Benzene ; toxicity ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Thrombocytopenia ; chemically induced

Background Percutaneous nephrolithotomy (PCNL) was mostly performed with fluoroscopy and/or ultrasonography.The safety and feasibility of PCNL performed totally under ultrasound are not clearly defined.Therefore,we introduce the 9-year experience of 8 025 ultrasound guided PCNL procedures from multiple centers in China performed by the same surgeon,to evaluate the feasibility and security of this technique.Methods From September 2004 to August 2013,8 025 cases,4 398 males (54.8％) and 3 627 females (45.2％),whose age ranged from 6 months to 85 years old,with upper urinary tract stones,underwent PCNL in our center and the supported hospitals.Puncture site selection and channel dilation were all guided using only Doppler ultrasound.Single stones were treated in 1 356 cases,there were 2 817 cases of multi stones,and 3 852 cases of staghorn calculi.The pre-and post-operative imaging data,the intraoperative findings,operation time,perioperative complications,and related parameters were recorded.Results All procedures were successful.No patients died during the operation.Average operation time was 42 minutes (range 10 to 168 minutes),4 cases converted to open surgery,and 2 patients lost the diseased kidney due to refractory bleeding in the early stage of the PCNL.Ninety-four (1.2％) patients received blood transfusions and 20 (0.25％) patients needed highly selective renal artery embolization.Fifteen (0.19％) patients had a pleural injury.5 457 (68％) cases were completed by a single tract and 2 568 (32％) cases added more tracts.The mean stone size (longest diameter) was 2.8 cm (range 1.2 to 26.5 cm).The final stone-free rate was 85.5％.Residual stones occurred mainly in patients with renal dysfunction,medullary sponge kidney,and complete staghom calculi with a slim calyceal neck.Conclusions X-ray free Doppler ultrasound guided percutaneous nephrolithotomy is feasible and safe in a variety of cases of renal and/or upper ureteral stones.The probability of radiation hazard and adjacent organ injury is low.The morbidity from major complications was reduced remarkably after special training.It is worthy of wider use compared with fluoroscopy in patients with special kidneys (e.g.solitary kidney,spinal deformity,ectopic kidney) and in infants.

Ganglioneuroblastoma ; complications ; Humans ; Infant ; Male ; Paraneoplastic Cerebellar Degeneration ; etiology ; Tomography, X-Ray Computed

Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; pathology ; physiopathology ; Pituitary Gland ; pathology ; Pituitary Neoplasms ; pathology

Objective To explore the value of DWI and ADC in evaluation the pathologic characteristics of hepatic alveolar echinococcosis (HAE).Methods Twenty six patients with HAE underwent routine MRI and DWI ( b =500,800 s/mm2 ) scan,ADC values of different part including the center,peripheral area and surrounding zone of the lesion were measured,respectively.One-way ANOVA was used for comparing the ADC values of two groups.HE staining specimens and MVD of peripheral area of the lesion were analyzed by different pathological staining methods.The correlation between MVD and ADC values of the peripheral area was analyzed by using the Pearson rank correlation analysis.ResultsTotally 32 lesions were detected in 26 HAE patients.The ADC values of the center,the peripheral zone and the surrounding area of the lesions were (1.3 ±0.3) × 10-3,(1.1 ±0.4) × 10-3 and (1.8 ±0.5) ×10 -3 mm2/s when b =500 s/mm2,but when b =800 s/mm2,the ADC values were ( 1.2 ± 0.4) × 10 -3,(1.1 ± 0.3) × 10-3 and (1.9 ± 0.4) × 10-3 mm2/s,respectively.There were significant difference of the ADC values between two groups(P ＜0.01 ).The significant differences of the ADC values were also found in different area of the lesion (P ＜ 0.05 ).There were no correlation was found between ADC value and MVD [(12.9 ± 3.7)/HP] in the peripheral area of HAE(r =-0.042 and -0.077,P ＞ 0.05).ConclusionsDWI reflected the heteromorphism of peripheral zone and help to identify the infiltration area and biological boundary.No relationship was found between the ADC values of peripheral zone of lesion and MVD.

