Objective To improve the awareness of pel vi c lipomatosis in clinical practice. Methods A 51-year- old male patient with pelvic lipomatosis was admitted. Imaging studies showed th at there was mild degree of hydronephrosis on his both sides on IVU and a typica l inverted-pear shape of bladder and extended posterior urethra were also seen on IVU.CT scan showed that low density lipid piled in the pelvic cavity.MRI show ed obvious thickened soft tissue lesion around the bladder,rectum and in the pel vic cavity. The lesions in the pelvic cavity and around the ureters were removed and the lower segments of the ureters were loosened by laparoscopic surgery. Th e clinical characteristics of lipomatosis were reviewed by combination with the literature. Results Intraoperatively,apparently increase d lipid tissue was found in the pelvic cavity and there was large amount of lipi d tissue filling the space around bladder,rectum and sigmoid colon.This finding was consistent with the imaging study findings.About 500g lipid tissue was remov ed in the laparoscopic procedure.Pathologic study showed it was mature lipid tis sue.The patient was discharged 1 week after surgery.Two weeks after surgery,B-u ltrasound showed that there was improvement of hydronephrosis on both sides.The maximum width of right renal fluid sonolucent area decreased from 2.9 cm to 2.0 cm;the width of right upper ureter decreased from 1.2 cm to 1.0 cm;the maximum w idth of left renal pelvis decreased from 1.8 cm to 1.3 cm;and the width of left upper ureter decreased from 0.8 cm to 0.5 cm. Conclusions X-ray,CT scan and MRI are the most valuable examinations in the diagnosis of lipomatosis.Removing the lipid in the pelvis and around the bladder and loosenin g the ureters by laparoscopic surgery are minimally invasive,safe and effective in the treatment of pelvic lipomatosis.

Adolescent ; Adult ; Aged ; Endocrine Surgical Procedures ; methods ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Parathyroid Neoplasms ; surgery ; Thyroid Neoplasms ; surgery ; Young Adult

OBJECTIVE:To evaluate the economics of alendronate sodium preventing osteoporotic fractures in postmenopausal women,and to provide reference for osteoporotic and osteopenia patients to select economical and effective therapy plan. METH-ODS:Using Markov economic model,TreeAge Pro 2011 software was used for cost-utility analysis using RCTs literature data of basic medication(calcium and vitamin D3)and basic medication combined with alendronate sodium as baseline data. Using quality adjusted life years(QALYs)and incremental cost utility ratio(ICUR)as economics evaluation indexes,the stability of established model was investigate by single factor sensitivity analysis. RESULTS:QALYs of the basic treatment group was 0.704 years,and QALYs of drug combination group was only 0.708 years. However,ICUR of two groups reached 714252.44. For the late period of hip fracture and other fractures,drug combination group was in high cost and low benefit,obviously had no economic advan-tage. For vertebral fractures,the cumulative probability of fracture in drug combination group was significantly lower than basic treatment group,and ICUR of the two groups was only 13902.17,with economic advantage. For hip fracture,the cumulative prob-ability of fracture in basic treatment group was the same as drug combination group,and ICUR was 19109.00,with economic ad-vantage. For wrist fractures,curative effect and economy needed further study. CONCLUSIONS:For the low-risk population with osteoporotic fractures,calcium and vitamin D3 are more economical in preventing osteoporosis fractures. For the high-risk popula-tion with vertebral and hip fractures,alendronate sodium combined with basic treatment is effective and economical.

To compare the effect and advantage of performing rhegmatogenous retina detachment surgery under operation microscope with under direct ophthalmoscopes .METHODS: Ninety - three patients ( 93 eyes ) were randomized to two groups, Group A ( under operation microscope during rhegmatogenous retina detachment surgery, 47 cases ) , Group B ( under direct ophthalmoscopes during rhegmatogenous retina detachment surgery, 46 cases ) . All patients were followed up for 2wk to observe success rate and visual improving rate.RESULTS: Total percentage of success was 95. 74% in group A and 80. 43% in group B. The visual improving rate of group A was 82. 98% and it was 67. 39% in group B. Operative time in group A was significantly shorter than that in group B (P<0. 05). CONCLUSlON: Performing rhegmatogenous retina detachment surgery under operation microscope is ascertaining and it is more effective and handy than performing that surgery under direct ophthalmoscopes.

Epiretinal membrane (ERM) is a relatively common macular disease that forms along the surface of the internal limiting membrane (ILM) of the retina to some reason.The pathogenesis is not clear.Microincision vitrectomy surgery has been confirmed as a minimally invasive and very safe modality of treatment.Deciding when to perform a vitrectomy can be difficult.There are many factors which can affect the postoperative visual acuity,such as age,the thickness of macular,integrity of photoreceptor inner segment/outer segment (IS/OS) junction.

Objective To observe the effect of core stability training combined with eye acupuncture on motor function in patients with hemiplegia after stroke.Methods Eighty patients with hemiplegia after stroke were randomly divided into a treatment group and a control group (40 cases in each).Both groups were given regular rehabilitation training, but the patients in the treatment group also were taught core stability training of their waist and abdominal muscle groups, their shoulder muscles, trunk and pelvis.They were also given eye acupuncture.A trunk control test (TCT) , Berg's balance scale (BBS), the modified Barthel index (MBI), functional ambulation categories (FACs) and the Fugl Meyer assessment scale (FMA) were used to assess motor function before and after treatment.Results At the end of 6 weeks of treatment, all of the measurements in both groups had significantly improved.The average TCT, BBS, MBI, FMA, and FAC scores of the treatment group significantly exceeded those of the control group.Conclusions Core stability training and eye acupuncture together can significantly improve the motor function of hemiplegic stroke survivors.The combination therapy is worthy of clinical popularization and application.

