OBJECTIVETo observe the therapeutic effect of Equiguard in old patients with Shen-yang deficiency syndrome (SYDS).

METHODSTwenty old patients with diagnosis matching the criteria of SYDS selected from out-patients were administered with Equiguard capsule 3 times per day, 0.70 g each time for 3 successive months. The changes in general condition, peripheral blood picture, function of the liver and kidney, and sex hormones before and after treatment were observed. The changes in the American Urinary Surgery Association (AUA) score of prostatism, urosis and residue urine in the urinary bladder were also estimated.

RESULTSAfter the 3-month treatment, no significant change was found in the patients' general condition, peripheral blood picture, liver and kidney function and sex hormones, while the symptoms of prostatism and urosis were markedly improved (P<0.01), and the volume of residue urine in the urinary bladder was obviously reduced.

CONCLUSIONEquiguard shows a significant therapeutic effect in treating old patients with SYDS, which could effectively improve the symptoms of prostatism and urosis in patients and is highly safe.

Aged ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Syndrome ; Yang Deficiency ; drug therapy

OBJECTIVEPancreatic metastasis from renal cell carcinoma (RCC) is a rare event and has not been reported in our country. We report a series of 3 patients with metastatic RCC to the pancreas after radical nephrectomy at our institution. The published reports in the literature were reviewed, and the diagnosis, treatment as well as prognosis of this rare event were discussed.

METHODSThe data of 3 RCC patients with metastasis to the pancreas were reviewed retrospectively, including radical nephrectomy, metastatic interval, the second and third surgical removal. Survival of the three patients was analyzed and the reports in the literature were compared as well.

RESULTSThe average interval from radical nephrectectomy to the comfirmed pancreatic metastasis was 6.6 years (range, 1.2 to 12 years). The pathological stage revealed T2N0M0 (n = 2) or T3N0M0 (n = 1), with right-sided tumor in 2 patients and left side in 1. One patient was asymptomatic, while the other two cases were symptomatic at presentation, including upper abdominal pain, weight loss, slight xanthochromia of the skin and titillation, clay stool (n = 1); irregular fever, weight loss and jaundice (n = 1). All pancreatic metastases were hypervascular on arterial stage of CT imaging. One patient had only a solitary pancreatic metastasis (n = 1), the another showed two metastatic lesions (n = 1), the third one had multiple lesions (n = 1). Surgical removal was accomplished in 2 patients: including pylorus-preserving pancreaticoduodenectomy in one, and pylorus-preserving pancreaticoduodenectomy together with partial tail resection in another one. The third one only received interventional therapy due to widespread extrapancreatic metastasis, and died of disseminated disease 11 months after the therapy. One of the above two surgically treated patients underwent the second removal due to local recurrence 2.5 years after the first removal of pancreatic metastasis. These two patients were still alive after follow-up of 8.6 years and 16.1 years, respectively.

CONCLUSIONRenal cell carcinoma is an unpredictable tumor that may demonstrate very delayed metastasis even from early-stage of the disease. The pancreas is a rare site of metastasis from renal cell carcinoma. We advocate careful long-term follow-up of patients with a history of RCC. Aggressive surgical management of pancreatic metastatic lesions may provide a chance of long-term survival.

Aged ; Carcinoma, Renal Cell ; pathology ; surgery ; Chemotherapy, Cancer, Regional Perfusion ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Nephrectomy ; methods ; Pancreatic Neoplasms ; diagnosis ; drug therapy ; secondary ; surgery ; Pancreaticoduodenectomy ; methods ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography, Doppler, Color

Objective To study the effect of propofol intravenous on myocardial damage degree and cardiac function for 2 diabetes patients before and after coronary artery bypass grafting.Methods Seventy-six patients with type 2 diabetes in our hospital was selected from April 2014 to October 2015.The patients were divided into treatment group and control group,according to the method of random numbers,38 cases in each group.Patients in two groups were taken general anesthesia induction,treatment group were infused 1-2 μg · kg-1 · mL-1 propofol after anesthesia induction to maintain anesthesia,continuous intravenous infusion of 0.2-0.4 μg · kg-1 · min-1 fentanyl.Patients in control group isoflurane inhalation and intravenous 0.2-0.4 μg · kg-1 · min-1 fentanyl.Before surgery and postoperative 12 h,the level of the malondialdehyde (MDA),superoxide dismutase (SOD),ischemia modified albumin (IMA),troponin I (cardiac troponin I,cTnI) in two groups were measured by spectrophotometer.Results Before the operation,the level of MDA,SOD,IMA,cTnI in the treatment group were (3.69 ±0.43) nmol · L-1,(73.24 ±6.13) nmol · L-1,(77.29 ± 3.94)ABSU · mL-1,(0.08 ± 0.02) μg · L-1,respectively while in control group were (3.62 ± 0.37) nmol · L-1,(72.36 ±8.22)nmol · L-1,(77.61 ± 3.74) ABSU · mL-1,(0.07 ± 0.01) μg · L-1 with no significant difference (P＞0.05).After 12 h of operation,the level of MDA,IMA,cTnI in treatment group were (4.42 ±0.82) nmol · L-1,(70.52 ± 2.62) ABSU · mL-1,(3.70 ± 0.28) μg · L-1,significantly lower than control group with (7.14 ±1.01)nmol · L-1,(73.63 ±4.12) ABSU · mL-1,(4.79 ±0.29)μg · L-1.But SOD in treatment group was (68.74 ± 6.82) nmol · L-1,significantly higher than the control group with (64.O1 ± 5.88) nmol · L-1,the difference between two groups above factors had statistical significance (all P ＜ 0.05).Conclusion Patients with type 2 diabetes using CABG surgery,the use of intravenous propofol,compared with isoflurane,can effectively reduce the degree of myocardial injury and effectively protect the cardiac function in patients.

