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Objective To measure and analyze the external nasal morphology of normal Uygur in Xinjiang,which will provide the anatomical basis for the rhinoplasty.Methods From the Department of Otolaryngology and Plastic Surgery of our hospital,we collected the Uighur patients' families as the research objects during January 2011 to December 2012,and at the same time Han nationality patients' families were set as control group.Related parameters of external nose measurements were completed,and the parameters of external nose of 95％ confidence interval calculated,and compared with those of Han people.Results The measured data showed that there were the 95％ confidence interval of the Uighurs external nasal related indicators; The nasal length,height,depth,dorsum slope length,temples,nasal tip angle of the male Uighur were greater than those of male Han; Uighur women had longer,higher nose,more slope length of the nose back,and greater nasal-facial angle and nosewing angle than that of Han women.The proportion of ultra narrow nasal type,narrow nose,the middle nose in Uighur men was 14.02％,79.50％,and 6.48％ ; that in Uighur women was 14.60％,67.72％,and 17.68％,respectively; compared with those in Han nationality,there was a significantly statistical difference (P＜0.05).Conclusions The external nasal morphology of the Uygur people in Xinjiang has its characteristics,with dominants of narrow nasal type; 95％ of medical reference range will provide an objective reference basis for the future clinical work.
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Objective To investigate the clinical characteristic of 1 000 Hz probe tone tympanometry obtained from neonates who didn’t pass the TEOAE screening . .Methods TEOAE screening were performed to screen the hearing with GSI -70 Automated OAE(Grason-Stadler ,USA) .Then neonates were detected the 1 000 Hz probe tone tympanograms by GSI Tympstar Version Ⅱ Middle Ear Analyzer(Grason-Stadler ,USA) .The relative infor-mation ,including tympanometric peak pressure (Tpp) ,peak admittance(Yp) ,peak compensated static acoustic ad-mittance (Ypc)、tympanometric width(TW) were collatea .The of 1 000 Hz probe tone tympanometry of 47 ears that didn’t pass the first TEOAE and 1 300 ears that passed the first TEOAE were asnpared .Results We found in the single-peak type ,the ratio of the experimental group(59 .57% ) was less than that of the control group(74 .00% ) , and in the flat type the ratio of the the experimental group (23 .40% ) was more than that of the control group (8 . 54% ) ,there was a statistical significance between the two groups in each different type proportion (P<0 .05) .But there is not a statistical significance in the relative values of single -peak type admittance between the two groups , such as tympanometric peak pressure (Tpp)、peak admittance(Yp) etc .Conclusion The majority of 1000Hz tympa-nograms of the neonates who passed TEOAE is the single -peak type ,but the neonates who didn’t pass the first TEOAE mostly shored the flat type The .
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<p><b>OBJECTIVE</b>To summarize our experience with extraperitoneal robot-assisted laparoscopic radical prostatectomy (RLRP).</p><p><b>METHODS</b>Twenty patients with confirmed prostate cancer by transrectal needle biopsy but no metastasis detected by radiographic examination underwent extraperitoneal RLRP, including 7 with Gleason score of less than 6, 10 with a score of 7, 2 with a score of 8, and 1 with a score of 9.</p><p><b>RESULTS</b>The procedures were performed successfully in all the patients. In 4 cases, a postoperative PSA value of more than 0.2 ng/ml at 4 weeks suggested residual tumor, for which maximal androgen block therapy was administered before elective radiotherapy. Sixteen patients were followed up for 10 to 37 months (mean 15.5 months). In the 20 cases, the operation was completed in a mean of 180 min (range 150-230 min), with the mean installation time of 48.5 min (range 40-60 min) and average blood loss of 298 ml (range 80-800 ml). The mean postoperative eating time was 1.7 days (1 to 3 days), the mean bladder catheter time was 10.7 days (7 to 14 days), and the mean hospital stay was 10.7 days (range 7-14 days). No postoperative complications occurred in these cases. Postoperative pathology showed a Gleason score no higher than 6 in 6 cases, 7 in 5 cases, and no less than 8 in 9 cases.</p><p><b>CONCLUSION</b>The technique of extraperitoneal RLRP can be easily mastered by the surgeons and is especially advantageous for complicated pelvic operations.</p>
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Anciano , Humanos , Masculino , Persona de Mediana Edad , Laparoscopía , Métodos , Prostatectomía , Métodos , Neoplasias de la Próstata , Cirugía General , RobóticaRESUMEN
Objective To investigate the feasibility and safety of retroperitoneal laparoendoscopic single-site (LESS) donor nephrectomy using home-made single-port device.Methods From January 2011 to June 2012,11 consecutive LESS left donor nephrectomies using home-made single-port device with conventional laparoscopic instrument were performed through retroperitoneal access in our center.Results The procedures were completed and no complications occurred in all donors.Mean operative time was 149.5 min.Estimated blood loss was 30-350 ml.Warm ischemia time was 2-4 min.The urine output was prompt in all cases.Recipient graft function was normal within 2 weeks.Donor hospital stay was 5-6 days after operation.Conclusion LESS donor nephrectomy using home-made single-port device in our initial experience is feasible and safe.It is also cost-effective and minimally invasive with conventional laparoscopic donor nephrectomy.This technique is a good option for living donor nephrectomy.
