A comparative study of the effect of irreversible electroporation and radiofrequency ablation on rat liver neovascularization / 中华肝胆外科杂志

Objective To investigate the difference of hepatic microvessel density, neovasculariza-tion of regenerating liver tissue after ablation of two ways of irreversible electroporation and radiofrequency ablation in rats. Methods 90 male Sprague-Dawley rats were randomly divided into 3 groups, including the control group ( n =30), the irreversible electroporation group ( n =30 ) and the radiofrequency ablation group (n=30). 3,7 and 10 days were executed after the operation and draw material, expression of vascu-lar endothelial growth factor(VEGF) and CD34 in tissue was studied by immunohistochemistry, and the mi-crovascular density of tissue and VEGF positive cells were measured. Results The microvascular density of 3, 7 and 10 days in the control group was 50. 3 ± 12. 5, 54. 6 ± 11. 9 and 58. 2 ± 14. 7, the microvascular density of the radiofrequency ablation group was 18. 4 ± 4. 7, 17. 3 ± 5. 1 and 18. 1 ± 5. 9, respectively. The microvascular density of the irreversible electroporation group was 42. 8 ± 10. 4, 45. 6 ± 10. 2 and 49. 2 ± 13. 8, respectively. The positive cells of VEGF in control group was 50, 56 and 57 at 3, 7 and 10 days, and 32, 30 and 33 at 3, 7 and 10 days in radiofrequency ablation group, 44, 43 and 45 at 3, 7 and 10 days in irreversible electroporation group; expression of VEGF and CD34 in 3, 7, 10 d and the microvascular density of ablation area in radiofrequency ablation group was significantly lower than those in control group after irreversible electroporation and radiofrequency ablation. No significant differences were found between irreversible electroporation group and control group. Conclusion The irreversible electroporation can effectively protect the microvessels in the ablation area, ensure the tissue’s blood supply after the ablation, and provide a guarantee for the repair and regeneration of the tissue.

Clinical study of correlation between syncope and risk of death in patients with cardiovascular emergencies / 中华急诊医学杂志

Objective To explore the relationship between syncope and risk of death in patients with cardiovascular emergencies including acute myocardial infarction(AMI), arrhythmia, acute heart failure(AHF), pulmonary thromboembolism(PTE) and aortic dissection(AD) rupture. Methods Data from 2 789 patients with cardiovascular emergency admitted from June 2010 to June 2016 in the Emergency Department, Air Force General Hospital, PLA was retrospectively analyzed. Difference in gender, age and motality were compared between patients with syncope and those without syncope. Among fi ve kinds of cardiovascular emergency events with syncope, difference in mortality were compared. Difference in mortality were also analyzed by the CHM corrected chi square test when difference of disease, gender and age were taken into consideration. Syncope, the type of cardiovascular emergency, gender and age were analyzed as potential risk/protective factors for death by the multiple logistic regression analysis. Results The mortalities of the fi ve diseases accompanied with syncope were 50%, 30.43%, 26.53%, 20% and 7.04% respectively in arterial dissection, pulmonary embolism, acute myocardial infarction, acute heart failure and arrhythmia.There was a statistically signifi cant difference in mortality among the fi ve kinds of cardiovascular emergencies accompanied with syncope(P<0.05).The mortalities of patients with syncope were significantly higher than those without syncopein AMI patients(26.53% vs.11.20%,P<0.05) and cardiac arrhythmias patients(7.04% vs.0.36%,P<0.05).The results of the CHM corrected chi square test showed that there was signifi cant difference in mortality between the syncope group and non-syncope group, when the differences in disease type, age and gender were adjusted (χ2=35.876, P<0.01). The mortality of syncope group was higher than that of non-syncope group.When age, gender and disease type were considered as covariates, the multiple logistic regression analysis showed that syncope signifi cantly increased the risk of mortality(OR=3.876,95% CI:2.362-6.359,P<0.01).Conclusion Syncope is an independent risk factor of death in patients with cardiovascular emergencies.

