Objective To study the expressi on of thrombomodulin (TM) in endometrial carcinoma and explore its relation to the infiltration degree and histological grading of endometrial carcinoma. Methods The expression of TM was detected by immunohistochemistry in 50 cases of endometrial adenocarcinoma, 10 cases of endometrial complex hyper plasia and 10 cases of normal endometrium. Results The posi tive rate of TM in endometrial carcinoma was significantly higher than that in c omplex hyperplasia and normal endometrium (P 0.05). Conclusion TM can be used as a new index for judging progre ssion and prognosis of endometrial carcinoma.

Objective To investigate the effects of levels of serum C-reactive protein (CRP), B-natriuretic peptide (BNP) and cholinesterase (ChE) on prognosis of elderly patients with pulmonary infection.Methods Sixty cases aged ≥ 65 years old with lung infection admitted to Departments of Infectious Diseases and Respiration of Hebei Provincial People's Hospital from March 2012 to March 2014 were enrolled. According to the diagnostic criteria of pulmonary infection and the severity score (PSI) of pneumonia, the patients were classified into three groups with different grades of infectious severity (PSI Ⅰ-Ⅲ, PSI Ⅳ, PSI Ⅴ groups), 20 cases in each group; in the same period, 20 elderly healthy people having accepted the physical examination in this hospital were designed as the healthy control group. Furthermore, according to the difference in prognosis, the patients were divided into a survival group (52 cases) and a death group (8 cases). The PSI scores, the levels of white blood cell count (WBC), D-Dimer, CRP, BNP and ChE, mortalities, times of stay in hospital were compared between the PSI Ⅰ-Ⅲ, PSI Ⅳ, PSI Ⅴ groups and the healthy control group as well as between the survival and death groups.Results The periods of stay in hospital of patients with PSI Ⅳ and Ⅴ were much longer than that patients with PSI Ⅰ-Ⅲ (days: 14.7±2.1, 18.3±2.6 vs. 9.2±1.7, both P < 0.05), the degree of increase in time in the PSI Ⅴ group being the most significant. Before treatment, compared with the healthy control group, the PSI score, the levels of WBC, D-dimer, CRP and BNP were significantly increased, the level of ChE was markedly decreased in patients with PSI Ⅱ-Ⅲ, Ⅳ and Ⅴ groups, and along with the rise of PSI score the changes were more remarkable [PSI score: 78.9±13.7, 117.4±20.2, 152.1±34.8 vs. 51.3±7.9; WBC (×109/L): 11.4±1.4, 13.6±1.9, 16.7±2.2 vs. 8.9±1.1; D-Dimer (μg/L): 779.6±46.1, 1 068.2±142.6, 1 846.2±215.0 vs.348.3±31.8; CRP (mg/L): 30.1±3.7, 58.2±6.7, 74.7±9.2 vs. 6.8±0.9; BNP (ng/L): 1 057.4±205.1, 1 976.7±333.7, 2 437.7±468.9 vs. 115.8±21.7; ChE (U/L): 6 260±826, 3 390±437, 1 861±268 vs. 7 804±904, allP < 0.05]. The mortalities of groups PSI Ⅳ and PSI Ⅴwere more than that in group PSI Ⅱ - Ⅲ [10.0% (2/20), 30.0% (6/20) vs. 0]; there was no statistically significant difference in age between the survival group and death group (P > 0.05). Compared with the survival group, the PSI score, the levels of WBC, D-dimer, CRP and BNP after treatment in death group were markedly higher [PSI score: 141.5±23.3 vs. 97.6±18.2; WBC (×109/L): 15.9±1.9 vs. 12.1±1.8; D-Dimer (μg/L): 1 373.9±179.4 vs. 627.4±69.6; CRP (mg/L): 69.8±9.8 vs. 42.6±7.3; BNP (ng/L): 2 745.6±374.9 vs. 1 022.2±171.3; allP < 0.05], the level of ChE was significantly lower (U/L: 2 569±309 vs. 5 692±777,P < 0.05).Conclusion The serum levels of CRP, BNP and ChE in aged patients with pulmonary infection are helpful to the early diagnosis of disease severity, so as they have guiding significance in predicting prognosis.

