Objective To observe the therapeutic effects of ganciclovir(GCV)with differentInjection methods on experimental acute retinal necrosis(ARN).Methods The right eyes of 41pigmented rabbits were infected by herpes simplex virus(HSV-1)(COS strain)to establish ARN animalmodel.After 24 and 72 hours,GCV was given by intravitreal injection(10 eyes),intravenous injection(11 eyes)and the intravitreal+intravenous injection(10 eyes);intravitreal injection of GCV anddexamethasone(6 eyes)was also included.Four eyes were not treated as the control.The dosage of GCVin intravitreal and intravenous injection was 800 μg and 5 mg/kg weight,respectively.Retina necrosis wasobserved and the grade was recorded 1-21 days after injection according to the grade standard ofretinopathy.The maximum grades of retinal necrosis in different groups were compared.Results Thegrade of retinal necosis was 3.8 in the control group,and 0.2,0.4,0.8,and 2.2 in intravitreal iniection,intravitrcal+intravenous injection,intravitreal injection with GCV and dexamethasone,and intravenousrejection,respectively,24 hours after the model was set up.The effects of the first 3 groups wereobviously better than the Iast group(P=0.003,0.011,0.045);while the difference among the first 3groups were not significant(P=0.881,0.054,0.107).Seventy-two hours after the mode J was set up,thegrades of retinal necrosis were above 1.4 in 4 groups,and the differences among the 4 groups were notapparent(P=0.214).Conclusions In the animal model of ARN,intravitreal injection with GCV caneffectively decrease the grade of retinal necrosis.The difference among intravitrealinjection,intravitreal+intravenous injection,intravitreal injection with GCV and dexamethasone,and intravenous injection is notsignificant.

Objective To evaluate the clinical efficacy and safety of retroperitoneal laparoscopy and open surgical treatment of simple renal cyst by Meta analysis.Methods Computer retrieval of MED-LINE,Cochrane Library,EMBASE,CNKI,Wanfang and VIP databases,according to the inclusion and exclusion criteria collected and screened out a randomized controlled studies on the treatment of simple renal cysts,published from January 1,2000 to August 31,2015.Two independent authors screened out randomized clinical trials (RCTs),extracted data,assessed quality of data,and then carried out Meta analysis by Revman 5.0 software with related data.Results Twenty one studies met the inclusion criteria with a total of 2 296 patients,including 1 162 patients of retroperitoneal laparoscopy and 1 134 cases of open operation group.Compared to the open operation group,retroperitoneal laparoscopy showed shorter operation time,less bleeding,shorter hospitalization time,and earlier postoperative drainage tube extraction time.No significant difference was found in the recurrence rate of the cyst for two groups.Conclusions The clinical efficacy,safety,and complication of retroperitoneal laparoscopy in the treatment of simple renal cyst is better than the open operation.

In order to make a report on 90 cases of insomnia treated by the Wei-defensive qi-regulating and brain-strengthening needling technique,as a clinical subject of the multiple center,for assessing the preliminary standardized indications and operating methods and making an initial summary for writing the draft of the technique operation.Methods:By ratio of 1:1,the patients in conformity with the criteria were randomly divided into the experimental group and control group.In the experimental group,45 cases were treated with the Wei-defensive qi-regulating and brain-strengthening needling technique on Baihui (GV 20),Dazhui(GV 14),Shenmai(BL 62),Zhaohai(KI 6),plus ear points.In the control group,45 cases were treated with routine acupuncture on Sishencong(Ex-HN 1),Shenmen (HT 7),Sanyinjiao(SP 6),etc.The therapeutic effects in the two groups were observed and assessed in comparison.Results:The results showed cure in 15 cases.remarkable effect in 27 cases,effect in 42 cases,failure in 6 cases,and the total eriective rate in 94.4% in 90 cases of insomnia.In the three centers,the statistic management was performed based upon PSQI integral and showed significant difference(P＜0.01),and no significant difference among various groups(P＞0.01).Conclusion:The therapeutic effect in the treatment of insomnia by Wei-defensive qi-regulating and brain-strengthening needling technique is better than the control group and the therapeutic effect and methods in various centers are stable.without any deviation.