Research status and progress of ablation therapy for locally advanced pancreatic cancer / 中华肝胆外科杂志

Locally advanced pancreatic cancer remains to be a disease with dismal prognosis,despite the improvements in chemotherapy or chemoradiotherapy,which was recognized as standard treatment.A heterogeneous armamentarium of locoregional ablative therapeutic options has been successfully applied for other solid organ malignancies.Recently,they were gradually applied in pancreas and commenced to show benefits.However,there are still many problems to be discussed.Here we reviewed the recent publications on the feasibility,safety and efficiency of various ablation treatments that have been applied to pancreatic cancer.

Comparison of laparoscopic distal pancreatectomy and open distal pancreatectomy in pancreatic ductal adenocarcinoma / 中华肿瘤杂志

Objective@#To compare and evaluate the curative effect of laparoscopic distal pancreatectomy(LDP) and traditional open distal pancreatectomy(ODP) in pancreatic ductal adenocarcinoma.@*Methods@#The clinical data of 15 patients treated by LDP and 87 contemporaneous cases treated by ODP from January 2010 to November 2015 was collected, and the curative effect and prognosis of these patients were retrospectively analyzed.@*Results@#The operation time of LDP group was (286.5±48.1) min, significantly longer than that of OPD group(226.6±56.8) min (P<0.05). The operative hemorrhage, postoperative exhaust time, recovery eating time, the whole and postoperative hospitalization time of LDP group were (188.7±108.9) ml, (2.2±1.3) d, (2.9±1.1) d, (13.2±10.4) d and (9.3±8.1) d, respectively, dramatically shorter than those of ODP group (625.2±982.1) ml, (4.3±1.7) d, (5.2±1.8) d, (20.7±8.7) d and (14.9±7.8) d, respectively (all of P<0.05). There were no intraoperative blood transfusion case in LDP group, however, 13 patients in ODP group received intraoperative blood transfusion, without significant difference (P=0.207). Alternatively, 6 cases occurred pancreatic fistula in LDP group, among them, 5 cases were grade A and 1 case was grade B; In ODP group, 17 cases occurred pancreatic fistula, among them 13 cases were grade A, 1 case was grade B and 3 cases were grade C, without significant differences (P=0.130). There were 2 cases of delayed gastric empty, 1 case of pulmonary infection in LDP group. In ODP group, there were 5 cases of postoperative delayed gastric empty, 3 cases of pulmonary infection and 6 cases of intra-abdominal infection, without significant differences (P>0.05). In both LDP group and ODP group, none occurred percutaneous drainage, re-admissions, second operation or perioperative death.@*Conclusions@#Compared to ODP, LDP is much safer and more steady in perioperative periodand operation. Patients of pancreatic ductal adenocarcinoma received LDP can acquire more benefit and recovery sooner, and LDP is a safe and effective operative method.

Irreversible electroporation for treatment of locally advanced pancreatic cancer / 中华肝胆外科杂志

Objective To evaluate the overall survival in patients with locally advanced pancreatic cancer (LAC) treated with irreversible electroporation (IRE) and chemotherapy.Methods A retrospective study on the overall survival of 30 patients with LAC treated with IRE,and 30 patients with LAC treated with chemotherapy from July 2015 to October 2016 in the PLA General Hospital was conducted.Results For the 30 patients with LAC who underwent IRE successfully,there were 21 women and 9 men.The median age was 59 (36 ～81) years.Twenty-four patients had primary pancreatic head cancer and 6 had body cancer.Twelve (40.0％) of these patients had chemotherapy after the IRE ablation.The 90-day mortality in the IRE treated patients was 3 (10.0％).For the 30 patients with LAC who were treated with chemotherapy,the 90-day mortality was 6 (20.0％).In comparison of the IRE treated patients with the chemotherapy treated patients,improvements on disease-free survival (6 months vs.4 months,P ＜ 0.05) and overall survival (11 months vs.5.6 months,P ＜ 0.05) were observed.Conclusion IRE ablation of LAC was safe and could potentially improve overall survival when compared with the standard chemotherapy treatment.

