Comparison of therapeutic effects by testis sparing surgery and radical orchiectomy for benign testicular tumors / 现代泌尿外科杂志

【Objective】 To explore the surgical treatments and therapeutic outcomes for benign testicular tumor. 【Methods】 Clinical data of 53 patients with benign testicular tumor treated with surgery during May 2004 and Jul.2021 were retrospectively analyzed. 【Results】 The postoperative pathological diagnosis of 53 patients included 33 patients with epidermal cysts, 12 with mature teratomas, 2 with bilateral testicular tumors (one of them was epidermal cysts in the left and mature teratoma in the right, and the other was bilateral leiomyomas), and 6 benign cases. Testis sparing surgery (TSS) group had 23 patients and radical orchiectomy (RO) group had 30 patients. There were no significant differences in patients’ age, tumor location, disease course, and ultrasound examination results between the two groups (P>0.05). The tumor size of the RO group was (2.60±0.94) cm, which was larger than that of the TSS group (1.55±0.52) cm (P0.05). A total of 15 patients (13 with TSS and 2 with RO) underwent intraoperative frozen rapid pathological examination (FSA), which was consistent with post-operative paraffin pathological results. Durign the follow up of 2-219 months,median 38 months, there was no recurrence in either groups. 【Conclusion】 Testis sparing surgery is a reliable treatment modality for benign testicular tumor, which may also decrease the level of androgen and incidence of asthenozoospermia. It can be considered for tumors less than 2 cm with benign tendency or uncertain nature.

Association between Ubiquitin-specific Proteases 24 Gene Polymorphisms and Sporadic Parkinson's Disease in the Han Guangdong Population / 中国康复理论与实践

Objective To explore the association of ubiquitin-specific proteases 24 (USP24) gene polymorphisms with susceptibility to sporadic Parkinson's disease (PD) in the Han Guangdong population. Methods From August, 2006 to January, 2014, single nucleotide poly-morphisms (SNPs) of rs12138592 and rs6671533 in the intron region of USP24 were genotyped in 200 patients with sporadic PD and 200 healthy controls using the SNaPshot technique. Results There was significant difference in the allele and genotype frequency of rs12138592 between the patients and the controls (P0.05). Conclusion The SNP of rs12138592 in the intron region of USP24 is associated with the susceptibility to sporadic PD in the Han Guangdong population, and the A allele may contribute a protective roles to PD.

Magnetic resonance imaging features of choledochal traumatic neuroma / 中华消化外科杂志

Objective To summarize magnetic the resonance imaging (MRI) features of choledochal traumatic neuroma,and investigate the key points of diagnosis and differentiation.Methods This was a retrospective descriptive study.The clinicopathological data of 1 patient with choledochal traumatic neuroma who was admitted to the Yantaishan Hospital on 18 August,2015 were collected.The patient received pre-contrast and dynamic-contrast-enhanced MRI and MR cholangiopancreatography (MRCP).Observational indexes included:(1) imaging features:location,size,signal intensity and enhancement characteristics of the lesion;(2) treatment and prognosis:surgical treatment,pathological findings,results of immunohistochemical staining and clinical follow-up.After preoperative related examinations,the patient and relatives were willing to receive surgical therapy,and postoperative pathological examinations and immunohistochemical staining were conducted.The follow-up using outpatient examination was performed to detect the patient's recovery and clinical symptoms up to January 2016.Ultrasound and laboratory examinations [alanine transaminase (ALT),aspartate transaminase (AST),γ-glutamyl transpeptidase (GGT) and total bilirubin (TBil)] were also recorded.Results (1) Imaging features:pre-contrast MRI revealed a stricture and intra-lumen nodular in the middle portion of common bile duct.The nodular was measured 1.2 cm × 0.9 cm at maximum cross-section.The nodular was well-demarcated and homogeneous of hypointensity on T1-weighted image comparing to hepatic parenchyma,slight hyperintensity on T2-weighted image and slight hypointensity on fat-suppressed T2-weighted image.MRCP could demonstrate the nodular more clearly and dilation of distal bile duct and intra-hepatic bile ducts.The width of common bile duct was 1.4 cm.After administration of contrast materials,the nodular showed avid enhancement and delay enhancement,which was mild enhancement at the artery phase,and gradual increase at the portal vein phase and the delay phase.The length of central stricture of the common bile duct was 1.3 cm.There was no abnormal enhancement in liver,spleen and pancreas.No retroperitoneal lymphadenopathy could be seen.The imaging diagnosis was cholangiocarcinoma with dilation of bile ducts.(2) Treatment and prognosis:the patient received surgery for tumor resection and Roux-en-Y reconstruction.The removed gross specimen was a grey-white nodular measured 2.0 cm × 1.0 cm.The cute surface was grey-white and stiff.The microscopic evaluation revealed haphazard arrangement of nerve bundles within the hyperplasia fibrotic stroma.Normal biliary epithelial cells can be seen beside the nerve bundles.Immunohistochemical staining showed S-100 and Vimentin were positive.The index of Ki-67 was 5％.The patient was discharged at 14 days postoperatively with the good recovery.During postoperative 5-month follow-up,the patient had good recovery and jaundice seleras were disappeared.Ultrasound showed the bile ducts were not dilated.The results of laboratory examinations were normal.Conclusion MRI features of choledochal traumatic neuroma include an intra-lumen nodular with biliary stricture and avid and delay enhancement after contrast materials administration.

