Table of Content

20 June 2014, Volume 14 Issue 03

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论文

Inhibitory effects of microRNA-449a on migratory ability of bladder tumor cell line J82 by targeting Notch1

Zhong Guangzheng, Peng Yang, He Wang, Lin Tianxin

2014, 14(03):  230-234.  DOI: j.issn.1009-976X.2014.03.002

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【Abstract】〓Objective〓To explore the influence of microRNA-449a (miR-449a) on migratory ability of bladder cancer cell line J82 and evaluate the correlation between miR-449a and Notch1. Methods〓After transfection of microRNA mimics into J82 cells, cell migratory ability was assessed by transwell chamber assay and wound healing assay. Expression of Notch1 was evaluated by quantitative real-time polymerase chain reaction and western blotting. Luciferase assay was used to confirm the relationship between miR-449a and Notch1. Results〓Transwell chamber assays and wound healing assays revealed that transfection of miR-449a suppressed the cell migration of J82 cells. Ectopic overexpression of miR-449a caused significant decrease of protein levels of Notch1 (P=0.0135), while the mRNA levels of Notch1 showed little change.(P=0.5739). In addition, luciferase assays showed that miR-449a significantly reduced the normalized Notch1 3'UTR luciferase activity.(P=0.0016). Conclusion〓Overexpressed miR-449a can inhibit migration of bladder cancer cells by antagonizing Notch1,.thus indicating its tumor suppressive function in bladder cancer.

Clinical efficacy of endoscopic photodynamic therapy on cholangiocarcinoma

Li Yue, Zhang Dawei, Xue Ping, Lu Haiwu, Zheng Qiang, Cao Liangqi

2014, 14(03):  235-238.  DOI: j.issn.1009-976X.2014.03.003

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【Abstract】 Objective To evaluate the efficacy of endoscopic photodynamic therapy combined with stent implantation on cholangiocarcinoma..Methods Sixty-two cases of patients with cholangioc-arcinoma from October 2005 to June 2009 in our hospital were divided into two groups,.32 cases in the control group were treated by endoscopic stent placement,.and 30 cases in the treatment group were treated with the endoscopic stent placement combined with photodynamic therapy. The follow-up was done in 62 cases,.including survival time and quality of life..Results After 3years of follow-up, the median overall survival time of treatment group was 18 months,.the 1-,.2- and 3-year survival rate were 63.3%, 43.3%, and 20.0%, respectively. The median overall survival time of control group was 8 months, the 1-, 2- and 3-year survival rate were 43.8%, 25.0% and 9.4%, respectively. The total score of FACT-Hep scales in treatment group were higher than those in control group at postoperative 6 months,.9 months and 12 months(P<0.05). Cox multivariate analysis demonstrated that among the factors analyzed,.the level of bilirubin,.lymph node status,.and therapeutic method were independent prognostic factors for overall survival in patients with cholangiocarcinoma..Conclusion Endoscopic photodynamic therapy combined with stent implantation improves survival and quality of life, and is an effective treatment for patients with cholangiocarcinoma.

The application of the primary culture of liver cancer cells with tissue slice method

Lin Manzhou, Hu Min, Wu Guilin, Miao Huilai, Zhu Runzhi, Huang Haili, Li Mingyi

2014, 14(03):  239-233.  DOI: j.issn.1009-976X.2014.03.004

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【Abstract】〓Objective〓To investigate the application of the primary culture of liver cancer cells with tissue slice method. Methods〓The primary liver cancer cells from human liver tissue were isolated by using tissue slice method and tissue pieces respectively, and the success rate of cultivation, the cell climbed-out time, cell morphology, and the expression of GPC3 of two methods were analyzed. Results The success rate of cultivation with the tissue slice method was 66.67%,the cell climbed-out time was (7.89±0.78)..d..In the second generation of culture cells can be observed with morphological rules. Meanwhile HepG2 cells and primary liver cancer stably expressed GPC3..Conclusion The both methods can successfully cultured primary liver cancer cells,.but it is better with tissue slice method to raise the liver cancer cells in the cell morphology and cleanliness and which can stably express GPC3

The effect of hepatic oval cell transplantation on TGFβ/smad signaling transduction in rats with hepatic cirrhosis

Deng Wujian, Xiang Guangyang, Cheng Lin, Yu Kun, Chen De

2014, 14(03):  243-246.  DOI: j.issn.1009-976X.2014.03.005

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【Abstract】 Objective To investigate the role of TGFβ/smad signaling transduction in a rat carbon tetrachloride (CCL4)-induced model of hepatic cirrhosis, and the effect of hepatic oval cells for inhibiting development of hepatic cirrhosis. Methods〓Hepatic oval cells were cultured, proliferated, separated and transplanted into liver tissue of rats with hepatic cirrhosis. The rats transplanted with hepatic oval cells were assigned as research group,.those without hepatic oval cells were served as Control Group. The morphological character by HE staining, and serum ALB, AST and ALT were observed in all animals. Expression of protein TGFβ1, TGFβRⅡ, Smad2, Smad4 and Smad7 in liver tissue were measured by western blot. Results〓The hepatic fibrosis tissue observed in Research Group animals seemed alleviated compared with controls. The levels of serum AST and ALT in research group animals were also lower than that in controls except for serum ALB (P<0.05). Meanwhile, Expression of TGFβ1, TGFβRⅡ, Smad2, Smad4 in liver tissues of research group were lower than that of controls but Smad7. Conclusion〓Liver oval cells showed an antifibrotic effect on experimental liver fibrosis. The possible mechanism is that hepatic oval cells inhibit the expression of by TGFβ/smad signaling transduction.