Perioperative safety and effect of irreversible electroporation in the management of locally advanced pancreatic carcinoma / 中华肝胆外科杂志

Objective To evaluate the perioperative safety and effect of irreversible electroporation (IRE) in the treatment of locally advanced pancreatic carcinoma (LAPC).Methods Twenty patients with imaging and cytohystological diagnosis of unresectable locally advanced pancreatic carcinoma were enrolled to undergo IRE treatment.The perioperative IRE-related complications were primarily analyzed to evaluate the safety of the procedure.The tumor reduction and biological response were analyzed through CT/MRI imaging and serous level of CA19-9.Results All patients were successfully treated with an average tumor size of(4.2 ± 0.6) cm and an average procedure time of (52.0 ± 23.3) minutes.Three intraoperative procedure-related complications were observed (15.0％) including two transient hypertension and one transient superventricular tachycardia.Six postoperative complications were described including two Grade A pancreatic fistula,one infection of incision,one portal vein thrombosis,one gastrointestinal hemorrhage and two functional delayed gastric emptying.The symptom remission rate was 73.7％ and lower serum CA19-9 level was recorded in all patients at discharge.Conclusions IRE is a safe and feasible procedure in the treatment of LAPC, and a reasonable operation strategy of IRE is helpful to consolidate the safety and efficacy.

Application of irreversible electroporation in the management of locally advanced pancreatic adenocarcinoma / 中华肝胆外科杂志

Irreversible electroporation (IRE) is a nontemperature based novel ablation therapy in which short highvoltage pulses are applied to treat tissues to permeabilize the cell membrane irreversibly and thus lead to cell apoptosis.Because it is characterized as non-thermal,IRE can reduce the risk of thermal damage to vital organs and structures so that it is more feasible for the treatment of unresectable pancreatic cancer and thus provide an ideal alternative to other thermal treatment modalities.This review aims to analyze current literature of IRE and to discuss the new progress of the application of IRE in the management of locally advanced pancreatic adenocarcinoma.

Diagnosis and treatment of primary hepatic neuroendocrine carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the clinical features, diagnostic and therapeutic methods of primary hepatic neuroendocrine carcinoma.</p><p><b>METHODS</b>The clinicopathological data of fourteen patients with primary hepatic neuroendocrine carcinoma confirmed by pathology were analyzed retrospectively and related literatures were reviewed.</p><p><b>RESULTS</b>The fourteen patients, including eight males and six females, had an age range of 23-58 years (mean 45.9 years). Four tumors were located in the right liver lobe, four in the left liver lobe and six in both. The clinical manifestations were nonspecific and variable. The most common clinical manifestation was abdominal distention or right upper quadrant pain. Radiological findings were not specific and could not distinguish primary hepatic neuroendocrine tumor from hepatocellular carcinoma. Diagnosis of primary hepatic neuroendocrine tumor was confirmed by pathology using immunohistochemical staining and by the absence of extrahepatic primary lesions. Extrahepatic primary neuroendocrine carcinoma was ruled out by ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography-computed tomography (PET-CT), preoperative gastrointestinal endoscopy and long-term postoperative follow up. Three patients received surgical treatment, two cases received surgical resection and radiofrequency ablation (RFA), six patients received transarterial chemoembolization, one case received orthotopic liver transplantation, one case only received exploratory laparotomy, and one case received chemotherapy. All 14 patients were followed up and seven of them are still alive, the others died of liver failure or recurrence.</p><p><b>CONCLUSIONS</b>Primary hepatic neuroendocrine carcinomas are extremely rare. Its diagnosis should be confirmed by pathology. Preoperative fine needle biopsy is strongly recommended. Prognosis is relatively favorable. Surgical resection is treatment of first choice, and TACE, RFA, and chemotherapy can be used for unresectable patients.</p>

