乙肝病毒相关性肾炎（hepatitis B virus associated glomerulonephritis,HBV-GN）是由乙型肝炎病毒感染后引发的继发性免疫复合物性肾小球肾炎,是慢性乙型肝炎病毒感染患者最常见肝外损伤之一。本病的主要临床特征是起病隐匿、血尿及...乙肝病毒相关性肾炎（hepatitis B virus associated glomerulonephritis,HBV-GN）是由乙型肝炎病毒感染后引发的继发性免疫复合物性肾小球肾炎,是慢性乙型肝炎病毒感染患者最常见肝外损伤之一。本病的主要临床特征是起病隐匿、血尿及蛋白尿,相当一部分病例可表现为肾病综合征,少数可伴肾功能损害甚至肾衰竭。展开更多
Objective To analyze the clinical characteristics of nonfunctioning pheochromocytoma, and to evaluate the efficacy of 131I-metaiodobenzylguanidine (MIBG) scan in the diagnosis and perioperative treatment of nonfunctio...Objective To analyze the clinical characteristics of nonfunctioning pheochromocytoma, and to evaluate the efficacy of 131I-metaiodobenzylguanidine (MIBG) scan in the diagnosis and perioperative treatment of nonfunctioning pheochromocy- toma. Methods The clinical data of 14 patients with nonfunctioning pheochromocytoma were analyzed retrospectively. Plasma free corticoid, renin, aldosterone, and urine catecholamines levels were estimated. B-mode ultrasonography, computed tomo- graphy scan, thoracic X-ray and 131I-MIBG were used. Results All patients with nonfunctioning pheochromocytoma had no hypertension and the tumors were found inciden- tally. The 24 hours urine catecholamines levels in 80% (8/10) patients were normal. The positive rate of 131I-MIBG was 80% (8/10) and the specificity was 100%. All patients underwent surgical operation of tumor resection. No preoperative volume expansion was given to all patients. All tumors were resected completely, and no death accident happened. There was no recurrence and metastasis after operation by long-term follow-up. Conclusion 131I-MIBG scan is the first choice technique for the diagnosis of nonfunctioning pheochromocytoma. Blood volume expansion is unnecessary before resection of pheochromocytoma.no recurrence and metastasis})展开更多
Objective To evaluate the effect of intraoperative combined forced-air warming and fluid warming system on patient＇s core temperature, blood loss, transfusion demand, extubation time, and incidence of postoperative s...Objective To evaluate the effect of intraoperative combined forced-air warming and fluid warming system on patient＇s core temperature, blood loss, transfusion demand, extubation time, and incidence of postoperative shivering. Mothods Forty patients with American Society of Anesthesiologists physical status I and II, aged 18-70 years, scheduled for elective abdominal surgery were randomly assigned to receive intraoperative warming from a forced-air blanket and fluid warming system or conventional cotton blanket, 20 in each group. The core temperature was recorded every 20 minutes during the operation, as well as the blood loss, blood transfusion, extubation time, and incidence of postoperative shivering. Results The core temperature at the end of the surgery in the warming group was significantly different from that in the control group （36.4±0.4℃ vs. 35.3±0.5℃, P〈0.001）. Application of intraoperative warming significantly shortened the time between the end of the surgery and extubation （P〈0.01）. Postoperative shivering occurred in 30% of the patients in the control group compared to no patient in the warming group （P 〈0.01）. Conclusion Active warming with air-forced blanket and fluid warming system provides sufficient heat to prevent hypothermia during abdominal surgery.展开更多
Objectives To address whether menopause affects outcome of catheter ablation （CA） for atrial fibrillation （AF） by comparing the safety and long-term outcome of a single-procedure in pre-and post-menopausal women. ...Objectives To address whether menopause affects outcome of catheter ablation （CA） for atrial fibrillation （AF） by comparing the safety and long-term outcome of a single-procedure in pre-and post-menopausal women. Methods A total of 743 female patients who underwent a single CA procedure of drug-refractory AF were retrospectively analyzed. The differences in clinical presentation and outcomes of CA for AF between the pre-menopausal women （PreM group, 94 patients, 12.7%） and the post-menopausal women （PostM group, 649 patients, 87.3%） were assessed. Results The patients in the PreM group were younger （P＆lt;0.001） and less likely to have hypertension （P＆lt;0.001） and diabetes （P=0.005） than those in the PostM