Intense venous reflux, quantified by a new software to analyze presurgical ultrasound, is associated with unfavorable outcomes of microsurgical varicocelectomy / 亚洲男科学杂志(英文版)

The hemodynamic characteristics of venous reflux are associated with infertility in patients with varicocele; however, an effective method for quantifying the structural distribution of the reflux is lacking. This study aimed to predict surgical outcomes using a new software for venous reflux quantification. This was a retrospective cohort study of a consecutive series of 105 patients (age range: 22-44 years) between July 2017 and September 2019. Venous reflux of the varicocele was obtained using the Valsalva maneuver during scrotal Doppler ultrasonography before microsurgical varicocelectomy. Using this software, the colored reflux signals were segmented, and the gray scale of the color pixels representing the reflux velocity was comprehensively quantified into the mean reflux velocity of the green layer (MRVG) and the reflux velocity standard deviation of the green layer (RVSDG). Spontaneous pregnancy and changes from baseline in the semen parameters were assessed during a 12-month follow-up period. Data were analyzed using logistic regression analysis. An association of the high MRVG group with impaired progressive motility (odds ratio [OR] = 2.868, 95% confidence interval [CI]: 1.133-7.265) and impaired sperm concentration (OR = 2.943, 95% CI: 1.196-7.239) was found during multivariate analysis. High MRVG (OR = 2.680, 95% CI: 1.086-6.614) and high RVSDG (OR = 2.508, 95% CI: 1.030-6.111) were found to be independent predictors of failure to achieve pregnancy following microsurgical repair. In summary, intense venous reflux is an independent predictor of impaired progressive motility, sperm concentration, and pregnancy outcomes after microsurgical varicocelectomy.

Transrectal shear wave elastography combined with transition zone biopsy for detecting prostate cancer / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the application of shear wave elastography (SWE) combined with transition zone biopsy in the detection of prostate cancer (PCa).</p><p><b>METHODS</b>A total of 489 patients with suspected PCa underwent transrectal ultrasonography (TRUS) and SWE-guided prostatic biopsy. We evaluated the role of SWE combined with transition zone biopsy in promoting the detection rate in comparison with the results of biopsy pathology.</p><p><b>RESULTS</b>The pathological results confirmed 221 malignant and 268 benign cases. Based on systematic biopsy, SWE combined with transition zone biopsy achieved a detection rate of 45. 19% , significantly higher than that of systematic biopsy alone (33.13%) (P < 0.05). The diagnostic sensitivity, specificity, and accuracy of SWE were significantly better than those of TRUS (P < 0.05). The mean elasticity (Emean) of SWE was remarkably higher for malignant than for benign lesions ([40.1 ± 9.5] vs [21.6 ± 8.3] kPa, P < 0.05). With 28.5 kPa as the threshold of the Emean value, the area under the ROC curve was 0. 899, and the diagnostic sensitivity and specificity were 88.71% and 86.23%, respectively.</p><p><b>CONCLUSION</b>SWE combined with transition zone biopsy could significantly improve the detection rate of prostate cancer.</p>

Analysis of extubation time and late complications after early tracheotomy in patients with inhalation injury / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the appropriate extubation time and treatment of late complications after early tracheotomy in patients with moderate or severe inhalation injury.</p><p><b>METHODS</b>One hundred and fifty patients (105 males and 45 females) with inhalation injury were admitted to our hospital from January 2000 to January 2009. Among them, 109 out of 129 cases with moderate inhalation injury received early tracheotomy, and all 21 cases with severe inhalation injury received early tracheotomy. Data were collected for analysis as follows: (1) incidence of re-intubation due to suffocation and pneumonia incidence after extubation within 2 weeks or after 2 weeks post inhalation injury (PII), and mortality rate within the first week after injury were recorded. (2) Conservative treatments including expectorant, oral antibiotics, and absolute bedrest were recommended for patients who had severe cough, hoarseness or poor pulmonary function after late extubation and closure of tracheostomy wound. Fiberoptic bronchoscopy findings (tracheostenosis degree, granuloma formation rate, vocal cord paralysis rate) and pulmonary function index (FEV(1)) data were collected and analyzed in 30 cases with moderate inhalation injury and 10 cases with severe inhalation injury within 3 months after injury for follow-up. Data were processed with t test or chi-square test.</p><p><b>RESULTS</b>There was no obvious difference in the rate of re-intubation after extubation in patients with moderate inhalation injury between those done within 2 weeks PII (15/70, 21.4%) and those done after 2 weeks PII (2/25, 8.0%) (χ(2) = 1.52, P > 0.05). Pneumonia incidence in patients of moderate inhalation injury with extubation within 2 weeks PII (21/70, 30.0%) was lower than those with extubation after 2 weeks PII (15/25, 60.0%) (χ(2) = 7.04, P < 0.05). Levels of above-mentioned indexes in patients with severe inhalation injury extubated in different stages were similar to those of patients with moderate inhalation injury. Within the first week after injury, mortality rate of patients with severe inhalation injury was higher than that of patients with moderate inhalation injury (χ(2) = 11.90, P < 0.05). During follow-up, tracheostenosis rate in patients with moderate or severe inhalation injury was 100.0%; granuloma formation rate and vocal cord paralysis rate in patients with severe inhalation injury were higher than those of patients with moderate inhalation injury (with χ(2) value respectively 4.59, 13.47, P values all below 0.05). The FEV(1) value of patients with moderate inhalation injury in the 1st, 2nd, 3rd month after injury was respectively higher than that of patients with severe inhalation injury (with t value respectively 5.48, 12.10, 6.25, P values all below 0.05). The values recovered to normal level in the 3rd month after injury.</p><p><b>CONCLUSIONS</b>Extubation time of tracheotomy for patients with moderate or severe inhalation injury within 2 weeks or after 2 weeks PII has its own advantage and disadvantage, and it should be performed according to specific conditions of each patient. Conservative treatment is optional for late complications of respiratory system.</p>

