Current state of the art of hybrid coronary revascularization / 中华胸心血管外科杂志

Hybrid coronary revascularization has been developing for more than 20 years since it was first proposed by Angelini in 1996. HCR combines the benefit of surgical anastomosis of the left internal mammary artery to the left anterior descending coronary artery graft along with stenting of non-LAD lesions with percutaneous coronary intervention, and achieves complete revascularization. In this review, we have summarized the current state of the art of HCR, including the history, conception, types, patient selection, perioperative antiplatelet strategies, surgical techniques, clinical results as compared with conventional coronary artery bypass grafting and PCI, and the future of HCR.

Research progress on clinical outcomes of hybrid coronary revascularization / 中国胸心血管外科临床杂志

@#Hybrid coronary revascularization (HCR) combines the advantages of minimally invasive direct coronary artery bypass grafting (MIDCAB) and percutaneous coronary intervention (PCI), and avoids its relative shortcomings, which has received particular attention in recent years. HCR seems to have become the third revascularization strategy for multi-vessel disease in coronary heart diseases. However, the clinical researches on HCR are still limited. This article will systematically review the comparison of HCR with coronary artery bypass grafting (CABG) and PCI, the results of HCR in specific patients, and the clinical results of different HCR strategies.

Cross-sectional survey of life quality of patients with deep partial-thickness and above burns on head and face at discharge and analysis of its influencing factors / 中华烧伤杂志

Objective@#To study the quality of life and its influencing factors of patients with deep partial-thickness and above burns on head and face at discharge, and to guide clinical nurses to provide targeted nursing for patients.@*Methods@#A cross-sectional survey was conducted on 42 patients with deep partial-thickness and above burns on head and face who met the inclusion criteria. The patients were hospitalized from January 2014 to November 2017 in the Department of Burns and Plastic Surgery of our hospital and were selected by adopting the convenient sampling method. On the day before discharge, the Chinese version of the Abbreviated Burn Specific Health Scale was used to assess the scores in various fields of patients′ quality of life and total scores. The self-designed general situation questionnaire was used to investigate the gender, age, education level, occupation, marital status, cause of injury, and source of expenses of patients, and the scores in various fields of quality of life of patients in various general conditions and total scores were recorded. Data were processed with t test or one-way analysis of variance. The indicators with statistically significance in the total score difference in the above analysis were chosen, and multivariate linear regression analysis was performed to screen the factors influencing the quality of life of patients.@*Results@#Totally 42 groups of questionnaires were sent out and 42 groups of valid questionnaires were retrieved. The effective recovery rate was 100%. The total score of quality of life of patients at discharge was (49±10) points. The scores of general health status (57±23) points, social relations (56±18) points, physical function (49±17) points, and mental health (41±20) points were ranked from high to low. There were statistically significant differences in the scores of physical function, mental health, and general health status among patients of different age groups (F=8.115, 14.182, 19.285, P<0.01). There were statistically significant differences in the scores of mental health, social relations, and general health status among patients with different educational levels (F=3.312, 51.176, 21.852, P<0.05 or P<0.01). There were statistically significant differences in the scores of mental health and general health status among patients with different occupations (F=3.667, 2.947, P<0.05). The scores of mental health and social relations of married patients were significantly higher than those of unmarried patients (t=27.096, 4.885, P<0.05 or P<0.01). There were statistically significant differences in the scores of physical function, mental health, social relations, general health status of patients with different causes of injury (F=3.000, 5.438, 4.005, 9.125, P<0.05 or P<0.01). There were statistically significant differences in the scores of mental health and general health status of patients with different sources of expenses (F=10.456, 3.368, P<0.05 or P<0.01). The total scores of quality of life of patients with different gender and causes of injury were similar (t=0.407, F=1.145, P>0.05); there were statistically significant differences in the total scores of quality of life of patients of different age groups, with different education levels, occupations, sources of expenses, and marital status (F=2.947, 17.064, 9.324, 4.101, t=7.225, P<0.05 or P<0.01). Multivariate linear regression analysis showed that age, education level, occupation, marital status, and source of expenses were the factors influencing the quality of life of patients at discharge (t=-2.437, 8.037, -2.994, 5.016, 3.519, P<0.05 or P<0.01).@*Conclusions@#The quality of life of patients with deep partial-thickness and above burns on head and face is at a low level at discharge. The influencing factors include age, education level, occupation, marital status, and source of expenses. Nurses should screen the relevant items when the patient is hospitalized. Emphasis should be laid on young, with undergraduate and above education, unmarried, self-funded patients, and those engaged in occupations with high facial requirements, to minimize the negative mood of patients, encourage them to face life, choose the right career, and improve their quality of life.