group. The two groups were similar with regards to the proportion of concomitant mitral valve regurgitation coronary artery disease, left atrium dimensions, and left ventricular ejection fraction. The overall rate of complica-tions related to AF ablation was similar in both groups （P=0.385）. After 43 （16-108） months of follow-up, the success rate of ablation was 54.3%in the PreM group and 54.2%in the PostM group （P=0.842）. The overall freedom from atrial tachyarrhythmia recurrence was simi-lar in both groups. Menopause was not found to be an independent predictive factor of the recurrence of atrial tachyarrhythmia. Conclusions The long-term outcomes of single-procedure CA for AF are similar in pre-and post-menopausal women. Results indicated that CA of AF appears to be as safe and effective in pre-menopausal women as in post-menopausal women.展开更多
Objective: Whether single low shear stress can result in atherosclerosis without hyperliposis-diet in vivo or not is unknown. Methods: Based on an electromagnetic blood flow meter and a method to determine the pulsati...Objective: Whether single low shear stress can result in atherosclerosis without hyperliposis-diet in vivo or not is unknown. Methods: Based on an electromagnetic blood flow meter and a method to determine the pulsatile shear stress from blood flow rate waveform and its software,we developed an in vivo pulsatile blood flow rate-shear stress determining system.The left external carotid arteries of 20 adult New Zealand white rabbits were ligated and the rabbits were fed with a standard chow for 2,4,8 or 12 weeks,then the common carotid arteries of 2 sides in each rabbit were harvested for morphologic test. Results: The ligation reduced pulsatile shear stress of left common carotid significantly,for example,τ_ mean changed from(21.16±7.17) dynes/cm 2 to(3.13±2.28) dynes/cm 2(p=2.176E-21),meanwhile,the pulsatile shear stress of right common carotid did not change significantly,which lasted more than 12 weeks.Atherosclerotic plaques were found after 8 and 12 weeks in pulsatile-low-shear-stress left(not normal-shear-stress right) common carotid arteries.Conclusion:Single pulsatile low shear stress can result in atherosclerosis.It supports the pulsatile low shear stress(not hypolipidemia) is the key risk factor for atherosclerosis.展开更多
VAGAL paraganglioma （VP） is an uncommon neoplasm originating from neural crest paraganglion cells located along the vagus nerve, repre-senting less than 5 % of all paragangliomas of the head and neck Despite improve...VAGAL paraganglioma （VP） is an uncommon neoplasm originating from neural crest paraganglion cells located along the vagus nerve, repre-senting less than 5 % of all paragangliomas of the head and neck Despite improvement in microsurgical techniques,展开更多
Objective： To sum up 7 patients with cervicothoracic vertebrae tumors （Cr to T3） from March 1999 and May 2002, who underwent operative treatment via anterior approaches. Methods ：The anterior approaches included l...Objective： To sum up 7 patients with cervicothoracic vertebrae tumors （Cr to T3） from March 1999 and May 2002, who underwent operative treatment via anterior approaches. Methods ：The anterior approaches included low anterior cervical approach and high transthoracic approach. In 5 cases of segments of T1 and above involved, the low anterior cervical approaches were adopted, otherwise the high transthoracic approaches were used（2 cases）. Excision of tumor was carried out according to demands of the Weinstein-Boriani-Biagini （WBB） staging system. Spine stability was reconstructed by bone autografting and instrumentation. There were 4 cases of primary tumor and 3 of metastases. Their mean age was 45. 1 years （23 to 66）. The mean follow-up was 18.9 months （3 to 45）. Results were evaluated by occurrence of complications, improvement of symptoms, local recurrence and mortality. Results： All patients stood surgery well. No significant complications occurred during and after operation. Local pain was significantly alleviated and neurological deficit was improved at least one Frankel grade. Three patients died. Local tumor control was obtained in 6 patients （85.7 % ） until the end of follow-up. Conclusion.-Our experience showed that via low anterior cervical approach and high transthoracic approach, the cervicothoracic vertebrae tumor could be excised safely and adequately. Moreover, excision of tumor according to the WBB surgical staging system and reconstruction of spine stability have made great contribution to local tumor control and the neurological function improvement.展开更多