Clinical improvement in the therapy of aural keloids / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Keloids have a predilection for the aural region because of the special shape of the pinna. It is difficult to resect keloids entirely and maintain a satisfactory pinnal shape. Surgical excision in combination with radiotherapy is considered to be the most efficacious treatment available for severe keloids. This study was conducted to evaluate the treatment of aural keloids with intralesional excision and immediate postoperative adjuvant radiotherapy.</p><p><b>METHODS</b>Forty-six patients with a combined total of 74 aural keloids were treated by intralesional excision and immediate postoperative adjuvant radiotherapy. All patients received a total dose of 20 Gy in 10 consecutive days. The time interval between keloid excision and delivery of the first radiotherapy fraction was < 24 hours in all cases. The median follow-up was 2.2 years.</p><p><b>RESULTS</b>Twenty-nine patients with 48 keloids (64.9%) were highly satisfied with their outcome, and were rated as good by the surgeon. Six patients with 12 keloids (16.2%) showed general satisfaction but wanted aesthetic refinement, and these patients were rated as fair by the surgeon. Three patients with four keloids (5.4%) showed no evidence of recurrence after surgery, but disliked the result because of the discoloration and irregularity of the scar surface. These patients were rated as poor by the surgeon. Partial recurrence occurred in 8 patients with 10 keloids (13.5%). No major complications were observed.</p><p><b>CONCLUSION</b>Intralesional excision and immediate postoperative adjuvant radiotherapy is well tolerated and very effective in preventing recurrence of aural region keloids.</p>

Premovement of polyacrylamide hydrogel (PAAH) from breast through submammary fold incision / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the bad effect of breast augmentation with PAAH injection and the technique to remove PAAH from breast effectively and safely.</p><p><b>METHODS</b>43 cases (86 sides) underwent operation to remove the PAAH from breast through submammary incision, followed by dressing with pressure for 3 days. The patients received colored doppler ultrasonography and immunologic test before and 3 months after operation.</p><p><b>RESULTS</b>Postoperative ultrasonography showed residual PAAH in breast in one case. Among the 20 cases who had preoperative breast pain, the pain relieved completely in 10 cases and improved in the other 10 cases. All the patients had some abnormal results in immunologic test which improved 3 months after operation.</p><p><b>CONCLUSIONS</b>Breast augmentation with PAAH injection can result in breast pain and other complications. It may also have bad effect on the immune system. PAAH should be removed as soon as possible. The technique through submammary incision to remove PAAH is one of the safe and reliable methods.</p>

Replication of pathological scar in nude mice / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of reproduce hypertrophic scar and keloid in nude mice in the study of pathological scars.</p><p><b>METHODS</b>Pieces (0.8 x 0.8 x 0.5 cm) of hypertrophic scars and keloids were implanted into subcutaneous tissue of the nude mice for 16 days, during this period the gross condition of the nude mice and the state of the implants were observed. The implants were extracted after 16 days, and the volume, the microscopic characteristics of the scar, the content of acid mucopolysaccharide, and different types of collagen were determined and compared with that of the original specimens.</p><p><b>RESULTS</b>All mice survived with nice wound healing after the surgery. There was no obvious difference in the acid mucopolysaccharide content in keloid and hyperplastic scar before implantation (3448 +/- 1452, 1940 +/- 509), and after implantation (3237 +/- 1871, 1809 +/- 552, P > 0.05). The implants maintained the collagen pattern, with no signs of cell degeneration and necrosis.</p><p><b>CONCLUSION</b>This experiment showed that the viability and morphology of hypertrophic scars and keloids were maintained after they were implanted in nude mice. Therefore it is feasible to use nude mice as the animal model in the study of hypertrophic scars and keloids.</p>

Analysis of complications induced by polyacrylamide hydrogel injection for augmentation mammaplasty / 中华整形外科杂志

<p><b>OBJECTIVE</b>To analyze the complications induced by polyacrylamide hydrogel injection for augmentation mammaplasty, explore the reason of the complication.</p><p><b>METHODS</b>Twenty three patients with complications after polyacrylamide hydrogel injection were classified by signs and symptoms, ultrasound and pathologic examinations were made.</p><p><b>RESULTS</b>The main complications were pain, hard nodule, asymmetry and breast deformation. The injected material was distributed diffusely behind gland, in gland, in muscles subcutaneous, even out of breast, caused some pathologic changes and it's hard to be cleaned completely from normal tissue.</p><p><b>CONCLUSIONS</b>The complications were caused mainly by incorrect manipulation during operation, others might be relative to the injected material. The reliability of this injection method for augmentation should be cautiously observed.</p>