Table of Content

20 December 2014, Volume 14 Issue 06

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论文

Laparoscopic hepatectomy in a porcine model

He Hai, Lin Haoming,Li Guolin, Zhang Peidong, Han Qingfang, Wei Jinxing, Min Jun

2014, 14(06):  617-620.  DOI: j.issn.1009-976X.2014.06.001

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【Abstract】〓Objective〓To introduce our experience in laparoscopic hepatectomy in a porcine model and assess its value. Methods〓A porcine model of laparoscopic left lateral lobectomy was establised in 10 animals. The technique included placement of ports, establishment of CO2 pneumoperitoneum, mobilization of the liver, selective occlusion of portal inflow, transection of the liver parenchyma and the vascular structures. Results〓Laparoscopic left lateral lobectomy were successfully performed, the mean operative time was 65.4±10.4 min, the mean blood loss was 164.2±23.5 ml. No vascular or intra-abdominal injuries were noted. Conclusion〓 Laparoscopic hepatectomy in a porcine model appears to be safe and feasible, which can be an important way to learn laparoscopic liver resection technology.

Immunoprotection of transplant mouse heart by blockage OX40 pathway

Hu Hongxing, Hu Jianbo, Ma Shengli

2014, 14(06):  620-623.  DOI: j.issn.1009-976X.2014.06.002

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【Abstract】〓Objective〓To value the immunoprotection of transplant heat that was mediated by eukaryotic expression vector of siRNA technique. Methods〓First, we did mouse heart transplantation using strains representing minor histocompatibility complex antigen mismatches (mHC), and all the experimental animals were divided into three groups. Then we injected respectively sodium chloride, pRNAT-CTL negative control vector and pRNAT-OX40siRNA into the three groups of mouse thymus at the 1st day and the fourth day after heart transplantation..At the 7th day of post-transplantation, we collected the transplant heart,.blood serum and spleen for pathological examination, besides cardiac muscle zymogram,..RT-PCR and Western blot tests,.respectively..Results〓The survival time of transplant heart in pRNAT-OX40siRNA was significantly prolonged,..and the transplant heart pathological examination was significantly bettered and lactate dehydrogenase,.glutamic oxalacetic transaminase, troponin, spleen OX40mRNA expression and OX40 membrane protein expression were significantly lowered compared with those in mice with sodium chloride and pRNAT-CTL negative control vector..Conclusion Our results clearly show that blockade OX40/OX40L pathway has immunoprotection for heart transplantation of mouse with mHC-incompatible.

Effect of lupeol on proliferation and apoptosis of hepatocellular carcinoma SMMC-7721 cells

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

2014, 14(06):  624-627.  DOI: j.issn.1009-976X.2014.06.003

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【Abstract】〓Objective〓To explore the effect and mechanism of lupeol on proliferation and apoptosis of hepatocellular carcinoma SMMC-7721 cells. Methods〓The effect of lupeol on growth inhibition of hepatocellular carcinoma SMMC-7721 cells and normal liver cells L-02 were analyzed by MTT assay. Cell apoptosis were measured and analyzed by flow cytometry and caspase enzymatic assays, and the expressions of TRAIL receptor and anti-apoptotic proteins were determined by Western blot. Results〓The proliferation of SMMC-7721 cells were dramatically inhibited by lupeol (IC50=40 μmol/L), with almost no toxicity to normal cells L-02. The apoptotic rates of SMMC-7721 cells were 5.5%, 12.6%, and 28% treated with lupeol for 48 hours at concentration distribution 30, 40, and 50 μmol/L. The expressions of anti-apoptotic pretein c-FLIPL was down-regulated and the activities of caspase-8 and -3 were increased in a concentration-dependent manner. Conclusion〓Lupeol induces apoptosis of hepatocellular carcinoma cells through down-regulation of c-FLIPL and activation of caspase-dependent pathways, consequently inhibiting proliferation of cells.

Clinicopathological features of young and aged patients with colorectal cancer in Minnan area

Lin Tiansheng, Xu Junming, You Jun, Xu Lin, Li Yongwen, Hong Qingqi

2014, 14(06):  628-630.  DOI: j.issn.1009-976X.2014.06.004

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【Abstract】〓Objective〓To study the clinical and pathological characteristics of young and aged patients with colorectal cancer in Minnan area, Fujian province. Methods〓The clinicopathological features and survival time of 132 young patients with colorectal cancer were analyzed retrospectively compared with those of 893 aged patients. Results〓The main clinical manifestations were bloody stool or mucus bloody stool in both groups and the rectum was the most common site of tumor in the both groups. The ratio of mucinous adenocarcinoma and signet ring cell cancer and the ratio of advanced stage (Dukes C+D) of the young group were significantly higher than those of the aged group. The five-year survival rate of the younger group was lower than that of the aged one. Conclusion〓There are different clinical and pathological characteristics between young and aged patients with colorectal cancer. It is important to diagnose and treat both young and aged patients as early as possible, and the early diagnosis of colorectal cancer in young patients should be paid more attention.

