Table of Content

20 August 2013, Volume 13 Issue 04

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论文

Discussion of clinical dose of dexmedetomidine for inhibiting reaction of awake fiberoptic bronchoscopic  intubation

Miao Liping, Zhang Rong, Zeng Jingxian, Xia Shuxuan, Chen Liang

2013, 13(04):  273-277.  DOI: 10.3969/j.issn.1009-976X.2013.04.002

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【Abstract】 Objective To investigate the effective dose of dexmedetomidine at which awake fiberoptic bronchoscopic intubation was tolerable in 50% of patients (ED50). Methods Twenty patients with difficult airways,.ASA physical grading Ⅰor Ⅱ,.aged 38-65 years,.body weight 45-70 kg, undergoing elective surgery under general anaethesia were enrolled in this study..After intravenous administration of dexmedetomidine over 10 minutes, the local mucous anesthesia of tongue-root, throat and supraglottic region was performed with 1% dicaine by laryngeal spray,.and the intratracheal topical anesthesia was performed with 2 ml of 2% lidocaine through thyrocricocentesis..Median effective dose (ED50) was determined by modified Dixon's up-and-down sequential experiment. The ratio of two successive dose of dexmedetomidine was 1.2..The ED50 and 95% confidence interval.(CI).of dexmedetomidine were calculated by the modified Dixon's up-and-down method and the ED50 and 95% CI were analyzed using the probit test in a logistic regression model..Results ED50 of dexmedetomidine for awake fiberoptic  bronchoscopic intubation obtained by modified Dixon's up-and-down method was 0.74 μg/kg (95%CI 0.68-0.82 μg/kg). Conclusion Intravenous administration of dexmedetomidine 0.74 μg/kg over 10 min in conjunction with local anesthesia would provide good intubating condition for awake fiberoptic bronchoscopic intubation in 50% of patients,and there are no intubation responses.

A comparative analysis on the direct sign of breast malignant tumor in ultrasonic and mammography

He Hongyan, Chen Jianyu, Huang Wubin

2013, 13(04):  277-281.  DOI: 10.3969/j.issn.1009-976X.2013.04.003

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【Abstract】〓Objective〓To explore the accuracy and the rate of visualization of the direct sign and the clinical value of ultrasonography (US) only,.mammography (MG) only and combination of them in diagnosis of breast malignant tumor. Methods A total of 564 cases with breast malignant tumor diagnosed by operation and pathology was performed both MG and US. The clinical data were analyzed retrospectively according to the tumor's characters of medical imaging such as tumor location, shape, size, border, density, internal or rear echo and blood supply. The multi-comparisons were performed on diagnostic accuracy among MG only,.US only and combination of both. Results There were 564 cases breast malignant tumors including 439 cases invasive ductal carcinomas. The correct diagnosis by MG was 422 cases and by UG was 432 cases and by combination of them was 490 cases of all patients. The correct diagnosis by MG was 341 cases and by US were 356 cases and by combination of them was 398 cases of 439 cases invasive ductal carcinomas patients. Conclusion The diagnostic accuracy of the combination of US and MG is higher than of only MG or only US of invasive ductal carcinomas,.but no difference between of only US and of only MG..The diagnostic accuracy of US only is higher than of MG only of tumors in dense breast,.but on the contrary of tumors in fat breast.

Guiding value of early lactate clearance for the treatment of fluid resuscitation in patients with sepsis in emergency department

Jiang Jun, Fu Yue, Xie Chunming. et. al.

2013, 13(04):  282-284.  DOI: 10.3969/j.issn.1009-976X.2013.04.004

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【Abstract】 Objective To explore the correlation between early lactate clearance and prognosis in patients with severe sepsis or septic shock, and evaluate the directive value of early lactate clearance for fluid resuscitation. Methods The clinical data of patients with severe sepsis or septic shock in emergency department from July 2009 to July 2012 were analyzed retrospectively..Sixty-eight patients were divided into survival group and non-survival group according to prognosis,.or low lactate clearance group and high lactate clearance group according to the level of lactate clearance after 6 hours..The mortality,.the level of baseline lactate and early lactate clearance were compared respectively. Results There was no statistical difference between the two groups in age,sex and the baseline of lactate (P>0.05). The early lactate clearance in survival group was significantly higher than that in non-survival group (31.04±12.65 vs 14.58±9.11,.P<0.01)..The mortality in high lactate clearance group was significantly lower than that in low lactate group(18.92% vs 61.29%,P<0.01). Conclusion Early lactate clearance is a good prognostic factor of severe sepsis and septic shock, and may serve as a guiding goal for early fluid resuscitation.

