Objective To understand the latest research developments of the formation mechanism of psammoma body in human tumors and related issues. Methods Related domestic and foreign literatures were widely referred, analyzed, and reviewed. Results Psammoma body is unique pathological calcification in some tumors, which is arranged in concentric, laminar circles microscopically. Psammoma body is commonly seen in thyroid papillary carcinoma, meningiomas, ovarian serous papillary carcinoma, and so on. Conclusions Although arranged in concentric, laminar circles microscopically in tumor, the formation process of psammoma body is not entirely the same in different tumors. A comprehensive and objective understanding of psammoma body would be useful in cancer diagnosis and treatment.
Objective To summarize the experience of open heart operation on neonates with critical and complex congenital heart diseases and evaluate the methods of perioperative management. Methods From May 2001 to January 2003, 12 patients of neonates with congenital heart diseases underwent emergency operation. Their operating ages ranged from 6 to 30 days, the body weights were 2.8 to 4.5 kg. Their diagnoses included D-transposition of the great arteries in 4 cases, ventricular septal defect with atrial septal defect in 5 cases, complete atrioventricular septal defect, obstructed supracardiac total anomalous pulmonary venous drainage and cardiac rhabdomyomas in 1 case respectively. 12 cases were operated under moderate or deep hypothermic cardiopulmonary bypass. Results All cases were observed in ICU for 2-11 days and discharged 7-19 days after operation. The postoperative complications included low cardiac output, mediastinal infection, respiratory distress syndrome, systemic capillary leak syndrome and acute renal failure. All cases were cured and the follow-up (from 6 months to 2 years) showed satisfactory outcome. Conclusion A particular cardiopulmonary bypass and proper perioperative management is very important to ensure the successful outcome. Peritoneal dialysis is an effective and safe method for treating acute renal failure after cardiac operation in neonates.
Objective To summarize the visual outcome of patients with severe ocular trauma treated with vitreous surgery. Methods Clinical data of 188(191 eyes) with severe ocular trauma treated with vitreous surgery in a period from November 1996 to April 1998 were analysed retrospectively. Results The study included penetrating injury in 56 eyes, foreign bodies in the posterior segment in 70 eyes, blunt injury in 41 eyes , and globe rupture in 24 eyes. Main complications included endophthalmitis in 35 eyes, choroidal bleeding in 20 eyes, retinal detachment in 60 eyes, and vitreous hemorrhage in 97 eyes. Post-opera-tively, out of 188 eyes, except for 3 of patients too young to examine, visual acuity improved in 133(70.7%), including 85(45.2%) with visal acuity 0.02-1.0, 46(24.5%) remained unchanged; and 9(4.8%) had worse vision. Among 34 with no-light-perception, 12 had light-perception or over. Conclusion A majority of severe trauma eyes can be salvaged with considerable visual recovery after adequate and timely vitreous surgery. (Chin J Ocul Fundus Dis,1999,15:4-6)
This study reports the first successful clinical application of a robotic-assisted system in transcatheter balloon-expandable aortic valve implantation using the Edwards SAPIEN 3 valve. Two male patients, aged 60 and 63 years, respectively, presented with severe aortic stenosis confirmed by echocardiography and computed tomography, showing significant valvular calcification and elevated transvalvular pressure gradients, meeting the indications for transcatheter aortic valve implantation (TAVI). Both procedures were performed via the right femoral artery using a robotic-assisted delivery and positioning system developed by Shanghai Surgerii Medical Technology Co., Ltd. The operator controlled the delivery system and valve positioning precisely through the console, while the assistant performed balloon expansion and valve deployment. Both procedures were completed successfully without intraoperative complications. The operative times were 75 minutes and 67 minutes, with fluoroscopy times of 16 minutes and 23 minutes, and radiation doses of 714 mGy and 971 mGy, respectively. Postoperative echocardiography demonstrated well-functioning prosthetic valves, with mean transvalvular pressure gradients of 3.9 mm Hg and 8.0 mm Hg, and none or trivial paravalvular leakage. No coronary obstruction, conduction disturbance, or vascular complications were observed. This report represents the world’s first clinical use of a robotic-assisted system for balloon-expandable TAVI. It confirms the feasibility and safety of robotic assistance in transcatheter valve delivery and positioning, offering a new approach to enhance procedural precision and stability, and providing valuable insights for the future development of intelligent, minimally invasive therapies for structural heart disease.
