Objective To summarize the operative experience and to study the value and efficacy of retroperitoneal laparoseopie adrenaleetomy.Methods Clinical data of 66 cases undergoing retroperitoneal laparoscopic adrenalectomy in Yijishan Hospital were retrospectively reviewed.There were 22 cases with adrenal adenoms located at left side and 44 cases at fight side.Tumor diameter was from 1.2 to 6.4 cm,with 3.3 cm as the average.There were 36 cases of nonfunctional adrenal adenoma,13 cases of primary hyperaldosteronism,10 cases of adrenal pheochromocytoma,6 cases of adrenal myelolipoma,and 1 case of adrenal cyst.Results 4 cases were converted to open surgery while the other 62 cases were completed successfully.The operation duration was from 35 to 190 min,with 90 min as the average.Intraoperative blood loss was from 20 to 800 ml,with 70 ml as the average.5 cases received blood transfusion because of massive hemorrhage.All cases were followed up for 3to 36 months.None of them had long-term complications or recurrence.Conclusion Retroperitoneal laparoscopic adrenalectomy has advantages of safety,less trauma,short hospitalization time,and quick recovery,making it the flint choice for patients with benign adrenal neoplasms.

Ataxia Telangiectasia Mutated Proteins ; Breast ; metabolism ; pathology ; Breast Neoplasms ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; Carcinoma, Intraductal, Noninfiltrating ; metabolism ; pathology ; Cell Cycle Proteins ; metabolism ; Checkpoint Kinase 2 ; DNA-Binding Proteins ; metabolism ; Female ; Humans ; Lymphatic Metastasis ; Neoplasm Grading ; Protein-Serine-Threonine Kinases ; metabolism ; Tumor Burden ; Tumor Suppressor Protein p53 ; metabolism ; Tumor Suppressor Proteins ; metabolism

Objective:To evaluate the effect of vacuum disk(VD) for non-invasive treatment of recurrent and acquired pectus excavatum(PE).Methods:From June 2017 to June 2019, 29 patients recruited from our outpatient clinic were included in this retrospective study and followed-up every 3 month according to the schedule. The patients were distributed into three groups(group 1 treated ≤6 months; group 2 treated from 6 months to 12 months; group 3 treated >12 months). The device should be applied regularly for more than 2 hours daily. The deformity chest wall was scanned by three-dimensional(3D)scanner at clinic, and the 3D-depth(3D-DE) and 3D-Haller index(3D-HI) of PE were calculated through Geomagic software.Results:In this cohort, 29 patients were eligible, 18 symmetrical PE and 11 asymmetric PE. The application time ranged from 3 months to 15 months(average 7.6 months). 4 paitents was lifted to a normal level, 23 patients were differently improved. However, 2 paitents had no improvement. The average of the depth and 3D-HI of all patients were improved from 17.7 mm to 11.6 mm and 1.739 to 1.598, respectively. It’s no statistically significant difference for the elevation of 3D-DE and 3D-HI between symmetrical and asymmetric PE( t=-2.821, P=0.558; t=0.074, P=0.068). When comparing the improvement of 3D-DE or 3D-HI of PE to the patient's treatment time, a statistically significant difference was proved between the group 2 and group 1( t=-2.261, P=0.014; t=-0.436, P=0.043), but not between the group 3 and group 2( t=-1.240, P=0.139; t=0.622, P=0.568). The main side effects include moderate subcutaneous hematoma(84%), petechial bleeding(27%), thoracalgia(32%) and chest tightness(17%), no other side effect appear till now. Conclusion:VD for treatment of recurrent and acquired PE is convenient, safe and noninvasive, which can be an alternative treatment for recurrent and acquired PE, However, long term of efficacy evaluation is still needed.

OBJECTIVETo observe effect of Xue Hanjing oral fluid on mice immunological function.

METHODThe weight of thymus gland and spleen and the function of abdominal cavity macrophage were measured. Production of the hemolysin antibody, the immunoglobulin of blood serum and complement and the proliferation of T lymphocytes were observed respectively by means of microblood, immune-turbidimetry and MTT staining.