Effect of Curcum in combined with LY294002 on cell proliferation of Prostate Carcinoma PC-3 cells

Li Song, Deng Xinjun, Li Zhengming, Li Gang, Ruan Li, Luo Bin, Huang Hai

2014, 14(03):  247-251.  DOI: j.issn.1009-976X.2014.03.006

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【Abstract】〓Objective〓To explore the effect of curcumin in combined with LY294002 on prostate carcinoma PC-3 cells and the possible mechanism. Methods〓The experiments were divided into four groups according to different drug administration: control group (PPS), curcumin group (25 μmoL/L of curcumin), LY group (25 μmoL/L of LY294002) and combination group (mixture of curcumin and LY294002). Then proliferation viability of PC-3 cells was observed by MTS assay, apoptotic rate was detected by flow cytometry,.the mRNA expression of NF-κB、P53 and caspase-9 were examined by Q-PCR,respectively...Results....PC-3 cell proliferation was inhibited in three groups, curcumin group, LY294002 group and combination group. The proliferation rate in combination group was more decreased than that in other two groups..The apoptosis rate of PC-3 cells in combination group was significantly increased when compared with curcumin group or LY294002 group(P<0.05)..NF-κB expression in combination group was also significant lower than curcumin group or LY294002 group (P<0.05), while the expression of P53 and caspase-9 in combination group were obviously higher than these in groups of drug administrated alone (P<0.05). Conclusion〓The combined use of curcumin and LY294002 can effectively inhibit the growth of PC-3 cells in vitro, its mechanism might be inhibiting cell proliferation by decreasing the expression of NF-κB, and promoting cell apoptosis by increasing the expression of P53 and caspase-9.

Comparison of clinical outcome between laparoscopic assisted Dixon and Miles radical surgery for low rectal cancer

Tan Minghua, Zhu Jingtao, Lv Yizhong, Peng Liang

2014, 14(03):  251-255.  DOI: j.issn.1009-976X.2014.03.007

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【Abstract】 Objective〓To compare the the therapeutical effect between laparoscopic assisted Dixon and Miles radical resection for low rectal cancer. Methods〓Eighty-three patients with low rectal cancer who received laparoscopic assisted surgery were included in the study according to the inclusion and exclusion criteria from January 2008 to December 2010..The enrolled patients were divided into two groups: Dixon group (41 cases) and Miles group (42 cases). The clinicopathological data, surgical quality, postoperative survival and recurrence data were compared between two groups. Results〓There were no distribution differences in clinical data between Dixon group and Miles group. The mean operative time and intraoperative blood loss in Dixon group were shorter than that in Miles group (P<0.05), however the Miles group cost less postoperatively. No differences were found between two groups in the numbers of lymph nodes harvested postoperatively and positive lymph nodes. Both two groups had similar bowel function recover time..The overall postoperative complication rate in Dixon group was 17.0% and 21.4% in the Miles group(P>0.05)..The postoperative 5-years overall survival rate of Dixon and Miles group was 60.6% and 56.2% respectively and no survival difference was found between them..During follow-up period,.the recurrence rates between Dixon and Miles groups were similar(12.2% vs 11.9%,.P>0.05)...Conclusions〓Laparoscopic assisted Dixon radical opera-tion for low rectal cancer was a safe surgical procedure and had similar clinical effect with laparoscopic assisted Miles rectal surgery..The long-term survival outcome of laparoscopic assisted Dixon surgery was similar to laparoscopic assisted Miles surgery.

Analysis risk factors and short-term outcomes of acute kidney injury following CABG with extrac-orporeal circulation

Jiang Huiqi,.Zeng Kuan,.Wang Meng,.Hua Ping,.Zhang Shuming,.Gao Minnan

2014, 14(03):  256-260.  DOI: j.issn.1009-976X.2014.03.008

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【Abstract】〓Objective〓To investigate risk factors and short-term outcomes of acute kidney injury (AKI).following CABG with extracorporeal circulation...Methods AKI was defined as relative 50% increase or an absolute increment of 26.4 umol/L in Scr within 48 hours and/or urine volume <0.5 ml·kg-1·h-1 up to 6h..According to the definition of AKI,.189 patients who received on-pump CABG from January 2007 to October 2013 were divided into acute renal injury group (AKI group, n=18) and non acute renal injury group(non AKI group,.n=171),.and were compared with clinical characteristics, complications and mortality. Results〓The incidence of AKI was 9.5% (18 cases). In-hospital mortality of AKI group was 22.2%, which was significantly higher than that of non-AKI group vs. (3.5%, P<0.05). Age in AKI group (70.22±9.52) was significantly higher than that in non-AKI group (vs. 63.94±10.79, P=0.019), as was Diabetes mellitus 55.6% vs 30.9% (P=0.035), hypertention 88.9% vs 62.7% (P=0.026), chronic obstructive pulmonary disease 11.1% vs 0.6% (P=0.024), EuroSCORE (The European System for Cardiac Operative Risk Evaluation) 5.94±3.09 vs 3.84±2.52 (P=0.002), extracorporeal circula-tion time 110.33±42.64 min vs 90.39±30.39 min(P=0.012),.with IABP 22.2% vs 7.1% (P=0.028), and postoperative glomerular filtration rate 31.10±15.20 vs 67.4±23.45 mL·min-1·1.73 m-2(P<0.001). Conclusion〓Age, Diabetes mellitus, hypertention, chronic obstructive pulmonary disease, EuroSCORE, extracorporeal circulation time, with IABP were risk factors of post-operative AKI for patients undergoing CABG with extracorporeal circulation. AKI was associated with higher mortality rate.