The clinical effect of laparoscopic hepatectomy on hepatic hemangioma

Chen Jie, Ye Yibiao, Luo Xingxi, Lu Zhenhuan, Wu Xiao, Chen Tao

2014, 14(06):  631-634.  DOI: j.issn.1009-976X.2014.06.005

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【Abstract】〓Objective〓To evaluate the feasibility and efficacy of laparoscopic hepatectomy of hepatic hemangioma. Methods〓Clinical data of 18 patients with hepatic hemangioma who underwent laparoscopic liver resection in Department of Hepatobiliary Surgery, the Sun Yat-sen Memorial Hospital from January 2011 to December 2012 were analyzed retrospectively. Results〓Laparoscopic hepatectomy of hepatic hemangioma was successfully performed in 18 patients. The mean diameter of hemangioma was 7.6 (5.5-14) cm, the operating time was (121±44) min. Thirteen patients underwent selective inflow controlled, mean blood loss was 283 (60-900) ml, and mean postoperative hospital stay was 8 (6-12)..d. Postoperative pathological examination showed cavernous hemangioma. Postoperative pleural effusion occurred in one patient, and was cured by conservative surgery. Conclusion〓Laparoscopic hepatectomy of hepatic hemangioma is safe and feasible for selective patients when half-Pringle maneuver and parenchymal transection devices are used appropriately.

Diagnosis and treatment of biliary cystadenoma:.a report of six cases and literature review

Peng Yaorong,.Liu Chunxia,.Zhang Heyun,.Li Wenbin,.Wang Jie

2014, 14(06):  634-638.  DOI: j.issn.1009-976X.2014.06.006

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【Abstract】〓Objective〓To explore the clinical characteristics of biliary cystadenoma (BCA) and review literature. Methods〓Six cases with BCA were admitted to Sun Yat-sen Memorial Hospital from September 2009 to September 2014 and underwent surgical procedure. The Clinical manifestation, imaging feature and surgical results from six BCAs were analyzed retrospectively. Results〓All 6 patients were female, and aged from 28 to 46 years old. Chief complains were upper abdominal pain (50%, 3/6), asymptomatic examination found (33.3%,..2/6) and jaundice with fever(13.7%,..1/6). Course of disease ranged from 3 days to 16 years. No abnormal preoperative liver functions were found except the cases with jaundice and fever,..and tumor markers of all the patients showed no abnormality. Preoperative B ultrasound,..and CT examinations failed to make an accurate diagnosis, only two case were confirmed by MR...All patients underwent complete resection of the whole lesion without complication or recurrence in a follow-up duration of 3-46 months. Conclusion〓The incidence of BCA is rare and its cause is unclear. It occurs predominantly in middle-aged women with mild clinical symptoms and it is hard to make an accurate preoperative diagnosis by laboratory and imaging examinations. The final diagnosis still depends on pathological examination. Complete removal of the whole lesion is essential for BCA.

Coparison of short-term effects between laparoscope and open Dixon radical resection for rectal cancer

Luo Yuqing, Lin Xiaosong, Lin Guihai, Yuan Yangchun, Lin Jiayu

2014, 14(06):  639-641.  DOI: j.issn.1009-976X.2014.06.007

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【Abstract】〓Objective〓To compare the short-term effects of laparoscopic versus open Dixon radical resection for rectal cancer. Methods〓Eighty-four patients with rectal cancer were nonrandomly divided into two groups, the laparoscopic group(n=44) were treated with laparoscopic Dixon radical resection and the open group(n=40) with open Dixon raidcal resection. Short-term effects, including number of resected lymph nodes, distal resection margin, operative time, blood loss, postoperative anal exhaust time, length of stay, hospitalization expenses, and incidence of complications, were observed and compared between the two groups. Results〓The number of resected lymph nodes (12.91±3.58 vs 14.33±3.38) and distal resection margins (3.15±0.61 cm vs 3.28±0.74 cm) showed significanly differeces between the two groups (both P>0.05). Laparoscopic group was associated with significantly longer operative time (191.75±23.06 min vs 154.80±12.99 min), less blood loss (132.63±35.73 mL vs 181.02±75.79 mL), shorter postoperative anal exhaust time (2.93±1.33 d vs 4.70±1.39 d) and length of stay (11.38±2.00 d vs 16.82±1.85 d), and higher hospitalization expenses (36.9±3.0 thousand vs 30.3±3.7 thousand)(all P<0.05). Incidence of complications was found no difference between the two groups(9.1% vs 17.5%,P>0.05). Conclusion〓Laparoscopic Dixon radical resection is superior to open Dixon radical resection in the management of rectal cancer in terms of improving short-term efficacy.