Objective To study the efficacy and complications of reconstruction of failed urethro-plasty for hypospadias with pedicle flap , bladder mucosa , buccal mucosa , and biological patch . Methods 23 patients were enrolled from Jul .2005 to Dec.2011.8 patients, with good local skin condition , were performed with pedicle flap urethroplasty .The other 15 patients, with bad local skin condition or with long segment urethral stricture , were performed with free grafts , including 6 bladder mucosa , 7 buccal muco-sal and 2 biological patch. Results Of the 23 cases, 7 cases were cured by one phase operation .There were 16 (16/25) cases had complications.3 (3/16) cases were failed because of serious infection (2 pedi-cle flap, 1 bladder mucosa ) .The failed cases were implemented with urethroplasty 6 months later by the buccal mucosa installments operation .4 (4/16) cases had solitary urethral fistula (1 pedicle flap, 2 bladder mucosa, and 1 buccal mucosal), who were successfully treated with simple fistula repair 3 to 6 months later. 9 ( 9/16) cases had urethral stricture ( 2 pedicle flap , 3 bladder mucosa , 3 buccal mucosal , and 1 biologi-cal patch graft ) , who were treated with urethral sound and got good result .We had reconstructed the urethra using mucosa graft onlay urethroplasty .All of the 23 patients were followed up with an average of 14.5 ( 6-24) months.23 cases were satisfied with the stretched penis , urination and no need to expand the urethra more than 6 months.3 cases were not satisfied with penile appearance .After communication, these patients did not require a further penis orthopedic surgery . Conclusions Pedicle flap, bladder mucosa , buccal mucosa and biological patch can be used in urethral repair and construction of failed urethroplasty for hypos -padias.Urethral sound dilation plays an important role in hypospadias repair .

Objective:To establish a database for pelvic trauma in Hunan Province,and to start the work of multicenter pelvic trauma registry.Methods:To establish the database,literatures relevant to pelvic trauma were screened,the experiences from the established trauma database in China and abroad were learned,and the actual situations for pelvic trauma rescue in Hunan Province were considered.The database for pelvic trauma was established based on the PostgreSQL and the advanced programming language Java 1.6.Results:The complex procedure for pelvic trauma rescue was described structurally.The contents for the database included general patient information,injurious condition,prehospital rescue,conditions in admission,treatment in hospital,status on discharge,diagnosis,classification,complication,trauma scoring and therapeutic effect.The database can be accessed through the internet by browser/servicer.The functions for the database include patient information management,data export,history query,progress report,video-image management and personal information management.Conclusion:The database with whole life cycle pelvic trauma is successfully established for the first time in China.It is scientific,functional,practical,and user-friendly.

OBJECTIVE: To analyze the epidemiological characteristics and treatment situation of pelvic fractures in 5 cities in Hunan, improve the treatment and provide epidemiological data for policymakers. METHODS: The clinical data of 65 patients with pelvic fractures were collected from 9 third-tier hospitals in Hunan from October 2012 to March 2013. The gender, age, cause, volume of blood transfusion, and prognosis were analyzed with SPSS 13.0. RESULTS: There were 44 male and 21 female patients (2.10:1.00). The age ranged from11 to 86 years and 74.6% of the patients were between 20 and 59. The main cause was traffic injury (30 cases, 46.2%) and fall injury (22 cases, 33.8%). About 73.8% patients suffered associated injuries all over the body. By Tile's classification of pelvic fractures, the average blood transfusion of type A was 483.33 mL, that of type B was 1 026.92 mL and type C was 1 905.56 mL. Compared with type A, the treatment outcome of type C patients was worse. CONCLUSION Pelvic fractures are mostly caused in young and middle-aged males by high-energy. Tile C pelvic fractures need more blood transfusion and have poor prognosis. Patients had better be taken straight to municipal hospitals by expertise. Safety education for high-risk groups should be enhanced to reduce the incidence of pelvic fractures.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; China ; epidemiology ; Cities ; Female ; Fractures, Bone ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Pelvic Bones ; pathology ; Tertiary Care Centers ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the clinical effect of modified Koyanagi technique with coverage by tunica vaginalis of testis in severe hypospadias.