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Objective To compare the clinical effectiveness and safety of transperitoneal robot assisted and retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty for the treatment of ureteropelvic junction obstruction. Methods From September 2008 to June 2009,six patients with primary UPJO underwent transperitoneal robot assisted dismembered pyeloplasty (TRADP) (5 males and 1 female;average age 25 yrs,range from 14-40 yrs),of whom 4 with severe hydronephrosis,2 with intermediate.According to the demographic and preoperative information,each patient in the TRADP group was matched to two corresponding patients with primary UPJO accepting retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty (RLADP) in the same period.The operative time,the intracorporeal suturing time,intraoperative blood loss,the duration of the urethral catheter and the drainage time,the postoperative hospital stay and the postoperative result were compared between the 2 groups.The two groups were identical with regard to gender,side of UPJO,and surgical procedure.The mean age and BMI were comparable between the TRADP and RLADP. Results Between the two groups,the operative time was ( 157 ± 20) min vs ( 127 ± 18) min ( P ＞ 0.05 ),the intracorporeal suturing time was (44 ± 6) min vs (49 ± 6 ) min ( P ＞0.05).In TRADP and RLADP groups,the intraoperative blood loss was (23 ± 8) ml vs (21 ± 17) ml ( P ＞ 0.05 ),the duration of the drain was (47 ± 10) h vs ( 161 ± 41 ) h ( P ＜ 0.01 ),the duration of the urethral catheter was (92 ±46) h vs ( 175 ±26) h (P ＜0.05),the postoperative hospital stays were (6.0 ± 0.8 ) d vs (8.0 ± 0.5) d ( P ＜ 0.01 ).The operation was successful in all cases of two groups,with no conversion to open surgery.The follow-up of 6 -32 months,with average of 20 months,showed that the clinical symptoms in the two groups disappeared and the hydronephrosis relieved. Conclusion Compared with RLADP,the TRADP has the comparable operative time,but the postoperative management for TRADP is more simple and the healing is faster,the postoperative outcomes are comparable as well.
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Retroperitoneal laparoscopic live donor nephrectomy offers an intrinsic advantage over conventional transperitoneal laparoscopic nephrectomy because of the potentially lower risk for early and late donor intraperitoneal complications. Herein we presented our experience performing retroperitoneal laparoscopic live donor nephrectomy in 105 donors. All donor nephrectomy was successful. There were no donor deaths and no conversion to open surgery. Mean operation time was 112 min (range, 70-200 min). Intraoperative blood loss was 10-150 mL with an average of 30 mL. Warm ischemia time was 1.3 to 6 min with an average of 3.1 min. Postoperative retroperitoneal hematoma occurred in only one case and there were no other surgical complications. Donors were discharged from the hospital 5 to 10 days postoperation. Average postoperative hospital stay was 6.4 days. One graft was removed due to acute rejection. Delayed graft function occurred in two recipients but renal function returned to normal within four weeks. The other recipients had normal renal function in two weeks except three recipients in four weeks. We believe that retroperitoneal laparoscopic live donor nephrectomy is safe, reliable, and less invasive.
