Objective To evaluate the techniques and effects of arthroscopic resection of cystic lesions of soft tissue. Methods Twenty-six patients with soft tissue cysts underwent arthroscopic shaving of cyst wall from February 1998 to February 2001. Results Follow-up observation ranged from 6 months to 12 months, with a mean of 8.6 months. The total effective rate reached 96.2% (25 of 26), and no postoperative complications occurred. Recurrence was only seen in 1 patient with thecal cyst on the right dorsal wrist. Conclusions Arthroscopic resection of cystic lesions of soft tissue can be a less invasive method, with fewer complications, a high effective rate and a rapid recovery.

Objective To analyze the effect of bifrontal decompressive craniectomy on patients with refractory diffusing of brain swelling after severe traumatic brain injury.Methods The clinical data of 68 patients with refractory diffusing of brain swelling after severe traumatic brain injury were analyzed retrospectively.Thirty-five patients were performed with bifrontal decompressive craniectomy as observed group,continued intracranial pressure monitoring after surgery.Thirty-three patients were treated conservatively to reduce intracranial pressure as control group,continued intracranial pressure monitoring.The Glasgow outcome scale after discharge 6 months were assessed.The efficacy,the incidence of complications were observed in observed group.Results The admission intracranial pressure in observed group was significantly higher than that after surgery [(35.9 ±6.9) mmHg (1 mmHg =0.133 kPa) vs.(17.5 ±5.2) mmHg,P ＜0.05].The admission intracranial pressure in control group was (34.2 ± 8.6) mmHg,after admission 10.5 h was (32.0 ±4.8) mmHg (P ＜0.05),difference was no statistically significant (P＞ 0.05).The intracranial pressure after admission 10.5 h in control group was significantly higher than that in observed group after surgery (P ＜0.05).Two cases of subdural effusion,1 case of postoperative hydrocephalus in observed group.The better prognosis rate in observed group was significantly higher than that in control group [45.7％ (16/35) vs.18.2％ (6/33),P ＜ 0.05].Conclusions Bifrontal decompressive craniectomy is a suitable measure to decrease the intracranial pressure in the patients with refractory diffusing of brain swelling.If carried out early,it could provide better outcome for these patients.

Drugs for the treatment of premature ejaculation (PE) are divided to two categories: oral drugs and local drugs. Oral drugs include antidepressive drugs, alpha-adrenoceptor blocking drugs, phosphodiesterase type V blocking drugs and Chinese herbal medicine. Local drugs include local surface drugs, intracavernosal injective drugs and local urethra drugs. Antidepressive drugs are extensively used, which have moderate efficacy, relatively more side effects and high recurrence rate; alpha-adrenoceptor blocking drugs are seldom used and are less effective than antidepressive drugs; phosphodiesterase type V blocking drugs like sildenafil have good efficacy and few side-effects and are worthy to be studied further. Local surface drugs like SS-Cream have good efficacy and few side-effects and are worthy to be applied and promoted; local urethral drugs like MUSE and Befar may become a new method to treat PE after being further studied. Medication for premature ejaculation shall be made specific and suitable as much as for each individual patient.
Adrenergic alpha-Antagonists ; therapeutic use ; Antidepressive Agents ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Ejaculation ; drug effects ; Humans ; Male ; Phosphodiesterase Inhibitors ; therapeutic use

