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Objective To evaluate the safety and efficacy of tabularized urethral plate disassembly for epispadias repair in infant.Methods From January 2016 to September 2018,10 boys aged between 18 to 36 months old with mishaft epispadias were included.The main complaint was that the urethral opening was found on the dorsal side of the penis.Preoperative cystography revealed that 3 of them had unilateral vesicoureteral reflux (Grade Ⅰ),and white blood cells in routine urinary in all 10 patients were negative.Physical examination:the penis is short and flat,the width is 17-25 mm,average is 20.7 mm,the penis curvature is 15°-30°,average is 21.5°,and the urethral opening located on the dorsal side of the penis.The anesthesia method was selected for tracheal intubation,intravenous anesthesia combined with caudal anesthesia,and the surgical position was supine position.The surgical method:one stage of tabularized urethral plate disassembly urethroplasty:during the operation,the penile curve was corrected by free urethral plate and penile degloving.Two of them were unsatisfied with the correction of the curvature,and the ventral tunica folded was applicate.To avoid urethral plate ischemia,attention should pay to blood supply protection.The two corpus cavernosum are separated in the root,and the urethra is completely displaced to the ventral side of the cavernous body.The ventral side of the urethral under glans is shaped into a fissured that conforms to the anatomy.The prognosis and surgical choice of the midshaft epispadias were discussed combined with literature.Result The operation time was 130-200 min with an average of 157 mins.Intraoperative hemorrhage 5-30 ml,average is 16 ml,1 case of glans skin was black one day after surgery,with enhanced dressing change.After 1 month,the glans was local atrophy and scar formation.No skin incision infection case.After discharge from the hospital,the follow up through the internet and outpatients for 3-40 months,average is 21 months,2 cases with urethral fistula,more surgery to repair the fistula successfully after 6 months.The penile curvature was corrected in 8 cases,and the residual curvature of 2 cases was about 10-15°,which was temporarily observed.Patients with unilateral vesicoureteral reflux preoperatively,they still suffered from vesicoureteral reflux in the 6-12 months regular review after surgery without any intervention due to white blood cell was negative in urine routine.All cases had urinary patency and no cases with urethral stricture.Conclusion Tubularized urethral plate disassembly is a effective and simple procedure that can correct the midshaft epispadias in infant.
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Objective@#To evaluate the safety and efficacy of tabularized urethral plate disassembly for epispadias repair in infant.@*Methods@#From January 2016 to September 2018, 10 boys aged between 18 to 36 months old with mishaft epispadias were included. The main complaint was that the urethral opening was found on the dorsal side of the penis. Preoperative cystography revealed that 3 of them had unilateral vesicoureteral reflux (Grade Ⅰ), and white blood cells in routine urinary in all 10 patients were negative. Physical examination: the penis is short and flat, the width is 17-25 mm, average is 20.7 mm, the penis curvature is 15°-30°, average is 21.5°, and the urethral opening located on the dorsal side of the penis. The anesthesia method was selected for tracheal intubation, intravenous anesthesia combined with caudal anesthesia, and the surgical position was supine position. The surgical method: one stage of tabularized urethral plate disassembly urethroplasty: during the operation, the penile curve was corrected by free urethral plate and penile degloving. Two of them were unsatisfied with the correction of the curvature, and the ventral tunica folded was applicate. To avoid urethral plate ischemia, attention should pay to blood supply protection. The two corpus cavernosum are separated in the root, and the urethra is completely displaced to the ventral side of the cavernous body. The ventral side of the urethral under glans is shaped into a fissured that conforms to the anatomy. The prognosis and surgical choice of the midshaft epispadias were discussed combined with literature.@*Result@#The operation time was 130-200 min with an average of 157 mins. Intraoperative hemorrhage 5-30 ml, average is 16 ml, 1 case of glans skin was black one day after surgery, with enhanced dressing change. After 1 month, the glans was local atrophy and scar formation. No skin incision infection case. After discharge from the hospital, the follow up through the internet and outpatients for 3-40 months, average is 21 months, 2 cases with urethral fistula, more surgery to repair the fistula successfully after 6 months. The penile curvature was corrected in 8 cases, and the residual curvature of 2 cases was about 10-15°, which was temporarily observed. Patients with unilateral vesicoureteral reflux preoperatively, they still suffered from vesicoureteral reflux in the 6-12 months regular review after surgery without any intervention due to white blood cell was negative in urine routine. All cases had urinary patency and no cases with urethral stricture.@*Conclusion@#Tubularized urethral plate disassembly is a effective and simple procedure that can correct the midshaft epispadias in infant.
