is still low ,but resistance to NNRTI is relatively high .CRF01_AE is the major subtype of drug resistance .It is necessary to strengthen the HIV drug resistance surveillance in MSM group in Shanghai .

Objective To explore the method of repairing wound defects with exposed tibia. Methods 32 patients with soft tissue defects with exposed tibia were treated with three kinds of flaps pedicled with interior,lateral and posterior vascular perforating branches in the leg,respectively.Re- suits One flap with distal part necrotic was treated with change of dressings and got one-stage healing. One case had delayed union for muscular infection under the flap.Other flaps all were successful and sur- vived.No ostemyelitis was found.Conclusion The flap pedicled with vascular perforating branches of leg has abundant blood supply and is a good method for repairing small or middle wound defect with ex- posed tibia.