Table of Content

20 August 2014, Volume 14 Issue 04

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论文

Diagnostic value of non-hepatocellular carcinoma focal Liver lesions by contrast-enhanced ultrasound

Yan Yanqiong, Xie Xiaoyan, Zheng Rongqin, Li Anhua, Luo Baoming

2014, 14(04):  353-357.  DOI: 10.3969/j.issn.1009-976X.2014.04.001

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【Abstract】〓Objective〓To explore the value of contrast-enhanced ultrasound (CEUS) in diagnosis of non-hepatocellular carcinoma(HCC).focal liver lesion.(FLL)..Methods〓CEUS characterizations of 1753 cases with non-HCC FLL were retrospectively analyzed. All cases were compared to the gold standard and collected from four hospitals..The diagnostic value of CEUS differentiating non-HCC FLL was evaluated between benign and malignant tumor, and different type of lesion were evaluated. Results〓In 1753 non-HCC FLL,.1318 cases were benign lesions,.of which 92.94% (1225/1318) benign lesions were diagnosed correctly by CEUS; 435 cases were malignant lesions,of which 88.74%(386/435).malignant lesions were diagnosed correctly by CEUS..The sensitivity, specificity, accuracy rate, positive predictive value and negative predictive value of CEUS were 88.74% (386/435),.92.94% (1225/1318), 91.90% (1611/1753), 80.58% (386/479), 96.15% (1225/1274), respectively..The CEUS diagnosis was correct in 97.41% of hemangiomas (640/657), in 96.43% focal fatty sparings and deposits (216/224), in 84.81% of metastatic liver cancer (268/316), 85.55% of focal nodular hyperplasia (225/263), 58.82% of inflammatory lesions (40/68),.57.14% of regenerative nodule (28/49) and 12.50% of dysplastic nodule (2/16). Conclusion〓CEUS is more reliable in differentiating between benign and malignant non-HCC FLL, but qualitative diagnosis accuracy of lesions type needs to be improved.

Decreased expression of myosin light chain (MYL9) in stroma predicts malignant progression and adverse clinical outcomes in patients with prostate cancer

Xu Wenfeng,Yu Dingyu,Zhang Youqiang,Chen Yanru,Huang Yaqiang,Chen Jiahong,

2014, 14(04):  358-361.  DOI: 10.3969/j.issn.1009-976X.2014.04.002

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【Abstract】〓Objective〓To investigate the association of MYL9 expression with tumor progression and prognosis in patients with prostate cancer (PCa). Methods〓MYL9 protein expressions in human PCa and non-cancerous prostate tissues were detected by immunohistochemistry analyses. Then,the associations of MYL9 expression with clinicopathological features and clinical outcome of PCa patients were statistically analyzed. Results〓Immunohistochemistry analyses showed that MYL9 expression significantly decreased in PCa tissues as compared with those in non-cancerous prostate tissues. In addition, MYL9 was mainly expressed in the cytoplasm of stromal cells of prostate tissues, and the decreased expression of MYL9 in PCa tissues was significantly correlated with the higher Gleason score. Conclusion〓Our data strongly confirmed for the first time that the decreased expression of MYL9 may play an important role in tumor progression of PCa.

Experiment study on gemcitabin echrono-chemotherapy to nude mice bearing the tumor

Wang Yingyan, Chang Ruiming, Chang Jianxing

2014, 14(04):  362-365.  DOI: 10.3969/j.issn.1009-976X.2014.04.003

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【Abstract】〓Objective〓To construct the model of nude mice bearing lung cancer A549 cell line. The curative effect and side effect were observed after gemcitabinechrono-chemotherapy, and the best time to administer drug was screened out. Methods〓A549 cells (2×10⁷/mL) in exponential phase of growth were vaccinated in the nude mice by subcutaneous injection. Gemcitabine(50 mg/kg) was administrated by intraperitoneal injection at 2 am,8 am,14 pm in experimental groups and equal sodium chloride in control group when the tumor growing to reach 1 cm×1 cm×1 cm approximately. The growth and weight curves were drawn by measuring data and blood and tissue specimen were hurvested. Results〓Gemcitabine had therapeutic effect on nude mice bearing tumor, in which the lesion of lung, liver and renal in the therapeutic groups was alleviated as compared with that in control group, and hepatorenal function was ameliorated in the administrated group. But there were differences among those groups on the therapeutic efficacy, the 2 am group showed the best effect while the 8 am group had the worst effect(P<0.05, 8 am, 14 pm, 20 pm group vs. hepatoma model group; P<0.01, 2 am group vs. hepatomamodel group; P<0.05, 2 am group vs. 8 am group). Conclusion〓Gemcitabine has therapeutic effect on nude mice bearing tumor, which can retain the growth of tumor, may alleviate the lesion of lung, liver and renal, ameliorate hepatorenal function caused by tumor as well. There were different curative effects in accordance with different administration time. There was the best therapeutic effect in the 2 am group while there was the worst effect in 8 am group.

Experience of laparoscopic radiofrequency ablation on the treatment of liver cancer

Li Liuzheng, Peng Lianfang, Xiang Chunming, Xu Leisheng, Wang Zhiping, Xi Yuanji

2014, 14(04):  366-368.  DOI: 10.3969/j.issn.1009-976X.2014.04.004

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【Abstract】〓Objective〓To summarize up the clinical experience on treatment of liver cancer through laparoscopic radiofrequency ablation(LRFA). Methods〓A total of 26 cases were included in the study from October 2010 to March 2014. Of all patients with Child?鄄Pugh class A to B, the tumors were located in the liver Ⅲ,Ⅳ,Ⅴ,Ⅷ segments or diaphragm and adjacent gallbladder gastric cavity viscera,and had the size of 2.2 to11.0 cm in diameter with single lesion in 18 cases, multifocal lesion in 8 cases (a total of 39 lesions). Results〓The LRFA operation was successfully completed in all cases without transferring operation. Operation time was 12 to 112 min, the average of 48 min. The operative complications included ascites in 2 cases, pleural effusion in 1 case. No postoperative bleeding, liver function failure, bile duct injury happened. The ultrasound and CT scan findings showed tumor necrosis in 17 cases, partial liquefaction in four cases and portal venous tumor emboli. Conclusion LRFA has the advantages of easy operation and less complications, and is a selective surgery approach for liver cancer, especially for specific parts of the liver cancer.

Hospital-based mortality in Guangzhou hospitals-China,2003-2011

2014, 14(04):  369-371.  DOI: 10.3969/j.issn.1009-976X.2014.04.005

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【Abstract】〓Objective〓The aim of this study is to provide a comprehensive report on the various causesof death in our hospital from 2003 to 2011..Methods〓This was a descriptive,retrospective study of 4068 deaths recorded inhospital..The world health organization.(WHO).ICD-10 disease classif-ication principles was used to classify all deaths,.and SPSS18.0 software was used to clean data, statistical description and analysis..Results〓A total number of 4068 deaths were recorded during the study period and the ratio of male to female was 1.67∶1..The death proportion was decreased in age 50- and 60-years,.and increased in age 40s..Neoplasia,cardiovascular and circulatorydiseases were the most common causes of death, and respiratory diseases was the third main cause of death. Death from infectious and parasitic diseases reduced from 25(6.1%) to 10(2.2%). Conclusion〓Our study shows that death from neoplasia,cardiovascular and circulatory,respiratory diseases are the main cause. It’s important to　prevent and treat these diseases..At the same time,.we need to focus on the health of age 40s male population to reduce their death.

