[Injection of indocyanine green by vasopuncture in fluorescence laparoscopic radical prostatectomy].

OBJECTIVE: To investigate the clinical application value of injection of indocyanine green (ICG) via vasopuncture in fluorescence laparoscopic radical prostatectomy (FLRP). METHODS: We retrospectively analyzed the clinical data on 50 cases of PCa treated by injection of ICG via vasopuncture in FLRP. The patients were aged (70.60 ± 5.67) years old, with an average PSA value of (18.42 ± 2.69) µg/L. During the operation, we injected ICG at 0.5 ml by vasopuncture through the vas deferens at each side of the scrotum, observed the visualized images of the vas deferens and seminal vesicles using normal high-definition, black-and-white fluorescence, green fluorescence, and color fluorescence respectively, and then isolated the adherent seminal vesicles under the laparoscope. RESULTS: A total of 93 injections of ICG were completed, 86 bilaterally, 4 on the right and 3 on the left. The vas deferens and seminal vesicles were visualized in 41 cases (60 sides, 64.52%), 19 bilaterally, 7 on the right and 15 on the left. Spillage of the fluorescent agent occurred in 9 cases during the incision of the bladder neck and adhesion of the seminal vesicles was found intraoperatively in 10 cases, in which the seminal vesicles were all quickly located by fluorescence visualization. No rectal injury occurred during the surgery. Mild scrotal subcutaneous bruises were observed in 2 cases, with a postoperative pathological Gleason's score of 7.44 ± 0.88. CONCLUSION: Injection of ICG by vasopuncture is minimally invasive and safe. ICG-mediated near-infrared imaging and real-time fluorescence imaging of the vas deferens and seminal vesicles can achieve precise positioning and removal of the seminal vesicles and prostate gland without causing rectal injury.

[A viral meningitis outbreak associated with Echo30 in drinking water].

OBJECTIVE: To study the source of infection, the scope of epidemic and control measures in an outbreak involving students having symptoms as fever, dizziness, headache, vomiting and nausea. METHODS: The suspected-case was defined as fever (armpit temperature ≥ 37°C) and with one or more of the following symptoms: dizziness, headache, vomiting and nausea, among students and teachers at school from Mar 1, 2012. Confirmed-case was among suspected case accompanied by both throat and rectal swabs enterovirus positive by RT-PCR. All the cases were collected through checking the medical records from 4 hospitals as well as through the absence records of students and teachers, from Mar 1, 2012. We conducted a case-control study with ratio of 1:2 and data on the exposures to water among students and teachers was collected prior to the illness. 27 cases' throat and rectal swabs were collected and analyzed by RT-PCR and PCR sequence methods. 2 warm-water samples were collected for testing the counts on total bacteria and E. coli. RESULTS: 103 students' cases were identified in school L, with the attack rate as 4.6% (103/2255). Students from Grade three had the high attack rate as 18.1% (72/397) and 77.7% (80/103) of the cases located in the building with 'multiple-functions'. Epidemic curve of the outbreak showed a pattern with continuous common source of infection. It seemed that the exposure to warm-water appeared to be the major risk factor (OR = 18.3, 95%CI: 2.0 - 169.5) together with the intake of un-boiled water (OR = 15.5, 95%CI: 1.7 - 141.8). Specimens from 27 students (81.5%, 22/27) were identified enterovirus positive by RT-PCR, and 7 of the 9 students were confirmed carrying Echo 30. Bacteria and coli were negative from the 2 warm-water samples. CONCLUSION: This viral meningitis-outbreak was caused by Echo 30, with drinking water as the major risk factor.

Crossing anastomosis of nerve bundles near innervated organs to treat irreparable nerve injuries.

OBJECTIVE: To study the therapeutical effects of crossing anastomosis of nerve on the peripheral and central nerve injuries. METHODS: Twelve kinds of central and peripheral nerve disorders and their complications were treated with 11 kinds of crossing anastomosis of nerve bundles near the innervated organs. After nerve injury and repair, somatosensory evoked potentials (SEPs) and horseradish peroxidase (HRP) retrograde tracing studies were used to investigate the rabbit's nerve function and morphology. RESULTS: The ulcers of all patients healed. Sensation, voluntary movement, and joint function recovered. Four weeks after the anastomosis of distal stump of radialis superficialis nerve and median nerve, pain sensation regained and SEPs appeared. HRP retrograde tracing studies demonstrated sensory nerve ending of medial nerve formed new connection with the body of neuron. CONCLUSION: Crossing anastomosis of nerve is an effective method to treat peripheral and central nerve injuries.