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【Objective】 To evaluate the safety and efficacy of modified ultrasound-guided needle-like visible nephroscope (Needle perc) holmium laser lithotripsy in the treatment of 1-2 cm calyceal calculi, and provide a reference for the selection of clinical treatment methods. 【Methods】 The clinical data of 60 patients with single intrarenal calyceal calculi (the largest diameter 1~2 cm) treated in our hospital during Jan.2022 and May 2023 were retrospectively analyzed.The patients were divided into ureteroscopic holmium laser lithotripsy group (flexible ureteroscope group) and Needle perc group, with 30 patients in either group.The clinical data of the two groups were compared. 【Results】 Compared with the flexible ureteroscope group, the Needle perc group had shorter overall hospitalization time [(3.00±1.25) d vs. (4.00±1.25) d], shorter operation time [(44.63±5.42) min vs. (48.50±7.24) min], lower hospitalization expenses [(15 518±441) yuan vs. (16 872±903) yuan], higher stone-clearance rate [93.3% (28/30) vs. 50.7% (15/30), P<0.001], less increase of procalcitonin after operation [(0.02±0.01) vs. (0.12±0.18), P=0.007], and lower incidence of complications [3.3% (1/30) vs. 26.7% (8/30), P=0.030]. 【Conclusion】 The modified ultrasound-guided Needle perc holmium laser lithotripsy is safe and effective in the treatment of 1-2 cm lower calyceal calculi, with high stone removal rate and low complication rate.
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Objective To investigate the clinical application value of transrectal real-time tissue elastography(TRTE)guided targeted puncture in the diagnosis of prostate cancer.Methods A total of 52 patients with suspected prostate cancer who were treated in the First People's Hospital of Zhengzhou from January 2020 to December 2022 were selected as the study objects.Preoperative routine transrectal ultrasound and TRTE examination were performed to evaluate the benign and malignant prostates.For the 28 patients with suspected lesions found in TRTE,TRTE-guided targeted puncture(2 needles)+ systematic puncture(8 needles)were performed,for the 24 patients with no suspicious lesions found in TRTE,routine ultrasound-guided systematic puncture(12 needles)was performed.The efficacy of TRTE in the diagnosis of prostate cancer was analyzed and the positive rate of targeted puncture and systematic puncture was compared.Results In this study,25 cases of prostate cancer and 27 cases of benign lesions were ultimately pathologically diagnosed,while a total of 28 cases of prostate cancer and 24 cases of benign lesions were diagnosed with TRTE.The positive predictive value and negative predictive value of the diagnosis were 75.0%(21/28)and 83.3%(20/24),respectively.In 28 patients with suspected lesions found by TRTE,a total of 56 needles were targeted puncture,36 needles were diagnosed with prostate cancer,positive rate was 64.29%(36/56),and a total of 224 needles were systematic puncture,89 needles were diagnosed with prostate cancer,with a positive rate of 39.73%(89/224).The positive rate of prostate cancer by targeted puncture was significantly higher than that by systematic puncture(P<0.05).Conclusion TRTE can better diagnose prostate cancer,and its guided targeted puncture has a higher positive rate in the diagnosis of prostate cancer,which can maximize the positive rate of puncture while reducing the number of puncture needles.