Adult ; Female ; Humans ; Liver Neoplasms ; diagnosis ; surgery ; Neoplasms, Germ Cell and Embryonal ; diagnosis ; surgery ; Sarcoma ; diagnosis ; surgery ; Tomography, X-Ray Computed

OBJECTIVETo discuss the clinical features and surgical treatments of giant coronary artery aneurysm (CAA).

METHODSFrom July 1996 to October 2004, 6 giant CAA patients were underwent surgery at Fuwai hospital. Three cases were underwent CAA resection, 2 concomitant coronary bypass, 3 reconstruction. The giant CAA was often combined with other cardiac diseases. Four cases underwent additional procedures of fistula closure, 3 aortic valve replacements, 2 aortoplasty and 1 thrombus cleaning at the same time.

RESULTSAll patients recovered uneventfully. The mean of cardiopulmonary bypass time was (144 +/- 26) min (range 67 to 207 min). Aortic cross clamping time was (104 +/- 21) min (range 56 to 172 min). Patients follow-up time occurred from 8 to 87 months (mean of 48 months). All patients were free of symptoms during follow-up. None of the patients died during the follow-up period and none of the CAA recurred.

CONCLUSIONSThe giant CAA is a serious cardiovascular disease, early diagnosis and surgical treatment are mandatory.

Adult ; Coronary Aneurysm ; pathology ; surgery ; Coronary Artery Bypass ; Coronary Vessels ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Surgical Procedures, Operative ; methods ; Treatment Outcome

OBJECTIVETo observe the precise time of the recurrence after resection of hepatocellular carcinoma (HCC) and to further explore the risk factors associated with postoperative recurrence.

METHODSTotally 94 patients who had undergone resection of HCC were divided into three groups based on the time of recurrence, which was indicated by the digital subtraction angiography (DSA) examination: recurrence between 1 to 6 months, recurrence between 7 to 12 months, and tumor-free after 12 months. Patients with intra-hepatic recurrence were treated with transcatheter arterial chemoembolization and confirmed by CT scans after embolization, contrast-enhanced ultrasound, or magnetic resonance imaging.

RESULTSThe recurrence rates of 6 months and 1 year were 30.9% and 36.2%, respectively. No statistically significant difference between 6-month and 1-year recurrence rates was observed. Nine (26.5%) patients with recurrence and five (8.3%) patients free of tumor had previously presented as multifocal HCC, which showed a statistical significance (P = 0.032). The diagnostic accuracy of DSA was 87.2%, which was eventually confirmed by the other investigations.

CONCLUSIONSMost recurrences occure within the first six months postoperatively and multifocal carcinogenesis is one of the risk factors associated with early recurrence after liver resection for advanced HCC. DSA is an important surveillance for early detection of intra-hepatic recurrence after surgery; meanwhile, it also provides information for early management to control the disease progression and for future active therapies.

Adult ; Aged ; Carcinoma, Hepatocellular ; diagnostic imaging ; pathology ; surgery ; Female ; Hepatectomy ; Humans ; Liver Neoplasms ; diagnostic imaging ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Postoperative Period ; Tomography, X-Ray Computed

OBJECTIVETo establish a three-dimentional liver function evaluation system using 99mTc-diethyl iminodiacetic acid (99mTc-EHIDA) scintigraphy based on single photon emission computed tomography (SPECT).

METHODSTotally 16 patients with liver lesions were divided into cirrhosis group and non-cirrhosis group. SPECT was performed 2 days before operation and 5 days after operation. Serum liver functions were examined on the same day of scintigraphy. SPECT images of areas of interest of heart and liver were aquired. Time of the peak of EHIDA density in liver (Tpeak), five-minutes heart liver index (HLI5), blood clearance index (HH15), receptor index (LHL15), and the predictive values were calculated.

RESULTSTpeak was not significantly different between two groups, while HLI5, HH15, and LHL15 were significantly different (P = 0.033, P = 0.001, and P = 0.005). HLI, and LHL15 were significantly correlated with preoperative total protein and prealbumin levels (P = 0.003, P = 0.015, P = 0.022, P = 0.038) and post-operative prealbumin (P = 0.037, P = 0.042). The predictive values of HLI5 and LHL15 correlated well with postoperative HLI5 and LHL15 (r = 0.675, P = 0.016; r = 0.629, P = 0.028).