Objective To evaluate the effects of health education on HIV/AIDS high-risk behaviors,knowledge,and attitude among floating population in China.Methods A computerized literature searching was carried out in Chinese Biomedical Database,Chinese National Knowledge Infrastructure,Wan Fang and VIP databases to collect articles published in China between 2005 and 2010.Words as “AIDS”,“ Floating Population”,“ Intervention ”,“ Health Education ”,“ High-risk Behavior” were used.Type of studies would include “self-control intervention studies or studies containing sections of self-control intervention”.Meta-analyses were performed to assess 8 outcomes which targeting on high-risk behavior,knowledge and attitudes of AIDS.RevMan 4.2 software was used to analyze the intervention effects for these indexes.Results After the interventions,the rate on awareness of “Whether condoms can reduce the HIV/AIDS infection risk” increased by 23％ [rate difference (RD) 95％ CI: 0.19,0.27] and “Whether keeping monogamous sexual relationship can reduce the risk of infection” increased by 18％ (RD 95％CI: 0.14,0.23 ).The proportion of “Willing to use condoms in sexual life” increased by 16％ (RD 95％ CI: 0.11,0.22) ; and “The incidence of commercial sex behaviors” reduced by 6％ (RD 95％ CI:-0.11,-0.02).“The Ratio of condom use during commercial sex behaviors” increased by 17％ (RD 95％CI: 0.10,0.23).and “Recent use of condoms during sex” increased by 25％ (RD 95％CI: 0.15,0.35).All the data showed significant differences (P＜0.01),respectively.Conclusion After health education,great improvements were found for HIV-related sexual knowledge,attitudes,and behaviors among the floating population.

Objective To investigate the clinical value of a new anvil inserting method for esophagogastrostomy or esophagojejunostomy during laparoscopic radical proximal gastrectomy or radical total gastrectomy for gastric cancer.Methods The clinical data of 21 patients with gastric cancer who received laparoscopic radical proximal gastrectomy or radical total gastrectomy at the Southwest Hospital from March 2010 to February 2011 were retrospectively analyzed.Five trocars were inserted through the abdominal wall of the patients.After perigastric lymphadenectomy and mobilization of esophagus,an incision was made on the esophagus above the tumor,and then the anvil with drawn wire attached was inserted into the esophagus.An endo-cutter was applied to cut the esophagus adjacent to the incision left the drawn wire untouched,and then the stem of the anvil was pulled out by the drawn wire for laparoscopic anastomosis. Results The operations were successfully accomplished under the laparoscope with no conversion to open surgery.Fifteen patients received laparoscopic radical total gastrectomy and 6 received laparoscopic radical proximal gastrectomy. The mean operation time,volume of blood loss,time to off-bed activity,passage of flatus and postoperative duration of hospital stay were (257 ± 38) minutes,( 119 ± 32) ml,(2.5 ± 0.5 ) days,( 3.7 ± 0.8 ) days and (7.5 ± 2.6) days,respectively.No perioperative mortality,anastomotic bleeding or anastomotic fistula was detected.One patient was complicated with pulmonary infection + pleural effusion and was cured by conservative treatment; 1 was complicated with anastomotic stenosis which was alleviated by gastroscopic balloon dilation; 1 was complicated by incisional infection and was cured by medical treatment after drainage.No cancer cells were detected at the anastomotic ring or resection margin of the specimen.There were 4 patients with well-differentiated adenoma,8 with moderate-differentiated adenoma and 9 with poor-differentiated mucinous adenoma.There were 5 patients in stage Ⅰ,10 in stage Ⅱ and 6 in stage Ⅲ (UICC staging).Twenty-one patients were followed up for a mean period of (11 ±4) months (range,6-17 months ),no tumor recurrence or metastasis was detected. Conclusions The new technique for anvil insertion is safe,effective and easy for manipulation and learn.It offers a new approach for laparoscopic digestive tract reconstruction.

