Expression and clinical significance of circ_002082 in breast cancer / 中华内分泌外科杂志

Objective:This paper mainly discusses the expression of hsa_circ_002082 in breast cancer and its clinical significance to breast cancer.Methods:The up-regulated hsa_circ_002082 in breast cancer was screened out through the bioinformatics website, and verified by quantitative reverse transcription PCR (qRT-PCR). The differential expression of hsa_circ_002082 in different clinical index groups was analyzed by one-way ANOVA and t-test, and the ROC curve was used to analyze the value of hsa_circ_002082 in diagnosing breast cancer or identifying clinical indexes.Results:Compared with para-cancerous tissue (1.00±0.21), the expression of hsa_circ_002082 in cancer tissue (1.34±0.25) was higher than that in peripheral blood of healthy people (1.00±0.26), and the expression of hsa_circ_002082 in peripheral blood of breast cancer patients (1.39±0.24) increased (all P<0.05). The AUC value of hsa_circ_002082 for breast cancer diagnosis was 0.8520 ( P<0.05). There were differences in the expression of hsa_circ_002082 in tumor grade, estrogen receptor (ER) positive, carcino-embryonic antigen (CEA) positive, Ki-67 proliferation index, tumor metastasis, and TNM grade (all P<0.05). The relative expression level of hsa_circ_002082 was significantly positively correlated with the level of tumor marker CEA ( r=0.368, P=0.009). The AUC values of hsa_circ_002082 for distinguishing tumor grade, ER positive, CEA positive, Ki-67 proliferation index, tumor metastasis, and TNM grade were 0.8744, 0.7005, 0.7890, 0.8075, 0.8317, and 0.8301, respectively (all P<0.05) . Conclusion:hsa_circ_002082 is highly expressed in breast cancer tissue and peripheral blood, and hsa the potential to be a biomarker for the diagnosis of breast cancer.

Predictive value of foramen ovale size on pain recurrence after percutaneous balloon compression / 中南大学学报(医学版)

OBJECTIVES@#Primary trigeminal neuralgia (PTN) is a common cranial nerve disease in neurosurgery, which seriously endangers the physical and mental health of patients. Percutaneous balloon compression (PBC) has become an effective procedure for the treatment of PTN by blocking pain conduction through minimally invasive puncture. However, the recurrence of facial pain after PBC is still a major problem for PTN patients. Intraoperative balloon shape, pressure and compression time can affect the prognosis of patients with PBC after surgery. The foramen ovale size has an effect on the balloon pressure in Meckel's lumen. This study aims to analyse the predictive value of foramen ovale size for postoperative pain recurrence of PBC by exploring the relationship between foramen ovale size and postoperative pain recurrence of PBC.@*METHODS@#A retrospectively analysis was conducted on the clinical data of 60 patients with PTN who were treated with PBC in Department of Neurosurgery, Affiliated Hospital of Chengde Medical College from November 2018 to December 2021. We followed-up and recorded the Barrow Neurological Institute (BNI) pain score at 1, 3, 6 and 12 months after operation. According to the BNI pain score at 12 months after surgery, the patients were divided into a cure group (BNI pain score I to Ⅱ) and a recurrence group (BNI pain score Ⅲ to Ⅴ). The long diameter, transverse diameter and area of foramen ovale on the affected side and the healthy side of the 2 groups were measured. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used for analysis the relationship between the recurrence of pain and the long diameter, transverse diameter, area of foramen ovale on the affected side, and aspect ratio, transverse diameter ratio, area ratio of foramen ovale on the affected side to healthy side in the 2 groups.@*RESULTS@#At the end of 12 months of follow-up, 50 (83.3%) patients had pain relief (the cured group), 10 (16.7%) patients had different degrees of pain recurrence (the recurrence group), and the total effective rate was 83.3%. There were no significant differences in preoperative baseline data between the 2 groups (all P>0.05). The long diameter of foramen ovale on the affected side, the long diameter ratio and area ratio of foramen ovale on the affected/healthy side in the cured group were significantly higher than those in the recurrence group (all P<0.05), and there were no significant differences in the transverse diameter and area of foramen ovale on the affected side and the transverse diameter ratio of foramen ovale on the affected/healthy side between the 2 groups (all P>0.05). The ROC curve analysis showed that the AUC of the long diameter of foramen ovale on the affected side was 0.290 (95% CI 0.131 to 0.449, P=0.073), and the AUC of aspect ratio of foramen ovale on the affected side to healthy side was 0.792 (95% CI 0.628 to 0.956, P=0.004). The AUC of area ratio of foramen ovale on the affected side to healthy side was 0.766 (95% CI 0.591 to 0.941, P=0.008), indicating that aspect ratio and area ratio of foramen ovale on the affected side to healthy side had a good predictive effect on postoperative pain recurrence of PBC. When aspect ratio of foramen ovale on the affected side to healthy side was less than 0.886 3 or area ratio of foramen ovale on the affected side to healthy side was less than 0.869 4, postoperative pain recurrence was common.@*CONCLUSIONS@#Accurate evaluation of the foramen ovale size of skull base before operation is of great significance in predicting pain recurrence after PBC.