METHODS49 cases with severe hypospadias treated from Jan. 2009 to Sep. 2011 were retrospectively studied. 25 patients underwent Koyanagi technique with coverage by tunica vaginalis of testis. 24 cases underwent one-stage Duplay + Duckett technique in the same term. The patients were followed up for 7-24 months.

RESULTSAmong the 25 children treated with Koyanagi procedure, 20 cases were cured, 5 patients had postoperative complications, including urethral fistula in 3 cases,urethral stenosis in 2 cases. At the same time, in the Duplay + Duckett group, 17 cases were cured, 7 children had postoperative complications, including urethral fistula in 4 cases, and urethral stenosis in 3 cases. All the patients with urethral fistula were repaired successfully 6 months after the first surgery; The urethral stenosis were cured by dilatation within 1 to 3 months. The successful rate in the 2 groups had no significant difference(P >0.05).

CONCLUSIONSKoyanagi technique with coverage by tunica vaginalis of testis is relatively simple with similar effect as Duplay + Duckett technique for severe hypospadias.

Child ; Child, Preschool ; Humans ; Hypospadias ; surgery ; Male ; Postoperative Complications ; etiology ; therapy ; Retrospective Studies ; Surgical Flaps ; transplantation ; Testis ; surgery ; Urethral Diseases ; etiology ; therapy ; Urethral Stricture ; etiology ; therapy ; Urinary Fistula ; etiology ; surgery

Objective To study the occurrence site characteristics of middle cerebral artery aneurysm (MCAA ) in volume CT digital subtraction angiograhy(VCTDSA) .Methods The image characteristics in 72 cases of MCAA from May 2009 to January 2011 were retrospectively analyzed ,according to the running of middle cerebral artery ,the occurrence sites of aneurysm were divided into four categories :M1 segment ,M2 bifurcation ,M2 distal and M3-M5 segment ,the aneurysm number was conducted the statistics and the image characteristics were analyzed ;two neuroradiologists adopted the double-blind method to measure the MCAA angle in bifurcation of M2 segment and compared it with the bifurcation angle in the normal middle cerebral artery ,the difference between them were statistically analyzed .Results (1)M1 segment aneurysms were 7 cases(9 .70% ) ,M2 bifurcation aneurysms were 58 ca-ses(80 .56% ) ,M2 distal aneurysms were 5 cases(6 .94% ) and M3-M5 segment aneurysms were 2 cases(2 .78% ) .(2)The angle in M2 bifurcation of the normal middle cerebral artery was(99 .30 ± 22 .96)° ,M2 bifurcation aneurysm angle was(139 .26 ± 27 .61)° , the difference between them showing statistical significance (P<0 .01) .(3)The difference between left and right of M 2 bifurcation angle in the normal middle cerebral artery had no statistical significance (P>0 .05) .(4)The M2 bifurcation angle in ruptured aneu-rysm was(133 .98 ± 30 .24)° ,which in unruptured aneurysms was(144 .53 ± 21 .81)° ,the difference between them had no statistical significance(P>0 .05) .Conclusion MCAA mainly occurred in M2 bifurcation .There is significant difference in M2 bifurcation an-gle between the aneurysm group and non-aneurysm group ,M2 bifurcation angle is increased ,the probability of aneurysm occurrence is increased .

