Objective To investigate the learning curve of CT-guided percutaneous lung biopsy.Methods Using cumulative sum(CUSUM)analysis method,the clinical data from 110 patients,who underwent CT-guided percutaneous lung biopsy performed by the same physician at the First Affiliated Hospital of Zhengzhou University of China between May 2024 and October 2024,were retrospectively analyzed.The CUSUM learning curve was fitted,and R2 was used to assess the goodness of fit.The baseline and perioperative data were compared between different stages of the learning curve so as to determine the number of accomplished surgical cases that was required for a physician to reach the proficiency stage from the learning stage in performing CT-guided percutaneous lung biopsy.Results Successful CT-guided percutaneous lung biopsy was accomplished in all patients,with a mean operation time of(20.2+3.4)minutes(range of 15-29 minutes).With the accumulation of surgical cases,the operation time showed a gradual downward trend.The learning curve was best fitted with a cubic equation,the equation was as follows:CUSUM(110)=0.000 3x3-0.081 3x2+5.597 9x+0.774 3(where x representing the number of cases),with a goodness-of-fit coefficient R2=0.991.The fitted curve reached its peak at the performance of the 46th case,which was used as the cutoff point to divide the learning curve into two phases.Compared with the learning phase,in the proficiency phase the incidence of complications was significantly lower(pneumothorax:18.8％vs 37.0％,P=0.033)and the mean operation time was obviously shorter[(18.33+2.31)min vs(22.80±3.02)min,P＜0.001].Conclusion Through precise CUSUM analysis of the learning curves obtained from 110 patients receiving CT-guided percutaneous lung biopsy,the results of this study indicates that it requires to accomplish 46 operations before a physician can skillfully master the technique of CT-guided percutaneous lung biopsy.

Objective:To explore the urodynamic characteristics of bladder function in patients with abnormal urination after radical hysterectomy of cervical cancer.Methods:In a prospective self-controlled study, a total of 84 patients with cervical cancer and clinical stage of ⅠB to ⅡA, meeting the preoperative inclusion criteria in our hospital from January 2016 to June 2018 were enrolled.All patients were tested for urodynamic testing 1 week before and 6 months after surgery.Patient bladder function status was observed and evaluated before and after surgery and urodynamic examination results were analyzed.Results:Of 84 study cases, the 58 patients developed abnormal urination after radical surgery, there were no urination abnormalities in 26 cases.There was no significant difference in age, clinical stage and pathological diagnosis between patients with and without urination abnormalities.Abnormal urination after radical surgery included difficulty in urinating(55%), frequent urination with a feeling of urination not complete(34%), stress urinary incontinence(7%), and urinary incontinence(4%). Among the 26 patients without urination abnormalities after radical surgery, only one case showed an abnormal urodynamic examination(abnormal bladder sensation). In patients without abnormal urination after surgery, differences in the urodynamic examination findings between pre-and post-surgery were not statistically significant(all P> 0.05). At the same time, in all cases of abnormal urination after radical hysterectomy of cervical cancer, 43 patients(74%)with bladder dysfunction had normal urination pattern before operation, but after operation, the urination abnormality required abdominal pressure.Of the patients with bladder dysfunction after surgery, the maximum flow rate(Qmax)was(12.9±10.3)ml/s, the average flow rate(Qave)was(6.0±4.2)ml/s, the voided volume was(148.0±36.8)ml, voiding time was(32.9±22.1)s, maximum flow time was(11.4±5.0)s, postvoid residual urine was(260.2±219.2)ml, maximal detrusor pressure was(12.1±8.9)cmH 2O, bladder compliance was(16.1±4.3)ml/cmH 2O, normal desire to void was(354.5±204.3)ml, maximal capacity was(587.4±152.5)ml, maximum urethral pressure was(97.6±33.1)cmH 2O, maximum urethral closure pressure was(89.9±36.4)cmH 2O, and function urethral length was(29.6±6.5)mm; In comparison, the above indexes-corresponding values at 1 week before surgery were respectively as follows: the Qmax was(25.1±11.4)ml/s, the Qave was(11.4±6.6)ml/s, the voided volume was(318.6±96.4)ml, voiding time was(29.2±18.5)s, maximum flow time was(6.7±3.9)s, postvoid residual urine was(29.9±21.5)ml, maximal detrusor pressure was(31.9±21.4)cmH 2O, bladder compliance was(78.1±33.9)ml/cmH 2O, normal desire to void was(258.2±185.5)ml, maximal capacity was(335.1±124.9)ml, maximum urethral pressure was(96.4±33.9)cm H 2O, maximum urethral closure pressure was(88.5±35.2)cmH 2O, and function urethral length was(37.2±7.2)mm.It can be seen that Qmax, Qave, voided volume, maximum detrusor pressure, bladder compliance, and functional urethral length in patients with abnormal urination are significantly lower after radical hysterectomy of cervical cancer than before the surgery.While, normal desire to void, maximum capacity, maximum flow time, and postvoid residual urine volume were higher after radical hysterectomy than before surgery( P<0.05). In addition, there was no significant difference in voiding time, maximum urethral pressure and maximum urethral closure pressure between pre-and post-operation.Besides, it is worth noting that there was no significant difference in preoperative urodynamic test results between patients without abnormal urination versus patients with abnormal urination( P>0.05), and the difference in urodynamic test results between the two groups is statistically significant( P<0.05). There was no statistically significant difference in abnormal urination and in urodynamic test results between different clinical stages and between different pathological types( P>0.05). Conclusions:The characteristics of urinary dynamics in patients with abnormal urination after radical hysterectomy of cervical cancer are mainly manifested as decreased bladder sensory function and abnormal detrusor function.And the urodynamic test can provide objective clinical indicators for early diagnosis.