CONCLUSIONThe three-dimentional liver function evaluation system using 99mTc-EHIDA based on liver SPECT may facilitate the further studies of risks of liver surgery.

Adult ; Aged ; Animals ; Female ; Humans ; Liver Diseases ; diagnosis ; diagnostic imaging ; physiopathology ; Liver Function Tests ; Male ; Middle Aged ; Postoperative Period ; Preoperative Period ; Radiopharmaceuticals ; administration & dosage ; Technetium Tc 99m Diethyl-iminodiacetic Acid ; administration & dosage ; Tomography, Emission-Computed, Single-Photon

OBJECTIVETo summarize the surgical experiences, risks, complications, and managements for hepatic masses in difficult sites.

METHODSTotally 47 patients were divided into three groups based on the liver tumor sites: primary porta hepatis group, secondary porta hepatis group, and caudate lobe group. All patients underwent different portion of hepatectomy.

RESULTSThe surgery duration was (289.6 +/- 62.2) ml-nutes, intra-operative blood loss was (602.3 +/- 256.4) ml, and intra-operative blood transfusion was (524.0 +/- 325.9) ml. Incidence of surgical complications in each group was 61.5%, 26.9%, and 25%, respectively. Serious complications observed were biliary leakage (27.7%), bleeding (6.4%), and post-operative liver failure (2.1%). Three perioperative deaths were reported: two patients died of bleeding, and one patient died from liver failure.

CONCLUSIONSDissection of the liver and exposure of major blood vessels and biliary ducts are of critical importance in the surgeries for hepatic masses in difficult sites, and post-operative complications may be remarkably reduced through delicate manipulations of the small intra-hepatic vessels and biliary ducts during resection. A thorough pre-operative evaluation plays a key role in predicting the feasibility and risks of the surgery. Damage to the major blood vessels adjacent to the tumor, in addition to bleeding, may result in in-flow or outflow obstruction and cause necrosis of the corresponding hepatic lobe. Compared with damage to the primary portal area, vascular damage to the secondary porta is generally associated with higher fatality.

Adult ; Aged ; Blood Loss, Surgical ; Female ; Hepatectomy ; adverse effects ; Humans ; Liver Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Postoperative Complications ; Preoperative Care

OBJECTIVETo assess the role of Zhongji (CV 3) in treatment of benign hyperplasia of prostate.

METHODSMulti-central, randomized, controlled, single bland clinical method was adopted, and 276 cases were divided into an electroacupuncture (EA) group and a medication group, 138 cases in each group. The EA group were treated with EA at Zhongji (CV 3) and the medication group with oral administration of Qianliekang tablets. After treatment of 1 course, their therapeutic effects and changes of international prostate symptom (I-PSS) cumulative score, life quality index (L) cumulative score, nocturia times, urine stream state, lower abdominal symptom, maximal volume of urine flow, residual urine volume, prostatic volume, etc. Were assessed in the two groups.

RESULTSThe total effective rate was 96.4% in the EA group and 86.2% in the medication group, the former being better than the latter (P<0. 01); the two groups were effective in improvement of international prostate symptom (I-PSS) cumulative score, life quality index (L) cumulative score, nocturia times, urine stream state, hypogastrium symptom, maximal volume of urine flow, residual urine volume, prostatic volume, etc. with the former better than the latter.

CONCLUSIONAcupuncture at Zhongji (CV 3) has a significant therapeutic effect for treatment of benign hyperplasia of prostate.

Acupuncture Points ; Aged ; Electroacupuncture ; methods ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; therapy

Objective Streptococcus pneumoniae is one of the main pathogenic factors of chronic rhinosinusitis (CRS). This study was to explore the method of establishing a CRS model in C57BL/6J mice.Methods Thirty C57BL/6J mice were equally randomized into a CRS model, a sham operation and a blank control group. The CRS model was made by implanting type-Ⅲ streptococcus pneumoniae in the maxillary sinuses, the mice of the sham operation group underwent opening and suturing of the maxillary sinuses without implantation of any streptococcus pneumonia, while the blank controls did not receive any operation. Two months later, all the mice were sacrificed and the nasal sinus mucosal tissue was harvested, embedded with paraffin, sectioned, and subjected to HE staining, followed by observation of the pathological changes under the microscope.Results The CRS model mice exhibited significant proliferation and disorderly arrangement of epithelial cells in the nasal mucosal tissue, with degeneration, necrosis, exfoliation, ulceration, goblet cell proliferation, gland and tissue hyperplasia, and infiltration of lymphocytes, plasmocytes and monocytes. No obvious inflammation was observed in the sham operation and blank control groups. The pathology index score of the nasal sinus mucosal tissue was significantly higher in the CRS model than in the sham operation and blank control groups (\[14.800±5.200\] vs \[2.000±2.906\] and \[1.800±2.098\], P<0.05) but no statistically significant difference between the latter two groups (P>0.05).Conclusion The CRS model was successfully established in mice, which has provided some reference for the construction of the CRS model in animals.