Congresses as Topic ; Otolaryngology ; Otorhinolaryngologic Diseases ; surgery

Objective To analyze the clinical features of urothelial carcinoma in renal allograft re- cipients and to investigate its diagnosis and treatment.Methods A retrospective study was undertaken on 1293 renal allograft recipients in our center between 1998 and 2003.Of them ,21 cases(72.4% )had urothe- lial carcinoma(4 males and 17 females).All the cases had not had tumor before transplantation.In 17 cases the protopathy was chronic interstitial nephritis(CIN).The mean interval between tumorigenesis and trans- plantation was 26 months(range,6-62 months).Of the 21 cases,6 had bladder transitional cell carcinoma (TCC);6 had unilateral pelvic or ureter TCC;8 had unilateral pelvic or ureter and bladder TCC;1 had bilat- eral pelvic and ureter TCC.In 10 cases,the ipsilateral upper urinary tract of the graft was involved;and in 4 cases,the contralateral upper urinary tract was involved.Painless gross hematuria and iterative urinary tract infection were the cardinal symptoms.Surgical treatment was performed in 19 cases.Postoperatively,all the cases received immunosuppressants at one third reduction dose in combination with intravesical instillation chemotherapy.Results Two cases receiving palliative treatment died 5 and 8 months after diagnosis.The other 19 cases were followed for 2-5 years.Of them,13 cases had tumor recurrence.The recurrence sites were bladder and the contralateral upper urinary tract.All the cases had no acute rejection at reduced dose of immunosuppressants,and all had normal renal function except for 2 cases,who underwent removal of the graft and had dialysis again.Conclusions Renal allograft recipients whose protopathy is CIN and female recipients have the risk of urothelial carcinoma after renal transplantation.Urothelial carcinoma occurs more often in ipsilateral upper urinary tract of the graft than in contralateral upper urinary tract.Considering the high possibility of bilateral upper urinary tract involvement by TCC,prophylactic bilateral nephroureterectomy with bladder cuff excision should be considered in renal allograft recipients who have involvement of contra- lateral upper urinary tract of the graft.

AIM: To observe effect of the iris location to femtosecond - combined wavefront guided LASIK for myopia and astigmatism.?METHODS:The patients with astigmatism >1. 0D during the same time and followed up for 1a were selected. A total of 129 eyes in 67 patients were treated under iris location with femtosecond-combined wavefront guided LASIK ( experimental group) and 161 eyes in 82 cases with femtosecond-combined wavefront guided LASIK ( control group) . Laser cutting went with the same laser machine. The uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA) , and wavefront aberration between the two groups were compared at 1, 3, 6mo and 1a after surgery.?RESULTS:At 1 and 3mo after surgery, the number of patients with better postoperative UCVA than preoperative BCVA between the two group showed a statistically significant difference (χ2=6. 423, P=0. 011,χ2=14. 431, P=0. 01 ); at 1d and 1mo after surgery, the residual astigmatism showed a statistically significant difference between two groups (t=1. 98, P<0. 05; t=2. 23, P<0. 05). At 3, 6mo and 1a after surgery, the differences on the change of residual astigmatism between the two groups weren’t significant ( P > 0. 05 ). At 6mo and 1a after surgery, the differences on UCVA between the two groups weren’t significant ( P > 0. 05 ). Until 1a after surgery, the root mean square ( RMS ) of high order wavefront aberration of the two groups, spherical aberration and coma aberration ( COMA ) were all enhanced compared to before surgery(P<0. 05). At 1, 3mo after surgery, the RMS showed a statistically significant difference between two groups (P<0. 05). At 1, 3, 6mo, 1a after surgery, the increase of COMA in experimental group was significantly lower than that in control group (P<0. 05).? CONCLUSION: Iris location technology applied in femtosecond - combined wavefront guided LASIK for myopia and astigmatism, can make the vision recovery faster, the RMS of high order and COMA increase less, the residual astigmatism less, show better and more stable treatment effect.