RESULTXue Hanjing oral fluid could enhance index of the thymus gland and spleen and the phago-percent of abdominal cavity macrophage, increase the immunoglobulin of blood serum(IgG and IgM), and accelerate production of the hemolysin antibody and the proliferation of T lymphocytes.

CONCLUSIONSXue Hanjing oral can reinforce immunological function in mice.

Adjuvants, Immunologic ; pharmacology ; Administration, Oral ; Animals ; Antibody Formation ; Cell Division ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Female ; Hemolysin Proteins ; immunology ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Macrophages, Peritoneal ; physiology ; Male ; Mice ; Organ Size ; drug effects ; Phagocytosis ; drug effects ; Plants, Medicinal ; chemistry ; Poaceae ; chemistry ; Random Allocation ; T-Lymphocytes ; cytology

Objective To evaluate the correlation between the concentrations of matrix metalloproteinase-9 (MMP-9) and adiponectin (ADP) and postoperative delirium (POD) in perioperative serum of elderly patients undergoing lobectomy. Methods Seventy-three elderly patients undergoing lobectomy under general anesthesia, 38 males and 35 females, aged 65-80 years, BMI ＜ 24 kg/m2, falling into ASA physical status Ⅰ or Ⅱ, were selected in some suitable period. All patients were divided into POD group and non-POD group according to the Chinese Version of Consciousness Assessment Scale at 24 hours, 48 hours, and 72 hours after operation, and their blood samples were collected 5 minutes before induction of anesthesia (T0), at the time of tracheal extubation (T1) and at postoperative 24 hours (T2), 48 hours (T3), and 72 hours (T4) to determine the concentrations of MMP-9 and ADP in their serums. Results POD occurred in 19 patients, with the incidence rate of 17.8％. The concentrations of MMP-9 at T1-T4 were significantly higher than those before lobectomy in serums in POD group, while the concentrations of ADP in serums were significantly lower than those before lobectomy (P ＜ 0.05). The concentrations of MMP-9 in serums at T1 were significantly higher than those before lobectomy in non-POD group, while the concentrations of ADP in serums were significantly lower than those before lobectomy (P ＜ 0.05). In the comparison between the two groups, the concentrations of MMP-9 in POD group at T1-T4 were significantly higher than those in non-POD group, while the concentrations of ADP in POD group were significantly lower than those in non-POD group (P ＜ 0.05). Conclusion The serum level of MMP-9 is increased and ADP is decreased in perioperative, wich maybe involved in the pathophysiological process of POD in elderly patients undergoing lobectomy.

OBJECTIVE: To investigate the respiratory pathogens and clinical features in children with acute exacerbation of bronchial asthma. METHODS: Nasopharyngeal swabs were collected from 225 children with acute exacerbation of bronchial asthma, aged <14 years, who attended the outpatient service or were hospitalized from August 2017 to August 2019. Quantitative real-time PCR was used to detect 12 pathogens, i.e., respiratory syncytial virus (RSV), human rhinovirus (HRV), influenza virus A (IFVA), influenza virus B (IFVB), parainfluenza virus types 1-3 (PIV1-3), human metapneumovirus (HMPV), adenovirus (ADV), Bordetella pertussis (BP), Chlamydia pneumoniae (CP), and Mycoplasma pneumoniae (MP). RESULTS: The overall detection rate of virus was 46.2% (104/225), and 7 kinds of viruses were detected, i.e., HRV (19.6%, 44/225), ADV (16.0%, 36/225), IFVB (5.8%, 13/225), RSV (4.9%, 11/225), IFVA (3.6%, 8/225), PIV3 (1.8%, 4/225), and HMPV (0.4%, 1/225). Of all pathogens, BP had the highest detection rate of 28.4% (64/225), and the detection rates of MP and CP were 16.4% (37/225) and 0.4% (1/225), respectively. The mild exacerbation group had a higher detection rate of BP than the severe exacerbation group (P<0.05), while the severe exacerbation group had significantly higher detection rates of RSV and MP than the mild exacerbation group (P<0.05). There were significant differences in the proportion of children with paroxysmal cough, spasmodic cough, fever, lung rales and abnormal lung imaging findings among the simple BP infection, simple virus infection and simple MP infection groups (P<0.05). CONCLUSIONS BP, HRV, and MP are common respiratory pathogens detected in children with acute exacerbation of bronchial asthma, and respiratory virus infection is an important pathogen of acute exacerbation of asthma in children. Acute exacerbation of asthma caused by different pathogens has different clinical features and severities.
Adolescent ; Asthma/diagnosis* ; Child ; Humans ; Mycoplasma pneumoniae ; Pneumonia, Mycoplasma ; Respiratory Syncytial Virus, Human

