Adenocarcinoma, Sebaceous ; pathology ; Humans ; Male ; Middle Aged ; Parotid Neoplasms ; pathology

Objective To evaluate the feasibility and advantages of transvaginal hysterectomy (TVH) for enlarged uterus without prolapse. Methods Six hundred and ninety-six patients underwent TVH for gynecological disorders from Sept, 1998 to Dec, 2002. Meanwhile, the method of operation, complications of surgery, operation time, estimated operative blood loss, postoperative recovery and hospital stay days were retrospectively analyzed. Results The operation was successful in 693 out of 696 cases (99.6%). The mean operative time was 49.3 minutes (11-125 minutes). The estimated blood loss was 69.7ml (15-450ml). Operative injuries were found in 3 patients (0.4%). Complications attributable to surgery were found in 6 cases (1%). The mean time of subsidence of fever was 1.2 days (0-5 days) and the time of passing flatus was 22.6 hours (8-32 hours). The average hospital stay was 5.3 days (4-15 days). Conclusion TVH can be performed safely for most of non-prolapsed large uterus. Because it has the advantages of less bleeding, short operating time, rapid recovery and less cost compared to TAH and LAVH, it is our opinion it should be the first option for enlarged uterus.

Objective To evaluate the advantages and feasibility of transvaginal excision of ovarian tumor. Methods A series of 62 patients with ovarian benign tumors had the tumors excised transvaginally from Dec 2001 to Oct 2003. The indications of transvaginal surgery, the method of operation, the complications following the operation, the overall operation time, the estimated blood loss during operation, the postoperative complications, and hospital stay days were analyzed retrospectively. Results Transvaginal ovarian tumor excision was successfully completed with neither the aid of laparoscopy or shift to laparotomy. No intra-abdominal spillage of cystic contents occurred. The mean operation time was 39.4 minutes. The estimated blood loss was 37.5ml. No postoperative complications occurred. The mean length of a low fever was 1.3 days, and the time of recovery of bowel movement was 20.1 hours. The average hospital stay was 4.2 days. Conclusion For free benign ovarian tumors, the transvaginal route should be considered to minimize trauma. There would be no skin incision, and it could be carried out in patients who had relatively large ovarian tumors with no intra-abdominal spillage. There would be less blood loss, shorter operation time, shorter hospital stay and lower cost.

Objective To evaluate the feasibility and advantages of the excision of uterine fibroids by vaginal myomectomy. Methods A series of 58 patients with uterine fibroids were managed with myomectomy from May 2001 to Dec 2003. Meanwhile, the indications of vaginal surgery, the methods of operation, the complications of surgery, the overall operating time, the estimated operative blood loss, the postoperative recovery and hospital stay were explored. Results Myomectomy were successfully completed vaginally without shifting laparotomy in 57 patients. The successful rate was 98 3%. The mean operative time was 48 16 minutes. The estimated blood loss was 70 58ml. The postoperative complication was occurred in one patient with uterine infection. The mean length of lower fever was 1 8 days and the bower movement was 1 3 days. The average hospital stay was 4 9 days. Conclusions For uterine fibroids, the vaginal myomectomy is a good choice when the indication of operation are managed properly. It can be used in patients who have numerous, relatively large, and intramural fibroids with micro invasive surgery, little interfering with abdominal organs, less blood loss, less operating time, less cost and less hospital stay in comparison with abdominal myomectomy or laparoscopic myomectomy

Objective To evaluate the feasibility and efficacy of treatment of leukoplakia vulvae with high-intensity focused ultrasound. Methods 65 patients with leukoplakia of the vulva were treated with high-intensity focused ultrasound. The patients were followed up after the treatment, and the symptoms including itch of the vulva, color change, the elasticity of the vulva lesions, and release of adhesions were observed and evaluated at the different times after treatment. Result All of the patients experienced relief in different degree (the ratio of effectiveness was 100%). Of them 28 patients were complete cured, 29 were distinctly improved, 8 were improved. In 5 patients there was a recrudescence with mild itch 2-3 months after treatment, but there was still a positive response to the second course of treatment. Conclusions High-intensity focused ultrasound is a highly effective instrument in the treatment of leukoplakia of the vulva. The treatment not only stops itch, but enables the color and elasticity of the vulva to recover as well.

Objective To evaluate the value of bispectral index(BIS)monitoring as an indicator for extubation sedation level after children's oper?ation by total intravenous anesthesia. Methods One hundred and eighty children(2?13 years old)were randomly divided into six groups with 30 cases in each. Group A kept BIS 56?60,and Group B 61?65,Group C 66?70,Group D 71?75,Group E 76?80,Group F 81?85 till extubation. All children were given fentanyl,propofol and cisatracurium besilate when induced,and maintained with propofol and remifentanil. All cases kept BIS 40?55 during the operation. Then the changes of electrocardiogram,mean arterial pressure,heart rate,SpO2,postoperative complications and recovery time were observed. Results Groups A and B were extubated at deep anesthesia,cycle stability,but with high incidence of adverse reactions and awaked with a long time. Groups E and F were extubated when awaked,but with greater stimulation and easier agitation. Groups C and D were lighter hemodynamic responses,less respiratory effects and less postoperative complications of anesthesia. Conclusion The BIS level of 66?75 is a good se?dation level for extubation,especially in the level of 71?75.