目的 探討改道置管肛外引流術治療直腸黏膜下膿腫的臨床療效。 方法 2007年5月－2012年5月，將76例直腸黏膜下膿腫患者分為改道置管肛外引流術（治療組）和傳統切開引流術（對照組）治療，每組各38例，兩組患者在年齡、性別比、病程等方面具有可比性。觀察兩組患者治愈時間、治愈率、隨訪3個月的復發情況以及肛門直腸壓力測定，評價兩組患者臨床療效及肛門功能保護情況。 結果 治療組患者治愈時間為（21.3 ± 6.37）d，對照組為（29.5 ± 4.52）d，治療組時間明顯縮短（t=5.79，P＜0.01）；治療組治愈率97.3%，對照組為73.6%，差異有統計學差異（χ2=6.81，P＜0. 01）；兩組患者隨訪3個月的肛門功能比較，RRP治療組為3.48 ± 0.61，對照組3.22 ± 0.79，差異無統計學意義（t=?1.61，P＞0.05）；ARP治療組為19.05 ± 3.76，對照組為17.55 ± 3.31，差異無統計學意義（t=?1.85，P＞0.05）；ALCT治療組為36.74 ± 4.70，對照組為37.13 ± 3.90，差異無統計學意義（t=?0.39，P＞0.05）；AMCP治療組為24.03 ± 5.80，對照組為21.8 ± 4.91，差異無統計學意義（t=?1.61，P＞0.05）。 結論 改道置管肛外引流術治療直腸黏膜下膿腫可縮短療程，提高治愈率。
ObjectiveTo investigate the effectiveness of arthroscopic treatment of pigmented villonodular synovitis (PVNS) of the ankle. MethodsTwelve patients who were initially diagnosed as having PVNS of the ankle were treated between January 2005 and May 2012.There were 6 males and 6 females,aged 20-50 years (mean,35.4 years).Disease duration ranged from 6 months to 12 years (median,3.6 years).One case of recurrence was included.The preoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 55.5±7.6.According to degree and range of the PVNS lesions,4 cases of local PVNS were treated with arthroscopic debridement,and 8 cases of diffuse PVNS were treated with arthroscopically assisted arthrotomy;and local radiotherapy was given in all patients after operation. ResultsPrimary healing of incision was obtained in all patients.The mean follow-up time was 2.8 years (range,1-6 years).At 12 months after operation,no obvious pain,swelling,and limited range of motion of the ankle were observed.The AOFAS score was increased to 84.3±3.4 at 12 months,and it was significantly higher than that at preoperation (P<0.05) and at 3 months after operation (82.8±3.8)(P<0.05).There was no recurrence during follow-up. ConclusionArthroscopic arthrotomy combined with postoperative radiotherapy are recommended for PVNS of the ankle according to the PVNS lesion degree and range.And arthroscopically assisted surgery has many advantages of less traumas and hemorrhage,fast recovery,and less complications.
Eighteen cases of primary incompetence of the valves of the deep veins of leg were treated by various types of operations were reported. The patients were followed up for 4 to 26 months, with complete disappearance of symptoms and marked improvement of the concomittant dermatitis. The ulcerative lesions were healed within 1 to 3 weeks after operation. Three patients received postoperative vcnography with retrograde vcnography, the results showed that the valves had first degree function.
There was no enough evidence to support the view that endovascular treatment could alternate the endarterectomy to be a standard treatment of carotid stenosis. A recent Cochrane systematic review found no difference in major outcomes between endovascular treatment and surgery. The randomised trials provided data to show that the main advantage of endovascular treatment for carotid artery stenosis was the avoidance of minor complications such as cranial nerve palsy and wound haematoma of surgery. Longer term follow also showed no difference in the rate of stroke during follow-up, but the confidence intervals were very wide allowing the possibility of a substantial difference in risk and benefits of the two treatments. There was no difference in avoidance of stroke between carotid stenting using protection devices and surgery, and the protection devices could cause additional complications.
目的:分析經后腹腔鏡腎上腺囊腫去頂減壓術的療效,安全性和臨床價值。方法:我院2004年12月至2007年12月6例經后腹腔鏡腎上腺囊腫去頂減壓臨床資料進行回顧分析。結果:經后腹腔鏡5例腎上腺囊腫患者順利切除去頂,其中左側腎上腺囊腫3例,右側腎上腺囊腫3例。1例轉開放,為雙側腎上腺囊腫。平均手術時間(45.73±1.32)min,平均術中出血量(7.35±0.45)mL。平均住院天數(7.67±0.24)天,平均術后住院天數(5.0±0.11)天。結論:經后腹腔鏡腎上腺囊腫去頂減壓是一種安全,有效且可行的治療方式,必要時應及時轉開放。
Ten cases of soft tissue defect at palm orwrist were repaired by reversed fasciocutaneousflap from the forearm. All were. survived excepttwo cases having necrosis of the distal portion ofthe graft. The blood supply of the skin of the fore-arm was comming from the perforation fasciocuta-neous and musculocutaneous giving rise from theulna , radial and interosseous arteries. Therefore ,when the flap was designed,it was best to have thefascial pedicle over the arterial trunks in order toinclude more perforating arteries in the flap . It was indicated that venous supply might also played an important role in flap nutrition.