Learning curve and feasibility study of percutaneous closure of patent foramen ovale guided solely by transthoracic echocardiography / 中华胸心血管外科杂志

Objective:To study the learning curve of percutaneous patent foramen ovale (PFO) occlusion guided solely by transthoracic echocardiography (TTE), as well as the success rate and safety of the learning curve.Methods:To retrospectively analyze these patients with indications for PFO occlusion admitted in our department from April 2021 to April 2022, and obtained 100 samples the author's initial cases guided solely by TTE, including 25 men and 75 women, with a mean age of (48.22±10.44) years old.Analyze preoperative baseline data: gender, age, height, weight, body mass index, the tunnel length and size of the PFO measured by transesophageal echocardiography, the grade of contrast-transcranial doppler test, combined atrial septal aneurysm, etc.Operation time, success rate, and complications were analyzed in all patients.Results:With the accumulation of cases, the operation time gradually shortened, accumulated to about 50 cases, the operation time has significantly shortened ( P<0.05), and the learning curve was leveled off after 50 cases ( P<0.05), there was statistical difference.The comparison of the success rate and complication of cases within the learning curve and those after completing the learning curve was no statistical significance( P>0.05). Conclusion:The learning curve of percutaneousc closure of patent foramen ovale guided solely by TTE is long, requiring about 50 cases to complete the learning curve. The success rate and safety of the learning curve are high. This procedure is worth popularizing.

Professor He Jialin's Experiences in Treating Leucorrhoea Disease / 浙江中医药大学学报

Objective] Summarize the experience of diagnosis and treatment of leucorrhoea disease by professor He Jialin. [Method] By collecting medical records, from the pathogenesis, syndrome differentiation, to expound the academic viewpoints and clinical experience of professor He Jialin in treating leucorrhoea disease, summarize its academic characteristics on integrating traditional Chinese and western medicines, internal and external treatments and TCM prescription, and exemplify that. [Results] Professor He Jialin believes that the major pathogenesis is dampness,with intrinsic deficiency in spleen and kidney, explicit accumulation of damp and heat.Combined with western medicine examination methods, professor He Jialin treats the disease by invigorating the spleen for damp elimination, nourishing kidneys to consolidate thoroughfare vessel, heat-clearing and detoxicating, each therapeutic principle combined with external therapy receives a good effect. [Conclusion] Professor He Jialin's academic thoughts and clinical experience on syndrome differentiation, application method, addition or subtraction of changes provide a more complete mentality and pragmatic value in treating leucorrhoea disease.

122 cases of endoscopic thyroidectomies through modified chest and mammary areola approach / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the safety and feasibility of endoscopic thyroidectomies through modified chest and mammary areola approach.@*METHOD@#We retrospectively analyzed 122 cases of endoscopic thyroidectomies through a modified chest and mammary areola approach without extensive dissection of thoracic flap. The information about general status, surgical procedures and techniques, complications, etc. were summarized and discussed.@*RESULT@#One hundred and twenty-one cases were operated successfully while 1 case was converted to video-assisted thyroidectomy through infraclavicular approach. The maximum diameter of the mass was (2.05 ± 1.06) cm, mean operation time was (88.61 ± 27.87) min, the operative blood loss was (31.23 ± 16.14) ml, duration of postoperative drainage was (3.54 ± 0.88) d and overall drainage volume was (139.09 ± 95.93) ml. Parathyroid glands were detected in specimens of 9 cases while no case of permanent postoperative hypocalcaemia was displayed. 6 cases of hoarseness were developed. One case experienced conversion surgery, all the others obtained satisfactory cosmetic result. All cases were followed up for 0-24 months without relapse and metastasis of the disease.@*CONCLUSION@#Endoscopic thyroidectomy via a modified chest and breast areola approach can facilitated the procedure and avoid extensive dissection of thoracic flap, and proved to be safe and effective.

Comparison the application of 3D versus 2D laparoscopic thyroidectomy via modified chest and mammary areola approach / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the safety, effectiveness and feasibility of 3D laparoscopy in thyroidectomy via modified chest and mammary areola approach comparing with 2D.@*METHOD@#Twenty six cases received 3D laparoscopic thyroidectomy (3D group) and 34 cases experienced 2D (2D group). We compared the indexes about general status, operation time, operative blood loss, duration and overall volume of postoperative drainage, complications, etc between two groups.@*RESULT@#Eight cases of thyroid cancer were detected in 3D group and 3 cases in 2D group. While there was no statistical difference between two groups with respect to other observation indexes such as other general status, operation time, operative blood loss, duration and overall volume of postoperative drainage, complications, etc.@*CONCLUSION@#3D laparoscopic thyroidectomy via modified chest and mammary areola approach is a safe, effective and feasible procedure, and it may substitute the place of 2D in the future.

The Experience of Professor He Jialin in the Treatment on Polycystic Ovary Syndrome / 浙江中医药大学学报

Objective] Investigate the experience of professor He Jialin in the treatment on polycystic ovary syndrome. [Methods]Discuss the clinical experience of professor He Jialin in the treatment on polycystic ovary syndrome from the pathogenesis, treatment, prescription and one case. [Results] Professor He Jialin believes that the disease is caused by kidney deficiency, mixing with phlegmatic block and blood stasis. It can achieve good effect with Bushen Huoxue Huatan method combined with Tiaozhou therapy. [Conclusion] Professor He Jialin's academic thoughts and clinical experience on syndrome differentiation, application method, addition or subtraction of changes provide a more complete mentality and pragmatic value in treating polycystic ovary syndrome.

