ObjectiveTo present the innovative transurethral resection of the distal ureter and bladder cuff by Holmium laser and to compare the perioperative and oncological outcomes following nephroureterectomy using three different methods of managing the distal ureter and bladder cuff.Methods From January 2000 to December 2010,162 patients underwent excision of the distal ureter and bladder cuff by transurethral Holmium laser (32 cases,Group A),transurethral electric resection (51 cases,Group B) or open procedure (79 cases,Group C) combined with open or retroperitoneal laparoscopic nephroureterectomy.5 French ureteral balloon catheter was inserted into the targeted ureter to prevent possible microscopic tumor seeding.The therapeutic effectiveness,perioperative complications,postoperative recovery and oncologic outcomes were compared among groups.The follow-up time was 3 -96 months.ResultsGroup A and B showed statistically significant better results on the operative time (203.6 ± 31.5 min and 207.2 ±24.3 min),blood loss ( 127.4 ± 63.2 ml and 135.0 ± 82.7 ml) and postoperative hospital stay (5.8 ± 1.3d and 5.6 ±1.2 d) than those of Group C (248.0 ±42.9 min,484.5 ±217.7 ml,8.7 ±3.5 d),respectively ( P ＜ 0.01 ).Six cases of obturator nervous reflex occurred in Group B,with 3 cases of bladder peroration and 2 conversions to open procedure.There were no difference in bladder tumor occurrence,retroperitoneal recurrence,tumor cell seeding and cancer-specific survival among the 3 groups.ConclusionsOur data have validated the superiority of transurethral approach over conventional open procedure including perioperative index,recovery and comparable oncologic outcomes with open group.Holmium laser demonstrated better results including fewer complication,cleaner surgical vision and operating accuracy than that of electric resection.Transurethral Holmium laser resection of the distal ureter and bladder cuff has been proved to be a technically innovative minimally invasive and oncological safe method.

Objective To construct a rapid genetic DNA extraction method, with nano magnetic beads, self-designed reagents system and extracting process. Method Part I: DNA extraction from old blood cotton swab sample with self-designed DNA extraction kit, then quantiifed by UV spectrophotometer. The method was further optimized on the preliminary results. Part II: All kinds of difficult DNA sample were tested with optimized kit, to detect the applicability of the kit. Result By improving the experimental condition, the extraction effects of different DNA sample is good, meanwhile, the extraction cost is relatively low.

Using the new negative pressure biopsy technology, the automatic negative pressure gun and the specific puncture needle for the biopsy have been developed. Renal biopsies were conducted in 1136 cases, with the success rate being 99.9%, and 29 cases gross hematuria while the hepatic biopsies were conducted in 16 cases, mass biopsies in 3 cases with the success rates being 100% respectively. The biopsy gun has the advantages of easy manipulation, higher success rate and lower incidence of complications.
Adolescent ; Adult ; Aged ; Biopsy, Needle ; instrumentation ; methods ; Child ; Child, Preschool ; Equipment Design ; Humans ; Kidney ; diagnostic imaging ; pathology ; Liver ; diagnostic imaging ; pathology ; Middle Aged ; Needles ; Ultrasonography

The combination of melanocytic nevus with other tumors of epidermal or adnexal origin has been described since the first case reported by Andresen and Enos in 1952. Most of reported cases are melanocytic nevi combined with common epidermoid cysts. The combination of nevus and cyst could possibly be misdiagnosed clinically as a malignant melanoma upon initial examination. A 58-year-old woman presented with an asymptomatic, solitary, skin-colored, erythematous 1.0 cm-diameter pedunculated nodule on the occipital scalp which had been present childhood. The histopathologic specimen of the nodule showed a solitary cyst surrounded by intradermal melanocytic nevus. The cyst was located in the dermis lined by squamous epithelium, which was ruptured and inflamed. It contained degenerated keratin materials and multiple transversely and obliquely cut vellus hairs. We herein report a rare case of melanocytic nevus combined with a vellus hair cyst.
Bone Cysts ; Dermis ; Epidermal Cyst ; Epithelium ; Female ; Hair* ; Humans ; Melanoma ; Middle Aged ; Nevus ; Nevus, Pigmented* ; Scalp