Diagnosis and treatment of pregnancy with acute pancreatitis: an experience of 16 case

Xiang Dongmei, Liu Jianling, Xu Yingmei, Li Shaohua

2014, 14(06):  642-645.  DOI: j.issn.1009-976X.2014.06.008

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【Abstract】〓Objective〓To report the experience in treating pregnancy with acute pancreatitis (APIP), discuss the clinical characteristics, treatment principles and prevention measures and their effects on maternal and fetal outcome. Methods〓Sixteen cases of APIP who submitted in our hospital between Jan 2006 and Jun 2014 were retrospectively analyzed clinical characteristics, treatment and outcome. Results〓All pregnant women were cured. Thirteen cases with mild acute pancreatitis were treated by conservative treatment, no cesarean section due to pancreatitis, maternal and child are safe discharge. Three cases of severe acute pancreatitis were failed to conservative treatment and continuous renal replacement therapy,.and emergency cesarean was performed. Conclusion〓Among these patients,.bile duct disease and hyperlipidemia were the main cause of APIP. Diagnosis was mainly depended on imaging examination..Conservative treatment was effective to mild acute pancreatitis, while severe acute pancreatitis after conservative treatment should be determined on the basis of termination of pregnancy and peripancreatic drainage.

Clinical experience of laparoscopic commom bile duct exploration with primary closure for treating choledocholithiasis

2014, 14(06):  646-648.  DOI: j.issn.1009-976X.2014.06.009

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【Abstract】〓Objective〓To investigate the effect of laparoscopic choledocholithotomy with primary suture for common bile duct stones. Methods〓From 2011 May to 2012 October, 56 patients underwent laparoscopic common bile duct exploration and primary suture (without T-tube drainage) for treating choledocholithiasis. Of 56 cases, there were no personal history of common bile duct calculi operation, no stenosis or malformation of bile duct, no malignant tumor in and around bile duct, no intrahepatic calculus. The bile duct wall thickening and expansion ranged from 1 cm to 2 cm, and no obvious acute inflammatory reaction. Common bile duct twelve duodenal opening were unobstructed in operation. Results〓Fifty-six patients were successfully completed the operation. Five cases had complications, postoperative biliary fistula occurred in 3 cases, pulmonary infection in 2 case and urinary retention in 2 cases, and all cured by conservative treatment, no wound infection, no peri-operation period death. Conclusion〓Laparoscopy common bile duct exploration and primary closure has good clinical effect for treatment of bile duct stones. The patients would get well soon without T-tube drainade and have small trauma, shorter hospitalization period.

Experience in fast-track concept applied in perioperative period of hepatobiliary surgery hepatic surgery operation

Wu Zhiyang, Li Gang, Lu Deguang, He Qixiong, Liu Yarong, Xie Wenqing, Chen Ming,

2014, 14(06):  649-651.  DOI: j.issn.1009-976X.2014.06.010

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【Abstract】〓Objective〓To investigate the effect of fast-track in hepatic surgery operation. Methods〓From Nov 2009 to May 2014,192 cases of hepatobiliary operation were treated by laparoscopy and choledochoscopy under the guidunce of fast-track surgery. The surgical experience in hepatobiliary operation was described. Results〓No case died in prerioperative period in 192 cases, 114 underwent surgical procedure with laparoscopic mini-cholecystolithotomy with gallbladder preserved and choledochoscopic stone extraction in which there were 4 cases of recurrence(1 case underwent cholecystectomy, 3 cases were followed up regularly). Forty-six cases with postoperative residual bile duct stones were treated by choledochoscopic stone extraction from T tube in 6 week after operation. The other surgical operation were performed in 32 cases, including LC without T tube, tumor of bile duct, laparoscopic hepatectomy, etc. Conclusion〓Both laparoscopy and choledochoscopy in hepatobiliary operation embody the concept of rapid rehabilitation surgery.

Clinical analysis of modified single-port laparoscopic approach in treatment of indirect inguinal hernia in children

Hou Yuanfa, Guan Weijun, Yang Kai, Wang Hongjian, Zeng Huaizhen.