Objective To investigate the characteristics of gut microbiota in patients with schizophrenia. Methods The composition of the fecal microbiota in 16 schizophrenia patients and 20 healthy controls was analyzed by 16S rRNA sequencing. Results At the phylum level, TM7 was increased in the patients (P<0.05). At the class level, the abundance of Peptostreptococcaceae, Lactobacillaceae and Actinomycetaceae in the patients increased (P<0.05), whereas the abundance of Tissierellaceae decreased relative to health controls (P<0.05). At the genus level, Actinomyces, Scardovia, Atopobium, Moryella, G07 and Lactobacillus were increased in the patients relative to healthy controls (P<0.05). Prediction of functional properties of bacterial flora showed that the metabolic pathways of fatty acids and pyruvate were different between the patients and healthy controls (P<0.05). Conclusion The present study reveals an alteration in the characteristics of gut microbiota in schizophrenia patients which may be an auxiliary diagnosis marker for clinical diagnosis of schizophrenia.

OBJECTIVETo explore the incidence, pathogenesis, risk factors and effective treatment of pulmonary complications after allogeneic peripheral blood stem cell transplantation (allo-PBSCT).

METHODSPulmonary complications in 70 patients received allo-PBSCT were analyzed.

RESULTSThirty one episodes were observed in 26 patients. Among them episodes were infectious complications, including bacteria pneumonia, pulmonary fungus disease, CMV interstitial pneumonia and tuberculosis, some cases were caused by two pathogens, and 11 episodes were noninfectious complications, including late-onset noninfectious pulmonary complications (LONIPCs) (n=9), pulmonary edema (n=1) and interstitial pneumonia (n=1). The overall mortality was 12.9%. Graft-versus-host disease (GVHD) prophylaxis without MTX, severe acute GVHD and extensive chronic GVHD were high risk factors for pulmonary complications and advanced disease at transplantation, extensive chronic GVHD were significantly associated with the incidence of LONIPCs.

CONCLUSIONPulmonary disease is the main complication occurred in patients undergoing allo-PBSCT. It is of greatly importance to treat pathogens specifically and diagnose LONIPCs in its early stage.

Adolescent ; Adult ; Female ; Graft vs Host Disease ; prevention & control ; Hematologic Diseases ; surgery ; Humans ; Lung Diseases ; etiology ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; adverse effects

OBJECTIVECombined methylmalonic acidemia with homocystinuria is a common form of methylmalonic acidemia in China. Patients with this disease can progress to death without timely and effective treatment. This study aimed to analyze the treatment outcomes of patients with combined methylmalonic acidemia and homocystinuria.

METHODFrom September 2004 to April 2012, 58 patients with combined methylmalonic acidemia and homocystinuria (34 males and 24 females) were diagnosed and treated in our hospital. Fifty cases were from clinical patients including 42 early-onset cases and 8 late-onset cases. Their age when they were diagnosed ranged from 18 days to 30.8 years. The other 8 cases were from newborn screening. All the patients were treated with vitamin B12, betaine, folic acid, vitamin B6, and L-carnitine. The physical and neuropsychological development, general laboratory tests, the levels of amino acids, acylcarnitines, and homocysteine in blood, and organic acids in urine were followed up.

