简介：精索静脉曲张在临床的实践被认出了为在一个世纪。原来，这些过程为疼痛的管理被利用，但是自从1952，修理主要为男不孕的处理。然而，因为pathophysiology不是清楚的，精索静脉曲张的诊断和治疗是争论的，研究的入口标准在中心之中变化了，并且有很少使随机化的临床的试用。不过，临床医生们继续为精索静脉曲张的修正开发技术，基本科学家在精索静脉曲张的pathophysiology上继续调查，并且从未来的使随机化的试用的新结果数据出现在世界的文学。因此，Andrology的亚洲杂志的这个特殊版本被建议报导许多与精索静脉曲张有关的新信息，作为这个工程的特定的部分，现在的文章作为进化的全面评论和校正过程的精炼被开发。

简介：Esophagealandgastriccancer(GC)arerelatedtoobesityandbariatricsurgery.Riskfactors,suchasgastroesophagealrefluxandHelicobacterpylori,mustbeinvestigatedandtreatedinobesepopulation.Aftersurgery,GCreportsareanecdotalandtreatmentisnotstandardized.ThisreviewaimstodiscussGCrelatedtoobesitybeforeandafterbariatricsurgery.

简介：BackgroundDeepsternawoundinfection(DSWI)aftermediansternotomyforcardiacsurgeryisoneofthemostcomplexandpotentiallylife-threateningcomplications.ItsverydifficulttotreatDSWI,andthereislackofagreementregardingthebesttherapystrategy.Thus,weaimedtosummarizeourexperiencesofsurgicaltreatmentforDSWI,inwhichsatisfactoryclinicalresultswereobtained.MethodsWeretrospectivelyanalyzed17caseswhosufferedfromDSWIaftercardiacsurgeryinourdepartmentfromJanuary2010toJune2015.Therewere8maleand9femalepatientswiththeiraverageageof62.7±9.5years(range42~75years).Allpatientsreceivedreservationofpartofsternumcombinedwithvacuum-assistedsuctiondrainageandbilateralpectoralismajormyocutaneousadvancementflaps.ResultsTheaverageintervalbetweencardiacsurgeryanddiagnosedDSWIwas10.9±6.5days(range5~21days).Timeofvacuum-assistedsuctiondrainagewas11.6±4.8days(range5~15days)andwoundhealingtimewas27.3±7.2days(range23~35days).Allpatientshadanuneventfulpostoperativerecoveryandgoodwoundhealing.Follow-uptimewas33.7±13.3months(range8~74months).Norecurrentinfectionwasobserved.ConclusionsReservationofpartofsternumcombinedwithvacuum-assistedsuctiondrainageandbilateralpectoralismajormyocutaneousadvancementflapsisasimpleandeffectivesurgicalstrategyforthetreatmentofDSWIaftercardiacsurgery.

简介：Objective:Survivalandtreatmentofpatientswithmicroinvasivebreastcancer(MIBC)remaincontroversial.Inthispaper,weevaluatedwhetheradjuvantchemotherapyisnecessaryforpatientswithMIBCtoidentifyriskfactorsinfluencingitsprognosisanddecidetheindicationforadjuvantchemotherapy.Methods:Inthisretrospectivestudy,108patientswithMIBCwererecruitedaccordingtoseventheditionofthestagingmanualoftheAmericanJointCommitteeonCancer(AJCC).Thesubjectsweredividedintochemotherapyandnon-chemotherapygroups.Wecomparedthe5-yeardisease-freesurvival(DFS)andoverallsurvival(OS)ratesbetweengroups.Furthermore,weanalyzedthefactorsrelatedtoprognosisforpatientswithMIBCusingunivariateandmultivariateanalyses.Wealsoevaluatedtheimpactofadjuvantchemotherapyontheprognosticfactorsbysubgroupanalysisaftermedianfollow-uptimeof33months(13-104months).Results:The5-yearDFSandOSratesforthechemotherapygroupwere93.7%and97.5%,whereasthoseforthenonchemotherapygroupwere89.7%and100%.Resultsindicatethat5-yearDFSwassuperior,butOSwasinferior,intheformergroupcomparedwiththelattergroup.However,nostatisticalsignificancewasobservedinthe5-yearDFS(P=0.223)orOS(P=0.530)rateofthetwogroups.Mostrelevantpoor-prognosticfactorswereKi-67overexpressionandnegativehormonalreceptors.Cumulativesurvivalwas98.2%vs.86.5%betweenlowKi-67(≤20%)andhighKi-67(>20%).ThehazardratioofpatientswithhighKi-67was16.585[95%confidenceinterval(CI),1.969-139.724;P=0.010].Meanwhile,ER(-)/PR(-)patientswithMIBChadcumulativesurvivalof79.3%comparedwith97.5%forER(+)orPR(+)patientswithMIBC.ThehazardratioforER(-)/PR(-)patientswithMIBCwas19.149(95%CI,3.702-99.057;P<0.001).SubgroupanalysisshowedthatchemotherapycouldimprovetheoutcomesofER(-)/PR(-)patients(P=0.014),butnotthosewhooverexpressKi-67(P=0.105).Conclusions:PatientswithMIBCwhooverexpressKi-67and