Nanoknife ablation of the pancreas in vivo experiment / 中华肝胆外科杂志

Objective Nanoknife,also called irreversible electroporation,is a new technique of tissue ablation.Short,microsecond electrical pulses with high voltage are applied to the cell membrane,causing pores to form within the membrane and finally leading to cell death.The current study was to investigate the efficacy and safety of the nanoknife in the ablation of the healthy pig pancreas.Methods Three healthy pigs underwent open pancreatic tissue ablation with nanoknife,and blood leukocytes and amylase were detected before and after treatment.Three pigs were sacrificed and gross specimens were collected on day 5,day 10 and day 15 after the procedure,respectively.HE staining and TUNEL staining were conducted and tissue,cellular and subcellular structures were observed under the ordinary microscope and transmission electron microscopy.Results Three experimental pigs recovered well after the procedure.No significant adhesions were found surrounding the pancreatic tissue,and the ablation zone was slightly harder.Transiently increased leukocyte count and amylase level were observed after the ablation,which decreased to the normal level on day 3 after treatment.Under light microscope,the pancreatic tissues in ablation zone appeared to be significantly different from the normal surrounding regions,with more cell death and more apoptotic cells detected by TUNEL staining.The subcellular structure changes also changed under electron microscope.But the main pancreatic duct and its large branches,together with arteriovenous distributions did not change much.Conclusions Nanoknife pancreatic tissue ablation can induce irreversible damage.In the ablation area,pancreatic duct and vascular structures are kept intact.Within a reasonable voltage range and appropriate electrical pulses setting,nanoknife ablation is safe in vivo experiment.

Diagnosis and surgical treatment of functional insulinomas: report of 132 cases / 国际外科学杂志

Objective To investigate the diagnosis and surgical treatment of functional insulinomas.Methods One hundred and thirty two patients from January 2002 to May 2013 were retrospectively reviewed who was confirmed as functional insulinomas by pathology.Results There were 43 males and 89 females.56 cases were located in the head of pancreas,76 body and tail of pancreas.69 patients underwent open enucleation,48 patients had Laparoscopic surgery,5 patients underwent distal pancreatectomy,9 patients had Laparoscopic distal pancreatectomy,1 patients had pancreaticoduodenectomy.The difference of variant imaging examination in Checking insulinomas was statistical significant(P ＜0.01).Laparoscopic treatment of insulinomas was at least as safe as open treatment.Conclusions Imaging examination could improve the accuracy of preoperative diagnosis of insulinomas.Surgery was the most effective methods to cure insulinomas and Laparoscopic surgery was becoming increasingly popular in treating insulinomas.

Clinicopathological and CT features of mucinous cystic neoplasms of the pancreas / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the clinicopathological and CT features of mucinous cystic neoplasms (MCNs) of the pancreas and analyze the correlative risk factors for malignant pancreatic mucinous cystic neoplasms.</p><p><b>METHODS</b>Ninety-eight patients who underwent curative resection for mucinous cystic neoplasms of the pancreas at PLA General Hospital from April 1994 to January 2013 were included in this study. All clinicopathological data available were retrospectively analyzed. All patients were divided into benign tumors + premalignant lesion group (70 patients) and malignant tumor group (28 patients). Clinicopathological and CT features of the mucinous cystic neoplasms of the pancreas and risk factors of malignant pancreatic mucinous cystic neoplasms were analyzed.</p><p><b>RESULTS</b>Mucinous cystic neoplasms were seen mostly in perimenopausal women (71.4%, 70/98 cases,), and 51.0% (50/98 cases) of the patients had obvious clinical signs, mostly non-specific abdominal pain, but jaundice was present only in cases of malignant mucinous cystic neoplasms. Benign mucinous cystic neoplasms were mostly located in the distal pancreas (74.3%) and characterized with septa and thin cystic wall, while more malignant mucinous cystic neoplasms were located at the proximal pancreas (57.1%) and characterized with thick cystic wall and solid components. Univariate analysis showed that findings associated with malignancy gender, age ≥ 60, presence of symptoms, jaundice, weight loss, tumor location, margin, wall thickness, solid components and dilation of the main pancreatic duct were significantly correlated with malignant tumor development (P < 0.05 for all). The results of multiple logistic regression analysis showed that thick wall and solid components were independent prognostic factors for malignancy (OR = 31.417 and 34.976, P < 0.05 for both).</p><p><b>CONCLUSIONS</b>Gender, age ≥ 60, presence of symptoms, jaundice, weight loss, tumor location, margin, wall thickness, solid components and dilation of the main pancreatic duct are important diagnostic indices of malignant mucinous cystic tumors of the pancreas, while thick wall and solid components are independent risk factors of malignant pancreatic mucinous cystic neoplasms.</p>