Endoscope-assisted excision of second branchial cleft cysts via retroauricular approach

Chen Liqiang, Liang Faya, Cai Qian, Han Ping, Wang Xiaolin, Huang Xiaoming

2013, 13(04):  285-288.  DOI: 10.3969/j.issn.1009-976X.2013.04.005

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【Abstract】 Objective To investigate the surgical method of endoscopic-assisted excision of second branchial cleftcysts via retroauricular approach and evaluate its feasibility effectiveness and safety. Methods From November 2008 to February 2011, six patients with second branchial cleft cysts accepted endoscope-assisted excision via retroauricular hairline approach. Results All operations were successfully performed using the endoscope-assisted approach in retroauricular region. There were no conversions of the vianeck approach operations and no postoperative complications were found such as wound infection, bleeding,hematoma and mecrosis of skinflap, injury of great auricular nerve or facial nerve. Average follow-up period was 36 months.(range from:.22-51 months). No tumor recurrence..was found A good cosmetic results were got in all csses after operation. Conclusion Endoscope-assisted excision of second branchial cleft cysts via retroauricular hairline approach possesses feasibility,safety,effectiveness,adequate exposure of operative feild and a good cosmetic results. So it would be considered as a new surgical method for this disease.

Comparative study on two anastomotic methods in 112 cases with cardiac carcinoma

Huang Guanqun, Zhou Rujian, Li Weipeng, Luo Jie, Jian Zhixiang

2013, 13(04):  289-291.  DOI: 10.3969/j.issn.1009-976X.2013.04.006

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【Abstract】 Objective To investigate the difference between the manual oval anastomotic method and manual traditional anastomotic method in cardia cancer surgery. Methods A retrospective data were analyzed in 112 cases with cardiac carcinoma, who underwent of radical operation for cardiac carcinoma using both of anastomosis method from September 2009 to September 2012. Results Among 112 cases, anastomotic leakage of esophageal anastomosis occurred in four cases, of which three in traditional anastomosis group of patients, one in oval anastomosis group (P<0.05). Stricture of esophageal anastomosis occurred in five cases, of which four in traditional anastomosis group and one in oval anastomosis group (P<0.05). Moreover, esophageal reflux occurred in twelve patients, in whom ten cases happened in traditional anastomosis group, two cases were in oval anastomosis group (P<0.05). No differences were found in operative time and the amount of bleeding between two groups. Conclusion In the digestive tract reconstruction of cardiac cancer surgery, manual oval anastomosis can prevent and reduce anastomotic fistula and anastomotic stricture, and can prevent reflux esophagitis.

Effect of continuous blood purification on the plasma inflammatory mediators in patients with severe acute pancreatitis

Luo Keqin, Shi Yini, Chang Jianxing

2013, 13(04):  292-294.  DOI: 10.3969/j.issn.1009-976X.2013.04.007

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【Abstract】 Objective To explore the effect of continuous blood purification.(CBP).for eliminating plasma inflammatory mediators in patients with severe acute pancreatitis (SAP). Methods Thirty -six patients with SAP were treated by CBP..Four plasma cytokines including TNF -α,.IL -1β,.IL -6,.IL -8 were detected by ELISA at 0,.24,.48 hours after CBP. Results The levels of TNF -α,.IL -1β,.IL -6,IL -8 were significantly higher than that of control group..Thirty -one of all patients got rehabilitation after CBP with a high survival rate.(86.1%).and significant improvement of serum biochemical indexes..The plasma level of cytokines declined at 24 hours after CBP.(P<0.05).and these indexes had rebound in different degree at 48 hours after CBP but were still lower than that before CBP..Conclusion CBP effectively clears the plasma inflammatory mediators,.therefore blocks systemic inflammatory response and improves the prognosis of SAP.