Molecular genetic analysis of two individuals with weak D variant of the Rh blood type / 中华医学遗传学杂志

OBJECTIVE@#To explore the molecular basis of two individuals with weak D variant of the Rh blood type.@*METHODS@#Routine serological testing was carried out to detect the D, C, c, E and e antigens of the Rh blood group. The D antigen was further detected with an indirect antiglobulin test. The presence of Rhesus box was detected by PCR to determine the homozygosity of the RHD gene.@*RESULTS@#Both samples were determined as weak D phenotype by the indirect antiglobulin test. DNA sequencing revealed that case 1 harbored a heterozygous 208C>T variant in exon 2 and a heterozygous 1227G>A variant in exon 9; while case 2 harbored homozygous 779A>G variants of exon 5 of the RHD gene. Case 1 was determined as RHD+/RHD+, while case 2 was determined as RHD+/RHD-. The two samples were respectively named as weak D type 122 and weak D type 149 based on the rules of Rhesus Base Nomenclature.@*CONCLUSION@#D negative blood donors should subject to indirect antiglobulin testing and molecular analysis for safer transfusion.

Study on the classification of dominant pathogens related to febrile respiratory syndrome, based on the method of Bayes discriminant analysis / 中华流行病学杂志

Objective To understand the dominant pathogens of febrile respiratory syndrome (FRS) patients in Gansu province and to establish the Bayes discriminant function in order to identify the patients infected with the dominant pathogens.Methods FRS patients were collected in various sentinel hospitals of Gansu province from 2009 to 2015 and the dominant pathogens were determined by describing the composition of pathogenic profile.Significant clinical variables were selected by stepwise discriminant analysis to establish the Bayes discriminant function.Results In the detection of pathogens for FRS,both influenza virus and rhinovirus showed higher positive rates than those caused by other viruses (13.79％,8.63％),that accounting for 54.38％,13.73％ of total viral positive patients.Most frequently detected bacteria would include Streptococcus pneumoniae,and haemophilus influenza (44.41％,18.07％) that accounting for 66.21％ and 24.55％ among the bacterial positive patients.The original-validated rate of discriminant function,established by 11 clinical variables,was 73.1％,with the cross-validated rate as 70.6％.Conclusion Influenza virus,Rhinovirus,Streptococcus pneumoniae and Haemophilus influenzae were the dominant pathogens of FRS in Gansu province.Results from the Bayes discriminant analysis showed both higher accuracy in the classification of dominant pathogens,and applicative value for FRS.

Study on the classification of dominant pathogens related to febrile respiratory syndrome, based on the method of Bayes discriminant analysis / 中华流行病学杂志

Objective To understand the dominant pathogens of febrile respiratory syndrome (FRS) patients in Gansu province and to establish the Bayes discriminant function in order to identify the patients infected with the dominant pathogens.Methods FRS patients were collected in various sentinel hospitals of Gansu province from 2009 to 2015 and the dominant pathogens were determined by describing the composition of pathogenic profile.Significant clinical variables were selected by stepwise discriminant analysis to establish the Bayes discriminant function.Results In the detection of pathogens for FRS,both influenza virus and rhinovirus showed higher positive rates than those caused by other viruses (13.79％,8.63％),that accounting for 54.38％,13.73％ of total viral positive patients.Most frequently detected bacteria would include Streptococcus pneumoniae,and haemophilus influenza (44.41％,18.07％) that accounting for 66.21％ and 24.55％ among the bacterial positive patients.The original-validated rate of discriminant function,established by 11 clinical variables,was 73.1％,with the cross-validated rate as 70.6％.Conclusion Influenza virus,Rhinovirus,Streptococcus pneumoniae and Haemophilus influenzae were the dominant pathogens of FRS in Gansu province.Results from the Bayes discriminant analysis showed both higher accuracy in the classification of dominant pathogens,and applicative value for FRS.