Perioperative management of pancreaticoduodenectomy patients / 中华肝胆外科杂志

Objective To investigate the perioperative treatment and reduce the surgical risk in patients after pancreaticoduodenectomy (PD).Methods We retrospectively analyzed the clinical data of 213 PD patients operated at the PLA General Hospital from January 2012 to December 2012.Results The postoperative complications included pancreatic fistula (51 cases,24％),biliary fistula (8 cases,3.8％),intestinal fistula (8 cases,3.8％),gastroparesis (35 cases,16.4％),abdominal infection (16 cases,7.5％),and postoperative bleeding (16 cases,7.5％).The perioperative mortality was 1.9％ (4/213).Conclusion Strengthening the perioperative management of PD patients plays an important role in improving surgical safety and reducing postoperative complications.

Observation of Clinical Efficacy of Chushi Huowei Decoction in Treating Inflammation of Gastric Relict of Spleen-Stomach Damp Heat Type / 中国中医药信息杂志

Objective To observe the clinical efficacy and safety of Chushi Huowei Decoction in treating inflammation of gastric relict of spleen-stomach damp heat type. Methods Totally 62 patients with inflammation of gastric relict were divided into treatment group and control group with random number table, 31 patients in each group. The control group was given hydrotalcite and the treatment group was treated by adding of Chushi Huowei Decoction. After eight-week treatment, the clinical efficacy, gastric mucosal lesions efficacy, and gastric mucosal pathology efficacy of the two groups were compared. Results Eight-weeks later, traditional Chinese medicine symptom scores of both groups were obviously lower than those before treatment (P<0.01). And the decrease in the treatment group was more obvious than that in the control group (P<0.01). Curative effects of gastric mucosal lesions and pathologic condition in treatment group were better than those in the control group (P<0.05, P<0.01). Neither groups had any adverse reaction. Conclusion Chushi Huowei Decoction has reliable therapeutic effect and safety in treating inflammation of gastric relict of spleen-stomach damp heat type.

Impact of lower calyceal anatomic structure on flexible fibreoptic ureteroscopy with Holmium laserin treatment of calyceal calculi / 中华泌尿外科杂志

Objective To evaluate the impact of lower renal calyceal anatomic structure on flexible fibreoptic ureteroscopy with holmium laserin treatment of calyceal calculi.Methods From January 2007 to December 2011,a total of 60 patients with a lower calyceal renal stone were enrolled in this study.The mean age was 51 years (range 23 to 78 years).The mean height was 169.8 cm,and mean body mass was 71.2 kg.Intravenous urogram (IVU) was performed on all patients and the lower pole anatomy (including infundibulopelvic angle,length of the inferior caliceal infundibulum and infundibular width) were measured in these patients.The correlation between lower pole anatomy and the success of flexible fibreoptic ureteroscopy with holmium laser for calyceal calculi was analyzed.Results Of the 60 patients,42 patients were successful in stone clearance.The patients in the stone-free group age of (50.1 ± 14.6) years,height (169.8 ±5.1) cm,body mass (71.4 ±5.1) kg,the maximum stone size in diameter (10.9 ±2.1) mm,stone burden (85.4 ± 9.5) mm2,lower infundibular length (36.3 ± 3.7) mm and lower infundibular width (4.9 ±1.4) mm; the other 18 patients age (50.7 ± 11.7) years,height (169.9 ±6.4) cm,body mass (71.6±4.7) kg,the maximum stone size in diameter (11.3 ±2.4) mm,stone burden (82.5 ±8.6)mm2,lower infundibular length (37.2 ± 2.3) mm and lower infundibular width (4.8 ± 1.9) mm.There was no difference between the stone-free group and the residual group in all above parameters (P ＞ 0.05).However,the infundibulopelvic angle in the stone-free group was significantly greater than that in the residual group (63.4 ± 23.2 vs 45.32 ± 17.6,P ＜ 0.05).x2 test showed the stone clearance rate in patients with angle ≥45 was better than that in those with angle ＜45 (84.6％ vs 42.7％,P ＜0.05).If grouped by infundibulopelvic angle,patients with infundibulopelvic angle greater than 90°had stone clearance rate 92.3％ (12/13),those with angle ranged from 30° to 90° had 73.2％ (30/41),and those with infundibulopelvic angle smaller than 30° had 0％ (0/6).Logistic regression analysis showed that the angle was a significant independent predictor of stone clearance (OR =1.12,P ＜ 0.05).Conclusions The infundibulopelvic angle has adverse influences on the performances of flexible ureteroscopy.The samller the angle is,the poorer the performances of flexible ureteroscopy is.

