OBJECTIVETo explore the value of spinal canal and dural sac dimensions for the treatment of lumbar disc herniation in MRI.

METHODSThe clinical data of 144 patients with single-level lumbar disc herniation underwent nonsurgical or surgical treatment from January 2010 to December 2012 were retrospectively analyzed. There were 91 patients in the nonsurgical group, including 55 males and 36 females, ranging in age from 20 to 68 years old with an average of (43.37±12.48) years; and there were 53 patients in the surgical group, including 28 males and 25 females, ranging in age from 20 to 64 years old with an average of (42.98±12.95) years. JOA scores (29 scores) were used to evaluate clinical manifestation (including subjective symptoms, objective findings, limitation of daily activities and bladder function) and outcomes. The parameters related to spinal canal and dural sac dimensions (including spinal canal midsagittal diameter and available diameter, lateral recess width, spinal canal and dural sac cross-sectional area) in the initial axial T2-weighted MRI were measured, and odds ratio of available diameter to midsagittal diameter, odds ratio of lateral recess width to midsagittal diameter and area ratio of dural sac to spinal canal were calculated. Then, the differences of all parameters between two groups, and the correlations with initial JOA scores were analyzed.

RESULTS(1) All patients were followed up from 1 to 3 years with an average of 2.1 years. JOA scores before treatment were 16.27±2.96 in nonsurgical group and 12.64±3.30 in surgical group, there was statistically significant difference (t=6.319, P<0.01). At final follow-up time, there was no statistically significant difference in JOA scores (25.41±2.22 vs 25.76±2.29), improvement rate [(72.95±12.54)% vs (76.80±9.45)%], and the excellent and good rate (84.91% vs 78.02%) between two groups (P>0.05). But, the relapse rate of nonsurgical group was higher than surgical group (14.29% vs 5.67%). (2) Spinal canal midsagittal diameter and available diameter, lateral recess width, spinal canal and dural sac area, the ratio of available diameter to midsagittal diameter, and the ratio of lateral recess width to midsagittal diameter in surgical group were smaller than that of nonsurgical group, but the area ratio of dural sac to spinal canal was larger, and there were statistically significant differences between two groups (P<0.01). (3) The initial JOA scores showed significantly positive correlation with spinal canal midsagittal diameter and available diameter, lateral recess width, and canal and dural sac area (P<0.01); also presented positive correlation with the ratio of available diameter to midsagittal diameter and the ratio of lateral recess width to midsagittal diameter (P<0.05); but there was a significantly negative correlation between initial JOA scores and the area ratio of dural sac to spinal canal.

CONCLUSIONBoth nonsurgical and surgical treatment of lumbar disc herniation can obtain good effect, but the recurrence rate of non-surgical treatment is higher. Preoperative MRI measurement parameters of spinal canal and dural sac dimensions has certain value for the treatment selection of lumbar disc herniation, but further refinement and validation is still required.

Adult ; Aged ; Dura Mater ; pathology ; Female ; Humans ; Intervertebral Disc Displacement ; pathology ; therapy ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Spinal Canal ; pathology

The abnormality of the clitoral prepuce not only hinders the appearance, but also reduces the sensitivity of the clitoris, affecting sexual intercourse, exercise, and local hygiene. Clitoral hood plastic surgery is the main treatment to correct the deformity, which can improve the appearance and sexual simulation. In recent years, with the rise of female genital cosmetic surgery, surgical correction of abnormal clitoris prepuce have been further developed. The anatomy and classification of the clitoris prepuce and the progress of treatment are reviewed in this article.

Objective To evaluate the clinical effect of modified water infusion single colonoscopy. Methods Seventy patients underwent single colonoscopy from June 2016 to June 2017 were selected and randomly divided (by means of random number table) into study group (n = 35) and control group (n = 35). The study group was given modified water infusion single colonoscopy, and the control group was given air insufflation single colonoscopy. The success rate of ileocecal inserted, times of cecal intubation and complications rates were recorded;Visual analogue scale (VAS) was used to assess the severity of abdominal pain and abdominal bloating. Results The success rate of ileocecal inserted and complications rates were not significantly different between the two groups (P > 0.05). Times of cecal intubation of study group (4.86 ± 1.66) min was significantly shorter than that of the control group (6.45 ± 2.34) min (P < 0.05). The mean abdominal pain score of study group was significantly lower than that of control group [(2.71 ± 1.05) vs (3.31 ± 1.13), P < 0.05]. The mean abdominal bloating score of study group was significantly lower than that of control group [(3.31 ± 1.05) vs (3.97 ± 1.10), P < 0.05]. Conclusion Modified water infusion colonoscopy is rapid and security, which can effectively improve the comfortableness of patients.