Stage Ⅰ/Ⅱ breast reconstruction with prosthetic implantation after total mastectomy in breast cancer

Yang Jianmin, Wang Qi, Yu Haijing, Zhang Anqin, Li Wenping, Xu Juan

2013, 13(04):  295-297.  DOI: 10.3969/j.issn.1009-976X.2013.04.008

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【Abstract】 Objective To sum up experience of the stage Ⅰ/Ⅱ breast reconstruction with prostheric implantation after mastectomy in patients with breast cancer. Methods The retrospective study was performed in 87 patients with breast cancer who were treated with stage Ⅰ/Ⅱ breast reconstruction with prostheric implantation after mastectomy from June 2005 to December 2012. Results The objective evaluation after primary breast reconstruction showed that the excellent and good rate reached to 95.2%,..and the subjective evaluation were 93.6%..The objective and subjective evaluations after delayed secondary reconstruction were 100%..The inchemic necrosis in nipple and areola occurred in two cases after the primary breast reconstruction,.and the silicone gel prosthesis was removed..And scar formed after healing in one case because of nipple necrosis..All the cases were followed up for 2-92 months,.no metastasis and local recurrence were found. Conclusion Stage Ⅰ/Ⅱ breast reconstruction with silicone gel prosthesis after total mastectomy is proven to be an effective and safe method with the advantage of fast recovery.

Clinical diagnosis and surgical treatment of infective endocarditis in 85 cases

Yu Xiaoli, Zhang Dongcheng, Lin Qinwen, Yu Tao, Qin Xianyu

2013, 13(04):  298-300.  DOI: 10.3969/j.issn.1009-976X.2013.04.009

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【Abstract】〓Objective〓To summarize the experience of clinical diagnosis,.surgical operation and perioperative treatment of infective endocarditis(IE)..Methods From September 2004 to December 2012,.85 IE patients underwent heart operations in our hospital..There were 52 male and 33 female patients,.with an average age of 35±16.2 years old..Twelve patients undevwent emergency operation..Seventy -one patients received preoperative blood culture and the positive rate was 28.1% (20/71)..Ultrasound echocardiography found vegetation in 73 patients..All patients received surgical removal of infected lesions,.correction of valvular lesions and malformation of heart..Results All patients were recovered and discharged..No patient died of surgical procedure..Follow-up was performed in 72 patients and the duration was from 2-95.(53.3±26).months..No recurrence was found in 71 cases..The cardiac function status was NYHA I in 61 cases and NYHA II in 24 cases..Conclusion Early cliagnosis,controlled optimal surgiealtiming,complete clearance of infective foci and corrected use of antibiotics are an important measure for the treatment of infective endocarditis.

Study on fast track surgery in the application of perioperative period of colorectal tumor

Li Yuechun, Wang Dongxia, Li Caishi, Lu Huanquan, Ye Zhenpeng

2013, 13(04):  301-304. 

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【Abstract】 Objective To investigate the feasibility and effectiveness of fast track surgery (FTS) for colorectal tumor during perioperative period. Methods Fifty -six patients with colorectal tumor received FTS(n=28)and conventional perioperative management (n=28). Outcomes were assessed by clinical parameters of preoperative general status, time to restore bowel function, time of oral intake of food,and postoperative complications rate. Results The complication rate showed no statistically significant differences between the two groups(P>0.05). FTS group had significantly shorter gastrointestinal recovery time and early oral intake of food (P<0.05). Meanwhile, compared with the CPM group, the FTS group had less days with getting flatulence and abdominal pain (P<0.05). Conclusions Application of FTS is feasible and effective for patients with colorectal tumor.It can accelerate recovery after operation.

Clinical and diagnostic characteristics of intraductal papilloma of breast in 663 cases

Han Xiaorong,.Wang Qi, Lian Zhenqiang, Zhang Jiangyu, Han Ni, He Qiuyuan

2013, 13(04):  304-307.  DOI: 10.3969/j.issn.1009-976X.2013.04.011

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【Abstract】Objective To investigate the clinical and diagnostic characteristics of intraductal papilloma of breast. Methods The clinical data of 663 patients with intraductal papilloma from Jan 2008 to Dec 2010 were analyzed retrospectively. Results The age of this group mainly distributed in 30-50 years old and nipple-discharge was the main clinical characteristic. Some cases were non-palpable breast mass and were detected by ultrasonography and vacuum assisted biopsy. In this group,.there were about 40.2% patients who had positive results in ultrasonography and there were only about 10% patients who had a positive results in mammography. The diagnostic accordance rate of fibro-optic ductoscopy for IP was 98%. The sensitivity and specificity of thinprep cytology test (TCT) for IP were 74% and 96.3% respectively. The average follow-up time of this group was 13.3 months, there were 25 patients who had homolateral recurrence and all of these were multiple intraductal papilloma. Conclusions The main clinical characteristic of intraductal papilloma is nipple discharge and fibro-optic ductoscopy is a preferred diagnostic method for intraductal papilloma..TCT is helpful to increase the diagnostic accuracy. Multiple intraductal papilloma has recurrence rate of 4.5%, so the regular follow-up is necessary.

