Objective To study the standard operating methods and skills of Lichtenstein's tenaion-free her-nioplasty for treating groin hernia and the methods of reducing the postoperative complication and recrudescence. Methods Clinical data of treating greinhemia in 178 eases at Department of General Surgery, Luan People's Hospi-tal were reviewed and analyzed. Results On average, each operation needs 50 minutes and the patients spend 4 days in hospital. After 2～3 weeks,the patients can restore the daily activity and manual labour. There were 9 cases of uri-nary retention after operation,5 cases of scrotum haematoma's accumulating liquid,7 cases of the cut fat deliques-cing, 14 cases of various pain and numbness in groin area and 1 case of hernia recrudescence. Conclusion Lichten-stein's tension-free hemioplasty is a perfect surgical operation method which has many advantages, such as minimal trauma,rapid recovery, simple operation sequence, and less postoperative complication and recrudescence. It is in keeping with anatomy physiology.

Objective To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS), and compare it with contrast-enhanced CT(CECT). Methods Eighty-one focal liver lesions were evaluated with CEUS and CECT, diagnostic value of two modalities were calculated, vaseularity manifestations of two modalities in arterial phase were compared. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CEUS were 96.6 %, 86.9 %, 94.9 %, 90.9 %, 93. 80%, respectively, and the diagnostic value of CECT were 98.3%, 82. 6%, 93.4%, 95.0%, 93.8%, respectively. Among all the metastasis, hypervascular manifestation lesions in arterial phase of CEUS and CECT were 72% (18/25) and 32% (8/25)( P <0.05). Conclusions The diagnostic value of CEUS and CECT in focal liver lesions are comparably satisfying,and there is no significant difference between them, the combination use of two modalities would improve the diagnosis performance. CEUS can show more hypervaseular metastasis than CECT in arterial phase.

BACKGROUND: The key to success in laryngeal transplantation is to control the infection. In practice, how to minimize the risk of infection should be considered first, so that the laryngeal allograft can survive after revascularization under the immunosuppressive state. Then the therapeutics methods should be focused on the functional recovery of respiratory, swallowing and phonation.OBJECTIVE: To explore the feasibility of staged allogeneic larynx transplant for dogs in order to decrease the infection rate.METHODS: Ten male conspecific Beagle dogs were assigned into five pairs of donor and receptor according to body mass and the size of larynx. The allogeneic larynx was embedded under the neck skin by allotransplantation. The dogs were treated with immunosuppressant daily to resist immnological rejection. The pharynx and trachea were contraposed after larynx survived to establishⅡstage laryngeal transplantation animal model.RESULTS AND CONCLUSION: InⅠstage of laryngeal transplantation, the laryngeal allograft survived well, blood supply was passable. Receptor dog 1 with vertical midline incision in the neck, receptor dogs 4 and 5 with transverse incisions in the neck grew well. No infection phenomena was found in receptor dogs 4 and 5. The lastⅡstage laryngeal transplantation was performed in the 4th week afterⅠstage laryngeal transplantation. Skin flap necrosis occurred in receptor dogs 2 and 3 with U-shape incisions. The donor larynx had different degree infection. Laryngeal allograft of receptor dog 2 died; laryngeal allograft of receptor dog 3 survived after treatment. The survival period of donor larynx in receptors was as long as 4 weeks. These findings indicate that the larynx infection is avoid or reduced by staged larynx transplantation with pre-embed laryngeal allograft after total laryngectomy. The receptor dog is tolerant; the donor larynx is easy to survive. The main histological change occurs in the epithelial mucosae which can be used as an inspect index of immunosuppressive agents. However, glandular organ secretion is a troublesome problem and immunodepressant must be continuously administrated for a long time.

OBJECTIVE To explore the feasibility of transnasal endoscopic surgery to treatment of intraorbital space occupying by ethmoidal-lamina papy-racea approach. METHODS The clinical data of 10 cases who underwent intraorbital surgery via transnasal endoscopic ethmoidal-lamina papyracea approach from June 2003 and Aug. 2006 were retrospectively studied. The patients included foreign body 1 case, cavernous hemangioma 2 case, lipoma 2 cases, inflammatory pseudotumor 2cases and hematoma 3cases. All intraorbital space occupying were operated by transnasal endoscopic ethmoidal-lamina papyracea approach but for one cavernous hemangioma which was dealt with through extra orbitectomy. The inflammatory pseudotumors were prescribed with glucocorticoid after operation.RESULTS Foreign body was removed successfully. One case of cavernous haemangioma was removed completely by transnasal endoscopic surgery and the other by extroorbital operation. All symptoms of proptosis and diplopia disappeared. One vision was enhanced from hand moving to 0.3 and another from light to hand moving. However, there was one hematoma which had been hindered about 14 days after damaged lost eyesight after operation. All cases were cured but one pseudotumor which recurred and was operated again. All cases were followed up 3 to 24 months. CONCLUSION Intraorbital surgery via transnasal endoscopic ethmoidal-lamina papyracea approach was available and feasible for the advantages of clear operation field, direct vision operation, less damage, rapid recovery and avoiding of facial scar, and intranasal endoscopic surgery can treat the rhino-orbital related diseases and nasal diseases at the same time.