RESULTThe follow-up period ranged from 1 month to 7.1 years. Three cases died (all were early-onset cases). In the other patients after treatment, the symptoms such as recurrent vomiting, seizures, lethargy, and poor feeding disappeared, muscle strength and muscle tension were improved, and general biochemical abnormalities such as anemia and metabolic acidosis were corrected. Among the surviving 55 cases, 49 had neurological impairments such as developmental delay and mental retardation. The median levels of blood propionylcarnitine and its ratio with acetylcarnitine, serum homocysteine, and urine methylmalonic acid were significantly decreased (P < 0.01), from 7.73 µmol/L (ranged from 1.5 to 18.61 µmol/L), 0.74 (ranged from 0.29 to 2.06), 97.3 µmol/L (ranged from 25.1 to 250 µmol/L) and 168.55 (ranged from 3.66 to 1032.82) before treatment to 2.74 µmol/L (ranged from 0.47 to 12.09 µmol/L), 0.16 (ranged from 0.03 to 0.62), 43.8 µmol/L (ranged from 17 to 97.8 µmol/L) and 6.81 (ranged from 0 to 95.43) after treatment, respectively.

CONCLUSIONPatients with combined methylmalonic acidemia and homocystinuria respond to a combined treatment consisting of supplementation of hydroxycobalamin, betaine, folic acid, vitamin B6 and L-carnitine with clinical and biochemical improvement. But the long-term outcomes are unsatisfactory, with neurological sequelae in most patients.

Adolescent ; Adult ; Amino Acid Metabolism, Inborn Errors ; blood ; diagnosis ; therapy ; Betaine ; administration & dosage ; therapeutic use ; Carnitine ; analogs & derivatives ; blood ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Homocystine ; blood ; Homocystinuria ; blood ; diagnosis ; therapy ; Humans ; Hydroxocobalamin ; administration & dosage ; therapeutic use ; Infant ; Infant, Newborn ; Male ; Methylmalonic Acid ; urine ; Neonatal Screening ; Treatment Outcome ; Vitamin B 12 ; administration & dosage ; therapeutic use ; Vitamin B 12 Deficiency ; congenital ; Young Adult

In order to get clinical information about safety and feasibility of successively double autologous hemopoietic stem cell transplants (SD-AHSCT) in malignant hematological disease patients, the complications and hematological reconstitution after SD-AHSCT in 20 patients were analyzed retrospectively. 20 patients with hematologic malignancies received autologous peripheral blood stem/progenitor cell transplantation at the first transplant, and then were given autologous bone marrow transplantation as the second transplant at 4-10 months. The results showed that all the patients tolerated mobilization and collection of peripheral blood stem/progenitor cells as well as bone marrow collection. All the patients got enough hematological stem/progenitor cells for SD-AHSCT and achieved hematological reconstitution after SD-AHSCT. The speed of hematological reconstitution was positively correlated with the transfused quantity of hematological stem/progenitor cells (r = 0.968). The hematological reconstitution after the first autologous hemopoietic stem cell transplant (AHSCT) was earlier than that of the second (P < 0.05). There was no statistical difference between the first and the second AHSCT for the incidence of skin or mucous membrane bleeding (P > 0.05). No patients occurred massive hemorrhage during SD-AHSCT. The quantity of platelet transfusion in the second AHSCT was larger than that in the first AHSCT (P < 0.01). The incidence of oral ulcer in the first AHSCT was significantly higher than that in the second (P < 0.01). No statistical difference between the first and the second AHSCT was there in infectious sites, infectious pathogens and infection incidence (P > 0.10). All the complications were improved or cured, and no patients died of SD-AHSCT complications. In conclusion, SD-AHSCT is safe and feasible, and worthy to be further popularized.
Adolescent ; Adult ; Female ; Hematologic Neoplasms ; surgery ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Male ; Oral Ulcer ; etiology ; Peripheral Blood Stem Cell Transplantation ; adverse effects ; methods ; Platelet Transfusion ; statistics & numerical data ; Reproducibility of Results ; Retrospective Studies ; Transplantation, Autologous