ObjectiveTo evaluate the application of multi-slice CT (MSCT) perfusion scan technique in predicting renal function recovery after unilateral hydronephrosis treatment.MethodsThirtyeight patients with unilateral obstructive hydronephrosis not shown on intravenous urography (IVU) and a normal contralateral kidney were recruited for this study.Patients were divided into detected (D) and undetected (UD) groups depending on whether the IVU detected urinary tract obstruction.All patients underwent plain abdominal X-ray,gray-scale ultrasonography,excretory urography and MSCT perfusion scan before and after the treatment.Patients were followed-up at six months or more after the treatment for a mean duration of 12.5 months (range from 6 to 22 ).ResultsOf the 38 cases,22 cases were in group D,16 cases were in group UD.On MSCT,renal cortex blood flow (BF) and blood volume ( BV ) value after treatment in group D were 561.1 ± 165.4 ml/( 100 g · min) and 35.9 ± 11.3 ml/100 g compared with before treatment rates of 361.6 ±109.7 ml/(100g· min) and24.1 ±10.2 ml/100g,t=-3.38,-2.34,P＜0.01,0.05.In the UD group,the differences of these parameters were after treatment 38.7 ± 15.4 ml/(100 g · min),10.306 ± 4.925 ml/100 g and before treatment 39.1 ± 22.5 ml/( 100 g · min) and 8.7 ± 4.4 ml/100 g,P ＞ 0.05.In the aspects of BF and BV,there were statistically significant differences between group D and group U D both before and after the treatment,t=9.09,4.15,P ＜ 0.01.ConclusionsM SCT perfusion can provide a valuable prediction technique of the renal function recovery in patients with unilateral obstructive hydronephrosis.Improvement of renal function can be expected after relief of obstructive hydronephrosis if the patients have a BF 361.6 ml/( 100 g · min) and BV 24.1 ml/100 g or greater measured by MSCT perfusion.

In order to explore the effect and underlying mechanism of hypoxia on body weight, the effect of intermittent moderate hypoxia on high-fat diet-induced obesity was observed in mice, and the role of leptin in hypoxic effect was identified. Healthy Kunming mice were divided randomly into 4 groups (n=20 in each group). The control group: the mice were fed normally under the normal oxygen pressure. Hypoxia group: the mice were fed normally, and given intermittent moderate hypoxia training. Obesity group: the mice were fed diet rich in fat and sugar under the normal oxygen pressure. Hypoxia + obesity group: the mice were fed diet rich in fat and sugar, and given intermittent moderate hypoxia training. After 40 d of feeding and training, the body weight of mice was determined, and the average increasing rate of body weight in each group was calculated and normalized with food intake. Meanwhile, plasma leptin level was measured with ELISA method, and fatty degeneration and leptin receptor expression in liver were observed by Sudan III staining and immunohistochemistry, respectively. The obesity mouse model was successfully established with increases in body weight, plasma leptin level and distribution of adipocytes in the liver. The average body weight and density of adipocytes in the liver in hypoxia and hypoxia + obesity groups decreased obviously, while plasma leptin level and leptin receptor expression in the liver were increased. It is suggested that intermittent moderate hypoxia reduces body weight through elevating plasma leptin level and/or enhancing leptin receptor expression in the liver.
Adipocytes ; cytology ; Animals ; Body Weight ; Female ; Hypoxia ; metabolism ; pathology ; Immunohistochemistry ; Leptin ; blood ; Liver ; chemistry ; Mice ; Mice, Obese ; Obesity ; metabolism ; pathology ; Receptors, Leptin ; analysis

OBJECTIVETo study intra-operative radionuclide lymphatic mapping in sentinel lymph node (SLN) biopsy of breast cancer.

METHODSForty-two breast cancer (diameter 98%, size of colloid granule 100 approximately 200 nm) was injected into the mammary tissue around the tumor or biopsy site at four points. SLN in breast cancer was detected and dissected with the help of lymphoscintigraphy and intra-operative gamma probe. Routine lymph node dissection was performed for all patients.

RESULTSThe detection rate was 88.1% in lymphoscintigraphy and 97.6% in intra-operative gamma probe detection for SLN in breast cancer. The sensitivity, accuracy, false negative and specificity of SLN biopsy were 93.3% (14 in 15), 97.6% (40 in 41), 6.7% (1 in 15) and 100% (26 in 26).

CONCLUSIONSentinel lymph node in breast cancer, detected by preoperative lymphoscintigraphy combined with intra-operative gamma probe, is able to predict regional lymph node metastasis. The successful rate of SLN biopsy can be raised by improvement in the quality of nuclear imaging agent, technic of injection and method of measurement.

