Objective To review and evaluate the effect of one stage surgical correction of congenital heart disease with tracheal stenosis in infants.Methods Between August 2001 and December 2005,six infants with congenital heart disease with tracheal steno- sis were repaired at one stage operation.The age was 24 d～3 y[mean(13.16?12.03)months]and the weight was 4.2～10.0 kg [mean(7.98?2.03)kg].There were 3 patients with tetralogy of Fallot,1 with pulmonary atresia;2 with ventricular septal defect, 1 with coarctation of aorta;and 1 with pulmonary sling.The congenital heart disease were repaired underwent low temperature and car- diopulmonary bypass,and the tracheal stenosis were corrected simultancously.Results There was one death postoperative because of right and left branch stenosis.One patient with pulmonary sling died of granulation tissue on the patch 3 months after operation.All other 4 patients recovered uneventfully.These patients were followed up from 6 month to 4 years.There were no complications.CT scan shows that the tracheal anastomosis was patent without any stenosis.Conclusion One stage repair of congenital heart disease with tracheal stenosis in infants may have a satisfactory result.To deal with the tracheal stenosis is difficult,the operative methods de- pends on the length of stenosis.The principles of surgical methods consist of using autologous material,maintaining its contour and function of respiratory epithelium,and maintaining its growth.

Objective Aortic arch obstruction is a commonly associated malformation in the patients with Taussig-Bing anoma- ly.Herein,we reported our outcomes of single stage corrections in patients with the Taussig-Bing anomaly associated with aortic arch obstruction.Methods Between May,2000 and Dec,2006,12 patients with Taussig-Bing anomaly associated with aortic arch obstr- uction (5 patients associated with interrupted aortic arch) underwent arterial switch operation with baffling of the left ventricle to neo- aorta.The corrections of aortic arch obstruction included extended resection combined with end to end anastomosis to aortic arch or end to side anastomosis to ascending aorta.Results The hospital mortality rate was 25% (3/12).The ventilating time and ICU stay were (7.4?2.1) days and (11.7?4.6) days,respectively.No reoperation because of residual anomalies was required.Conclusion Tanssig-Bing anomaly,especially associated with aortic arch obstruction,is different from transposition of great artery.The opti- mized operative indications,techniques and the managements of aortic arch obstruction are discussed in the article.

Objective It has become more important to protect brain function in operation and post-operation period with the developmen of surgery therapy for congenital heart surgery.Methods The primary cultured neuron cell of l8-day-pregnan embryoid Sprague-Dawley rat's hippocampus has been selected as the experimental material.The experimental concentration of magnesium sulfate will be 0 mmol/L,1 mmol/L,2 mmol/L,4 mmol/L;0 mmol/L is for control group.Selecting c-fos protein as target for primary antibody.Results After immunohistochemistry procedure,we found the mortality of neuronal cultures with magnesium sulfate in different concentration was 89.47 %,49.35 %,52.56 %,90.67 %(P

OBJECTIVETo evaluate the effect of the treatment on paraplegic patients with erectile dysfunction (ED) by implantation of China-made three-piece inflatable penile prosthesis.

METHODSEighteen paraplegic patients with ED refractory to non-operative treatment were implanted with three-piece inflatable penile prosthesis through an incision at the border of penis and scrotum. The rate of maintained coitus and the satisfactory coitus of spouse were obtained by inquiring and letter visiting.

RESULTSOperations were successfully performed upon all 18 patients. Follow-ups after operations ranged from 3 months to 36 months, mean follow-up being 18 months. Fluid exudation from penile prosthesis and localized infection occurred in one patient and mechanic complication occurred in two. Maintained coitus rate was 17/18. Ejaculation reflection occurred in three patients.

CONCLUSIONSTreatment of paraplegic patient with ED refractory to non-operative treatment by implantation of China-made three-piece inflatable penile prosthesis has good concealment and rehabilitative effect, with similar mechanical troubles to imported products. With excellent covertness, implantation of three-piece inflatable penile prosthesis is well accepted by ED patients.

Adult ; Erectile Dysfunction ; etiology ; surgery ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Paraplegia ; complications ; Penile Implantation ; Penile Prosthesis

OBJECTIVETo analyze the influence of intravesical Pirarubicin (THP) instillation on the prediction results of European Organization for Research and Treatment of Cancer (EORTC) risk tables and to discuss the efficacy of EORTC risk tables in clinical application.

METHODSWe retrospectively reviewed the clinical data of 389 patients with non-muscle invasive bladder cancer after TURBT treated with intravesical pirarubicin instillation. According to the EORTC Scoring System, all the cases were divided into low risk group, intermediate risk group and high risk group. The 1-year and 5-year recurrence and progression rates of each group were calculated and compared with the prediction results of the EORTC risk tables.

RESULTSThe 1-year recurrence and progression rates of the low risk group were 8.0% and 0, those of the intermediate risk group were 31.0% and 2.8%, and those of the high risk group were 52.5% and 18.6%, respectively. The 5-year recurrence and progression rates of low risk group were 16.0% and 5.3%, those of the intermediate risk group were 42.6% and 10.7%, and those of the high risk group were 63.9% and 41.9%, respectively. The prediction results of progression rate were similar to that of the EORTC risk tables while the overall recurrence rate was lower.

