OBJECTIVE: To analyze the factors of intracranial infection after transnasal endoscopic crannialbase approach. METHOD: Retrospective analysis of 346 patients of ransnasal endoscopic crannialbase approach, logistic regression analysis of the factors was carried out. RESULT: The total number of cases of postoperative infections were 19 cases in 346 patients, the infection rate was 5.49%. The cerebrospinal fluid rhinorrhea , the restitution of skull base, the history of crannialbase approach, the history of radiotherapy and diabetes were infection fators after transnasal endoscopic diabetes (P < 0.05), while sex,age,operative approach,the use of artificial material,longer application of antibiotics before or after operation,and the history of chemotherapy had no obvious effects (P > 0.05). CONCLUSION Intracranial infection after transnasal endoscopic the use of artificial material was affected by many factors. Much attention should be paid for the intracranial infection prevention.
Cerebrospinal Fluid Rhinorrhea ; etiology ; Endoscopy ; Humans ; Postoperative Complications ; Retrospective Studies ; Skull Base ; surgery

Acid Anhydride Hydrolases ; genetics ; metabolism ; Animals ; Antimetabolites, Antineoplastic ; pharmacology ; Azacitidine ; analogs & derivatives ; pharmacology ; Biomarkers, Tumor ; analysis ; Carcinoma, Squamous Cell ; diagnosis ; genetics ; metabolism ; pathology ; Cyclin-Dependent Kinase Inhibitor p16 ; genetics ; metabolism ; DNA Methylation ; drug effects ; Genes, p16 ; Humans ; Laryngeal Neoplasms ; diagnosis ; genetics ; metabolism ; pathology ; Neoplasm Proteins ; genetics ; metabolism ; Tumor Suppressor Proteins ; genetics ; metabolism

Epistaxis ; diagnosis ; etiology ; Hemophilia B ; complications ; diagnosis ; Humans ; Male ; Young Adult

As a common and frequently-occurring disease,glenohumeral instability is become one of disease which restrict upper limb activity. The diagnosis of this disease is easy, but it is very difficult to assess the degree of periarticular soft tissue injuries. With the development of magnetic resonance imaging and arthroscopy, MRA become the gold standard for evaluation of glenoid labrum, joint capsule and ligaments injury. The traditional manual reduction is a fast, simple method, but often can cause adverse consequences,such as rotator cuff tear,ligament relaxation,and habitual dislocation. Open operation can rebuild stability of joint,but with many new treatment methods,especially the arthroscopic reconstruction has gradually replaced the open operation, and become the mainstream trend, but for the long-term effect of capsular tightening surgery, rotator cuff gap closure is not clear,it is need further follow-up observation.
Arthroscopy ; Humans ; Joint Instability ; diagnosis ; etiology ; therapy ; Shoulder Joint

Objective To study the clinicopathological features of C3 glomerulonephritis and the associations between plasma complement fragments level and clinical manifestations.Methods The clinical and pathological data of the 12 patients with C3 glomerulonephritis in our division from January 1999 to June 2010 were analyzed retrospectively.Concentrations of plasma factor B,Ba,C3,C3a,C4a and C5a were detected by commercial available sandwich ELISA kits on the day of renal biopsy.Results Ten of the 12 patients were C3 glomerulonephritis without MPGN,and the rest 2 were C3 glomerulonephritis with MPGN.All the patients presented proteinuria.Two of the 10 C3 glomerulonephritis patients without MPGN presented nephrotic range proteinuria,6 with microhematuria,1 with gross hematuria,and 2 with renal insufficiency.One of the 2 C3 glomerulonephritis patients with MPGN presented nephrotic range proteinuria,accompanied by microhematuria,hypertension and renal insufficiency.The other patient showed moderate proteinuria with normal renal function.Most of C3 glomerulonephritis patients without MPGN showed mild mesangial proliferative glomerulonephritis,and 4/10 patients had various degree cresentic formation.One C3 glomerulonephritis patient with MPGN had 47.1％ cresentic formation.The concentration of plasma C3 in C3 glomerulonephritis patients was normal,while the plasma factor B was significantly decreased,and the concentrations of plasma Ba,C3a,C4a and C5a were significantly elevated.The concentration of plasma Ba was positively correlated with the proteinuria level,while the concentrations of plasma C3a,C4a and C5a were not correlated with the levels of proteinuria or plasma creatinine.Conclusions Majority of these 12 patients were C3 glomerulonephritis without MPGN,manifests as nephritic syndrome clinically and mild mesangial proliferative glomerulonephritis histopathologically.Complement activation via alternative pathway may play an important role in the pathogenesis of C3 glomerulonephritis.

Acetylation regulated by histone deacetylases (HDAC) has a broad influence on plenty of physiological processes and regulation of malignant tumor.HDAC inhibitors can promote tumor cell apoptosis and have little effect on normal cells,so they have been developed a new kind of anti-tumor agent,and part of them have entered clinical trials.Vorinostat and romidepsin have been approved by FDA for treating cutaneous T cell lymphoma patients with progressive,persistent and recurrent disease.Studies of the molecular mechanisms of the HDAC inhibitors will contribute to the further clinical application.