Adult ; Animals ; Asthma ; epidemiology ; etiology ; Female ; Humans ; Immunoglobulin E ; blood ; Male ; Occupational Diseases ; epidemiology ; etiology ; Pyroglyphidae ; Skin Tests

Objective: To study the antitumor effects of transmembrane TNF-? and secretory TNF-? in vivo. Methods: Three types of TNF-? cDNA plasmids (wild type TNF-?; transmembrane TNF-? mutant; secretory TNF-? mutant) were directly injected into tumor-tearing mice. Results: The three types of TNF-? could be expressed by tumor cells and all of them could inhibit evidently the rate of tumor growth. The tumor regression after treatment with transmembrane TNF-? mutant at the early stage was more significant than that with the other two types of TNF-?( P

Objective To evaluate the reliability and validity of hepatocellular carcinoma (HCC)using the liver imaging reporting and data system (LI-RADS).Methods By using the LI-RADS v2013.1,two radiologists evaluated 1 62 patients with cirrhosis or with a risk of HCC according to an inclusion criteria.The Kappa value was used to evaluate the consistency between two different diagnoses and was compared with pathological and follow-up results.The accuracy of the LI-RADS was assessed including sensitivi-ty,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio and accuracy rating.Results In all 1 62 patients,there were HCCs in 97 patients including 7 patients belonging to the LR3,benign diseases in 50,and other kinds of malignancy in 1 5.The Kappa value was 0.882 (P =0.000)between two observers on LI-RADS grading. The sensitivity,specificity and accuracy rating of LI-RADS grading in diagnosing HCC was 100.00%,91.30%,and 97.06%,re-spectively.Conclusion The LI-RADS has high consistency and stability in evaluation and diagnosis of HCC by enhanced CT.LR3 di-agnosis should be cautious because of a susceptible development to HCC,which can be improved through the combination of clinic and laboratory examination.

Objective To observe the enhancement pattern and time-intensity curve of endometrial carcinomas by using contrast-enhanced ultrasound(CEUS). Methods Altogether 30 endometrial carcinomas were evaluated with real-time gray-scale CEUS, using pulse inversion harmonies technique. The enhancement patterns were observed. Twenty tumors were compared for the size between traditional ultrasound and CEUS. In 21 cases, the parameters of time-intenaity curve were compared between the endometrial lesion and un-involved myometrium. Results The contrast agent arrived at the feeding vessels firstly and then branched into the endometrial tumors. All of the endometrial tumors were enhanced completely except for the necrosis area. In 73.3 % (22/30) of cases, the tumors washed out earlier than the un-involved myometrium. By using CEUS 76. 7% (23/30) of cases showed the feeding vessels of tumor. 43.3% (13/30) of cases showed more clearly than traditional ultrasound in tumor base, position and boundary. The mean enhancement sizes of tumor were bigger than the size showed by traditional ultrasound in 85% of cases by (0. 62±0.50)cm. More than 90% cases showed the tumors start to enhance and wash-out earlier than or at the same time as myometrium. The arrival time and peak time of cancer group were significantly earlier than myometrium group. The peak intensity, enhancement intensity and the rising rate of the tumor group were significantly higher than those of the myometrium group. Conclusions There are some characteristic points in CEUS of endometrial carcinomas. CEUS can provide richer information in tumor imaging than traditional ultrasound and has certain clinical value.

ObjectiveTo evaluate the application of chest-abdomen longitudinal diameter ratio,total lung area and lung longitudinal diameter in different gestational ages by two-dimensional ultrasonography.MethodsFive hundred and ninty-two fetus of normal singleton pregnancy between 18 and 40 weeks were ultrasonic scanned by standard 4-chamber view and fetus torso coronal section.The heart area,thoracic area,bilateral lungs pointed to the corresponding diaphragmatic dome gallery on the top of the vertical distance,diaphragmatic dome iterated top to the bottom of the fetal bladder distance were measured respectively.Related regression analysis was done on fitting total lung area and longitudinal diameter with pregnant increasing.ResultsA normal pregnancy fetal total lung area and lung longitudinal diameter were increased as long as the gestational age.The best-fit regression equations of total lung area was:Y =0.83 X +13.894,R2 =0.914;Lung longitudinal diameter was:Y =0.669 X + 3.124,R2 =0.892.Chest-abdomen longitudinal diameter ratio from 18 to 40 weeks gestation was in constant range:0.44 - 0.59.Conclusions Chest-abdomen longitudinal diameter ratio from 18 to 40 weeks gestation is in constant range.The normal pregnancy fetal total lung area and lung longitudinal diameter were increased as long as the gestational age.These parameters may be useful for the prenatal assessment of lung development.

Objective To evaluate and screen out the specific characters of thyroid nodules on grayscale and color Doppler ultrasonography. Methods One hundred and four thyroid nodules in 95 patients were studied with gray-scale and color Doppler ultrasound before surgery.According to the probability of malignancy,the main independent characters were screened out by Logistic regression analysis and then got the formula which could calculate the probability of malignancy.Results Fifty three nodules,included 44 hyperplasia,7 adenomas,1 switch granuloma and 1 Hashimoto's disease,were benign.Fifty one nodules,included 47 papillary carcinomas,3 medullary carcinomas,1 metastatic carcinomas,were malignant pathologically.The significant characters to differentiate malignant from benign were the shape,margin,border,halo,echostucture,echogenecity,echo uniformity,calcicum,bolood vessel shape and partial abnormal rich blood of thyroid nodules.After two variables logistic regression analysis,a fomula were worked out.Probability of malignancy=1/1+e-z,which z=-7.44+1.30×halo+1.05×calcicum+1.5×vessel shape.If a thyroid nodule with no halo,microcalcicum and irregular vessel shape,the probability of malignancy was 0.99,while with complete halo,no calcicum and regular vessele shape,the probability of malignancy of the nodule was 0.02.Conclusions The halo,calcium and blood vessel shape of thyroid nodules were three independent characters of thyroid nodules to predict malignant thyroid nodules on gray scale and color Doppler ultrasound.