2014, 14(06):  652-654.  DOI: j.issn.1009-976X.2014.06.011

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【Abstract】〓Objective〓To explore the effect of a modified single port laparoscopic surgery on treatment of high ligation of hernial sac in children with inguinal hernia..Methods〓Retrospective review was conducted to 100 children underwent laparoscopic high of hernial sac transfixion between June 2011and June 2014..Of 100 cases, 95 were unilateral indirect inguinal hernia, 5 bilateral indirect inguinal hernia, Amodified surgical procedure was performed in operating. Results〓All cases were operated successfully. The mean operation time was 10-35 minutes in unilateral hernia and 25-45 minutes in bilateral hernia. The average hospital stay after operation was 1-2 days. There were no complication and no recurrence..Conclusion〓The modified single port laparoscopy is safe and effective for children with good cosmetic results and few complications, which can be handled the other side of contralateral inguinal hernia.

Clinical diagnosis and treatment on epididymitis secondary to urethral stricture after hypospadias repair

Liang Weiqiang, Chen Yuhong, Zhang Jinming, Ji Chenyang

2014, 14(06):  655-659.  DOI: j.issn.1009-976X.2014.06.012

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【Abstract】〓Objective〓To investigate the clinical features and curative effect of epididymitis sec-ondary to urethral stricture after hypospadias repair. Methods〓Eight cases with epididymitis secondary to urethral stricture were found in 46 patients with urethral stricture after hypospadias repair and were admitted in our hospital from January 2005 to February 2011. These 8 patients then received urinary tract exploration and urethroplasty with local pedicle flap or free tissue transplantation as soon as possible to repair urethral stricture based on anti-infection and other symptomatic treatments. Results The symptoms of 8 cases with acute epididymitis secondary to urethral stricture disappeared within 8 days postoperative. One case encountered central penis fistula caused by wound infection, and wounds of other 7 patients healed well with smooth urination and no urinary fistula..One case with urinary fistula underwent urinary fistula repair 3 months postoperatively healed well without urinary fistula..In follow-up of 3 to 12 months,.all patients had no urethral stricture or epididymitis recurrence performance..Conclusion〓Epididymitis secondary to urethral stricture after hypospadias repair were found in elder patients with severe urethral stricture. Urethral stricture after hypospadias repair should be treated actively..After anti-infection and other conservative treatments in the premise when the acute epididymitis occurs,.urethroplasty should be applied as soon as possible to repair urethral stricture in favor of restoring normal urine flow.

Some special treatment of skin avulsion for the elderly patients

Zhang Zhihua, Wang Susheng, Liang Gang, Ji Hang, Hou Chun.

2014, 14(06):  659-661.  DOI: j.issn.1009-976X.2014.06.013

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Objective〓To investigate the characteristic and experience of special skin avulsion's treatment with elderly patients. Methods〓According to 22 cases of special patients tearing for the diagnosis and treatment,avulsion skin are used after debridement suture in situ, pressurized bandaging treatment method. Results〓All the grafts or most survived,one cases caused a skin graft necrosis by infection, skin graft healing later. From 4 months to 3 years, feeling and activity are good after the replantation skin. Conclusion〓The features of elderly patients with shallow, less trauma, the clear suture and bandaging treatment can obtain satisfactory effect.

Free thoracoumbilical flap for repairing massive soft tissue defect associate with bone exposure of lower extremities(Report of 15 cases)

Huang Ke, Huang Hongjun, Xie Wenguang

2014, 14(06):  662-664.  DOI: j.issn.1009-976X.2014.06.014

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【Abstract】〓Objective〓To introduce the method and experience of free thoracoumbilical flap for repairing soft tissue defect of lower extremities. Methods〓Fifteen patients (male 12 cases, female 3 cases, and aged 21-56 years old) with soft tissue defect of lower extremities were reported between 2009 and 2012, including 10 cases of traffic accident injury, 3 cases of crush injury and 2 cases of machine injury. Of 15 cases, the sites of the soft-tissue defects included shank region in 11 cases, lower leg (including internal, external malleolus) in 4 cases. The defect size was 18 cm × 13 cm in length to 28 cm × 16 cm in width. All soft tissue losses were filled with free thoraco-umbilical flap. Results〓All pedicled thoraco-umbilicus flaps survived. Vascular crisis postoperation occurred in one case due to arterial embolization in donor, and healed by autogenous vein graft. Distal part skin necrosis was found in one case and recovered after dressing change. Conclusion〓Free thoracoumbilical flap can supply a large and high quality skinflap for repairing soft tissue defect of compex extremity trauma.

