简介：OneofthemostcommoncausesofvertigoisBenignParoxysmalPositionalVertigo(BPPV),asensationofspinningthatiscausedbyasuddenchangeinheadposition.ThistypeofvertigowasfirstdescribedbyRobertBaranyintheearly1920s[1].HesuggestedthatBPPVwascausedbyabnormalotoliths,alsocalledstatoconiumorotoconius,astructureinthesacculeorutriclein

简介：AbstractBackground:Thermal ablation of thyroid nodules is new modality for the management of the benign and malign lesions. This minimally invasive treatment is performed as an outpatient, local anesthetic, single professional procedure that can treat neoplastic lesions without removing normal thyroid tissue and thus avoiding hypothyroidism.Method:A comprehensive review of the most relevant literature regarding the thermal ablation of benign and malign nodules was performed in order to currently define its role on the management of the nodular thyroid disease. The data was divided into benign and malign literature.Results:The benign nodules can be effectively treated by radiofrequency ablation (RFA) but some limitation exists regarding the nodule’s size but not nodules characteristics. The RFA of primary malign tumors of the thyroid recently demonstrated positive and safe long-term follow-up and encouraged additional investigation and possibly a definitive role in the management of these low risk nodules.Conclusion:RFA is a safe, cost-effective minimally invasive procedure that avoids thyroid tissue removal while destroying neoplastic one thus, preventing hypothyroidism.

简介：Benignparoxysmalpositionalvertigo(BPPV)isprobablythemostcommondiagnosisatvertigoclinics.Seasonalcyclesofseveralhumanillnessescouldbeattributedvariouslytochangesinatmosphericorweatherconditions.Inthisretrospectivestudy,patientswithBPPVfromJanuary2010toDecember2012werestudied,andtheirchartswerereviewed.Statisticalanalysisrevealedastatisticallysignificantdifferenceinpatients’numbersamongdifferentmonthsoftheyear.Alsothereisasignificantstatisticalcorrelationbetweenthenumbersofpatientswithclimaticvariationsespeciallythetemperature.ThepresentpaperdiscussesthepossibleexplanationsfortheseresultswhichconfirmstheseasonalvariationsinBPPV,togetherwithareviewofliteraturetoviewthepossibleassociationswithotherdisordersthatcausessuchseasonality.

简介：AbstractBenign paroxysmal positional vertigo (BPPV) is the most common vestibular peripheral disease, and has increasingly become the focus of research on vertigo diseases in recent years. In particular, otolaryngology and neurology societies worldwide have placed a greater focus on the study of BPPV. This article reviews the current diagnosis and treatment status and research progress of benign paroxysmal positional vertigo in China from the aspects of disease etiology, pathology, and pathophysiology. We will also consider potential future research in this field.

简介：Livermetastasessynchronouslyormetachronouslyoccurinapproximately50%ofcolorectalcancerpatients.Multimodalitycomprehensivetreatmentisthebesttherapeuticstrategyforthesepatients.However,theoptimalpatternofmultimodalitytherapyisstillcontroversial,anditraisesseveralsignificantconcerns.Liverresectionisthemostimportanttreatmentforcolorectallivermetastases.ThedefinitionofresectabilityhasshiftedtofocusonthecompletionofR0resectionandnormalliverfunctionmaintenance.Theroleofneoadjuvantandadjuvantchemotherapystillneedstobeclarified.Themanagementofeitherprogressionorcompleteremissionduringneoadjuvantchemotherapyischallenging.Theoptimalsequencingofsurgeryandchemotherapyinsynchronouscolorectallivermetastasespatientsisstillunclear.Conversionalchemotherapy,portalveinembolization,two-stageresection,andtumorablationareeffectiveapproachestoimproveresectabilityforinitiallyunresectablepatients.Severaltechnicalissuesandconcernsrelatedtothesemethodsneedtobefurtherexplored.Forpatientswithdefinitelyunresectableliverdisease,thenecessityofresectingtheprimarytumorisstilldebatable,andevaluatingandpredictingtheefficacyoftargetedtherapydeservefurtherinvestigation.Thisreviewdiscussesdifferentpatternsandimportantconcernsofmultidisciplinarytreatmentofcolorectallivermetastases.

