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Objective To evaluate the diagnostic value of ultrasonography and MRI in the diagnosis of placenta accrete.Methods First,the relevant literatures about placenta accrete were retrieved at home and abroad,then the data were extracted and Meta-analysis was performed.The combined sensitivity and specificity of ultrasound and MRI and AUC were obtained.Results The combined sensitivity of ultrasonography was 0.80,specificity was 0.88,AUC was 0.88;combined sensitivity of MRI was 0.86,specificity was 0.90,AUC was 0.93.Conclusion Ultrasound and MRI are very valuable in the diagnosis of placenta accrete.However,MRI is a useful complement of ultrasound,and the diagnostic value is slightly better than that of ultrasound.The diagnostic value will be higher when they combined together.
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Objective To research the clinical effect of transurethral plasmakinetic enucleation of prostate (PKEP) in the treatment of high-risk huge benign prostate hyperplasia(BPH).Methods Fifty-two cases of high-risk huge(＞120 g) BPH in this hospita1 from May 2010 to May 2015 were selected and performed PKEP.International prostate symptoms score(IPSS),quality of life(QOL) score,residual urine(RUV) and biggest urine flow rate(Qmax) were observed after operation.Results The mean operation time was (130.12 ± 12.14) min,the mean intraroperation bleeding amount was (120.24±9.81) mL,the mean hospital stay was (14.52 ± 1.82)d,the mean weight of resected prostate tissues was (113.42 ± 12.53)g.Follow-up lasted for 6 months without serious complications.IPSS、QOL,RUV and Qmax after operation were improved obviously,the difference was statistically significant compared with before operation(P＜0.05).Conclusion PKEP is safe and effective in the treatment of high-risk huge BPH.
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Objective To compare and analyze clinical effects of Bipolar transurethral plasma kinetic enucleation of prostate (PKEP) and transurethral resection of the prostate(TURP) on the treatment huge benign prostatic hyperplasia.Methods Nine-six cases of huge benign prostatic hyperplasia were selected in this hospital from March 2012 to March 2015.All the patients were divided into two groups according to different operation method,namely PKEP group and TURP group.Then the operative time,bleeding amount,bladder washing time,hospital stay,complications between two groups were compared,and the international prostate symptom score (IPSS),quality of life score (QOL),maximal urinary flow rate (Qmax),residual urine volume 6 months before and after operation were compared between the two groups.Results The operative time [(100.0 ± 3.5)min],bleeding amount [(161.0 ± 9.2) mL],bladder washing time[(15.2 ± 1.2) h],hospital stay[(10.8 ± 2.6) d],complications (6 cases) in PKEP group were less than that in the TURP group,which were(132.0±4.2)min,(198.0±12.1)mL,(36.8±1.3)h,(13.6±2.9)d,complications (18 cases)respectively(P＜0.05).The IPSS,QOL,Qmax,residual urine volume in both group were significantly improved compared with surgery before(P＜0.05),and there were no significant differences between the two groups(P＞0.05).Conclusion PKEP and TURP both are effective surgeries for the treatment of huge BPH,while PKEP has short operation time,less intraoperarive bleeding and low incidence of complications,it is worthy of further clinical promotion.
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Objective To explore the safety and efficiency of patients with impacted upper ureter calculus combined with renal intrarenal infection treated by ureteroscopic pneumatic lithotripsy (URL ) and minimally invasive percutaneous nephrolithotomy (MPCNL) .Methods 126 cases of impacted upper ureteral calculi combined with renal intrarenal infection were treated in this hos-pita1 from July 2007 to July 2011 ,including 58 cases of URL ,68 cases of MPCNL .The success rate of primary lithotripsy ,stone-free rate ,postoperative adjuvant therapy ,operative time ,hospital stay ,incidence of postoperative complications and other data were analyzed .Results The success rate of group URL was 82 .76% (48/58) ,the success rate of group MPCNL was 100 .00% .The stone-free rate seven day after operation :URL was 62 .07% (36/58) ,MPCNL was 98 .53% (67/68)(P0 .05) .Conclusion It has higher successful rate and stone-free rate in patients with upper ureter calculus combined with renal intrarenal infection by MPCNL than those treated by URL .The safety and efficency of the former is better that of the latter .MPCNL can be the first choice for the upper ureter calculus combined with renal intrarenal infection .