Experience of transurethral incision of the bladder neck for female primary bladder neck obstruction / 中华泌尿外科杂志

Objective To analyse and discuss the outcomes of female primary bladder neck obstruction(PBNO) with transurethral incision of the bladder neck(TUIBN).Methods From January 2004 to December 2013, 38 female patients who underwent transurethral incision of the bladder neck were retrospectively reviewed.The mean age of patients was 57.7 years and the duration of symptoms before diagnosis was 3.5 years.All patients presented with varying degree of difficulty of urination.There were 10 cases with lower abdominal discomfort and 20 cases with history of urinary infection. Preoperative examinations included physical examination, urine routine, international prostate symptom score ( IPSS ) , quality of life ( QOL) , ultrasonography, urodynamics and cystoscopy.The urodynamic diagnostic criteria for PBNO were a maximum uroflow rate ( Qmax ) 20 cmH2 O.All patients failed with 3-6 month alpha-blockers treatment and then underwent TUIBN.Results Follow-up data of all patients were available for 12-60 months ( average 29.6) after operation.Successful recovery after operation was achieved in 33 of 38 ( 86.84 %) .At the first year follow-up, the IPSS decreased from 26.63 ±3.15 to 13.00 ±7.18 (P<0.01), the Qmax increased from (8.65 ±1.32) ml/s to (15.91 ±3.89) ml/s (P <0.01), the postvoid residual decreased from (122.92 ±58.36) ml to (56.55 ±36.57) ml (P<0.01), and the Pdet.Qmax decreased from (52.18 ±7.31) cmH2O to (36.12 ± 4.74) cmH2O (P<0.01), respectively.Of the 5 cases in which the first operation was not successful, 3 cases ( 7.89%) underwent an additional TUIBN 1 to 2 years after the initial operation and 2 cases detected bilateral renal hydronephrosis by B-ultrasound before operation underwent life-long catheter cystostomy.The second operation of 3 cases was successful.Pathological examinations revealed fibrous tissue hyperplasia with chronic inflammation in 32 cases, glandular cystitis in 4 cases and chronic inflammation with squmaors metaplasia in 2 cases.Conclusions The diagnosis of primary bladder neck obstruction in women is based on typical symptoms, urodynamics and cystoscopy.TUIBN is a safe and effective therapy for PBNO.

Effect of micellar polymer PEG-PLL-OPG on osteoporosis and arteriosclerosis in mice / 实用医学杂志

Objective By using PEG-PLL and OPG-expressing plasmid to synthesize a nanocompound PEG-PLL-OPG (PPO), to investigate its effects on osteoblasts (OB) and arteriosclerosis (AS) in mice. Methods The incidences of osteoporosis (OP) and AS were studied in people. Collect people′s serum , and divide them into different groups According to the results of diagnosis, the patients were grouped into the groups of Control, AS, OP, and AS. PPO was used to deal with OB in different groups. The cell apoptosis, cell activity, the adhersion and calcification to scaffold PCL were determined by flow cytometry, MTT, alizarin red stain and SEM,respectively. PPO was also injected intp the ApoE-/-RANKL+/+ mice via caudal vein to demonstrate its effects on BMD and AS. Results PPO could increase the cell activity , inhibit OB apoptosis and promote cell adhersion and calcifica-tion on scaffold PCL in vitro. PPO could also decrease the area and calcification of atheromatous plaque , and in-crease the BMD of collum femoris in vivo. Conclusion PPO may be a new drug for OP and AS treatments.

