Laparoscopic enucleation of a renal cell carcinoma

The purpose of this study was to report on the feasibility of laparoscopic excision of renal cell carcinoma. An 81-year-old female with renovascular disease underwent a laparoscopic excisional operation for a 2-cm tumor localized in the left kidney.Pathological evaluation showed a low-grade tumor without any extension through the renal capsule (grade I Hand Broder, stage I Robson). The postoperative course was uneventful; there was minimal postoperative pain. The patient was discharged home on the sixth day. Laparoscopic excision would appear to be a safe and effective technique in selected cases.     

经阴道行良性卵巢囊肿剥离术195例报告

目的探讨经阴道行良性卵巢囊肿剥离术的临床实用价值.方法2001年1月2004年6月对有手术指征的良性卵巢囊肿195例实施阴式手术,并观察有关手术指标.结果经阴道完成手术190例,5例因盆腔广泛粘连中转开腹.手术时间45～83 min,平均50 min.术中出血30～90 ml,平均45 ml.术后排气时间4～24 h,平均8.5 h.术后病率18.4%(35/190).183例随访2周内恢复日常家务及工作者分别为72.1%(132/183)、48.1%(88/183).结论经阴道行良性卵巢囊肿剥离术是一种安全、微创的手术.     

壁间型膀胱平滑肌瘤十例患者诊治经验的初步探讨

目的通过对壁间型膀胱平滑肌瘤的诊疗进行回顾性分析,初步探讨其临床诊疗方式。方法回顾性分析2010年1月至2019年1月于徐州医科大学附属医院泌尿外科行手术治疗壁间型膀胱平滑肌瘤10例患者资料。其中男性1例,女性9例,年龄33~51(44±6)岁。其中5例患者以膀胱刺激症状为主要临床表现,1例患者以下腹痛为主要表现,还有4例患者无明显临床症状,患者发病时间1周至2年,平均4.9个月。患者泌尿系彩超检查发现膀胱壁上形态规则、表面覆盖黏膜高回声的低回声包块。CTU检查为膀胱壁均质样实性肿块,边界清楚、光滑,无侵蚀表现,膀胱壁走形自然,且壁周脂肪间隙清晰,膀胱内可见充盈缺损。膀胱镜检查可见瘤体表面黏膜常完整连续,可见局部稍向膀胱内隆起。根据患者肿瘤部位、大小,10例患者分别采用经尿道平滑肌瘤剜除术和腹腔镜下平滑肌瘤剜除术,3例患者术中冰冻切片示:膀胱平滑肌瘤。结果10例患者中有临床症状者:其中5例以膀胱刺激症状为主诉的患者术后症状明显缓解,表现为下腹部疼痛症状的患者术后腹痛症状消失,所有患者术后均未发生并发症,术后随访4~24个月(平均16个月)均未见肿瘤复发且未诉漏尿等常见并发症。结论泌尿系彩超,CTU等影像学检查与膀胱镜相结合是诊断壁间型膀胱平滑肌瘤的主要手段,经尿道肿瘤剜除术、腹腔镜下肿瘤剜除术是治疗壁间型膀胱平滑肌瘤安全有效的手术方式且预后较好。     

Methylmercury-induced IL-6 release requires phospholipase C activities

Previous studies have reported that intrahemispheric connections between area 17 (V1, striate cortex) and other cortical visual areas are not point-to-point, but instead have some degree of convergence and divergence. Many pathological conditions can interfere with the normal development of patterns of cortico-cortical connections, but there is little information regarding whether or not early pathological insults can also induce permanent changes in the convergence and divergence of cortical connections. Obtaining this information is important because loss of precision in neural projections can contribute to functional deficits and behavioral impairment. In the present study we investigated whether retinal input is required for the development of normal values of convergence and divergence in the visual callosal pathway. We found that enucleation performed at birth induced significant increases in convergence and divergence compared to control animals. In contrast, values of convergence and divergence in rats enucleated at postnatal day 7 (P7) were similar to those in controls. Previous studies have shown that retinal input during the first postnatal week is required for the specification of the overall distribution and internal topography of visual callosal pathways. Our present results therefore extend these previous finding by showing that retinal input during the first postnatal week also specifies the precision of cortico-cortical projections. These findings raise the possibility that the precision of neural connections may be reduced in other pathological conditions that affect early development of neural connections.     

