2.MRI diagnosis of Wernicke encephalopathy after major surgical operation
Ying DONG ; Chuntao YE ; Ming JI ; Wei LIU
Chinese Journal of General Surgery 2014;29(11):843-846
Objective To analyze MRI imaging features of patients with Wernicke encephalopathy after major surgical operation.Methods Clinical data including cranial MRI features were reviewed on five patients of Wernicke encephalopathy after major surgical operation from Jan 2012 to Nov 2013.Results The clinical features of patients with Wernicke encephalopathy after major surgical operation were noncharacterized and most of them had no specific value for diagnosis except for a definite history of vit B1 insufficiency.MRI imaging showed abnormal signal in the medial thalamus,third ventricle,surrounding area of the aqueduct of midbrain,column of fornix and the dorsal midbrain and pons ; Lesions were showed with long T1 and long T2 signal intensity and high signal intensity on fluid-attenuated inversion recovery (FLAIR),and high signal intensity on DWI(b equals 1 000 s/mm2).ADC value in all lesions increased from [(0.46-0.59) ×10-3 mm2/s] before treatment to [(0.81-1.10) ×10-3 mm2/s] after vit B1 supplement.Conclusions Wernicke encephalopathy has typical MRI imaging presentations.Early diagnosis and timely supplement of vitamin B1 can improve the prognosis.
3.Clinical research of ureteral replacement using the Yang-Monti principle
Wei SHI ; Ze QIN ; Junsheng BAO ; Ye LI ; Li DONG
Chinese Journal of Urology 2017;38(5):367-370
Objective We summarized the clinical experience of modified ileal ureter substitution for treating long segment ureteral defection.Methods We retrospectively analyze the clinical data of 2 patients with long segment ureteral defect who treated with Yang-Monti ileal ureter substitution between March 2015 and November 2015.One 75 years old male patient was diagnosed as upper ureteral malignance and solitary kidney.The length of defection from renal pelvis to bladder was 22 em.His serum creatinine was 100 μmol/L,blood urea nitrogen was 5.7 mmol/L,serum chloride was 98 mmol/L.Another one 41 years old female patient was diagnosed as middle and lower ureteral iatrogenic injury.The traumatic length was 15 cm.Her serum creatinine was 70 μmol/L,blood urea nitrogen was 5.1 mmol/L,serum chloride was 100 mmol/L.they were both treated by Yang-Monti ileal ureter substitution.The ileal intestinal segment was used for the ureteral replacement,which were more than 15 cm to the ilealcecum.The length of intestine was 10.0 cm and 7.5 cm,respectively.The ileal mesentery was preserved.After closing the mesangial hiatus,the ileal segment was pull into the retroperitoneal space and pulling out via descending colonic mesangial window.The ileal segment was divided into three parts,which was 2.5 to 3.0 cm in each part.Each part was opened via long axis and then rotated 90 degree.The 4-0 absorable suture was used to suture the edge of each intestinal part continuously.The sutured intestine was re-tubularized,using 4-0 absorable suture and the F16 catheter was used as the tube model.The length of reconstructed ureter was 22 cm and 18 cm,respectively.The neo-ureter was re-anastomosed with renal pelvis and bladder wall.Two F6 double J stents were placed in the neo-ureter.Results The operative time was 160 min and blood loss was 200 ml in the first case.In the second case,the operative time was 180 min and blood loss was 220 ml.No significant complications were noticed intra-operation and post-operation.Six months after operation,the male patient's serum creatinine was 112 pmol/L,blood urea nitrogen was 6.1 mmol/L,serum chloride was 106.0 mmol/L and electrolytes were normal.In another patient,serum creatinine was 79 μmol/L,blood urea nitrogen was 5.9 mmol/L and serum chloride was 103.0 mmol/L.The GFR was 24.9 ml/min and 22.1 m]/min 3 and 6 months after operation,respectively.Ureteral obstruction wasn't detected on IVU images 3 months after operation.Conclusions For patient with long ureteral defect,which cannot be replaced by other urinary tissue,YangMonti ileal ureter substitution is one of the optional modalities.As a new technique of ureteral substitution,Yang-Monti ileal ureter substitution is simple and fewer complications and can improve the quality of life in patient compared with traditional ureteral substitution.