Gastrointestinal surgery perioperative diabetes treatment analysis(report of 63 cases)

Zhou Jun,.Zhu zhonghua, Liu Lu, Wu Heng, Luo Xingxi, Zeng Yujie

2014, 14(03):  260-263.  DOI: j.issn.1009-976X.2014.03.009

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【Abstract】〓Objective〓To report the perioperative experience in handling the diabetic patients underwent gastrointestinal surgery...Methods〓During May 2009 to February 2013,.the perioperative treatment of 63 cases accepted gastrointestinal surgery combined diabetic patients were retrospectively analyzed..The hyperglycemia univariate were compared against surgical complications and mortality. The clinical significance of glycemic control were assessed....Results〓Among the 63 cases,.elective surgery were 11 cases, the deadline for surgery were 45 cases and seven cases were emergency surgery. Cure rate were 88.30% (55/63), improvement rate of were 9.52% (6/63),.the fatality rate were 3.17%.(2/63)..Most surgical complications were associated with post-operative infection,.accounting for 68.00% (17/25),.the incision infection were the most common,.followed by urinary tract infections and lung infections. The most serious complications were postoperative sepsis,.high sugar hyperosmolar nonketotic coma, ketoacidosis and cardiopulmonary dysfunction..Perioperative patient deaths were associated with these complications....Conclusion〓Diabetes increases the risk of gastrointestinal surgery,.prone to complica-tions..To perioperative correctly grasp, the principles and methods of treatment will benefit the patient to smooth out the surgery. And the incidence of postoperative complications may be greatly reduced.

Comparison of two kinds of minimally invasive operation in treating concomitant cholecyst-olithiasis and choledocholithiasis in senile patients

2014, 14(03):  264-267.  DOI: j.issn.1009-976X.2014.03.010

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【Abstract】〓Objective〓To evaluate the therapeutic effect of laparoscopic cholecystectomy (LC)+laparoscopic common bile duct exploration(LCBDE) and endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy(EST)+LC in treatment for concomitant cholecystolithiasis and choledocholithiasis in senile patients. Methods〓The clinical data of 96 senile patients with cholecy-stolithiasis and choledocholithiasis, who underwent surgical treatment in our hospital from January 2010 to January 2013 were retrospectively analyzed. Thirty-eight senile patients received LC+LCBDE, and the others underwent ERCP/EST+LC. The success rate of operation, the clearance rate of calculus, incidence of postoperative complications,.hospital stay,.and hospitalization charge were compared between two groups. Results〓There were no statistical significances in the success rate of operation, the clearance rate of calculus, and incidence of postoperative complications between two groups (P>0.05). Hospital charge and time of hospital stay were lower in LC+LCBDE group. Conclusion〓Both LC+LCBDE and LC+ERCP/EST are safe and effective for senile patients with cholecystolithiasis and choledocholithiasis. The LC+LCBDE is a primary choice for the appropriate cases.

Comparison of two different methods for the management of cholecysto-choledocholithiasis

Liu Qingbo, Wang Weidong, Chen Xiaowu, Wu Zhiqiang, He Wei, Chen Jianping, Lin

2014, 14(03):  267-270.  DOI: j.issn.1009-976X.2014.03.011

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【Abstracts】〓Objective〓To compare the clinical effects between two methods for the management of cholecysto-choledocholithiasis. Methods〓From Jan 2008 to Mar 2013, a total of 153 cases of cholecysto-choledocholithiasis were treated by LCBDE (laparoscopic common bile duct exploration)+LC(laparoscopic cholecystectomy).or ERCP.(endoscopic retrograde cholangio-pancreatography)+LC. The surgical time, blood loss,.postoperative blood amylase,.total expenditure,.stones clearance rate,.complication rate were compared between two groups...Results〓LCBDE+LC group showed better than the ERCP+LC group in postoperative blood amylase,.operation failure rate, complication rate and total expenditure (P<0.05). The latter showed better in surgery time,.estimated blood loss (P<0.05). And there were no significant difference in stones clearance rate between the two groups.(P>0.05). Conclusion〓In the present study,.LCBDE+LC group had more advantages than the ERCP+LC group in postoperative blood amylase,.operation failure rate,.complication rate and total expenditure,.while we should insist on personalization options in actual practice.

Changes and significance of CD8⁺CD28^- regulatory T lymphocytes for patients with thyroid carcinoma undergoing radical mastectomy

Zhu Wudong, Wu Anren

2014, 14(03):  271-274.  DOI: j.issn.1009-976X.2014.03.013

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【Abstract】〓Objective〓To explore the changes and significance of CD8+CD28- regulatory T lymphocytes for patients with thyroid carcinoma undergoing radical mastectomy. Methods〓Thirty cases with bilateral thyroid carcinoma treated with surgical treatment were selected as the observation group (A group), and 30 cases with benign thyroid tumor and healthy volunteers were served as controls (A group and C group). Using flow cytometry detected three sets of peripheral blood CD8+CD28- regulating T cell growth factors and their intracellular cytokines 1 (TGF-beta 1) and the frequency of interleukin 10 (IL-10). The indexes obove were compared between. Results〓Compared with group C,A and B group of CD8+CD28-T cells and TGF-beta 1 were higher,but no statistical difference was found between group B and C,and the group A were significantly higher than that of group C (P<0.05). Compared with group C,IL-10 in A and B group were significantly increased, and the comparison between two groups have statistical difference(P<0.05). In 4 weeks after surgery in group A, CD8+CD28- T cells,TGF-beta 1 and IL-10 level were reduced than that before the operation (P<0.05), especialy CD8+CD28- T cells and TGF-beta. Conclusion〓CD8+CD28- T cells, TGF-beta 1 and IL-10 expression increases are important immunological factors in patients with thyroid cancer. TGF-beta 1 is relatively specific cytokines and is more sensitine than IL-10 in evaluating the operative efficacy.