The application of sigmoid vaginoplasty procedure in patients with congenital atresia of vagina

2014, 14(04):  372-374.  DOI: 10.3969/j.issn.1009-976X.2014.04.006

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【Abstract】〓Objective〓To explore the key points and safety of vaginoplasty by using sigmoid colon graft for congenital absence of vagina in open and laparoscopy-assisted procedure. Methods〓The methods and results of sigmoid vaginoplasty procedure in 28 patients were retrospectively analyzed and laparoscopy-assisted sigmoid vaginoplasty procedure was preliminarily studied. Results〓The surgical procedures of all 28 patients were successful with acceptable complications. Conclusion〓The procedure of sigmoid vaginoplasty is safe and effective for congenital atresia of vagina,.and the procedure of laparoscopy-assisted sigmoid vaginoplasty should become the trend of this procedure in future.

Bypass of the maxillary to proximal middle cerebral artery: an anatomical and technical study

2014, 14(04):  375-378.  DOI: 10.3969/j.issn.1009-976X.2014.04.007

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【Abstract】〓Objective〓To investigate the feasibility of bypass between the maxillary artery.(MA) and proximity of the second segment of middle cerebral artery (MCA). Methods〓The superficial temporal artery and its branches,.MA and deep temporal artery,.the bifurcation of MCA,.the bifurcation of common carotid artery,.the beginning of external and internal carotid artery were dissected in ten perfused adult cadaver heads(20 sides),.and the outer diameters were measured respectively..The lengths of grafts vessels between the external carotid artery,.internal carotid artery,.MA and proximal MCA were measured respectively..Ten healthy adults(20 sides) were also included in the study..The inner diameter and blood flow dynamic parameters of the MA,.common carotid artery,.external carotid artery,internal carotid artery,.superficial temporal artery and its two branches were measured with ultrasound examination. Results〓The outer diameter of MA was (2.60±0.20) mm,.which was larger than that of the temporal artery trunk(1.70±0.30) mm. The lengths of grafts vessels between the external carotid artery,.internal carotid artery and MCA bifurcate department were (162.40±2.60) mm and (171.00±2.70) mm,.respectively,.which were longer than that between MA and MCA bifurcate department (61.70±1.50) mm. The blood flow of the second segment of MA was (62.70±13.30) ml/min,.which was more than that of the two branches of the superficial temporal artery (15.90±3.70) and (17.70±4.10) ml/min,.respectively. Conclusion〓Bypass between the maxillary artery and proximity of the second segment of middle cerebral artery is feasible..It is a kind of effective high flow bypass,.with which the graft vessel is shorter and straighter.

Preoperative MRI diagnosis of anal fistula and compares with surgical results

Yu Taihui, Yang Qihua, Lv Zejian, Chen xiaodong, Cheng Ziliang, Mao Jiaji, Liang

2014, 14(04):  379-382.  DOI: 10.3969/j.issn.1009-976X.2014.04.008

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【Abstract】〓Objective〓To explore the application value of the preoperative magnetic resonance imaging (MRI) in diagnosis of anal fistula location and type. Methods〓Fifty cases of anal fistula were examined by MRI. According to MR findings,.the position of fistula and the relationship with the sinus and external anal sphincter were analyzed..Then the MR findings were contrasted with surgical results. Results〓The imaging of MRI all accorded with the clinical diagnosis,.including 30 cases of simple anal fistula,.20 cases of complex anal fistulas..Among 50 cases,.intersphincteric fistulas were 20 cases,.trans-sphincteric fistulas 12 cases,.suprasphincteric fistulas 6 cases,.extrasphincteric fistulas 3 cases,.and superficial fistulas 9 cases..A total of 72 primary fistulas,.78 interned openings,.77 extended openings, and 17 perianal abscesses were found. The sensitivity of MRI diagnosis for primary fistula,.interned opening and perianal abscess were respectively 93.1%, 96.2%, 100% and specificity were 91.5%,.97.5%,.91.3%. Conclusion〓MRI can accurately determine the type of anal fistula, fistula number,.course,.branch,.the location of interned opening and the presence of the abscess formation, providing important guidance for clinical surgery.

The clinical value of high-frequency color ultrasound in diagnosis for infant vomiting

2014, 14(04):  383-387.  DOI: 10.3969/j.issn.1009-976X.2014.04.009

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【Abstract】〓Objective〓To investigate the diagnostic values of high-frequency color ultrasound on baby vomiting. Methods〓Ninety-four cases of baby patients with vomiting diagnosed by gastrointestinal ultrasound were analyzed retrospectively. Results〓Forty-four cases were surgical diseases, confirmed by patholog pathological examination, in which 30 cases were congenital hypertrophic pyloric stenosis, 11 cases were duodenal ileus(five cases of duodenal atresia, three of stenosis, three of congenital intestinal malrotation), and three cases were pyloric atresia. Forty-one cases were diagnosed by preoperative ultrasound, the diagnostic rate was 93.18%. The remaining 50 cases were associated with internal medical diseases, of which 40 cases were gastroesophageal reflux, 10 cases of pyloric spasm. Internal medical diseases were confirmed by ultrasound and radiography of upper digestive tract. The ultrasound diagnostic rate was 98%. Conclusion〓Ultrasonography is non-invasive, safe, simple, reproducible, and it can be used as a routine screening tool for infant vomiting.

Comparative study between endoscopic neck dissection and traditional neck dissection in treatment of cN0 papillary thyroid carcinoma

Hong Yun, Huang Xiaoming, Feng Jianlun, Cao Hailing, Cao Yuyana, Li Songming

2014, 14(04):  387-390.  DOI: 10.3969/j.issn.1009-976X.2014.04.010

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【Abstract】〓Objective〓To investigate the feasibility of gasless endoscope-assisted neck dissection via the anterior chest wall and the ear-behind neck incision (the improved dual parallel incision) in cN0 papillary thyroid carcinoma (PCT). Methods〓Forth-five patients with cN0 PCT underwent endoscopic neck dissection, including 11 patients with pathological lymph node metastasis at level VI (endoscopic group). Meanwhile, another 11 patients with cN0 PCT underwent traditional neck dissection (traditional group). Operation time, estimated intraoperative blood loss, lymph node number at level II~IV and their metastasis number,.complications were compared between the two groups. Results〓Operation time was no difference (t=1.227, P=0.233) between endoscopic group (218.16±31.54 min) and traditional group (202.35±28.81 min). There was no difference (t=1.922, P=0.068) in intraoperative blood loss between endoscopic group (52.42±13.25 mL) and traditional group (64.27±15.57 mL). Lymph node number at level II-IV and their metastasis number were also no difference.(t=0.390,P=0.700 and t=1.913, P=0.070) in endoscopic group (15.37±4.61 and 2.82±0.34) and traditional group (16.19±5.23 and 3.15±0.46). There were one case of transient hoarseness in endoscopic group and one of lymphorrhagia in traditional group, and one of transient hypocalcemia in both groups. No difference was observed in complication occurrence between two groups..(χ2 =2.000, P=0.367). Conculsion Endoscopic neck dissection in cN0 papillary thyroid carcinoma is safe and feasible.