Preliminary experience in completely video-assisted thoracoscopic lobectomy and open thoracoscopic lobectomy in treatment of early-stage lung cancer

Qian Bin, Wang Daomeng, Wu Jun, Zhang Chunyang

2014, 14(06):  665-667.  DOI: j.issn.1009-976X.2014.06.015

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【Abstract】〓Objective〓To evaluate the clinical efficacy of the completely video-assisted thoracoscopic lobectomy for early lung cancer. Methods〓A retrospective analysis was performed in 35 lung cancer patients who underwent completely video-assisted thoracoscopic lobectomy (VATS group) from Sep 2012 to May 2013. Another 35 selective cases with lung cancer who received open lobectomy were served as controls. Operating time, intraoperative bleeding and postoperative extubation time, number of lymph node dissection, postoperative pain, postoperative complications, postoperative hospitalization time were compared between VATS group and control group. Results〓No death occurred in peri-operative period, and one case was converted to open surgery. In VATS patients, blood loss, retention time of drainage tube, postoperative pain duration, hospital stay were shorter than that in controls (P<0.05). The average operation time, average number of lymph node dissection in VATS patients were similar to that in controls. Conclusion〓Completely video-assisted thoracoscopic lobotomy has an advantage open operation over for treating early lung cancer.

Analysis of the bacteriology and treatment experience of severe intra-Abdominal infections in SICU patients of general surgery

Ye Hua, Li Li, Zhong Guifang, Zhan Kelin, Guo Ruilian, Cheng Haihua, He Qing.

2014, 14(06):  668-672.  DOI: j.issn.1009-976X.2014.06.016

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【Abstract】〓Objective〓To investigate the distribution and antibiotic resistance of clinical pathogen isolated from patients of intra abdominal infection associated sepsis in surgical intensive care unit (SICU) of our hospital, then instruct clinical application of antibiotics reasonably. Methods〓The clinical data of sIAI patients in our ICU from January 2012 to December 2013 were retrospectively analyzed. All the specimens were analyzed for pathogen distribution and drug susceptibility. Results〓A total of 151 strains of pathogenic bacteria was isolated, in which Gram-negative bacteria were the most popular pathogen (126 strains, 70.79%), among which escherichia coli was dominant, whereas Gram-positive bacteria accounted for 20.79% (39 strains), among which enterococcus faecium was the predominant species; and fungi accounted for 8.42% (13 strains). Of the 58 patients with sIAS, the mixed infections accounted for 89.66%. The rate of the ESBL-producing strains of escherichia coli and pneumonia were 67.50% and 57.25%. Both of them showed low resistance to carbapenem antibiotics. Conclusion〓Gram-negative bacteria were the most popular pathogen of the sIAI patients. The mixed infections rates and the resistance of the pathogen isolated from the patients are seriously high. Early and rational using of antibiotics is of great importance to control the production and transmission of drug resistance.

Application of spinous process osteotomy and titanium mesh laminoplasty in treating thoracolumbar fractures

Meng De

2014, 14(06):  672-674.  DOI: j.issn.1009-976X.2014.06.017

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【Abstract】〓Objective〓To explore the effect of spinous process osteotomy and titanium rete vertebral canaloplasty in the treatment of thoracolumbar vertebral fracture. Methods〓Spinous process osteotomy and titanium rete vertebral canaloplasty were conducted in 41 patients with thoracolumbar fracture between July 2012 and September 2013. All the patients had a follow-up for more than one year postoperatively. Results〓All fractures healed well within 3 months postoperatively in 23 cases, and were general in 17 cases, failed in one cases. After one year follow-up, 40 patients recovered well and the clinical outcomes were significantly improved compared with their preoperative data (P<0.05). No obvious statistical difference was found between their postoperative data and those in one year follow-up. Conclusion Spinous process osteotomy and titanium rete vertebral canaloplasty is efficient in the treatment of horacolumbar fracture patients...It can effectively promote the fracture healing and reduce the recurrence rate.

Preliminary outcome of intervertebral fusion under Quadrant minimally invasive system for treatment of recurrent intervertebral lumbar disc herniation

Chen Jiayu, Liu Zhanliang, Zhang Huicheng.

2014, 14(06):  675-678.  DOI: j.issn.1009-976X.2014.06.018

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【Abstract】〓Objective〓To evaluate preliminary clinical efficacy of minimally invasive posterior lumbar spine interbody fusion under Quadrant system for recurrent lumbar disc herniation. Methods From January 2010 to December 2012,.a total of 25 cases with recurrent lumbar disc herniation were implemented surgery. The patients underwent interbody fusion via bilateral paramedian approach under Quadrant invasive system. ODI and VAS score were used to evaluate the pre-and post-revision operation outcome. Lumbar CT scan and three-dimensional reconstruction were used to assess the lumbar interbody fusion. Results〓Twenty five patients were followed up for 12-36 months (mean, 19.2 months). The VAS score at preoperation was 8.26±1.4, and 2.47±0.65 at last follow-up after operation, which showed statistical significance (P<0.05). ODI score preoperative and the last follow-up after operation were 40.32+3.14 and 6.67±2.54 (P<0.05), respectively. All cases got bony fusion in the last follow-up after operation. No breakage of pedicle screws or fusion device shift was noted. Conclusions〓It is safe and effective by using the Quadrant minimally invasive system for lumbar interbody fusion in the treatment of recurrent lumbar disc herniation.

