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Objective@#To investigate the clinical characteristics and the effectiveness of surgical treatment of adrenal cysts.@*Methods@#The clinical data of adrenal cysts in Affiliated Zhangye people′s Hospital, Hexi College from May 2005 to July 2018 were retrospectively analyzed, including clinical manifestations, diagnosis, surgical methods, postoperative pathological results and follow-up process. Seventeen patients with adrenal cysts were identified including 10 males and 7 females. The median age was 45.6 ranging from 30 to 75. There were 12 left lesions and 5 right lesions. Only 4 patients (23.5%) had clinical symptoms, including low back pain, abdominal pain and dizziness caused by hypertension. Ultrasound, CT and MRI were the main imaging methods for preoperative diagnosis.@*Results@#All patients underwent surgical treatment. Laparoscopic surgery was adapted in 14 cases. The average operation time was (70.2 ± 18.5) min and the average bleeding was (47.0 ± 12.1) ml. For open surgery in 3 cases, the average operation time was (103.5 ± 25.0) min and the average bleeding was (85.6 ± 20.5) ml. Postoperative pathological results showed endothelial cysts in 11 cases, epithelial cysts in 3 cases and pseudocysts in 3 cases. No recurrence of cysts or hypoadrenalism occurred in 3-75 months′ follow-up.@*Conclusions@#Adrenal cysts are relatively rare and generally benign lesions. Imaging examination, especially abdominal enhanced CT is essential for diagnosis. Laparoscopic surgery is a safe and effective method for the treatment of adrenal cysts.
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Objective To investigate the clinical characteristics and the effectiveness of surgical treatment of adrenal cysts. Methods The clinical data of adrenal cysts in Affiliated Zhangye people′s Hospital, Hexi College from May 2005 to July 2018 were retrospectively analyzed, including clinical manifestations, diagnosis, surgical methods, postoperative pathological results and follow-up process. Seventeen patients with adrenal cysts were identified including 10 males and 7 females. The median age was 45.6 ranging from 30 to 75. There were 12 left lesions and 5 right lesions. Only 4 patients (23.5% ) had clinical symptoms, including low back pain, abdominal pain and dizziness caused by hypertension. Ultrasound, CT and MRI were the main imaging methods for preoperative diagnosis. Results All patients underwent surgical treatment. Laparoscopic surgery was adapted in 14 cases. The average operation time was (70.2 ± 18.5) min and the average bleeding was (47.0 ± 12.1) ml. For open surgery in 3 cases, the average operation time was (103.5 ± 25.0) min and the average bleeding was (85.6 ± 20.5) ml. Postoperative pathological results showed endothelial cysts in 11 cases, epithelial cysts in 3 cases and pseudocysts in 3 cases. No recurrence of cysts or hypoadrenalism occurred in 3-75 months′follow-up. Conclusions Adrenal cysts are relatively rare and generally benign lesions. Imaging examination, especially abdominal enhanced CT is essential for diagnosis. Laparoscopic surgery is a safe and effective method for the treatment of adrenal cysts.
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Objective To report treatment of infectious bone and soft tissue defects caused by tibial shaft fracture of Gustilo type Ⅲ B using free flap and Ilizarov bone transport.Methods Nineteen patients who had suffered from infectious bone and soft tissue defects following tibial shaft fracture of Gustilo type Ⅲ11 B were treated from May 2010 to February 2015.They were 15 men and 4 women,aged from 21 to 58 years (average,45.3 years).Their course of disease ranged from 16 to 21 months,averaging 17.9 months.The area of their infectious defects ranged from 10 cm × 6 cm to 21 cm × 12 cm,and the length of their bone defects from 5 to 11 cm (average,7.4 cm).They were treated with debridement,simple external fixation to reconstruct bony support,coverage of wounds with free flap,and stuffing the dead space with antibiotic concrete beads,followed by Ilizarov bone transport and bone graft after control of infection to reconstruct the defective tibia and function of the affected limb.Results All the flaps survived.Necrosis occurred at the distal margin of one flap but responded to dressing.Pin tract infection occurred in 4 cases but also responded to dressing and antibiotic therapy.Autografts of iliac cancellous bone were implanted into the gliding and traction ends of the bone fragments one month after bone transport had come to rest.All the patients achieved direct bony union.The patients were followed up for an average of 25 months(range,from 19 to 36 months).No secondary fractures or angular deformity was observed.The total treatment time averaged 17.9 months,with no recurrence of infection.According to the Puno score system for functional evaluation at the last follow-up,7 cases were rated as excellent,6 as good and 6 as fair.Conclusion The infectious bone and soft tissue defects caused by tibial shaft fracture of Gustilo type Ⅲ B can be treated by free flap and Ilizarov bone transport,resulting in definitely positive outcomes.
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Objective To obtain reasonable treatment by urodynamic detection and analysis in patients with diabetic cystopathy (DCP) complicated with benign prostatic hyperplasia (BPH).Methods Sixty patients with DCP complicated with BPH were selected,among the total 32 patients (duration of diabetes ＞ 12 years,blood glucose control was not ideal) were recognized as experimental group,and 28 patients (duration of diabetes ≤ 8 years,blood glucose control was stable) were recognized as control group.Using the Laborie UDS-120XLT urodynamic detection instrument,the urodynamic was detected and the international prostate symptom score (IPSS) was evaluate,and the results were compared between the 2 groups.Results There was no statistical difference in residual urine volume between experimental group and control group [(146 ±71) ml vs.(160 ±64) ml,P ＞0.05].The maximum urinary flow-rate in experimental group was significantly lower than that in control group [(5.4 ± 2.0) ml/s vs.(8.0 ± 3.2) ml/s],the symptom total score of IPSS was significantly higher than that in control group [(25.8 ± 4.1) scores vs.(22.6 ±5.0) scores],there were statistical differences (P ＜0.01).The maximum bladder capacity,compliance,incipient micturition desire volume in experimental group were significantly lower than those in control group,there were statistical differences (P ＜ 0.01).Conclusions The influence of DCP on the function of the bladder in BPH patients is significant.Urodynamic detection can provide objective basis for the selection of therapeutic methods,suitable to be operated and forecast the postoperative effect.It has an important reference value in DCP complicated with BPH patients.