Clinical value of the changes of ER,.PR,.HER2 and Ki?鄄67 expressions before and after neoadjuvant chemotherapy in breast cancer

Wang Yongnan, Wang Qi, Zhang Anqin, Li Wenping, Han Xiaorong, Cheng Zhongyang

2013, 13(04):  308-312.  DOI: 10.3969/j.issn.1009-976X.2013.04.012

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【Abstract】〓Objective〓To investigate clinical value of the changes of ER, PR, HER2 and Ki-67 expressions before and after neoadjuvant chemotherapy in breast cancer. Methods From January 2007 to December 2012,.the clinical data of 72 patients with locally advanced breast cancer,.which received neoadjuvant chemotherapy were collected..The relationship between curative effect of neoadjuvant chemotherapy and clinical feature,.ER,.PR,.HER2 and Ki-67 were analyzed retrospectively. Results In the 72 cases of breast cancer,the total effective rate of neoadjuvant chemotherapy was 76.4 (55/72). Among them, CR, PR an SD were 16.7% (12/72), 59.7% (43/72) and 23.6% (17/72) respectively. No progressed case was found. Pathological complete remission (pCR) was in 9.72% (7/72). There were significant relationships between the clinical effective rate of neoadjuvant chemotherapy and the size of primary tumor, ER, PR, HER 2 and Ki-67 (P<0.05). Pathological complete remission was correlated with the status of ER, and PR (P<0.05). The changes of ER, PR, HER2 and Ki-67 were in 22.2%,.25.0%,.15.3% and 55.6% respectively before and after between neoadjuvant chemotherapy in breast cancer..There were significant correlation between the curative effect of neoadjuvant chemotherapy and changes of ER,.PR,.Ki-67.(P<0.05)..There were no significant correlation between HER2 and curative effect of neoadjuvant chemotherapy. Conclusion The ER, PR,.HER2 and Ki-67 expressions show significant changes after neoadjuvant chemotherapy in breast cancer. ER, PR and Ki-67 would predict the curative effects of neoadjuvant chemotherapy.

Expreessive significance of survivin and COX-2 in colonic epithelial lesions

Tang Xingkui, Li Jing, Cai Yuzhi, Peng Huihua, Liang Weixiong

2013, 13(04):  313-314.  DOI: 10.3969/j.issn.1009-976X.2013.04.013

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【Abstract】 Objective To investigate the expression correlation of survivin and cyclooxygenase-2 (COX-2) in normal colon tissue, colonic adenomas and colon cancer. Methods In order to establish the role of survivin and COX-2 in colon cancer development,we studied the expression of survivin and COX-2 in 46 cases of normal colon mucosa,58 cases of colonic adenomas and 34 cases of colon cancer by using immunohistochemical techniques using EnVision system. Results No expression of survivin and COX-2 was found in normal colonic mucosa. However, colonic adenomas and colon tumors exhibited a high degree of survivin and COX-2 expression,.especially in colon cancer tissue. Conclusions The high expression of survivin and COX-2 is integrally associated with the process of colon carcinogenesis. There may be a common activation mechanism between survivin and COX-2 expressions.

MMP-9 Mediates sMICA shedding in human colon cancer cell

Zhou Taicheng, Yang Shaoyu, Luo Hongtu, et. al.

2013, 13(04):  315-317.  DOI: 10.3969/j.issn.1009-976X.2013.04.014

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【Abstract】 Objective To investigate the effect of MMP-9 in the process of mMICA shedding to sMICA in human colon cancer cells. Methods MMP-9 siRNA plasmid was transfected into HT-29 cells, the expressions of MMP-9 and MICA mRNA were detected through qPCR, he proteins of MMP-9, sMICA and mMICA were detected by ELISA. Results Transfection of MMP-9 siRNA into HT-29 resulted in a significant decrease in the levels of MMP-9 mRNA and protein, decreased the shedding of sMICA form mMICA, and upgraded the produce of protein of mMICA, however, it didn’t affect the expression of mRNA of MICA. Conclusion Inhibiting the expression of MMP-9 can decrease the porduction of sMICA as well as increase mMICA.