Minimally invasive percutaneous pedicle screws osteosynthesis for treatment of thoraco-lumbar vertebra fracture

Lin Shuxin, Lin Jianming, Xu Zhiwei

2014, 14(06):  679-682.  DOI: j.issn.1009-976X.2014.06.019

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【Abstract】〓Objective〓To investigate the efficacy of minimally invasive percutaneous pedicle screw fixation on thoracic vertebral compression fractures. Methods〓Thirty patients with thoracic vertebral compression fractures from January 2012 to November 2014 were included in the study, the data were analyzed retrospectively. Of these 30 cases, 15 underwent surgical procedure of minimally invasive percutaneous pedicle screw fixation (observation group) and 15 were treated with open surgery of traditional posterior midline longitudinal incision approach. The operation time, blood loss, hospital stay, postoperative visual analogue scale (VAS), postoperative Cobb angle correction rate, postoperative failed back surgery syndrome(FBSS) were compared between two groups. Results〓In observation group, the mean operation time, blood loss, hospital stay were significantly reduced when compared with control(P<0.05). VAS at 48 h was significantly lower in observation group than in control group(P<0.05). The postoperative Cobb angle correction rate in observation group was similar to that in control. FBSS patients in control group was higher than in the observation group, but the difference was not statistically significant. Conclusion〓Minimally invasive percutaneous pedicle screws osteosynthesis has better surgical results than the traditional posterior midline longitudinal incision approach in treatment of thoraco-lumbar vertebra fracture.

Microsurgery treatment of hypertensive basal ganglia hematoma through transinsular lateral cleft approach

Zhuo Shaowei, Huang Liujun, Cai Shujia, Guo Shaolei

2014, 14(06):  682-684.  DOI: j.issn.1009-976X.2014.06.020

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【Abstract】〓Objective〓To investigate the effects of using microsurgery to treat hypertensive basal ganglia hematoma. Methods〓The clinical date of 23 patients underwent microsurgery treatment through pterional approach were retrospectively analyzed. Results〓The postoperative CT scan within 24 h showed that the hematomas of 21(91.3%) cases were removed for more than 90%. Within 6-36 months of follow-up period,the therapeutic effects of all patients were evaluated according to activities of daily living (ADL) categories, and grade I, grade Ⅱ, grade Ⅲ, grade IV and grade V were found in 8,9,3,2 and 1 patients,respectively. Conclusion〓Microsurgery treatment of hypertensive basal ganglia Hematoma through pterional approach approach had a high clearance rate of hematoma and better neurologic function recovery.

Expression of CD4+CD25+ regulatory T cells and its correlation with Hunt’s classification for the patients with subarachnoid hemorrhage caused by intracranial aneurysm

Chen Cheng, Chen Dong, Xiang Wei, Xu Fei.

2014, 14(06):  685-687.  DOI: j.issn.1009-976X.2014.06.021

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【Abstract】〓Objective〓To investigate the expression of CD4+CD25+ regulatory T cells (Treg) and its correlation with Hunt?蒺s classification for the patients with subarachnoid hemorrhage caused by intracranial aneurysm. Methods〓Fifty aneurysm patients with SAH,.50 cases with intracranial infection patients and 50 healthy people were included in this study. The peripheral blood examples were collected to detect the levels of transforming growth factors beta 1 (TGF-beta 1) and interleukin 10 (IL-10) by using flow cytometry. Levels of Tregs, TGF-beta 1 and IL-10 were compared between three groups,.and the correlation between Treg,.TGF-beta 1,.IL-10 and aneurysmal SAH Hunt classification were analyzed. Results〓The percentage composition of Treg, mean fluorescence intensity of TGF-beta 1 and IL-10 in patients with intracranial aneurysms group were significantly lower than those in healthy group,.and significantly lower than in the intracranial infection patients,.but no statistical difference was found between intracranial infection group and control group..Any of three levels of Treg,.TGF-beta 1 and IL-10 in aneurysm patients showed a negative correlation with any level of Ⅰ-Ⅴ Hunt classification(r absolute value is greater than 0.7, P<0.05),.in which the maximum correlation showed in Ⅴ level (P<0.001). Conclusion〓Treg, TGF-beta 1 and IL-10 could be protective factors of patients with intracranial aneurysm,.and lower expressions of the three factors would worsen the SAH condition.