Objective:To assess the feasibility and effects of the mobile device-based video teaching in plastic surgery education.Methods:In the study, 22 participants were assigned into two groups according to their standardized training area. The intervention group ( n=11) which was outside Beijing had an unlimited access to video-based education; the control group ( n=11) which was in Beijing received traditional teaching. After the end of the first semester of teaching, the two groups of students were tested on theory and clinical operational theory, and the evaluation results were compared. SPSS 18.0 software was applied for t test and chi-square test. Results:After the first semester, the effect of teaching method was evaluated by the scores of written examination and clinical examination. The average scores of the written test in the intervention group were (38.82±3.22) points, while that in the control group were (38.36±2.98) points, without significant differences between the two groups ( P=0.74); the average scores of the clinical examination theory test in the intervention group and the control group were (46.36±3.44) points and (41.00±5.24) points, respectively, with significant differences between the two groups ( P=0.01). In term of total scores, the average scores of the intervention group were (85.18±4.83) points, and those of the control group were (79.36±5.52) points, with statistical differences between the two groups ( P=0.016). Conclusion:Mobile device-based video teaching in plastic surgery education can not only improve students' performance but also facilitate their clinic skills, which is worth popularizing.

BACKGROUNDThe morbidity and mortality of prostate cancer have been increasing rapidly in recent China. There were few studies investigating prostate-specific antigen (PSA) values ranges in the healthy Chinese population. We performed this study to determine the distribution of serum PSA in a large healthy Chinese population.

METHODSFrom January 2001 to May 2008, 11 150 healthy Chinese men aged 30 - 79 years came to our hospital for routine health check-up. All subjects without a previous diagnosis of prostate cancer, a history of prostate surgery, or urogenital tract infection were proposed to undergo systematic serum PSA measurement and digital rectal examination (DRE). Men with normal DRE and PSA ≤ 4.0 ng/ml and those PSA > 4.0 ng/ml or abnormal DRE but without adverse findings on prostate biopsy were included (n = 9358). Age and serum PSA concentration were recorded and correlated through Logistic regression analysis.

RESULTSThe 95th percentile serum PSA concentration was 1.89 ng/ml for men aged 30 to 39 years, 2.19 ng/ml for men aged 40 to 49 years, 2.88 ng/ml for men aged 50 to 59 years, 4.42 ng/ml for men aged 60 to 69 years, and 6.52 ng/ml for men aged 70 to 79 years. The serum PSA concentration correlated with age (P < 0.0001) with an annual increase of 0.97% for men in 40 years, 1.58% for men in 50 years, 3.04% for men in 60 years, and 3.99% for men in 70 years.

CONCLUSIONSThe serum PSA level correlates directly with age in Chinese men older than 40 years, not in Chinese men younger than 40 years old. Chinese men have lower PSA level compared with white men above 60 years of age, not in those under 60 years of age.

Adult ; Age Factors ; Aged ; Asian Continental Ancestry Group ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; epidemiology

PURPOSE: CO₂ leakage along the trocar (chimney effect) has been proposed to be an important factor underlying port-site metastasis after laparoscopic surgery. This study aimed to test this hypothesis by comparing the incidence of port-site metastasis between B-ultrasound-guided and laparoscopically-assisted hyperthermic intraperitoneal perfusion chemotherapy (HIPPC). MATERIALS AND METHODS: Sixty-two patients with malignant ascites induced by gastrointestinal or ovarian cancer were divided into two groups to receive either B-ultrasound-guided or laparoscopically-assisted HIPPC. Clinical efficacy was assessed from the objective remission rate (ORR), the Karnofsky Performance Status (KPS) score, and overall survival. The incidence of port-site metastasis was compared between the two groups. RESULTS: Patients in the B-ultrasound (n=32) and laparoscopy (n=30) groups were comparable in terms of age, sex, primary disease type, volume of ascites, and free cancer cell (FCC)-positive ascites. After HIPPC, there were no significant differences between the B-ultrasound and laparoscopy groups in the KPS score change, ORR, and median survival time. The incidence of port-site metastasis after HIPPC was not significantly different between the B-ultrasound (3 of 32, 9.36%) and laparoscopy (3 of 30, 10%) groups, but significantly different among pancreatic, gastric, ovarian, and colorectal cancer (33.33, 15.79, 10.00, and 0.00%, p<0.001). CONCLUSION: The chimney effect may not be the key reason for port-site metastasis after laparoscopy. Other factors may play a role, including the local microenvironment at the trocar site and the delivery of viable FCCs (from the tumor or malignant ascites) to the trauma site during laparoscopic surgery.
Ascites ; Colorectal Neoplasms ; Drug Therapy* ; Humans ; Incidence ; Karnofsky Performance Status ; Laparoscopy ; Neoplasm Metastasis* ; Ovarian Neoplasms ; Perfusion* ; Surgical Instruments ; Treatment Outcome

OBJECTIVETo study the curative effects of close nail-pry reduction and internal fixation with hollow screws for treatment of linguiform calcaneus fracture.

METHODSFrom May 2006 to October 2009,32 patients (35 feet) with linguiform calcaneus fracture were treated by close nail-pry reduction and internal fixation with hollow screws, including 23 males and 9 females ranging in age from 25 to 46 years, with a mean of 37.6 years. According to Paley classification, 3 cases were Paley II a, and 29 cases were Paley II b. All cases were close fractures. The time from injury to operation was 3 to 10 days after most swelling subsided. Böhler angle and Gissane angle were measured by X-ray before and after operation. The therapeutic effect was assessed according to ZHANG Tie-liang's foot score.