Establishment of a method for repairing extremities with extensively deep burn using fresh allogeneic scalp and autologous microskin and observation of its effect / 中华烧伤杂志

Objective@#To establish a method for repairing extremities with extensively deep burn using large piece of fresh allogeneic scalp spliced by Meek glue combined with autologous microskin and observe its effect.@*Methods@#Medical records of two male patients with extremely extensive deep burn admitted to our hospital from May to November in 2018 were retrospectively analyzed. Two patients aged 44 and 25 years respectively, with total burn area of 90% and 97% total body surface area (TBSA) and full-thickness burn area of 85% and 70% TBSA, respectively. Preoperatively, the surgical area on the extremities was calculated to estimate the necessary amount of allogeneic scalp and Meek miniature skin. The large piece of fresh allogeneic scalp spliced by Meek glue combined with autologous microskin was prepared according to the methods described as follows. Thin medium-thickness fresh scalps with 3% TBSA and 0.30-0.35 mm in depth were harvested from each donor and spliced into a large piece with epidermis upward by spraying Meek glue. Then the spliced scalp was punched after covered with a single-layer gauze. Autologous microskin was transported onto the dermis of fresh large piece of allogeneic scalp by traditional floating method. Bilateral extremities with full-thickness burn of two patients were selected for self-control. The left upper extremity was denoted as treatment group while the right upper extremity was denoted as control group in Patient 1. The right lower extremity was denoted as treatment group while the left lower extremity was denoted as control group in Patient 2. Wounds in the treatment group were treated with fresh large piece of allogeneic scalp spliced by Meek glue and autologous microskin with expansion ratio of 1∶15 after escharectomy, while wounds in control group received grafting of Meek miniature skin with expansion ratio of 1∶6 and or 1∶9 after escharectomy. The donors of allogeneic scalp were 32 males who were the relatives or friends of the patients, aged 21-50 years, with scalp area of (548±48) cm2. The healing conditions of donor sites of scalp were observed on post operation day 10, and were followed up within 3 months after operation to observe whether forming alopecia and hypertrophic scar or not. Wound healing condition was evaluated during follow-up in post operation week (POW) 2-5 and 4 months after operation. Wound coverage rates were calculated in both treatment and control groups in POW 2, 3, 4, and 5.@*Results@#The donor sites of all allogeneic scalp of donors healed completely on post operation day 10. There was no alopecia or hypertrophic scar within 3 months after operation for follow-up. In POW 2, allogeneic scalp grafts basically survived in treatment group without obvious exudation, and most of the Meek miniature skin survived in control group with obvious exudation. Part of allogeneic scalp grafts dissolved and detached in treatment group in POW 3, and the surviving grafts scabbed. The eschar detached and new epithelium was observed in treatment group in POW 4 and 5. In POW 3-5, surviving Meek miniature skin in control group creeped and was incorporated, and the wounds shrank. Hypertrophic scar was observed in both treatment and control groups 4 months after operation, without obvious difference in scar as a whole. The wound coverage rates were respectively 84%-98% and 76%-92% in treatment group of two patients in POW 2-5, close to or higher than those of control group (35%-97% and 28%-81%, respectively).@*Conclusions@#The study establishes a novel method for splicing fresh allogeneic scalps into a large piece as the covering of microskin, which has good effect for repairing extensively deep burn wounds. Considering that allogeneic skin is scarce, this method may be a new option in clinical treatment for extensively deep burn patients.