CONCLUSIONSThe EORTC risk tables can be effectively used to predict the recurrence rate and progression rate of non-muscle invasive bladder cancer. However, the EORTC risk tables have a tendency to overestimate the recurrence rate. Intravesical pirarubicin instillation is helpful to reduce the recurrence rate, yet has no obvious influence on the tumor progression.

Administration, Intravesical ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; administration & dosage ; therapeutic use ; Disease Progression ; Doxorubicin ; administration & dosage ; analogs & derivatives ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Retrospective Studies ; Risk Assessment ; Urinary Bladder Neoplasms ; drug therapy ; pathology

OBJECTIVETo identify the affect of chronic low back pain on multifidus muscle atrophy and fatty infiltration.

METHODSFrom March 2010 to August 2013, a retrospective study were carried out in the department of orthopedics of patients with low back pain. Finally 31 cases were selected to this study including 19 males and 12 females with an average age of 36.4 years ranging from 23 to 55 years. The main symptoms of these patients were repeated back pain. Duration was more than 1 year. X-ray, CT, MRI showed no obvious abnormalities. The changes of net cross-sectional area of multifidus and T2 signal ratio of the same patient were measured at different time by MRI. VAS and Oswestry disability scores were recorded in two MRI examination. Correlation between these change of multifidus net area and T2 signal ratio in two times measurement and duration of low back pain, VAS, Oswestry disability scores were analyzed to find the affection of low back pain on paraspinal multifidus muscle.

RESULTSThe net multifidus cross-sectional area in same case by the second follow-up MRI is significantly smaller than that of the first follow-up, T2 signal ratio at second was significantly higher than that of the first (P < 0.05). The net cross sectional area of multifidus muscles reduced rate were positively correlated with VAS scores, duration and of Oswestry disabilitry scores (P < 0.001). The rate of increase in T2 signal ratio was not correlated with VAS scores,duration and the Oswestry disability scores (P > 0.05).

CONCLUSIONChronic low back pain is one of the most important reasons of paraspinal multifidus muscle atrophy and fatty. The duration, VAS and Oswestry disability scores of chronic low back pain were positively correlated with the multifidus muscle atrophy.

Adult ; Chronic Disease ; Female ; Humans ; Low Back Pain ; complications ; Male ; Middle Aged ; Muscular Atrophy ; diagnostic imaging ; etiology ; Paraspinal Muscles ; diagnostic imaging ; Radiography ; Retrospective Studies ; Young Adult

OBJECTIVETo investigate the diagnoses and treatment of interstitial cystitis (IC).

METHODSThe clinical data of 16 IC patients were analyzed respectively. The patients with urinary frequency, urgency, suprapubic pain and chronic pelvic pain. They were misdiagnosed as chronic cystitis, pelvic inflammation, endometriosis, cystophthisis and urethral syndrome, and were diagnosed finally by the means of pathology or cystoscopy. Among the 16 patients, 4 cases had the operation of ileal reservoir, Two cases had sigmoid-cysto-plasty, and 10 cases had drug treatment. The methods of IC diagnosis and treatment were discussed with the review of literature.

RESULTSThe pelvic ache disappeared completely in 4 cases after the operation of ileal reservoir; Two cases after cystoplasty felt lightly discomfortable in perineum occasionally, and their bladder capacity was above 350 ml, no recurrence after operation having been found after follow-up for 24 months and 33 months; Ten cases treated with non-operative treatment improved obviously, with the O'Leary-Sant IC symptom index and IC problem index decreased from 15.4 +/- 4.1, 9.4 +/- 2.7 to 4.1 +/- 2.1 and 5.1 +/- 3.9, respectively.

CONCLUSIONSSufficient attention should be paid to the diagnosis and differential diagnosis of IC; Early diagnosis and therapeutic alliance with manifold measures can relieve the patients' symptom and improve the quality of life.

Adult ; Cystitis, Interstitial ; diagnosis ; therapy ; Cystoscopy ; Diagnostic Errors ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Urinary Diversion ; methods