Objective To investigate the relationship between the expression of long non-coding RNA HOXA-AS2(lncRNA HOXA-AS2),long non-coding RNA FOXD2-AS1(lncRNA FOXD2-AS1),and long non-coding RNA CRNDE(lncRNA CRNDE)in endometrial carcinoma and the clinical pathological character-istics and prognosis of patients.Methods Collect samples of endometrial carcinoma cancer tissues and adja-cent tissues excised during surgery from 119 endometrial carcinoma patients admitted to a hospital from Octo-ber 2017 to February 2020.The relative expression levels of HOXA-AS2,FOXD2-AS1 and CRNDE in tissues were retrospectively analyzed,as well as their relationship with clinicopathological features and 3-year survival rate of patients.Results The relative expression levels of HOXA-AS2,FOXD2-AS1 and CRNDE in cancer tissues of endometrial carcinoma patients were higher than those in adjacent tissues,with statistical signifi-cance(P＜0.05).The relative expression levels of HOXA-AS2,FOXD2-AS1 and CRNDE in cancer tissues of endometrial carcinoma patients were positively correlated(rHOXA-As2 vs.FOXD2-AS1=0.384,P=0.001;rHoXA-AS2 vs.CRNDE=0.576,P＜0.001;rFoXD2-AS1 vs.CRNDE=0.326,P=0.003).In the HOXA-AS2,FOXD2-AS1 and CRNDE high expression group,the proportion of patients with international federation of gynecology and ob-stetrics(FIGO)stage Ⅲ+Ⅳ,lymph node metastasis,deep infiltration and low differentiation was higher than that in the low expression group,with statistical significance(P＜0.05).The 3-year survival rate of low HOXA-AS2 expression group in endometrial cancer patients(52/60,86.67％)was higher than that of high HOXA-AS2 expression group(40/59,67.79％),the difference was statistically significant(x2=6.039,P＜0.05).The 3-year survival rate of patients with endometrial cancer with low FOXD2-AS1 expression group(53/59,89.83％)was higher than that of patients with endometrial cancer with high FOXD2-AS1 expression group(39/60,65.00％),and the difference was statistically significant(x2=10.456,P＜0.05).The 3-year sur-vival rate of low CRNDE expression group in endometrial cancer patients(51/60,85.00％)was higher than that of high CRNDE expression group(41/59,69.49％),and the difference was statistically significant(x2=4.079,P＜0.05).HOXA-AS2,FOXD2-AS1,and CRNDE were risk factors for death in endometrial carcinoma patients(P＜0.05).Conclusion The expression of HOXA-AS2,FOXD2-AS1,and CRNDE in endometrial carcinoma cancer tissue is closely related to the clinical pathological characteristics and prognosis of patients.

Objective: To explore the feasibility and effectiveness of transoral surgery (TOS) for the treatment of hypopharyngeal carcinoma by means of the radiofrequency coblation(RFC). Methods: Twenty-two patients with hypopharyngeal carcinoma who were treated with TOS using RFC during the years of 2010-2016 were enrolled. Among these patients, 15 suffered from pyriform sinus carcinoma, 4 suffered from postcricoid carcinoma, and 3 suffered from posterior hypopharyngeal wall carcinoma. According to the AJCC 2002 guideline, the tumor stages were T1N0M0 for 3 patients, T2N0M0 for 9 patients, T1N1M0 for 1 patient, T1N2M0 for 1 patient, T2N1M0 for 4 patients, and T2N2M0 for 4 patients respectively. All patients with N+ underwent concurrent neck dissection; 2 patients underwent concurrent prophylactic tracheotomy; 17 underwent post-operative radiotherapy for 50-66 Gy. The follow-up time was 6-72 months with a median 35 months.Two patients were lost to follow-up. Results: All patients except 2 underwent the TOS successfully, while the two patients were treated with open approach surgery due to unsure safe margin. Most patients returned to oral feeding within one week. Among the 18 patients with complete follow up data, 3 had the local recurrence of the tumor (16.7%) and one died due to local recurrence, multiple primary esophageal carcinoma, and distant metastasis 4 years after surgery (5.6%). According to the Kaplan-Meier method, the 5-years local control rate and survival rate were 57.8% and 67.5% respectively. All patients had no disorders in speech, swallowing and respiration during the follow up. Conclusions The RFC can be applied in TOS for the treatments of hypopharyngeal carcinoma with high cutting efficiency and better control of intraoperative hemorrhage, which is useful in lowering the operation difficulty. The oncologic results are comparable to the open surgery with satisfactory postoperative organ function preservation.