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Objective To investigate the clinical effectiveness of foam sclerotherapy for lower extremity varicose vein with deep venous valve incompetence.Methods A retrospective study was carried out in 124 patients (185 limbs) receiving foam sclerotherapy in our department.Sixty-one limbs diagnosed as deep venous valve incompetence were categorized as the observation group,while 124 limbs without that were the control group.The main outcome were success rate,remission rate of various symptoms and signs,the scores of CEAP and CIVIQ.Results The follow up rate was 69.3％,and the follow-up period ranged from one to nine months.There was no statistical difference in the success rate between the observation group (93.4％) and control group (94.4％)(P＞0.05).However,the symptom of heaviness and oedema and the CIVIQ scores in observation group be inferior to the control group,and the difference of them were statistically significant (P＜0.05).Conclusion Deep venous valve incompetence could not decrease the success rate of foam sclerotherapy,but may influence the remission of some symptoms.It should be supplemented with medical elastic stockings or ringing of femoral veins.
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Objective To observe the curative effect and safety of operation combined with recombinant human erythropoietin on patients with severe intracerebral hemorrhage. Methods Seventy-six surgery patients with severe intracerebral hemorrhage were divided into rHu-EPO group (40 cases) and control group (36 cases) by random digits table method. The rHu-EPO group was injected subcutaneously with rHu-EPO, and the control group was treated with placebo. Neurologic impairment (National Institute of Health Stroke Scale, NIHSS score) and activities of daily living (Barthel index) were evaluated 1 month and 3 months after treatment respectively. Moreover, blood pressure, hemoglobin, and adverse reaction were also observed. Results The scores of NIHSS and Barthel index in two groups before treatment had no significant differences (P>0.05). One month and 3 months after treatment, the scores of NIHSS and Barthel index in rHu-EPO group were significantly better: (12.27±5.26) scores vs. (15.36±4.34) scores and (8.17±2.40) scores vs. (13.90±2.54) scores, (54.36±21.87) scores vs. (43.47±20.29) scores and (69.71±23.08) scores vs. (52.56±21.32) scores, there were statistical differences(P0.05). There were no apparente adverse reactions such as fever, erythra, itching and deep venous thrombosis in rHu-EPO group. Conclusions Operation combined with recombinant human erythropoietin has nerve protective effect, and might be an effective and safe therapy target in severe intracerebral hemorrhage.
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Objective:To study the influence of different dietary patterns in hypertension, and to provide references for establishing a healthy dietary pattern, improving the abnormal blood pressure, preventing the early hypertension and controlling the high blood pressure.Methods:Random cluster sampling was adopted to analyze the dietary,examine the physical situations,and measure the blood pressures among 1 394 residents of Han nationality and Korean nationality aged from 40 to 80 years old from 8 villages in Jinlin Province from 2010 to 2011.Factor analysis was used to establish the dietary patterns and to analyze the effects of different dietary patterns on the prevalence of hypertension.Results:The prevalence of hypertension of middle aged and elderly people in the rural areas of Jilin Province was 35.3%.4 dietary patterns were obtained through factor analysis,including salted product dietary pattern,alcohol dietary pattern,condiments dietary pattern and high protein dietary pattern.By multivariate Logistic regression analysis and adjustment of the age,the gender,the nationality,the education and the career background, alcohol dietary pattern was positively correlated with the occurrence of the hypertension (OR=1.43,95%CI 1.07-1.90).Conclusion:Alcohol dietary pattern is closely related to the hypertension. Long-time large amount of alcohol is a risk cause for high blood pressure. Reducing alcohol consumption and developing healthy diet habits can help to prevent hypertension.
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Objective To observe the short-term curative effect and safety of recombinant human erythropoietin(rHu-EPO)on patients with primary brain stem injury. Methods Sixty patients with primary brain stem injury were recruited at Liaocheng People' Hospital from July 2010 to July 2013. All cases were randomly divided into EPO group and control group. The patients in EPO group were injected subcutaneous with rHu-EPO five times at dose of 6 000 U,while patients in the control group were treated with placebo in 2 weeks. All other conventional treatments were the same. NIHSS score and GOS score were evaluated in two weeks and three months respectively. Moreover,blood pressure and hemoglobin were also measured. Results NIHSS score in EPO group was 11. 37 ± 7. 78,significant higher than that of control group after two weeks(19. 41 ± 8. 26,P = 0. 019). GOS score in EPO group was also significant differences in two groups after three months (Z = - 2. 367,P = 0. 009 ). However,no significant difference was observed in the followed-up blood tests. Conclusion Recombinant human erythropoietin could be the exact nerve protective effect,and might be an effective therapy for patients with primary brain stem injury.
