Objective To evaluate the effect of controlled hypotension with nitroglycerin and esmolol in the operation of endoscopic nasal surgery.Methods 60 patients undergoing selective endoscopic nasal surgery were randomly divided into three groups averagely: control group (groupⅠ), controlled hypotension with nitroglycerin group(group Ⅱ), controlled hypotension with nitroglycerin and esmolol group (groupⅢ). Every group has 20 patients.Mean artery pressure (MAP), HR, scores of surgical field quality(SSFQ) were recorded before anaesthesia and 10,20,30,40 minutes after anaesthesia. After the operation, bleeding capacity, operation time and dosage of nitroglycerin were recorded too.Results The bleeding capacity and operation time in groupⅡ and Ⅲ was significantly less than that in groupⅠ(P

Adult ; Anesthesia, General ; Bronchoalveolar Lavage ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; surgery ; Ventilators, Mechanical

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common clinical disease that seriously threatens human health and life. Accurate location of the upper airway obstruction is the key to the diagnosis and treatment of OSAHS. Acoustic pharyngometry uses sound reflection to quickly assess the cross-sectional area and volume of the upper airway. Acoustic pharyngometry represents a simple, quick, non-invasive method for measuring upper airway dimensions which could predict sleep apnea risk. In this article we sought to introduce the application of acoustic pharyngometry in the diagnosis and treatment of OSAHS.
Acoustics ; Humans ; Larynx ; Pharynx ; diagnostic imaging ; Sleep Apnea, Obstructive ; diagnosis ; therapy ; Syndrome

Objective　To investigate the clinical feasibility of robotic-assisted laparoscopic radical cystectomy (RARC) by da Vinci surgical system and to summarize the operative technique and outcomes.Methods　From December 2007 to March 2012,22 patients (20 males and 2 females) with the bladder urothelial carcinomas were enrolled.Patient age was from 37 -72 years (rnean 62 years) ; the body mass index was 22.5 - 30.1 kg/m2 ( mean 26.1 kg/m2 ) ; and the American Society of Anesthesiologists score was 1 -2. All patients were diagnosed preoperatively with muscle -invasive or high-risk non-muscle-invasive bladder urothelial carcinomas in cystoscopic biopsy.There were no adjacent organ infiltration,pelvic lymph node involvement or dístant metastasis found on preoperative examinations.The clinical stage of all cases was under T2 N0 M0.Patients were under general anesthesia for RARC with urinary diversion.Extracorporeal urinary diversions (orthotopic ileal neobladder for 2 patients and ileal conduit urinary diversion for 13 patients)were performed on 15 patients and intracorporeal urinary diversions ( ileal conduit urinary diversion for 2 patientsand orthotopic ileal neobladder for 5 patients) were performed on 7 patients.　Results　All RARC procedure were completed on patients as planned.The operative time was 300 - 667 min ( mean 480 min)with estimated blood loss of 100 - 1200 ml (mean 550 ml),and the number of removed lymph nodes was 6 -25 (mean 15). All patients resumed ambulation on the 2nd to 3rd day postoperatively,and bowel function recovered on the 3rd or 4th day postoperatively.The length of hospital stay was 8 - 35 days ( mean 16 days).For patients underwent orthotopic ileal neobladder,the ileoureteral stents and the urethral catheter were removed 1 month after a cystogram confirming watertight healing.During the follow up of 4 -49 months (mean 32 months),2 patients had disease recurrence and 1 patient died of disease development and 2 patients had developed hydronephrosis.The other patients were with good urinary continence and normal renal functions.　Conclusions　RARC with urinary diversion are feasible and safe treatment option for bladder urothelial carcinoma.This technique will be more popular with more extensive surgical experiences and large randomized clinical trials.

Objective To study serum level of prostate specific antigen (PSA) by age and its relationship with positive prostatic biopsy.Methods A total of 8818 adults who underwent PSA scanning at Health Chek-up Center of Beijing Hospital during July 2009 and July 2010 were retrospectively studied,40 of whom performed prostatic biopsy.Linear regression was used to assess the relation of PSA with age,while Chi-square test was used to compare positive prostatic biopsy in different PSA groups.Results Serum PSA of more than 4 μg/L was more commonly seen in the elderly group (40 ～ year-old group 1.4％,50 ～ yearold group 1.9％,60 ～ year-old group 9.2％,70 ～ year-old group 15.5％,80 year-old group 17％ ; P ＜0.001 ; RR =0.196).In those whose PSA was ＞ 20 μg/L,6 (83.3 ％) were found to have positive prostatic biopsy; and the figure was 10 (50.0％) or 24 (24.0％) when PSA was ＜4 μg/L or 4-10 μg/L group (P =0.048).Conclusions Age was positively correlated with PSA,although no linear correlation was confirmed.Higher serum PSA level (＞ 4 μg/L) may be more common in elderly people and those with a positive prostatic biopsy.