Study on influencing prognostic factors for tibial plateau fracture

Su Tao, Yan Huanhuan, Su Huansheng, Xu Baisheng

2013, 13(04):  318-321.  DOI: 10.3969/j.issn.1009-976X.2013.04.015

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【Abstract】 Objective To investigate the prognostic influence factors for tibial plateau fracture through clinical treatment and observation. Methods Sixty-two cases with tibial plateau fracture of were were collected in our hospital from January 2006 to December 2011. Among them, cases were treated by operation and the others(19 cases)were treated by non-operation. Results All the patients were followed up from 2 months to 5 years and the average follow-up period was 2.8 years. The excellent and good rates of tibial plateau fracture were 88.4% in operation group and 73.7% in non-operation group according to Lyslom's criteria. The prognosis of Schatzker Ⅰ, Ⅱand Ⅲ were significantly better than that of Ⅳ, Ⅴ and Ⅵ respectively (P<0.05). There was no significant difference in the excellent and good rates between males and females (P>0.05). The excellent and good rates of patients who were treated within 8 hours were significantly higher than that over 8 hours after the fracture (P<0.05), and the patients above 60 year-old were worse than those under 60 years old. Three cases of patients were found traumatic arthritis, and 2 patients had articular surface collaps in different degree. Conclusion Surgical treatment is an effective method for tivial plateau fracture. The type of tibial plateau fractures, the means of treatment and the selection of operative timing,early functional exercises and the age of patients have a significant impact on patient's prognosis.

Misdiagnosis of MR in one case with idiopathic granulomatous mastitis and review of literature

Yang Qihua, Yang Zehong, Yu Taihui, Liang Biling

2013, 13(04):  322-325.  DOI: 10.3969/j.issn.1009-976X.2013.04.016

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【Abstract】 Objective To improve the knowlege about the clinical features and magnetic resonance imaging findings of idiopathic granulomatous mastitis and avoid misdiagnosis.. Methods   The clinical data,laboratory results,ultrasound and magnetic resonance imaging findings were reported in one case with idiopathic granulomatous mastitis which was misdiagnosed by magnetic resonance and the relative literatures were reviewed. Results The patient underwent segmental excision after blood roatine test,.ultrasound and magnetic resonance and recovered well after surgery. Conclusion pre-operation diagnosis of idiopathic granulomatous mastitis with magnetic resonance is difficult, but it has a definate specific feature in MR finding..If there are correlated sign appearance, the diagnosis of this disease should be considered and it would contribute to provide a therapeutic project for patients.

Application of transanal endoscopic operation for treatment of middle-high position rectal benign and malignant neoplasm

Feng Jiali, Chen Xiaowu, Ju Yongle, Zhu Dajian, Lu Guangsheng

2013, 13(04):  326-328.  DOI: 10.3969/j.issn.1009-976X.2013.04.017

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【Abstract】 Objective To study the curative effect of transanal endoscopic operation/ microsurgery(TEO/TEM)on middle-high position benign and malignant rectal tumors. Methods The data of 21 patients undergoing transanal endoscopic operation from January 2012 to December 2012 in The First Hospital of Foshan Shunde were analyzed retrospectively. Results Transanal endoscopic operations were successfully performed in all the patients. The average operative time was 85(40~120) min. The histologic diagnosis indicated 14 adenomas, 5 carcinomas, 1 carcinoids, 1 interstitialoma. The average hospital stay after transanal endoscopic operation was 4 (2~10) days. Postoperative complications included rectal bleeding (n=3), acute retention of urine (n=2) fecalincontinence (n=1) and low fever (n=1). Conclusion Transanal endoscopic operation may be the preferred method in patients with middle-high position benign and malignant rectal tumors, and is a safe and feasible technique.

Comparison between the transureteroscopic pneumatic lithotripsy and minimally invasive percutaneous nephrolithotomy for the treatment of upper ureteral stones

Weng Wenfeng,Dong Chaoxiong,.He Zuqiang

2013, 13(04):  329-331.  DOI: 10.3969/j.issn.1009-976X.2013.04.018

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【Abstract】Objective To compare the clinical efficacy between transureteroscopic pneumatic lithotripsy (TUPL) and minimally invasive percutaneous nephrolithotomy (MIP) for treatment of upper ureteral stones..Methods From August 2009 to August 2011,.collected 80 patients with the upper ureteral stones in our hospital were divided into the control group (n=40) and the observation group (cases=40). TUPL was performed in observation group and MIP in control group. The operation time, intraoperative blood loss, postoperative hospitalization time, incidence rate of postoperative complications,.lithotriptic rate and the lithecbole rate were compared between two groups. Results The lithotrip rate and lithecbole rate in control group were higher than that in the observation group (P<0.05), but the operation time, the intraoperative blood loss, the hospitalization time and the complications in the observation group were significant lower than that in the control group (P<0.05). Conclusion As for clinical effectiveness,.TUPL may be inferior to that of MIP for upper ureteral stones,.but TUPL have advanteges in the less bleeding and few complications..The clinical physician should choose a suitable method according to hospital equipment condition,calculus in location, size and ureteral situation.