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Objective To summarize clinical diagnosis and microsurgical treatment method of cerebellopontine angle epidermoid cyst presenting with trigeminal neuralgia.Methods Thirty-seven cases of cerebellopontine angle epidermoid cyst presenting with trigeminal neuralgia treated by microneurosurgery procedure were analyzed retrospectively.Results Complete resection was achieved in 31 cases,and subtotal was achieved in 6 cases,with no operative mortality.Postoperatively,the symptom of trigeminal neuralgia disappeared in 28 cases,was eased obviously in 6 cases,and was eased in 3 cases.The symptom of dizziness in all 6 cases vanished,and hearing in 3 cases was improved.Three cases appeared cerebrospinal fluid leakage,and 4 cases appeared oral herpes.Symptom in 1 case aggravated after 6 months,and oral medicine was ineffective.The pain symptom disappeared after reoperation.Conclusions The suboccipital retrosigmoid approach microneurosurgery is the principal treatment method for cerebellopontine angle epidermoid cyst presenting with trigeminal neuralgia.Microsurgical technique combined with surgical skill is the guarantee for increasing total removal rate of tumors and decreasing complications.
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Objective To understand the prevalence of hypertension and selenium intake of the residents in rural areas of Jilin province,and to discuss the relationship between selenium intake and the prevalence of hypertension, and to provide reference for prevention and therapy of hypertension.Methods A total of 1 380 inhabitants in rural areas of Jilin province were selected by way of cluster sampling to conduct dietary investigation,physical and blood examination.The selenium intake was categorized into three groups according to tritiles after adjusted by energy, and the relative risk for incidence of hypertension in each group was estimate by using the Logistic regression model with the first group as the reference.Results The prevalence of hypertension in the study area was 37.4%.The average for selenium intake was 35.908μg·d-1 and was lower than the standard level of selenium recommended by RNI.After adjustment for other risk factors,the relative risk for incidence of hypertension for different selenium intakes in the men was 1.00,0.471(95%CI 0.290-0.765),and 0.596(95%CI 0.373-0.951),the P values were 0.002 and 0.030. There was no significant relationship between selenium intake and the incidence of hypertension in the women,and there was also no significant relationship between Han people and Korean people in China.Conclusion The selenium intake is the influencing factor affecting the incidence of hypertension of the male rural residents in Jilin province,which reminds that the increasing selenium intake is helpful for the prevention of male hypertension.
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Objective To observe influence of continuous lumbar cistern drainage on levels of amyloid β-peptide (Aβ) subtype (Aβ1-42) in cerebrospinal fluid and plasma in patients with diffuse axonal injury (DAI) and investigate its clinical significance.Methods Eighty-one DAI patients were enrolled and randomized into treatment group (42 cases) and control group (39 cases).Patients in control group received simple conventional therapy,while the patients in treatment group received not only conventional therapy but 14 days of continuous lumbar cistern drainage.Levels of Aβ1-42 in cerebrospinal fluid and plasma were detected by ELISA assay before therapy and at 1,5,9,and 14 days after therapy.Prognosis was assessed using GOS at 6 months after therapy.Results Levels of Aβ1-42 in cerebrospinal fluid and plasma showed a decrease in the first place and a gradual decrease afterwards in both groups,but a bigger and earlier drop of Aβ1-42 levels was observed in treatment group.Two groups showed significant difference of Aβ1-42 levels at day 14 (P ＜ 0.05).At 6 months after therapy,GOS score between treatment and control groups was (4.1 ± O.5) and (3.4 ± 0.3) points respectively (P ＜0.05).Conclusion Continuous lumbar cistern drainage improves the prognosis of DAI and this may relates to the decrease of Aβ1-42 levels in cerebrospinal fluid and plasma.