Dermatofibrosarcoma protuberans(DFSP) is an unusual, locally aggressive, cutaneous neoplasm of low grade malignancy. Several histologic variants have been described. Among them, fibrosarcomatous dermatofibrosarcoma protuberans is associated with a higher rate of local recurrence and distal metastases as well as a shorter latency period of time until recurrence than does ordinary DFSP. As a result, it needs more intense treatments and more vigorous follow up. A 37-year-old man presented with an asymptomatic erythematous hard nodule and several reddish papules on the chest for 2 years. Histopathologic examination revealed fibrosarcomatous dermatofibrosarcoma protuberans. We, herein, report an unusual case of fibrosarcomatous dermatofibrosarcoma protuberans.
Adult ; Dermatofibrosarcoma* ; Follow-Up Studies ; Humans ; Latency Period (Psychology) ; Neoplasm Metastasis ; Recurrence ; Thorax

Bowen's disease is a kind of squamous cell carcinoma in situ. In some cases, a pagetoid growth pattern can be observed with cytologically atypical clear cells arranged singly or in nests. The differential diagnosis of clear-cell Bowen's disease includes primarily Paget's disease and malignant melanoma in situ. A 66-year-old man presented with intermittently painful, solitary, well-demarcated, annular, erythematous, scaly plaque on the left fourth finger for 7 months. This had been treated by cryotherapy 8 months earlier, following the diagnosis of Bowen's disease. The skin biopsy specimen revealed nests of atypical clear cells in upper layer of the epidermis in addition to typical features of Bowen's disease. We, herein, report a rare case of clear-cell Bowen's disease, which is thought to have developed after cryotherapy.
Aged ; Biopsy ; Bowen's Disease* ; Carcinoma, Squamous Cell ; Cryotherapy* ; Diagnosis ; Diagnosis, Differential ; Epidermis ; Fingers ; Humans ; Melanoma ; Skin

OBJECTIVETo define the determinants of perioperative death and complications after cardiac valve replacement in 702 patients.

METHODSClinical data of the patients after cardiac valve replacement were analyzed retrospectively.

RESULTSPerioperative mortality and morbidity correlated significantly with some of the perioperative variables, such as higher NYHA functional class (III or IV), large left ventricular end-diastolic diameter (>/= 70 mm), C/T >/= 0.70, prolonged aortic cross-clamping time and cardiopulmonary bypass time, unsatisfactory myocardial protection.

CONCLUSIONSPerioperative mortality and morbidity correlate significantly with some of perioperative variables, such as higher NYHA functional class, unsatisfactory myocardial protection, inappropriate surgical procedure, improper therapy of some complications after cardiac valve replacement. To avoid the occurrence of these independent predictors or to correct them timely might effectively decrease the perioperative mortality and morbidity after cardiac valve replacement.

Adolescent ; Adult ; Aged ; Cause of Death ; Child ; Female ; Heart Valve Diseases ; mortality ; surgery ; Heart Valve Prosthesis ; adverse effects ; Humans ; Intraoperative Complications ; mortality ; Male ; Middle Aged ; Mortality ; Postoperative Complications ; mortality

Objective To explore the effects of early activity on preventing acquired weakness in Cardiovascular Critical Surgery patients. MethodsFrom May 2018 to May 2019, we selected 140 patients of Cardiovascular Critical Surgery at Zhengzhou Seventh People's Hospital as subjects by convenient sampling. All of patients were divided into observation group and control group with the method of random number table, 70 cases in each group. Control group implemented routine nursing. On the basis of that in control group, observation group carried out early activity. We compared the incidence of acquired weakness, time of mechanical ventilation, hospital stay, time to get out of bed, the scores of Medical Research Council (MRC) when leaving Cardiovascular Critical Surgery, the Fugl-Meyer measurement for motor function and activities of daily living (ADL) one month after discharge of patients between two groups. ResultsThe incidence of acquired weakness of observation group was 7.1%(5/70) lower than that (20.0%,14/70) of control group with a statistical difference (P＜0.05). The time of mechanical ventilation, hospital stay, time to get out of bed in observation group were shorter than those in control group with statistical differences (P＜ 0.05). After intervention, the scores of MRC when leaving Cardiovascular Critical Surgery, the Fugl-Meyer measurement for motor function and ADL one month after discharge in observation group were higher than those in control group with statistical differences (P＜ 0.05). ConclusionsEarly activity can effectively decrease the acquired weakness in Cardiovascular Critical Surgery patients, shorten the hospital stay, improve patients' motor function and ADL, which is worthy of clinic application.