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简介：Objective:Tostudythetechniquesofplacementofmemoryalloyplatinggoldbiliarystentandplasticstentforpalliationofmalignantandbenignbiliaryobstruction,andtoassessitsclinicaleffectiveness.Methods:Thepatientsinplasticstentgroupincludedpaplillaofduodenuminflamationalstrictures(n=24),commonbileductinflammationalinferiorsegmentstrictures(n=4),choledocholithiasis(n=5),bileleak(n=11),bileductsurgeryinjurey(n=7)andpancreaticcarcinoma(n=1).Thepatientsinplatinggoldstentgroupincludedcommonbileductcarcinoma(n=5)andpancreaticcarcinoma(n=6).Underfluoroscopicguidancethestentwasinsertedintobiliaryobstructionsitesfromoralcavityinallcases.Complications,liverfunctionandbloodserumamylasewereinvestigatedduringthestudyperiod.Results:Successfulstentplacementwasachievedinallcases.Afteroperationof7days,ingoldbiliarystentgroups,theratesofdecreaseofbloodserumtotalbilirubin,glutamic-pyruvictransaminase,r-glutamyltranspeptidaseandalkalinephosphatasewere67.16%,58.37%,40.63%and41.54%respectively.Inplasticstentgroup,theratesofdecreaseofSTB,ALT,r-GTandAKPwere53.24%,55.03%,37.15%,34.12%respectively.Earlycomplicationincludedpost-ERCPpancreatitisandcholangititis.Occlusionofstentwasthemajorlatecomplication.Conclusion:Memoryalloyplatinggoldbiliarystentandplasticstentweresafeandefficaciousmethodsformalignantandbenignbiliaryobstruction,andcouldimprovepatient'slivingquality.Plasticstentwasanefficientcomplementfortherapyofbileleakandbileductinjury.

简介：Earlyrepolarizationisawell-described,commonelectrocardiographicvariant.Itwasinitiallyfelttobebenign,butinthelasttwentyyearsasuggestedalinkbetweenspecifictypesofearlyrepolarizationandsuddencardiacdeathhasemerged.ThisassociationwashasbeentermedtheJwavesyndromeandincludesboththehighriskearlyrepolarizationandBrugadaECGpatterns.Theoddsofearlyrepolarizationchangebeingassociatedwithpooroutcomesarestillexceedinglysmall.Nevertheless,theassociationofafairlyubiquitousECGfindingwithfatalornearfatalclinicaloutcomeshasraisedconcern.Howcanweidentifythetrulyhigh-riskpatients?IfapatienthasasignificantclinicaleventwithaconcerningECGrepolarizationpattern,whatshouldbedonenext?TheauthorsofthisreviewpresentcurrentinformationregardingtheEarlyRepolarizationandBrugadaSyndromesandhowtoproceedwithdiagnosis,management,andriskstratificationwhenearlyrepolarizationchangeisobservedonECG.

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简介：Ithaslongbeenappreciatedthatahealthylifestyleplaysacriticalroleincardiovascularhealth.Itisnowapparentthatthesameistrueinthedevelopmentofbenignprostatichyperplasia(BPH).ProspectivecohortdataoriginatingfromrecentlypublishedrandomizedtrialsonthemedicaltreatmentofBPHandpreventionofprostatecancerhavebeeninvaluable.Agrowingbodyofevidencesuggeststhatexerciseandtheintakeofspecificmacronutrientsandmicronutrientsthroughregulardietplayabeneficialrole.Moststrikingly,themagnitudeoftheseeffectsissimilartomedicaltherapiesusingalpha-blockersand5-alpha-reductaseinhibitors.Theuseof

简介：Benignparoxysmalpositionalvertigo(BPPV)isthemostfrequentepisodicvestibulardisorder.Itisduetootolithreststhatarefreeintothecanalsorattachedtothecupulas.Wellover90%ofpatientscanbesuccessfullytreatedwithmanoeuvresthatmovetheparticlesbacktotheutriculus.Amongthegreatvarietyofproceduresthathavebeendescribed,themanoeuvresthataresupportedbyevidenced-basedstudiesorextensiveseriesarecommentedinthisreview.SometopicsregardingBPPVtreatment,suchascontrollingtheaccuracyoftheproceduresortheutilityofpost-manoeuvrerestrictionsarealsodiscussed.