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BACKGROUND@#Xuanwei and Fuyuan are rural counties, located in the late Permian coal poly area of eastern Yunnan and western Guizhou, where lung cancer mortality rates are among the highest in the China, with similarity for both men and women, younger age at diagnosis and death, and higher in rural areas than in urban areas. In this paper, long-term follow-up of lung cancer cases in local peasants was conducted to observe their survival prognosis and its influencing factors.@*METHODS@#Data of patients diagnosed with lung cancer from January 2005 to June 2011, who had lived in Xuanwei and Fuyuan counties for many years, were collected from 20 hospitals at the local provincial, municipal and county levels. To estimate survival outcomes, individuals were followed up until the end of 2021. The 5-year, 10-year and 15-year survival rates were estimated using the Kaplan-Meier method. Survival differences were examined with Kaplan-Meier curves and Cox proportional hazards models.@*RESULTS@#A total of 3,017 cases were effectively followed up (2,537 peasants and 480 non-peasants). The median age at diagnosis was 57 years, and the median follow-up time was 122 months. During the follow-up period, 2,493 cases (82.6%) died. The distribution of cases by clinical stage was as follows: stage I (3.7%), stage II (6.7%), stage III (15.8%), stage IV (21.1%) and unknown stage (52.7%). Treatment at the provincial, municipal and county-level hospitals accounted for 32.5%, 22.2% and 45.3%, respectively, and surgical treatment was performed in 23.3% of cases. The median survival time was 15.4 months (95%CI: 13.9-16.1), and the 5-year, 10-year and 15-year overall survival rates were 19.5% (95%CI: 18.0%-21.1%), 7.7% (95%CI: 6.5%-8.8%) and 2.0% (95%CI: 0.8%-3.9%), respectively. Peasants with lung cancer had a lower median age at diagnosis, higher proportion residing in remote rural areas, and higher use of bituminous coal as a household fuel. They also have a lower proportion of early-stage cases, treatment at provincial or municipal hospitals, and surgical treatment, leading to poorer survival outcomes (HR=1.57). Even when considering factors such as gender, age, residential location, clinical stage at diagnosis, histological type, hospital level of service, and surgical intervention, peasants still exhibit a survival disadvantage. Multivariable Cox model analysis comparing peasants and non-peasants reveals that surgical intervention, tumor-node-metastasis (TNM) stage, and hospital level of service are common factors influencing survival prognosis, while the use of bituminous coal as a household fuel, hospital level of service and adenocarcinoma (compared to squamous cell carcinoma) are independent prognostic factors for lung cancer survival among peasants.@*CONCLUSIONS@#The lower lung cancer survival rate among peasants is associated with their lower socioeconomic status, lower proportion of early-stage diagnoses, lower proportion of surgical interventions, and treatment at provincial-level hospitals. Furthermore, the impact of other factors such as high-risk exposure to bituminous coal pollution on survival prognosis requires further investigation.
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Male , Humans , Female , Lung Neoplasms/epidemiology , China/epidemiology , Adenocarcinoma , Carcinoma, Squamous Cell , CoalABSTRACT
@#Objective To explore the indications and clinical effects of simultaneous mandibular angleplasty on the unaffected side, performed using preformed titanium mesh combined with mandibular angle bone graft, for the treatment of hemifacial microsomia (HFM). Methods The study group included 11 patients between 2013 and 2021 with HFM who underwent simultaneous mandibular angle reduction of the unaffected side and augmentation of the affected side using resected bone scaffolds within the titanium mesh. A series of mandibular linear measurements such as ramus height(RH)and mandibular body length(BL), angular measurements, and asymmetry index combined with clinical photographs and postoperative complications were used to assess the therapeutic effect. Results Postoperatively, all patients were satisfied. Significant improvement in mandibular contour was shown, with no obvious complications. Postoperative data, such as BL and angular measurements, showed no statistically significant differences(P>0.05) between the affected and unaffected sides with improvement in symmetry, except for RH(P<0.05). The preoperative and postoperative asymmetry index were (17.11±4.56)% and (4.81±1.73)%, respectively, with significant improvement(P=0.002). Conclusion This approach provides satisfactory results and significantly improves facial asymmetries for unilateral HFM with hypertrophy of the contralateral mandibular angle.