Objective To summarize the experience in application of da Vinci robotic surgical system in radical resection of rectal cancer,and investigate the proper position of trocars and operative techniques.Methods The clinical data of 13 patients who received radical resection of rectal cancer accomplished by the da Vinci robotic surgical system at the Southwest Hospital from February 2010 to February 2011 were retrospectively analyzed.The patients were in lithotomy position and received combined intravenous anesthesia.Five or 4 trocars were used.Miles procedures were performed on patients with lower tumor position,and the other patients received Dixon procedure.Results The operation was successfully performed on all patients.Five trocars were selected for the first 3 patients,and 4 trocars for the other 10 patients.Nine Dixon procedures and 4 Miles procedures were selected.The mean operation time was 217.3 minutes (range,160-260 minutes).The mean operative blood loss was 53.3 ml (range,40-70 ml) in Dixon procedure and 120.0 ml (range,90-130 ml) in the Miles procedure,and no blood transfusion was needed.The mean number of lymph nodes dissected was 13.9 (range,8-21 ),and the time to bowel movement was 3.2 days (range,2-5 days).Two patients were complicated with pulmonary infection,1 with urinary tract infection,and they were cured by antimicrobial therapy.No other morbidity or mortality was found.The results of postoperative pathological examination showed that there were no residual cancer cells at the resection margin,and the distance between the resection margin and the tumor was 6.3 cm (range,3-10 cm).There were 1 patient in stage Ⅰ,5 in stage Ⅱ and 7 in stage Ⅲ.The mean time of follow-up was 5.9 months (range,3-12 months),and no recurrence or metastasis was found during follow-up.ConclusionsRadical resection of rectal cancer with da Vinci robotic surgical system utilizing 4 trocars has the advantages of minimally invasive surgery with fast recovery as well as the ease of dissection afforded by the surgical robot.

Child ; Cold Temperature ; adverse effects ; Female ; Hand Injuries ; etiology ; Humans ; Magnetic Resonance Imaging ; Recurrence ; Syringomyelia ; complications

OBJECTIVEIn order to provide scientific basis for introduction breeding and production regionalization of Panax notoginseng, the environment of producing area, agronomic traits and medicinal material output were investigated.

METHODUsing field survey sampling at harvest time, agronomic traits indicators of leaf segment, stem segment and roots segment etc. of commodity P. notoginseng, longitude and latitude, elevation, soil type, landform of producing area were measured and observed.

RESULTThe P. notogiseng cultivation was expanding from traditional area like Wenshang to new areas as Honghe, Kunming, Qujing at large scale. Comparing with traditional cultivated fields, the elevation of new fields, which are red soil of moderate or low mountain slopes and gentle hills between 1 800-2 130 m, increases markedly. The agronomic traits of new cultivated fields such as plant height, stem diameter, the ground and underground biomass were better than those of traditional cultivated fields in varying degree. Furthermore, the root weight, taproot weight, taproot length and other agronomic index augmented more than 20%. Comparison among different cultivated fields showed P. notoginseng of Honghe Shiping Niujie, Kunming Shilin Guishan, Honghe Jiangshui Guanting etc. had better agronomic traits, the plant were thick and tall, the taproot and the top of reed were large, the number of root was more. Inversely, P. notoginseng of Kunming Guandu Xiaoshao, Guangxi Jingxi Lutong, Wenshang Yanshan Jiangna were thin and small. Cluster analysis showed that cultivated fields of P. notoginseng which was across clustered by traditional and new cultivated fields can be divided into three groups, including a high-yielding region insist of three new cultivated fields Honghe Shiping Niujie, Kunming Shilin Guishan, Honghe Jiangshui Guanting and one traditional cultivated field Wenshan Yanshan Jiangna. Correlation analysis indicated that the size and weight of taproot and top of reed were significantly positive correlated with plant height, stem diameter, leaf size, leaf weight and stem weight. Regression analysis pointed out that stem diameter, leaf width, leaf length/width, leaf weight were the main factors affecting the dry weight of taproot, and the main factors influencing the dry weight of top of reed were plant height, petiole, leaf length, leaf width and other agronomic traits.

CONCLUSIONFrom agronomic traits, P. notoginseng in new cultivated fields were more robust than that in traditional fields, but besides the length of taproot, the difference of rest agronomic traits didn't reach the significant level. It is suggested that, in the west and the north of traditional area, the red soil land of moderate or low mountain slopes and gentle hills where the elevation is between 1 800-2 130 m is suitable for cultivating P. notoginseng. Honghe Shiping Niujie, Honghe Jianshui Guanting, Kuming Shilin Gongshan can be used as vital development area for commodity P. notoginseng.

Agriculture ; methods ; Breeding ; China ; Drugs, Chinese Herbal ; analysis ; Panax notoginseng ; chemistry ; classification ; genetics ; growth & development ; Quality Control ; Quantitative Trait Loci ; Soil ; chemistry