Wide local excision surgery combined with 5-aminolaevulinic acid photodynamic therapy for Paget's disease of the scrotum in elderly people / 中华老年医学杂志

Objective To investigate the safety and efficacy of wide local excision surgery combined with 5-aminolaevulinic acid(ALA)-photodynamic therapy(PDT)in treating Paget's disease of the scrotum in elderly people.Methods Patients with an average age of 68.4 ± 4.7 years undergoing wide local excision surgery combined with ALA-PDT for Paget's disease of the scrotum from June 2014 to February 2018 were followed up.All patients underwent wide local excision surgical treatment first and were then enrolled in ALA-PDT study after the diagnosis of Paget's disease of the scrotum was confirmed.Four cases were eliminated as a result of two patients refusing photodynamictherapy for various reasons and two patients lost during follow-up after ALA-PDT.A total of 16 patients were included in the study,of whom 6 cases were in Ray stage A1,7 cases in stage A2 and 3 cases in stage B.Patients underwent 3 courses of ALA-PDT after operation.Then the efficacy,shortand medium-term complications were followed up.Results The duration of disease among the 16 patients ranged from 4 to 76 months before diagnosis,with an average of 35.7 months.Surgery was performed immediately after diagnosis.Ten patients underwent resection and suture and 6 patients were treated with skin flap transfers.Of the patients treated with surgery,3 patients received suspicious lymph node dissection and 1 patient underwent reoperation due to skin flap necrosis.Patients were followed up for 3 months to 3 years and 6 months after ALA-PDT.Recurrence and distant metastasis occurred in 2 cases,with 1 case of brain metastasis and 1 case of systemic metastasis,and the overall recurrence rate was 12.5％.During the follow-up,there were no other serious complications except for 1 case(6.3 ％)with lower limb movement disorders.Conclusions Wide local excision surgery combined ALA-PDT has good clinical outcomes,low recurrence rates and few complications for the treatment of Paget's disease of the scrotum in elderly people.

Research progress in autosomal dominant polycystic kidney disease / 中南大学学报(医学版)

Autosomal dominant polycystic kidney disease (ADPKD) is a common hereditary disease, mainly caused by polycystic kidney disease 1/2 (PKD1/2) gene mutation. The main manifestation is the formation of multiple progressive enlarged cysts in both kidneys, which can be accompanied by decreased glomerular filtration rate, hypertension, liver cyst and cerebral aneurysm. About 45% of patients will progress to end-stage renal failure before the age of 60. ADPKD gene sequencing can be chosen for suspicious patients with atypical clinical features, no positive family history, and inconspicuous imaging findings. In the ADPKD positive families, imaging examination is the main means of diagnosing ADPKD. Height-adjusted total kidney volume (htTKV) and kidney growth rate are commonly used to monitor ADPKD disease progression and prognosis. There is no effective treatment for ADPKD to stop its progress. Drugs such as tolvaptan and bosutinib can delay the renal disfunction and they have been applied to clinical therapy in Europe and America.

Analysis on treatment of eight extremely severe burn patients in August 2nd Kunshan factory aluminum dust explosion accident / 中华烧伤杂志