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BACKGROUND@#Lung cancer rates among women in rural Xuanwei and Fuyuan counties in eastern Yunnan province, China, are among the highest in the world, even though almost all women are non-smokers, and they tend to develop lung cancer at a younger age than other locations by roughly 5 yr-10 yr. This study investigated the survival of lung cancer patients among female never-smokers.@*METHODS@#The female never-smokers, who had lived for many years in Xuanwei and Fuyuan counties, with lung cancer newly-diagnosed between July 2006 to March 2010, were followed up through the end of 2016. Age-standardized relative survival for all cases was calculated using local life table. The Kaplan-Meier method and Log-rank test were used to analyze the relationship between the variables and the prognosis in univariate analysis. Cox regression analysis was employed in the multivariate analysis.@*RESULTS@#Among 1,250 total subjects, 1,075 died and the remaining 175 were censored during the follow-up, with a median follow-up period of 69 months (95%CI: 61.9-76.0). Overall, the mean age was (54.8 ±10.9) yr, with variable clinical stages: 3.5% of cases were stage I, 8.7% stage II, 20.7% stage III, 29.7% stage IV, and 37.4% stage unknown. The 645 patients(51.6%) with cyto-histological diagnosis contains 303 with Squamous cell carcinoma, and 231 with adenocarcinoma, 24 with small cell, 43 with other specified type and 39 with unknown histological type. Only 215 (17.2%) patients received surgery, 487 (39.0%) were treated without surgery, and 548 (43.8%) did not receive any specific anticancer therapy. The 5-year observed survival rate and age-standardized relative survival were 8.9% (95%CI: 7.0-10.6), and 10.1% (95%CI: 3.7-20.5) respectively, with a median survival of 13.2 months. The 5-year survival rates were 41.1% for stage I, 22.4% for stage II, 5.3% for stage III, 1.3% for stage IV, 11.2% for missing stage, 17.9% for adenocarcinoma, and 5.6% for squamous cell carcinoma respectively. Surgery significantly improved 5-year survival rate compared with non-surgery (34.8% vs 3.2%, P<0.001). The patients with non-treatment, aged 65 years and older, living in rural areas and farmer with low socioeconomic status had poorer survival, whereas the patients treated in provincial hospitals and chest X-ray screening had better survival. Cox multivariate analysis further showed that stage of tumor-node-metastasis (TNM), treatment status, hospital-level, and X-ray screening were factors correlated with survival.@*CONCLUSIONS@#Patients with lung cancer among female never-smokers in Xuanwei and Fuyuan experience poorer survival, because they are less likely to be diagnosed at early stage, as well as less likely to receive surgery and comprehensive treatment. Furthermore low socioeconomic status and poor health security are also responsible for the low survival.
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Objective To discuss cause and treatment measures of the postoperative failed to fully automatic nail in patients with circumcision by disposable circumcision suture device, so as to improve the quality of the circumcision.Methods 182 cases received circumcision by disposable circumcision suture device were randomly selected from September 2014 to March 2015 in the hospital and divided into control group ( n =86 ) and treatment group (n=96).All the patients received oral antibiotics for three days conventionally.Patients in control group were dressing with 0.1%iodine after treatment, dressing change every two or three days, while the treatment group soaking with 30 mL to 40 mL compound prescription cortex phellodendri chinensis fluid for 15 min two times per day.The postoperative wound anastomosis nail loss effect in two groups were compared.Results The time of complete nail loss in patients soaking with compound prescription cortex phellodendri chinensis fluid was significantly shorter than that in patients dressing with 0.1% iodine (P<0.05), but there was no significantly difference of the first time to lose nail between two groups.The rate of complete nail loss in treatment group was 94 cases (97.9%), which was significantly higher than 68 cases (79.1%) in control group (χ2 =16.47,P<0.05). The adverse reactions were mild of two groups.Conclusion The compound prescription cortex phellodendri chinensis fluid has exact effect on postoperative wound anastomosis nail loss and recovery in patients’ with circumcision by disposable circumcision suture device.
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Objective:To introduce a 2-stage treatment protocol for the management of temporomandibular joint ankylosis with sec-ondary deformities in adults.Methods:24 adult patients (9 males and 15 female)(30 joints)at the average age of 26.1 years un-derwent TMJ reconstruction as the initial surgery,followed by orthodontic treatment and correction of secondary deformities as the sec-ond surgery.Clinical outcome was assessed based on maximal incisal opening,radiography and medical photography.Results:Skele-tal deformities were significantly improved in all patients,satisfactory occlusion was achieved with the orthodontic treatment,average maximal incisal opening increased from 3.4 mm to 32.5 mm(P <0.05).Conclusion:The 2-stage treatment protocol is an effective approach for management of TMJ ankylosis with secondary deformities in adult patients.