The aim of this paper is to describe the mechanism, clinical manifestation, diagnosis and surgical management of congenital choledochal cyst. [WT5”BX] Methods.[WT5”BZ] From 1984 to 1997, 56 cases of congenital chole...The aim of this paper is to describe the mechanism, clinical manifestation, diagnosis and surgical management of congenital choledochal cyst. [WT5”BX] Methods.[WT5”BZ] From 1984 to 1997, 56 cases of congenital choledochal cyst were reviewed. Among them, 8 patients were male, 48 patients were female, the age ranges from 12 to 50 years old with an average of 26 3. [WT5”BX] Results.[WT5”BZ]The main clinical manifestation includes jaundice, abdominal pain and abdominal mass. All of them were confirmed by ultrasonography, while 39 cases were performed ERCP and PTC with the same diagnosis. Fifty one patients were performed cystectomy and hepatojejunostomy, two cases were performed cystjejunostomy because of diffused angioma and severe hemorrhage respectively, external drainage was performed in one case with emergent cholangitis, the other two cases were reported malignancy through biopsy and operation was abandoned. [WT5”BX] Conclusions. [WT5”BZ]Ultrasound diagnostics is essential to accurately diagnose the cyst, preoperative ERCP is helpful for differentiating pancreatic duct from bile duct, while MRCP is a reliable method; cystectomy and cholangiojejunostomy is recommended, laparoscopic procedure is becoming more and more accepted.展开更多
To improve clinical knowledge of Peutz- Jeghers syndrome. Methods. Eight patients with Peutz- Jeghers syndrome from 1984 to 1998 in our hospital were retrospectively reviewed and analyzed in the present study. Result....To improve clinical knowledge of Peutz- Jeghers syndrome. Methods. Eight patients with Peutz- Jeghers syndrome from 1984 to 1998 in our hospital were retrospectively reviewed and analyzed in the present study. Result. The result of this analysis showed that there were 4 patients appeared with family histories of Peutz- Jeghers syndrome. All of the included patients admitted to the hospital with various complications, and eventually received surgical interventions for these complications, among which, 6 of them had intestinal obstructions mostly (5/6) due to small bowel intussusception, and 2 of them suffered with hemafecia. Post- operative recoveries were generally satisfactory with zero mortality. Conclusion. Peutz- Jeghers syndrome is an uncommon digestive dominant hereditary disease. The diagnosis of it with history, symptoms, signs, and proper examinations usually is not difficult. Surgical interventions are necessary once complications occur.展开更多
文摘乙肝病毒相关性肾炎（hepatitis B virus associated glomerulonephritis,HBV-GN）是由乙型肝炎病毒感染后引发的继发性免疫复合物性肾小球肾炎,是慢性乙型肝炎病毒感染患者最常见肝外损伤之一。本病的主要临床特征是起病隐匿、血尿及蛋白尿,相当一部分病例可表现为肾病综合征,少数可伴肾功能损害甚至肾衰竭。
文摘Objective To analyze the clinical characteristics of nonfunctioning pheochromocytoma, and to evaluate the efficacy of 131I-metaiodobenzylguanidine (MIBG) scan in the diagnosis and perioperative treatment of nonfunctioning pheochromocy- toma. Methods The clinical data of 14 patients with nonfunctioning pheochromocytoma were analyzed retrospectively. Plasma free corticoid, renin, aldosterone, and urine catecholamines levels were estimated. B-mode ultrasonography, computed tomo- graphy scan, thoracic X-ray and 131I-MIBG were used. Results All patients with nonfunctioning pheochromocytoma had no hypertension and the tumors were found inciden- tally. The 24 hours urine catecholamines levels in 80% (8/10) patients were normal. The positive rate of 131I-MIBG was 80% (8/10) and the specificity was 100%. All patients underwent surgical operation of tumor resection. No preoperative volume expansion was given to all patients. All tumors were resected completely, and no death accident happened. There was no recurrence and metastasis after operation by long-term follow-up. Conclusion 131I-MIBG scan is the first choice technique for the diagnosis of nonfunctioning pheochromocytoma. Blood volume expansion is unnecessary before resection of pheochromocytoma.no recurrence and metastasis})
