Objective To evaluate the therapeutic effects and safety of trabeculectomy combined with Schlemm canal suture implantation in patients POAG). Design Retrospective, noncomparative case series. Participants 11 patients (19 eyes)with POAG. Methods Two layers of scleral flap were made and the deeper one was dissected. The outer wall of Schlemm canal was cut away. 6-0 nylon thread was implanted between the two cut ends of the canal. Penetrating trabeculectomy was performed and followed with peripheral iridectomy. Superficial scleral flap was sutured. Main Outcome Measures The postoperative observation included intraocular pressure (IOP), formation of the anterior chamber, inflammatory reaction, visual acuity, complications and situation of filtering bleb. Results The mean postoperative follow-up period was 18.05?12.78 months (ranging from 6 to 48 months). There was significant statistical difference between preoperative and postoperative IOPs(31.23?9.72mmHg VS 15.11?6.13mmHg) (t=6.769, P=0.000). The postoperative investigation of IOP for 11 cases (19 eyes) after using medicine showed that IOP≥22mmHg only 1 case. The efficiency was 94.74%. Filtering blebs formed in 6 cases (8 eyes)(42.11%), including the case with IOP≥22mmHg. There was no significant difference in change of preoperative and postoperative IOP in patients with or without filtering blebs with t-test (t=-1.662, P=0.071). The anterior chamber formed well in each case postoperatively. Hyphemia appeared in 4 eyes (21.05%). Hypertonia oculi (IOP≥22mmHg) and hypotonia oculi (IOP≤6mmHg) appeared occasionally in 3 eyes(15.78%) and 11 eyes(57.89%) respectively. Postoperatively,no fibrinous exudates in anterior chamber, choroidal detachment and other complications occurred in any case. Conclusions The control of IOP appears to be good after the surgery of trabeculectomy combined with Schlemm canal suture implantation. It is a promising approach for glaucoma and good with fewer postoperative complications, easier postoperative management and deserve further development.

Objective Type around the HRCT manifestations of pulmonary hamartoma , in order to improve the level of diag-nosis of the disease .Methods Last 14 years retrospective analysis confirmed by surgery and biopsy of peripheral pulmonary hamar -toma 23 cases of CT performance.Results Nine cases of right lung (for 3 cases of the upper lobe of right lung middle in 2 cases, 4 cases were characterized by lower lobe ), 14 cases had left lung (6 cases left upper lobe, left lower lobe 8 cases), 12 cases round, round 8 cases, shallow points Ye Zheng 3 cases, border and clear, no deep lobulated, burr and satellite lesions.1.0~5.4 cm in di-ameter, the average is about 2.6 cm in diameter, less than 3 cm17 cases.5 cases of lesions containing fat , 7 cases there are both fat and calcification;8 cases of lesions with calcification , typical popcorn calcification in 3 cases;All 11 cases in 15 cases of calcified lesions located in the middle and lower lobe basal segment .3 cases of homogeneous soft tissue density with increase in mild to moderate strengthening , soft tissue density partial reinforcement degree about 5~16 HU.Conclusions HRCT can show pulmonary hamartoma characteristic calcification and fat density with help in the diagnosis of peripheral hamartoma lungs .Fat or there are both fat and calcifi-cation isolated pulmonary nodules or masses , can consider hamartoma;Instead of n/med tuberculosis good hair part containing calcium isolated pulmonary nodules , should think of hamartoma diagnosis .

Objective To share the experience of heart thransplantation. Methods 3 recipients with terminal myocardiosis were reviewed. The transplantation was performed with inferior and superior vena anastomofic technique. During perioperative period, we selected and maintained the recipients, protected donor-isolated heart, supported circulation,decreased immune reaction and controlled infections. Results All the 3 patients survived. Heart function improved from NYHA class 1V before heart transplant to NYHA class Ⅰ, Ⅱ. The follow-up time was 19 months ,28 months and 49 months respectively. Rejection occurred in two cases due to non-compliance to medication. Conclusions Suitable recipient, proper donor heart procurement and preservation, suitable maintenance of circulation, proper managements of anti-immunitive reaction, prevention of infections are critical for successfal heart transplantation. Medicine-take required may avoid or reduce rejection.