Clinical application of laparoscopic-assisted radical resection of rectal carcinoma (Report of 58 cases)

Hu Bin, Deng Jian, Fu Zhengcai, Ni Xinjian, Ding Zhiping

2013, 13(04):  332-334.  DOI: 10.3969/j.issn.1009-976X.2013.04.019

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【Abstract】 Objective To investigate the therapeutic effect and feasibility of double-view laparoscopic-assisted radical resection for patients with rectal cancer. Methods Fifty-eight patients with rectal cancer received radical resection with a lower abdominal midline incision 6 cm in length using double-view laparoscope, which combined direct vision and screen vision so that the advantage of direct vision and laparoscopic operation could be complementary. Results Double-view laparoscopic-assisted operations were successfully completed in all patients..Among them,.49 cases underwent L-Dixon method and 9 cases undervwnt L-Miles' method. Anastomotic leakage was found in 2 patients and the two patiens cured by colostomy plus abdominal drainage and conservative treatment plus abdominal drainage respectively and conservative treatment. Fourty-three of 58 cases were followed up for 6-36 months (mean,18 months), Most of patients had good recovery. Liver metastasis was found in one case and underwent partial liver resection 25 months after surgery. One case was found the local recurrence and multi-metastasis 19 months after operation,but this patient gave up treatment by himself. Conclusion Double-view laparoscopic-assisted radical resection for patients with rectal cancer has definite advantages over traditional laparotomy, such as brighter operative field, more precise anatomy, techneque easier to control, less trauma and rapid recovery.

Analysis of curative effects on minimally invasive hollow compression screws fixation for the treatment of femoral neck fracture

Liu Guoqiang, Yin Wenhua, Liu Shengping, Guo Jiekun,.Zhang Guangming

2013, 13(04):  335-338.  DOI: 10.3969/j.issn.1009-976X.2013.04.020

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【Abstract】. Objective To investigate the clinical effectiveness for treatment of femoral neck fracture by minimally invasive hollow compression screws fixation..Methods From Augest 2008 to Augest 2010,.71 cases with fresh neck fracture were treated by closed reduction and minimally invasive hollow compression screws fixation..And the clinical data of patients were analyzed retrospectively..Results As of August 2012,.59 patients achieved bone union with average 5.1 months after surgery..The healing rate was 83%. The nonunion or ischemic necrosis occurred in 12 cases (17%)..According to Harris hip score for the functional evaluation of hip joints,.the excellent and good rate was 84.7%. Garden Ⅰ,Ⅱ,Ⅲ, Ⅳ-type bone healing rates were 100%,.95.2%,.78.1%, 60% respectively..Graden reset index A,.B,.C group healing rates were 92.9%,.77.3%,.42.9% respectively. Conclusion Using suitable closed reduction and hollow-compression screws fixation have an ideal outcome, simple manipulation, reliable fixation and less trauma for treatment of the femoral neck fracture within the Garden Ⅲ type.

Surgical treatment of the acute epidural hematoma

Cao Lianghui, Kang Liang

2013, 13(04):  339-340.  DOI: 10.3969/j.issn.1009-976X.2013.04.021

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【Abstract】 Objective To summarize the experience of clinical diagnosis and treatment of acute epidural hematoma. Methods The clinical data of 75 patients with acute epidural hematoma was analyzed retrospectively from 2005 to 2012 in our hospital. All patients underwent craniotomy evacuation of hematoma. Results Among 75 patients, 59 cases were cured, 8 cases were improved, 2 cases were severe disability, 6 cases died. The total effective rate was 89.33%. Conclusion Acute epidural hematoma is acute and severe craniocerebral trauma and early aggressive surgical treatment would achieve satisfactory outcomes.