Feasibility of resection of internal wall for pancreatic mucinous cystic neolplasms / 中国综合临床

Objective To investigate the feasibility of resection of internal wall for pancreatic mucinous cystic neolplasms (MCN).Methods Successive observation and cyst wall thickness measurement of the pathological sections of 24 cases with pancreatic MCN admitted in our hospital during 2008-2011.One patient with pancreatic tail MCN was treated by resection of internal wall.Results The cyst wall thicknesses of the 24 cases vary from 2 mm to more than 2 cm,and the thicknesses of fibrous envelop near pancreatic vary from 0.1 mm to 8.0 mm.The fibrous envelop thickness of 17 cases were more than 0.5 mm(70.8％,17/24).These cases could be treated with resection of internal wall.Pancreatic leakage occurred in 8 of the 24 patients (33.3％,8/24).The patient treated by resection of internal wall had no pancreatic leakage.Conclusion We consider that 70.8％ cases of pancreatic MCN could be treated by resection of internal wall to cure MCN and avoid the possibility of postoperative pancreatic fistula.

Optimizing plan for right lobe living donor hepatectomy based on the territorial volume drained by the middle hepatic vein / 中华普通外科杂志

Objective To optimize plan for right lobe living donor hepatectomy based on the territorial volume drained by the middle hepatic vein (MHV) as shown by preoperative MR image in donors.Methods Utilizing preoperative MR dynamic enhancement scanning image,virtually plot three types of hepatic parenchyma transsection plane based on the variation of including MHV for right lobe graft procurement. Results From June 2006 to May 2010,65 adult-to-adult right lobe living donor liver transplantations was performed at General Hospital of Chinese PLA,in which there were 43 grafts including MHV (66.2％,43/65 ), eight grafts including partial MHV which was dissected before the V4b abouchement ( 12.3％,8/65) and 14 grafts not including MHV (21.5％,14/65). There was no postoperative death in donors and the postoperative complications developed in 10.76％ (7/65). The recipients' perioperative mortality was 7.69％ (5/65). Ttwenty-one complications developed in 18 recipients,and the morbidity was 32.31％. The cumulative survival rates were 86％,77％ and 68％respectively for 1,2 and 3 years. Conclusions The optimizing liver resection plane could be practically designed preoperatively for right lobe graft procurement based on the territorial volume drained by MHV.

Dagnosis and treatment of traumatic pancreatic injury / 中华肝胆外科杂志

Objective To investigate the diagnosis and treatment of traumatic pancreatic injury.Method The clinical data of 35 patients with traumatic pancreatic injury treated between January 1998and July 2010 at the General Hospital of Chinese PLA were retrospectively analyzed.Results There were 9 patients with Grade Ⅰ injury,7 with Grade Ⅱ injury,7 with Grade Ⅲ,7 with Grade Ⅳ,and 5 with Grade V injury,respectively.The diagnostic rate using CT before operation was 75.8％.8 patients with mild traumatic pancreatic injury received nonoperative treatment. 27 patients underwent open operation which included 15 simple external drainage of the pancreas area,2 distal pancreatectomy,5 Roux-en-Y pancraticojejunostomy,3 duodenal diverticulisation procedure,and 2 pancreaticoduodenectomy.After operation,there were 14 patients with pancreatic leakage,9 with intraabdominal infection,and 6 with intrabdominal bleeding.There were 3 patients with Grade Ⅳ and Grade V injuries who died of multiple organ failure or uncontrolled massive intraabdominal bleeding.Conclusions It was difficult to diagnose pancreatic injury before operation.CT was a suitable method to accurately diagnose severe traumatic pancreatic injury.Most minor pancreatic injury could be treated nonoperatively or by external drainage.The appropriate operation should be selected according to the extent and degree of the injuries basing on the principle of damage control in patients with major injuries.Pancreatic fistula,intraabdominal infection and bleeding were conrmon complications after operation.Multiple organ failure and massive bleeding were the main causes for mortality.