Comparative study of partial left liver resection between laparoscopic surgery and open surgery for treatment of hepatocellular carcinoma

Zheng Qiang, Zhang Dawei, Lu Haiwu, Wen Zilong, Cao Liangqi, Xue Ping

2014, 14(03):  274-277.  DOI: j.issn.1009-976X.2014.03.012

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【Abstract】〓Objective〓To evaluate the short- and long-term efficacy of laparoscopic partial left liver resection for treatment of hepatocellular carcinoma. Methods〓The clinical data of 51 patients who received laparoscopic partial left liver resection(laparoscopic group) were retrospectively compared with 50 patients who underwent open partial left liver resection (open group) from May 2008 to June 2012. The duration of operation, intraoperative blood loss, hospital stay, postoperative complications, hospital cost and the rate of survival and recurrence were compared respectively. Results〓The duration of opera-tion was longer in laparoscopic group than that in open group(128.6±29.7 min vs 106.3±26.5 min, P<0.05), the blood loss during operation was more than that in open group (180.5±53.6 ml vs 130.2±44.5 ml,P<0.05)..Average hospital stay in laparoscopic group was shorter than that in open group (6.8±1.4 d vs 11.4±3.0, P<0.05)..Total hospital cost in laparoscopic group was lower than that in open group(P<0.05). The rate of postoperative complications between the two groups was not statistically significant..The median overall survival time was 40 months in laparoscopic group and 41 in open group. The 1-, 2- and 3-year survival rate was 90.2%, 80.4%, 68.6%, respectively in laparoscopic group and 90.0%,.82.0%,.66.0% in open group. The median disease-free survival time was 29 months in laparoscopic group and 31 in open group. The 1-,2- and 3-year recurrence rate was 19.6%,45.1%, and 54.9%, respectively in laparoscopic group and 22.0%,42.0% and 50.0% in open group..Conclusion〓Laparoscopic partial left liver resection is safe and feasible,.and has similar effect on prognosis of patients with hepatocellular carcinoma. When Compared with open surgery. and laparoscopic surgery have some advantages, including minimally invasive,.faster recovery,.shorter hospital stay and lower cost.

The effects of Globulin/Cholinesterase ratio in evaluating liver reserve function

Wu Zhihui, Lin Qing, Ye Liangtao, Tan Langping, Chen Rufu

2014, 14(03):  278-281.  DOI: j.issn.1009-976X.2014.03.014

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【Abstract】〓Objective〓To investigate a method for predicting sensitively and specifically hepatic insufficiency by comparing globulin/cholinesterase(G/C) ratio with Child-Pugh scores in advance of hepatec-tomy in liver cancer patients. Methods〓We recruited patients retrospectively from May 2012 to January 2014 undergoing HCC hepatectomy in Sun Yat-Sen University Memorial Hospital,.including 138 males and 36 females. The study was conducted by analysis of G/C ratio compared with A,.B and C levels of Child-Pugh classification respectively. Results〓G/C ratio had positive relationship with Child-Pugh classification in evaluating preo-perative liver function(r=0.307, P<0.05). G/C ratio (OR=4.668, P=0.04) preceded Child-Pugh classification (OR=2.909, P=0.126) in predicting incidence of postoperative hepatic insufficiency. Conclusion〓In our present study, G/C ratio had positive correlation with Child-Pugh classification in evaluating liver reserve function preoperatively in HCC patients, but the former was superior to Child-Pugh classification in predicting hepatic insufficiency postoperatively.

The relationship of postoperative IGF-I level with diabetes and hypertensions for growth hormone-secreting adenomas

Li Yanfeng, Mao Zhigang

2014, 14(03):  281-283.  DOI: j.issn.1009-976X.2014.03.015

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【Abstract】 Objective〓To evaluate the relationship of postoperative Insulin-like growth factor I (IGF-I).level with diabetes and hypertensions for growth hormone(GH)-secreting adenoma patients after transsphenoidal microsurgery. Methods〓Seventy-three patients harboring GH-secreting adenomas underwent transsphenoidal microsurgery were investigated retrospectively..Biochemical remission was defined as a normal age- and gender-matched IGF-I level. Among them, 21 cases were diabetes and 15 cases were hypertensions..Results〓Eleven cases got clinical symptomatic relief in diabetes among 15 cases with normal IGF-I level,and one case was clinical symptomatic relief among 6 cases with abnormal IGF-I level(P<0.05)..Six cases were hypertension clinical symptomatic relief among 10 cases with normal IGF-I level,.and one case was hypertension clinical symptomatic relief among 5 cases with abnormal IGF-I level..Conclusion〓Normal postoperative IGF-I level could moderate diabetes and hyperten-sion clinical symptoms for acromegalic patients with GH-secreting adenomas.

Diagnosis and therapy for subcentimeter pulmonary nodules by video-assisted thoracoscopic surgery:a clinical analysis

Jiang Haiming, Huang Weizhao, Wu Yingmeng, Ye Hongyu

2014, 14(03):  284-286.  DOI: j.issn.1009-976X.2014.03.016

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【Abstract】〓Objective〓To summarize the diagnostic and therapic experence of video-assisted thoracoscopic surgery for subcentimeter pulmonary nodules. Methods〓Thirty-eight patients with subcent-imeter pulmonary nodules highly suggested of a malignancy by CT scan were retrospectively analyzed. Perioperative period data about hookwire location and video-assisted thoracoscopic surgery was summarized..Pathological results of the subcentimeter pulmonary nodules was analyzed. Results〓All lesions were successfully identified by the hookwire approach..All the operations were completed with no serious complication,.including wedge resection in 24 cases, segmentectomy in 4 and lobectomy with lymph node dissection in 10..Pathological diagnosis identified 15 invasive carcinomas,.5 pre-invasive carcinomas, 2 metastatic tumors and 16 benign lesions..The pathological coincidence rate between frozen section and paraffin section was 92.1%..Conclusion〓Subcentimeter pulmonary nodules are difficultly diagnosed in preoperative and intranperative period..Video-assisted thoracoscopic surgery is one of the effective and safe techniques for the diagnosis and therapy of subcentimeter pulmonary nodules.