文摘Objective To evaluate the effect of intraoperative combined forced-air warming and fluid warming system on patient＇s core temperature, blood loss, transfusion demand, extubation time, and incidence of postoperative shivering. Mothods Forty patients with American Society of Anesthesiologists physical status I and II, aged 18-70 years, scheduled for elective abdominal surgery were randomly assigned to receive intraoperative warming from a forced-air blanket and fluid warming system or conventional cotton blanket, 20 in each group. The core temperature was recorded every 20 minutes during the operation, as well as the blood loss, blood transfusion, extubation time, and incidence of postoperative shivering. Results The core temperature at the end of the surgery in the warming group was significantly different from that in the control group （36.4±0.4℃ vs. 35.3±0.5℃, P〈0.001）. Application of intraoperative warming significantly shortened the time between the end of the surgery and extubation （P〈0.01）. Postoperative shivering occurred in 30% of the patients in the control group compared to no patient in the warming group （P 〈0.01）. Conclusion Active warming with air-forced blanket and fluid warming system provides sufficient heat to prevent hypothermia during abdominal surgery.
文摘Objectives To address whether menopause affects outcome of catheter ablation （CA） for atrial fibrillation （AF） by comparing the safety and long-term outcome of a single-procedure in pre-and post-menopausal women. Methods A total of 743 female patients who underwent a single CA procedure of drug-refractory AF were retrospectively analyzed. The differences in clinical presentation and outcomes of CA for AF between the pre-menopausal women （PreM group, 94 patients, 12.7%） and the post-menopausal women （PostM group, 649 patients, 87.3%） were assessed. Results The patients in the PreM group were younger （P＆lt;0.001） and less likely to have hypertension （P＆lt;0.001） and diabetes （P=0.005） than those in the PostM group. The two groups were similar with regards to the proportion of concomitant mitral valve regurgitation coronary artery disease, left atrium dimensions, and left ventricular ejection fraction. The overall rate of complica-tions related to AF ablation was similar in both groups （P=0.385）. After 43 （16-108） months of follow-up, the success rate of ablation was 54.3%in the PreM group and 54.2%in the PostM group （P=0.842）. The overall freedom from atrial tachyarrhythmia recurrence was simi-lar in both groups. Menopause was not found to be an independent predictive factor of the recurrence of atrial tachyarrhythmia. Conclusions The long-term outcomes of single-procedure CA for AF are similar in pre-and post-menopausal women. Results indicated that CA of AF appears to be as safe and effective in pre-menopausal women as in post-menopausal women.
文摘Objective: Whether single low shear stress can result in atherosclerosis without hyperliposis-diet in vivo or not is unknown. Methods: Based on an electromagnetic blood flow meter and a method to determine the pulsatile shear stress from blood flow rate waveform and its software,we developed an in vivo pulsatile blood flow rate-shear stress determining system.The left external carotid arteries of 20 adult New Zealand white rabbits were ligated and the rabbits were fed with a standard chow for 2,4,8 or 12 weeks,then the common carotid arteries of 2 sides in each rabbit were harvested for morphologic test. Results: The ligation reduced pulsatile shear stress of left common carotid significantly,for example,τ_ mean changed from(21.16±7.17) dynes/cm 2 to(3.13±2.28) dynes/cm 2(p=2.176E-21),meanwhile,the pulsatile shear stress of right common carotid did not change significantly,which lasted more than 12 weeks.Atherosclerotic plaques were found after 8 and 12 weeks in pulsatile-low-shear-stress left(not normal-shear-stress right) common carotid arteries.Conclusion:Single pulsatile low shear stress can result in atherosclerosis.It supports the pulsatile low shear stress(not hypolipidemia) is the key risk factor for atherosclerosis.