Redox regulation of FOXO3 a transcription factor / 中国药理学通报

ROS-mediated oxidative stress involved in a variety of cellular signal transduction, FOXO3a transcription factor is an intersection in regulating a variety of cellular oxidative stress. FoxO3a has been extensively studied in regulating oxidative stress because of its rather complex and pivotal regulation of cell proliferation, cell cycle arrest, ROS scavenging and apoptosis. This review will elucidate the FOXO3a’s regulatory mechanisms and describe the target genes involved. It will also provide the clinical significance and strategies to target FOXO3a to regulate oxidative stress.

System Review of Acupotomy Treatment for Stenosing Tenovaginitis of Flexor Digitorum / 中国中医药信息杂志

Objective To systematically evaluate the efficacy of acupotomy treatment for the stenosing tenovaginitis of flexor digitorum.Methods Articles about RCTs of acupotomy treatment and local blocking for the treatment of stenosing tenovaginitis of flexor digitorum were retrieved from CBM, CNKI, VIP, Wanfang database, PubMed, Embase, and Cochrane library. And then according to the requirement of Cochrane Handbook for Systemetic Reviews 5.1.0, two reviewers independently chose tests, extracted data, had a cross check, accessed methodological qualities and finally used RevMan 5.3 software for Meta analysis. The total effective rate, cure rate and improvement rate of acupotomy treatment and local blocking in treating stenosing tenovaginitis of flexor digitorum were assessed by using odds ratio (OR).Results Totally 10 articles involving 1426 cases were included. The cure rate in acupotomy treatment group was higher than that of local blocking group [OR=13.11 (95% CI: 8.23–20.89),Z=10.83 (P<0.000 01)], funnel plot Begg’s testP=0.858, Egger’s testP=0.579; the improvement rate of local blocking rate was higher than that of acupotomy treatment group [OR=0.14 (95% CI: 0.10–0.19),Z=11.60 (P<0.000 01)], funnel plot Begg’s test P=1.000, Egger’s testP=0.926; the total effective rate of acupotomy treatment group was higher than that of local blocking group [OR=18.26 (95% CI: 9.95–33.50),Z=9.38 (P<0.000 01)], funnel plot Begg’s testP=0.592, Egger’s testP=0.936.Conclusion Acupotomy treatment for stenosing tenovaginitis of flexor digitorum is superior to local blocking injection. However, the quality of the RCTs is low, so more large-sample, multi-center, and high-quality clinical RCTs are required for further verification.

MicroRNA-638 inhibits cell proliferation by targeting phospholipase D1 in human gastric carcinoma

MicroRNAs (miRNAs) are a type of small non-coding RNAs that are often play important roles in carcinogenesis, but the carcinogenic mechanism of miRNAs is still unclear. This study will investigate the function and the mechanism of miR-638 in carcinoma (GC). The expression of miR-638 in GC and the DNA copy number of miR-638 were detected by real-time PCR. The effect of miR-638 on cell proliferation was measured by counting kit-8 assay. Different assays, including bioinformatics algorithms (TargetScan and miRanda), luciferase report assay and Western blotting, were used to identify the target gene of miR-638 in GC. The expression of miR-638 target gene in clinical CRC tissues was also validated by immunohistochemical assay. From this research, we found that miR-638 was downregulated in GC tissues compared with corresponding noncancerous tissues (NCTs), and the DNA copy number of miR-638 was lower in GC than NCTs, which may induce the corresponding downregulation of miR-638 in GC. Ectopic expression of miR-638 inhibited GC cell growth in vitro. Subsequently, we identified that PLD1 is the target gene of miR-638 in GC, and silencing PLD1 expression phenocopied the inhibitory effect of miR-638 on GC cell proliferation. Furthermore, we observed that PLD1 was overexpressed in GC tissues, and high expression of PLD1 in GC predicted poor overall survival. In summary, we revealed that miR-638 functions as a tumor suppressor in GC through inhibiting PLD1.