ObjectiveTo explore clinical distribution rule of manifestations in patients with CAS,to provide objective basis of standardization,clinical diagnosis and treatment.MethodsEpidemiological methods were used to investigate on guanan'men hospital patients with CAS.Altogether 298 records of CAS patients were enrolled in this study,the frequency of main syndromes and the distribution characteristics of accompanying symptoms were analyzed.ResultsThe main syndromes of CAS were sputum stasis syndrome,qi stagnation and blood stasis syndrome,and deficiency syndrome of both liver and kidney yin,all together accounted for 39.3％.The major symptoms were vertigo or dizziness (64.1％),chest distress (60.1％),dry mouth (63.8％),amnesia (58.7％),and insomnia (50.0％) separately.ConclusionSputum stasis syndrome,Qi stagnation and blood stasis syndrome and deficiency syndrome of both liver and kidney yin group were as a combine form in patients with CAS,and dizziness or vertigo was its main clinical manifestation.

To investigate the association between Helicobacter pylori ( Hp ) infection and type 2 diabetes.Total 4 129 health check up subjects aged (49.1 ±11.3) years (18-92 years), including 2 649 males and 1 480 females were enrolled in this cross-section study.Hp infection was confirmed by 13 C-urea breath test;type 2 diabetes mellitus was diagnosed according to WHO criteria (1999).Single factor analysis and multiple regression analysis were used to evaluate the association between Hp affection and the prevalence of type 2 diabetes.Hp infection rate in diabetic group was significantly higher than that in non-diabetic group (45.6%vs.39.0%, P<0.05).Hp infection rate in subjects with newly diagnosed diabetes was highest than those with previously diagnosed diabetes and non-diabetic subjects ( P<0.05).The glycosylated hemoglobin level in Hp infection group was higher than that in non infection group [ ( 5.88 ±0.64 )% vs.( 5.62 ± 0.88)%, P<0.05];the fasting plasma glucose and postprandial blood glucose levels in Hp infection group were also higher than those in non-infection group ( P<0.05 ).Logistic regression analysis showed that Hp infection was one of the independent risk factors of type 2 diabetes (OR=2.002, 95%CI:1.564-2.563, P<0.05).The study indicates that Hp infection is closely associated with type 2 diabetes mellitus.

Chronic activation of the B-cell antigen receptor (BCR) signaling pathway performs a critical function in the pathogenesis of numerous subtypes of B-cell malignancies and transforms normal cells into malignant cells. Bruton tyrosine kinase (BTK) is a member of the TEC family of tyrosine kinases and is a key regulator of the BCR signaling pathway. BTK inhibition has emerged as a new target for therapeutic intervention in B-cell malignancies. This review summarizes recent developments of BTK inhibitors in B-cell malignan-cies.

Objective To analyze the relationship between the levels of plasma total homocysteine (Hcy) and umbilical arterial with color doppler ultrasound with the severity of preeclampsia(PE).Methods A total of 70 cases of the third trimester of normal pregnancy, 72 cases of mild PE, and 66 cases of severe PE were selected.Then plasma Hcy levels and umbilical arterial with color doppler ultrasound were detected.Results Hcy levels were statistically significant difference among the normal control group,mild PE group,and severe PE group((8.950±0.585), (11.116±0.615), (14.648±0.620) μmol/L,P＜0.05).Umbilical artery blood flow parameter S/D values in severe PE group was significantly higher in mild PE group and in contrg.1 group (3.43 ±0.72 vs.2.86 ± 0.82 vs 2.75 ± 0.56, P＜ 0.05), while the control group, mild PE group had no significant difference(P＞0.05).Resistance index(RI) ,Pulsatility index(PI) in mild PE group and severe PE group were significantly higher than control group(0.60±0.05,0.78±0.07 vs.0.57±0.06;1.24±0.21,1.47±0.64 vs.0.67±0.35), and the differences among three groups were significant(P＜0.05), while the mild PE, severe PE group had no significant difference(P＞0.05).Hcy of mild PE group was positively correlated with S/D, RI and PI(r=0.548,P=0.009;r=0.587,P=0.008;r=0.324,P=0.02).Hcy of severe PE group was positively correlated with S/D,RI and PI(r=0.752,P=0.001;r=0.627,P=0.003;r =0.438,P=0.024).Hcy and the severity of PE was positively correlated (r =0.450, P ＜ 0.05), S/D and the severity of PE was positively correlated(r=0.316, P =0.002).RI, PI and the severity of PE was no correlation (r =0.024, P =0.726;r =0.054,P =0.649).Conclusion The levels of Hcy and S/D were related to the severity of PE.To reduce Hcy,and monitor S/D were new ways for the diagnosis and treatment of pre-eclampsia.