Table of Content

20 June 2012, Volume 12 Issue 03

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Experimental research of liver regeneration degree and liver regeneration index after partial hepatectomy in two liver regeneration’s models .

2012, 12(03):  168-170. 

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【Abstract】　Objective To investigate change of liver regeneration degree(LRD) and liver regeneration index(LRI) after partial hepatectomy in two different rats’liver regeneration models. Methods SD rats were randomized into 2 groups : ①liver regeneration models’group mediated by Hepatic cells proliferation (PH) ②liver regeneration models’group mediated by oval cells proliferation (2AAF/PH); LRD and LRI were calculated in the time points of 4、8、12、16、20days after liver resection. Results. PH group and 2AAF/PH group, LRD and LRI of POD(post operation day)4 increased significantly , and reached the peak on POD12 and the weight of residual liver was more than two-thirds of the total amount of regeneration. On POD20 residual liver almost reach the original liver heavy .And on POD4、8、12, LRD of PH group are higher than 2AAF/PH group ( P < 0.05). But on POD16, LRD of 2AAF/PH group are higher than PH group ( P < 0.05). On POD4、8, LRI of PH group are higher than 2AAF/PH group ( P < 0.05) and no statistical difference on POD12、16、20（P＞0.05）. Conclusions To evaluate change of liver regeneration quality, LRD and LRI are intuitive and precise index. But LRD is more accuracy than LRI in reflecting the liver regeneration regular.

Subserosal treatment of cystic artery for laparoscopic cholecystectomy

2012, 12(03):  171-172. 

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Objective To evalue the subserosal treatment of cystic artery for laparoscopic cholecystectomy in clinical application. Methods From January 2008 to October 2011,in 169 cases of LC, subserosal treatment of cystic artery branch which come into gallbladder wall was carried out after dissection of cystic duct and anterograde dissociation adjoin to the gallbladder wall. Treatment of the cystic artery included coagulation hook in 113 cases, ultrasonic Scalpel in 39 cases, Ligasure in 8 cases, titanium clip in 5 case and clip with Hem-O-Lok in 4 cases in which the cystic artery lined with the cystic duct was clipped together with the lined cystic duct. Results The procedure was completed in 169 of the cases under laparoscope. 8 cases underwent laparoscopic common bile duct exploration, T tube drainage of common bile duct at the same time. The operation time of the cases ranged from 25 to 205 min( mean, 43 min). The blood loss ranged from 5 to 250 mL ( mean, 10 mL ). It showed the cystic artery in the Calot`s tiangle that were originated from the right hepatic artery in 65cases and other artery in 104 cases that were treated with its branches, not search its source. Postoperative hospital stay was ranged from 1 to 12 days( m ean, 4.3 days ), 169 cases were followed up for 2 to 18 months ( mean, 8 months ). No abdominal hemorrhage or biliary injury occurred in all patients. Conclusions Subserosal treatment of cystic artery for laparoscopic cholecystectomy is more consistent with the concept of security and minimal invasion,and we recommend it as a promising technique for the operation.

Spontaneous rupture of gastroduodenal artery aneurysm：report of a case

2012, 12(03):  184-185. 

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Objective Gastroduodenal artery (GDA) aneurysm is a rare entity, We report a case of Spontaneous rupture of GDA aneurysm. Methods By abdomen CTA (Computer Tomography Angiography by Phillips Brilliance iCT) and exploratory laparotomy. Results we make a definite diagnosis. An exploratory laparotomy revealed hemoperitoneum, contain over 2500ml of blood and clot. After blood and clot was removed, revealing ruptured gastroduodenal artery aneurysm with active hemorrhage. The opening was isolated and closed. Conclusion Spontaneous rupture of GDA aneurysm has extremely high mortality,once diagnosed it should be treated immediately and effectively, the surgical treatment has satisfactory result of hemostasis,and remove blood and clot that’s helpful for patient’s postoperative recovery.

Response and prognosis of TAC neoadjuvant chemotherapy in patients with triple negative breast cancer

2012, 12(03):  187-189. 