Objective:To explore the effect of the special group nursing model of internal fistula based on multidisciplinary collaboration in patients with arteriovenous fistula (AVF) pseudoaneurysm.Methods:From February 2019 to August 2020, convenience sampling was used to select 92 patients with AVF pseudoaneurysm in the Blood Purification Center of Seventh People's Hospital of Zhengzhou as the research object. According to the random number table method, the patients were divided into the control group and the observation group, each with 46 cases. The patients in the control group received the conventional nursing model, and the patients in the observation group received the special group nursing model of internal fistula based on multidisciplinary collaboration. The average number of punctures in a single dialysis, the operation rate of pseudoaneurysms, the size and number of pseudoaneurysm, and the incidence of pseudoaneurysm-related complications were compared between the two groups of patients.Results:The average number of punctures in a single dialysis of the observation group was lower than that of the control group, the size of pseudoaneurysm was smaller than that of the control group, and the number of pseudoaneurysm was less than that of the control group, and the differences were statistically significant ( P<0.05) . There was no significant difference in the operation rate of pseudoaneurysm between the observation group and the control group ( P>0.05) . The total incidence of complications in the observation group was 4.35% (2/46) , which was lower than 21.74% (10/46) in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The special group nursing model of internal fistula based on multidisciplinary collaboration can effectively reduce the average number of puncture per dialysis in patients with AVF pseudoaneurysm, lower the incidence of complications related to pseudoaneurysm, and improve the patient's pseudoaneurysm to a certain extent. It is worthy of clinical promotion.

Objective: To investigate the fatigue status of military personnel stationed in plateau and high cold region, and to analyze the mediator effect of trait coping style on job stress and fatigue. Methods: In October 2010, with the method of cluster random sampling survey, 531 military personnel stationed in plateau and high cold region were chosen as subject. The fatigue status were evaluated by the Chinese version multidimensional fatigue inventory (MFI-20) , job stress were evaluated by the Job Stress Survey (JSS) , and trait coping style were evaluated by the Trait Coping Style Questionnaire (TCSQ) . Results: According to the information of different population characteristics, mean rank of physical fatigue about the urban (town) group were higher than that of rural group (Z=-2.200, P<0.05) ; mean rank of reduced motivation about the urban (town) group were higher than that of rural group (Z=-2.781, P<0.05) ; mean rank of general fatigue scores about the urban (town) group were higher than that of rural group (Z=-3.026, P<0.05) ; mean rank of physical fatigue about the up or equal 20-years old age group were higher than that of below 20-years old age group (Z=-4.045, P<0.05) ; mean rank of reduced motivation about the up or equal 20-years old age group were higher than that of below 20-years old age group (Z=-2.182, P<0.05) ; mean rank of mental fatigue about the up or equal 20-years old age group were higher than that of below 20-years old age group (Z=-2.879, P<0.05) ; mean rank of general fatigue scores about the up or equal 20-years old age group were higher than that of below 20-years old age group (Z=-3.647, P<0.05) ; mean rank of reduced motivation were significant statistical difference among the military officers, sergeancy and soldier group (F=18.965, P<0.05) ; mean rank of general fatigue scores were significant statistical difference among the military officers, sergeancy and soldier group (F=14.711, P<0.05) . The score of negative coping style were positively correlated with the score of physical fatigue (r_s=0.129) , reduced activity (r_s=0.123) , reduced motivation (r_s=0.149) and general fatigue (r_s=0.174) respectively, the score of organizational support lack strength were positively correlated with the score of physical fatigue (r_s=0.090) , reduced activity (r_s=0.098) , reduced motivation (r_s=0.099) and general fatigue (r_s=0.130) respectively. The mediator effect of negative coping style on the job stress and fatigue was 0.013 (P<0.01) . Conclusion The fatigue statuses of the urban (town) group and the up or equal 20-years old age group are poor, and the negative coping style plays mediator effect on the job stress and fatigue.