Objective@#To summarize the measures and experience of treatment in mass extremely severe burn patients.@*Methods@#The clinical data and treatment of 8 extremely severe burn patients in August 2 Kunshan factory aluminum dust explosion accident who were admitted in the 100th Hospital of PLA on August 2nd, 2014, were retrospectively analyzed. There were 4 males and 4 females, aging 22-45 (34±7) years, with total burn area of 55%-98% [(89±15)%] total body surface area (TBSA) and full-thickness burn area of 45%-97% [(80±21)%] TBSA. All the 8 patients were accompanied with severe shock, inhalation injury, and blast injury. According to the requirements of former PLA General Logistics Department and Nanjing Military Command, a treatment team was set up including a special medical unit and a special care unit, with Chai Jiake from the First Affiliated Hospital of PLA General Hospital as the team leader, Zheng Qingyi from the 175th Hospital of PLA (the Affiliated Dongnan Hospital of Xiamen University) as the deputy leader, the 100th Hospital of PLA as the treatment base, and burn care, respiratory, nephrology, nursing specialists from the First Affiliated Hospital of PLA General Hospital, and the burn care experts and nursing staff from the 180th Hospital of PLA, 118th Hospital of PLA, 98th Hospital of PLA, and 175th Hospital of PLA, and nurses from the 85th Hospital of PLA, 455th Hospital of PLA, 101th Hospital of PLA, 113th Hospital of PLA as team members. Treatment strategies were adopted as unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns. With exception of one patient who received deep vein catheterization before admission, the other 7 patients were treated with deep vein catheterization 0.5 to 3.0 hours after admission to correct hypovolemic shock as soon as possible. Eight patients received tracheotomy, and 7 patients were treated with mechanical ventilation by ventilator in protective ventilation strategy with low tide volume and low volume pressure to assist breathing. Fiberoptic bronchoscopy was done one to three times for all the 8 patients to confirm airway injuries and healing status. Escharectomy and Meek dermatoplasty in the extremities of all the 8 patients were performed 3 to 6 days after injury for the first time. Escharectomy, microskin grafting, and covering of large pieces of allogeneic skin on the trunks of 4 patients were performed 11 to 16 days after injury for the second time. The broad-spectrum antibiotics were uniformly used at first time of anti-infective therapy, and then the antibiotics species were adjusted in time. The balance of internal environment was maintained and the visceral functions were protected. One special care unit was on responsibility of only one patient. Psychological intervention was performed on admission. The rehabilitative treatment was started at early stage and in company with the whole treatment.@*Results@#Acute renal injury occurred in 5 patients within 36 hours after injury and their renal function was restored to normal 4 days after injury due to active adjustment of fluid resuscitation program. No pulmonary complications, such as severe pulmonary infection and ventilator-associated pneumonia, occurred in the survived patients. One of the 8 patients died, and the other 7 patients were cured successfully. The wounds were basically healed in 2 patients in 26 or 27 days by 2 or 3 times of operation, and in 5 patients by 4 or 5 times of operation. The basic wound healing time was 26-64 (48±15) days for all the 7 patients.@*Conclusions@#Treatment strategies of unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns are the bases to successful treatment. Correcting shock as soon as possible is the prerequisite and closing wound as soon as possible is the key to successful treatment. Comprehensive treatment measures, such as maintaining and regulating the function of viscera, improving the body immunity, and preventing and treating the complications, are the important components to successful treatment. It is emphasized that in the treatment of mass extremely severe burn patients, specialist burn treatment should always be in the dominant position, and other related disciplines may play a part in auxiliary function.

Analysis on influence factors of quality of life for burn patients undergoing amputation / 中国实用护理杂志

Objective To investigate the level and its influencing factors of quality of life for burn patients undergoing amputation,and take treatment measures for clinical nursing. Methods The single factor analysis method was taken on the burn patients undergoing amputation in different social demographic characteristics from January 2013 to July 2016. Results The score of quality of life was (56.08 ± 17.97) points,and the four dimensions scored as physical function (63.64 ± 27.51) points, mental health(54.76±20.28)points,social relations(58.71±19.19)points and general health(46.00±18.61)points, which were at a low level.Multiple regression analysis showed that the influencing factors of quality of life were patient education, marital status, cost source, economic conditions, prosthetic replacement, and amputation site,which had a statistically significant difference between the effects on the quality of life(F/t=4.367,3.836,4.436,4.412,2.916,4.591,P<0.01)and into stepwise multiple regression equations.The patient′s age and career had statistically significant(F=3.495,3.640,P<0.05),but not into stepwise multiple regression euqtions. Conclusions Burn patients undergoing amputation are physical and spiritual double whammy,through to the influencing factors,clinical medical staff to be able to make this part of the population cause enough attention,enhancing the quality of life,strive for an early return to family and society.

Pharmaceutical Care for One Case of Complicated Intra-abdominal Infection after Pancreatoduodenectomy / 中国药师

Objective: To share the anti-infection experience for the patients with complicated intra-abdominal infection after operation.Methods: The whole course of drug administration participated by clinical pharmacist in one patient with complicated intra-abdominal infection after pancreatoduodenectomy were retrospectively analyzed and discussed.Results: Enterococcus was found in the blood culture and ascites.According to the results of drug sensitive tests, clinical pharmacist provided medication suggestions and performed medication mornitoring.According to the blood concentration, clinical pharmacist adjusted the dose of vancomycin, and changed the therapy regimen according to the changes of conditions.As a result, adverse reactions were controlled timely, and satisfactory treatment effects were obtained.Conclusion: The aetiology of complicated intra-abdominal infection is complex with intractable treatment, and the participation of clinical pharmacists in the treatment can improve the efficiency and safety.