Plasma albumin levels predict mortality in patients with burns

Fan Jianyong

2014, 14(03):  287-290.  DOI: j.issn.1009-976X.2014.03.017

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【Abstract】〓Objective〓To investigate whether the level of serum albumin to predict mortality in burn patients. Methods〓The clinical data in burn patients aged more than 16 years old were analyzed,including abbreviation of burn severity index(ABSI), plasma albumin, globulin, blood fat. The ROC curve was used to evaluate albumin level on mortality prediction...Results〓486 people were included in this study,.and most of them with burn area were less than 30%.(83.1%),.only 16.9% of patients were more than 30%..The most common cause was a flame injury..Work situation,.burn properties, full-thickness burns, inhalation burn, blood albumin in the distribution of live and death in patients were significantly different (P<0.05). There was a significantly difference between survival patients and death patients, in burn area,.hospital ABSI, total cholesterol, triglycerides, globulin, albumin, total protein (P<0.05). The areas under ROC curve for mortality prediction on the levels of albumin, total protein,.white globulin ratio,.globulin,.total cholesterol,.triglyceride predicts mortality of area under the ROC curve respectively were 0.861,0.852,0.836, 0.756, 0.744, 0.372. Conclusion〓On admission,.albumin levels in patients with burns can be as a sensitive and specific marker to predict mortality.

Clinical experience of using Mammotome system in treatment of breast tumors

Xu Tai, Li Shunrong, Lai Yeqian, Huang Jiewen, Qiu Dongqing, Fan Yuanlin, Li Lu

2014, 14(03):  291-293.  DOI: j.issn.1009-976X.2014.03.018

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【Abstract】〓Objective〓To summarize experience in clinical practice of breast tunors by using ultrasound-guided Mammotome system. Methods〓600 patients with breast lesions underwent the tumor resection by Mammotome biopsy system (Johnson & Johnson US) and Siemens Ultrasound X150 from April 2012 to August 2013. The patients were followed up in one month, three months and six months after operation. Results〓Of the 600 cases, benign fibroadenoma was in 508 cases, benign fibrocystic breast disease in 22,.adenosis of breast in 51,.intraductal papilloma in 6,.milk product in 5, invasive breast carcinoma in 8..In the breast carcinoma patients,.6 cases underwent modified radical mastectomy, 2 received breast conserving treatment..In postoperative complications,.active bleeding occurred in 2 cases and underwent second operation,.hematoma formation was found in 5 cases and treated by aspiration, large subcutaneous congestion was found in 9 cases and recovered by conservative treatment except incision and drainage..A total of 510 patients were followed up,.in which 5 were found new tumor,.1 relapsed..None of the breast cancer patients were found recurrence and metastasis. Conclusion〓Mammotome atherectomy is safe and feasible for the benign breast tumor, and it can provide enough pathological specimens for the diagnosis and further treatment of the malignant tumor.

Curative effect of double working sheath in the applications of percutaneous nephrolithotomy

Li Jian, Zheng Minli, Huang Yuqing, Feng Lingsong, Zou Huosheng, Huang Minzhi

2014, 14(03):  294-296.  DOI: j.issn.1009-976X.2014.03.019

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【Abstract】〓Objective〓To evaluate the efficacy and safety of double working sheath in the appli-cations of percutaneous nephrolithotomy(PCNL). Methods〓From January 2008 to November 2013, 1260 patients with kidney or ureteral calculi were treated by PCNL..All cases were carried out F20 channel. During the operations, an F16 or F18 working sheath were put in the F20 working sheath as an inner sheath on the concrete circumstances as needed..The stones were fragmented and removed through an 12F rigid nephroscope or 9.8 F rigid ureteroscope..Results〓All cases were successfully to carry out F20 channel..No one died of operation..Among them,.1192 operations were successful in first stage. Sixty-eight cases performed second stage operations. The average operation time was 53±8 min (12 to 120 min) in the first stage. The average operation time was 18±5 min (15 to 42 min) in the second stage. The total stone-free rate was 94.84% (1195/1260). 75 cases had middle to high fever temperature post-operation..Four patients had to undergo renal vascular interventional therapy for severe bleeding after PCNL..No serious complications such as pneumothorax and intestinal injury. Conclusion〓Double working sheath in the applications of PCNL is helpful to improve stone-free rate, shorten the operation time and reduce the surgical complications. This method is safe, effective and worthy of clinical promotion

Comparative study of the clinical effects on the mini-incision and traditional total hip arthro-plasty

Fu Chaohua, Chen Zhongxian, Liang Shengen, Fan Quan, Xue Zhonglin, Xie Qinghua

2014, 14(03):  297-297.  DOI: j.issn.1009-976X.2014.03.020

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【Abstract】〓Objective〓To compare the mini-incision and traditional posterolateral surgical appr-oach for total hip arthroplasty and investigate the characteristic of the mini-incision short clinical efficacy. Methods〓Eighty cases were divided into two groups, in which 40 cases (MIS-THA group) underwent a mini-incision,.and 40 cases (THA group) received THA with standard posterolateral incision. The length of incision,.blood loss, operation time, anteversion angle of acetabulum cup, abduction angle of acetabulum cup,.Harris score and complications were observed and compared between two groups..Results〓All patients were followed with an average of 12 months (range from 6 to 24). Average length of incision for MIS-THA group was 8.5 cm (6.8-10.3 cm) and 18.2 cm (15.6-23.8 cm) for THA group. Hemorrhage amount and postoperative drainage blood loss in MIS-THA group and THA group were 163.8±15.6 ml, 325.4±20.3 ml and 283.5±13.5 ml, 410.4±27.6 ml respectively (comparison between two group, P<0.05)..Operative time for MIS-THA group was 89.4±14.2 min and 123.5±10.3 min for THA group(P<0.05)..According to the postoperative x-ray,.the abduction angle of acetabulum cup for MIS-THA group was 43.8±8.5° and 46.5±6.7° for THA group. The anteversion angle of cup was 22.8±3.5° for MIS group and 23.5±2.9°for THA group(P<0.05)..Regarding Harris hip score postoperation,.there were significant differences between two group at the first and the third month of fellow-up.(P<0.05),.but no significant differences at the sixth and twelfth month of fellow-up..No infection, fracture dislocation and neurovascular injury occurred in both groups. Conclusion〓Mini-incision THA approach reduces intraoperative blood loss,.postoperative drainage and operative time and this approach whould be beneficial to postoperative training rehabilitation.

