Objective To evaluate the efficacy of pneumocystoscopy for congenital malformation of the vesicoureteral junction. Methods A total of 18 children (male 11 and female 7, aged from 3 months to 7 years with a mean of 3.6 years) with congenital malformation of the vesicoureteral junction (22 ureters) were enrolled in this study. Among the patients, 9 had vesicoureteral reflux (4 of them had bilateral reflux), 2 had bladder diverticulum complicated with urethral stenosis, and 7 had urethral stenosis and ipsilateral hydronephrosis. After the bladder was insufflated with CO2 through a Foley catheter (16 mm Hg), three trocars were inserted into the bladder, and the bladder was fixed on the abdominal wall using silk thread. By pneumocystoscopy, the Cohen procedure was done through the trocars. A Foley catheter was indwelled at the end of the procedure. Results The procedure was completed in all but one patient, who was converted to open surgery because the contraction of the urethra. The mean operation time was 130 min (110 to 145 min) for unilateral cases (13), and 242 min (225 to 250 min) for bilateral cases. The patients were discharged form hospital 9 to 12 days after the operation, and were followed up fro 6 months to 5 years with a mean of 3.8 years. During this period, MUC showed no ureteral reflux. One of the cases developed mild infection of the urethra, and was cured by circumcision. Conclusion Pneumocystoscopy is effective for congenital malformation of the vesicoureteral junction.

Prostate cancer, bladder cancer, and rectal cancer are common malignancies in the male pelvis. The incidence rate of erectile dysfunction (ED) following radical prostatectomy, cystectomy or rectal cancer surgery is about 25% - 100%. The main cause of post-surgery ED is mainly attributed to injury of neurovascular bundles, which may lead to reduced oxygenation in and fibrosis of the penile tissue. Early penile rehabilitation after surgery can improve or restore the erectile function of the patients. This article focuses on penile rehabilitation after radical pelvic surgery.
Cystectomy ; Erectile Dysfunction ; etiology ; rehabilitation ; Humans ; Male ; Pelvic Neoplasms ; surgery ; Penile Erection ; Penis ; Postoperative Complications ; rehabilitation ; Postoperative Period ; Prostatectomy ; adverse effects ; Prostatic Neoplasms ; surgery ; Rectal Neoplasms ; surgery ; Urinary Bladder Neoplasms ; surgery

AIM To study the scavenging free radicals and antioxidant effect of diterpenoid compounds. METHODS Reductive cytochrome C (cytc Ⅱ) in fenton reaction system was detected by spectrophotometer to indicate the scavenging capability of the test compounds scavenging. The NO - 2 content was measured by spectrophotometery. DNTB method was used to measure the content of GSH. RESULTS oridonin (Orid), ponicidin (Pon), amethystonal(Ame), Isodonoiol(Iso) 50,100,200 ?mol?L -1 could scavenge hydroxyl radicals(?OH) in Fenten's reaction. Orid, Pon, Ame, Iso 400, 800 ?mol?L -1 could scavenge superoxide anion(O -? 2) in xanthine/xanthine oxidase system. Orid, Pon, Ame, Iso 2,4 ?mol?L -1 decreased the content of NO - 2, in macrophages stimulated by LPS and also inhibited the decrease of GSH content in liver cell caused by CCl 4. CONCLUSION Orid, Pon, Ame, Iso all have antioxidative effect through scavenging ?OH, NO - 2 and inhibiting lipid peroxidation.

AIM: To discuss the clinical efficacy of fresh amniotic membrane ( AM ) during the microscopic adjustable suture surgery in children's intercommunity strabismus, in order to guide clinical treatment.
METHODS: With the clinical randomized control study (RCT), 60 (112 eyes) cases of patients in childhood who received microscopic strabismus surgery in our hospital were divided them into two different groups from Jan. 2010 to Oct. 2015. According to the application of AM on the basis of ophthalmology outpatient number, 30 cases (58 eyes) in group A were treated with rectus muscle recession surgery combined adjustable suture combined with AM. The other 30 cases (54 eyes) in group B were treated with rectus muscle recession surgery combined adjustable suture only. All patients in two groups were followed-up over 6mo after the strabismus surgery.
RESULTS:Twenty-seven cases ( 48 eyes ) of all the strabismus patients must be adjusted after strabismus surgery, and the eye position adjustment rate was 42.9%. At 1mo after surgery, eye position of 18 cases (29 eyes) can be adjusted in all patients, and 44. 8% (16 cases, 26 eyes ) in group A with the average of adjustment lengths was 2. 56±0. 64mm, and 5. 6% ( 2 cases, 3 eyes ) in group B, with the average of adjustment lengths was 0. 52±0. 28mm, the differences of the adjustment rate and the average of adjustment amount were both high statistically significant (χ2 =22.477, P<0. 01; t=16. 502, P<0. 01 ) between the two groups. Except of 3 cases who couldn't cooperate with eye position adjustment, they all received eye position adjustment in different degrees in one month after strabismus surgery,and after eye position adjustment, 27 cases (53 eyes) in group A got normal eye position, and the correction rate of eye position was 91. 4%, and 16 cases (28 eyes) in group B got normal eye position after eye position adjustment, the correction rate was 51. 9%, the differences of the correction rate were statistically significant (χ2=21. 827, P<0. 01) between the two groups.
CONCLUSION: The application of fresh AM in the microscopic adjustable suture strabismus surgery is exactly effective in treatment of children's intercommunity strabismus. It can significantly extend the adjustment time and increase the adjustment amount, and it also can statistically improve the controllability and achievement ratio for children's strabismus surgery.