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Objective To discuss the cause of the postoperative complications, prevention and treatment measures of circumcision with disposable circumcision suture device, so as to reduce the incidence of postoperative complications, further improve the quality of the circumcision. Methods A total of 111 patients undergoing circumcision with dispos-able circumcision suture device were included. Complications and the satisfaction of the post-operative appearance were evaluated. Results The total rate of postoperative complications was 8.1%(9/111). The complications were infec-tion 1.8%(2/111),bleeding 6.3%(7/111),without wound dehiscence and penile edema. Conclusion Circumcision with disposable circumcision suture device has the advantages of fewer complications, and higher satisfied postoperative ap-pearance of the penile. Most of the complications can be treated with conservative management.
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Objective To study MR imaging features of dysembryoplastic neuroepithelial tumors (DNET). Methods MRI ap-pearances of 10 patients with surgery and pathology proved DNET were analyzed retrospectively. All of 10 patients underwent routine and contrast-enhanced MRI. Results All lesions were located in the regions near the surface of brain,including frontal lobe (4 ca-ses) ,parietal lobe (4 cases),temporal lobe (1 case) and parietoinsular lobe (1 case). The lesions appeared as sector in 4 cases, re-versed triangle in 4 cases,irregularity in 2 cases. Homogeneous or heterogeneous long T_1 and long Tz signal intensity were seen on MR imaging. The lesion showed predominant cystic component and septa, no obvious mass effect and peritumoral edema could be found in all cases. Bone thinning of the adjacent calvaria could be seen in 6 cases. On post contrast MRI scan,the lesions had no obvi-ous enhancement in 6 cases ,while mild enhancement could be found in the intra-tumorous solid nodule or septations in 4 cases. Conclusion DNETs are of certain clinical manifestations and MRI features,it is helpful for preoperative diagnosis of DNET.
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@#ObjectiveTo explore the effect of left move and twists of I/t curve on predicting prognosis of facial paralysis.Methods181 cases with 171 Bell's palsy and 10 Hunt's syndrome were examined with I/t curve of frontal muscle and upper orbicularis. The assessing criterion of diseases course was determined according to the recovery time of frontal muscle evaluated by raising eyebrow, the recovery time of orbicularis ascertained by House-Brackmann Ⅰ, Ⅱ grades and stable phase in partial moderate and severe facial paralysis.ResultsThe recovery time of frontal muscle and orbicularis between twist and non-twist in I/t curve and in sex was not significant. The left move of I/t curve was confined to slight, moderate and severe arranges; the recovery time was not significant also. Twist rate in I/t curve was highest in moderate facial paralysis and then second in orbicularis of slight paralysis. The left move of I/t curve had a very significant relationship with recovery time of frontal muscle and orbicualris.ConclusionThe left move of I/t curve plays a very important role in determining nerve injury degrees and predicting prognosis of facial paralysis.
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@#ObjectiveTo observe the effect of ultrashort wave and acoustic frequency on chronic pelvic inflammation.Methods183 patients diagnosed as chronic pelvic inflammation were randomly divided into two groups. Group A(n=80) was treated with ultrashort wave and group B (n=103) was treated with ultrashort wave and acoustic frequency current.ResultsThe clinical cure rates were 1.25% in group A and 15.33% in group B; the efficiency rates were 91.25% in group A and 97.09 % in group B; there was a significant difference between two groups (P<0.01).ConclusionThe effect of ultrashort wave and acoustic frequency current on chronic pelvic inflammation is better than that of single ultrashort wave.
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@#ObjectiveTo observe the easing pain effect of being used Guishen Pain-Killer, a Chinese medicine, for improving the anaesthesia project which was used in using micro-wave heating among tissue to treat hemorrhoid.MethodsOn the basic of the original anaesthesia project, patients drunk the Chinese medicine Guishen Pain-Killer 50ml which was heated to 40℃ by microwave stove for pre-anaesthesia drug 10 minutes before the operation. The effect of adding drinking Guishen Pain-Killer and of merely using the original anaesthesia project were estimated with the McGill Questionnaire and stated the data with u test.ResultsThe pain estimation of those patients who drunk Guishen Pain-Killer before operation was (1.71±1.05) and (1.32±0.83), in operation and just after operation,while that of patients who didn't drink Guishen Pain-Killer before operation was (2.58±1.03) and (1.93±1.11),P<0.01.ConclusionGuishen Pain-Killer can be used as the pre-anaesthesia drug in micro-wave heating among tissue to treat hemorrhoids.