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Objective To study the curative effect of neoadjuvant chemotherapy of TAC in the treatment of triple-negative breast cancer. Methods To accept 4～6 cycles TAC neoadjuvant chemotherapy of 63 cases of TNBC were retrospectively study. Analysis the near-term and long-term curative effects. Results Of the 63 patients,the overal response rate(RR) was 96.83%, including complete response(CR) was 57.14%（36/63)，partial response(PR) was 39.68%(25/63）；the major complications included neutropenia（57.14%）,nertropenia associated fever（39.68%）,nausea and vomiting（52.38%）,diarrhea（22.22%）,oral mucositis （20.63%）,malaise and weakness（15.87%）.Postoperative death was 7 cases，There were 8 cases of local recurrence and 21 cases of remote metastasis. The overall 3-year survival rate was 88.89%. Conclusion TAC neoadjuvant chemotherapy could improve the curative effect of TNBC with better quality of life and promoted 3-year survival rate.

Implant double tissue expanders superposingly in mastoid region for total ear reconstruction.

2012, 12(03):  196-198. 

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Objective To present our clinical experience in using two tissue expanders implanted superposingly in the mastoid region and Medpor ear framework for congenital microtia reconstruction. Methods During the period from Jan 2008 to Dec 2011, 27 patients were treated by total ear reconstruction. In the first surgical stage, a 50 mL and 80 mL (or 100 mL) of kidney-shaped tissue expanders were implanted subcutaneously in mastoid region and then overlaid the big expander on the small one. After the first surgery stage they were inflated with normal saline alternately for 3 to 6 months until the tissue expander was removed in the second surgical stage. After that the anterior and posterior wall of the Medpor ear framework was directly covered by expanded skin flap. A drainage tube was introduced into the space between the expanded skin flap and the ear framework to maintain a healthy contact between them and the contour of the reconstructed auricle. Results The postoperative follow-up time ranged from 4 to 50 months. 27 patients acquired symmetrical, subtle contour, prominent reconstructed auricles. The new reconstructed ear had a good contour and nearly normal skin. The postauricular sulcus was stable and the expanded skin flap looked well without necrosis. The Medpor ear framework was exposed in 2 patients (7.4%) because of wound dehiscence and he healed uneventfully after a further repair surgery. Conclusion For this operation, overlying implantation of double tissue expanders solved the problem of insufficient amount of the skin flap, avoided postauriclar skin grafting and application of the temporoparietal fascia and postauriclar fascia, simplified the surgical procedure and shortened the operation time significantly. The subunit of some reconstructed ear was unclear, but this method gets reliable and satisfactory results.

The Serum Neuron-Specific Enolase As a Tumor Marker In Lung Cancer Patients

2012, 12(03):  199-201. 

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Objective Our research investigate the usefulness of the serum neuron-specific enolase (NSE）as a tumor marker in lung cancer patients. Methods 510 lung cancer patients were involved the study. The serum NSE levels were measured using the Electrochemiluminescence immunoassay. The serum NSE levels and the positive ratio between different groups were analyzed using One-way analysis of variance (ANOVA) test and the Chi-square test, respectively. Results In the 510 lung cancer patients, there were 150 patients with serum NSE positive. According to the histological type of lung cancer, the positive rate was 80.0%（24/30）in the small cell carcinomas (SCLC) and 26.27%（126/462） in the non-small cell carcinomas (NSCLC). The mean levels of NSE in SCLC and NSCLC patients were 45.50±19.61 ng/mL and 13.99±0.52 ng/mL, respectively. The serum levels of NSE in the SCLC patients were significantly higher (P<0.01) than those NSCLC patients. Conclusions The serum NSE level was useful as a tumor marker for Chinese SCLC patients.

Closed Reduction and Internal Fxation Treatment for Completely Displaced and Rotated Fractures of the Lateral Condyle of the Humerus in Children

2012, 12(03):  204-206. 