Objective To investigate the causes and treatment of familial neurohypophyseal diabetes insipidus with hydronephrosis.Methods A retrospective analysis was conducted in 6 cases (5 males and 1 female,aged 11 to 53 years) of familial neurohypophyseal diabetes insipidus with hydronephrosis treated in our institute from June 2009 to December 2010.All cases had polydipsia and polyuria since their childhood.The daily output of urine ranged from 5,290 to 15,040 ml.The urine specific gravity was less than 1.005.The water deprivation and vasopressin injection test showed positive results,and MRI showed that the shape and size of pituitary gland were in normal range.Ultrasound and IVU showed that all cases had hydronephrosis.Five adult cases were administered with Desmopressin 0.2 mg three times a day,and 1 juvenile patient given half dosage of Desmopressin as in adult.The case No.1 underwent percutaneous nephrostomy and bilateral ureteral reimplantation.Case No.2 received urethral catheterization for 5 days and Tamsulosin.Three cases with urinary tract infection were given antibiotics on the base of urine culture and antibiotic sensitivity test results.Follow-up was undertaken every 3 mon for the duration of 18-36 mon.Results In 6 cases,polydipsia and polyuria were significantly improved after the treatment.Daily urine output dropped to 6000 ml in 5 adult cases and decreased to 2000 ml in the juvenile case.The flank sore of case No.1 was relieved after percutaneous nephrostomy,and hydronephrosis improved 6 mon after bilateral ureteral reimplantation.The residual urine volume of case No.2 was reduced to 40 ml,and no recurrence was observed after anti-infection therapy.During the follow-up,6 cases showed relieved hydronephrosis and no recurrent infection.Conclusions It is of important to reduce the urine volume for the treatment of familial neurohypophyseal diabetes insipidus with hydronephrosis.Early diagnosis and treatment of the diseases is crucial for the improvement of renal function.

AIM: To investigate the effect of probucol on proliferation of rat vascular smooth muscle cells(VSMC) stimulated by basic fibroblast growth factor (bFGF) and/or hydrogen peroxide(H 2O 2). METHODS: Effects of probucol on VSMC proliferation and DNA synthesis stimulated by bFGF and/or H 2O 2 were observed by means of MTT test, cell number count and [ 3H]-TdR incorporation. RESULTS: ①Probucol significantly inhibited proliferation and DNA synthesis in VSMC stimulated by bFGF and/or H 2O 2, with dosage-dependent manner. Cell number, A value and [ 3H]-TdR incorporation in group probucol+bFGF and group probucol+H 2O 2 were reduced by 40.0%, 39.1%, 45 5% and 46 9%, 45 0%, 39 5%, respectively, compared with group bFGF and group H 2O 2 ( P 0.05). CONCLUSION: Probucol dramatically inhibited proliferation and DNA synthesis in VSMC stimulated by bFGF and/or H 2O 2, but had no inhibitory effect on the cell proliferation prestimulated by bFGF and /or H 2O 2. [

This study presented our experience in the treatment of testicular torsion, which may help achieve early diagnosis and improve therapeutic effects. A retrospective analysis was conducted in 71 patients with testicular torsion who were treated in our hospital from October 2007 to April 2011. The age of the patients ranged from 16 days to 34 years. All the patients had unilateral testicular torsion, which took place on the left side in 43 cases and on the right side in 28 cases. The course of the disease varied between three hours to 30 days. Post-operative follow-up was conducted until October 2011. Items examined included signs and symptoms at their first clinical visit, ultrasound findings, treatment in emergency surgery, and post-operative follow-up. In this study, the 71 patients were diagnosed with testicular torsion by color Doppler sonography, 7 had testicular fixation, 63 patients received orchiectomy, while 1 patient did not undergo surgery due to pressure from family members. Post-operative follow-up showed that the one patient's testicle, which had been reserved, atrophied, while all the other survived. No recurrence was found during the follow-up visits. It is concluded that an early diagnosis and surgery is important in improving the survival rate of testicular torsion, and the diagnosis and treatment by the first attending clinician is of critical importance.

ObjectiveTo investigate the predictive factors for acute cholangitis in patients with obstructive jaundice. MethodsA retrospective analysis was performed for the clinical data of 358 patients with common bile duct stones and obstructive jaundice who were treated in The Fourth People′s Hospital of Haikou from October 2010 to October 2015. According to the presence or absence of acute cholangitis, the patients were divided into acute cholangitis group(n=223) and obstructive jaundice group(n=135). Age, sex, and comorbidities were compared between the two groups, and the association between abnormalities in serum tumor markers and liver function parameters and the development of acute cholangitis was examined. The parameters with statistical significance were used to establish the receiver operating characteristic (ROC) curves, and their sensitivity and specificity in the diagnosis of acute cholangitis were evaluated. The t test and χ2 test were applied for comparison of continuous data and categorical data between groups, respectively. ResultsThe acute cholangitis group had significantly higher serum levels of CA19-9 and CA12-5 than the obstructive jaundice group (serum level of CA19-9: 82.33±23.01 kU/L vs 36.75±12.58 kU/L, t=11.028, P＜0.05; serum level of CA125: 30.21±9.59 kU/L vs 18.62±5.27 kU/L, t=8.597, P＜005). The analysis of the ROC curves showed that the areas under the ROC curve for serum CA19-9 and CA12-5 were 0.891 and 0705, respectively, and the corresponding cut-off values for the highest diagnostic accuracy were 61.01 kU/L and 22.56 kU/L, respectively, with sensitivities of 82.1% and 77.6% and specificities of 79.8% and 69.5%. ConclusionIncreased serum CA19-9 level has a great value in predicting acute cholangitis in patients with common bile duct stones and obstructive jaundice.