Analysis of curative effect on local hypertonic environment improves healing of chronic traumatic wounds

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

2014, 14(06):  688-390.  DOI: j.issn.1009-976X.2014.06.022

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【Abstract】〓Objective〓To compare the effects of hypertonic saline and isotonic saline solutions on the healing of chronic traumatic wounds. Methods〓Between March 2011 and March 2014, sixty-two patients with chronic traumatic wounds were randomized to 2 groups. Thirty-one cases were treated with 28% sodium chloride medical fiber/polyester non-woven dressing (group A) and the other 31 cases, with 0.9% sodium chloride medical gauze (group B). Series of wound cultures were performed, wound conditions were assessed, and the timing of wound healing and adverse reactions were recorded. Results〓The average healing time in group A was 18.6 days. The average healing time for group B patients was 22.5 days (P<0.05). No obvious adverse effects were observed in either group. Wound cultures showed that 80% of the patients with positive pre-treatment cultures became negative after 3 days of hypertonic saline treatment whereas only 10% turned negative in group B. Conclusion〓Local hypertonic environment may significantly reduce bacteria load in chronic wounds and improve wound healing.

Study on treatment of upper ureteral calculi using rigid ureteroscope and holmium:YAG laser lithotripsy (report of 112 cases)

Xu Hanxin, Wu Zhaochun, Huang Hai

2014, 14(06):  691-693.  DOI: j.issn.1009-976X.2014.06.023

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【Abstract】〓Objective〓To investigate clinical effect and safety of holmium: YAG laser lithotripsy under ureteroscopy for managing upper ureteral calculi. Methods〓The clinical data of 112 cases of ureter calculi treated by ureteroscope with Holmium laser lithotripsy were retrospectively analyzed. Among these patients, 63 were male, and 49 were female. The age of the patients varied between 18~87 years with a mean age of 46.7 years. The largest diameter of the largest stone was 0.7~2.2 cm (1.2±0.5 cm). There are 5 cases of bilateral upper ureteral calculi, and the total number of left upper ureteral calculi was 61, and the right side was 46. There were 26 cases affiliated with ureteral polypus, and 31 cases with ESWL treatment history preoperative. All the cases had different degrees of hydronephrosis. Results〓The overall successful operation rate for all level of ureteral stones in single procedure was 88.4% (99/112). The operation time ranged 15~80 min (33.6±16.8 min), and the postoperative hospital stay was 3~14 d (4.7±2.1 d). No complications occurred such as severe hematouria, ureteral perforation, ureteral avulsion and ureteral stone street in this post cohort operation. There were three cases with urinary tract infection and suffered fever. Urosepsis occurred in one case, and cured by timely anti-infection treatment. Conclusion〓Rigid ureterorenoscopy using Ho:YAG laser lithotripsy for upper ureteral calculi can be an effective and safely performed technique.

Comparative study of clinical features and drug tolerance on pseudomonasaeruginosa in AIDS and non-AIDS patients

Ye Lu,Chen Jingfeng,Pan Jingsheng,Wang Jian,Cai Weiping,Zheng Haipeng,Li Gaopeng

2014, 14(06):  694-697.  DOI: j.issn.1009-976X.2014.06.024

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【Abstract】〓Objective〓To investigate differences in infective pathway, clinical manifestations and drug susceptibility results of pseudomonas aeruginosa infections between AIDS and non-AIDS patients, for improving diagnosis and treatment. Methods〓Totally 32 AIDS patients with pseudomonas aeruginosa infections from Jan..2010 to Aug..2014 were selected as the research subjects in observation group,and another 27 non-AIDS patients with pseudomonas aeruginosa infections during the same period were selected as the control group..Differences of two groups in infective pathway,.clinical manifestations and drug susceptibility results were compared and analyzed..Results〓The primary infective pathway of two groups was the same and derived from respiratory tract infection..The main clinical manifestations of observation group were fever,.cough and sputum..The clinical manifestations of control group were more complicated.. Twenty strains (62.5%) of pathogens were isolated from the patients of observation group,.and 24 strains(88.9%) were isolated (P<0.05) from control group..In the observation group, P.aeruginosa had a low resistance to imipenem and meropenem..In the control group,.P.aeruginosa had a relatively low resistance to amikacin,.cefotaxime and meropenem..Conclusion〓The difference of clinical manifestation and drug susceptibility results were significant between pseudomonas aeruginosa infections between AIDS and non-AIDS patients..Clinician should analyse the different conditions of patients comprehensively and choose the antibiotics reasonably.