Comparison of the effects of dexmedetomidine and midazolam on memory in patients with anxiety

Han Zhixiao, Fu Yanni, He Bo, Zhang Kun, Li Yujuan

2014, 14(03):  301-304.  DOI: j.issn.1009-976X.2014.03.021

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【Abstract】〓Objective〓To compare the effects of dexmedetomidine and midazolam on memory in patients with anxiety. Methods〓Sixty patients with Anxiety Visual Analog Test (AVAT)>30 mm, ASA Ⅰor Ⅱ,who were scheduled for hypogastrium and lower limbs surgery under combined spinal-eunder anesthesia were randomly divided into four groups(n=15,each group): dexmedetomidine (DXM) 0.5 µg·Kg^-1 group (group D_0.5), DXM 1 µg·Kg^-1 group (group D₁), midazolam group (group M) and saline group(group C). After spinal anesthesia in L2/3, patients were infused intravenously with dexmedetomidine at 0.5 µg·Kg^-1 in Group D_0.5,1 µg·Kg^-1 in group D₁, midazolam at 0.07 mg·Kg^-1 in group M and saline 10 ml in group C over 10 minutes..AVAT, Rasmay score and memory function were evaluated at preoperation,.before and thirty minutes after drug infusion. Memory function were evaluated again 4 hours after operation. Mean blood pressure (MBP), heart rates (HR), SpO₂,.respiratory rates (RR)of patients during operation were recorded..Results〓Patients in groups of D_0.5,.D₁ and M had significant sedation and decrease in anxiety after drug infusion when compared to preoperation(P<0.05 for all groups),and also had anterograde amnesia effect compared to group C (P<0.05 for all groups). The degree of anterograde amnesia in group D₁ was significantly higher in group D₁ than that in group D_0.5 (P<0.05), but was the same to that in group M(P>0.05)..MBP,.HR in groups of D_0.5 and D₁ were lower than those in group M and group C..The respiratory rates had no significant difference among all groups. However,.two patients in group M had a decrease in SpO₂ below 94%. Conclusion〓Dexmdetomidine has significant effects on antianxiety and sedation, and has an anterograde amnesia in patients with anxiety. The degree of anterograde amnesia at dexmedetomidine 1 µg·Kg^-1 has the same effect as 0.07 mg·Kg^-1 of midazolam.

Study on the repair of severe radiation-induced ulceration

Tan Junqiang, Wu Zhongqiang, Xie Guangfu

2014, 14(03):  305-308.  DOI: j.issn.1009-976X.2014.03.022

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【Abstract】〓Objective〓To investigate the method to repair severe radiation-induced ulceration and evaluate its clinical effects. Methods〓Twenty-two cases with severe radiation-induced ulceration treated by flaps or musculocutaneous flaps transfer in our hospital from Jan 2010 to Jan 2012 were respectively analyzed. Of 22 case, 4 cases were treated by latissimus dorsa flaps, 3 cases by lateral abdominal flap, 3 cases by paraumbilical flap, 4 cases by anterolateral femoral flaps ,6 cases by pectoralis majorflap, 2 cases by gluteus maximus muscle flap. Results〓20 cases flaps survived with primary healing, 2 cases flap with partial distal necrosis. The colour and texture of the flaps were excellent,and the outline and functional results were satisfactory after 1 to 2 years follow-up..There was no ulcer recurrence. Conclusion〓The efficacy of cervical radiation induced ulceration by flaps and musculocutaneous flaps was proved. The reconstruction could prevent the recurrence of ulcer.

Study of the adverse drug reactions of iodinated contrast agent in different temperatures after CT angiography

Hu Huijun, Chen Jiaoxia, Deng Hong, Zhang Xiang, Shen Jun

2014, 14(03):  308-310.  DOI: j.issn.1009-976X.2014.03.023

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【Abstract】〓Objective〓To investigate the relationship between iodinated contrast agent in different temperatures with incidence of adverse drug reactions (ADR) after CT angiography. Methods 3200 testers who examined with multi detector CT angiography were randomly divided into two groups, normal temperature group(n=1520) and heating group(n=1680), which performed CT angiography with contrast agent of home temperature and heated to 37 in the constant temperature box..The incidence of exosmose and anaphylactoid reaction after contrast agent injection were detected. Results〓The incidence of exosmose and anaphylactoid reaction in heating group was lower than that of normal temperature group after iopromide intravenous injection..Conclusion〓It is worthy of being widely popularized in clinical application with heating of iodinated contrast agent which may reduce the incidence of ADR.

Clinical observation of intraoperative whole colon lavage and one-stage resection and anastomosis for obstructing colorectal cancer patients

Deng Donghai, Li Yunfu

2014, 14(03):  311-314.  DOI: j.issn.1009-976X.2014.03.024

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【Abstract】〓Objective〓To investigate the clinical effects of intraoperative whole colon lavage combined with one-stage radical surgery in patients with carcinomatous ileus. Methods〓A total of 60 cases of colorectal cancer complicated with carcinomatous ileus were included in the study from Aug 2001 to Aug 2013 and these patients underwent radical operation. The patients were divided into three groups according to the preoperative management,.intraoperative colonic lavage group (emergency radical operation and intraoperative whole colon lavage),.conventional management group (radical operation after conservative treatment and relieving obstruction) and staging operation group (one-stage intestinal fistulation and two-stage to intestinal anastomosis)..The clinical efficacy was compared between three groups. Results〓The operation time of intraoperative colonic lavage group was longer than that of other two groups (P<0.05), but no differences were observed in the incidence of complications between three groups..There were also not differences in blood loss,.gastric tube indwelling time, duration of fasting postoperation,.total duration of hospitalization in three groups..Conclusion〓For obstructing colorectal cancer patients,.one-stage resection and anastomosis by intraoperative whole colon lavage is feasible,.but it need patients in good general condition and correct judgment by the experienced, skilled surgeon.

