Objective To explore the feasibility of laparoscopic resection of large uterus .Methods Patients with large uterus ( volume such as 12~20 weeks pregnant size ) by the implementation of laparoscopic hysterectomy were collected in our hospital and Dongguan Tung Wah Hospital from January 2010 to December 2012 .The uterus was carried out a complete hysterectomy through intra-operation by upward into the abdominal puncture point , ligation cutting tumor , and reduction of the uterine body method .Results A total of 38 patients was carried out hysterectomy operation .According to the size of uterus , the lens opening and operating hole was cor-responding upward to expand the horizons and operating space under microscope , and the use of stepwise ligation method to gradually cut reduced uterine body and release the operation space for overcoming the narrow operation space .Each hysterectomy operation was smoothly completed , and no case was converted to laparotomy .Conclusions Laparoscopic hysterectomy with the puncture point , and moving after ligation cutting shrink small palace body method can effectively create space for operation , and safety and feasibility of lap-aroscopic resection is helpful to improve the large uterus .

Objective To evaluate the efficacy of nucleoside analogues (NAs) antiviral therapy on clinical outcome for hepatitis B virus (HBV)-related primary hepatic carcinoma patients after hepatectomy. Methods The clinical data of 156 HBV-related primary hepatic carcinoma patients after hepatectomy were retrospectively analyzed..According to whether accepted postoperative antiviral treatment, all patients were divided into control group (n = 80)and observation group (n = 76). The serum HBV DNA capacity, recurrence-free survival (RFS)and overall survival (OS)were compared between two groups. Results One week, 1 month, 2 months and 3 months after operation , the serum HBV DNA capacity of observation group was significantly lower than that of control group(P < 0.05). One year, 3 years and 5 years after operation, intergroup comparison of RFS rate of both groups showed statistical significance (P < 0.05) and 1 year, 3 years and 5 years after operation, the difference of OS rate of both groups indicated statistical significance (P < 0.05). Conclusion Standard NAs antiviral treatment for HBV-related primary hepatic carcinoma patients after hepatectomy ,can improve prognosis and prolong survival time. The inhibition the HBV copy active may be its mechanism.

OBJECTIVE:To investigate the compatible stability of Levetiracetam(Lev)injection with 3 injections. METHODS:Each Lev injection 1000 mg mixed with 0.9% Sodium chloride injection 100 mL,5% Glucose injection 100 mL or Sodium lactate Ringer's injection 100 mL respectively. Under the light condition,at 25 ℃,the color and clarification degree of mixtures were ob-served at different time points within 24 h after mixing;pH value and the number of insoluble particles were determined. The contents of related impurities(impurity A,B,C,D,2-hydroxypyridine)and Lev in mixtures were determined by HPLC. RESULTS:Under above condition,all mixtures were colorless clear liquid within 24 h;pH value had no significant change (RSD<1%,n=7);the number of insoluble particles was no more than the range stated in Chinese Pharmacopeia(2015 edition). Impurity B and C were not detected;the contents of other impurities were in line with the requirements of foreign pharmacopeia. No marked change was noted for relative content of Lev(RSD<1%,n=7). CONCLUSIONS:After mixing with 0.9% Sodium chloride injection,5% Glucose injec-tion or Sodium lactate Ringer's injection,Lev injection keep stable at 25℃within 24 h under the light condition.

Enhanced extracorporeal counterpulsation (EECP) information consists of both text and hemodynamic waveform data. At present EECP text information has been successfully managed through Web browser, while the management and sharing of hemodynamic waveform data through Internet has not been solved yet. In order to manage EECP information completely, based on the in-depth analysis of EECP hemodynamic waveform file of digital imaging and communications in medicine (DICOM) format and its disadvantages in Internet sharing, we proposed the use of the extensible markup language (XML), which is currently the Internet popular data exchange standard, as the storage specification for the sharing of EECP waveform data. Then we designed a web-based sharing system of EECP hemodynamic waveform data via ASP. NET 2.0 platform. Meanwhile, we specifically introduced the four main system function modules and their implement methods, including DICOM to XML conversion module, EECP waveform data management module, retrieval and display of EECP waveform module and the security mechanism of the system.
Computer Communication Networks ; standards ; Counterpulsation ; methods ; Heart-Assist Devices ; Hemodynamics ; Humans ; Internet ; Medical Records Systems, Computerized ; standards ; Programming Languages