Effects of scar excision combined with negative-pressure on repair of hypertrophic scar in burn children / 中华烧伤杂志

Objective@#To explore the effects of scar excision combined with negative-pressure on repair of hypertrophic scar in burn children.@*Methods@#From October 2010 to August 2016, 25 children with hypertrophic scar after deep burn were hospitalized, with scar course ranging from 3 months to 11 years and scar area ranging from 35 to 427 [83(51, 98)]cm2. A total of 35 scars of 25 children were located in trunk (11 scars), upper limb (11 scars), and lower limb (13 scars). All children received scar excision operation and negative-pressure treatment (negative-pressure value ranged from -40 to -20 kPa), among which 6 cases received scar excision operation and negative-pressure treatment for two times for further removal of scars. After scar excision, electronic spring scale was used to measure the tension of the incision. The tension value of children ranged from 3.43 to 23.84 [7.16 (5.59, 9.12)] N, and then the incision was closed with appropriate suture according to the value of the tension. The incision with smaller tension was firstly opened on post operation day (POD) 8. After removing the suture, negative-pressure was conducted to POD 14. The incision with larger tension was firstly opened on POD 12. After removing the suture, biological semi-membrane was used to reduce tension to POD 16. All healed incisions were performed with anti-scar treatment for 1 year and relaxation and fixation for 3 months. General condition of the incision was observed after operation. The reduction percentage of scar area was calculated half-year after operation. The Patient and Observer Scar Assessment Scale was used to record the overall score of scar and scar score of trunk, upper limb, and lower limb before operation and half-year after operation. Data were processed with paired t test and Wilcoxon rank sum test.@*Results@#After removing the suture, all incisions of children healed well without redness, effusion, and rupture. Half-year after operation, the appearance and deformity of incision were obviously improved, and the symptoms including pruritus and pain were basically relieved. Half-year after operation, the scar area of children ranged from 0 to 174 [21(9, 47)]cm2, which was significantly decreased as compared with that before operation (Z=-5.16, P<0.05). The reduction percentage of scar area ranged from 36% to 100% [(73±19)%]. Half-year after operation, the overall score of scar and scar score of trunk, upper limb, and lower limb of children were obviously decreased as compared with those before operation (with t values from 6.42 to 17.37, P values below 0.05).@*Conclusions@#Scar excision combined with negative-pressure treatment has a good clinical effect on repair of hypertrophic scar in burn children, which is suitable for clinical application.

Effects of electroacupuncture on synaptic plasticity in hippocampal CA3 area of rats with chronic stress depression / 中国针灸

<p><b>OBJECTIVE</b>To explore the effects of electroacupuncture (EA) on behavioral function and synaptic plasticity in hippocampal CA3 area in rats with chronic stress depression.</p><p><b>METHODS</b>According to the random number table method, 144 SD male rats were assigned into a blank group, a model group, an EA group and a fluoxetine group, then each group was divided into a 7 d subgroup, a 14 d subgroup and a 21 d subgroup, 12 rats in each subgroup. The chronic mild unpredictable stress stimulus combined with lonely breeding were applied to establish the depression model of rats, which was performed simultaneously with intervention treatment. The rats in the EA group were treated with EA (dilatational wave) at "Shenting" (GV 24) and "Baihui" (GV 20), while the rats in fluoxetine group were treated with intragastric administration of fluoxetine, once daily. With open-field test, sugar consumption experiment and transmission electron microscope, the changes of behavior and neuronal synapse inhippocampal CA3 area were observed.</p><p><b>RESULTS</b>On 7 d, 14 d and 21 d, compared with the blank group, the open-field test score, sugar consumption and body mass were significantly lower in the model group (all<0.01); compared with the model group, the open-field test score, sugar consumption and body mass were significantly higher in the EA group and the fluoxetine group on 14 d and 21 d (<0.01,<0.05). On 14 d and 21 d, compared with the blank group, the synapse in hippocampal CA3 area was significantly lower in the model group (both<0.01); compared with the model group, the synapse in hippocampal CA3 area was significantly higher in the EA group and the fluoxetine group (<0.01,<0.05). The neurons cells in hippocampal CA3 area in the model group showed pyknosis and deformation from 7 d with fusion structure and unclear boundary of synapse, which were significantly improved on 21 d; the neurons cells in hippocampal CA3 area in the EA group and the fluoxetine group were significantly improved from 14 d and restored to normal level on 21 d, in addition, the structure of synapse restored to normal level.</p><p><b>CONCLUSIONS</b>EA is involved in the regulation of synaptic plasticity in hippocampal CA3 area, and promotes the recovery of depression symptoms.</p>