Microsurgical treatment of 27 cases with cerebral arteriovenous malformations

2014, 14(03):  314-316.  DOI: j.issn.1009-976X.2014.03.025

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【Abstract】〓Objective〓To investigate the clinical effects on cerebral arteriovenous malformation microsurgery by microsurgery. Methods〓Twenty-seven patients with arteriovenous malformation were included in the study from Oct 2006 to Oct 2012. All patients were performed with microsurgery and the surgical effect was analyzed retrospectively. Results〓Of 27 patients, 13 cases were cured, 12 cases were improved, 2 cases became disabled. Conclusion〓For patients with cerebral arteriovenous malformation, preoperative vascular morphology, area, location of the lesion and hemodynamics should be fully evaluated in order to obtain satisfactory treatment.

Clinical experience for prolapse and hemorrhoids in treatment of hemorrhoids in anticoagulated patients

Hou Hui, Yu Zhitao, Huang Yuehui

2014, 14(03):  317-320.  DOI: j.issn.1009-976X.2014.03.026

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【Abstract】〓Objective〓To evaluate the efficacy and safety of surgical procedure for prolapse and hemorrhoids (PPH) in patients treating with anticoagulant (anticoagulated group). Methods〓From Jan 2009 to Dec 2011,36 patients with cardiovascular diseases treated with anticoagulant and 49 patients without anticoagulated therapy (control group) were included in this study. All patients underwent procedure for prolapse and hemorrhoids. A comparison was done between the two groups in terms of the following items: operation time, intraoperative and postoperative blood loss and the incidence of cardiovascular and cerebrovascular diseases,postoperative cure rate of prolapse and bleeding, significant postoperative anal pain,incontinence,anal stenosis,and hospital stay. Results〓All patients were cured. The differences between the anticoagulated group and control group were significant in terms of and postoperative blood loss(P<0.05),and no significant differences were noted in other items. Postoperative hemorrhage with a volume of 200ml to 500 ml happened in one case in anticoagulated group and 2 cases in control group, and were cured by conservative treatment. No case needed blood transfusion. Conclusion〓It is safe and effective for patients with cardiovascular diseases treated with anticoagulant.

The causes and therapeutical strategies of postoperative bleeding following procedure for prolapse and hemorrhoids

Chen Zhenfeng.

2014, 14(03):  320-322.  DOI: j.issn.1009-976X.2014.03.027

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【Abstract】〓Objective〓To investigate the causes and therapeutical strategies for postoperative ble-eding following procedure for prolapse and hemorrhoida(PPH). Method〓The clinical data from 15 patients with postoperative bleeding following PPH were retrospectively analyzed. The cause of postoperative bleeding was also analyzed. Results〓Of 15 cases with postoperative bleeding, bleeding happened within 12 hours after PPH in 9 cases and between 5 to 10 days in 6 cases. All patients with postoperative bleeding were cured by local compression, astringent and re-surgery. The postoperative bleeding was associated with surgical skills, coagulation function, constipation and strenuous exercise. Conclusion〓There are several causes for postoperative bleeding following PPH. The postoperative bleeding following PPH could be well treated according to its specific causes.

Clinical experience of primary hospital laparoscopic total extraperitoneal herniorrhaphy for inguinal hernia

Zhong Wenyi

2014, 14(03):  323-325.  DOI: j.issn.1009-976X.2014.03.028

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【Abstract】〓Objective〓To summarize experience of laparoscopic total extraperitoneal hernioplasty in 68 patients with inguinal hernia. Method〓The clinical data of 68 cases with inguinal hernia from Jan 2010 to May 2012 were analyzed retrospectively...All patients underwent laparoscopic total extraperitoneal herniorrhaphy (TEP) and the clinical efficacy was recorded. Results〓All patients were cured by TEP approach..Intraoperative complications happened in 7 cases, including bleeding in 2 cases, peritoneum perforated in 2 cases,.subcutaneous emphysema in 3 cases..No pain and infection occurred after operation..Inguinal hernia recurrence was in one case in 2 years after operation and the patient was cured by reoperation. Conclusion〓TEP procedure can be performed in basic hospital. For most farmer patients, the patch had better to be properly fixed during operation.

Clinical experience on treatment of traumatic cerebral infarction (Report of 51 cases)

Feng Yuxiu, Chen Zhiguo, Cai Wangqing

2014, 14(03):  325-328.  DOI: j.issn.1009-976X.2014.03.029

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【Abstract】〓Objective〓To investigate the clinical character and the prevention and treatment of traumatic cerebral infarction(TCI). Methods〓A retrospective analysis was conducted on the clinical data of 51 patients with traumatic cerebral infraction,.including diagnosis,.therapeutic method and outcome. Results〓Of 51 cases, 34 underwent surgical management, including clearance of hematoma by craniotomy with bone flap, brain contusion and laceration management and decompressive craniectomy. Seven cases were undertaken second operation..Twenty-two patients gained good recovery,.7 cases died..Nine were in moderate disability,.7 were in severe disability,.6 were in persistent vegetative state,.according GOS classification in two-year of follow-up. Conclusion〓The clinicians should pay attention to the prevention and therapy of traumatic cerebral infarction. Early prevention and treatment are essential for reducing mortality and morbidity of patients with traumatic cerebral infarction.