简介：Three-dimensional(3D)printing(3DP)isarapidprototypingtechnologythathasgainedincreasingrecognitioninmanydifferentfields.Inherentaccuracyandlow-costpropertyenableapplicabilityof3DPinmanyareas,suchasmanufacturing,aerospace,medical,andindustrialdesign.Recently,3DPhasgainedconsiderableattentioninthemedicalfield.Theimagedatacanbequicklyturnedintophysicalobjectsbyusing3DPtechnology.Theseobjectsarebeingusedacrossavarietyofsurgicalspecialties.Theshortageofcadaverspecimensisamajorprobleminmedicaleducation.However,thisconcernhasbeensolvedwiththeemergenceof3DPmodel.Custom-madeitemscanbeproducedbyusing3DPtechnology.Thisinnovationallows3DPuseinpreoperativeplanningandsurgicaltraining.Learningisdifficultamongmedicalstudentsbecauseofthecomplexanatomicalstructuresoftheliver.Thus,3Dvisualizationisausefultoolinanatomyteachingandhepaticsurgicaltraining.However,conventionalmodelsdonotcapturehapticqualities.3DPcanproducehighlyaccurateandcomplexphysicalmodels.Manytypesofhumanoranimaldifferentiatedcellscanbeprintedsuccessfullywiththedevelopmentof3Dbio-printingtechnology.Thisprogressrepresentsavaluablebreakthroughthatexhibitsmanypotentialuses,suchasresearchondrugmetabolismorliverdiseasemechanism.Thistechnologycanalsobeusedtosolveshortageoforgansfortransplantinthefuture.

简介：AIMTounderstandtheinfluenceoffrailtyonpostoperativeoutcomesforlaparoscopicandopencolectomy.METHODSDatawereobtainedfromtheNationalSurgicalQualityImprovementProgram(2005-2012)forpatientsundergoingcolonresection[opencolectomy(OC)andlaparoscopiccolectomy(LC)].Patientswereclassifiedasnon-frail(0points),lowfrailty(1point),moderatefrailty(2points),andseverefrailty(≥3)usingtheModifiedFrailtyIndex.30-dmortalityandcomplicationswereusedastheprimaryendpointandanalyzedfortheoverallpopulation.Complicationsweregroupedintomajorandminor.Subsetanalysiswasperformedforpatientsundergoingcolectomy(totalcolectomy,partialcolectomyandsigmoidcolectomy)andseparatelyforpatientsundergoingrectalsurgery(abdominoperinealresection,lowanteriorresection,andproctocolectomy).WeanalyzedthedatausingSASPlatformJMPProversion10.0.0(SASInstituteInc.,Cary,NC,UnitedStates).RESULTSAtotalof94811patientswereidentified;themajorityunderwentOC(58.7%),werewhite(76.9%),andnon-frail(44.8%).Themedianagewas61.3years.Prolongedlengthofstay(LOS)occurredin4.7%,and30-dmortalitywas2.28%.PatientsundergoingOCwereolder(61.89±15.31vs60.55±14.93)andhadahigherASAscore(48.3%ASA3vs57.7%ASA2intheLCgroup)(P<0.0001).Mostpatientswerenon-frail(42.5%OCvs48%LC,P<0.0001).Complications,prolongedLOS,andmortalityweresignificantlymorecommoninpatientsundergoingOC(P<0.0001).OChadahigherriskofdeathandcomplicationscomparedtoLCforallfrailtyscores(non-frail:OR=4.7,andOR=4.67;mildlyfrail:OR=2.51,andOR=2.47;moderatelyfrail:OR=2.94,andOR=2.02,severelyfrail:OR=2.37,andOR=2.34,P<0.05)andanincreaseinabsolutemortalitywithincreasingfrailty(non-frail0.68%OC,mildlyfrail1.39%,moderatelyfrail3.44%,andseverelyfrail5.83%,P<0.0001).CONCLUSIONLCisassociatedwithimprovedoutcomes.Althoughtheoddsofmortalityarehigherin

简介：DearEditor,WereadthearticlebyLeeetal~([1])withgreatinterest.Wewouldliketocongratulatetheauthorsforventuringintothisareathatassesstheconsecutiverecurrencefollowingearlysuccessofintermittentexotropia[X(T)]surgeryandtodeterminetheclinicalfactorsthataffectthesurvival.However,wewouldliketomakethefollowingcomments.Inthepresentstudy,itwasdiscussedaboutthecorrelationofearlypostoperativeovercorrectionwithlong-termoutcomes.ItisknownthatmostauthorswouldagreetoanearlypostoperativeovercorrectioninadultpatientswithX(T),the

