Image characteristics of DVA in different routine imaging sequence of MR and the diagnostic value of these different sequence / 中国医学装备

Objective: To explore the image characteristics of developmental venous anomaly (DVA) in different routine imaging sequence of magnetic resonance (MR) and the diagnostic value of these different sequence. Methods:The imaging data of 54 patients with DVA which were confirmed by using MR enhanced scan that was the contrasted standard were selected. The imaging features obtained from the T1WI, T2WI and FLAIR sequences were researched by using retrospective analysis, and the specificity and accuracy of diagnosis of each imaging sequence were calculated. Results: In the 54 patients, the accuracy of T1WI was 75.9% (41/54), and accuracy of T2WI was 68.5% (37/54), and that of FLAIR T2was 92.6% (50/54). The performance of MRI was that many of medullary vein drained into the central venous, and the shorter draining vein showed typical phenomenon of "jellyfish head"and many medullary vein of the longer draining vein showed the phenomenon of "centipede". The abnormal blood vessel on the T1WI showed strip low signal intensity, and many abnormal blood vessel on T2WI showed strip high signal intensity and minority of them showed strip low signal intensity. The larger central vein and peripherally scattered small medullary veins could be found on the sequence scan of T2FLAIR, and many of abnormal blood vessels showed strip high signal and a small part of abnormal blood vessels showed equisignal and low signal. Besides, the specificity of the diagnosis of sequence of T2FLAIR was 100% without false positive. And the accuracy of T2FLAIR was 92.6% that was higher than 75.9% of T1WI and 68.5% of T2WI. Conclusion: The sequence technique of T2FLAIR has higher accuracy for the detection of DVA and it can clearly display most abnormal blood vessel. Therefore, it has important reference value for diagnosing DVA of brain.

Onset age and pathology of prostate cancer in Uygurs and Hans in Xinjiang / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the differences in the onset age and pathology of prostate cancer between Uygurs and Hans in Xinjiang.</p><p><b>METHODS</b>We enrolled in this study 518 patients (138 Uygurs and 380 Hans) with prostate cancer confirmed between January 2002 and December 2011. We conducted comparative analyses on their ages, years of diagnosis and Gleason scores.</p><p><b>RESULTS</b>The incidence of prostate cancer increased year by year in both Uygur and Han people, but no statistically significant differences were found in the years of diagnosis between the two groups (chi2 = 1.063, P = 0.900). The median and mode ages of the Uygur patients were 70 and 63 years, and those of the Hans 73 and 71 years. The predilection age of prostate cancer was 70 -79 years in both the two groups. The Uygurs showed a significantly higher incidence of prostate cancer in the 50-59 yr and 60-69 yr groups than the Hans, but the results were just the opposite in the 80-89 yr group (chi2 = 40.375, P = 0.01). The median and mode of Gleason scores were 7 and 6 in the Uygurs, and 8 and 8 in the Hans, respectively, with no significant difference between the two groups (chi2 = 0.991, P = 0.01).</p><p><b>CONCLUSION</b>The Uygurs differed from the Hans in the age of prostate cancer onset, but there were no significant differences in the annually increased incidence and pathological stage of prostate cancer between the Uygurs and Hans in Xinjiang.</p>

Oral mucosa for hypospadias repair: a report of 19 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the indications and clinical effect of using oral mucosa as the graft in hypospadias repair.</p><p><b>METHODS</b>We performed hypospadias repair using oral mucosa for 19 patients, 10 with the urethral opening at the root of the penis, 7 at the scrotum and 2 at the perineum. Of these patients, 8 had received urethroplasty once, and 6 twice, unsuccessfully, and 7 of them were complicated by penile chordee. The lower lip mucosa was used as the graft for 14 cases, and the buccal mucosa for the other 5. Fifteen cases received autologous oral mucosa onlay for repair, with the new urethra covered by the dartos coat of the dorsal skin. For the other 4 cases, whose urethral plates had been damaged in the previous operations, oral mucosa strips were used to substitute the urethral plates to get the penis straightened, followed by urethroplasty 6 months later.</p><p><b>RESULTS</b>Of the 19 patients, 17 (89.5%) achieved satisfactory results, with a desirable shape of the penis and a vertical slit-like meatus at the tip of the glans. Chordee was corrected in all the patients. No urethral stricture was found during the 3 - 18 months follow-up. Urethral fistula occurred in 2 cases because of infection, but cured by surgical repair 6 months later.</p><p><b>CONCLUSION</b>Using oral mucosa as the graft is an effective surgical option for hypospadias repair.</p>