AIM:To contrast analysis of postoperative variation of corneal posterior surface heights after Femtosecond LASlK ( FS - LASlK ) and small incision lenticule extraction ( SMlLE) for high myopia.
●METHODS: Sixty-seven cases of high myopic patients (132 eyes) operated with laser corneal refractive in our hospital from May to Dec. in 2015 (-6. 00D≤spherical equivalent degree≤-10. 00D) were selected and divided into FS-LASlK group and SMlLE group. The thickness of corneal flaps at FS-LASlK and the thickness of map at SMlLE were designed to be 110μm. Corneal posterior surface heights were examined by Pentacam at preoperation, postoperative 3 and 6mo after FS-LASlK and SMlLE operation. Surface height changes after preoperative, postoperative 3 and 6mo were compared by measuring Pentacam corneal analysis system.
●RESULTS: Six months after operation, the FS-LASlK posterior corneal surface height was 6. 47 ± 1. 65mm, significantly higher than 5. 20 ± 1. 32mm before operation. SMlLE posterior corneal surface height was 6. 40 ± 1. 33mm, significantly higher than 5. 18 ± 1. 25mm before operation, the differences were statistically significant( P<0. 05). Six month after surgery, two methods of corneal surface height variation obtained was 1. 29 ± 1. 28mm and 1. 22 ± 0. 89mm, there was no significant difference ( P>0. 05).
●CONCLUSION:After FS-LASlK and SMlLE, the corneal posterior surface is protrusive. FS - LASlK is slightly obvious than SMlLE in early period. The stability of the posterior surface is better after SMlLE.

Genetic Predisposition to Disease ; Genome-Wide Association Study ; Humans

Child ; Humans ; Pneumonia ; diagnosis ; etiology ; Recurrence

Three-orientation medical talent training mainly include humanistic quality cultivation, professional quality and physical and mental quality. With professional ability as the guidance of profes-sional quality education requires students not only to grasp skilled medical technology, but also have the ability to enhance the medical technology. Based on the orientation of training target, this research mainly from habit set, authority set, set the multitude and empirical mind-set four aspects in this paper, the critical thinking, and put forward problems from finding problems, and expounds the innovative thinking of concise problem.

0.05).3.IL-8-251A and 781C were lingkaged(D′=0.348?0.019,r2=0.114 P

ObjectiveTo explore the diagnostic methods and surgery pattern at the first time of spontaneous perforation of congenital choledochal cyst.MethodsEleven cases(4 male,7 female) with spontaneous perforation of congenital choledochal cyst were 6 months to 5 years old,and their average course of disease were 4 days.Gustily abdominal distension,abdominal pain,crying and fever were present in all cases.Jaundice(7 cases) and emesis(5 cases) appeared.All cases were detected with physical sign of peritonitis by physical examination.Choledochal cysts were confirmed by CT or B ultrasound in 8 cases.All cases accepted abdominal paracentesis and biliary ascites was drawn.Three different operative procedures were performed:choledochocyst excision & Roux-Y choledocho-jejunostomy(2 cases),choledochotomy with T-tube drainage(3 cases),and cholecystostomy(6 cases).Nine children receiving external drainage operation accepted a second operation to rebuild biliary tract(choledochocyst excision & Roux-Y choledochoje-junostomy) after 3 to 6 months.ResultsAll cases had got satisfactory therapeutic efficacy without any grave complication such as fistula of anastomotic stoma,infection of biliary tract or obstruction of biliary tract.During operation,perforations were located in the juncture of choledochus and cystic duct in 5 children and were not found in the other 6 children.In the second operation,the cases receiving cholecystostomy had less peritoneal adhesion,anatomic structure changes,haemorrhage[(30-50) mL vs(100-200) mL] and operation time[(2.5-3.0) h vs(3.5-5.0) h] than those receiving choledochotomy with T-tube drainage,and did not appear inadequate drainage for cystic duct obstruction.ConclusionsFor children with more organ inflammatory edema and adherence and in a bad overall condition,the first-time operation of cholecystostomy is more reasonable.

Adolescent ; Adult ; Aged ; Anti-Ulcer Agents ; therapeutic use ; Chronic Disease ; Female ; Helicobacter Infections ; therapy ; Helicobacter pylori ; Humans ; Male ; Middle Aged ; Thrombocytopenia ; microbiology ; therapy ; Treatment Outcome ; Young Adult