Objective To explore the clinical significance of large spontaneous portosystemic shunts (L-SPSS) in Budd-Chiari syndrome (B-CS).Methods Clinical data of 382 B-CS patients treated at the First Affiliated Hospital of Zhengzhou University from Apr 2012 to Dec 2018 were analyzed retrospectively and we included 32 patients with B-CS complicated L-SPSS (diameter ＞ 8 mm).65 patients without L-SPSS were selected randomly to form the control group.The correlation between L-SPSS and liver function,upper gastrointestinal bleeding,ascites,hepatic encephalopathy,inferior vena cava thrombosis,portal vein diameter and splenic vein diameter were analyzed.Results TBil,Child-Pugh scores,incidence of hepatic encephalopathy,ascites and inferior vena cava thrombosis in the B-CS complicated L-SPSS group were higher than that in the B-CS without L-SPSS group.The percentage of Child-Pugh grade B and C patients in the B-CS complicated L-SPSS group were also higher than that in the B-CS without L-SPSS group.The level of ALB and hepatic volume per unit surface area were both significantly less in the experimental group.(P ＜0.05).There were no statistics differences in incidence of upper gastrointestinal bleeding and MELD scores between the two groups (P ＞ 0.05).Conclusions For those B-CS patients complicated L-SPSS,hepatic encephalopathy and ascites are more frequent,and they usually have poorer liver function.

Objective To observe the efficacy of traditional Chinese medicine and intertrochanteric combination thera-py fractures. Methods From January 2009 to January 2011 in our hospital,100 cases of intertrochanteric fracture pa-tients were randomly divided into observation group and control group,50 cases in each group,the two groups were performed within PFNA fixed,observation group were simultaneously combined traditional Chinese medicine treatment,after treatment,the fracture healing time,Harris hip score,incidence of complications of two groups were compared. Results After treatment,the excellent rate of observation group was 86%,was significantly higher than the control group of 72%,the difference was statistically significant (χ2=4.127,P<0.05).The fracture healing time of observation group was significantly shorter than the control group,but Harris hip score of t observation group patients was significantly higher than the control group,the difference was statistically significant (P<0.05).The complication rate of observation group was 10%,was significantly lower than the control group of 26%,the difference was statistically significant (χ2=11.348,P<0.05). Conclusion Integrative treatment of intertrochanteric fractures with good effect,can promote healing,significantly improve hip function in patients,reduce the incidence of complications,should be promoted and applied.

OBJECTIVE: To investigate the clinical characteristics of nasopharyngeal teratomas (NPT), improve the diagnosis and treatment of the disease. METHOD: We reported a 14 years old girl with NPT, and reviewed the literatures. RESULT: NPT was transorally expected under nasal endoscope, no recurrence was found over a 5 year follow-up. CONCLUSION NPT is rare,the diagnosis of the disease relies on clinical manifestations, imaging and pathological examination. Transoral endoscopic surgery is an effective method of treatment.
Adolescent ; Female ; Humans ; Nasopharyngeal Neoplasms ; Teratoma