Objective To systematically review and evaluate the perioperative indicators and surgical curative effect of 980 nm diode laser vaporization of prostate and transurethral resesction of prostate (TURP) in treating benign prostatic hyperplasia (BPH). Methods Retrieved published comparative studies 980 nm diode laser vaporization of prostate versus transurethral resesction of prostate in treating benign prostatic hyperplasia, and pooled the data from eligible studies. The statistical analysis was performed using Revman 5.3 software. Results Six trials including 839 patients were eligible to the criteria (450 in 980 nm diode laser group and 389 in TURP group). The baseline of patients characteristics were comparable in all the studies. Meta analysis showed that: the operative time was not significantly different between the 980 nm diode laser group and TURP group [SMD = 0.11, 95 ~ CI (-0.52,0.74), P > 0.05]; Compared with TURP group, 980 nm diode laser group has shorter hospital stays [SMD = -1.95, 95%CI (-3.42, -0.48), P < 0.05], and shorter catheterization time [SMD = -2.64, 95%CI (-3.92, -1.36), P < 0.05]. There was no significant difference between IPSS [WMD = 0.12, 95%CI (-0.27, 0.51), P > 0.05], QOL [SMD = 0.00, 95%CI (-0.57, 0.57), P > 0.05] and Qmax [SMD = 0.06, 95%CI (-0.26, 0.37), P > 0.05]. Conclusion 980 nm diode laser vaporization of prostate is safe and effective in treating benign prostatic hyperplasia, and compared with TURP, it has advantages in shorter hospital stays and shorter catheterization time.

Objective To introduce the therapeutic procedures of helical tomotherapy based total marrow irradiation(HT-TMI), and validate the feasibility of TMI. Methods At 1 week before bone marrow transplantation,12 patients received TMI conditioning regimen at a prescriptive dose of 12 Gy in 3 times,once daily. Patient immobilization, CT simulation, target delineation, plan design and dosimetric verification were implemented in sequence according to the TMI procedures. The dosimetric paramaters of the target and normal tissues were analysed. The correlation between the dose verification and image-guided results was observed. Results Compared with total body irradiation(TBI), TMI could significantly reduce the irradiation dose to normal tissues. The median dose D50of all normal tissues except the oral cavity were lower than 6 Gy,where The D50of lens,brain,lung and liver are (1.8±0.1) Gy, (5.7±0.2) Gy, (5.2±0.2) Gy, and (4.6±0.2) Gy, respectively. Pass rate of γ Index was larger than 95% with 3mm/3% criterian for each section. The positioning error of head and neck was relatively lower than that of pelvis at x-axis,and was higher at z-axis.Conclusions Helical tomotherapy based TMI is a feasible and reasonable approach,which has evident dosimetric advantage.

Objective To investigate the safety and efficacy of wide local excision surgery combined with 5-aminolaevulinic acid(ALA)-photodynamic therapy(PDT)in treating Paget's disease of the scrotum in elderly people.Methods Patients with an average age of 68.4 ± 4.7 years undergoing wide local excision surgery combined with ALA-PDT for Paget's disease of the scrotum from June 2014 to February 2018 were followed up.All patients underwent wide local excision surgical treatment first and were then enrolled in ALA-PDT study after the diagnosis of Paget's disease of the scrotum was confirmed.Four cases were eliminated as a result of two patients refusing photodynamictherapy for various reasons and two patients lost during follow-up after ALA-PDT.A total of 16 patients were included in the study,of whom 6 cases were in Ray stage A1,7 cases in stage A2 and 3 cases in stage B.Patients underwent 3 courses of ALA-PDT after operation.Then the efficacy,shortand medium-term complications were followed up.Results The duration of disease among the 16 patients ranged from 4 to 76 months before diagnosis,with an average of 35.7 months.Surgery was performed immediately after diagnosis.Ten patients underwent resection and suture and 6 patients were treated with skin flap transfers.Of the patients treated with surgery,3 patients received suspicious lymph node dissection and 1 patient underwent reoperation due to skin flap necrosis.Patients were followed up for 3 months to 3 years and 6 months after ALA-PDT.Recurrence and distant metastasis occurred in 2 cases,with 1 case of brain metastasis and 1 case of systemic metastasis,and the overall recurrence rate was 12.5％.During the follow-up,there were no other serious complications except for 1 case(6.3 ％)with lower limb movement disorders.Conclusions Wide local excision surgery combined ALA-PDT has good clinical outcomes,low recurrence rates and few complications for the treatment of Paget's disease of the scrotum in elderly people.