Diode laser vaporization of prostate versus transurethral resesction of prostate in treating benign prostatic hyperplasia: a Meta-analysis / 中国内镜杂志

Objective To systematically review and evaluate the perioperative indicators and surgical curative effect of 980 nm diode laser vaporization of prostate and transurethral resesction of prostate (TURP) in treating benign prostatic hyperplasia (BPH). Methods Retrieved published comparative studies 980 nm diode laser vaporization of prostate versus transurethral resesction of prostate in treating benign prostatic hyperplasia, and pooled the data from eligible studies. The statistical analysis was performed using Revman 5.3 software. Results Six trials including 839 patients were eligible to the criteria (450 in 980 nm diode laser group and 389 in TURP group). The baseline of patients characteristics were comparable in all the studies. Meta analysis showed that: the operative time was not significantly different between the 980 nm diode laser group and TURP group [SMD = 0.11, 95 ~ CI (-0.52,0.74), P > 0.05]; Compared with TURP group, 980 nm diode laser group has shorter hospital stays [SMD = -1.95, 95%CI (-3.42, -0.48), P 0.05], QOL [SMD = 0.00, 95%CI (-0.57, 0.57), P > 0.05] and Qmax [SMD = 0.06, 95%CI (-0.26, 0.37), P > 0.05]. Conclusion 980 nm diode laser vaporization of prostate is safe and effective in treating benign prostatic hyperplasia, and compared with TURP, it has advantages in shorter hospital stays and shorter catheterization time.

Sensitized cytotoxic effects of dexamethasone or radiation on multiple myeloma cells by chloroquine / 药学实践杂志

Objective To investigate the role and possible mechanism of combination use of chloroquine (CQ) with either dexamethasone (DEX) or radiation on multiple myeloma (MM) cell line U266 .Methods Cell viability of U266 treated with CQ alone ,or CQ combined with either DEX or radiation was measured by cell counting kit-8 (cck8) .CalcuSyn method was used to assess effect of drugs interaction .Cell viability and apoptosis of U266 pre-treated with CQ were also measured by cck8 and flow cytometry after radiation .Expression of B-cellymphoma-2 (Bcl-2) in U266 cells treated by CQ combined with DEX or radiation was determined by Western blot analysis .Results Either CQ or DEX displayed a dose dependent cell proliferation in-hibitory effect on U266 cells .Cytotoxic effect of DEX (125 μmol/L) on U266 cells was enhanced and expression of Bcl-2 pro-tein in U266 cells was decreased by combining with CQ (3 .9 μmol/L) .U266 cells were sensitized to radiation and cell death was induced by CQ (1 .0 μmol/L) .Conclusion CQ could sensitize cytotoxic effect of DEX or radiation on U 266 cells ,and the former was possibly related to down-regulation of Bcl-2 protein .

A Meta analysis of retroperitoneal laparoscopy and open surgical treatment for renal cyst / 中国医师杂志

Objective To evaluate the clinical efficacy and safety of retroperitoneal laparoscopy and open surgical treatment of simple renal cyst by Meta analysis.Methods Computer retrieval of MED-LINE,Cochrane Library,EMBASE,CNKI,Wanfang and VIP databases,according to the inclusion and exclusion criteria collected and screened out a randomized controlled studies on the treatment of simple renal cysts,published from January 1,2000 to August 31,2015.Two independent authors screened out randomized clinical trials (RCTs),extracted data,assessed quality of data,and then carried out Meta analysis by Revman 5.0 software with related data.Results Twenty one studies met the inclusion criteria with a total of 2 296 patients,including 1 162 patients of retroperitoneal laparoscopy and 1 134 cases of open operation group.Compared to the open operation group,retroperitoneal laparoscopy showed shorter operation time,less bleeding,shorter hospitalization time,and earlier postoperative drainage tube extraction time.No significant difference was found in the recurrence rate of the cyst for two groups.Conclusions The clinical efficacy,safety,and complication of retroperitoneal laparoscopy in the treatment of simple renal cyst is better than the open operation.