Alterations in imaging and histopathology after aspiration of nucleus pulposus of rabbit lumbar intervertebral disc / 中国组织工程研究

BACKGROUND:It remains unclear what kind of changes in imaging and histopathology would appear in intervertebral disc after removal of nucleus pulposus over time. OBJECTIVE:To observe the alteration in imaging and histopathology of rabbit lumbar intervertebral disc after nucleus pulposus aspiration. METHODS:A total of 32 Japanese rabbits were subjected to nucleus pulposus aspiration in posterior lateral L 3/4 intervertebral disc with a 21-gauge hypodermic needle. L 2/3 intervertebral disc served as a normal control. At 2, 4, 8 and 12 weeks after aspiration, eight rabbits according to grouping received radiograph in the lateral position of lumbar vertebra. The height of L 3/4 and L 2/3 intervertebral space was measured and intervertebral disc height index was calculated. Rabbits received median sagittal MRI examination and histopathological examination of intervertebral disc. RESULTS AND CONCLUSION:The intervertebral disc height degraded slowly at 2, 4, 8, and 12 weeks after aspiration. However, the difference between 8 and 12 weeks was reduced. Compared with normal control, intervertebral disc height index significantly reduced at various time points (P<0.05). The nucleus pulposus signal intensity was gradual y reduced at 2, 4, 8, and 12 weeks after aspiration, and reached grade 4 of modified Thompson grading criteria at 8 weeks. After aspiration, gelatinous nucleus pulposus of disc slowly exhibited fissures with time, morphous was slowly disordered and showed significant fibrosis performance at 12 weeks. In nucleus pulposus region, more cartilage-like cells were found at 4 weeks after operation. The cells were active. Nucleus pulposus cells decreased significantly. At 8 and 12 weeks after operation, fibroblasts increased in nucleus pulposus region, and the number of cartilage-like cells reduced. The annulus fibrosus gradual y became distorted, disordered, with processes and layers, and fiber breakage appeared. These results indicated that after puncturing lateral annulus fibrosus and aspirating the nucleus pulposus, radiograph height of the intervertebral disc and MRI T2-weighted signal intensity gradual y reduced. Pathological changes were observed. However, the degeneration al eviated between 8-12 weeks.

Relationship between bone structure parameters in lower lumbar spine and lumbar disc herniation / 中国组织工程研究

BACKGROUND:Changes in the parameters of lumbar spine bone structure are direct reaction of morphological changes in lower lumbar spine bone structure. These changes possibly result from normal structure strain of the spine affected by long-term external or internal factors. Whether the conditions reflected by different parameters are identical, and whether corresponding clinical symptoms are correlative stil deserves further exploration. OBJECTIVE:To measure and compare the construction parameters of lumbar spine bone structure in lower lumbar disc herniation patients, and to investigate whether abnormalities of lumbar bony structure could lead to lower lumbar disc herniation and to evaluate the significance in degenerative lumbar disc. METHODS:From March 2008 to March 2010, 207 cases of lower lumbar disc herniation were randomly selected from the Department of Orthopedics, First Affiliated Hospital, Fuzhou General Hospital, Nanjing Military Area Command of Chinese PLA. They received CT examination at the Department of Radiology at the same period, and results revealed that 143 cases of lower lumbar disc non-herniation served as control group. According to gender, they were divided into male and female groups. According to ages, they were divided into 25-34 group, 35-44 group, 45-54 group and 55-65 group. They were studied by measuring spinous process deflection angle, facet joint angle, lumbar vertebrae curvature, angle of lumbar vertebrae curvature, lumbosacral angle. RESULTS AND CONCLUSION:Process deflection angle at L 4 and L 5 levels had a significant statistical difference between the lower lumbar disc herniation group and the control group. The date did not show normal distribution. Using Rank sum test, it had a significant statistical difference (Z=-10.609,-12.074, P0.05). There only was significant difference on lumbosacral angle between male group and female group (P=0.007<0.01). There was significant difference on the facet asymmetry, lumbar vertebrae curvature, angle of lumbar vertebrae curvature and lumbosacral angle between 55-65 age group and 25-34 age group or 35-44 age group (P<0.01), and there was significant difference between 45-54 age group and 25-34 age group (P<0.01). These data suggested that the abnormalities of lumbar bony structure could not directly lead to the lumbar disc herniation, but the abnormalities of lumbar bony structure aggravate the lumbar intervertebral disc degeneration.