Application value of ureteroscopytherapy in the treatment of hematospermia / 中华泌尿外科杂志

Objective To treat hematospermia by ureteroscopy and investigate its application value for the treatment of hematospermia.Methods Nineteen patients with persistent hematospermia, TRUS,seminal vesicle MRI or CT were examined to exclude seminal vesicle tumor, tuberculosis, prostatic occupancy and preoperative prostatic fluid and drug sensitivity.Transurethral 4.5 - 6 F ureteroscopy entered through the microscopic seminal vesicle, wash of the old blood, reserved perfusion with Quinolones, and the lithoclasty on the seminal stones by holmium laser, resection of small polypi.Results The ureteroscopy was successful in 18 (95%) cases for bilateral seminal vesicle, wash and drug reserved perfusion, and one case was also successful seminal vesicle microscopy on the affected side; five cases with the seminal stones by olmium laser, three cases with small polypi by resection.The averse duration of the procedure was 35 10 -75) min.There were no compliocations during or after the operation.In 18 cases at 6 - 12 months follow-up the hematospermia and symptoms of hematospermia disappeared fully after 90 d.There was recurrence in one case which improved with anti-inflammaotry treatment.Conclusions Ureteroscopic treatment for persistent hematospermia by 4.5 - 6 F ureteroscopy through the seminal vesicle is effective and safe method and results in a micro-wound.

Effect of the differences in clinical classification and operational method of gallbladder carcinoma on the prognosis after resection / 中国综合临床

Objective To investigate the effect of clinical classification and operational methods of gallblad-der carcinoma on the prognosis.Methods Clinical data of 88 patients with gallbladder carcinoma treated surgically from January 1994 to December 2004 were retrospectively analyzed.Results 8 cases were in class Ⅰ and Ⅱ , 14 in class Ⅲ ,28 in class Ⅳ,38 in class Ⅴ.The mean survival of these 4 classifications was 36.5,9.3,4.6,3.9 months respectively.There was a remarkable difference(P <0.01,P<0.05) in survival among these 4 classifications ex-cept between class Ⅳ and class Ⅴ (P0.05).The mean survival of radical resection and palliative resection in class Ⅳ and Ⅴ was 4.2 and 3.8 months.There was no remarkable difference( P0.05 ) between them.Conclusion The key to increase the therapeutic effect gallbladder carcinoma is early diagnosis and radical resection.

Effect of mitomycin C instilled immediately after TUR added with low dose BCG maintenance therapy to prevent recurrence of superficial bladder cancer / 中国康复理论与实践

@#Objective To observe therapeutic effects of intravesical instillation of mitomycin C (MMC) immediately after TUR added with low dose BCG maintenance therapy to prevent recurrence of superficial bladder cancer. Methods 83 patients with superficial bladder cancer were randomly divided into two groups, 50 cases were managed with intravesical instillation of mitomycin C immediately after TUR added with low dose BCG maintenance therapy (group A), 33 cases were treated with traditional method of MMC therapy (group B) to prevent recurrence of superficial bladder cancer. Results After 12-66 months (mean 32 months) following up, 3 patients had tumor recurrence in the group A and 7 patients in the group B, the rate of tumor recurrence of the group A was 6.0% (3/50) and that of the group B was 21.2%(7/33), and there was a significantly difference between two groups (P<0.05). Side effects of the group B were obviously more than that of the group A. Conclusion Intravesical instillation of MMC immediately after TUR added with low dose BCG maintenance therapy is effective to prevent patients with superficial bladder cancer from recurrence.