Adult ; Aged ; Breast Neoplasms ; diagnostic imaging ; pathology ; Female ; Humans ; Lymph Nodes ; diagnostic imaging ; Middle Aged ; Radionuclide Imaging ; Sentinel Lymph Node Biopsy ; Technetium Tc 99m Sulfur Colloid

OBJECTIVETo observe the efficacy of biased constitution patients treated by auricular point therapy on the basis of "preventive treatment" theory.

METHODSBy means of self-control, 1477 cases of biased constitution were regulated by auricular point sticking therapy or acupuncture, and follow-up and statistical analysis were conducted to observe the efficacy.

RESULTSThere were 322 markedly effective patients, 914 effective patients, 241 failed patients and the total effective rate was 83.7% (1236/1477).

CONCLUSIONThe comprehensive auricular treatment which is easy to operate and acceptable for patients has obvious effect in biased constitution patients. As a new direction of the "preventive treatment" theory, it can be promoted to be a new intervention way of health care.

Acupuncture Points ; Acupuncture Therapy ; Acupuncture, Ear ; Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Preventive Medicine ; Young Adult

Objective To explore methods for performance appraisal of directors of municipal hospitals in Shanghai.Methods To assess the management performance of directors of 24 tertiary hospitals each year,measured by five dimensions of social satisfaction,management efficiency,capital operation,development sustainability and staff satisfaction,and 23 indexes.Results Implementation of the performance appraisal has witnessed constant improvement of patient satisfaction and quality of medical care,as well as rational control of medical expenses and cost.In 2014 for example,the cost of emergency/outpatients per visit at such hospitals were 312 yuan and 1 5 600 yuan per hospitalization respectively,with 7.6 days of stay in average.Also improved were service efficiency,clinical research output and hospital business performance in general.Conclusion Performance appraisal of directors of public hospitals proves an important means for guiding the hospitals to adhere to public welfare, consistent with the government medical institution operation target, and to strengthen internal management of such hospitals.

OBJECTIVETo explore the optimal methods for the reconstruction and preservation of the glans after partial penis resection in the treatment of early-stage penile cancer.

METHODSBetween January 2012 and June 2015, we treated 6 cases of early- stage penile cancer by partial penis resection, inner thigh skin graft, and glans reconstruction and followed them up for 0.5-3 years.

RESULTSThe length of the penis before and after operation was ([6.5 ± 1.2] vs [4.5 ± 1.8] cm) in the flaccid state and ([12.8 ± 2.3] vs [9.1 ± 2.1] cm) in the erectile state. The sense of the reconstructed glans was completely recovered at 3 months after surgery. The glans skin was pale red and soft, nearly normal at 12 months, with no obvious graft contracture or scar formation. All the patients achieved normal erection and their partners were satisfied with their intercourse. No recurrence or metastasis was observed.

CONCLUSIONThe strategy of partial penis resection, inner thigh skin graft and glans reconstruction, simple, effective, and with few complications, is one of the best treatments of early-stage penile cancer, which not only ensures radical removal of the tumor but also maximally reserves the function of the organ.

Humans ; Male ; Penile Neoplasms ; surgery ; Penis ; surgery ; Reconstructive Surgical Procedures ; Skin Transplantation ; Thigh

Objective To study the present situation and influence factors of pulmonary rehabilitation among COPD patients in community.Methods The present situation of pulmonary rehabilitation was investigated using questionnaire in 201 COPD patients,including one community in Guangzhou and three communities in Qingyuan,and the influencing factors were analyzed by Logistic regression.Results Total of 201 COPD patients,20.4％ COPD patients could insist on oxygen therapy,just one patient's oxygen time more than 15 hours;40.8％ COPD patients would increase the oxygen flow if exacerbation;17.9％ COPD patients could insist on respiratory exercising,and 75.5％ COPD patients took exercise in wrong way.50.7％ COPD patients took exercise in their life.3-4 times in hospital with a high rate of home oxygen therapy.Farmers and the course more than ten years with a high rate of exercising.Conclusions The cognition of COPD patients about pulmonary rehabilitation is poor,and also the compliance of pulmonary rehabilitation exercise is bad.The medical staff should strengthen the education of pulmonary rehabilitation of COPI patients in community,and pay attention to patients' hospitalization,occupation,and course of disease.