Diagnosis values of multi-slice CT in gastrointestinal tract perforation

2014, 14(04):  391-394.  DOI: 10.3969/j.issn.1009-976X.2014.04.011

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【Abstract】〓Objective〓To evaluate the diagnostic value of multi-slice spiral CT (MSCT) in gastrointestinal tract perforation..Methods〓MSCT findings of 25 patients with surgically and patholo-gically proved gastrointestinal tract perforation were reviewed retrospectively..Multiplanar reformation was performed in all patients..The imaging signs,.diagnosis and localization capability of MSCT were analyzed..Results〓Among the 25 patients,.perforation of stomach/duodenum were found in 18 patients,.jejunoileum in 2 patients,.colon in 3 patients,.appendix in 2 patients..The presence of perforation was correctly diagnosed in 100% (25/25) of the patients on MSCT,.and perforation location was correctly diagnosed in 96% (24/25) of the patients before surgery..CT direct sign of perforation was discontinuity of gastrointestinal wall.in 12 patients (48%)..Indirect signs of perforation included intraperitoneal free air in 23 patients(92%), inflammation change around the perforated site in 25 patients(100%), ascites in 12 patients (48%), thickening of the gastrointestinal wall in 13 patients (52%), lesser sac effusion in 3 patients (12%), appendix abscess in 2 patients (8%), diffuse peritonitis in 2 patients (8%). Conclusion〓MSCT is of high value for correct diagnosis of gastrointestinal perforation and detecting the perforation location, and helpful for surgical treatment.

Expression and significance of CD4⁺CD29⁺T cells for patients with gastric carcinoma

Wu Anren, Liang Zhongzeng

2014, 14(04):  394-397.  DOI: 10.3969/j.issn.1009-976X.2014.04.012

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【Abstract】〓Objective〓To explore the expression and significance of CD4⁺CD29⁺T cells for patients with gastric carcinoma. Methods〓Sixty-four patients with gastric cancer, including Ⅰ-Ⅳ stage, were enrolled, as well 60 chronic gastritis patients and healthy subjects. The peripheral blood CD4⁺CD29⁺T cells and cytokines γ-interferon (IFN-γ) and interleukin 4 (IL-4) were tested using flow cytometry. The levels of intercellular adhesion molecule 1 (ICAM-1), transforming growth factor beta 1 (TGF-beta 1) and carcinoembryonic antigen (CEA) were also tested. The correlation between the above-mentioned 6 indexes was analyzed via Pearson test. Results〓The percentage of CD4⁺CD29⁺T cells and mean fluorescence intensity of IL-4 of the gastric cancer patients were higher than those in the chronic gastritis and healthy subjects (P<0.05); whereas the mean fluorescence intensity of IFN-γ were lower than the other two groups for the gastric cancer patients. CD4⁺CD29⁺T cells and IL-4 increased and but IFN-γ decreased for the Ⅰto Ⅳ stage gastric cancer patients, and the levels of ICAM-1,.TGF-β1and CEA also increased when compared with the other two groups (P<0.05). Pearson analysis showed that CD4⁺CD29⁺T cells and IL-4 positively correlate with CAM-1, TGF-β1 and CEA; but IFN-γ negatively correlate with CAM-1, TGF-β1 and CEA (P<0.05). Conclusion〓Increase of CD4⁺CD29⁺T cells and IL-4,.as well the decrease of IFN-γ were the important immunological features for gastric cancer patients. CD4⁺CD29⁺T cells, IL-4 and IFN-γ were differently expressed in early and end stages for patients with gastric carcinoma significantly, and they correlated with the factors which are closely related the tumor angiogenesis.

Study of pathological lesions in kidneys of fetal lambs with unilateral partial ureteral obstruction

Wang Fenghua, Liu Wei, Liang Jianhua, Sun Junjie, Mo Jiacong

2014, 14(04):  398-403.  DOI: 10.3969/j.issn.1009-976X.2014.04.013

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【Abstract】〓Objective〓To explore the dynamic changes of pathological lesions in the fetal kidney when the ureter was obstructed..Methods〓A silastic tube was tied around the left superior segment ureter to induce unilateral partial ureteral obstruction in fetal lambs at 75-85 days of gestation..In different postoperative stages,.the kidneys of the fetal lambs were removed to study the changes in gross and histology,and the expression of paired-box 2.(PAX2).and vascular endothelial growth factor.(VEGF).wene detected by immunohistochemistry assay..Results〓In the obstructed kidneys,.we observed thinner renal cortex,.cysts of various sizes in the cortex,.fibrosis in the interstitial tissue,.much decreased number of glomeruli,.markedly increased PAX2 and decreased VEGF expressions. Conclusion〓In fetal lambs, when the ureter was obstructed, after the homolateral kidney gains markedly pathological changes.

Applicability of proximal radical gastrectomy in patients with proximal stomach cancer

Huang Jianqiang, Li Xiaoyue

2014, 14(04):  403-406.  DOI: 10.3969/j.issn.1009-976X.2014.04.014

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【Abstract】〓Objective〓To compare complications, nutritional status and quality of life between total gastrectomy and proximal radical gastrectomy in patients with advanced proximal gastric carcinoma. Methods〓Eighty-five patients with proximal stomach cancer were enrolled from Jan 2002 to Dec 2008 and underwent total gastrectomy (total gastrectomy group,n=40) and proximal radical gastrectomy (proximal radical gastrectomy group,n=45). Nutritional status, incidence of reflux esophagitis and cholecystolithiasis, 5-year survival rate, quality of life were investigated. Results〓Median survival time of total gastrectomy group and proximal radical gastrectomy group were 41 months and 46 months respectively. There was no significant difference in 5-year survival rate between two groups (P>0.05). There was significant difference in incidence of reflux esophagitis between total gastrectomy group and proximal radical gastrectomy group (10/40, 25% vs. 4/45, 8.9%, P<0.05). There was significant difference in incidence of cholecystolithiasis between total gastrectomy group and proximal radical gastrectomy group (11/40, 27.5% vs. 4/45, 8.9%,P<0.05). Hemoglobin, albumin, vitamin B12 and ferritin in proximal radical gastrectomy group were higher than those in total gastrectomy group (142.2±10.6 vs. 128.4±11.4; 41.3±5.8 vs. 35.9±3.8; 271.5±39.7 vs. 184.5±24.6; 220.2±59.7 vs. 170.2±27.6; P<0.05). Diet and labor in proximal radical gastrectomy group were better than those in total gastrectomy group (P<0.05). Conclusion〓Proximal radical gastrectomy decreases incidence of reflux esophagitis and cholecystolithiasis, improve nutritional status and quality of life.