MiR-139-5p inhibits migration and invasion of colorectal cancer by downregulating AMFR and NOTCH1

MicroRNAs (miRNAs) that exert function by posttranscriptional suppression have recently brought insight in our understanding of the role of non-protein-coding RNAs in carcinogenesis and metastasis. In this study, we described the function and molecular mechanism of miR-139-5p in colorectal cancer (CRC) and its potential clinical application in CRC. We found that miR-139-5p was significantly downregulated in 73.8% CRC samples compared with adjacent noncancerous tissues (NCTs), and decreased miR-139-5p was associated with poor prognosis. Functional analyses demonstrated that ectopic expression of miR-139-5p suppressed CRC cell migration and invasion in vitro and metastasis in vivo. Mechanistic investigations revealed that miR-139-5p suppress CRC cell invasion and metastasis by targeting AMFR and NOTCH1. Knockdown of the two genes phenocopied the inhibitory effect of miR-139-5p on CRC metastasis. Furthermore, the protein levels of the two genes were upregulated in CRC samples compared with NCTs, and inversely correlated with the miR-139-5p expression. Increased NOTCH1 protein expression was correlated with poor prognosis of CRC patients. Together, our data indicate that miR-139-5p is a potential tumor suppressor and prognostic factor for CRC, and targeting miR-139-5p may repress the metastasis of CRC and improve survival.

Clinical characters of the primary transitional cell carcinoma of ureter with lower stage and grade / 中华泌尿外科杂志

Objective To discuss the diagnosis,therapy and prognosis of primary ureter transitional cell carcinoma with low stage and grade.Methods Retrospective review of 18 cases surgery to treat the primary ureter carcinoma of G1-2 Ta-2 was carried out.There were 12 males and 6 females with the mean age of 67 years.Of the 18 cases with the size of tumor were from 0.5 to 1.5 cm.13 cases had the tumors on the left and 5 cases on the right.The tumors were located at middle parts of the ureter in 3 cases,and at the lower part in 15 cases.The course of the disease was from 5 days to 3 months.10 cases had gross hematuria and 8 cases renal hydronephrosis were found incidentally by B-ultrasound.B-ultrasound was performed in all cases.15 cases were indicated pyelic separation from 1.0-1.5 cm and ureteral separation from 0.8-1.0 cm.8 cases were indicated the low-echo space-occupying disease of ureter.IVU indicated mild hydronephrosis in 12 cases of 15 cases,of whom 5 cases were demonstrated a filling defect.CT indicated the mass of ureter in 10 cases of 15 cases.Cystoscope were performed in 18 cases,of whom 5 cases were found the tumor in the ureter-bladder cuff.Retrograde pyelogram showed filling defect of the diseased ureter in 10 of 11 cases(2 cases had failure of intubation).4 cases ureteroscopy with biopsy were used and demonstrated the diagnosis.Results 8 cases were treated surgically of radical nephroureterectomy with a bladder cuff excision.7 cases were performed ureteral segmental resection,of which 2 cases anastomosis and 5 cases ureterocystostomy with bladder cuff excision.3 cases tumors were resected by ureteroscopy postoperative pathological findings confirmed the diagnosis of transitional cell carcinoma.Pathological staging showed Ta(1 case);T1 (8),T2(9),and grading showed G1(8);G2(10).16 cases(88.9％)were followed up form 6-132 months.The overall 5-year survival rate was 87.5％.Of the 25％ patient showed bladder recurrence in post-operation 6-24 months.2 cases died of tumor recurrence and metastasis in post-operation 36-48 months.Conclusions The primary transitional cell carcinoma of ureter was uncommon and has poor prognosis.Ureter carcinoma with lower stage and grade might have better prognosis.Kidney-sparing surgery is a feasible treatment option in patients with lower stage and grade.The long-term follow up is meticulous.

Experience in management of high-risk patients of benign prostatic hyperplasia treated with transurethral resection of prostate / 中华泌尿外科杂志