Objective To assess the current status of knowledge, attitude and practice (KAP) towards antibiotic use among community residents in Hangzhou, and to explore the correlations among them. Methods A total of 449 permanent residents in Hangzhou were randomly selected using a multistage stratified random sampling method. Self-reported data on basic demographic factors, and relevant KAP information were collected by the questionnaire survey. Differences in KAP scores according to each demographic factor were assessed by the t test or ANOVA test, and AMOS 21.0 was used for the path analysis. Results Scores for knowledge, attitude and practice regarding antibiotic use were (6.17±2.45), (6.45±0.99) and (6.21±1.02) respectively. Results of the path analysis showed that education level and age had effects on the knowledge (coefficients: 0.57 and -0.38 respectively) . Age, gender and knowledge had effects on the attitude (coefficients: -0.27, 0.12 和 0.02 respectively), and attitudes, gender, monthly income and the level of education had effects on the practice (coefficients: 0.48、 0.37、 0.06 and 0.02 respectively) . Conclusion Community residents in Hangzhou lack relevant knowledge, and there are some irrational attitudes and practices regarding antibiotic use. There is a correlation between knowledge and attitudes, as well as between attitudes and practices, but the knowledge and practices are not correlated.

Objective To examine the clinical manifestations and pulmonary radiological features in patients with triphosgene poisoning.Methods Clinical manifestations,laboratory tests and CT scans were analyzed retrospectively in 17 patients with triphosgene poisoning.We focused on the severity,development and repair of pulmonary impairment.Results Plain film and CT scans in five mild cases demonstrated bilateral scattered pulmonary patchy shadows.Of 12 cases with moderate to severe diseases,three showed bilateral multiple pulmonary patchy shadows and nodules with confluence of part of the lesions on plain film and CT scans;bilateral lungs were involved in nine cases with imaging findings of bilateral disseminated pulmonary round or ovary nodules with different size,ill-defined and partly-confluent patchy shadows and thickening of both interlobular septum and the wall of bronchus.Of clinical interests,imaging findings were closely correlated with clinical course and laboratory results.Conclusion Radiological examinations with plain films and CT scans could reveal the severity,evolvement of pulmonary edema in patients with triphosgene poisoning,and these are of clinical benefit in the early management and prognostic evaluation of patients with triphosgene poisoning.

OBJECTIVETo study therapeutic effects between hook plate fixation and modified Weaver-Dunn surgery for the treatment of acromioclavicular joint dislocation.

METHODSForty patients with fresh acromioclavicular joint dislocations of type III according to Rockwood classification were reviewed. All the patients were divided into two groups: hook plate fixation group and modified surgery group. There were 20 patients in hook plate fixation group, including 13 males and 7 females, with an average age of (37.45 +/- 14.29) years old; 12 patients had injuries in the left and 8 patients had injuries in the right; preoperative Constant-Murley score was 40.75 +/- 10.40. And there were 20 patients in modified surgery group,including 11 males and 9 females, with an average age of (41.65 +/- 14.83) years old; 11 patients had injuries in the left and 9 patients had injuries in the right; preoperative Constant-Murley score was 42.75 +/- 8.18. The Lazzcano standard, Constant-Murley score and imaging changes were used to evaluate shoulder joint function before and after surgery.

RESULTSAll the patients were followed up,and the duration ranged from 7 to 32 months,with an average of 24 months. According to Lazzcano evaluation, 16 patients got an excellent result,3 good and 1 poor in modified surgery group with no re-dislocation, and 1 patient had pain more than middle degree; while in hook plate fixation group, 9 patients got an excellent result, 7 good and 4 poor, 1 patient had re-dislocation, and 3 patients got pain more than middle degree. The therapeutic effects of modified surgery group were better than those of hook plate fixation group. Constant-Murley scores:preoperative 42.75 +/- 8.18 vs 93.40 +/- 4.04 at the latest follow-up in modified surgery group; preoperative 40.75 +/- 10.40 vs postoperative 88.40 +/- 4.81 and 92.05 +/- 4.49 at the latest follow-up in hook plate fixation group. The postoperative scores all improved compared to preoperative scores in two groups. And there was no statistical difference of scores at the latest follow-up between two groups.