Tunica vaginalis of testis and spermatic fascia: a good alternative for the repair of urethral fistula resulting from hypospadias operation / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the methods of repairing urethral fistula resulting from hypospadias operation.</p><p><b>METHODS</b>We analyzed the clinical data of 46 cases of surgical repair of urethral fistula resulting from hypospadias operation. The patients ranged in age from 3 to 26 (mean 11.7) years. There were 52 fistulas in all, with the diameters of less than 5 mm, of which 25 were in the midshaft of the penis, 12 in the penoscrotum, and 9 in the scrotum. Of the 46 cases, 20 were repaired by continuous knock suture and 26 by tunica vaginalis of testis and spermatic fascia.</p><p><b>RESULTS</b>The one-stage success rate of continuous knock suture repair was 55% (11/20) and that of the combined use of continuous knock suture with tunica vaginalis of testis and spermatic fascia repair was 84.6% (22/26).</p><p><b>CONCLUSION</b>Based on continuous knock suture, the additional use of tunica vaginalis of testis and spermatic fascia yields a high success rate in repairing urethral fistula resulting from hypospadias operation.</p>

Experience of surgical treatment for cervical esophageal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To summarize the experience of surgical treatment for cervical esophageal carcinoma.</p><p><b>METHODS</b>Clinical and follow-up data of 82 patients with cervical esophageal carcinoma undergone surgical treatment in Henan Provincial Cancer Hospital from Dec. 1993 to Dec. 2005 were analyzed retrospectively. The difference of the therapeutic regimen and 5-year survival rate of these patients were evaluated.</p><p><b>RESULTS</b>Before 1997, patients mainly underwent surgical therapy solely (27 cases). After 1997, 50 cases received surgical therapy following neoadjuvant radiotherapy (multimodality group), except 5 early-stage cases received surgical therapy solely. Seventy-three patients underwent esophagectomy without thoracotomy, including 21 cases of invert-stripping of the esophagus, and 52 cases of blunt denudation of esophagus. Nine patients underwent transthoracic esophagectomy. Concurrent monolateral or bilateral cervical lymph node dissection accounted for 14 cases and combined organ resection 12 cases. No serious hemorrhage and tracheal or bronchial tearing occurred. No hospital death occurred. Postoperative complications were found in 14 patients, and the incidence of complication was 19.5%. In sole surgery group, upper incised margins of 5 patients were confirmed to be positive. The laryngeal function of 26 patients in sole surgery group was preserved, while 47 patients in multimodality group preserved. Lymph node metastasis occurred in 14 cases, including 13 cases cervical lymph node metastasis (monolateral 9, bilateral 4) and 1 case of upper mediastinal lymph node metastasis. During follow-up, 3 patients were lost. The total 5-year survival rate was 43%. The patients in multimodality group had higher 5-year survival rate as compared to those in sole surgery group. (50.2% vs 33.9%,chi(2 )=7.17,P=0.007). The 5-year survival rates of patients with transthoracic esophagectomy, esophagectomy plus concurrent monolateral or bilateral cervical lymph nodes dissection or combined organ resection were 36.5%, 45.8% and 33.3% respectively. All the 5-year survival rates of these subgroups were lower as compared to multimodality group.</p><p><b>CONCLUSIONS</b>For patients with early stage cervical esophageal carcinoma and with proximal end of residual normal esophagus longer than 2 cm, the optimal therapy should be surgery. For most of the patients, surgery combined with neoadjuvant radiotherapy is the ideal therapeutic strategy, which can lower the risk of positive revised margin, improve the possibility of preserving the laryngeal function and result in the improvement of 5-year survival rate. Esophagectomy without thoracotomy should be preferred. Combined organ resection or bilateral lymph node dissection should be chosen carefully because these operating procedures may lead to severe injury and function lose.</p>