OBJECTIVE: To explore and compare the effect of clinical characters on quality of life (QOL) of laryngeal carcinoma postoperative patients. METHOD: We performed a retrospective cohort follow up study of 303 patients who underwent operation for laryngeal carcinoma. The Chinese version of the general and the head and neck specific quality of life questionnaires of the European Organization for the Research and Treatment of Cancer (EORTC QLQ-C30 and EORTC QLQ-H&H35) were used to measure the quality of life of those patients in the cohort, to study the relationship between QOL and clinical factors. RESULT: In the 303 cases, there were 78 cases retaining the permanent tracheostomies (59 total laryngectomy and 19 partial laryngectomy); 4 patient retain the nasal feed pipe. Female patients were worse than male patients in the domain of physical function and global QOL (P<0.05). Older patients were worse than younger patients in the domain of physical function and speech (P<0.05). Patients with glottic tumors experience better global QOL than their peers with under glottic or supraglottic tumors. The patients with supraglottic tumor have more problem with swallowings (P<0.05). Earlier stage patients have better suitation in many domains than later stage patients, but III stage have more difficulty with swallowing than IV stage. Patients who accepted minimally invasive operation and laryngofissure have better QOL than those accepted partial laryngectomy or total laryngectomy; total laryngectomee have more problems with physical, emotion function, global QOL, sense, speech, cough and morbid feeling than patients with partial laryngectomy, but less problem with fatigue, pain, dyspnea, swollowing and dry mouth; Patients with partial horizontal laryngectomy have more difficulty with swallowing. In the multivariable analysis, the operation mode was an independent factor to speech problem. Patients who accepted neck dissction have more negative outcomes than patients without neck dissection. In the univariable analysis, the permanent tracheostomy was a notable factor which affected many domains in the quality of life; multivariable analysis showed that permanent tracheostomy was an important factor which worked on global quality of life. CONCLUSION The quality of life was affected by many clinical factors. The operation mode was an independent factor which affect speech problem. Decannulation after partial laryngectomy was very important to keep the quality of life.
Female ; Humans ; Laryngeal Neoplasms ; psychology ; surgery ; Laryngectomy ; psychology ; Male ; Postoperative Period ; Quality of Life ; Retrospective Studies ; Surveys and Questionnaires