Clinical analysis of transurethral plasma kinetic enucleation of prostate in treatment of high risk patients with benign prostatic hyperplasia

Li Song, Li Zhengming, Li Gang, Shi Guoqiang, Ruan Li, Luo Bin, Deng Xinjun

2014, 14(04):  407-410.  DOI: 10.3969/j.issn.1009-976X.2014.04.015

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【Abstract】〓Objective〓To evaluate the effects of transurethral plasma kinetic enucleation of prostate in treatment of high risk patients suffered from benign prostatic hyperplasia. Methods〓Eighty-nine benign prostatic hyperplasia patients with severe complications were treated with transurethral plasma kinetic enucleation of the prostate. Perioperative prostate volume, residual urine, international prostate symptom score (IPSS), quality of life (QoL) and maximal flow rate (Qmax) were evaluated. Results〓Eighty-nine patients were performed the surgical protocol successfully,.no severe post-complication was noticed..The operation time was from 30 to 110 min,.an average 45±12.6 min. The weight of excision gland ranged from 20 to 60 g,.an average 30.6±13.2 g..Blood loss during operation was 50-300 ml, an average 110±26.9 ml. The average follow-up visit time was 3 months. IPSS dropped from 21.6±3.9 to11.8±5.1.(P<0.05)..RUV decreased from 120.2±27.6 ml to 20.2±12.3 ml (P<0.05). The Qmax increased from 7.1±4.4 ml/s to 14.6±5.2 ml/s(P<0.05). Conclusion〓Transurethral plasma kinetic enucleation of the middle lobe is an effective and safe surgical procedure for the patients with high risk benign prostatic hyperplasia.

Changes and significance of natural killer T cells for the patients with prostate cancer undergoing extraperitoneal laparoscopic radical prostatectomy

Cai Haipeng, Li Qingrong

2014, 14(04):  411-413.  DOI: 10.3969/j.issn.1009-976X.2014.04.016

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【Abstract】〓Objective〓To observe the changes and significance of natural killer T cells for the patients with prostate cancer undergoing extraperitoneal laparoscopic radical prostatectomy(ELRP). Methods〓Thirty-five patients with prostate cancer and 35 healthy subjects were enrolled. The peripheral blood of the two groups were collected, and the levels of NKT cells and its intracellular gamma interferon(IFN-γ) and interleukin 4 (IL-4) using flow cytometry test. Two weeks after ELRP, the prostate cancer patients underwent the second test of NKT and its cytokines. Results〓Compared with the healthy subjects,levels of NKT,IFN-γ and IL-4 belonging to the patients with prostate cancer were 5.92±1.47,.4.23±1.90 and 2.15±1.04, which were significantly lower than that of the healthy subjects (12.53±4.16, 8.94±2.76 and 5.86±1.97,.P<0.05). Levels of NKT, IFN-γ and IL-4 increased significantly after ELRP when compared with preoperation (9.13±2.69, 6.19±2.03 and 3.37±1.28, P<0.05),and the mean fluorescence intensity of IFN-γ increased more apparently than IL-4. Conclusion〓Decreasing of NKT, IFN-γ and IL-4 is an important immunological characteristic for patients with prostate cancer, and ELRP can improve the cellular immune dysfunction in patients with prostate cancer effectively.

Application of flexible ureteroscopy and minimally invasive percutaneous nephroscope in the treatment of renal staghorn calculi (a report of 26 cases)

Chen Nanhui, Chen Zhilin, Huang Zhicheng, Peng Dong

2014, 14(04):  414-416.  DOI: 10.3969/j.issn.1009-976X.2014.04.017

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【Abstract】〓Objective〓To observe the effect of flexible ureteroscopy combined with minimally invasive percutaneous nephroscope in the treatment of renal staghorn calculi. Methods〓Twenty-six cases with renal staghorn calculus underwent the treatment of flexible ureteroscopy and minimally invasive percutaneous nephroscope (F16-20). The clinical data, including operation time and the rate of residual stones were recorded and analyzed. Results〓All the operation was completed successfully. There was no occurrence of serious complications such as ureteral perforation,pneumothorax, intestinal damage and hemorrhage. KUB showed that the stone clearance rate reached 81% (21/26) in the first stage of operation. The operation time was 60-150 min, 95±13 min on average. The second stage of operation was performed 5 to 7 days postoperatively. The stone clearance rate was 92.3%(24/26) in the two stages of operation. The operation time was 30-150 min, 45±11 min on average. Two residual calculi patients were performed with extracorporeal shock wave lithotripsy (ESWL) in one month after operation and the residual stones were discharged. The hospitalization time was 5-12 d, 6.5 d on average. Conclusion〓Flexible ureteroscope operation combined with minimally invasive percutaneous nephroscope is a good choice for treatment of complicated renal calculi.

Ulinastatin alleviates paclitexel-induced allodynia in a dose-dependent manner

2014, 14(04):  417-420.  DOI: 10.3969/j.issn.1009-976X.2014.04.018

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【Abstract】〓Objective〓To evaluate the neuroprotective effect of ulinastatin in paclitexel-induced peripheral neuropathy. Methods〓Twenty-four SD rats were randomized into 3 groups, the rats in group A were administered normal saline and those in group B were administered 25 kU/kg of ulinastatin. Rats in group C were administered 50 kU/kg of ulinastatin. Normal saline or ulinastatin were i.p. once per day for 7 consecutive days (from days 1 to 7). Paclitaxel (2 mg/kg per injection) was administered i.p. on four alternate days (Days 1, 3, 5 and 7; cumulative dose 8 mg/kg) after the injection of normal saline or ulinastatin. The paw withdraw threshold was measured using the von Frey test on day 0, 5, 8, 15, 21 and 28 d. Results〓The paw withdrawal thresholds were significantly increased in rats of group C compared to the other groups (P<0.01), and the paw withdrawal thresholds in rats of group B were higher than those in group A (P<0.05). Conclusion〓Ulinastatin can alleviate paclitexel-induced allodynia in a dose-dependent manner, and it could have a neuroprotective effect in paclitexel-induced peripheral neuropathy.