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<p><b>OBJECTIVE</b>To discuss the reasons and the treatments for the femoral refracture.</p><p><b>METHODS</b>From 2004 to 2008, 10 cases of femoral refracture after plate removal were selected and treated with open reduction and bone nail internal fixation, included 4 males and 6 females ranging from 19 to 48 years with an average age of 33 years old. According to Müller classification, there were 4 cases of type A, 3 of B, 3 of C. The skeletal tissues were taken for pathological analysis.</p><p><b>RESULTS</b>Ten patients were followed-up for 10 to 18 months (averaged 14 months). All wound healed at one stage,there were no complications. The fuction of lower limbs walking and weight loading werer recovered. Pathological section showed that part of the lamellar bone tissues were necrotic. The bone architectures were chaotic, micrangium blocked, Haversian canals were atrophy, new vessels and Haversian canals growed in necrotic bone. The tunnel in rigid bone and new Haversian system were formed. The structure was cutting cone. It was the process of new bone substitutting necrotic bone in bony remodeling.</p><p><b>CONCLUSION</b>The internal fixation using ordinary plates overwhelmingly destroy blood circulation of bone and cause necrosis of bone. It can also effect bone remodeling and descent mechanical property. Refracture can readily happen after the plate removal. Treatment of open reduction and bone nail internal fixation can achieve excellent and good effect.</p>
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Adult , Female , Humans , Male , Middle Aged , Bone Plates , Femoral Fractures , Pathology , General Surgery , Fracture Fixation, Internal , RecurrenceABSTRACT
<p><b>OBJECTIVE</b>To compare the clinical efficacy of grade III, IV supination-eversion fractures-dislocations of ankle joint between manipulative treatment and operative treatment.</p><p><b>METHODS</b>From September 2007 to December 2008, the clinical data of 60 patients with grade III, IV supination-eversion fractures-dislocations of ankle joint were retrospectively analyzed. There were 32 males and 28 females, ranging in age from 18 to 70 years with an average age of 38.17 years. All patients were respectively treated with manipulative treatment (conservative group, 30 cases) and operative treatment (operative group, 30 cases). The joint function was compared with Mazur standard; the reduction and shifting of fractures were observed with X-ray; the hospitalization day and the therapeutic cost were compared between two groups.</p><p><b>RESULTS</b>All patients were followed up with an average of 15.27 months (ranged, 6 to 25 months). In conservative group, 16 cases got excellent result in joint function, 10 good, 3 fair, 1 poor; in operative group, 20 cases got excellent result, 8 good, 2 fair, 0 poor. In conservative group in the X-ray showed 25 cases obtained excellent and good reduction, 4 fair, 1 poor; and in operative group in the X-ray showed 28 cases obtained excellent and good reduction, 2 fair, 0 poor. There was no significant difference at the joint function and X-ray film after treatment between two groups (P > 0.05). The hospital day was respectively (7.87 +/- 3.34), (17.37 +/- 4.64) d in conservative group and operative group; and the therapeutic cost was respectively (2 506.67 +/- 649.10), (11 473.33 +/- 1 564.90) yuan. There was significant difference at hospital day and therapeutic cost between two groups (P < 0.05).</p><p><b>CONCLUSION</b>Conservative treatment and operative treatment can both reach a very good result in treating grade III, IV supination-eversion fractures and dislocations of ankle joint. However, conservative treatment has advantage of high safety factor, low therapeutic cost, can reduce medical costs for patients.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Ankle Joint , Case-Control Studies , Fracture Fixation, Internal , Fractures, Bone , General Surgery , Joint Dislocations , General Surgery , Supination , X-Ray Film , X-RaysABSTRACT
Biocompatibility is the essential property of biomaterials, which is the essence of biomaterial evaluation as well as the foundation of the design and improvement of biomaterials. Several methods were carried out to evaluate the biocompatibility of poly(L-Lactide)-b-poly(trimethylene carbonate (PLLA-b-PTMC) and poly(D,L-Lactide)-b-poly(trimethylene carbonate) (PDLLA-b-PTMC) with poly(L-Lactide) (PLLA) and poly(trimethylene carbonate) (PTMC) as control, including extract liquid experiment, directly contact experiment of materials and cells, hemolytic ratio analysis and platelet adhesion investigation. The results revealed that all the materials exhibited an acceptable cytotoxicity, and proliferation of cells on the modified materials was less than that on the PLLA but more than that on PTMC. The results of hemocompatibility experiments showed that no significant hemolysis was detected when all the materials were in use; in addition, the numbers of platelets adhered on the surface of copolymers were smaller than that on the surface of PLLA, and the degree of platelet deformation was slighter. So, the biocompatibility of copolymers is similar to that of PLLA, the biocompatibility of PLLA is not remarkably changed by modification with PTMC, but rather is improved.