Objective To investigate the effect of vasopressin injection technique on ovarian reserve in patients with laparoscopic cystectomy of unilateral ovarian endometrioma .Methods 70 patients with unilateral ovarian endometrioma were randomly allocated into study group (37 cases) and control group(33 cases) according to the digital table .Diluted vasopressin was injected into the space between the normal ovarian cortex and the cyst wall before stripping in the study group , and ordinary laparoscopic cystectomy without injection was adopted in control group.The average contents of anti -mullerian hormone(AMH),follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),antral follicle count(AFC) and peak systolic velocity(PSV) were compared in two groups before and after surgery .Results The operative time of the study group was (37.6 ±8.6) min,which was significantly shorter than (42.8 ±9.1)min of the control group(t=2.46,P<0.05).The blood loss of the study group was (23.2 ±12.1)mL,which was significantly less than (31.4 ±17.3)mL of the control group(t=2.32,P<0.05).In the control group,the E2 levels preoperation and postoperative were (201.46 ±7.51)pmol/L,(153.94 ± 8.72)pmol/L,respectively,the difference was statistically significant between preoperation and postoperation (t =23.72,P<0.05).The AMH levels in the control group preoperation and postoperation were (2.31 ±0.79)ng/mL, (1.67 ±0.75)ng/mL,respectively,there was statistically significant difference between preoperation and postoperation (t=3.38,P<0.05).The FSH levels in the control group preoperation and postoperation were (6.58 ±2.70)U/L, (10.24 ±1.21)U/L,respectively,there was statistically significant difference between preoperation and postoperation (t=7.12,P<0.05).The LH levels in the control group preoperation and postoperation were (5.87 ±1.76)U/L, (6.15 ±2.14) U/L,respectively,there was no significant difference between preoperation and postoperation (t =0.58,P>0.05).The F0 levels in the control group preoperation and postoperation were (8.7 ±2.8),(4.6 ±0.7), respectively,there was significant difference between preoperation and postoperation (P<0.05).The PSV levels in the control group preoperation and postoperation were (13.8 ±5.9)cm/s,(7.5 ±2.4)cm/s,respectively,there was significant difference between preoperation and postoperation (P<0.05).The E2 levels in the study group preopera-tion and postoperation were (199.36 ±8.42)pmol/L,(197.12 ±8.33)pmol/L,respectively,there was no significant difference between preoperation and postoperation (t=1.15,P>0.05).The AMH levels in the study group preopera-tion and postoperation were (2.23 ±0.85) ng/mL,(2.19 ±0.83) ng/mL,respectively,there was no statistically significant difference between preoperation and postoperation (t=0.20,P>0.05).The FSH levels in the study group preoperation and postoperation were (6.27 ±2.35)U/L,(6.73 ±2.23)U/L,respectively,there was no statistically significant difference between preoperation and postoperation (t=0.86,P>0.05).The LH levels in the study group preoperation and postoperation were (5.92 ±2.32) U/L,(5.57 ±2.31) U/L,respectively,there was no statistically significantl difference between preoperation and postoperation (t=0.65,P>0.05).The F0 levels in the study group preoperation and postoperation were (9.2 ±2.4),(8.9 ±2.7),respectively,there was no statistically significant difference between preoperation and postoperation (P>0.05).The PSV levels in the study group preoperation and postoperation were (14.7 ±5.4) cm/s,(14.0 ±4.7) cm/s,respectively,there was no statistically significant difference between preoperation and postoperation (P>0.05).Conclusion Vasopressin injection technique used in unilateral ovarian endometrioma laparoscopic cystectomy is safe and effective ,and it can protect the ovarian reserve .

Objective:To investigate the analgesic effect and safety of using an epidural analgesia pump versus an intravenous analgesia pump for uterine artery embolization in the treatment of uterine fibroids. Methods:Fifty patients with uterine fibroids undergoing uterine artery embolization admitted to The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University from January 2019 to December 2021 were included in this study. They were divided into an observation group and a control group ( n = 25/group). Patients in the observation group used an epidural analgesia pump for pain relief, while patients in the control group used an intravenous analgesia pump for pain relief. At 1, 6, 12, and 24 hours after surgery, pain severity was compared between the two groups using the Visual Analogue Scale. Comfort level was compared between the two groups using the Bruggemann Comfort scale. Before and after surgery, respiratory rate, heart rate, blood pressure, and adverse reactions were compared between the two groups. Results:At 1 hour after surgery, the Visual Analogue Scale score in the observation group was significantly lower than that in the control group [3.00 (2.00, 5.50) vs. 7.00 (6.00, 8.00), Z = -3.84, P < 0.05]. At 6, 12, and 24 hours after surgery, there was a significant difference in the Visual Analogue Scale score between the two groups (all P > 0.05). Within 24 hours after surgery, the use of opioid analgesics in the observation group was less than that in the control group [16.00% (4/25) vs. 88.00% (22/25), χ2 = 25.96, P < 0.001]. At 1 hour after surgery, the Bruggemann Comfort Scale score in the observation group was significantly higher than that in the control group [0.00 (0.00, 0.50) vs. 0.00 (0.00, 0.00), Z = 2.08, P < 0.05]. At 6, 12, and 24 hours after surgery, there was no significant difference in the Bruggemann Comfort Scale score between the two groups (all P > 0.05). After surgery, heart rate was significantly decreased in each group compared with before surgery (both P < 0.05). There were no significant differences in respiratory rate and mean arterial pressure between the two groups before and after surgery (both P > 0.05). There were no significant differences in the incidences of postoperative nausea, vomiting, and fever between the two groups (all P > 0.05). Conclusion:The epidural analgesia pump used for uterine artery embolization in the treatment of uterine fibroids has a better analgesic effect and provides more comfort and is safer than the intravenous analgesia pump. The former is worthy of clinical promotion.