RESULTSAll the patients were followed-up for 6 to 18 months, with a mean of 12 months. All fractures gained bone healing. The time of fracture healing averaged 12 months. The fractures healed completely and no infection occurred. According to ZHANG Tie-liang's foot scale, the postoperative function was excellent in 18 feet, good in 10 feet, moderate in 5 feet and poor in 2 feet. The Böhler angle and Gissane angle were significant improved after treatment (P < 0.01).

CONCLUSIONThe surgical method of close nail-pry reduction and internal fixation with hollow screws for treatment of linguiform calcaneus fracture can regain the foot function, with minimal injury, fewer complications, earlier recovery and lower costs.

Adult ; Bone Nails ; Bone Screws ; Calcaneus ; injuries ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged

OBJECTIVETo investigate the current smoking regulations and their impacts on the environmental tobacco smoke (ETS) levels inside restaurants and bars in Beijing.

METHODSTelephone survey was used to investigate the smoking regulations. TSI Sidepak AM510 was used to measure the level of fine particles less than 2.5 microns in diameter (PM2.5) in restaurants and bars. Analysis of variance and non-parametric rank tests were used to examine the association between indoor and outdoor PM2.5 levels and (1) smoking regulations; and (2) types of restaurants and bars.

RESULTSOf the 305 restaurants and bars surveyed, 27.9% had complete or partial smoking prohibiting rules. The average indoor PM2.5, level of the 92 restaurants and bars was 253.08 microg/m3 , 102.37% higher than the outdoor level. The average indoor and outdoor PM2.5 levels in the restaurants and bars with smoking ban regulations were 93.10 microg/m3 and 110.33 microg/m3 whole 289.34 microg/m3 and 128.40 microg/m3 in those without, respectively. The average indoor and outdoor PM2.5 levels of bars were 413.46 microg/m3 and 190.62 microg/m3, respectively, while in the western fast-food restaurants, they were 83.86 microg/m3 and 104.77 microg/m3, respectively. The outdoor PM2.5 levels were higher than the indoor levels in different classes of restaurants and bars. Furthermore, there was a significant positive correlation between PM2.5 levels and the number of smokers per cube meters (r = 0.47, P < 0.001).

CONCLUSIONSmoking regulations could effectively reduce the ETS level in restaurants and bars.

Air Pollution, Indoor ; analysis ; legislation & jurisprudence ; China ; Environmental Monitoring ; Particulate Matter ; analysis ; Restaurants ; Smoking ; legislation & jurisprudence ; Tobacco Smoke Pollution ; analysis ; legislation & jurisprudence

Objective:To investigate the method of the complex labia minora and clitoris prepuce hypertrophy and summarize the experience.Methods:From January 2016 to October 2019, a total of 432 patients with complex labia minora and clitoris prepuce hypertrophy in the 10th Department of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, were selected by classification. The patients were 18-46 years old (average 28 years old). The redundant prepuce of clitoris was repaired to transform the complex labia minora and clitoris prepuce hypertrophy into simple labia minora hypertrophy, and then labiaplasty was performed by edge or wedge resection.Results:A total of 346 cases were followed up for 3-12 months, 86 cases were lost. Hematoma occurred in 2 cases, bilateral asymmetry in 9 cases, irregular edge in 12 cases, and scar hyperplasia in 1 case. After respective treatment and secondary repair, the patients were satisfied. The overall satisfaction rate was 93.6%(324/346).Conclusions:Our method, through the decomposition operation, will change the complex shape into simple labia minora hyperplasia, reduce the difficulty of operation at the same time, which can achieve more satisfactory appearance.

Objective:To investigate the motivation of patients seeking labiaplasty and the external influencing factors.Methods:From January 2018 to December 2019, 268 patients who sought for operative labiaplasty at the Gynecological Plastic Surgery Center of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences were investigated for their motivation and influencing factors in the questionnaire. The motivation includes four options: aesthetic reasons, functional impairment, both aesthetic and functional reasons, and psychological factors. External influencing factors include two options: a self-requirement, was influenced by others. After collating the data, statistical analysis of the survey result was performed.Results:A total of 216 valid questionnaires were received. Motivation for pursuing operative labiaplasty: 22.2% (48/216) of the patients complained about cosmetic reasons, 38.4% (83/216) of dysfunction, and 35.2% (76/216) had both aesthetic and functional reasons. Psychological factors accounted for 4.2% (9/216). In terms of external influencing factors: all patients motivated by dysfunction were not influenced by others, while 6.3% (3/48) of patients of cosmetic reasons were affected by male partners. In the other two motivations, 7.9% (6/76) and 6/9 respectively indicated that they were affected by male spouse. In addition, there were 2.6% of patients with these 2 motivations (2/76) and 3/9 were affected by the media.Conclusions:Most patients seek labia minora reduction surgery because of functional reasons, and a small number of people are affected by sexual partners and media.