Objective To investigate the experience in management of the high risk benign prostatic hyperplasia (BPH) patients in order to improve the safety of the operation.Methods The high-risk factors of 115 patients with BPH who had been treated with transurethral resection of prostate (TURP) were analyzed.The blood pressure of hypertensive patients should be controlled below 140/90 mm Hg.The patients with myocardial infarction should be in stable condition for more than 6 months.Smoking cessation,oxygen inhalation,and pulmonary function training should be carried out during the perioperative period in patients with chronic obstructive pulmonary disease,correct expectoration methods and rational use of antibiotics were also needed to improve the maximum amount of pulmonary ventilation to more than 70％.The blood-glucose of diabetic patients should be controlled below 8 mmol/L by insulin.Catheter was indwelled in patients with chronic obstructive renal insufficiency for more than 2 weeks so that the blood Cr could be below 130 μmol/L.Anticoagulant therapy should stop at least 5 days before surgery.Patients were encouraged to have physical training early after surgery and to have ankle stretch movement when they recovered form anesthesia,and pressure cycle drive therapeutic apparatus were also used to prevent deep venous thrombosis.Results All the patients tolerated TURP safely.Operation time was 30 to 60 min,the weight of the resection prostate tissue was 12 to 37 g,blood loss was 80 to 150 ml,and catheterization time was 3 to 7 days.The overall incidence of complications was 1.7％.There were 2 cases with deep venous thrombosis,who recovered after anticoagulant therapy.There were no pulmonary infection,bleeding,TUR syndrome,and other complications.Conclusion Correct analysis and effective management of the perioperative risk factors in high-risk BPH patients treated with TURP can improve the safety of the operation and reduce the complications.

Diagnosis and treatment of specially cystic lesion located at the area of the left adrenal gland : 2 cases reports of adult gastric duplicated cyst / 中华泌尿外科杂志

Objective To evaluate thedifferential diagnosis of specially cystic masses located at the area of the left adrenal gland,and to improve the understanding of the clinical symptoms and pathological features,diagnosis and treatment of gastric duplicated cyst.Methods A retrospective study,with literature review,of clinical characteristics and imaging findings of pathologically proved gastric duplicated cyst in 2 adults (2 males,28 years and 42 years)was conducted.Two patients presented no clinical manifestation.Abdominal ultrasonography and CT scan revealed a cystic lesion,in the area of the left adrenal gland,with a thickness wall,measuring 5 cm ×6 cm× 7 cm and 8 cm × 12 cm × 13 cm,attached to the greater curvature of the stomach.The lesion had septums,and the walls and septums could not be enhanced.Preoperative diagnosis of patients was misdiagnosed as a cyst of the left adrenal gland,with inflection or bleeding.Results Complete excision was performed by laparoscopic surgery in all cases.The lesion located in the area of left adrenal gland and no communication between the duplicated cyst and the lumen of stomach was detected.Postoperatively,the lesions were pathologically proved to be gastric duplicated cyst.There was no recurrence during the follow-up of 8 months and 2 years.Conclusions Preoperative definite diagnosis of adult gastric duplication cyst is very difficult.Ultrasonography and Computed Tomography are valuable imaging modality for locating the site and determining the nature of adult gastric duplicated cyst.Preoperative definite diagnosis could be made by EUS (endoscopic ultrasonography) and EUS-guided fine needle aspiration biopsy in gastric duplicated cyst.Although adult gastric duplicated cyst is an extremely rare disease entity,but this unusual developmental abnormality should be include in the differential diagnosis of cystic masses located the area of the left adrenal gland.Because of the possibility of malignancy of the cyst,laparoscopic excision is the first choice as the minimally invasive treatment.

Prevention and treatment of splenic injury during the urological surgery / 中华泌尿外科杂志

Objective To discuss the cause,treatment and prevention of splenic injury during the urological surgery.Methods The clinical data of 16 cases with splenic injury in operation for renal and adrenal tumors in 496 cases were retrospectively analyzed.Nine cases were left radical nephrectomy,3 cases were left renal hamartoma enucleation,4 cases were left adrenal tumor resection.Damage located at outer edge of the spleen in 8 cases,the splenorenal ligament in 6 cases,and the splenic hilum in 2 cases.In these 16 cases,14 patients spared the spleen (Ⅰ Grade injury 8 cases,Ⅱ grade 6 cases).The injuryed spleen was directly pressed with hemostatic gauze in 3 cases; 5 patients used coagulation,bonding,hemostatic gauze to stop bleeding; 2 cases of grade Ⅱ injury used U-shaped suture and coated with fibrin glue,then compressed with hemostatic gauze to stop bleeding; 2 cases of grade Ⅱ injuries with the greater omentum stitched into the seam,sprayed biological glue,were compressed with gelatin sponge; 2 cases of grade Ⅱ injury underwent splenic artery branch ligation.The other 2 cases (1 Ⅱ grade and 1 Ⅲ grade) underwent splenectomy.Results All of the 16 patients were cured and followed up for 6 months to 5 years.There was no delayed bleeding of spleen and splenic dysfunction.One patient died of tumor recurrence 6 months after operation.Conclusions Splenic injury is a common complication during urological surgery,especially the tumor is large or adhered to spleen in the upper pole of left kidney.Once spenic injury occurs,doctors should choose the right treatment plan according to surgical injury,and try to save the spleen.