Laparoscopic transabdominal preperitoneal hernia repair with non stapling

Li Xiang, Liu Xueyi, Shi Zhenchao

2014, 14(03):  329-330.  DOI: j.issn.1009-976X.2014.03.030

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【Abstract】〓Objective〓To evaluate the efficacy of laparoscopic transabdominal preperitoneal (TAPP)hernia repair with non stapling mesh. Methods〓104 patients with inguinal hernia were included in the study from Oct 2009 to Feb 2014, and the clinical data were analyzed retrospectively. The brief surgical procedure was as follow. After setting the pneumoperitoneum, cut the peritoneum,then, place polypropylene mesh and fixed with non-stapling via preperitoneal operation. Results〓All operations were completed successfully, and no bleed occurred during and after surgery and no recurrence was found in one to 20 months of follow-up. Conclusion〓TAPP with non-tapling mesh is safe and feasible, and this operation reduces hospital cost and avoids the pain due to stapling.

Diagnosis and treatment for multiple intracranial aneurysms presenting with subarachnoid hemorrhage

Ma Lin, Zhang Xiangmao

2014, 14(03):  331-334.  DOI: j.issn.1009-976X.2014.03.031

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【Abstract】〓With the wider availability and continuous advances of imaging techniques, the increasing numbers of multiple intracranial aneurysms are detected in patients with aneurysmal subarachnoid hemorrhage. Studies have shown that unruptured aneurysms in patients with previous subara-chnoid hemorrhage have higher rupture risk than those without previous subarachnoid hemorrhage. For patients with multiple intracranial aneurysms presenting with subarachnoid hemorrhage, in addition to the ruptured aneurysms are identified and dealt with first, the unruptured aneurysms should be detected and treated aggressively. Therefore, the diagnosis and treatment of multiple intracranial aneurysms are more difficult than those of single ones.

Recent advances in treatment of breast cancer

2014, 14(03):  335-338.  DOI: j.issn.1009-976X.2014.03.032

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【Abstract】〓Breast cancer is a common malignancy. With the development of medical technology and early diagnosis, the treatment of breast cancer developed into breast-conserving surgery from radical mastectomy (including mastectomy). Therefore, the current treatment of breast cancer is based on surgery, including chemotherapy, hormonal therapy, radiation therapy, targeted therapy and immunotherapy. The article will review the new progress in treatment of breast cancer.

Management for radiation-induced sarcoma

Hu Tingting, Su Fengxi

2014, 14(03):  339-341.  DOI: j.issn.1009-976X.2014.03.033

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【Abstract】〓Radiation induced sarcoma (RIS) is a rare and highly malignant tumor, which mostly occurs in following radiation of breast cancer, gynecological cancer, Hodgkin's lymphoma and other types of tumor. Breast cancer radiation induced sarcoma accounted for the larger proportion. At present, the treatment for RIS is still a big challenge in the clinical settings. Whether it was operation therapy or adjuvant chemotherapy, the 5 years survival rate was low and local recurrencerate was high. To improve the prognosis of the patients and offer the clinicians more effective therapeutic regimen, we reviewed the current progresses in the treatment of radiation induced sarcoma.

A contrast study about using compound lidocaine cream combined with psychological intervention in the urethral catheterization of male patients

Zheng Xiaojing, Liang Ming, Qiu Yihong, Huang Minyi, Lin Daowei

2014, 14(03):  342-344.  DOI: j.issn.1009-976X.2014.03.034

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【Abstract】〓Objective〓To investigate the effect of compound lidocaine cream combined with psychological intervention in the urethral catherixation of male patients. Methods〓A total of 120 patients were included in the study and randomized into four groups, group one: control group, group two: using compound lidocaine cream without psychological intervention, group three: psychological intervention without using compound lidocaine cream, group four: using compound lidocaine cream combined with psychological intervention. The dysphoria degree and the pain degree of patients were evaluated by RS and VAS. Results〓The rate of dysphoria in Group four was lower than those in other three groups significantly (P<0.05). There was no significant difference in VAS degree among four groups. Conclusion〓Compound lidocaine cream combined with psychological intervention in the urethral catheterization of male patients is an effect method to alleviate the dysphoria of patients.

Effect of body positioning on intra-abdominal pressure and abdominal perfusion pressure in critically ill patients

Wang Haiqin, Ma Jie

2014, 14(03):  345-348.  DOI: j.issn.1009-976X.2014.03.035

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Purpose: To observe the effects of body positioning on intra—abdominal hypertension（IAP） and abdominal perfusion pressure（APP）in critically ill patients. Methods: We investigated 78 patients admitted to ICU and measured their IAP from January 2013 to December 2013. IAP was measured with the patient head of bed (HOB) increases from 0°15°,30°to 45°via the bladder. APP were also calculated simultaneously. Results: In the patients of high IAP,Compared with IAP at supine position (bed of head=0°, 16.31 ±3.38 mmHg)， it showed significant difference at 30° (21.46±3.91 mmHg，P=0.001) and 45° (25.69±4.09 mmHg，P<0.001).And APP had significantly decreased at 45°（51.92±10.05mmHg，P=0.03）when compared with that at supine position (60.54 ±9.86 mmHg). In the patients of nomal IAP,Compared with IAP at supine position (bed of head=0°, 7.23±2.14mmHg)， it showed significant difference at 30° (11.17±3.24mmHg，P =0.002) and 45° (15.59±4.13 mmHg，P =0.001).And APP had significantly decreased at 45°（60.78±9.13mmHg，P=0.004） when compared with that at supine position (71.28 ±8.86 mmHg). Conclusion : Body positioning had effects on IAP and APP, IAP significantly increased and APP decreased when the patient's HOB was elevated. The potential contribution of body position in elevating IAP should be considered in critically ill patients.