Suprapubis-assisted umbilical laparoendoscopic mini-dual-site surgery for varicocele: a report of 80 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the safety, effectiveness and feasibility of suprapubis-assisted umbilical laparoendoscopic mini-dual-site surgery (SAU-LEMDS) in the treatment of varicocele.</p><p><b>METHODS</b>This study included 80 varicocele patients aged 24 - 44 (mean 28.5 +/- 2.6) years, 25 cases of grade I, 45 cases of grade II and 10 cases of grade III, 58 cases in the left side, 6 in the right and 16 in both sides, and all with asthenospermia. The patients were treated by SAU-LEMDS under subarachnoid anesthesia combined with general anesthesia in a supine position with a head-down-feet-up slope of 15 degrees. Two 5 mm trocars were inserted bilaterally at the umbilical edge, one with a 5 mm 30 degrees laparoscope placed in it, and another into the abdominal cavity below the pubic hairline with a 5 mm laparoendoscopic clipper placed in it. The operation procedure was similar to that of standard laparoscopic ligation of spermatic veins, with reservation of the spermatic artery and double-ligation of spermatic veins. And the procedure was repeated for the contralateral lesion in the bilateral cases. Postoperative follow-up was conducted for the incidences of orchiatrophy and testicular hydrocele and changes of seminal parameters.</p><p><b>RESULTS</b>All the operations were successful, with the mean operation time of (10 +/- 5.0) min (range 8 to 25 min) for the unilateral cases and (18 +/- 6.5) min (range 15 to 30 min) for the bilateral cases, the mean blood loss of (1.5 +/- 0.5) ml (range 1 to 2 ml), and the mean postoperative hospital stay of (2 +/- 0.5) d (range 1.5 to 3 d). The patients were followed up for 6 -24 (12 +/- 2.5) months, which showed significant improvement in sperm motility as compared with the baseline ([28.53 +/- 5.21] vs [19.62 +/- 3.56]%, P < 0.05), with 28 cases (35.0%) restored to normal. Recurrence was found in 4 cases (5.0%). Testicular hydrocele occurred in 7 cases (8.75%), but orchiatrophy in none. The scars in the umbilicus and suprapubis were invisible because of the wrinkles and pubic hair.</p><p><b>CONCLUSION</b>SAU-LEMDS is safe, effective and feasible for the treatment of varicocele. It is superior to umbilical laparoendoscopic single-site surgery (U-LESS) for its less invasiveness, simpler operation, and better cosmetic appearance.</p>

A study on the neuronal mechanism of retrieval of long-term digital memory in human by functional magnetic resonance imaging / 生理学报

To investigate the neuronal mechanism of retrieval of long-term digital memory in healthy volunteers, functional magnetic resonance imaging (fMRI) technique was used in the study. Twenty-two right-handed volunteers were subjected to a long-term digital memory test with block-design. The memory task and control task were adopted in the experiment alternatively. The fMRI data were recorded by a Siemens 1.5T MR machine and analyzed by SPM99. The activated brain regions were shown in the Talairach coordinate. The results showed that the Brodmann's area (BA) 9 region in left middle frontal gyrus was the most activated cortex during the long-term digital memory task. The left medial frontal gyrus, left inferior frontal gyrus, right inferior frontal gyrus, cingulate gyrus, left inferior parietal lobule, left superior parietal lobule, right superior parietal lobule, right middle temporal gyrus, left lingual gyrus, left middle occipital gyrus, right middle brain, cerebellum and right caudate nucleus tail were also involved. The activation in cortices showed obvious left predominance. It is suggested that a series of brain regions with left predominance are involved in long-term digital memory. Left lateral frontal cortex would be the most important structure for information extraction, while the other cortices and their connections may be important for processing and long-term storage of digital information.

Activated brain areas during simple and complex mental calculation--a functional MRI study / 生理学报

Functional magnetic resonance imaging (fMRI) was used to study the activated brain areas of human during simple and complex digital calculation, and to investigate the role of cortical and subcortical structures involved in the mental calculation. Sixteen right-handed healthy volunteers performed mental calculation of simple and complex addition/subtraction respectively, while the fMRI data were recorded by a Seimens 1.5 T MR machine. Block-design was used in the tasks. Two calculation tasks and one base-line tasks were performed for the block-design. Simple calculation task was single-digit addition and subtraction, while the complex was multi-digit addition and subtraction. The base-line task was to tell whether the two numbers were the same in every trial. Statistical parametric mapping (SPM99) was employed to process data and localize functional areas. We compared the average activation intensity of each activated brain regions in the same calculation task and the activation intensity of the same regions in both tasks respectively. Both the cortex and the subcortical structures including basal ganglia and thalamus were activated during simple and complex mental calculations. Similar brain regions in subjects including frontal lobe, parietal lobe, occipital lobe, cingulate gyrus, thalamus and cerebellum were engaged in simple and complex addition/subtraction. In the same task, activation intensity of all activated brain areas differed insignificantly. Compared with the complex task, the right parietal lobe was not activated in the simple one. The subcortical structures such as the caudate nucleus and the left marginal division of the striatum (MrD) were activated in both two calculation tasks. The cortical regions involved in both simple and complex addition/subtraction were similar. In conclusion, both the cortex and the subcortical structures were activated during the mental calculation. The cortex including the frontal cortex, parietal cortex, and cingulate gyrus were activated during mental calculation, while the subcortical structures such as the caudate nucleus, the globus pallidum and the left marginal division of the striatum also played a critical role in the neural networks of the calculation at the same time. Right parietal lobe (supramarginal gyrus) was engaged only in the complex task, which suggested that this region might be involved in the visuospatial memory and processing.