Observation on the curative effect of horizontal rectus transposition combining recess-resect treatment on monocular elevation deficiency with horizontal strabismus

Purpose: To explore the clinical effect of horizontal rectus transposition combining recess and resect treatment on monocular elevation deficiency (MED) with horizontal strabismus. Methods: Ten patients (10 eyes) scheduled to undergo horizontal rectus transposition combining recess?resect surgery to treat MED with horizontal strabismus in the ME Department of Ophthalmology of the First Affiliated Hospital of Guangxi Medical University between July 2016 and February 2022 were included in the study. The degree of vertical and horizontal prism strabismus, the grading of upper movement of the paralyzed eye, and the improvement of binocular vision were evaluated before and after the surgery. Results: Horizontal rectus transposition combined with recess and resect treatment was used to treat 10 patients with MED combined with horizontal strabismus. A good curative effect was seen in eight patients. The differences in the degree of vertical strabismus, the degree of horizontal strabismus, and the movement function of the paretic eyes before and after surgery were significantly different (all P < 0.05). The binocular haplopia function in six patients was reconstructed in the primary position after surgery. Conclusion: Horizontal rectus transposition combining recess?resect is easy to perform, and the number of recti involved in the surgery is small. This approach can effectively correct the eye position, improve eye movement, and reconstruct binocular vision in patients with MED by combining horizontal strabismus

Application of narrow-band imaging without magnifying in diagnosis of colorectal lesions by NICE classification / 上海交通大学学报（医学版）

Objective: To evaluate narrow-band imaging (NBI) without magnifying in the diagnosis of colorectal lesions by NBI International Colorectal Endoscopic Criteria (NICE classification), and analyze the safety and practicability of "do-not-resect" and "resect and discard" policies in clinical practice. Methods: The patients undergoing screening or surveillance colonoscopy, who were found colorectal lesions in the examination, from May to December in 2017 were enrolled. All the patients were examined by NBI without magnifying by any of the designated two physicians. NICE classification was used to diagnose colorectal lesions, and the diagnostic confidence of each lesion was recorded. The results of endoscopy were compared with those of pathology, and the accuracy rate and the confidence rate of diagnosis were calculated. The sensitivity, specificity, positive predictive value and negative predictive value of the diagnostic method for differentiating superficial tumors from non-tumors were also calculated. Finally, the feasibility, safety and cost savings of using "do-not-resect" and "resect and discard" policies in clinic were analyzed. Results: A total of 764 lesions were detected in the 636 enrolled patients. The overall accuracy of NICE classification was 84.95% and the diagnostic confidence rate was 81.68%. The sensitivity, specificity, positive predictive value and negative predictive value for differentiating tumors from non-tumors were 91.77%, 67.68%, 88.69%, and 74.86%, respectively. The diagnostic accuracy of diminutive colorectal lesions (≤5 mm) with high confidence was 94.98%, and the negative predictive value of diminutive rectosigmoid lesions (≤5 mm) with high confidence was 96.25%. They achieved the criteria of "resect and discard" and "do-not-resect" policies. If "do-not-resect" and "resect and discard" policies had been executed in clinical practice, ¥165 490 could have been saved and the omission diagnostic rates of "do-not-resect" and "resect and discard" policies would have been 3.75% and 0, respectively, in this study. Conclusion: It is feasible to use NBI without magnifying in differentiating tumors from non-tumors. The diminutive colorectal lesions and rectosigmoid lesions with high diagnostic confidence may achieve the criteria of "resect and discard" and "do-not-resect" policies, respectively.

Xanthogranulomatous cystitis with pelvic lymph node hyperplasia case report and literature review / 重庆医学

Objective To decrease the error and missed diagnosis of xanthogranulomatous cystitis(XC) .Methods Combined with laboratory and imaging examnation ,we considered the diagnosis of urachal carcinoma complicated by urinary track infection . Anti-infection treatment before surgery ,we removaled of the pathological tissues ,and the final diagnosis was XC .Results The clin-ical symptoms of XC was not typical ,and this case was similar to that of urachal carcinoma .Cystoscope and imaging examination had no specificity .There were not frequent micturition ,the the urgency of urination and low back pain of patiut of the patient by one year follow-up .Conclusion XC is very rarely ,and it is hard to differentiate from other bladder diseases ,tumor of the urachus .The final diagnosis may still depends on histopathological examination .

Clinical apllication of laparoscopic resection in 17 patients with colorectal cancer / 中国基层医药

Objective To investigate the feasibility and clinical results under laparoscopic resection of colorectal cancer.Methods Clinical data of 17 colorectal cancer patients with laparoscopic resection from October 2009 to September 2011 were analyzed.Results There were 16 cases of successful completion of laparoscopic surgery,conversion to open surgery in 1 case.Postoperative of incomplete intestinal obstruction and rectal vaginal fistula are each 1 case.Oncology did not occur metastasis through puncture holes in postoperative follow-up up to 2 years.Conclusion Laparoscopic resection of colorectal cancer should be widely applied,and it had more advantages such as less trauma,safety,recover quickly,consistent with the effect of laparotomy.