A combination of castration with 125I brachtherapy in middle and late period prostate cancer / 中华泌尿外科杂志

Objective To investigate the therapeutic efficacy of castration with 125I brachtherapy in middle and late stage prostate cancer. Methods Sixty-six patients with prostate cancer from 2004 to 2009 were analyzed, 40 were at clinical stage C and 26 were at clinical stage D, 42 had a pathologic grade G2 and 24 had a pathologic grade G3. The first endocrinal therapy used was total androgen blockade (chemical castration and anti-androgen drugs). The therapeutic time was three months before bilateral orchidectomy and brachtherapy. A 3D radiotherapy planning system was used for brachtherapy with transrectal ultrasound-guided radioactive 125I seed uniform implantation. Follow-up endocrinal therapy was decided according to a monthly check of serum PSA (prostate specific antigen) levels. After six months, serum PSA, IPSS and volume of the prostate before and after treatment were compared. Results The operations were completed successfully in all cases. The mean number of 125I seeds implanted was 55. The mean follow-up was 10 to 62 months, with an average of 49 months. Serum PSA, IPSS and the volume of the prostate was reduced significantly six months after operation (P<0.05). Conclusions Castration with 125I brachtherapy is an effective approach in combination therapy for treating middle and late stage prostate cancer.

Endovascular treatment of chronic total occlusions of the iliac vein / 中华普通外科杂志

Objective To present clinical results of endovascular treatment of total iliac vein occlusions and to discuss the technique details of this treatment. Methods From Feb 2006 to Aug 2010,15 patients with chronic total occlusive lesions of the iliac vein and adjacent vein segments underwent endovascular treatment. Average age was (62 ±7) years (range 35 to 81 years), the male/female ratio was 12: 3. Clinical score of CEAP was grade 3 in 33. 3%, grade 4 in 40%, grade 5 in 13. 3%, and grade 6 in 13.3%. Venography showed left iliac vein was occluded in all 15 patients, common femoral vein was occluded in 14 patients, and superior femoral vein was occluded in 9 patients, however profounder femoral vein was patent in these patients with superior femoral vein being occluded. Results No postoperative major morbidity or mortality was seen. The technique success rate was 93. 3%. Treatment failure was caused in one case for a wrong selection of the femoral vein approach site. The average length of stent was 18. 4 cm.In 12(80. 0% ) stents crossed the inguinal ligament. The average follow-up time was 11.6 ± 2. 4 months.The primary patency rates of the stents at 6 months were 92. 9%. 10 (66. 7% ) patients were asympotomatic, 3(20% )were improved, 1 (6. 7% ) was unchanged, and 1 (6.7%) was worse, compared to before intervention. Conclusions Endovscular recanalization and stent placement is a safe and effective treatment for chronic total occluded iliac veins, with good patency, significant symptom resolution, and minimal morbidity in the short term follow-up.

Clinical analysis of central venous stenosis In 5 hemodialysis patients without a previous history of catheterization / 中华肾脏病杂志

Objective To evaluate imaging findings and treatment experience in central venous stenosis without a history of previous catheterization in hemodialysis patients. Methods Clinical data of 5 haemodialysis cases of central vein stenosis without a previous catheterization history in our hospital from July 2006 to July 2008 were analyzed retrospectively. Results Patients were three women and two men aged 43 to 65 years with mean age(53±8)years and all had arm swelling as the main complaint.The vascular accesses were located at the wrist in all the patients.The mean duration of the vascular accesses from the time of creation was(33.6±35.4)months.Venography showed occlusion in 2 cases and stenosis in 3 cages of central vein including 1 case of stenosis in brachiocephalic vein.1 case of stenosis beth in branchiocephalic vein and subclavian vein,1 case of stenosis in two segments of subclavian vein.The stenosis of branchiocephalic vein was fixed anterior to the tracheal and CT showed the compression of the vein by the aorta.Symptoms were resolved by the treatment of PTA.subclavian vein-contralateral subclavian vein bypass and ligation of the access. Conclusions Central venous stenosis in haemodialysis patients without a history of catheterization may be due to the intimal hyperplasia of the compression site or valve which is accelerated by the high flow of vascular access.Venography is the first choice for the diagnosis and the current management of central venous stenosis is far from being effective for the long term.

