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Objective:To analyze the clinical characteristics of nephrogenic adenoma of the bladder.Methods:The clinical and pathological data of 8 patients with bladder nephrogenic adenoma, during the period from July 2016 to June 2019, were retrospectively analyzed. Patients’ age were 33 to 71 years old and the average age was 55, including 5 males and 3 females. The clinical manifestations were hematuria in 7 cases, urinary tract irritation in 6 cases, and no obvious symptoms in 1 case. There were 7 cases with cystitis, 3 cases with urolithiasis, 2 cases with bladder cancer, 1 case with invasive colonic mesentery fibroma, and 1 case without other complications. 5 cases had the history of urological operation. The predilection site was the lateral wall with 5cases; 5 cases were solitary; the average maximum diameter of the tumor was 0.9 cm (range 0.1-1.8 cm). Under cystoscope, papillary mass can be seen, the surface is bright red, the pedicle is not obvious, the papilla is thick and short, easy to bleed when touching; some of them are scattered and lichen like changes. All patients received transurethral resection of bladder mucosa.Results:Pathological examination shows that the bladder mucosa showed chronic inflammation, interstitial edema, granulation tissue hyperplasia, eosinophil infiltration and metaplasia of mesonephroid epithelium. All of the 8 patients were followed up by telephone for 2 to 38 months, with an average of 17.1 months. So far, neither recurrence has been detected.Conclusions:The diagnosis of nephrogenic adenoma of the bladder depends on pathological examination. It must be totally removed during operation. The recurrence and malignancy should be treated in time after operation.
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Objective To compare the results of Danielson procedure with and without prosthetic valve ring in treating Ebstein anomaly and to define the effect of prosthetic valve ring on the procedure.Methods From January 2006 to December 2009,31 cases of Ebstein anomaly over 10 years old were classified as type A or type B according the Carpentier＇s classification scheme.Patients were treated by Danielson procedure or Danielson procedure plus prosthetic valve ring at Anzhen hospital.They were retrospectively classified as Danielson procedure group (group A,n =19) and Danielson procedure plus prosthetic valve ring group (group B,n =12 ).Results There was 1 early in-hospital death due to lung infection and hypoxemia in group A,and no early death in group B ( Fisher exact test,P =0.51 ).The mean follow-up time was ( 23.0 ± 18.5 ) months (5 -41 months).The cumulative follow-up time was 59.42 patient-years.There was one late death in group A due to the redo tricuspid valve plastic procedure because of severe tricuspid regurgitation,and no late death in group B.With echocardiography inspection,11 patients had mild and 7 had moderate to severe tricuspid regurgitation in group A,and only 2 mild tricuspid regurgitation in group B.The tricuspid valve competence after surgery in group B was better than in group A ( Fisher exact test,P=0.024).The 6-minute walk distance test (6MWD) in group B was significantly better than in group A(415 ±41 )m vs ( 382 ± 46 ) m( t test,P =0.047 ).The New York heart functional class in group B was statistically better than in Group A ( P =0.024).Conclusion Although there was no significant difference in the early and late mortality rate between the two groups after surgery,Danielson procedure plus prosthetic valve ring was better than pure Danielson procedure in prevention of late tricuspid regurgitation recurrence,heart function and 6MWD test during follow-up.
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Objective The rate of post -operative complications has been increased with the changes in patients' age,prolonged duration, more severe and diffused lesions, and more patients with complications in recent years. We try to identify the risk factors associated with prolonged stay in the intensive care unit ( ICU ) after coronary artery bypass graft surgery (CABG). Methods 1623 patients who received CABG surgery in Beijing Anzhen Hospital Between June 1, 2006 and December 31,2007 were divided into two groups based on their stay duration in the ICU. Prolonged stay in ICU was defined as 5days or more. Univariate and multivariate analysis ( logistic regression) were used to identify the risk factors. The discrimination and calibration of the result were tested after the risk factors were determined. Results Fifty one patients had prolonged ICU stay, accounting for 3.14% of total cases. Multivariate logistic analysis showed that the age of patients, peripheral vascular diseases, critical status before operation, LVEF, operative status, mitral regurgitation, postoperative respiratory failure,postoperative renal failure, secondary thoracotomy for postoperative bleeding were associated risk factors. Conclusion Prolonged ICU stay after CABG surgery can be predicted based on the above factors. For patients with these risk factors, more pre-and postoperative care strategies are needed.