This study was aimed to analyze the clinical and laboratorial characteristics of patients with chronic lymphocytic leukemia (CLL), as well as their relationship with outcomes of patients. The clinical and laboratorial data of 40 CLL patients admitted from 2004 to 2010 in our hospital were analyzed retrospectively. The results indicated that the most of CLL attacked the elderly male patients with median age 66 (from 42 to 80). Flow cytometric analysis showed that 25 cases were positive for typical immunophenotype of CLL. On the other hand, all the patients clearly expressed CD19 and CD5, 7 cases (17.5%) and 14 cases (35%) were positive for the expression of CD38 and Zap70 respectively. 8 cases harbored a mutated immunoglobulin heavy-chain (VH) gene, among them 4 cases belong to VH3 family. Interphase FISH analysis showed that P53 deletion, RB1 deletion, trisomy 12 and normal chromosome were detected in 6, 3, 1, and 5 cases, respectively. The median PFS in 31 patients received treatment of fludarabine based chemotherapy was 48 months (95%CI: 39 - 57 months), among them 27 cases (87.1%) achieved CR + PR. While PFS was 14 months (95%CI: 10 - 18 months, P < 0.001) in 9 patients received other treatment regimen, out of them only 3 cases (33.3%) achieved CR + PR. Patients with normal level of serum β2-microglobulin at diagnosis showed significantly higher overall survival (78%, 95%CI: 69% - 87%) in 36 months than those with abnormal level of serum β2-microglobulin (47%, 95%CI: 35% - 59%, P = 0.004). Significant difference in the rate of CR + PR was noted in the Zap70 positive group (50%) and in negative group (88.5%, P = 0.006). All of 8 patients with IgVH mutation displayed CR after treatment, while 4 cases (66.7%) archived CR among 6 patients without IgVH mutation. It is concluded that CLL is characterized by high heterogeneity in both clinical features and molecular markers, which are associated with prediction of outcomes for patients. The treatment with fludarabine-based chemotherapy results in a major benefit and long survival for patients with CLL.
ADP-ribosyl Cyclase 1 ; metabolism ; Adult ; Aged ; Aged, 80 and over ; Female ; Flow Cytometry ; Humans ; Immunoglobulin Variable Region ; genetics ; Leukemia, Lymphocytic, Chronic, B-Cell ; genetics ; metabolism ; Male ; Middle Aged ; Mutation ; Retrospective Studies ; ZAP-70 Protein-Tyrosine Kinase ; metabolism

This study was aimed to investigate the relationship between Richter's syndrome (RS) transformation and clinical characteristics as well as karyotype of patient with chronic lymphocytic leukemia (CLL). By the follow-up of a patient with CLL, the clinical characteristics, karyotype, treatment pattern and its effect, as well as disease progression were monitored regularly with serological test, flow cytometry and FISH technique. The results indicated that the patient typically presented with history of CLL at initial diagnosis, with expression of CD5(+), CD19(+) and CD23(+), Binet stage C, as well as karyotype aberration of trisomy 12, and poorly responded to 4 cycles of standard chemotherapy of FCR regimen. The disease progression was confirmed at 5 months with the symptoms of fever in the absence of infection, elevated lactate dehydrogenase level and rapidly enlarging lymphnodes which showed typically diffuse large B cell lymphoma by the biopsy. It is concluded that karyotype aberration of trisomy 12 is one of the risk factors for RS transformation, and treatment pattern of the patient with CLL may be associated with the transformation of RS.
Cell Transformation, Neoplastic ; genetics ; Chromosomes, Human, Pair 12 ; Female ; Humans ; Karyotype ; Karyotyping ; Leukemia, Lymphocytic, Chronic, B-Cell ; genetics ; Middle Aged ; Trisomy

BACKGROUNDBladder leiomyoma is an uncommon type of bladder neoplasms. Most publications are reports of isolated cases. The influence of tumor size on patients' early symptoms was seldom analyzed. We aim to investigate the clinical characteristics of bladder leiomyoma and the influence of tumor size on patients'symptoms in Chinese population.

METHODSWe reviewed the medical records of eight patients diagnosed with bladder leiomyoma at our department, collected 53 cases from Chinese National Knowledge Infrastructure (CNKI), Wangfang data base, and Chinese Biological Medicine Disk, and performed a pooled analysis. The clinical characteristics of the patients were analyzed and then classified into symptomatic and asymptomatic groups. The association between tumor size and the occurrence of symptoms was evaluated. Furthermore, Logistic regression model was constructed to discriminate variables.

RESULTSWomen comprised the majority of the patients (49/61, 80.3%). The mean age and tumor size were (42.3 ± 14.0) years and (45.0 ± 25.7) mm, respectively. Among all the symptoms, irritative symptoms occurred most frequently (37.7%, 23/61), followed by obstructive urinary symptoms (31.1%, 19/61), hematuria (24.6%, 15/61), and abdominal bulge or pain (14.8%, 9/61). In our study, patients who were 45 years old or younger tended to be asymptomatic compared with elder ones (14/36 vs. 3/25, P = 0.021). The histological, as well as anatomical, location of tumor, did not show significant differences between symptomatic and asymptomatic patients (P = 0.306 and 0.700). Tumors larger than 30 mm in the greatest diameter would cause clinical symptoms such as obstructive urinary symptoms (P = 0.048) and irritative symptoms (P = 0.037). Logistic regression confirmed the association between tumor size and the occurrence of symptoms, which was related with age.

CONCLUSIONSBladder leiomyoma occurs mainly in women and most frequently with irritative symptoms. The occurrence of symptoms is related to tumor size rather than the location. In this setting, patients with endovesical tumors smaller than 30 mm in the greatest diameter tended to be asymptomatic, which were usually treated with transurethral resection of bladder tumor.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Leiomyoma ; pathology ; Male ; Middle Aged ; Urinary Bladder Neoplasms ; pathology ; Young Adult