Objective To investigate the feasibility and efficacy of posterior retroperitoneoscopic adrenalectomy (PRA).Methods From September 2013 to September 2015,the clinical data of 35 patients who underwent posterior retroperitoneoscopic adrenalectomy were reviewed.There were 14 males and 21 females,aged 15-70 years,with the average of 45.8 years.Preoperative CT scan showed 19 adrenal tumors in the left side,16 in the right side,and one case with the left adrenal adenoma combining with right renal cyst.Tumor diameter is between 10 ～ 60mm,with the average of 31mam.Twenty-two cases were diagnosed as primary aldosteronism,4 pheochromocytoma,and 9 non-functional adrenal tumor.The posterior retroperitoneoscopic adrenalectomy were performed in all of the cases,which are under general anesthesia with tracheal intubation and prone position with hip joints and knee joints flexion of 90.Results Thirty-five operations were successfully completed via the posterior approach demonstrating clear anatomical layers.The operation time was 38-138min(mean 70 min),the drainage tube indwelling duration was l-Sd(average 2d),and the hospital stay was 2-6d (average 4d).Total costs of hospitalization were 14 789-31 992 yuan RMB,with an average of 21 239 yuan RMB.No complications occurred during the perioperative period.The average follow-up was 11 months,and no complications such as tumor recurrence occured.Conclusions Retroperitoneoscopic adrenalectomy provided clear anatomical views.It could be a safe and effective operation for the treatment of adrenal tumors.

Objective To investigate the feasibility and efficacy of posterior retroperitoneoscopic adrenalectomy (PRA).Methods To review the clinical data of 35 patients who underwent posterior retroperitoneoscopic adrenalectomy from September 2013 to September 2015.There were 14 males and 21 females, aged 15-70 years, with an average of 45.8 years.Preoperative CT scan was performed to determine the size, shape and location of the tumor.Tumor diameter 10-60 mm, average 31 mm.Results 35 operations were successfully accomplished via the posterior approach.The operation time was 38-138 min (mean 70.1 min) ,and the drainage tube indwelling time was 1-5 d(average 2.1 d) ,the hospital stay was 2-6d(average 3.7 d).Total hospital costs were 14 789-31 992 yuan, average of 21 239 yuan.No complications occurred during the perioperative period.Conclusions Posterior retroperitoneoscopic adrenalectomy might provide clear anatomical views.It could be a safe and effective operation for the clinical treatment of adrenal tumors.

Berberine Alkaloids ; therapeutic use ; Humans ; Phytotherapy ; Tachycardia ; drug therapy

Objective To analyze the function of let-7e in the carcinogenesis of non-small-cell lung cancer.Methods The microRNA let-7e expression levels in cancer tissues and adjacent normal lung tissues were detected by quantitative real-time reverse transcription-PCR from 35 non-small-cell lung cancer patients,U6 RNA as an actin.Results The expression of microRNA let-7e in cancer tissues was significantly higher than adjacent normal lung tissues (10.111±6.135,P ＜ 0.0001),there was a significantly different between squamous carcinoma group (9.635±8.300) and adenocarcinoma group (10.301 ±5.228,P ＜ 0.05),independently of sex,smoking history,stage,and histologic characteristics of the tumor.Conclusion The expression of microRNA let-7e in cancerous tissues is high,microRNA let-7e should play oncogene role in process of non-small-cell lung cancer,and would be an useful biomarker.

Objective To investigate prognostic factors for bloodstream infection in adult patients. Methods Clinical data of 131 adult patients with positive blood cultures during January 2002 to December 2003 in the Hospital were collected and 91 cases of them were retrospectively analyzed to understand their pathogen species and prognostic factors for it.Results Blood samples from 91 patients were cultured positive,53 cases(58.2%)with gram-negative bacteria mainly including Escherichia coli,Salmonella spp. and Klebsiella pneumoniae,28(30.8%)with gram-positive bacteria,mainly including Staphylococcus aureus and coagnlase-negative Staphylococci,eight(8.8%)with fungi and two(2.2%)with multiple infections.Case fatality ratio in this group of patients with septicemia was 30.8% during their hospitalization,and that in those with Pseudomonas aeruginosa,Staphylococcus aureus,Stenotrophomonas maltophilia and E.coli with extended-spectrum beta-lactamase was over 50%.Case fatality ratio was associated with severity of sepsis(OR=1.15)and inappropriately initial empirical treatment with antibiotics (OR=6.77).Conclusions Pathogen causing bloodstream infection in adults were mainly gram-negative bacteria and severity of infection and inappropriate initial antibiotics treatment could increase their fatality.

group Nor(P0.05).Conclusions The changes of ambulatory pulse pressure can reflect the degree of EH.The obvious increase of PP and decrease of DBP maybe are the exclusive features of ABPM in EH patients with target organs damage.

BACKGROUND:With the development of industry and agriculture, organotin compounds have been widely used in China. Organotin compounds cause a common occupational poisoning. The toxicity of organotin was reported in animal studies; however the reports about human organotin intoxication are very rare. In this study we retrospectively analyzed the clinical manifestations of 15 organotin-poisoned patients who had been treated at our hospital from 2002 through 2007. METHODS:Fifteen patients with organotin poisoning were admitted to Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine from 2002 to 2007. They were 9 males and 6 females, aged from 25 to 52 years. Clinical manifestations and Glasgow Coma Scales showed that the poisoning was mild in 4 patients, moderate in 6 and severe in 5. The severe patients were given glucocorticoid after hospitalization by intravenous guttae of 500 mg methylprednisolone for the first day, followed by 160 mg methylprednisolone per day for three days, and then 80 mg methylprednisolone per day for another three days. Potassium glutamate and sodium glutamate were intravenously dripped to reduce blood ammonia; intravenous guttae plus oral administration of potassium 9 g/day was used to correct intractable hypokalemia; sodium bicarbonate was used to correct metabolic acidosis, and sedatives were used to control spasm and twitch; mechanical ventilators were used in 4 patients with dyspnea. RESULTS:Most of the patients showed elevated level of blood ammonia, decreased level of blood potassium and metabolic acidosis, but some had demyelination changes shown by CT and MRI. Treatments included correction of metabolic acids, blood potassium and ammonia, and mechanical ventilation when necessary. For patients with injuries of the nervous system, glucocorticoids were given immediately after hospitalization. These patients showed intractable hypokalemia and metabolic acidosis during the treatment. Forteen patients recovered completely without long-term side-effect. One patient in the aphasiac stage restored the linguistic capacity during a 6-month follow-up. CONCLUSIONS:Elevated level of blood ammonia, decresed level of blood potassium, and metabolic acidosis are common in patients with organotin poisoning. Demyelination can be observed in patients with severe poisoning. The abnormalities of the patients are reversible after suitable treatments.

Antibodies, Antineutrophil Cytoplasmic ; blood ; Biopsy ; Child ; Diagnosis, Differential ; Female ; Humans ; Kidney Glomerulus ; pathology ; Lupus Erythematosus, Systemic ; complications ; immunology ; Lupus Nephritis ; diagnosis ; etiology ; immunology ; pathology ; Necrosis

Animals ; Central Nervous System ; radiation effects ; Humans ; Mice ; Microwaves ; Rats