4.Primary clear cell carcinoma of the epididymis (a case report and review of the literature)
Weibing PAN ; Nengben DONG ; Qinghan ZHANG ; Xulong YE ; Wei PENG
Chinese Journal of Urology 2001;0(03):-
Objective To evaluate the pathological,histochemical and clinical features of primary clear cell carcinoma of the epididymis,and to investigate its diagnosis,treatment and prognosis.Methods The clinical data of one case of primary clear cell carcinoma of the epididymis were reported and the relevant literature was reviewed.Results The patient was a 43-year-old man presenting with a painless mass in the left epididymis.On physical examination,a 1.0 cm-sized smooth solid nodule on the head of left epididymis could be palpated without tenderness.Then the patient underwent left epididymectomy.On postoperative histopathological study,the tumor was characterized by diffuse sheets of clear cells and adenoid structures.Immunohistochemical assay showed AE(++),AE3(+/-),NSE(-) and interstitialoma(-) in the tumor tissues.Postoperatively,MRI showed no space-occupying lesion in both kidneys,and B-ultrasound indicated no abnormality of the bladder.Fifteen days after operation,left orchiectomy was performed on the patient.Pathology showed no clear cell carcinoma tissue of the testis.Follow-up was 15 months.The patient was reported to be alive and tumor-free.Conclusions The histogenesis of primary clear cell carcinoma of epididymis is unclear yet.The diagnosis depends on pathologic studies,and should be differentiated from nephrogenic adenoma and metastatic carcinoma.Radical surgery is the main treatment choice.
5.Correlation Study on Iron Content, Yield and Quality ofCornus ofifcinalis
Yuping XIONG ; Chengming DONG ; Wei XIA ; Zhenhui DU ; Haidong YE
World Science and Technology-Modernization of Traditional Chinese Medicine 2015;(5):1022-1024
This article was aimed to study the correlation between iron content inCornus officinalis leaves and its yield as well as quality. The method of microwave digestion atomic absorption spectrophotometer was used to determine the content of iron element inCornus officinalis leaves. HPLC was used to determine the content of loganin and ursolic acid in fruits. Correlation analysis was made among the content of iron element, yield of fruits, loganin and ursolic acid in fruits. The results showed that iron element in leaves of different yield level cornus officinalis was different. It also had some correlation with yield and quality of fruits. It was concluded that the research can improve relations of source-sink inCornus ofifcinalis, adjust source-sink balance, guide farmers to master the period of spraying iron fertilizer, and increase production and quality ofCornus ofifcinalis.
7.Expression of Bcl-2,Bax and proliferating cell nuclear antigen in the liver of rats with hepatic fibrosis and the effect of transforming growth factor-?1 vaccine on them
Wei-Dong YE ; Yong-Ping CHEN ; Shao-Jie XU ; Yuan HUANG ; Yi-Ling ZHU ; Chen-Wei PAN ; Wei-Dan XU ;
Chinese Journal of Infectious Diseases 2007;0(07):-
Objective To observe the expression of Bcl-2,Bax and proliferating cell nuclear antigen(PCNA) in liver of rats with hepatic fibrosis and the effects of transforming growth factor (TGF)-?1 vaccine on them.Methods Thirty healthy male Sprague-Dawley rats were assigned into 3 groups,named healthy control group(n=10),hepatic fibrosis group(n=10) and TGF-?1 vaccine treated group(n=10).The animal model with hepatic fibrosis was established by injecting solution dimethylnitrosamine (DMN) into abdominal cavity with concentration as 0.5% and dose as 0.2 mL/ 100 g.In TGF-?1 vaccine treated group,every rat was not only injected with DMN but also 150?g TGF-?1 vaccine protein.On the 42nd day,all rats were sacrificed.Then the blood and the liver tis- sues were collected.The expression levels of Bcl-2,Bax and PCNA in liver tissues were detected by S -P immunohistochemistry and observed by routine pathological evaluation.Alanine aminotransferase (ALT),aspartate aminotransferase(AST) and albumin(Alb) were determined by auto biochemical analytical tool.Serum levels of hyaluronic acid (HA),laminin(LN) were detected by radioimmunoas- say (RIA).Results The expression of Bax,which promoted apoptosis,directly correlated with pathological grade in liver of rats,while the expression of Bcl-2 and Bcl-2/Bax,which protected a gainst apoptosis,inversely correlated with pathological grade in liver of rats.The expression levels of TGF-?1 and Bax in healthy control group were significantly lower than those of fibrosis group,how ever,the expression levels of Bcl-2 were comparable between these two groups.As compared with fi- brosis group,the expression of TGF-?1 was significantly lower while the expression of Bcl-2 was sig nificantly higher in TGF-?1 vaccine treated group.However,the expression of Bax was comparable between these two groups.The expression level of PCNA of fibrosis group was significantly higher than that of healthy control group but dramatically lower than that of TGF-?1 vaccine treated group (Both P
8.Risk Factors of Perioperative Complications in Patients Undergoing Radical Retropubic Prostatectomy: A Ten-year Experience
LIU XIAO-JUN ; CHANG KUN ; YE DING-WEI ; ZHENG YONG-FA ; YAO XU-DONG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2017;37(3):379-383
Radical retropubic prostatectomy (RRP) has been one of the most effective treatments for prostate cancer.This study is designed to identify the related predictive risk factors for complications in patients following RRP.Between 2000 and 2012 in Department of Urology,Fudan University Shanghai Cancer Center,421 cases undergoing RRP for localized prostate cancer by one surgeon were included in this retrospective analysis.We reviewed various risk factors that were correlated with perioperative complications,including patient characteristics [age,body mass index (BMI),co-morbidities],clinical findings (preoperative PSA level,Gleason score,clinical stage,pathological grade),and surgeon's own clinical practice.Charlson comorbidity index (CCI) was used to explain comorbidities.The total rate of perioperative complications was 23.2% (98/421).There were 45/421 (10.7%),28/421 (6.6%),24/421 (5.7%) and 1/421 (0.2%) in grade Ⅰ,Ⅱ,Ⅲ,Ⅳ respectively,and 323/421 (76.8%) cases had none of these complications.Statistical analysis of multiple potential risk factors revealed that BMI >30 (P=0.014),Charlson score ≥1 (P<0.001) and surgical experience (P=0.0252) were predictors of perioperative complications.Age,PSA level,Gleason score,TNM stage,operation time,blood loss,and blood transfusion were not correlated with perioperative complications (P>0.05).It was concluded that patients' own factors and surgeons' technical factors are related with an increased risk of development of perioperative complications following radical prostatectomy.Knowing these predictors can both favor risk stratification of patients undergoing RRP and help surgeons make treatment decisions.