Analysis of influential factors for prostate biopsy and establishment of logistic regression model for prostate cancer / 中南大学学报(医学版)

OBJECTIVE@#To establish logistic regression model for prostate cancer and provide basis for prostate biopsy.
@*METHODS@#A total of 117 cases of prostate biopsy were retrospectively analyzed in chronological sequence. All cases were assigned into a model group (n=78) and a validation group (n=39). Logistic regression model was established and its value was estimated by receiver operating characteristic (ROC) curve. 
@*RESULTS@#Digital rectal examination(DRE), transrectal ultrasound(TRUS), MRI, prostate-specific antigen density (PSAD), and free PSA/total PSA (fPSA/tPSA) were the influential factors for prostate biopsy (P<0.01). The established logistic regression model for prostate cancer by regression coefficient was: logit P=-2.362+2.561×DRE+1.747×TRUS+2.901×MRI+1.126×PSAD-
2.569×fPSA/tPSA and area under curve was 0.907. When the cutoff aimed at 0.12, the sensitivity and specificity were 81.80% and 89.30%, respectively.
@*CONCLUSION@#Logistic regression model for prostate cancer can provide sufficient basis for prostate biopsy. Prostate biopsy should be performed when P value is more than 0.12.

Effect of percutaneous nephrostolithotomy combined with flexible ureteroscopy on renal function in elderly patients with renal calculi / 中南大学学报(医学版)

OBJECTIVE@#To detect the levels of neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (Cys-C ) in blood and the level of kidney injury molecule 1 (KIM-1) in urine in elderly patients with renal calculi at diff erent times, and to explore the eff ect of percutaneous nephrostolithotomy (PCNL) combined with flexible ureteroscopy (FU) on early postoperative renal function.@*METHODS@#A total of 46 patients with renal calculi were selected, and their blood or urine specimens were collected respectively at preoperative and postoperative 2, 12, 24, 48, and 72 h. The concentrations of NGAL, Cys-C, KIM-1 were detected.@*RESULTS@#The levels of NGAL and Cys-C began to increase respectively at postoperative 2 and 12 h, and reached peak at postoperative 12 to 24 h. There was significant difference in the levels of NGAL and Cys-C between the postoperative 12 and 2 h or between postoperative 48 and 24 h (all P<0.05). The levels of NGAL and Cys-C began to decline and eventually returned to preoperative levels respectively at postoperative 48 and postoperative 72 h. The KIM-1 began to increase at postoperative 2 h and peaked at postoperative 24 h, which was significant difference between the postoperative 24 and 12 h or postoperative 48 and 24 h (both P<0.05). The level of KIM-1 began to decline and eventually returned to preoperative levels at postoperative 48 h.@*CONCLUSION@#After the combined treatment of percutaneous nephrostolithotomy with flexible ureteroscopy, the concentrations of NGAL, Cys-C and KIM-1 are significantly increased, suggesting injuries on renal function. The time of renal tubular injury and recovery is earlier than that of renal glomerulus.

Application of vacuum sealing drainage in the treatment of severe necrotizing fasciitis in extremities of patients / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the application of VSD in the treatment of severe necrotizing fasciitis in extremities of patients.</p><p><b>METHODS</b>Eight patients, suffering from severe necrotizing fasciitis, who had been traditionally treated with iodophor-soaked gauze for 21 to 365 days in other hospitals, were transferred to our institute because of the nonhealing wounds and systemic toxic symptoms induced by infection, from January 2011 to August 2013. After admission, surgical debridement was performed timely, and the necrotic tissue was collected during the operation for pathological observation after HE staining. After the operation, VSD was started with negative pressure ranging from -100 to -80 kPa, and the furacilin solution (0.2 g/L) and oxygen (2 L/min) were continuously infused into the wound during the treatment. Surgical debridement was performed repeatedly according to the wound condition followed by change of VSD dressings to continue VSD treatment. The wounds were closed by suturing or with autologous skin grafts after being covered by fresh granulation tissue. The times of surgical debridement, times of change of VSD materials, wound healing status, and length of stay in our institute were recorded. All patients were followed up for a long time. Results HE staining showed that there were diffuse necrotic adipose and fibrous connective tissues in the necrotic tissue, and the normal tissue structure disappeared accompanied by significant infiltration of inflammatory cells. The number of surgical debridement was 2 to 10 (3.9 +/- 2.8) times. The number of VSD materials change was 2 to 10 (4.0 +/- 2.9) times. Wounds were closed by suturing and healed in two patients; wounds in the other six patients were partially sutured, their residual wounds were healed by autologous skin grafting. The length of stay in our institute was 20 to 49 (33 +/- 10) days. All patients were discharged after recovery. Patients were followed up for 2 to 24 months, and their wounds were found to be in good condition without ulceration or recurrence.</p><p><b>CONCLUSIONS</b>VSD can effectively remove the necrotic tissues and exudates from the fascial spaces and promote proliferation of granulation tissue. Therefore it serves as an effective approach to the treatment of severe necrotizing fasciitis in extremities.</p>