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ObjectiveTo explore the short-term curative effect and safety of autologous bone marrow mesenchymal stem cells transplantation in patients with primary brain stem injury.MethodsFifty-four cases with primary brain stem injury were hospitalized during Jul.2007 to Jul.2010 at Liaocheng Brain Hospital,Shandong Province.All cases were randomized into transplantation group( n =30)or control group( n =24 ).The transplantation group was treated with autologous bone marrow mesenchymal stem cell transplantation by subarachnoid space injection (n =30).The control group were selected from primary brain stem injury patients without stem cell transplantation who were hospitalized at the same period with patients from the transplantation group.Respectively,National Institutes of Health Stroke Scale (NIHSS) score was employed to evaluate the condition of patients in the two groups one month after treatment,and Glasgow Outcome Scale (GOS) score was used to evaluate curative effects of the two groups at sixth months after treatment.Meanwhile,some other parameters were observed,including blood routine,clotting mechanisms,biochemicalitemsand tumor markers.ResultsThere was significant difference between the transplantation group and the control group in N IHSS score at one month after treatment [ ( 10.86 ± 7.48) vs.( 18.26 ± 8.74),t =2.681,P ＜ 0.05 ].GOS score was significantly different( Z =2.306,P ＜ 0.05 ) between the transplantation group and the control group at sixth month after transplantation.There was no significant difference between the two groups in the blood examination results during the followed-up period.Conclusion Autologous bone marrow mesenchymal stem cells transplantation is confirmed to be an effective and safe therapy in patients with primary brain stem injury in the short-term.Further evaluation still needs for its long-term efficacy on primary brain stem injury
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ObjectiveTo compare the short-term efficacy and safety of autologous bone marrow mesenchymal stem cells transplantation on patients with early spinal cord injury by subarachnoid injection and by intravenous injection.MethodsNinety-six patients with early spinal cord injury were hospitalized and treated from November 2006 to March 2010.Thirty-eight cases (subarachnoid transplantation group) got transplantation by subarachnoid injection,32 cases (intravenous transplantation group) got transplantation by intravenous injection,26 cases (control group) were hospitalized in the same period but not transplanted.The motor and sensory functions of all three groups were evaluated according to the score standard developed by American Spinal Injury Association(ASIA) before treatment and at the first,the third,the sixth month after treatment.Meanwhile,routine blood test,coagulation,biochemical items and tumor markers were also examined in follow-up.ResultsThe motor and sensory function of three groups had different degree of recovery at the first month after treatment,and sensory function recovered muchsignificantly,but the comparison among three groups had no statistical significance.The scores of motor function increased in three groups at the third month after treatment,but still had no statistical significance (P＞ 0.05).The scores of sensory function of subarachnoid transplantation group[(130.9 ±41.6) scores] and intravenous transplantation group [ (131.2±22.7 ) scores ] increased obviously,and had significant difference compared with control group [ (109.3±36.4) scores] (P ＜ 0.05),but there were nosignificant difference between subarachnoid transplantation group and intravenous transplantation group (P ＞ 0.05).The scores of sensory and motor function of control group didn't increase obviously at the sixth month after treatment,while the scores of subarachnoid transplantation group and intravenous transplantation group gradually improved and had statistical significance compared with control group(P ＜ 0.05).The scores of sensory function was higher in subarachnoid transplantation group[ (151.6±46.9) scores ] than that in intravenous ransplantation group [(134.6 ±40.7) scores] (P ＜0.05).There were no obvious abnormality in the results of followed-up examination.Conclusions The safety and short-term efficacy of autologous bone marrow mesenchymal stem cells transplantation in treating early spinal cord injury by subarachnoid injection and intravenous injection is certified.The subarachnoid injection is better than intravenous injection,but the long-term efficacy need furter study.
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Objective To explore the influence factors of health literacy in middle-aged and elderly people in Hunan province.Methods With multi-stage randomized cluster sampling, people aged 45 years and over were selected from both urban and rural areas of six geographical regions of Hunan province, using the China residents health literacy questionnaire developed by Chinese Health Education Center, by face to face survey to get data. The influence factors were analyzed retrospectively with univariate and ordinal regression analysis.Results The 1158 persons were investigated and the valid questionnaires were 1154, the effective recovery rate was 99.7%. Univariate analysis showed that there were significant differences in heath literacy among different degree of education, age, gender, marital status, income, region and occupation (all P＜0.05). The results of ordinal regression analysis Showed that the major influence factors were degree of education, income,age and occupation.Conclusions The people at low levels of education or income should be concerned about health education and health promotion strategies.