Application of MSCT volume measurement in the postoperative evaluation of percutaneous vertebroplasty and kyphoplasty

Yang Zehong, Yang Qihua, Cai Zhaoxi, Chen Jianyu

2013, 13(04):  341-344.  DOI: 10.3969/j.issn.1009-976X.2013.04.022

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【Abstract】 Objective To analyzed the application of MSCT volume measurement in comparing the effects of percutaneous vertebroplasty and kyphoplasty in the treatment of osteoporotic vertebral compression fractures. Methods Retrospective data of 34 patients with osteoporotic vertebral compression fractures were analyzed in our hospital during December 2007 to December 2012. The patients were treated by percutaneous vertebroplasty and kyphoplasty,and received MSCT examination within 72 hour after operation..By the CT volume measurement, the dispersion coefficient was calculated by the volume of bone cement introduced and dispersion volume..The differences of the dispersion coefficient and VAS scores.(preoperative minus the postoperative).between two groups that treated by PVP or PKP were performed Independent-Samples T Test, and the difference of the bone cement dispersion coefficient and VAS scores between two groups was compared..The relationship between the bone cement dispersion coefficient and VAS score changes were analyzed by Spearman Correlation Analysis. Results The bone cement dispersion coefficient between two groups of different operation method was statistically significant.(P=0.005). The differences of VAS scores between two groups was statistically significant (P=0.026). The relationship between the bone cement dispersion coefficient and VAS scores were certain relationship.(r=0.465)..Conclusion The bone cement dispersion coefficient of PVP is less than PKP. Bone cement dispersion coefficient can be used as a reference indicator of evaluating the effect of vertebral plasty.

Diagnostic values of multislice spiral CT in obturator hernia before operation

Huang Chuangji, Xu Xiaomao

2013, 13(04):  344-346.  DOI: 10.3969/j.issn.1009-976X.2013.04.023

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【Abstract】〓Objective To evaluate the value of multislice spiral CT (MSCT) in diagnosing obturator hernia. Methods The MSCT imaging features of 7 patients with obturator hernia were reviewed retrospectively. Results The presence of SBOs could be diagnosed in all patients on MSCT including dilation of the small bowel with fluid collection..Hernia sac were found between lateral obturator muscle and pectineus muscle..The thickening and swelling of the bowel wall and ascites which indicating ischemia were been seen in 4 patients..And perforations were found in 2 patients. Conclusion MSCT are not only useful for diagnosis of obturator hernia, but also useful for identifying the associated complications including ischemia and perforations of obturator hernia.

Complications and corresponding managements of clavicular hook plate fixation for distal clavicle fracture and acromioclavicular joint dislocation

Chen Chao, Yang Kangyong

2013, 13(04):  347-350.  DOI: 10.3969/j.issn.1009-976X.2013.04.024

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【Astract】〓Objective〓To analyze the reasons of complications caused by the clavicular hook plate fixation for distal clavicle fracture and acromioclavicular joint dislocation,.and to investigate the protective step. Methods From Oct 2009 to Nov 2012, 126 patients with distal clavicle fracture and acromioclavicular joint dislocation underwent clavicular hook plate fixation and the clinical data was retrospectively analyzed. Of 126 cases,.81 were males and 45 were females,.the average age was 37.6 years.(range 16-79 years)..Results All the patients were followed up from 3 months to 2 years (average 11 months)..Complications occurred in 39 patients,.presenting as shoulder pain,.stress fracture, decoupling. The function of the shoulder (according to Constant Scores) existed excellent in 32 cases, good in 68, and fair in 16, and the good-excellent rate was 79.4%. Conclusion For the treatment of distal clavicle fracture and acromioclavicular joint dislocation with clavicular hook plate fixation approach,.most of the complications can be prevented,.and correct placement,.fixation surgery and functional exercise are critical to prevent the complications.

Study on laparoscopic treatment for the cholangitis of clonorchis sinensis

Ye Yong, Ye Lin, Tang Wanrong, Yu Jiexiong

2013, 13(04):  350-352.  DOI: 10.3969/j.issn.1009-976X.2013.04.025

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【Abstract】 Objective To summarize the clinic experience of laparoscopic choledochotomy and T-tube drainage in treatment of cholangitis of clonorchis sinensis..Methods A clinical data of 26 cases with cholangitis of clonorchis sinensis undogoing laparoscopic treatment were analyzed retrospectively. All patients underwent laparoscopic choledochotomy with exploration and T-tube drainage in Jiangmen central hospital from Jun 2009 to Jun 2012. Results The 26 patients underwent laparoscopic choledoch-otomy with exploration and T-tube drainage..The average operative time was 120 minutes and the average hospitalization time was 11 days..Postoperative biliarly leakage was found in two cases,and hemobilia occurred in one case..The complications were cured by conservative treatment..All cases received antiscolic treatment with praziquantel one week after operation...Conclusion Laparoscopic choledochotomy with exploration and T-tube drainage for treatment of cholangitis of clonorchis sinensis. are safe,effective and reliable.