简介：Neuroendocrinetumors(NET)areaheterogeneousgroupofcancers,withindolentbehavior.Themostcommonprimaryoriginisthegastro-intestinaltractbutcanalsoappearinthelungs,kidneys,adrenals,ovariesandotherorgans.Ingeneral,NETisusuallydiscoveredinthemetastaticphase(40%-80%).Theliveristhemostcommonorganinvolvedwhenmetastasesoccur(40%-93%),followedbybone(12%-20%)andlung(8%-10%).Anumberofdifferenttherapeuticoptionsareavailableforthetreatmentofhepaticmetastasesincludingsurgicalresection,transplantation,ablation,trans-arterialchemoembolization,chemotherapyandsomatostatinanalogues.Recently,moleculartargetedtherapieshavebeenused,usuallyincombinationwithothertreatmentoptions,toimproveoutcomesinpatientswithmetastases.ThisarticleemphasizesontheroleofsurgeryinthetreatmentoflivermetastasesfromNET.

简介：Splenicmetastasisisgenerallynotacommonclinicalevent.However,metastasistothespleenfromadrenalpheochromocytomaisextremelyrareandhasnotbeenreportedinliterature.Thisreportpresentsacaseofa58year-oldmalepatientwhodevelopedspleen-onlymetastasesinJuly2007.ThepatienthadaprevioushistoryofleftepinephroectomyforadrenalpheochromocytomainJanuary2003.Abdominalcomputedtomographydemonstratedmultipleenhancinglesionssuggestiveofmetastases;thussplenectomywasperformed.Pathologicalexaminationsconfirmedthediagnosisofsplenicmetastasesfrompheochromocytoma.Thepatientwasalivewithoutrecurrence48monthsaftersplenectomy.Thisstudyisthefirstreportonsplenicmetastasisfrompreviousadrenalpheochromocytoma,andlong-termsurvivalwasachievedbysplenectomy.Ahistoryofmalignancyindicatesahighindexofsuspicionforsplenicmetastasis,andlong-termsurvivalcanbeachievedbysplenectomyforspleen-onlymetastasis.

简介：A64-year-oldmanwasadmittedtotheSunYat-SenUniversityCancerCenterwithchiefcomplaintsofrecurrentabdominalpainanddiarrheaforabout3yearsandwithahistoryofsurgicalrepairforintestinalperforationowingtostressulcer.Positronemissiontomography(PET)/computedtomography(CT)demonstratedaprimarytumoronthepancreatictailwithmultifocallivermetastases.Pathologicalandimmunohistochemistrystainingrevealedthelesiontobeapancreaticneuroendocrinetumor(pNET).AccordingtothelatestWorldHealthOrganization(WHO,2013)classification,thetumorwasclassifiedasstageIVfunctionalG1pNET.Afterreferraltothemultidisciplinarytreatmentboard(MDT),thepatientwasstartedonperiodicdoseofomeprazole,somatostatinanaloguesandInterferonα(IFNα)andhadscanningfollow-ups.Basedupontheimagingresults,CT-guidedradioactiveiodine-125(125I)seedsimplantationtherapy,radiofrequencyablationtherapy(RFA)ormicrowaveablationtechniquewerechosenforthetreatmentoftheprimarytumor.Transarterialchemoembolization(TACE),RFAandmicrowaveablationtechniquesweredecideduponforlivermetastases.Thepatientshowedbeneficialresponsetothetreatmentwithclinicallymanageablelow-gradesideeffectsandattainedpartialremission(RECISTcriteria)withagoodqualityoflife.