Color Doppler ultrasound follow-up for patients of femoropopliteal arteriosclerosis undergoing endovascular intervention therapy / 中华普通外科杂志

Objective To evaluate Color Doppler ultrasonography follow up for patients of femoropopliteal arteriosclerosis after interventional therapy.Methods We used Color Doppler ultrasound (CDU) in 57 cases' follow-up of endovascular intervention therapy of femoropopliteal arteriosclerosis lesion to monitor and analyze arterial hemodynamics after endovascular intervention therapy.Results An average follow-up of 13 months( range:3 -33 ) was achieved.31 of the 57 cases were found with mild stenosis,8 cases were moderate stenosis,6 cases were severe stenosis,12 cases were complete occlusion.In these 57 cases there were 7 in Fontaine stage Ⅰ,42 cases in Fontaine stage Ⅱ,6 cases were Fontaine stage Ⅲ,2 cases were Fontaine stage Ⅳ.Ankle brachial index (ABI) ABI≥I.0 in 2 cases,0.8≤ABI ＜ 1.0 in 10 cases,0.8≤ABI ＜ 1.0 in 31 cases,and ABI ＜0.5 in 14 cases.There was significant correlation between stenosis and Fontaine stage ( r =0.47,P ＜ 0.01 ),so was between stenosis and ABI ( r =0.66,P ＜ 0.01 ).In this series 29 cases also underwent DSA,and the results between CDU and DSA were significandy consistent ( Kappa value =0.61,P ＜ 0.01 ).The sensitivity of CDU was 92％,the specificity was 75％ and the accuracy was 89.2％.Conclusions CDU can continuously monitor hemodynamics after endovascular intervention therapy.It is a sensitive,non-invasive and effective method to evaluate the clinical efficacy of endovascular intervention.

Clinical diagnosis and treatment for urinary tract endometriosis / 中华泌尿外科杂志

Objective To evaluate the diagnosis and treatment of urinary tract endometriosis.Methods Retrospective review of 10 female cases of urinary tract endometriosis was carried out. All cases age was from 28-49, and the average age was 39-year-old. The course of this disease was from 6 months to 3 years. Four of 10 cases were bladder endometriosis. The clinical presentations included the urgency, frequency, pain at micturition and lower abdomen pain during menstruation, gross hematuria coinciding with menstruation 1 case. B-ultrasound and CT showed the mass of bladder from 2. 0 -3.5 cm but were not specific. Four of 6 cases ureteral endometriosis were the left side and 2 cases were the right side. This clinical presentation included non-specific flank or abdomenal discomfort in 4 cases, intermittent gross hematuria in 1 case and 1 case renal hydronephrosis was found incidentally by B-ultrasound. B-ultrasound indicated unilateral upper urinary tract dilation and hydrops in all cases,with pyelic separation from 2.0-4.5 cm and ureteral separation from 1-2 cm. CT indicated stenosis of the lower ureter in 5 cases, ureter tumor in 1 case. Results All cases were treated surgically.Partial cystectomy were performed in 4 cases of bladder endometriosis, of which, 1 case bilateral oophorectomy and hysterectomy. Five cases were performed ureteral segmental resection, of which, 3 ureterocystostomy and 2 terminoterminal anastomosis. 1 case was performed radical nephrectomy and ureterectomy. Postoperative pathological findings confirmed the diagnosis of endometriosis. Postoperative oral hormone therapy was given to 9 cases for 6-12 months. All cases were followed for 12-60months. 2 cases ureteral endometriosis had recurrent hydronephrosis in 18-24 months. The 2 cases received ureteral stent and cured by oral hormone therapy or goserelin subcutaneous injection for 3 months. Conclusions Urinary tract endometriosis usually shows non-specific symptoms. The diagnosis can be missed on both clinical examination and preoperative work-up. Surgical treatment is effective and adjuvant hormone therapy is often recommended to prevent the recurrence.