简介：AIMTo评估变化在phacoemulsification(PC)和femtosecond激光(FSL)期间帮助了的血压(BP)奔流surgery.METHODSA回顾的图表评论为从2013年7月收到了传统的phacoemulsification外科(PC组)和帮助FSL的奔流外科(FS组)到2014年12月的所有病人被执行。完全，从收到过程的二种类型的133个病人的206只眼睛被包括。耐心的特征(年龄，性，和高血压历史)，外科手术前、手术后的位／秒是收缩的collected.RESULTSThe支持operative，心脏舒张的位／秒(公里Hg)是124.89摥琠?桴?楳楬潣敮瀠畬？

简介：AIMTo用光连贯断层摄影术(10月)并且到在奔流外科以后在糖尿病的眼睛估计斑点的量的变化估计开发的发生或有斑点的浮肿变得更坏(我)在糖尿病的眼睛与或没有先存在ME.METHODSIn这未来的、观察研究，经历了奔流外科的60个糖尿病的病人的92只眼睛在外科前被评估并且1，在用10月有斑点的厚度的外科以后的3mo在九有斑点的子字段与10月被测量定义b另外，开发的发生或我变得更坏在糖尿病的眼睛被分析与或没有先存在，ME.RESULTSThe中央子字段平均数厚度增加了21.0µ；m和25.5µ；在1点的m，3mo后续，分别地(P<；0.01)。内部戒指和外部戒指的平均厚度增加了14.2µ；m和9.5µ；在1mo的m，18.2µ；m和12.9µ；在3mo的m。中央包含我在3mo在12只眼睛发展了，包括4与先存在与先存在看中央包含和8只眼睛非中央包含了我。先存在的糖尿病的有斑点的浮肿(DME)显著地与中央包含被联系我开发(P<；0.001).CONCLUSIONA尽管增加是温和的，统计上重要的增加能在中央子字段以及perifoveal和parafoveal部门被检测。并且有在奔流外科以前的外科手术前的DME的眼睛在为开发中央包含的更高的风险我。

简介：AIM:Tocomparetheclinicaloutcomesofcombined25-gaugeparsplanavitrectomy（PPV）andphacoemulsification/posteriorchamberintraocularlens（PC-IOL）implantationwithvitrectomyalonesurgeryinpatientswithvariousvitreoretinaldiseases.METHODS:Atotalof306eyes（145withPPValoneand161withphaco-vitrectomy）wereenrolledinthisretrospectiveanalysis.Thesurgicalapproachwas25-gaugePPVcombinedwithphacoemulsificationandPC-IOLimplantationatthesametimeineyesinphaco-vitrectomygroupandonlyPPVineyesinvitrectomyalonesurgerygroup.Themainoutcomemeasureswerepostoperativeclinicaloutcomesincludedanteriorchamberinflammation,changesinintraocularpressure（IOP）andbestcorrectedvisualacuity（BCVA）.RESULTS:Themostcommonpostoperativecomplicationwasanteriorchamberreactionwhichhashigherincidenceinphaco-vitrectomygroup（P<0.001）.Themeanpostoperative1stdayIOPofvitrectomyalonegroupwassignificantlylowerthanthatofphaco-vitrectomygroup（16.3±5.8mmHgvs17.8±8.1mmHg,respectively,P=0.02）.Hypotony(IOP（8mmHg）wasnotdifferentbetweengroupsinthepostoperative1stday（P>0.05）.Themeanpreoperativevisualacuitywasnotdifferentbetweengroups（1.6±0.9logMARvs1.8±0.9logMAR,respectively,P>0.05）.However,themeanvisualacuitywasdecreasedinvitrectomyalonegroupatthefinalvisitcomparedtophaco-vitrectomygroup（1.2±0.8logMAR,0.9±0.7logMAR,respectivelyP<0.05）.CONCLUSION:Twenty-fivegaugePPVcombinedwithphacoemulsificationsurgeryisasafeandefficientprocedure,whichcanbepreferredinphacicpatientswithavarietyofvitreoretinaldiseasescomparedtovitrectomyalone.Despiteimprovedoutcomes,thisapproachisnotfreeoflimitationsasanteriorchambercomplicationsespeciallywithcombinedsurgery.

简介：AIMTo比较fluorometholone的联合0.1%并且0.5%在控制发炎并且与intraocular透镜implantation.METHODSSixty在phacoemulsification以后阻止感染掉到tobramycin/dexamethasone眼睛的levofloxacin从60看经历奔流phacoemulsification的病人被使随机化进二个组；病人的一半与与levofloxacin(4times/d)相结合的fluorometholone(6times/d)被对待，当另外的一半与眼睛掉一个星期的tobramycin/dexamethasone(4times/d)被对待时。在操作和1wk追随者treatments.RESULTSThere不是在角膜的厚度(P0.629)的二个组之间的统计上重要的差别以前，外科手术前、手术后的intraocular压力，水的闪光，角膜的厚度，和症状被记录，水的闪光(P0.398)，并且症状分数(P0.350)在每次指。眼睛的高血压仅仅在与levofloxacin治疗表演相结合的tobramycin/dexamethasonegroup.CONCLUSIONFluorometholone在二只眼睛被观察可比较的功效但是没有增加intraocular压力的趋势；因此，它可能是为手术后的使用的更好的政体。