眼球摘除患者围手术期负性变化及护理对策

目的:探讨眼球摘除患者围手术期负性自动思维、自我接纳、社会支持的变化及护理对策。方法:将择期进行眼球摘除的80例患者随机分为观察组与对照组,每组各40例。对照组给予常规护理,观察组在常规护理的基础上进行心理干预。在干预的第3、7周分别通过负性自动思维调查问卷(ATQ)、自我接纳调查问卷(SAQ)以及社会支持量表(SSRS)对两组患者进行测评,并对测评结果进行比较分析。结果:干预之前两组患者各项指标比较差异无统计学意义(P>0.05);与干预前比较,对照组ATQ评分在第7周时明显降低(P<0.05),而观察组在第3周时就明显降低(P<0.05);两组患者的SAQ均有不同程度的升高,但观察组的较对照组升高幅度明显,且观察组在第3、7周时均明显优于对照组(P<0.05);对照组SSRS评分无变化(P>0.05),观察组明显升高(P<0.05),高于对照组(P<0.05)。结论:通过实施心理干预可以显著降低眼球摘除患者围手术期负性自动思维水平,有效改善自我接纳情况,提高社会支持的程度,值得临床推广应用。     

Attempted auto-enucleation in two incarcerated young men with psychosis

Auto-enucleation is a sign of untreated psychosis. We describe two patients who presented with attempted auto-enucleation while being incarcerated. This is an observation two-case series of two young men who suffered untreated psychosis while being incarcerated. These young men showed severe self-inflicted ocular trauma during episodes of untreated psychosis. Injuries included orbital bone fracture and dehiscence of the lateral rectus in one patient and severe retinal hemorrhage and partial optic nerve avulsion in the second patient. Auto-enucleation is a severe symptom of untreated psychosis. This urgent finding can occur in a jail setting in which psychiatric care may be minimal.     

Blood flow velocity in monocular retinoblastoma assessed by color doppler

OBJECTIVE:

To analyze the flow of retrobulbar vessels in retinoblastoma by color Doppler imaging.

METHODS:

A prospective study of monocular retinoblastoma treated by enucleation between 2010 and 2014. The examination comprised fundoscopy, magnetic resonance imaging, ultrasonography and color Doppler imaging. The peak blood velocities in the central retinal artery and central retinal vein of tumor-containing eyes (tuCRAv and tuCRVv, respectively) were assessed. The velocities were compared with those for normal eyes (nlCRAv and nlCRVv) and correlated with clinical and pathological findings. Tumor dimensions in the pathological sections were compared with those in magnetic resonance imaging and ultrasonography and were correlated with tuCRAv and tuCRVv. In tumor-containing eyes, the resistivity index in the central retinal artery and the pulse index in the central retinal vein were studied in relation to all variables.

RESULTS:

Eighteen patients were included. Comparisons between tuCRAv and nlCRAv and between tuCRVv and nlCRVv revealed higher velocities in tumor-containing eyes (p<0.001 for both), with a greater effect in the central retinal artery than in the central retinal vein (p=0.024). Magnetic resonance imaging and ultrasonography measurements were as reliable as pathology assessments (p=0.675 and p=0.375, respectively). A positive relationship was found between tuCRAv and the tumor volume (p=0.027). The pulse index in the central retinal vein was lower in male patients (p=0.017) and in eyes with optic nerve invasion (p=0.0088).

CONCLUSIONS:

TuCRAv and tuCRVv are higher in tumor-containing eyes than in normal eyes. Magnetic resonance imaging and ultrasonography measurements are reliable. The tumor volume is correlated with a higher tuCRAv and a reduced pulse in the central retinal vein is correlated with male sex and optic nerve invasion.