Objective To study the prevention and treatment of severe complications of percutaneous radiofrequency ablation(PRFA)for hepatic malignancy. Methods A series of 939 patients with primary hepatic carcinoma or hepatic metastasis confirmed by pathological examinations or clinical manifestations underwent 1098 treatments of PRFA between January 2006 and December 2009. All the patients were followed up to study the short-or long-term complications related to PRFA. Results Complications developed in 9 patients: bile duct injury (4 patients), hemothorax (2 patients), and intra-abdominal hemorrhage (3 patients). The incidence of complication was 0.82% (9/1098) and the complication-related mortality was 11.1% (1/9). Conclusions Although PRFA which is minimally invasive, is a safe and effective treatment, there were still risks for this procedure, especially when the tumor is located at the portahepatic region or the patient has coagulopathy. Some serious complications can be prevented. It is important to observe the strict indications for RFA and to carry out the procedure carefully. Early detection of complication is important.

Generally, hypoxia is a normal physiological condition in the flaccid penis, which is interrupted by regular nocturnal erections in men with normal erectile function. [1] Lack of spontaneous and nocturnal erections after radical prostatectomy due to neuropraxia results in persistent hypoxia of cavernosal tissue, which leads to apoptosis and degeneration of cavernosal smooth muscle fibers. Therefore, overcoming hypoxia is believed to play a crucial role during neuropraxia. The use of a vacuum erectile device (VED) in penile rehabilitation is reportedly effective and may prevent loss of penile length. The corporal blood after VED use is increased and consists of both arterial and venous blood, as revealed by color Doppler sonography and blood gas analysis. A similar phenomenon was observed in negative pressure wound therapy (NPWT). However, NPWT employs a lower negative pressure than VED, and a hypoperfused zone, which increases in response to negative pressure adjacent to the wound edge, was observed. Nonetheless, questions regarding ideal subatmospheric pressure levels, modes of action, and therapeutic duration of VED remain unanswered. Moreover, it remains unclear whether a hypoperfused zone or PO 2 gradient appears in the penis during VED therapy. To optimize a clinical VED protocol in penile rehabilitation, further research on the mechanism of VED, especially real-time PO 2 measurements in different parts of the penis, should be performed.

Erectile dysfunction and penile shrinkage are the common complications after radical prostatectomy. Penile rehabilitation is widely applied after the surgery. Vacuum therapy is one of the three penile rehabilitation methods used in the clinical setting, but its mechanism is not well known. This study was designed to investigate whether vacuum erectile device (VED) can prevent corporeal veno-occlusive dysfunction and penile shrinkage in the bilateral cavernous nerve crush (BCNC) rat model. Adult male Sprague-Dawley rats were randomly assigned into three groups: sham group, BCNC group, and BCNC + VED group. After 4 weeks, penile length and intracavernosal pressure (ICP) were measured, and then the middle part of the penis was harvested after dynamic infusion cavernosometry to complete the following items: smooth muscle/collagen ratios and collagen I/III ratios; ultramicrostructure of the tunica albuginea, endothelial cell, and smooth muscle cell; and the expression of calponin-1 and osteopontin. The penile shortening, peak ICP and ICP drop rate after alprostadil injection were significantly improved with vacuum therapy after 4-week treatment. Compared with BCNC group, VED significantly increased smooth muscle/collagen ratios, decreased collagen I/III ratios, and preserved the ultramicrostructure of the tunica albuginea, endothelial cell, and smooth muscle cell. The data also showed that animals exposed to VED could partially reverse the expression of calponin-1 and osteopontin induced by BCNC. In conclusion, vacuum therapy is effective to prevent penile shrinkage and veno-occlusive dysfunction in penile rehabilitation, which may be associated with well-preserved structure and function of the tunica albuginea, endothelial cell, and smooth muscle cell.

Objective To explore the accuracy and radiation dose of the right ventricular analysis with DSCT(dual-source computed tomography)using dual-step prospective ECG trigger.Methods Fortyeight consecutive patients who were suspected or diagnosed with coronary artery disease were examined with DSCT coronary angiography and MRI ventricular analysis.Sequential acquisition and dual-step prospective ECG-trigger were used with 30％-90％ width R-R interval.Full tube current output was adopted at 70％ (HR ≤70 bpm)or 40％ (HR ＞ 70 bpm) R-R interval according to heart rates,while 20％ current output was adopted in other R-R interval.Coronary artery was divided into 16 segments according to the American Heart Association.Image quality of coronary arteries were graded with 4-points scale.The DSCT date was reconstructed with 5％ R-R interval.RVESV,RVEDV and RVEF were evaluated in DSCT and MRI.Results Forty-two cases accomplished DSCT and MRI examination.In 558 evaluated coronary segments,96.42％ could be diagnosed.The average radiation dose was(2.82 ± 0.55)mSy.Paired t-test indicated that the RVESV,RVEDV and RVEF of DSCT and MRI had no statistically significant differences (t =-0.28,0.44 and 1.49,P＞0.05),and the correlation was high (r =0.89,0.89,0.87).Conclusions The two generation DSCT with dual-step prospective ECG-triggered sequential acquisition can be used in coronary angiography and right ventricular function analysis simultaneously,which is high in imaging quality of coronary artery,reliable in right ventricular function analysis,as well as lower in radiation dose.