简介：瞄准：与良性的职业人员静电干扰增生(BPH)在病人为职业人员静电干扰发炎程度和感染调查风险因素以便更高效地管理职业人员静电干扰发炎。方法：有在四川大学的韦斯特中国医院里经历在2005年9月和2005年12月之间的TURP的BPH的六十个病人被学习。前列腺液体(PF)为能分泌的IgA(SIgA)的测量被收集并且补充3(C3)。前列腺织物为由即时PCR的严峻的细菌的16SrDNA是镇定的，检验在织物的SIgA并且检验发炎。为职业人员静电干扰发炎或感染的可能的临床、有免疫力的风险因素被使用逻辑回归方法分析。结果：在尿分析法，职业人员静电干扰感染和在PF的C3的高集中的反常的白血房间计数是为职业人员静电干扰发炎程度的风险因素(P=0.025，0.034和0.035，分别地并且机会比率[或]=18.269，8.284和1.508，分别地)。为职业人员静电干扰感染的风险因素在PF包括C3集中和SIgA的集中(P=0.003和0.013，分别地并且OR=1.645并且0.993，分别地)。结论：现在的学习建议那职业人员静电干扰发炎与泌尿道感染，职业人员静电干扰感染和激活的补充被联系，那职业人员静电干扰感染与BPH在病人的前列腺与激活的补充并且在调整粘膜免疫下面被联系。单个有免疫力的规定应该与BPH在职业人员静电干扰发炎的治疗和病人的感染被考虑，这也被建议。

简介：Advancedgastriccancer(GC)hasbeenrecognizedaslethaldiseasewhenperitonealmetastases(PM)occurred.ThereisnostandardtreatmentforadvancedGCwithPM.Until1980s,thetherapeuticarenaforthesepatientshadremainedstagnant,withnotherapeuticapproachhavingshownasurvivalgaininGCwithPM.However,cytoreductivesurgery(CRS)withperitonectomyproceduresandintraperitonealchemotherapy(IPC)promisingnewcombinedtherapeuticapproachtoachievediseasecontrolforGCwithPM.TherecentpublicationschangedtheGCwithPMtreatmentlandscapebyprovidinganevidencethatCRSandIPCledtoprolongationinoverallsurvival(OS).ThisreviewwillprovideanoverviewoftheevolvingroleofCRSandIPCinthemanagementofadvancedGCwithPMinthecurrentera.

简介：AbstractPancreatic ductal adenocarcinoma (PDAC) represents one of the most aggressive malignancies, and the majority of patients with PDAC present with metastatic disease, mainly in the liver, at the time of diagnosis. Surgical resection is the only treatment that can offer prolonged survival and possible cure. However, the indications for surgery for patients with PDAC metastases remain extremely limited to highly selected patients with localized disease, and metastatic disease is generally regarded as a contraindication to surgery. Recently, however, the advent of more effective chemotherapy has changed the treatment strategy for metastatic PDAC. In fact, cases in which resection of synchronous or metachronous PDAC liver metastases lead to prolonged survival in highly selected patients have been reported. In this review, we provide current data regarding survival outcomes after surgery, and discuss the role of surgical resection and selection criteria for patients with PDAC liver metastases in the modern era.

简介：ＩＭＭＵＮＯＣＹＴＯＣＨＥＭＩＣＡＬＣＨＡＲＡＣＴＥＲＩＺＡＴＩＯＮＯＦＣＤ４４ＭＯＬＥＣＵＬＥＳＥＸＰＲＥＳＳＥＤＩＮＨＵＭＡＮＢＲＡＩＮＭＥＴＡＳＴＡＳＥＳＬｉＨｏｎｇ李宏；ＬｉｕＪｉａ刘佳；ＭａｒｔｉｎＨｏｆｍａｎｎ；Ｍａｒｉａｅ－Ｆｒａｎｃｅ...