A comparative study on different volumes of compund betamethasone of epidural injection in the treatment of nerve-root-type cervical spondylosis

Li Weixing, Lu Ya'nan, Chen Ruixia, Ye Xijiu

2013, 13(04):  353-355.  DOI: 10.3969/j.issn.1009-976X.2013.04.026

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【Abstract】Objective To compare the curative effect of different volumes of epidural compound betamethasone injection on nerve-root-type cervical spondylosis. Methods Sixty-eight patients with nerve-root-type cervical spondylosis were treated in our department from Jan...2012 to Dec. 2012. The patients were divided randomly into two groups, group A and group B. The cervical 6-7 intervertebral space was selected as the puncture site..After succeeding in epidural puncture and catheterization according to operation procedures, one ampulla of compound betamethasone injection was diluted to 40 mL (A group,n=35) and 20 mL (B group,n=33) with normal saline and injected through the catheter into the epidural space in group A and group B respectively. And then the curative effect were compared between two groups. Results The curative effect of nerve-root-type cervical spondylosis of group A was better than that of group B(P<0.05). Conclusion Different volumes of epidural steroid injection have a curative effect on nerve-root-type cervical spondylosis, but effect of the larger volume group is better than that of the smaller one.

Clinical summary of laparoscopic assisted therapy for urachal anomalies in children

Shi Chuan, Ma Shaofeng, Chen Jiangyi, Lu Jinrong, Che Mingbi

2013, 13(04):  355-357.  DOI: 10.3969/j.issn.1009-976X.2013.04.027

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【Abstract】 Objective To study the effects of laparoscopic for the treatment of urachal anomalies in children. Methods The clinical data of 20 children with urachal anomalies was analyzed retrospectively. Results The laparoscopic procedures were completed without fransffered to open surgery. The operating time ranged from 45 to 90 minutes (mean 60 minutes). Amount of bleeding was from 3 mL to 5 mL. The patients were discharged from hospital 5 to 7 days after operation. All achieved a mean of 6 months follow-up and none of them developed adhesive ileus and recurrence. The curative effect was satisfied. Conclusions Laparoscopic repair of urachal anomalies in children has the benefits of less invasiveness nice appearance, quike recovery and safety.

Analysis of effectiveness of chlormadinone acetate in the treatment of patients with benign prostatic hyperplasia

He Ming, Liu Zhuoming, Liu Risheng

2013, 13(04):  357-359.  DOI: 10.3969/j.issn.1009-976X.2013.04.028

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【Abstract】 Objective To explore the effectiveness of chlormadinone acetate in the treatment of patients with benign prostatic hyperplasia. Methods Thirty-two patients with benign prostatic hyperplasia were included in the study. All patients received chlormadinone acetate (50 mg/d) for 18 weeks. The prostate volume, International Prostate Symptom Score/Quality of Life,(IPSS/QoL), maximum urinary flow rate, international index of erectile function-5 (IIEF-5), and the adverse events were recorded. Results After treatment with chlormadinone acetate, the IPSS, IPSS voiding score, IPSS storage score, QoL, and IIEF-5 significantly decreased in patients(P<0.05). Meanwhile, maximum urinary flow rate significantly increased (P<0.05). Conclusion The therapy with chlormadinone acetate effectively relieves the symptoms of benign prostatic hyperplasia and improves the quality of life.

Research on the role of heat shock proteins in carcinogenesis,.proliferation,.recurrence, metastasis and anti-tumor immune responses of hepatocellular carcinoma

Wu Jiayi,Li Gaopeng, Luo Baoming

2013, 13(04):  367-369.  DOI: 10.3969/j.issn.1009-976X.2013.04.033

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【Abstract】 Heat shock proteins (HSPs) are a class of proteins with extremely conservation, which involve in many vital chaperoning processes such as protein folding, transporting, stabilization and antigenic presentation. Some of the HSPs, such as HSP27, HSP70, and HSP90, are frequently overexpressed in hepatocellular carcinoma(HCC). This review summarizes the role of HSPs in carcinogenesis, proliferation, recurrence, metastasis and anti-tumor immune responses of HCC.