CONCLUSIONThe surgery of allograft tendon transplantation combined with anchor fixation to strengthen coracoclavicular ligament, as well as part transposition of acromiocoracoid ligament and resection at the distal part of clavicle may got safety fixation and less postoperative complications compared with hook plate internal fixation.

Acromioclavicular Joint ; injuries ; Adolescent ; Adult ; Bone Plates ; Case-Control Studies ; Clavicle ; surgery ; Female ; Follow-Up Studies ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Orthopedic Procedures ; instrumentation ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the diagnostic value of magnetic resonance (MR) imaging in the diagnosis of mandibular invasion caused by oral cancers.

METHODSMedline, EMBASE, SIGLE, and Chinese biomedical literature database were searched electronically. Manual searching for 19 relevant Chinese journals was also performed. Two reviewers evaluated the literature and extracted the data. Meta-Disc 1.4 was chosen to conduct the sensitivity (SEN), specificity (SPE), and 95% confidence interval (95%CI).

RESULTSTwelve studies with a total of 476 patients, namely, 5 prospective studies and 7 retrospective studies, were included. All the studies had unclear risk of bias. Meta-analysis result showed that the combination of SEN of MR in diagnosing mandibular invasion was 0.779 (95%CI: 0.719-0.831), combination of SPE was 0.823 (95%CI: 0.767-0.870), positive likelihood ratio was 3.442 (95%CI: 2.181-5.431), negative likelihood ratio was 0.286 (95%CI: 0.181- 0.451), and diagnostic odds ratio was 25.702 (95%CI: 13.406-49.273). The area under curve was 0.903 9 and Q* was 0.835 4. Meta-analysis was not processed when diagnosing mandibular medullary invasion because only two studies with 55 patients had been reported. The SEN was 0.838, and the SPE was 0.722.

CONCLUSIONMR is efficient and has clinical value in the diagnosis of mandibular invasion caused by oral cancer.

Humans ; Magnetic Resonance Imaging ; Mandible ; Mouth Neoplasms ; Prospective Studies ; Retrospective Studies

Objective To analyze the associations between particulate air pollution (PM10,PM25) and stroke daily attack or mortality. Methods Meta-analysis method was used to polysynthetically analyze 16 quantitative studies about the associations between particulate air pollution and stroke daily attack or mortality. The relative odds ratio(OR) of stroke attack or mortality associated with per 10 μg/m3 increase of particulate matter concentration was used as effective value,taking a sensitivity analysis for the results. Results A 10 μg/m3 increase in PM10was associated with a 1.09% (95%CI: 0.10%-2.08% ) increase in stroke daily attack (OR=1.011,95%CI: 1.001-1.021)and 0.70% (95%CI: 0.60%-0.80% ) increase in stroke daily mortality (OR= 1.007, 95%CI: 1.006-1.008). The results of sensitivity analysis supported above results. As for PM2.5 OR appeared to be 1.001 (95%CI: 0.992-1.010) with a 10 μg/m3 increase in stroke daily attack and 1.052 (95%CI:0.958-1.154) for daily mortality. Conclusion There are positive associations between PM10 and stroke daily attack and mortality, increase of PM25 was not associated with stroke attack and mortality.

Objective To evaluate the feasibility of chest digital tomosynthesis(DTS)for lung lesion screening by comparing the effective dose of chest DTS with chest digital radiography(DR),low-dose MSCT and MSCT examinations.Methods The Fluke lung/chest phantom underwent posterior-anterior (PA),left lateral(LAT)chest DR and DTS with automatic exposure control technique.Using RTI DoseGuard and WinODS,the dose area product(DAP)and effective dose of PA,LAT and total DTS were calculated.CareDose technique was used for MSCT and low-dose MSCT scans,the dose length products (DLP)was acquired.According to the DLP to E(k)conversion coefficient in ICRP 103,the effective dose of low-dose MSCT and MSCT were calculated.Paired t test was used for comparison of the mean effective dose of DTS,DR and low-dose MSCT.Results The mean effective dose was 0.1 3 mSv for chest DR and 0.11 mSv for DTS examination.The mean effective dose of low-dose MSCT and MSCT scans were 1.13 mSv and 6.38 mSv.The effective dose of chest DTS was comparable to that of chest DR,and was approximately 1/10 and 1/60 times lower than that of low-dose MSCT and MSCT scans.There was no statistical difference between chest DTS and DR(t =3.514,P ＞0.01),and there was a significant difference between chest DTS and low-dose MSCT(t =178.769,P ＜0.01).Conclusion DTS is a new X-ray tomography which has the advantage of low radiation dosage in chest examination for lung lesion screening comparing with low-dose MSCT.