Blunt esophageal denudation without thoracotomy in the treatment of cervical esophageal carcinoma with laryngeal function preservation / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the feasibility and effect of Blunt esophageal denudation without thoracotomy in the treatment of cervical esophageal carcinoma with laryngeal function preservation.</p><p><b>METHODS</b>The data of 28 patients with cervical esophageal carcinoma, collected from Aug. 1997 to Nov. 2005, were investigated retrospectively.</p><p><b>RESULTS</b>All the 28 patients were diagnosed as cervical esophageal squamous cell carcinoma. Among them, 12 patients underwent surgery (surgery group), while the other 16 patients underwent surgery plus radiation therapy preoperatively or postoperatively (multimodality therapy group). No uncontrolled intraoperative and postoperative hemorrhage and tracheal tear occurred. The incidence of complications was 21.4% (6/28), including cervical anastomotic leakage in 2 patients and recurrent laryngeal nerve injury in 4 patients. The overall 5-year survival rate was 50.3%. The 5-year survival rate was 25.7% in surgery group and 66.1% in multimodality therapy group, and the difference between two groups was statistically significant (chi(2)=4.07; P=0.0438).</p><p><b>CONCLUSIONS</b>Blunt esophageal denudation without thoracotomy in the treatment of cervical esophageal carcinoma with larynx function preservation is possible. Combined with radiotherapy preoperatively or postoperatively, the survival time in patients with cervical esophageal carcinoma is able to be prolonged.</p>

The effects of antiarrhythmic peptide AAP10 on ventricular arrhythmias in rabbits with healed myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the effects of antiarrhythmic peptide (AAP10) on ventricular arrhythmias in rabbits with healed myocardial infarction (OMI).</p><p><b>METHODS</b>Thirty rabbits were randomly divided into three groups (n = 10 each): Sham group, left thoracotomy was performed without coronary ligation; OMI group and OMI + AAP10 group, the circumflex coronaries were ligated. Three months post operation, the electrophysiological and antiarrhythmic effects of AAP10 were assessed in the arterially perfused rabbit left ventricular wedge preparation. Sham and OMI group were perfused with Tyrode's solution and OMI + AAP10 group was perfused with Tyrode's solution + AAP10 (80 nmol/L). Transmembrane action potentials were recorded simultaneously from endocardium and epicardium together with a transmural ECG by use of 2 separate intracellular floating microelectrodes. The stimulus-response-interval (SRI) of the epicardium and the incidence of ventricular tachycardia (VT) were observed. Whole heart and left ventricular weights, the left ventricular thickness at infarct border zone were measured.</p><p><b>RESULTS</b>Whole heart and left ventricular weights as well as the left ventricular thickness at the infarct border zone significantly increased post infarction. VT was induced in 8 out of 10 rabbits in OMI group and in 2 out of 10 rabbits in OMI + AAP10 group (P < 0.05). SRI was also significantly shortened in OMI + AAP10 group compared to OMI group [SRI-1: (20.59 +/- 0.79) ms vs. (28.71 +/- 0.55) ms; SRI-2: (30.42 +/- 0.74) ms vs. (38.67 +/- 0.49) ms, all P < 0.01]. However, the action potential morphology and duration were similar between OMI and OMI + AAP10 groups.</p><p><b>CONCLUSION</b>The antiarrhythmic peptide (AAP10) can increase gap junctional intercellular conductance without affecting the action potential morphology and duration and decrease the incidence of inducible ventricular tachycardia.</p>