Objective To explore the clinical prognosis and efficacy of adjuvant therapy with imatinib of postoperative patients with gastric intermediate-risk gastrointestinal stromal tumor (GIST).Methods The clinicopathological data and follow-up data of 93 gastric intermediate-risk GIST cases from Jan 2005 to Dec 2016 at Union Hospital were analyzed retrospectively.Univariate and multivariate analysis were performed to assess the prognostic factors.Results There were 93 patients undergoing complete GIST resection with 42(45％) cases receiving post-op imatinib 400 mg/d for targeted therapy.The median target therapy period was 12 (6-72) months.86％ (80 cases) patients were followed up for 46 (6-120) months.The 1-,3-,5-year recurrence-free survival rate (RFS) of the whole group were 100％,91.5％,88.5％ respectively.Multivariate analysis revealed that mitotic count (P =0.040,RR =6.078,95％ CI:0.541-68.274) and neutrophil-lymphocyte ratio (NLR) (P =0.036,RR =6.102,95％ CI:0.782-47.632) were prognostic risk factors of RFS.For those mitotic count ＞ 2/50 HPF and NLR ＞ 2.3,adjuvant therapy with imatinib significantly increases RFS.Conclusion Mitotic count and NLR were independent risk factors of RFS in gastric intermediate-risk GIST.For those with mitotic count ＞ 2/50 HPF and NLR ＞ 2.3,postoperative adjuvant therapy with imatinib helps improve the prognosis.

Objective:To explore the value of conventional ultrasonography combined with cervical compression in the diagnosis of orbital venous malformation (OVM).Methods:A total of 43 patients with suspected OVM were admitted in sequentially from January 2019 to July 2022 in the Third Medical Center of PLA General Hospital. All patients were examined by ultrasonography combined with cervical compression and demonstrated by operation or digital subtraction angiography (DSA). The conventional ultrasound features of OVM were summarized, and the value of conventional ultrasonography combined with cervical compression in the diagnosis of OVM was discussed.Results:The features of the conventional ultrasound combined with cervical compression for diagnosis of OVM were as follows: the interior of lesion was mainly tubular structure, and the compression test was positive. After cervical compression, the lesion enlarged and the inner diameter of the internal tubular structure widened. Doppler flow imaging showed that the interior of lesion was mainly venous blood flow. Compared with the results of postoperative pathology or DSA, the sensitivity, specificity, accuracy and positive predictive value of ultrasonography combined with cervical compression were 0.952, 1.000, 95.3% and 100%, respectively. The results of Fisher exact diagnosis showed that there was no significant difference between ultrasonography and operation or DSA of OVM( P>0.05). Conclusions:Conventional ultrasound combined with cervical compression can be used as an effective method for the diagnosis of OVM.

Autosomal dominant polycystic kidney disease (ADPKD) is a common hereditary disease, mainly caused by polycystic kidney disease 1/2 (PKD1/2) gene mutation. The main manifestation is the formation of multiple progressive enlarged cysts in both kidneys, which can be accompanied by decreased glomerular filtration rate, hypertension, liver cyst and cerebral aneurysm. About 45% of patients will progress to end-stage renal failure before the age of 60. ADPKD gene sequencing can be chosen for suspicious patients with atypical clinical features, no positive family history, and inconspicuous imaging findings. In the ADPKD positive families, imaging examination is the main means of diagnosing ADPKD. Height-adjusted total kidney volume (htTKV) and kidney growth rate are commonly used to monitor ADPKD disease progression and prognosis. There is no effective treatment for ADPKD to stop its progress. Drugs such as tolvaptan and bosutinib can delay the renal disfunction and they have been applied to clinical therapy in Europe and America.
Disease Progression ; Glomerular Filtration Rate ; Humans ; Kidney ; Polycystic Kidney, Autosomal Dominant ; Tolvaptan