Effect of intravenous sufentanil in combination with ropivacaine wound infiltration for postoperative analgesia in pediatric laparotomy

Lei Dongxu, Pan Yongying, Jin Yulin, Jiang Xueling

2014, 14(04):  421-423.  DOI: 10.3969/j.issn.1009-976X.2014.04.019

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【Abstract】〓Objective〓To evaluate the analgesia effect of intravenous sufentanil in combination with ropivacaine infiltration and intravenous sufentanil for postoperative analgesia in pediatric laparotomy. Methods〓Eighty children aged 1-4 year scheduled for elective laparotomy were allocated randomly to 2 group. Group S+R received 0.25% ropivacaine wound infiltration according to the length of the wound(1 ml·cm^{-1) before skin closure and intravenous sufentanil 0.03 μg·kg-1·h-1 after operation, and group S received only intravenous sufentanil 0.03 μg·kg-1·h-1 for postoperative analgesia. The pain density was determined by FLACC at 1, 2, 4, 8, 12, 24, 48 h postoperatively. Results〓The pain score were significantly higher in group S when compared with group S+R at 1, 2, 4, 8 h postoperatively (P<0.05). There were no difference in the pain score at 12, 24, 48 h. Severe adverse events were not observed in the present study. Conclusion〓Intravenous sufentanil in combination with ropivacaine wound infiltration provided excellent and safe postoperative analgesia in pediatric laparotomy.}

Effects of tracheal intubation on median nerve somatosensory evoked potential under propofol anesthesia

Yang Tao, Chen Ruixia, Du Sujuan

2014, 14(04):  424-427.  DOI: 10.3969/j.issn.1009-976X.2014.04.020

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【Abstract】〓Objective〓To observe the effect of tracheal intubation on MnSSEP, investigate the feasibility of median nerve somatosensory evoked potentials for monitoring the noxious stimuli response of intubation. Methods〓Sixteen ASA Ⅰ~Ⅱ patients (8 male, 12 female) aged 18-40 yrs undergoing elective surgery under general anaesthesia. Anaesthesia was induced with TCI propofol. After the target effect-site concentration of propofol reach 5 μg·mL^{-1 and maintained for two minutes, intubation was facilitated by succinylcholine and MnSSEP, BIS, SBP, DBP, and HR of before, during and after intubation were recorded. Results〓There were no changes in all latencies of MnSSEP, BIS and HR. During intubation amplitudes of N20P25 increased, and after that they reinstated. SBP, DBP and the Amplitude of P15N20 increased during and after intubation. Conclusion〓Amplitude of N20P25 is suitable to reflect the effects of the noxious stimuli to tracheal intubation.}

Study on flurbiprofen targeting analgesia

Zhang Yaozhi, Yang Jingwen, He Jiang

2014, 14(04):  427-429.  DOI: 10.3969/j.issn.1009-976X.2014.04.021

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【Abstract】〓Objective〓To investigate the effect on flurbiprofen targeting analgesia given by systemic vein and local vein. Methods〓Sixty patients undergoing upper extremity surgery with tourniquet were randomly and equally allocated into three groups, group A (flurbiprofen 100 mg by local vein), group B (flurbiprofen 100 mg by systemic vein) and group C (fatty emulsion). After successful brachial plexus anesthesia,the flurbiprofen was given and visual analogue scale/score (VAS) was recorded at intraoperation, postoperative 1, 4, 8, 12, 24 hour. Meanwhile, tourniquet reaction and other side-effects were observed. Results〓VAS in the each time point, tourniquet reaction and other side-effects were compared between group A and group B, which showed no significant difference. VAS in the each time point and tourniquet reaction of the group A and B were lower than that of group C (P<0.05). Conclusion〓No matter what flurbiprofen is given by systemic or local vein, it has an excellent targeting analgesic results, and it would prolong time of tourniquet reaction and reduce tourniquet reaction and other side-effect.

Retroperitoneal laparoscopic ureterolithotomy for upper ureteral stone: report of 51 cases

Liu Jianping, Wang Yongzhong, Liang Shengjun, Gao Wei

2014, 14(04):  430-432.  DOI: 10.3969/j.issn.1009-976X.2014.04.022

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【Abstract】〓Objective〓To investigate the efficacy of retroperitoneal laparoscopic ureterolithotomy for upper ureteral stone..Methods〓From July 2005 to December 2013,.51 consecutive patients with upper ureteral stone underwent retroperitoneal laparoscopic ureterolithotomy..Perioperative outcomes (operating time,estimated blood loss, complications) and stone free rate were analyzed retrospectively. Results〓Forty-nine cases of operation finished uneventfully, except for 2 cases converted to open surgery because of stone migration. The mean operating time for laparoscopic surgery was 75 minutes (55-125 minutes),.the mean estimated blood loss was 30 ml(10-50 ml), the stone free rate was 100%. Three patients experienced urine leakage,.which managed with conservative treatment..Two patients experienced ureteral stricture, which managed with endoincision and Double-J stent drainage. Conclusion〓Retroperitoneal laparoscopic ureterolithotomy is a minimally invasive treatment for upper ureteral stones with high stone free rate. It could be a salvage therapy for upper ureteral stones after failure to extracorporeal shock wave lithotripsy or ureteroscopic lithotripsy.

Comparative study between a Zero-profile implant for anterior cervical diskectomy with fusion and anterior cervical discectomy with plate fixation

Zhou Wenyu,Gu Hongsheng,Wang Daping,Shang Peng, Bai Xueling, Yan Bing, Qiu Yiyan

2014, 14(04):  433-437.  DOI: 10.3969/j.issn.1009-976X.2014.04.023

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【Abstract】〓Objective〓To compare the clinical efficacy of anterior cervical discectomy with plate fixation (ACD) and Zero-profile implantation (zero-P). Methods〓A total of 134 cases were included in the study from December 2009 to February 2013. The patients (ACDF group, n=71) were performed anterior discectomy and interbody fusion with plate internal fixation and those (Zero-P group, n=63) underwent anterior discectomy and Zero-Profile implantation..All patients had different degrees of pain on the neck and shoulder, pain on the.limbs and numbness and weakness,.of which 68 cases with trunk banding and double lower limbs on cotton,.12 cases with mild defecation dysfunction..Single segment operation time,.intraoperative bleeding,.pre- and post-operation imaging,.VAS,.JOA,.D value and SWAL-QOL score in two groups were assessed and compared. Results〓All the cases were followed up for 8-24 months with an average 13±2.5 months..In ACDF and Zero-p group,.the operation time of each segment of ACDF and Zero-p group was 65±11.3 min and 47±7.6 min respectively,.estimated bleeding loss was 68.5±21.1 ml and 42.7±14.4 ml, hospital stay was 5.4 and 4.2 days..Zero-p group showed a better clinical efficacy when compared with ACD group, and there were significant differences. No implant subsidence or collapse, implant loosening screw were found. Conclusion〓The model of zero notch implant system has the advantages of simple operation, short operation time, less bleeding and good early clinical effect. The Zero-P implant is a valid alternative to anterior cervical plating after ACDF with a very low incidence of postoperative dysphagia and no implant-related complications.

Halo-Vest external fixation for the treatment of odontoid fractures

Ye Xuenian, Zhu Wenxiong, Jiang Ming

2014, 14(04):  438-441.  DOI: 10.3969/j.issn.1009-976X.2014.04.024

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【Abstract】〓Objective〓To report the clinical effect of fresh odontoid fracture treatment with the Halo-Vest external fixation. Methods〓Thirty-two patients with the odontoid fracture undergoing Halo-Vest external fixation were retrospectively investigated..According to the Grauer modified Anderson-D'Alonzo's classification, there were 15 cases of type IIA, 2 cases of type IIB, 6 cases of type IIC and 9 cases of type III. All the patients received occipito-mandibular traction after 3 weeks to Halo-Vest external fixation. Results〓All of the 32 patients were followed up for 4 months to 2 years, an average of 1 year and two months. By imaging examination findings, all patients obtained bone healing in 3 to 4 months after Halo-Vest external fixation..And the patients had sound atlantoaxial joint stability, good flexion extension and rotation function. Conclusion〓Halo-Vest external fixation has the advantage of cervical hyperextension traction and small trauma, and is a economic, simple and safe operation in the treatment of fresh odontoid fracture incuding the type II fracture.