Prevention of early posterior dislocation after total hip arthroplasty:significance of repairing posterior joint capsule and external rotators / 中国组织工程研究

BACKGROUND:Primary dislocation after total hip arthroplasty is a major complication, besides prosthesis loosening. It is controversial whether joint capsule and external rotators should be repaired during total hip arthroplasty through posterolateral approach. OBJECTIVE:To explore the clinical significance of joint capsule and external rotator repair on preventing hip dislocation after primary total hip arthroplasty through posterolateral approach. METHODClinical data of patients with primary or secondary hip osteoarthritis after primary total hip arthroplasty through posterolateral approach were retrospectively analyzed. They were assigned to two groups according to different strategies of soft tissue repair. Control group did not receive posterior soft tissue repair. Combined repair group received the repair of joint capsule and short external rotators. Al patients were fol owed up for more than 1 year. Early dislocation was defined as the dislocation occurred within 1 year after operation. The effects of different repair methods on early dislocation rate were compared. RESULTS AND CONCLUSION:There were 362 patients. Total y 390 case-times of primary total hip arthroplasty were included. Early dislocation occurred in 7 cases, of which 6 case-times in the control group (2.2%, 6/268), and 1 case-time in the repair group (0.8%, 1/122). There were significant differences in the incidence rate of early dislocation between the repair group and control group (P=0.012). These findings confirmed that the combined repair of posterior joint capsule and short external rotators could decrease the rate of early dislocation after primary total hip arthroplasty through posterolateral approach.

Constructing a rabbit model of intervertebral disc degeneration by simulating the removal of human nucleus pulposus through a posterior approach / 中国组织工程研究

BACKGROUND: Resection of the nudeus pulposus is the classical treatment for intervertebral disc protrusion, except a higher recurrence rate. OBJECTIVE: To verify the feasibility of establishing an animal model of intervertebral disc degeneration by puncture and aspiration via a posterolateral approach to simulate resection of human nucleus pulposus. DESIGN, TIME AND SE'I'FING: The experiment was conducted in the animal Experimental Center of Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from October 2006 to February 2007. MATERIALS: Twenty Japanese big ear rabbits were selected to establish animal models of intervertebral disc degeneration. METHODS: Some nucleus pulposus tissues were abstracted from the L1-2 and L3-4 segment of 20 rabbits by the puncture and aspiration method using a 21-gaege hypodermic needle. Histological analysis was performed at 2, 4, 8, 12 weeks after surgery, and L2-3 segment was used as control group.MAIN OUTCOME MEASURE: Histological structure of the intervertebral disc was observed by homatoxylin-eosin staining. RESULTS: Hematoxylin-eosin staining revealed a great deal of complete nudeus pulposus tissues, clear boundaries between nucleus pulposus and annulus fibrosus in the control group, and the structure of near normal annulus fibrosus was almost normal, nucleus pulposus tissue had a large number of nucleus pulposus cells. In the experimental group, the nucleus pulposus cell reduced in amount in the fourth week, the nucleus pulposus at the twelfth week were mainly full of flbroblests, while few nucleus pulposus cells were found.CONCLUSION: It is successful to establishing an animal model of intervertebral disc degeneration by puncture and aspiration via a posterolateral approach based on simulating the resection of human nucleus pulposus. This model is available for repairing intervertebrai disc degeneration using tissue engineering techniques.

Multiple suppressor gene p16 of human brain gliomas / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the relationship among p16, genesis, and development of brain gliomas.</p><p><b>METHODS</b>We detected the deletion and point mutation of p16 exon 2 by PCR-TGGE. Methylation sensitivity ristriction enzyme polymerase chain reaction was used to detect whether methylation is correlated with happening of glioma.</p><p><b>RESULTS</b>p16 homozygous deletion was detected in 14 of 48 gliomas. No deletions were found in low grade gliomas. Of the 48 gliomas, 5 anaplastic gliomas (WHO grade III) and 9 glioblastomas (WHO grade IV) showed homozygous deletion of exon 2 with a deletion rate of 33.33% (5/15) and 50.00% (9/18) respectively. The mutations of 34 gliomas with p16 positive amplification were detected point mutations in two gliomas, in which one was anaplatic glioma and the other was glioblastoma. Six of the 48 gliomas (12.5%) showed exon1 methylations.</p><p><b>CONCLUSIONS</b>p16 may play an important role in genesis of brain glioma. The main alteration of p16 in brain gliomas was homozygous deletion of exon 2, the methylation of p16 exon 1 was subcardinal, however, point mutation was rare. The deletion of p16 was found especially in high grade gliomas, so we could propose that it may be the late event of tumor occurrence.</p>

Application of neuroendoscopy in brain surgery / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of neuroendoscope on surgery.</p><p><b>METHODS</b>315 patients were treated with neuroendoscope. Endoscopic neurosurgery (EN) was used in 219 patients, endoscope-assisted microneurosurgery (EAM) in 72, and endoscope-controlled microneurosurgery (ECM) in 24.</p><p><b>RESULTS</b>201 (91.8%) of the 219 patients underwent EN effectively. In 72 patients who underwent EAM there was less retraction during tumor removal and visual control was improved. 21 (87.5%) of the 24 patients underwent ECM effectively. No severe complications were observed.</p><p><b>CONCLUSION</b>Neuroendoscopy can reduce tissue trauma, improve visualization during tumor removal, and reduce complications.</p>