CAD/CAM combined with RPMT in the treatment of midfacial fractures

Luo Xinxiang, Zeng Dahong, Huang Yuanbing

2014, 14(06):  697-700.  DOI: j.issn.1009-976X.2014.06.025

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【Abstract】〓Objective〓To summarize the application of omputer-aided design/computer-aided manufacturing (CAD/CAM) combined with rapid prototyping manufacturing technology (RPMT) in the reconstruction of midfacial fractures. Methods〓Eighteen sujects suffered with midfacial fractures and treated by CAD/CAM combined with RPMT were collected. Befort operation,.all the subjects were accepted maxillofacial CT scan, mimics software for three-dimensional (3D) reconstruction of CT scan data, and get the 3D model of virtual repair using mirror image technology, making real fracture 3D model. This model was used to guide the reduction and fixation of midfacial fractures. Results〓Patients were followed up for 3-24 months, and achieved anatomic reconstruction of fractures. The outcome after treatment was satisfied esthetically and functionally. Conclusions〓The use of CAD/CAM combined with RPMT is effective for complicated midfacial fractures, which could shorten the operation time and reduce operation risk, increase the repositioning precisely, and help to communicate between doctors and patients.

Research progress of nerve lengthening approach in repairing peripheral nerve defect

2014, 14(06):  701-703.  DOI: j.issn.1009-976X.2014.06.026

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【Abstract】〓Severe peripheral nerve injury is often accompanied with a long segment of peripheral nerve defect..This is a difficult problem for surgeons to repair peripheral nerve lesions..The autologous nerve grafting is a commonly used and is a traditional surgical method to repair peripheral nerve lesions with a long segment defect..However,.the surgical neural repair approach has a poor result..Recent clinical research has focused on nerve lengthening and its postoperative changes in histology and electrophysiology..Just like distraction osteogenesis,.the surgical method works by dragging nerve in order to lengthen nerve.

Research progresses in brain injury and brain protection in cardiopulmonary bypass

Wang Yao, Wang tao

2014, 14(06):  704-707.  DOI: j.issn.1009-976X.2014.06.027

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【Abstract】〓Cardiopulmonary bypass (CPB) is the essential component of the cardiac surgery. With more than half a century of basic research and clinical practice, CPB is becoming better and approaching perfection, greatly promote the development of cardiac surgery. But the brain injury after CPB is attention increasingly..This paper reviews the research progress in brain injury and brain protection of CPB.

Research progress in scoliosis for adolescent

Yu Shenghua,Yin Delong,Yang Zhanxiang

2014, 14(06):  708-711.  DOI: j.issn.1009-976X.2014.06.028

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【Abstract】〓Scoliosis types include functional scoliosis and structural scoliosis in that idiopathic scoliosis account for about 70-80% of all and are the most common structural clinically. Domestic and abroad research shows that prevalence rate of adolescent idiopathic scoliosis (AIS) is about 0.5%-3%, and it is believed the percent would rise with the pupillary study burden to raise in the present Chinese education. The key of prognosis of scoliosis is early detection, early intervention. The most effective way for early discovery of AIS should be census. Because the development of scoliosis often occurred in the period of rapid growth, in which AIS is easy to be corrected.

Advances in treatment of HER2-positive gastric cancer

Mao Wu, Xu Yunji, Liang Qingmo

2014, 14(06):  711-715.  DOI: j.issn.1009-976X.2014.06.029

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【Abstract】〓Gastric cancer is the fourth most common malignancy in the world..Surgery. chemotherapy and radiotherapy are the major strategies for treatment, but the efficacy is limited. With the development of molecular biology,.the gastric cancer target genes are detected and the targeted medicine is used for clinical purpose,.especially for HER2 gene and the HER2-targeted medicine which give new hope for HER2-positive gastric cancer..This article focuses on the advance of treatment in HER2-positive gastric cancer.

Research advances in the fixation of unilateral pedicle screw for lumber degenerative spondylolisthesis

Huang Kai, Liu Zhanliang, Liu Shaoyu

2014, 14(06):  716-718.  DOI: j.issn.1009-976X.2014.06.030

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【Abstract】〓The patients with lumber degenerative spondylolisthesis often have to undergo surgical treatment. Conventional surgical approach is performed by bilateral pedicle screw fixation in lumbar interbody fusion, and this maybe accelerate segment degeneration of adjacent vertebral bodies. The recent studies indicate that unilateral pedicle screw fixation in lumbar interbody fusion can achieve the same effect on stability and interbody fusion by using conventional bilateral pedicle screw fixation in lumbar interbody fusion,.and prevent from segment degeneration of vertebral bodies. But the operation indication must be restrictedly controlled, the operation technique be skilled.

Perioperative nursing methods of component separation technique in abdominal giant incisional hernia

2014, 14(06):  723-725.  DOI: j.issn.1009-976X.2014.06.032

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Nursing care of nasopharyngeal carcinoma over the course of radiation therapy

2014, 14(06):  728-729.  DOI: j.issn.1009-976X.2014.06.034

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Effect of indwelling catheter in pre-anesthetic and post-anesthetic performance on degree of comfort

2014, 14(06):  730-732.  DOI: j.issn.1009-976X.2014.06.035

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