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@#ObjectiveTo observe the effect of low frequency current hydroelectric bath therapy modulated by medium frequency on sequela of sprain of ankle. Methods46 patients with sequela of sprain of ankle were treated with ZM C intellectual faculties intermediate frequency therapeutics instrument. Medium frequency was modulated with full square wave. The frequency of carrying wave was 4KHz. The frequency of modulated wave was 100Hz. The depth of modulation was 80%. The water temperature was 40℃.ResultsAfter treatment, all patients got satisfactory effect and shorter treating course without adverse reactions appearing. Conclusions The low frequency current hydroelectric bath therapy modulated by medium frequency is a simple, safe and better treating method for sequela of sprain of ankle.
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<p><b>OBJECTIVE</b>To study the biomechanical properties of the new bone generated by mandibular distraction osteogenesis (DO).</p><p><b>METHODS</b>A total of 11 healthy adult goats were randomly divided into 2 groups, the experimental group (n=9) and the control group (n=2). For the goats in the experimental group, the bilateral mandibles were gradually lengthened for 10 mm with distraction appliances. Three goats were sacrificed respectively at 2, 4 and 8 weeks after completion of distraction. Compressive, three-point bending and shearing tests were conducted on the standard regenerated bone samples and the whole unilateral mandibular specimens. For the goats in the cont rol group, no operation was made and the whole unilateral mandible was taken as the test specimen.</p><p><b>RESULTS</b>The compressive strength and bending stiffness of the new bone reached the normal level at 4 and 8 weeks after completion of distraction, respectively. But the shearing strength remained significantly weaker than that of the controls at 8 weeks after distraction.</p><p><b>CONCLUSIONS</b>The distraction appliance can be removed and the lengthened mandible should be exposed to adaptive functional exercise at 8 weeks after completion of distraction.</p>
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Animals , Male , Biomechanical Phenomena , Bone Regeneration , Physiology , Goats , Mandibular Advancement , Models, Animal , Osteogenesis, Distraction , Probability , Random Allocation , Reference Values , Tensile StrengthABSTRACT
Objective:To study the spatial and temporal features of p roliferating vessels during mandibular distraction osteogenesis. Methods :Bilateral mandibles of twelve adult goats were lengthened by 10 mm wit h a custom-made distractor at 1 mm/d, two animals were killed at each intervals . Two additional goats were used as normal control. SEM microvascular corrosion casting was used to examine the spatial and temporal features of proliferative v essels within distraction gap. Results:During distraction perio d, numerous vessels from bone marrow and periosteum were regenerated into distra ction gap and began to form vascular network. In the early phase of fixation per iod, the orientation of vein sinus was in accord with distraction orientation. A long with the time, more vessles were connected, regeneration of vessels vanishe d, and the vascular system within distraction gap became more mature.Con clusion:Angiogenesis during DO is closely related to the osteogenesis; the blood supply of new bone in distraction gap is from both bone marrow and per iosteum.
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objective: To observe the changes in the bilateral condyles after unilateral mandibular lengthening with distraction osteogenesis. Methods: Unilateral mandibular osteodistraction (DO) was performed in 8 goats. 4 animals were sacrificed at 8 and 16 weeks after completion of distraction respectively. The TMJ specimens were harvested and processed for histologic, histomorphometric and scanning electron microscopic (SEM) examinations. Results: Reversible adaptive remodeling in the condyles was observed following mandibular distraction at a rate of 1 mm/d. No degenerative changes in the TMJs were found after mandibular lengthening. Conclusion: Gradual distraction at a rate of 1 mm/day may not lead to degenerative change in condylar cartilage.