OBJECTIVETo investigate the treatment outcome, laryngeal preservation and side-effect in locally advanced hypopharyngeal carcinoma treated with combined Hilical tomotherapy (HT) or intensity-modulated radiotherapy (IMRT) and chemotherapy and/or EGFR inhibitor (Cetuximab or Nimotuzumab).

METHODSA total of 68 patients (20 cases with T1-2N1-3M0 and 48 cases with T3-4N1-3M0) with locally advanced hypopharyngeal cancer were treated individualy with non-surgical combined modality treatments including induction chemotherapy followed by concurrent chemoradiotherapy, induction chemotherapy followed by concurrent radiotherapy and EGFR inhibitor, concurrent chemoradiotherapy and EGFR inhibitor, and concurrent radiotherapy and EGFR inhibitor. HT was used in 40 patients and IMRT in 28 patients. Side-effects were evaluated with the established Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 criteria.

RESULTSThe average follow-up time was 25.7 months (range 3-69 months). All patients completed the planned radiotherapy without treatment breaks, and 66 (97.0%) of 68 patients completed the planned chemotherapy. The 2-year and 3-year overall survival rates were 78.8% and 64.7% respectively, with an organ preservation rate of 84.2%. The most common side-effect greater than or equal to grade 3 was oropharyngeal mucositis. No patient dependent on a percutaneous gastrostomy and tracheostomy tube.

CONCLUSIONHypopharyngeal carcinoma can be treated with non-surgical combined modality treatment including HT or IMRT, with a high laryngeal organ preservation rate and minimal toxicities.

Antibodies, Monoclonal, Humanized ; Antineoplastic Agents ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Squamous Cell ; therapy ; Cetuximab ; Chemoradiotherapy ; Cisplatin ; Combined Modality Therapy ; methods ; Fluorouracil ; Head and Neck Neoplasms ; therapy ; Humans ; Hypopharyngeal Neoplasms ; therapy ; Larynx ; Larynx, Artificial ; Organ Preservation ; Radiotherapy, Intensity-Modulated ; Survival Rate ; Treatment Outcome

A model of myelosuppression with thrombocytopenia was produced in monkey by i.v. administration of carboplatin to the evaluate effects of rhIL-11 treatment in monkeys. Following myelosuppression, rhIL-11 was subcutaneously injected for 19 consecutive days at the dose of 50 or 100 micro g/kg. In myelosuppressed monkeys treated with rhIL-11, peripheral blood platelet started to drop at the day 8 after the administration of carboplatin, and reaching the nadir between the day 12 - 14, the decrease in blood platelet was less severe compared with untreated monkeys; peripheral blood platelet began to recovery on day 11 - 13 (D14 - D16) after rhIL-11 treatment, and reached or surpassed the baseline value before carboplatin administration after 13 - 15 days rhIL-11 treatment. Blood platelet counts remained high level after discontinuation of rhIL-11 administration and returned to baseline after 4 days. The results demonstrated that rhIL-11 has a significant thrombopoietic activity, it can reduce the severity of thrombocytopenia as well as shorten the duration of thrombocytopenia caused by myeloablastive agents, and is likely to become an effective agent against thrombocytopenia induced by chemotherapy.

Hematological effects of rhIL-11 on normal and myelosuppressed male BALB/c mice were observed. Mice were subcutaneously injected with rhIL-11 for 7 consecutive days, at the dose of 200 or 400 micro g/kg per day, peripheral blood platelet counts were moderately elevated on 5 days after administration and returned to base level within 4 days after discontinuation of injection. In myelosuppressed mice, treatment with rhIL-11 significantly ameliorated the degree of thrombocytopenia, the recovery of thrombocytopenia was also significantly accelerated at the dose range of 100 - 400 micro g/kg per day, and blood platelet counts reached pre-irradiated level after 13 - 15 days of treatment. The magnitudes of platelet count elevation were similar among groups of 100, 200 and 400 micro g/kg per day, although recovery appeared earlier in group of 400 micro g/kg per day. Significant increases in CFU-Meg were observed both in normal and myelosuppressed mice. Our results suggest that rhIL-11 promotes the increase of peripheral blood platelets both in normal and myelosuppressed mice, and can be used as a potential therapeutic agent for thrombocytopenia induced by chemotherapy.