MRI characteristics of spinal cord hemangioblastoma

Zeng Yuping, Liu Qingyu, Lai Bingjia

2014, 14(04):  441-445.  DOI: 10.3969/j.issn.1009-976X.2014.04.025

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【Abstract】〓Objective〓To elucidate the MRI characteristics of spinal cord hemangioblastomas. Methods〓The clinical data and MRI findings in seven patients with pathologically confirmed spinal cord hemangioblastimas were reviewed retrospectively. All of the patients underwent MRI scan. Results〓The hemangioblastimas showed single lesion in six patients and showed multiple lesions in one case by MRI. A total of eight intraspinal hemangioblastimas were located in intramedullary, including single lesion at medulla oblongata, four lesions at the cervical spinal cord, two lesions at the thoracic spinal cord and one lesion at the lumbar spinal cord. Tumors showed point-like or nodular appearance,some of them sausage-like or irregular shape. The tumors were isointensity or slight hypointensity on T1WI and hyperintensity on T2WI. Small(more than 20 mm) tumors showed obviously homogeneous enhancement after contrast injection, however, large (less than 20 mm) tumors showed obviously heterogeneous enhancement. Seven of those 8 tumors were accompanied by vascular flow voids or peritumoral edema. Conclusion〓The MRI findings of hemangioblastomas in the spinal cord are characteristic. MRI is valuable for establishing the diagnosis preoperately.

The evaluation of efficacy and safety of strontium ranelate on osteoporotic bone pain and bone mineral density in male osteoporosis

Yan Jun

2014, 14(04):  446-449.  DOI: 10.3969/j.issn.1009-976X.2014.04.026

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【Abstract】〓Objective〓To evaluate the efficacy and safety of strontium ranelate on bone pain during the treatment for male osteoporosis. Methods〓Fifty-eight elderly osteoporosis men were divided into strontium ranelate group (SR group, 26 cases) and calcium group (control group, 32 cases). Visualanalog scale (VAS) scores of the lumbar and back pain, bone mineral density (BMD) and T scores of the lumbar vertebra 1-4 and the Ward's triangle were determined. The incidence of osteoporotic fracture and side effects after drug treatment in both groups were also observed. Results The VAS scores in SR group were obviously improved,and were lower than those in control group (P<0.001). The BMD values of the lumbar venebra1-4 and Ward's triangle significantly increased in SR group after treatment compared to those before the treatment,.and the curative effects of strontium ranelate on SR group was obviously better than effects of calcium on control group (P<0.001). The adverse events were nausea and vomiting and erythra in SR group, and constipation in control group. Conclusion〓Strontium ranelate can effectively improve bone mineral density and ameliorate the chronic low back pain, which is a remarkable treatment for male patients with primary osteoporosis.

Clinical application research of endoscope-assisted styloidectomy via postauricular incision

Zheng Yunkai, Zhao Shidong, Zhong Chaoguan, Fan Minfang

2014, 14(04):  449-451.  DOI: 10.3969/j.issn.1009-976X.2014.04.027

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【Abstract】〓Objective〓To summarize the clinical experience of endoscope-assisted styloidectomy via postauricular incision and the anatomic landmarks of styloid process location. Methods〓Ten patients with Eagle's syndrome underwent surgery from January 2012 to August 2013,and the surgical procedure was performed by endoscope-assisted styloidectomy via postauricular incision. Results〓The important anatomic landmarks of endoscope-assisted styloidectomy via postauricular incision included posterior border of parotid,anterior border of the sternocleidomastoid muscle and posterior belly of digastric muscles..All patients were successfully located and truncated styloid process by serially exposed these anatomic landmarks mark. Incision length was 2.1±0.5 cm. The operative time was 54.5±11.7 min. Amputation length of styloid process on left side was 2.8±0.8 cm and 2.6 ± 0.7 cm on the right side. In 10 patients, 7 patients' symptoms were completely relieved, 2 patients' symptoms were improved and 1 case had no obvious relief. No recurrent case was found in 12.1±4.5 months of follow-up. One case had ear numbness on one side after surgery for 3 months and no case suffered facial paralysis. Conclusion〓Endoscope-assisted styloidectomy via postauricular incision is a effective, minimally invasive and postoperative appearance procedure. Precisely located styloid process need to serially expose the anatomic landmarks, such as endoscope-assisted styloidectomy via postauricular incision included posterior border of parotid, anterior border of the sternocleidomastoid muscle and posterior belly of digastric muscles. Followed these procedures would help to increased the operation quality and be benefit for patients with Eagle's syndrome.

Clinical effect of anatomical dynamic hip lock plate, on treatment of intertrochanteric fractures in the elderly

Lin Zhenrong, Wu Shengrong

2014, 14(04):  452-455.  DOI: 10.3969/j.issn.1009-976X.2014.04.028

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【Abstract】〓Objective〓To investigate the efficacy of using the anatomical dynamic hip lock plate (ADHLP) to treat the intertrochanteric fractures. Methods〓From February 2010 to September 2012, 124 elderly patients with intertrochanteric fractures were enrolled. Among them, 70 patients were performed the treatment of ADHLP(group A),.54 cases underwent dynamic hip screw fixation (group B)..The rate of fracture healing,.healing time,.excellent rate of surgical treatment and postoperative complications between two groups were compared and statistically analyzed. Results〓The healing rate in group A was 98.57%, which was slightly higher than the group B, but the difference was not statistically significant(P>0.05). Healing time in group A was shorter than in the group B, and the excellent rate of group A was higher than that of the group B (P<0.01). Conclusion〓The ADHLP is effective in treating elderly intertrochanteric fractures, and the healing rate, excellent rate of which were higher than the dynamic hip screw fixation method.

Value of exposing the recurrent laryngeal nerve in thyroid surgery and the methods to prevent the nerve injury

Chen Ming, Wu Zhiyang, Lu Deguang, Zeng Jintao, Chen Xiangqing, Li Gang

2014, 14(04):  455-457.  DOI: 10.3969/j.issn.1009-976X.2014.04.029

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【Abstract】〓Objective〓To investigate the significance of exposing the recurrent laryngeal nerve in the operation of thyroid gland and the methods to prevent the nerve injury. Methods〓The clinical data of 336 cases undergoing operation of thyroid gland were analyzed retrospectively..And the incidence of injury of recurrent laryngeal nerve was compared between the patients in recurrent laryngeal nerve exposure group (n=205) and those in non exposure group (n=131) through the postoperative laryngeal recurrent nerve injury judgment standard. Results〓Of 205 cases in recurrent laryngeal nerve exposure group, there were 2 cases (0.98%) of temporary hoarseness and restored in 3 month with conserving treatment. However, there were 6 cases (4.58%) of recurrent laryngeal nerve injury in non exposure group,4 cases with temporary injury of recurrent nerve and 2 cases with permanent damage (P<0.05, vs. recurrent nerve exposure group). Conclusion〓Exposure to recurrent laryngeal nerve intra-operation can reduce and prevent nerve injury in the thyroidectomy.