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Objective To summarize the clinical data of renal transplants survived with graft function more than 10 years and the adverse events during this period, and to discuss the main strategies for the long-term survival Methods Survival rate of renal transplants simultaneously survived with graft function > 10 years and grafts was counted respectively in total 1003 renal transplant recipients at our hospital before Dec. 31,1998 retrospectively. Their relevant survival,adverse events and initial post-operative immunosuppressive regimens were recorded simultaneously.Results As of Dec. 31, 2008, the 10-year survival rate of recipients was 62. 7% (629/1003), and recipients with graft function accounted for 85. 37 % (537/629). Of them, 94. 75 % (596/629) recipients received cyclosporine A (CsA) -based immunosuppression plus other antiproliferative immunosuppressive agents. Post-transplantation adverse events included coronary heart diseases in 57 cases (9. 06 %), liver damage in 32 cases (5. 09 %), malignancy in 29 cases (4. 61% ), diabetic mellitus in 25 cases (3. 97 %), apoplexy in 16 cases (2. 54 %), severe bone marrow depression in 14 cases (2. 23 %), femur head necrosis in 7 cases (1.11%), lower-extremity thrombosis in 3 cases (0. 48 %), sudden deafness in 2 cases (0. 32 %). There were 690 survival patients and 49 deaths including 19 (38. 78 %) due to cardiocerebral vascular accidents, 10 (20. 41%) due to malignancy, 9 (18. 37 %) due to hepatic failure, 4 (8. 16 %) due to infection, 3 (6. 12 %) due to treatment abandonment, 2 (4. 08 %) unknown reasons and 2 (4. 08 %) accidental deaths. Conclusion Long-term survival after renal transplantation is associated with the primary medication of CsA as the main immunosuppressive regimen. The non-immunologic factors such as the prevention and cure of cardioeerebral vascular diseases and the early finding of liver functional abnormality and tumor are the main points focused during follow-up.
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Objective To observe the effects and safety of rapamycin (Rap) in combination with cyclosporine A (CsA) and steroid (Pred) as triple regimen for prevention of acute rejection after renal transplantation.Methods Fifty patients with de novo cadaveric kidney allograft were randomized into two groups. In the study group there were 30 patients treated with Rap, CsA, and Pred, while in the control group there were 20 patients with conventional triple therapy of azathioprine (Aza), CsA, and Pred. Same dosages of CsA and Pred were used in both groups. Any adverse event after treatment was observed and recorded in detail. The laboratory investigations were checked and analyzed periodically.Results The pre-protocol population included 26 patients in study group and 18 patients in control group. The 2-year patient and graft survival rates in both groups were 100 %. The incidence of acute rejection was 3.7 % (1/27) in study group, 25 % (5/20) in control group, respectively. All episodes of acute rejection were reversed by methylprednisolone. The trough levels of CsA kept same in both groups, but CsA dose in study group was lower than that in control group. Blood concentrations of total cholesterol and triglyceride in study group were higher than those in control group. Conclusion Rap is an effective and safe immunosuppressive drug for prevention of acute rejection after renal transplantation. Rap combined with CsA allows reducing the dose of CsA. But its main side effect is hyperlipidemia.
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Objective To study the clinical features,the diagnosis and treatment of left renal entrapment syndrome. Methods Four male patients with left renal entrapment syndrome were reported.Their age ranged from 16 to 22 years.The clinical features were characterized by recurrent episodes of gross hematuria,and 1 case had left varicocele concomitantly.Cystoscopy showed hematuria from the left ureter orifice.B-ultrasonography and CT scan showed that the left vein was clearly compressed at the included angle of abdominal aorta and superior mesenteric artery and the proximal vein was dilated in all the 4 patients.The characteristics of onset and imaging, and treatment of left renal entrapment syndrome were reviewed and discussed with the relevant literature. Results The diagnosis was established in the 4 cases based on B-ultrasonography and CT scan.Left renal vein reconstruction was performed on them.The patients were cured and discharged,with renal vein outflow being normal and no hematuria occurring.At 6 and 9 months after operation,CT and ultrasonography showed that the kidney contour was normal,the reconstructed veins were patent,and the routine urine test results were normal. Conclusions Left renal entrapment syndrome clinically results in high pressure of renal vein,hematuria and left varicocele.Autotransplantation of the left renal vein is an effective treatment option.
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Experimental crush syndrome was inflicted to the kidneys of rabbits and specimens of renal tissues were studied with electron microscope. It was found that apart from the damage to the renal tubules, the ultrastructural alterations of the glomeruli were also prominent and were characterized as follows:(1) Hypertrophy and hyperplasia of the glomerular cells resulting in narrowing and/or obliteration of the capillary loops.(2) Retrogressive changes of the glomerular cells in varying degrees such as mitochondrial swelling, dilatation of ER, vacuole formation, etc.On the basis of the morphological findings of the renal tissues in association with the clinical manifestations of acute renal failure (ARF), it is proposed that in addition to the damage of the renal tubules, a reduction of the glomerular filtration rate, which is the result of the altered hemodynamics in the renal vessels and the ultrastructural changes of the glomerular cells also play an important role in the pathogenesis of ARF.