Objective To explore the correlation between apparent diffusion coefficient (ADC) and pathological grading and staging of cervical carcinoma.Methods Among 311 patients diagnosed with squamous cell carcinoma,87 patients were met the criteria for inclusion.All the patients were performed routine MR and diffusion-weighted imaging(DWI) with b=1 000 s/mm2 before treatments,and recorded the pathological grading and staging.The ADC values of the lesions were measured on GE AW4.5 workstation,and were compared among the groups with different pathological grading and staging by using LSD and paired t-test.Results The mean ADC value was (0.77±0.079)×10-3 mm2/s in the poorly-differentiated group,(0.88±0.10)×10-3 mm2/s in the moderately-differentiated group,and (1.05±0.084)×10-3 mm2/s in the well-differentiated group.There were significant differences among the different groups (P<0.05).The mean ADC value was (0.84±0.12)×10-3 mm2/s in the stage Ⅰb group, and (0.78±0.12)×10-3 mm2/s in the stage Ⅱa group.The difference was not statistical significance (P>0.05).Conclusion The increasing of the ADC values is correlated with the high levels of tumor cell differentiation, and not correlated with the pathological stages in cervical carcinoma.

Objective:To observe the clinical efficacy of Yi Jin Jing (Sinew-transforming Qigong Exercises) for primary osteoporosis in the elderly.Methods:Eighty old patients with primary osteoporosis were randomized into a Yi Jin Jing group and a medication group,40 cases in each group.The Yi Jin Jing group was intervened by Yi Jin Jing (Sinew-transforming Qigong Exercises) training,while the medication group was intervened by oral administration of alendronate sodium tablet.Prior to and after 6-month intervention,the bone mineral density (BMD) of the proximal femur,visual analog scale (VAS) and activities of daily living (ADL) were estimated.Results:There were no significant differences in the BMD of the proximal femur,and VAS and ADL scores between the two groups before the intervention (P＞0.05).After 6-month intervention,the above items all improved significantly in both groups (both P＜0.01);the improvements in VAS and ADL scores in Yi Jin Jing group were more significant than those in the medication group (P＜0.01),while the between-group difference in the BMD of the proximal femur was statistically insignificant (P＞0.05).Conclusion:Practice of Yi Jin Jing (Sinew-transforming Qigong Exercises) can effectively ameliorate the BMD in the elderly with primary osteoporosis,and it can reduce the pain and improve ADL,with a better general effect compared to oral administration of alendronate sodium tablet.

AIM: To analyze the genotype of the allele distribution of a polymorphic G-954C within the 5 upstream promoter region of the nitric oxide synthetase 2A gene (NOS2A) in samples of diabetic retinopathy in patients with cystoid macular edema in the mainland of China.METHODS: Eighty-nine patients with diabetic retinopathy and cystoid macular edema and 90 healthy controls were enrolled in this study. Nest polymerase chain reaction (PCR)was performed, and restriction endonudease digestion and gene fragments sequence were examined to detect the genotype of NOS24 G-954C.RESULTS: The genotypes of the sample population of 89 cases and 90 healthy controls were all detected as GG.CONCLUSION: The distribution of G-954C of NOS2A polymorphism are at a lower frequency in China, with little relevancy to the frequency of diabetic retinopathy combined with cystoid macular edema.

Background Macular hole in high myopia has been paid tremendous attention in clinical research due to its high recurrence rate and unpredictable prognosis.Spectral domain optical coherence tomography (SD-OCT) is considered to be of a good evaluating value for macular hole,yet its application is compromised in patient with high myopia.High myopia might lead to retinal detachment which consequently prevents an accurate OCT.Therefore,it is important to assess the effectiveness of OCT on prognosis in these patients after surgical restoration of the detached retina.Objective The aim of this study was to evaluate the risk of reopening of a macular hole in highly myopic patient after removing silicone oil by SD-OCT.Methods A case-observational study was designed.Twenty-five highly myopic patients with monocular macular holes who underwent vitrectomy combined with internal limiting membrane peeling and silicone oil tamponade were included in this study.Four patients were male and 21 patients were female,with the average age (61.4±9.0) years old and diopter (-14.14 ±6.86)D.Regular ocular examination,axial length measurement,fundus photography and OCT were performed at the day before removing silicone oil and every month till the 6 months after operation.Retinal thickness,macular height index (MHI) and choroidal thickness were measured by OCT.Written informed consent was obtained from each patient.Results All 25 patients finished the follow-up of 6 months.Macular holes remained closure 6 months after operation in 19 patients (76％) and reopened in 6 patients macular holes were in 1-5 months (24％),with a mean time at (3.3± 1.4) months.The average foveal retinal thickness,MHI and the choroidal thickness at the middle of the macular hole were (216.5±95.6) μm,0.30 ± 0.09 and (122.9 ± 20.5) μm in the closed group,respectively,and those in the unclosed group were (113.5±28.7) μm,0.58±0.27 and (96.8±22.9) μm,with significant differences between the two groups (t=2.577,-4.143,2.669,P ＜ 0.05).The percentage of macular hole closure was 85.7％ in the MHI＜0.5 group and 25.0％ in the MHI ≥ 0.5 group,showing a significant difference (P =0.031).The base diameter in the unclosed hole group was significantly larger than that in the closed hole group (1070.2±393.6 μm versus 533.3±277.7 μm) (t =-3.700,P =0.001).Conclusions The measurements of the retinal thickness,MHI and the choroidal thickness at the central area of the macular hole are helpful for the evaluation of reopening risk of macular hole after removing silicone oil.