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Objective To investigate the recent efficacy and safety of autologous bone marrow stem cells transplantation in treatment of early spinal cord injury. Methods 51 cases of early spinal cord injury admitted to Liaocheng People Hospital from 2007.11 to 2009.8 were enrolled in this study. In transplantation group, 24 patients were treated by subarachnoid space injection with autologous bone marrow stem cell transplantation. The patients who were not transplanted in the same period of hospitalization were selected as control group. Motor and sensory function ( AISA score) was assessed at 1, 3, 6 months before and after transplantation in two groups patients. And blood routine, clotting mechanisms, biochemical items andtunor markers were determined in followed up. Results After one month of transplantation, two groups ofpatients had recovered in motor and sensory function to some degree. After three months of transplantation,there was significant different between transplantation group and control group in sensory function recovery (P < 0. 05 ). After 6 months of transplantation, there were significant different between transplant group and control group in motor and sensory function recovery (P<0.05). Blood examination results did not show markedly abnormal in followed -up patientsConclusion The safety and recent effect of autologous bone marrow stem cells transplantation in treatment of early spinal cord injury were satisfied, but the long - term effect was still unclear.
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BACKGROUND: Previous animal studies demonstrated that bone marrow mesenchymal stem cells could differentiate into nerve cells under a certain condition; however, the clinical application for treating nervous system disease has been less reported. OBJECTIVE: To observe a short-term effect of autologous bone marrow mesenchymal stem cell transplantation on treating cerebral hemorrhage.METHODS: A total of 32 patients with cerebral hemorrhage who were selected from the Department of Neurosurgery, Liaocheng Brain Hospital between November 2007 and January 2009 were considered as a treatment group. According to general data and the amount of hematoma, they were treated by drilling drainage or hematoma evacuation. Drainage tubes were detained into hematoma cavity, and 3.5 mL autologous bone marrow mesenchymal stem cell suspension was injected through drainage tube. A total of 40 additional patients who did not treated with stem cell transplantation were considered as a control group. Neurologic impairment (NIHSS) and activities of daily living (Barthel index) were performed before and 6 months after transplantation; meanwhile, the brain MRI, serum biochemical and tumor marker were evaluated to detect security of stem cell transplantation. RESULTS AND CONCLUSION: The NIHSS score and Barthel index in the treatment group were similar to those in the control group before transplantation. Compared with control group, NIHSS scores were significantly decreased in the treatment group (P < 0.01), but Barthel index was significantly increased 6 months after transplantation (P < 0.01). Compared with before transplantation, NIHSS score were significantly decreased (P < 0.01), but Barthel index was significantly increased in the treatment group 6 months after transplantation (P < 0.01). Two patients in the treatment group had febrile, which was recovered after treatment. The following-up 6 months after transplantation demonstrated that brain MRI and biochemical indicators were normal except an increasing of CA-153 caused by lung cancer in one patient. The autologous bone marrow mesenchymal stem cell transplantation for treatment of cerebral hemorrhage is safe and effective in a short-term period; however the long-term effect still needs to be further studied.
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Objective To evaluate the effect of Jostent coronary stent-graft in endovascular treatment of traumatic carotid cavernous fistula. Methods Eight patients with traumatic carotid-cavernous fistula were treated by Jostent coronary steat graft from June 2001 to May 2007. Results The stent graft was successfully implanted in the target artery in all patients. The fistula in all patients was removed and the parent arteries kept unblocked. The clinical outcome was favorable, with no operation-related complications occurred. The ang4ogram showed normal patency of the parent arteries, without recanalization of the fistula six months after the stent graft implantation in six patients. Conclusions Stent graft is a useful tool for endovascular treatment of carotid cavernous fistula in selected patients. Further research is needed to optimize the stent graft for further use in cerebrovascular system.
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Objective To investigate the risk factors of symptomatic cerebral vasospasm (SCVS) after craniocerebral trauma. Method The clinical data of 308 patients with craniocerehral trauma were analyzed by single factor analysis and Logistic regression analysis. Resnlts SCVS occurred in 94 patients (30.52%). The risk factors were subarachnoid hemorrhage (SAH), Glasgow coma scale, blood glucose, emergency operation,smoking and age. Conclusions Various factors are related to the development of SCVS after craniocerebral trauma. Prophylactic treatments should be given in early stage for the patients with risk factors.
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Objective: To evaluate the effect of early enteral nutrition(EEN) on gastric acid secretion in patients with severe brain injury.Methods: 168 patients with severe brain injury(GCS≤8)were divided randomly into two groups.84 patients were given EEN by naso-gastric tube as EEN group and 84 patients were treated with parenteral nutrition(PN)as PN group.Gastric juice pH and upper gastrointestinal hemorrhage were monitored on admission,the 3rd,5th and 7th day after admission.Results: The gastric juice pH was significantly lowered in EEN group.Conclusion: EEN could neutralize gastric acid and increase the gastric juice pH in patients with severe brain injury.