Experience in diagnosis and treatment of Brucellar spondylitis (a report of 18 cases)

Xu Yunfeng, Qin Shilei, Wang Weiping

2014, 14(04):  458-461.  DOI: 10.3969/j.issn.1009-976X.2014.04.030

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【Abstract】〓Objective〓To report the clinical experience in treatment and diagnosis of Brucellar spondylitis. Methods〓Eighteen patients with brucellar spondylitis were included the study and the lesion distribution was from T₁₂ to S₁. Of 18 cases,.5 received conservative treatment and 13 underwent surgical treatment. All patients were administrated a combined modality therapy including doxycycline, rifampicin, and streptomycin. Surgical procedure was performed through cleaning the lesion, grafting iliac crest bone for intervertebral bone and fixation..from anterior or posterior lumbar approach. Follow-up was 2 years. Results〓All of the patients got good effect. Two conservative treatment cases had slight pain on low back after strenuous labor. And in those who underwent surgery, one had low fever, one case had minor residual pain on low back and felt discomfort on lower extremity..Conclusion〓With reasonable treatment plan,.Brucellar spondylitis could get satisfactory curative effect by combined surgery with drugs or drug alone.

Analysis of incidence and risk factors of vancomycin?鄄resistant enterococcus (VRE) colonization in neurosurgical intensive care unit (NICU)

Yu Jianglong, Lan Shiying

2014, 14(04):  462-465.  DOI: 10.3969/j.issn.1009-976X.2014.04.031

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【Abstract】〓Objective〓To investigate the incidence and risk factors of vancomycin-resistant enterococcus(VRE)colonization in neurosurgical intensive care unit (NICU). Methods〓From September 2010 to September 2013,this retrospective study was associated with cerebrovascular disease, brain trauma, brain tumor, spinal diseases in NICU. 414 patients were enrolled in the study, demographic characteristics and risk factors were collected for statistical analysis. Results〓Among 414 patients, 52 patients were infected with VRE, 362 patients were not infected with VRE. The third generation cephalosporins was the most used antibiotics accounting for 40.4% before VRE infection. The fourth generation cephalosporins was the least used antibiotics accounting for 5.8% before the VRE infection. The univariate analysis showed that women, GCS score<8, accompanied by symptoms of diabetes, indwelling tube>4, mechanical ventilation>2 weeks, ICU time>2 weeks, nearby VRE (+) patients (P<0.05) were risk factors for VRE infection. The Logistic regression analysis showed that GCS score<8, diabetes, catheterization>2 weeks, ICU time>2 weeks, nearby VRE (+) patients were independently associated with VRE infection (P<0.05). Conclusion〓When managing the high-risk patients being prone to be infected VRE in the NICU, extreme caution should be paid upon. The most crucial interventions are careful hand washing, strict glove handling, meticulous and active screening, and complete segregation.

Application of 3-litre plastic bags in intra-abdominal volume increment for treatment of intra-abdominal hypertension: a surgical experience

Chen Zhuanghao, Li Jianming, Chen Haisheng, Song Weiwei, Li Wei

2014, 14(04):  466-469.  DOI: 10.3969/j.issn.1009-976X.2014.04.032

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【Abstract】〓Objective〓To report an experience in treatment of intra-abdominal hypertension by using 3-litre plastic bags for the expansion of the abdominal cavity. Methods〓Eighteen patients with severe celiac diseases combined with intra-abdominal hypertension were included the study. All patients underwent surgical procedure for intraabdominal volume increment by using 3-litre plastic bags, and received second operation in 4 to 8 days after primary treatment. The postoperation results were recorded and retrospectively analyzed. Results〓Of the 18 patients,3 cases were dead of severe acute pancreatitis, total small bowel torsion and gastrointestinal perforation,respectively; 15 cases were cured. Two cases were found intra-abdominal abscess and another one had incisional hernia postoperation. Malabsorption of nutrients were happened in one case. Conclusion〓Application of 3-litre plastic bags for treatment of intra-abdominal hypertension is a elective, economy method.

Experience in the treatment of traumatic transection of pancreas (a report of 14 cases)

Guan Weijun, Hou Yuanfa, Song Yaoming, Wang Hongjian, Liang Jiayun

2014, 14(04):  470-473.  DOI: 10.3969/j.issn.1009-976X.2014.04.033

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【Abstract】〓Objective〓To report the experience in the diagnosis and treatment to the patients with pancreatic trauma. Methods〓The data of 14 cases with pancreatic injury treated in our hospital from Jun 2001 to Dec 2013 were reviewed and analyzed. Results〓All 14 patients with traumatic transection of pancreas underwent surgical procedure..Among the 14 cases,11 patients were cured and three patients died of multiple organ failure..Pancreatic fistula abdominal infection occurred in 6 patients..Postoperative abdominal bleeding occurred in two cases,.and pancreatic pseudocyst in three cases. Conclusion〓In these cases, preoperative diagnosis for traumatic transection of pancreas was difficult and the major diagnostic method was surgical exploration. According to the transverse position, injury degree, associated injuries, surgical method was selected. Enough abdominal drainage and combined treatment would improve the cure rate and reduce the postoperative complications and mortality to the patients.

Diagnosis and surgical treatment of traumatic pancreatic injury

2014, 14(04):  473-476.  DOI: 10.3969/j.issn.1009-976X.2014.04.034

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【Abstract】〓Objective〓To summarize up the clinical diagnosis and surgical treatment of traumatic pancreas injury. Methods〓Thirteen patients with pancreatic blunt injury were admitted in our hospital from Aug. 2009 to Feb. 2012,and the clinical data were analyzed retrospectively. Results Among 13 cases, pancreatic contusion occurred in 4 patients, pancreatic contusion and laceration in 9, in which pancreatic transection lesion was in 1 and pancreatic pseudocyst in 2. CT imaging findings showed in all the patients the thickening of pancreatic and renal facial and blurry parapancreatic fat rim and hydrops..Associated lesions included splenic rupture in 6 cases,.liver contusion and laceration in 5 cases,kidney contusion and laceration in 3 cases..Twelve cases got recovery..One case died of MODS..Three cases underwent second operation due to pancreatic pseudocyst in 6 months after operation. Conclusion〓CT is an effective tool in the early diagnosis of blunt pancreatic injury.

Teatment of minor facial and head lacerations with medical glue adhesives

Yu Menglei, Zhu Jie, Cao Yi, Luo Zitong, Peng Jicai, Huang Duping

2014, 14(04):  477-479.  DOI: 10.3969/j.issn.1009-976X.2014.04.035

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【Abstract】〓Objective〓To investigate the clinical efficacy of medical glue adhesives in treating slight facial and head lacerations. Methods〓A Total of 550 patients (313 males and 237 females) with facial and head lacerations received medical glue adhesive treatment in our emergency surgery department. Results〓Among 550 cases, 545 patients were one-stage healing and 5 patients were two-stage healing due to wound dehiscence. Conclusion〓The medical glue adhesives have advantages of using simply, less pain, smaller scar, convenient nursing, and is fit for minor facial and head lacerations.