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Objective To observe the effects of aerobic exercise on low-and high-density lipoprotein cholesterol,and to investigate the relationship between exercise intensities and high-density lipoprotein cholesterol (HDL-C) changes.Methods Sixty patients with low HDL-C were randomly allocated into a high intensity exercise group,a moderate intensity group or a low intensity group with 20 in each group.According to each patient's maximal heart rate in a restrictive electrocardiogram exercise test,the different aerobic exercise intensities were formulated as follows.The target heart rate of the high-intensity training group was 90％ of each subject's maximum heart rate; in the moderate-intensity group it was 70％ ; in the low-intensity group it was 50％.All 3 groups jogged on a medical treadmill for 20 minutes every other day with their heart rates monitored at all times.They maintained the target heart rate for 20 minutes.The experiment lasted 2 months.Results In the high intensity group HDL-C increased from 0.81 ± 0.22 to 1.04 ± 0.33 mmol/L after training; in the moderate intensity group it increased from 0.82±0.20 to 1.03 ±0.37 mmol/L; in the low intensity group it increased from 0.79 ±0.25 to 0.82 ± 0.27 mmol/L.That increase in the low intensity group was not statistically significant.After high intensity or moderate intensity training the HDL-C increases were statistically significant,but the difference between the groups was not.After training,in 15 cases among the high intensity group,13 cases from moderate intensity group and in 1 case from the low intensity group the HDL-C level achieved a normal value (≥ 1.04 mmol/L).Comparing the high intensity group to the low intensity group or the moderate intensity group to the low intensity group,there were significant differences in the number of patients who achieved normal HDL-C readings,but there was no significant difference between high intensity group and the moderate intensity group.Conclusion Low intensity aerobic exercise has no obvious effect on low HDL-C levels.High or moderate intensity aerobic exercise can effectively raise the HDL-C level,but there is no significant difference in the fraction of patients reaching normal values between high and moderate intensity aerobic exercise.So moderate intensity is recommended for improving low levels of HDL cholesterol.
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Objective To evaluate the value of computed tomography(CT) and magnetic resonance imaging(MRI) in diagnosis of avascular necrosis of the femoral head(ANFH). Methods The literatures of ANFH diagnosed with CT and MR imaging published in the last ten years were collected by searching. Of that,21 literatures were correspond for the standards in this study and were select-ed. These literatures in diagnosing ANFH with CT and MR imaging were analysed with Meta-analysis by the sofeware of StataSE10.1. Results MRI was more effective than CT in diagnosing ANFH. There was significantly different in statistics between them [OR=0.13,95%CI(0.03～0.51)]. Conclusion In comparison with CT,MRI is the better method in diagnosing ANFH.
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Objective To evaluate the value of three-dimensional color power angiography(3D-CPA,) in osteosarcoma diagnosis. Methods Forty-three cases with osteosarcoma were detected with 3D-CPA to assess the vascular classification(3D-CPA Ⅰ to Ⅲ) and measure the vascular parameters including vascularization index(VI), flow index(FI) and vascularization-flow index(VFI). Results All of the 43 cases were classified into 3D-CPA Ⅲ type. The space structure shape of blood vessels and the origin of nutrient vessels was clear. The quantitative measurement showed that VI was 25.84±6.87,FI was 34, 18±2.93, VFI was 9.02±4.04. Conclnsions It is a new method to analyze and diagnose osteosarcoma with 3D-CPA because it can show the nutrient vessels and the embranchments of blood vessels clearly, tridimensionally and integrally and Bake quantitative or partial-quantitative analysis.
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[Objective]To study the effect of arthroscopic reconstruction of anterior cruciate ligament with hamstring tendons and mini-plates.[Method]Thirteen cases of anterior cruciate ligament ruptures were reconstructed arthroscopically with over six strands of hamstring tendons in way of one-bundle and two-tunnel reconstruction.The grafts were fixed with suspension technique by mini-plates.The patients were followed up for one year.The clinical results were evaluated according to Lysholm rating scale.[Result]Twelve patients(92.31%) had negative Lachman test,and one patient showed positive Lachman test.Pivot shift test was negative in 12 cases,and was positive in one case.The Lysholm score increases from 47.77?1.96 to 95.38?4.74(P