AIM: To explore the predisposing factors, population characteristics and clinical features of severe fungal keratitis.
METHODS:The data of 233 cases 233 eyes of severe fungal keratitis in my hospital from January, 2008 to November, 2013 was retrospectively reviewed. The predisposing factors, population characteristics and clinical features were analyzed.
RESULTS: In 233 cases of severe fungal keratitis, the number of male patients was 153 ( 65. 7%) and the number ratio of male to female was 1. 9:1. The average age of them was (52. 7±11. 3), and most of them were middle-aged and elderly people living in the rural area (78. 1%) and were farmers ( 66. 1%) with low literacy (59. 7%). In 233 cases, 188 cases (80. 7%) possessed a clear history of ocular trauma, mainly caused by plant-based trauma (60. 9%). 90 cases (57. 3%) were infected with Fusarium, and 47 cases ( 29. 9%) by Aspergillus. The main treatment of severe fungal keratitis was surgery (87. 9%). 83 cases ( 52. 9%) were treated with penetrating keratoplasty, and in Fusarium and Aspergillus infected patients with severe fungal keratitis, 58. 4% ( 80/137 ) were performed with penetrating keratoplasty. In addition, patients treated with eye enucleation or evisceration, 68. 4% (13/19) were infected with Fusarium species.
CONCLUSION: Patients with severe fungalkeratitis in our hospital are mainly elderly male farmers living in rural, because of low economic condition and poor diagnosis consciousness. The main pathogens are Fusarium and Aspergillus species, and the major treatment is penetrating keratoplasty. Most of patients with poor clinical outcomes are infected with Fusarium species.

OBJECTIVETo compare the effect and safety of the no-flip method versus the external method in Shang Ring circumcision.

METHODSWe searched relevant randomized controlled trials published in China and abroad comparing the no-flip method and external method of Shang Ring circumcision. Based on the Cochrane Handbook for systematic review, two reviewers independently eval- uated the quality of the included studies and abstracted relevant data, followed by a meta-analysis using the statistical software Review Manager 5.1.0.

RESULTSTotally 7 studies with 1 200 cases were included. Compared with the external method, the no-flip method was associated with a lower total rate of complications (RR = 0.40, 95% CI: 0.18, 0.87, P = 0.02), a lower incidence of postop- erative edema (RR = 0.28, 95% CI: 0.09, 0.81, P = 0.02), and a lower 24 h postoperative pain score (MD = -0.35, 95% CI: -0.55, -0.14, P < 0.001).

CONCLUSIONThe no-flip method of Shang Ring circumcision was superior to the external method for its advantages of fewer complications, lower incidence of postoperative edema, and mild postoperative pain. However, our findings need further support by more high-quality randomized controlled trials.

China ; Circumcision, Male ; adverse effects ; instrumentation ; methods ; Edema ; epidemiology ; Humans ; Male ; Pain Measurement ; Pain, Postoperative ; epidemiology ; Randomized Controlled Trials as Topic

Objective　To study the expressions of some apoptosis related to genes in lung tissues and their relationship to the pathogenesis in rats to hypoxic pulmonary hypertension (HPH). Methods　A total of 60 rats were employed and equally divided into 5 groups, i.e. control, HPH, hemin, Tin Protoporphyrin (Snpp) and low concentration CO groups. Of them, the rats from middle 3 groups were treated with hypoxia under normal pressure for 7 h in every day, 3 weeks except Sunday. Hemin and Tin Protoporphyrin (Snpp) were given half an hour before hypoxia while low concentration CO after 2 h of hypoxia. The expression of bcl-2, bax, Fas and Fas ligand (FasL) were detected with immunohistochemical staining, in situ cell death detection, DNA fragment detection, and in situ hybridization. Results　In low concentration CO and hemin group, typical DNA ladder bands and apoptotic cells were found in lung tissues, and the expressions of Fas, FasL, bax, and bcl-2 mRNA were increased in the epithelial cells of alveoli, vascular and bronchial walls. And the expression of bcl-2 mRNA was decreased than in hypoxic group. Conclusion　CO can regulate the expression of bcl-2, bax, Fas and FasL, these apoptotic genes may involve in the regulation of cell apoptosis of lung tissues under HPH and play important roles in the genesis and development of chronic obstructive lung disorders.