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Abstract: Objective: To determine the usefulness of closed reduction and internal ?xation（CRIF）as the initial treatment for completely displaced and rotated fractures of the lateral condyle of the humerus in children. Methods: We prospectively studied 51 completely displaced and rotated lateral condylar fractures of the humerus in children (JAKOB Stage 3, 40 boys and 11 girls) that were treated by three different surgeons from 2007 to 2011. In 51 fractures, we initially attempted CRIF. We assessed the preoperative degree of displacement and postoperative radiographic quality of CRIF. Clinical results were graded using the criteria suggested by Hardacre et al. Results: Three fractures were treated with ORIF initially because of lack of experience with it. Closed reduction to within 2 mm failed in eleven fractures, so ORIF was then performed. 37 of 51 (72.5%) completely displaced and rotated fractures were reduced within 2 mm of residual displacement using the CRIF. There were no signi?cant complications such as limited range of motion, pain, osteonecrosis of the trochlea or capitellum, nonunion, malunion, or early physeal arrest. Conclusion: CRIF is an effective treatment for completely displaced and rotated lateral condyle fractures of the humerus in children.

Analysis of therapeutic effects of locking plate for the treatment of fracture of distal radius of 42 cases

2012, 12(03):  209-210. 

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Objective: To evaluate the early clinical effects of locking plate in treating fracture of distal radius(AO-C) Methods: From August 2008 to 2011 April, 42 pantients with fracture of distal radius(AO-C) were treated with locking plate . Fucktions of wrist joint were observed according to Denist standard. Result: All patients were followed up from to 8 months with an average of 7.3 months. According to Denist standard , 16 cases obtained excellent result, 17 good, 4 fair. CONCLUSION: Locking plate can obtained early satisfactory clinical effect in treating fracture of distal radius(A0-C) in pain ,range of wrist

The effect of Locking compression plate for internal fixation in geriatric femoral intertrochanteric fracture

2012, 12(03):  211-213. 

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[Abstract] Objective To investigate the therapeutic effect of proximal femoral locking compression plate (LCP) on treating senile osteoporotic intertrochanteric fractures. Patients and methods thirty-one patients with senile osteoporotic intertrochanteric fractures were treated by proximal femoral locking compression plate fixation, including 12 males and 19 females, mean age 74.3 (range 65-85) years. Bone healing, functional restoration of the limbs and complications were observed and evaluated. Results twenty-eight patients were followed, with a mean follow-up period of 13.5 months, ranges from 9 to 21 months. All got bone union. No complications such as non-union, loosening or coxa vara were found. Conclusions proximal femoral locking compression plate is a reliable choice for senile osteoporotic intertrochanteric fracture treatment with favorable results. [Key words] Femoral intertrochanteric fracture; Locking compression plate; osteoporosis

Advances in imaging technology for Assessment of liver functional reserve

2012, 12(03):  220-222. 

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Quantitative assessment of liver functional reserve on segmental and sub-segmental levels is a major concern for liver surgeons nowadays. Compared with other relevant methods, imaging techniques are much more superior, which have the features of non-invasive and simple operation. Recent research has shown that by the reason of its high spatial resolution, dynamic hepatobiliary-specific contrast-enhanced magnetic resonance imaging (DHCE-MRI) has wider clinical future applications in quantitative assessment of liver functional reserve on segmental and sub-segmental levels.

Micro channel endoscopic operation for the treatment of upper ureteral complicated calculi

2012, 12(03):  228-230. 

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[Abstract] Objective To explore the choice of different micro channel endoscopic operation mode for the treatment of upper ureteral complicated calculi characteristics and clinical therapeutic effect. Methods Retrospective analysis method, to our hospital urology patients as the research object, to accept the retrograde ureteroscopy ( URL ), minimally invasive percutaneous nephrolithotomy ( MPCNL ) and retroperitoneal laparoscopic ureterolithotomy ( RLU ) patients, observation and tracking, through its clinical effects, recovery to compare3 methods of treatment for stone clearance rate, success rate and complications. Results in the 101 patients,21 cases of URL patients,1 successful operation in 12 cases,2cases of patients undergo ureteroscopic intubation, unable to reach the position of stones, after January the stone-free rate was 85%, the complication rate was 9%; MPCNL in treatment of 60 patients with all1 successful operation, the stone-free rate was 100%, treatment of 20 cases without complications; RLU,1operation success rate of 100% stones in a single take as much as, without complication. Postoperative follow-up in 75 cases, follow-up time of 1to 2 years, no recurrence. Conclusion the 3minimally invasive operation manner and effect are exact and positive. But each has advantages and disadvantages, should according to the clinical needs and the actual situation of the hospital treatment options.