9.Interaction between polymorphisms in NQO1C609T and XRCC1G28152Aand their correlation with smoking on gastric cancer
Dao-Jun CHEN ; Rui DING ; Wei CAO ; Dong-Qing YE
Chinese Journal of Epidemiology 2011;32(1):5-8
Objective To investigate the relationship between polymorphism of NAD (P)H quinone oxidoreductase 1 (NQO1)and X-ray repair cross-complementing group 1 (XRCC1) and their correlation with smoking on the susceptibility to gastric cancer. Methods A 1:1 case-control study of 334 patients with primary gastric cancer, with non-cancer or alimentary inpatients as control group (matched for ages ± 5 years, sex and reqion) in Anhui province was conducted to analyze theNQO1C609T and XRCC1G28152A. Gene types by PCR-based restriction fragment length polymorphism techniques. Interaction index (γ) was calculated to determine the type of gene- environment interaction. Results The average age of 334 cases of gastric cancer patients was 57 years, with 65.3% of them were male. Smoking rate in the case group (55.09%) was significantly higher than in the control group (36.53%). The consequence showing that it carried the heterozygous variant (CT)or homozygous variant (TT) of NQO1 could enhance the risk of gastric cancer(OR= 1.507,3.050),but not the XRCC1G28152A gene polymorphism or the susceptibility to gastric cancer. At the same time,individuals that carrying XRCC1AG and NQO1TT could increase 2.789 times the incidence of gastric cancer than those who carrying the XRCC1AG or NQO1CC. The gastric cancer risk of XRCC1GG individuals that carrying NQO1TT was 4.448 times higher than those who carrying XRCC1GG or NQO1 CC. The positive interactions of NQO1 homozygous variant (TT) , XRCC1 homozygous variant (GG) and smoking were revealed in the occurrence rates of gastric cancer (OR=3.094,γ =2.070). Conclusion Our research findings showed that the significant interactions between genetic polymorphisms of NQO1, XRCC1 and smoking added the risk of gastric cancer, while genetic and environmental hazardous factors co-effecting the development of gastric cancer.
10.Foreskin-deglove and shaft-fix procedure combined with Z-plasty of penis and scrotum skin in treatment of concealed penis
ping, PING ; yi-dong, LIU ; yi-ran, HUANG ; wei-jing, YE
Journal of Shanghai Jiaotong University(Medical Science) 2006;0(09):-
Objective To explore the efficacy of foreskin-deglove and shaft-fix procedure combined with Z-plasty of penis and scrotum skin in the treatment of concealed penis. Methods Fifty-eight patients diagnosed as concealed penis were included in the study.All of them underwent the foreskin-deglove and shaft-fix procedure.Foreskin was degloved from 5 mm to 10 mm proximal to corona deep to the root,and bilateral tunica albuginea at this level was sutured to suprapubic scarpas' fascia.Z plasty of penis and scrotum skin was applied to cover penile shaft. Results After follow-up for 6 to 12 months,there was no recurrent retraction of the penile shaft,and all the patients were satisfied with the appearance of penis after plastic surgery.Edema of prepuce occurred in 2 patients,and completely regressed in 2 to 3 months.There was no incision scar hyperplasy,and the function of urination and erection were normal. Conclusion Foreskin-deglove and shaft-fix procedure combined with Z-plasty of penis and scrotum skin can resolve pathologic problems of concealed penis and has favourable aesthetic results with less complications.It is easy to perform and is an ideal procedure in the treatment of concealed penis.