BACKGROUND:Analgesia in different ways can be selected for the elderly in hip and knee arthroplasty. Considering the actual situation of the elderly patients, choice of anesthesia should be reasonable in order to achieve fast acting, long lasting time and good analgesic effect. OBJECTIVE:To explore the analgesic effect of ropivacaine of lumbar epidural anesthesia on elderly knee arthroplasty. METHODS:A total of 78 elderly patients aged 80-96 years, who were treated with hip and knee arthroplasty in the Shenyang Orthopaedic Hospital from September 2011 to September 2014, were enrol ed in this study. They were equal y and randomly assigned to control group and observation group, and separately administered continuous epidural anesthesia and lumbar epidural anesthesia with ropivacaine. The excel ent and good rate, onset time, anesthetic induction, frequency of use of Duffing mixture, and adverse reactions were compared between the two groups. RESULTS AND CONCLUSION:The excel ent and good rate of analgesic effect was higher in the observation group (97%) than in the control group (87%) (P<0.05). Onset time was significantly shorter, the dose of anesthetic was significantly less, frequency of use of Duffing mixture was significantly less in the observation group than in the control group (P<0.05). The difference was not significant in adverse reactions between the two groups (P>0.05). Above results indicated that lumbar epidural anesthesia of ropivacaine obtained good analgesic effects during elderly knee arthroplasty.

[ABSTRACT]OBJECTIVETo investigate malignant transformation of sinonasal inverted papilloma(SNIP) treated by endoscopic or endoscope assisted surgery, in order to analyze its probable prognostic factors and the optimized method.METHODSThe clinical data of 27 cases with malignant transformation of SNIP treated by endoscopic or endoscope assisted surgery from September 2001 to September 2010 were reviewed. According to preoperative imaging examination and UICC staging criteria, 3 cases were T1, 8 cases were T2, 12 cases were T3 and 4 cases were T4. 16 of them received radiotherapy after endoscopic surgery while the other 11 received surgery alone. RESULTSAll cases were confirmed as squamous cell carcinoma pathologically after surgery. The 5-year overall survival rate was 77.8% for all the patients. The 5-year survival rate was 75.0% for surgery alone group, of which 5 cases recurred locally after operation. The 5-year survival rate was 81.8% for surgery combined with radiotherapy group, of which 5 cases recurred locally and 2 cases died from intracranial metastasis.CONCLUSIONEndoscopic or endoscope assisted surgery can be used in the management of malignant transformation of SNIP to improve the quality of life, with the preponderances of desired effect and less complication. Application of radiotherapy after surgery could improve long-term survival rate of the patients.

Objective To promote the level of early diagnosis and strengthen the understanding of pathogenesis, pathological staging and prognosis of primary gallbladder carcinoma (PGC). Methods The data of 679 patients with PGC treated in our hospital from 1956 to 1998 were retrospectively analyzed. Results The incidence of PGC has been increasing in recent years while the surgical management for the disease was not satisfactory. Upon diagnosis, most patients were with PGC in advanced stage. PGC was usually found among the aged woman patients. The female/male ratio was 3∶1. There was a close relationship between gallstone and PGC, for the gallstone was found in 60% of the patients with PGC. The diagnostic accordance rate before and after operations was low. Most cases of PGC were found unexpectedly during operation due to gallstone or acute cholecystitis. It was even worse that many patients with PGC missed the opportunity of diagnosis and treatment because doctors noticed the gallstone only. Pathological classification revealed that most cases of PGC were of adenocarcinoma. Development in imaging medicine might help a lot in finding early-stage cases and improving prognosis. Conclusions Strengthening the understanding of pathogenesis, pathological staging and prognosis of the disease and proper use of various examinations are the basic means of obtaining early diagnosis and improving the prognosis.

Objective The aim of this study was to discuss the technical details on laparoscopic total cyst excision with Roux Y hepatoenterostomy for the treatment of choledochal cyst in children.Methods Eight patients with type Ⅰ choledochal cyst (median age 3 6 years) underwent laparoscopic cyst excision with Roux Y hepatoenterostomy from July 2001 to April 2002.Under laparoscopic guidance, intraoperative cholangiogram was performed, the gallbladder and the dilated bile duct were completely excised. Roux en Y jejunojejunostomy was performed extracorporeally through umbilical incision (2 cm), and an end to side anastomosis was carried out intracorporeally.Results Median duration of operation was 4 8 hours (3 6 to 6 0 hours), intraoperative bleeding was between 10 to 50 ml. Hospital stay after the operation ranged from 3 to 8 days. There was no intra or postoperative complication.ConclusionLaparoscopic total cyst excision with Roux Y hepatoenterostomy was effective and safe procedure for children with choledochal cyst.