A study on diagnostic values of combined detection of serum CA 125,HE4,SMRP for ovarian cancer / 国际检验医学杂志

Objective To evaluate the values of combined detection of carbohydrate antigen 125(CA125) ,human epididymis gene protein 4(HE4) ,soluble mesothelin related peptides(SMRP) in early diagnosis for ovarian cancer and the high-risk factors of ovari-an cancer .Methods 43 patients with malignant ovarian cancer were served as the malignant group ,54 patients with benign ovarian tumors as the benign group ,45 healthy women as the control group .Roche Cobas 6000 Automatic Electrochemiluminescence Immu-noassay Analyzer and enzyme-linked immunosorbent assay (ELISA) were adopted to detect serum CA125 ,HE4 ,SMRP levels . High-risk factors of ovarian cancer was subject to Logistic regression analysis .Results Serum levels of CA125 ,HE4 and SMRP of patients in malignant group were significantly higher than those in the benign group and the control group (P<0 .01) .The sensitivi-ties of CA125 ,HE4 and SMRP detection alone for ovarian cancer diagnosis were 73 .3% ,82 .8% and 70 .8% ,respectively ,while their specificities were 79 .1% ,87 .4% and 83 .3% ,respectively .The sensitivity and specificity of joint detection of CA 125 ,HE4 , SMRP for ovarian cancer diagnosis were 90 .2% and 79 .3% ,respectively .Logistic regression analysis showed that age at menarche younger than 13 years ,menstrual cycle less than 30 d and irregular menstruation were the high-risk factors of ovarian cancer ,with their odds ratio(OR) of 2 .11[95% confidence interval(CI):1 .09-4 .10 ,1 .91(95% CI:1 .21-3 .10) and 1 .57(95% CI:0 .83-2 .94) .Conclusion CA125 detection combined with HE4 or SMRP can markedly improve the diagnostic sensitivity for ovarian cancer .

Therapeutic effect of regular urethral dilatation on patients with postoperative urethral stricture / 中南大学学报(医学版)

Objective: To determine the therapeutic effect of regular urethral dilatation on patients with postoperative urethral stricture. Methods: A total of 142 patients underwent urethral stricture. The unimproved patients after the surgery were divided into a reoperation group and a regular urethral dilatation group. All the patients were followed up for 1-3 months, and the curative effect was compared. Results: Of the 142 patients, 42 had no improvement and 27 of them had reoperation, and symptoms in 21 were improved. Another 15 patients received regular urethral dilatation, and 5 improved. hTere was signiifcant difference between the 2 groups (P<0.01). Conclusion: Regular urethral dilatation has some effect on postoperative patients, but no obvious effect on patients with dissatisifed operation for urethral stricture or restenosis.

Ketamine induces apoptosis of human uroepithelial SV-HUC-1 cells / 中南大学学报(医学版)

Objective:To determine the effect of ketamine on the apoptosis of human uroepithelial cells (SV-HUC-1) and the pathogenesis of ketamine-associated cystitis. Methods:SV-HUC-1 cells were cultured under various concentrations of ketamine and different time. Flow cytometry was used to analyze the rate of cell apoptosis. hTe protein levels of Bax, Bcl-2, pro-caspase-3, and cleaved caspase-3 were detected by Western blot. Results:Compared with the control group, the apoptotic rate of ketamine cultured SV-HUC-1 cells increased. hTe expression of Bax increased, Bcl-2 expression decreased, and Bax/Bcl-2 in the ketamine cultured SV-HUC-1 cells was signiifcantly higher. hTe protein level of pro-caspase-3 was signiifcantly lower, and that of cleaved caspase-3 was signiifcantly higher than that in the control group (P<0.05), positively correlated with the dose of ketamine and time of culture (P<0.05). Conclusion:Ketamine can induce the apoptosis of SV-HUC-1 cells in a dose and time dependent manner.