Professor He Jialin's Experence in Treating Abdominal Mass with Infertility / 浙江中医药大学学报

Objective] To introduce Professor He Jialin's experence in treating abdominal mass with infertility. [Method] Through years of clinical learning from teacher, summarized the teacher's academic thoughts and the experiences of diagnosis and treatment. It expounds her special clinical experience from etiology and pathogenesis, fundamental law of treatment, medication characteristic, and classical proven cases. [Result] The disease covers a broad range. The typical syndromes are damp heat, phlegm, blood stasis. And blood stasis is most important. The fundamental law of treatment includes strengthening the body resistance, removing blood stasis, reducing phlegm and resolving masses, regulating menstruation. Doctor He combined traditional Chinese and western medicine, considering the comprehensive, combined with the individual constitution, emphasized the selection of herbal medicine with multiple functions. The clinical effect in the proven cases was amazing. [Conclusion] Professor He had rich experience treating abdominal mass with infertility, which might be used as reference data in clinical medicine.

"Ms He Jialin's Experience in Treating Gestation Disease with Principle""Toxic Drugs'Good Effect on Diseased Body""" / 浙江中医药大学学报

[Objective] To clear up Ms. He Jialin's recipe cases in treating gestation diseases, sum up her diagnosis and treatment thought and medication principle. [Method] Make mutual corroboration of doctor He's medical prescriptions and TCM classical theories and formulae, to explore He's experience of diagnosis and theoretic origin. [Result] Doctor He has rich experience in diagnosing and treating gestation diseases, with clear thought, and principle-method-recipe-medicines, wel-founded, closely observing disease development, considering the situation, using drugs as military forces, with consolidate steps. [Conclusion] Doctor He diagnosing refractory diseases, learning from ancient but not rigidly adhering to ancient, ful y embodies the treating principletoxic drugs'good effect on diseased body.

Radiotherapy for seventy-four patients with intracranial germinoma / 中华放射肿瘤学杂志

Objective To analyze the outcomes of radiotherapy for 74 patients with intracranial ger-minoma. Methods Between 1990 and 2007,74 patients with intracranial germinoma(9 pathologically diag-nosed and 65 clinically diagnosed) were treated with radiotherapy in our hospital. The median age at diagno-sis was 15 (range 5-45) years. Radiation treatment fields varied among patients, including craniospinal irra-diation(CSI), whole brain irradiation, whole ventricular irradiation with primary tumor boost, and involved-field irradiation only to the primary tumor plus margin. The dose was 38.5 -50.0 Gy to the tumor,18-25 Gy to the whole brain/ventricular,and 21-25 Gy to the whole spinal cord in fractions of 1.6-2.0 Gy per day,5 fractions per week. Results The median follow-up time was 80(range 12-168) months and the fol-low-up rate was 97%. Fourteen patients had been followed up for over 10 years. The 1-,5- and 10-year o-verall survival rates were 99% ,96% and 93%. The corresponding disease free survival rates were 97%, 90% and 83%, respectively. Relapses occurred in 9 patients. For the 6 patients with in-field relapse, the dose to the tumor was 38.5-40.0 Gy in 3 patients, 41-45 Gy in 2 and 46-50 Gy in 1. Relapse in the spinal cord was found in 3 patients and none of them received spinal irradiation. Twenty-one patients re-quired hormonal replacement therapy because of radiation induced hypofunction of prehypophysis. Conclu-sions Radiotherapy alone is a curative treatment for intracranial germinoma. The proper dose should be de-termined by tumor numbers and the examination of cerebrospinal fluid.

Surgical treatment for well-differentiated thyroid carcinoma invading the laryngotrachea / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To discuss the method of surgical treatment for well-differentiated thyroid carcinoma (WDTC) invading the laryngotrachea.</p><p><b>METHODS</b>According to surgical procedure, 21 patients with WDTC invading the laryngotrachea were divided into tumor radical removal group (Group A, n = 5), tumor chisel group (Group B, n = 11) and tumor debulking group (Group C, n = 5).</p><p><b>RESULTS</b>The overall 3-, 5- and 7-year survival rates were 81.0% (17/21), 61.9% (13/21) and 42.9% with better result in Group A (P < 0.001) and Group B (P < 0.03) than in Group C, however, without any significance between Groups A and B (P > 0.05).</p><p><b>CONCLUSION</b>Conservative operation should be considered in most patients with well differentiated thyroid carcinoma invading the laryngotrachea. Only in the presence of intraluminal invasion in the trachea causing hemoptysis and airway obstruction does it require radical operation.</p>

Clinical observation on 102 cases of chronic pelvic inflammation treated with Qi Jie Granules / 中医杂志

Objective: To investigate the therapeutic effect of Qi Jie Granules on chronic pelvic inflammation. Methods: 102 cases of chronic pelvic inflammation were treated by Qi Jie Granules, and 70 cases were treated with Fu Ke Qian Jin Tablets as control. Their therapeutic effects, subgroups of T-lymphocytes and hemorhelogical indexes were investigated. Results: The total clinical effective rate was 96. 08% in the treatment group and 84. 29% in the control group, with a significant difference between the two groups (P