The study was aimed to investigate the human leukocyte antigen (HLA)-A, B, DRB1 alleles and haplotype frequencies and the characteristics of linkage disequilibrium in north Chinese Han bone marrow donors. HLA phenotype data of 11 755 north Chinese Han bone marrow donors were identified by PCR-SSP and PCR-SSO. HLA-A, B, DRB1 allele and haplotype frequencies were calculated by computer software named Arleguin which was based on Expectation-Maximization (EM) algorithms. The results showed that the population of 11755 unrelated-donors was tested by Hardy-Weinberg equilibrium, and 18,42 and 15 specificities of HLA alleles were identified on the HLA-A, B, DRB1 locus respectively, including HLA-A25, B42, B53, B73 and DR3 which were rarely reported in Han population. HLA-A36, A43, A80, B78, B82 and DR18 were not detected in this study. The most frequent alleles with a frequency of over 0.05 were HLA-A*02, A*11, A*24, A*33, A*30, A*01, A*03, A*13, B62, B*51, B*46, B60, B61, B*35, B*44, DRB1*15, DRB1*09, DRB1*04, DRB1*07, DRB1*12, DRB1*11, DRB1*14, DRB1*08, DRB1*13. There were a total of 2 026 kinds of HLA-A-B-DR haplotypes (with a frequency of over 10(-6)) to be obtained. The each frequency of 26 kinds of three-locus haplotypes including HLA-A30-B13-DR7, A2-B46-DR9, A33-B58-DR17 etc was higher than 0.005. A30-B13-DR7 was the most frequent haplotype in north Chinese Han population. There were a total of 538 kinds of haplotypes for HLA-A-B, 227 kinds for A-DR and 522 kinds for B-DR to be obtained, and there were 409, 195, 423 kinds of haplotypes respectively with a frequency higher than 10 - 6. There were 28 kinds of HLA-A-B haplotypes including A30-B13, A2-B46, A33-B58 etc, 26 kinds of HLA-A-DR haplotypes including A2-DR9, A2-DR15, A30-DR7 etc, and 24 kinds of HLA-B-DR haplotypes including B13-DR7, B46-DR9, B13-DR12 etc with a frequency higher than 0.01. 296 (72%) kinds of HLA-A-B, 130 (67%) kinds of A-DR and 308 (73%) kinds of B-DR haplotypes were statistical linkage disequilibrium. HLA-A30-B13, A33-B58, A1-B37, A30-DR7, A33-DR13, A1-DR10, B37-DR10, B8-DR17, B13-DR7, B58-DR17 were significant positive linkage disequilibrium. It is concluded that this HLA-A, B, DRB1 gene and haplotype frequencies and linkage disequilibrium data with the largest sample size up to now is unique in north Chinese Han population. The study will be helpful to find matched donors for patients and establish the important foundation for further studying of transplantation immunity, HLA-related diseases and population genetics of this area.
Adolescent ; Adult ; Alleles ; Asian Continental Ancestry Group ; genetics ; Blood Donors ; Female ; Gene Frequency ; HLA-A Antigens ; genetics ; HLA-B Antigens ; genetics ; HLA-DR Antigens ; genetics ; HLA-DRB1 Chains ; Haplotypes ; Humans ; Male ; Middle Aged ; Registries

OBJECTIVETo evaluate the effect of testis homotransplantation in the treatment of androgen deficiency and infertility.

METHODSWe retrospectively analyzed 12 cases of testis homotransplantation.

RESULTSSurgical success was achieved in 11 cases, all with a significantly increased level of serum testosterone, and markedly improved secondary sex characteristics and sexual function.

CONCLUSIONTestis homotransplantation is highly effective for the treatment of androgen deficiency in males, but has little effect on spermatogenesis.

Adolescent ; Adult ; Humans ; Living Donors ; Male ; Retrospective Studies ; Testis ; transplantation ; Testosterone ; blood ; deficiency ; Transplantation, Homologous ; Treatment Outcome

Asian Continental Ancestry Group ; China ; Diabetes Mellitus, Type 2 ; ethnology ; genetics ; Genetic Variation ; Genotype ; Humans ; Insulin Receptor Substrate Proteins ; Intracellular Signaling Peptides and Proteins ; Phosphoproteins ; genetics