文摘VAGAL paraganglioma （VP） is an uncommon neoplasm originating from neural crest paraganglion cells located along the vagus nerve, repre-senting less than 5 % of all paragangliomas of the head and neck Despite improvement in microsurgical techniques,
文摘Objective： To sum up 7 patients with cervicothoracic vertebrae tumors （Cr to T3） from March 1999 and May 2002, who underwent operative treatment via anterior approaches. Methods ：The anterior approaches included low anterior cervical approach and high transthoracic approach. In 5 cases of segments of T1 and above involved, the low anterior cervical approaches were adopted, otherwise the high transthoracic approaches were used（2 cases）. Excision of tumor was carried out according to demands of the Weinstein-Boriani-Biagini （WBB） staging system. Spine stability was reconstructed by bone autografting and instrumentation. There were 4 cases of primary tumor and 3 of metastases. Their mean age was 45. 1 years （23 to 66）. The mean follow-up was 18.9 months （3 to 45）. Results were evaluated by occurrence of complications, improvement of symptoms, local recurrence and mortality. Results： All patients stood surgery well. No significant complications occurred during and after operation. Local pain was significantly alleviated and neurological deficit was improved at least one Frankel grade. Three patients died. Local tumor control was obtained in 6 patients （85.7 % ） until the end of follow-up. Conclusion.-Our experience showed that via low anterior cervical approach and high transthoracic approach, the cervicothoracic vertebrae tumor could be excised safely and adequately. Moreover, excision of tumor according to the WBB surgical staging system and reconstruction of spine stability have made great contribution to local tumor control and the neurological function improvement.
文摘The aim of this paper is to describe the mechanism, clinical manifestation, diagnosis and surgical management of congenital choledochal cyst. [WT5”BX] Methods.[WT5”BZ] From 1984 to 1997, 56 cases of congenital choledochal cyst were reviewed. Among them, 8 patients were male, 48 patients were female, the age ranges from 12 to 50 years old with an average of 26 3. [WT5”BX] Results.[WT5”BZ]The main clinical manifestation includes jaundice, abdominal pain and abdominal mass. All of them were confirmed by ultrasonography, while 39 cases were performed ERCP and PTC with the same diagnosis. Fifty one patients were performed cystectomy and hepatojejunostomy, two cases were performed cystjejunostomy because of diffused angioma and severe hemorrhage respectively, external drainage was performed in one case with emergent cholangitis, the other two cases were reported malignancy through biopsy and operation was abandoned. [WT5”BX] Conclusions. [WT5”BZ]Ultrasound diagnostics is essential to accurately diagnose the cyst, preoperative ERCP is helpful for differentiating pancreatic duct from bile duct, while MRCP is a reliable method; cystectomy and cholangiojejunostomy is recommended, laparoscopic procedure is becoming more and more accepted.
文摘To improve clinical knowledge of Peutz- Jeghers syndrome. Methods. Eight patients with Peutz- Jeghers syndrome from 1984 to 1998 in our hospital were retrospectively reviewed and analyzed in the present study. Result. The result of this analysis showed that there were 4 patients appeared with family histories of Peutz- Jeghers syndrome. All of the included patients admitted to the hospital with various complications, and eventually received surgical interventions for these complications, among which, 6 of them had intestinal obstructions mostly (5/6) due to small bowel intussusception, and 2 of them suffered with hemafecia. Post- operative recoveries were generally satisfactory with zero mortality. Conclusion. Peutz- Jeghers syndrome is an uncommon digestive dominant hereditary disease. The diagnosis of it with history, symptoms, signs, and proper examinations usually is not difficult. Surgical interventions are necessary once complications occur.