Aged ; Cerebrospinal Fluid Rhinorrhea ; etiology ; prevention & control ; therapy ; Female ; Humans ; Male ; Nose Neoplasms ; radiotherapy ; Paranasal Sinus Neoplasms ; radiotherapy ; Young Adult

Retroperitoneal laparoscopic live donor nephrectomy offers an intrinsic advantage over conventional transperitoneal laparoscopic nephrectomy because of the potentially lower risk for early and late donor intraperitoneal complications. Herein we presented our experience performing retroperitoneal laparoscopic live donor nephrectomy in 105 donors. All donor nephrectomy was successful. There were no donor deaths and no conversion to open surgery. Mean operation time was 112 min (range, 70-200 min). Intraoperative blood loss was 10-150 mL with an average of 30 mL. Warm ischemia time was 1.3 to 6 min with an average of 3.1 min. Postoperative retroperitoneal hematoma occurred in only one case and there were no other surgical complications. Donors were discharged from the hospital 5 to 10 days postoperation. Average postoperative hospital stay was 6.4 days. One graft was removed due to acute rejection. Delayed graft function occurred in two recipients but renal function returned to normal within four weeks. The other recipients had normal renal function in two weeks except three recipients in four weeks. We believe that retroperitoneal laparoscopic live donor nephrectomy is safe, reliable, and less invasive.

Objective To observe the effect of cistanche deserticola polysaccharides on learning and memory ability of different types of spatial learning and memory abilities in micey.Methods The 120 mice were randomly divided into blank group, model group, Cistanche deserticola polysaccharide, low and medium dose group, and Lacita group, 20 rats in each group. The low, medium and large dosage groups were given 25, 50 and 100 mg/kg Cistanche deserticola polysaccharides, piracetam group was given 10 mg/kg Laci Staw, blank group and model group were given 10 mg/kg volume distilled water. Continuous administration for 6 weeks. Cicloheximide mice were used to consolidate memory impairment model, using ethanol to establish a model with reappearance of memory disorders. The ability of learning and memory in water maze test in mice, the mice were detected in the brain of total protein, MDA, SOD.Results Compared with model group, the escape latency (9.45 ± 2.86 s, 12.73 ± 10.89 svs. 48.15 ± 30.33 s), and the first time arrived at the station (19.33 ± 3.27 s, 13.81 ± 9.79 svs. 40.71 ± 16.76 s) was the median, large dose group were significantly shortened (P<0.05); the first time to reach the site (11.58 ± 7.04 svs. 40.71 ± 16.76 s) in the low dose group was significantly shortened (P<0.05), the number of crossing the platform (5.46 ± 2.09vs. 3.03 ± 1.47) in the low dose group significantly increased (P<0.05); the total protein content in brain tissue (0.76 ± 0.25 g/Lvs. 0.55 ± 0.12 g/L) in the high dose group significantly increased (P<0.05). Compared with the ethanol model group, the escape latency (22.67 ± 18.35 s, 22.15 ± 16.22 s, 18.00 ± 13.44 svs. 51.33 ± 22.19 s), the first time arrived at the station (16.70 ± 11.25 s, 19.75 ± 14.62 s, 9.47 ± 5.46 svs. 30.09 ± 13.63 s) in the low, medium and high dose group were significantly shortened (P<0.05), crossing the target (5.15 ± 1.28, 4.83 ± 0.75vs. 1.34 ± 0.83) in the low, medium and high dose group were significantly increased (P<0.05).Conclusions Cistanche polysaccharide could significantly improve the reproducibility of memory impairment in mice.

Objective To analyse the correlation of age and BMI with prostate-specific antigen (PSA)in male younger than 50 years of age. Methods The routine health examination data of 6808 males, younger than 50 years of age, were collected and reviewed. The height and weight were measured, so as to calculate the body mass index (BMI). Serum PSA was also examined. Eligible men were classified into age groups spanning 10 years. BMI was categorized as normal (BMI 18. 5 - 22. 9) , overweight (BMI 23. 0-24. 9), obese (BMI 25. 0 - 29. 9) , and very obese (BMI≥30. 0) according to the re-defined World Health Organization criterion for the Asia Pacific Region. PSA levels were stratified by age and BMI category. Results The mean age was (39. 2±7. 0)years, mean BMI (25. 6± 4. 7)kg/m~2 and mean PSA (0. 89±0. 56)ng/ml for the whole population. The PSA level in 10 - 19 age group was significantly lower than the other three groups (P<0. 01) and no significant difference was found among the other three groups. The BMI had negative correlated with PSA even when comparing in sub-age groups, except the 10-19 age group. Spearman analysis also found PSA had significant positive correlation with age and negative correlation with BMI. Conclusions Serum PSA level changes significantly with age in adolescence whereas quite slowly between 20-50 years of age. BMI has negative influence on PSA in male younger than 50 years of age.

Objective To investigate the feasibility and primary therapeutic effect of inverted Y-shaped self-expandable metal stent for complex airway stenosis.Methods On the standpoint of the peculiar anatomic structure and the pathological changes of complex airway stenosis,we designed the inverted Y-shaped self- expandable metal stent.Under the fluoroscopic guidance,7 stents were implanted in 7 cases of airway complex stenosis.Results The inverted Y-shaped self-expandable metal stents were placed seccussfully,with instantaneous relief of dyspnea and improvement of living quality.Conclusion The placement of inverted Y- shaped self-expandable metal stent is feasible and safe for treating airway complex stenosis.(J Intervent Radiol, 2007,16:92-94)