Objective To explore the effect of bladder muscle flaps for long segment defect of ureter middle-lower segment and reconstruction method in laparoscopic surgery. Methods Clinical data of 3 patients with long segment defect of ureter middle-lower segment, all of whom underwent laparoscopic surgery from May 2014 to April 2016 was retrospectively evaluated. There were 1 male and 2 females, in 2 cases with history of ureteroscopy holmium laser lithotripsy in ureter middle-lower segment, in 2 cases with history of repeated ESWL. Preoperative urinary tract ultrasound, CT and intravenous urography imaging showed severe hydronephrosis, ureter middle-upper segment severe hydroureter, ureter middle-lower segment severe stricture. Results Operations were successful in 3 cases. After reconstruction bladder muscle flaps average length of is 9.6 cm, The average operation time of 180 min, The average length of hospital stay for 10 d, Postoperative eighth weeks extracted the double J tube and used ureteroscopy showed anastomotic unobstructed, it may smooth Through 8.5 F ureteroscopy, and no infection and urinary leakage occurred, Follow-up ranged from 3 to 18 months. 3 cases hydronephrosis and hydroureter significantly reduce, ureter unobstructed, no narrow in ureter and muscle flap of tube joint, serum creatinine valueswere in normal range. Conclusions The bladder muscle flaps for the treatment of long segment defect of ureter middle-lower segment in laparoscopic surgery was a safe and effective therapy, but it must be accomplished by seasoned doctors.

Objective To explore the efficacy and safety of Transurethral vaporization of the prostate using 1 470 nm diode laser in treatment of BPH.Methods 58 cases BPH patients underwent transurethral vaporization of the prostate using 1 470 nm diode laser from Dec. 2015 to Apr. 2016 were retrospectively analyzed, including the mean operation time and compared hemoglobin, electrolyte, urinary symptoms, before and after surgery.Result Operations were successfully performed in all the 58 cases, with average operation time of (48.2 ± 16.3) min. No difference was found in either hemoglobin decrease or electrolyte decrease before and after surgery. The patients were followed up for 1~3 months, which revealed a signiifcant reduction in IPSS and improvement in Qmaxand PVR (P < 0.05), compared with pre-operation. No severe complications were reported, including transurethral resection (TUR) syndrome, urinary incontinence and impaired erectile function.Conclusion Transurethral vaporization of the prostate using 1 470 nm diode laser is a safe and effective therapy for BPH. It has advantages of short learning curve, very little blood loss, high efifcacy. It has promising broad prospects.

This study presented our experience in the treatment of testicular torsion, which may help achieve early diagnosis and improve therapeutic effects. A retrospective analysis was conducted in 71 patients with testicular torsion who were treated in our hospital from October 2007 to April 2011. The age of the patients ranged from 16 days to 34 years. All the patients had unilateral testicular torsion, which took place on the left side in 43 cases and on the right side in 28 cases. The course of the disease varied between three hours to 30 days. Post-operative follow-up was conducted until October 2011. Items examined included signs and symptoms at their first clinical visit, ultrasound findings, treatment in emergency surgery, and post-operative follow-up. In this study, the 71 patients were diagnosed with testicular torsion by color Doppler sonography, 7 had testicular fixation, 63 patients received orchiectomy, while 1 patient did not undergo surgery due to pressure from family members. Post-operative follow-up showed that the one patient's testicle, which had been reserved, atrophied, while all the other survived. No recurrence was found during the follow-up visits. It is concluded that an early diagnosis and surgery is important in improving the survival rate of testicular torsion, and the diagnosis and treatment by the first attending clinician is of critical importance.
Adolescent ; Adult ; Emergency Treatment ; methods ; Humans ; Male ; Postoperative Period ; Testis ; surgery ; Young Adult