Comparative study on the clinical effect between laparoscopic and traditional open surgery in the treatment of gastroduodenal perforation

Lian Zhenbiao, Chen Bo

2014, 14(04):  479-481.  DOI: 10.3969/j.issn.1009-976X.2014.04.036

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【Abstract】〓Objective〓To compare the effect between laparoscopic and open surgery in the treatment of gastroduodenal ulcer perforation. Methods〓A retrospective data of patients with gastric ulcer perforation was analyzed,.in which 60 cases in each of undergoing laparoscopic operation and open surgery..The clinical effects were compared between two groups. Results〓Compared to open surgery,.the curative effect of laparoscopic group was superior to that of open operation in hospital stay,.postoperative off-bed time,.blood loss,.and the incision looking..The complications in laparoscopic group such as incision infection,.abdominal abscess,.intestinal adhesion in laparoscopic group were lower than in open operation group..There was no significant difference in operative time and hospital costs between two groups..Conclusion〓Compared to open surgery,.laparoscopic gastroduodenal ulcer perforation repair surgery has good clinical effect and low complication occurrence,.and is worthy of promotion.

Value of anus preserving operation with sustaining anastomotic tube in laparoscope for lower rectal cancer

Li Yuechun, Wang Dongxia, Lu Huanquan, Ye Zhenpeng, Chen Chongyuan

2014, 14(04):  482-485.  DOI: 10.3969/j.issn.1009-976X.2014.04.037

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【Abstract】〓Objective〓To assess the value of anus preserving operation with sustaining anastomotic tube in laparoscope for lower rectal cancer. Methods〓The alimentary tract reconstruction by colo-rectal (anal) anastomoses with a sustaining anastomotic tube through anal in laparoscope after TME in 14 cases of lower rectal cancer. Results〓Forteen ultralow colo-rectal/anal anastomoses were successfully completed laparoscopically and the anastomosis time was 15-30 min. The mesorectum was cut completely. The distance from stoma to the dentate line was less than 2 cm in 8 patients and colo-anal anastomosis was performed in 6 patients. The function of anal sphincter and micturition recovered smoothly after the operation without anastomotic stoma leakage and anastomotic stoma stenosis. The defecation function was satisfactory in 85.71% (12/14) cases. Postoperative 5 year survival and recurrence were 78.57% (11/14), 7.14% (1/14) respectively by life table method. Conclusion〓The anus preserving operation with sustaining anastomotic tube is safe and practicable in laparoscope for lower rectal cancer.

Studies of laparoscopy combined nephroscopic electrohydraulic lithotripsy in treatment of biliary calculi

Huang Jintuan, Lin Xufeng, Zeng Yuyou

2014, 14(04):  485-487.  DOI: 10.3969/j.issn.1009-976X.2014.04.038

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【Abstract】〓Objective〓To investigate the feasibility and safety in treating biliary calculi by using laparoscopy combined nephroscopic electrohydraulic lithotripsy. Methods〓Fifty-three patients with cholecystol-ithiasis and oledocholithiasis from January 2013 to January 2014 were included in the study, and underwent surgical treatment in our hospital by using laparoscopy combined nephroscopic electrohydraulic lithotripsy. The operative time, blood loss, hospital stay, were recorded and analyzed. Results〓All operations were completed successfully, without conversion to open surgery. Thirty-five cases underwent electrohydraulic lithotripsy for 3-10 times each case. There were 3 cases of biliary tract traumatic hemorrhage during operation and were controlled by proper management. No uncontrolled bleeding, perforation of bile duct and biliary tract lacerated wound occurred in operation. The hospital stay was 7.1±2.6 days, without any infection cases. Two cases were found residual bile duct stones and were recovered by treatment with digestive endoscopy. No stricture of common bile duct occurred in 6 months of follow-up. Conclusion Laparoscopic combined nephroscopic electrohydraulic lithotripsy is feasible and safe in surgical treatment of oledocholithiasis.

Research development of synovium mesenchymal stem cells

Huang Shenghui, Huang Jianrong

2014, 14(04):  488-490.  DOI: 10.3969/j.issn.1009-976X.2014.04.039

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【Abstract】〓Movement disorder caused by articular injury and synovial diseases is one of difficult clinical problems. Synovium mesenchymal stem cells (SMSCs) are the new member of mesenchymal stem cells family. SMSCs are considered to be promising seeded cells for bone and joint diseases because of showing outstanding proliferation and cartilage differentiation capacity. SMSCs have attracted much attention in recent years. Here,we aim to review the current state of SMSCs research about reviewing isolation and purification,basic characteristics,and clinical application of SMSCs,and discuss the related problems.

Effect of biofeedback training on the recovery of the patient with spinal cord injury in different segment and urinary bladder function

Yu Cong, Xie Xiaohua, Yang Shiwei, Hao Shuqin, Yin Meimei, Chen Xueping, Zhao Li

2014, 14(04):  491-493.  DOI: 10.3969/j.issn.1009-976X.2014.04.040

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【Abstract】〓Objective〓To investigate the effects of biofeedback rehabilitation training on urinary reflex and bladder function in patients with spinal cord injury. Methods〓From October 2011 to July 2013, 86 patients with traumatic spinal cord injury were treated with biofeedback training, including 53 male cases, 33 female cases, and aged from 21 to 64 years, with the average of 40.2. The patients were randomly divided into two groups,experimental group (n=45) and control group (n=41).The patients in experimental group patients were trained urination by biofeedback training method. The controls received the traditional method of indwelling catheter and routine nursing care. Results After 3-10 times of biofeedback training (average 5.9) in the experimental group patients, the time of catheter, catheter removal of residual urine volume, the number of autonomous urination after a week were lower than those in controls (P<0.05). Conclusion〓In our study, the biological feedback training effectively improved urination and bladder function in patients with different segment of the spinal cord injury. The patients with cervical, lumbar and thoracic spinal cord injury showed much better efficacy than cauda equina and sacrococcygeal spinal cord injury.

The application of root cause analysis in orthopedic surgical site infection prevention

Liang Min, Sha Liujuan, Shen Yuchong, Liang Hongxia

2014, 14(04):  494-496.  DOI: 10.3969/j.issn.1009-976X.2014.04.041

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【Abstract】〓Objective〓To investigate the risk factors for surgical site infection after orthopedic surgery, and to take effective measures to prevent and control infection. Methods〓Root cause analysis was employed to investigate the risk factors for surgical site infection, the effect of relative measures was assessed after intervention. Results〓The surgical site infection rate in investigation and intervention stage was 2.2% and 0.5% respectively, the differences between the two groups are statistically significant(P<0.05). Conclusion〓The intervention of root cause analysis can effectively reduce the orthopedic surgical site infection.

An Experience in management for abdominal incision infection by two methods

2014, 14(04):  496-497.  DOI: 10.3969/j.issn.1009-976X.2014.04.042

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