Table of Content

20 April 2015, Volume 15 Issue 02

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论文

C-reactive protein predicts pathologic complete response to neoadjuvantchemotherapy in breast cancer

Chen Yi, Guan Xiaofeng, Nie Yan, Gong Chang, Song Erwei

2015, 15(02):  125-131.  DOI: 10.3969/j.issn.1009-976X.2015.02.001

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【Abstract】〓Objective〓To analyze the relationship between C reactive protein (CRP) and clinical pathobiiology factors before and after neoadjuvant chemotherapy. Methods〓This research retrospectively analyzed 215 patients, who were diagnosed as breast cancer in stage Ⅱ-Ⅲ, admitted in the Breast Cancer Department of our hospital and accepted NAC in January 2001 to June 2010. The relationship of CRP with clinicopathological characteristics as well as efficacy of prediction of pathologic complete response according to two different standards were statistically analyzed. Results Patients with pCR were in lower CRP value comparing with non-pCR patients. CRP reached a high efficacy in predicting pCR (the absence of all invasive disease in the breast tumor). Conclusion〓The protein level of CRP shows predictive value of pCR with neoadjuvantchemotherapy patients.

Effects of dexmedetomidine pretreatment on the levels of myocardial enzyme and cardiac troponin I in patients undergoing value replacement

He Jiang, Zhang Bin, Li Heng, Shao Bin

2015, 15(02):  131-134.  DOI: 10.3969/j.issn.1009-976X.2015.02.002

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【Abstract】〓Objective〓To observe the effects of dexmedetomidine preconditioning on myocardial enzyme and cardiac troponin I in patients with heart value replacement and explore the protective effects on myocardium with ischemia/reperfusion injury. Methods〓Fifty patients undergoing heart valve replacement were randimized into dexemedetomine group (group D, n=25) and control group (group C, n=25). In group D, dexmedetomine was administered intravenously at 0.5 μg·kg-1·h-1 through a bolus infusion in 15 min before anesthesia and then continuous infusion- pumped carried on until aortic clamping, while the same volume of normal saline were given in group C. The central venous blood samples were collected in both groups at pre-opreration (T0), 30 min after aortic clamp (T1), 1 h after aortic-off clamping (T2), end of surgery (T3), 24 h after operation (T4) for detecting the plasma creatine kinase (CK), creating kinase-MB (CK-MB) activity and cardiac treponin I (cTnI) concentration. Meanwhile the rate of heart spontaneous rebeating, arrhythmia, left ventricular ejecfion fraction (LVEF) and usage of cardiac inotropic agents were recorded. Rusults〓The plasma CK, CK-Mb activity and the cTnI concentration, the doses of dopamine and adrenalin in group D were significantly lower than that in group C. There were no significantly statistical differences in the rate of heart spontaneous rebeating, arrhythmia between two groups. The postoperative LVEF was significantly higher in group D than in group C. Conclusion〓Dexmedetomidine pretreatment can attenuate the myocardial injury in patients undergoing cardiac valve replacement.

Gefitinib treatment in metastic breast cancer:.case report and review of the literature

Lin Xiao, Ding Linxiaoxiao, Ding Lin, Yao Herui

2015, 15(02):  135-138.  DOI: 10.3969/j.issn.1009-976X.2015.02.003

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【Abstract】〓Breast cancer is the most common cancer in women,which continues to be a major cause of morbidity among women in China..Molecular-targeted therapyhas become a critical focus of cancertherapy..Gefitinib is a specific inhibitor of epidermal growth factor receptor-associated tyrosinekinase, which has been commonly used in the standard first-line treatment for NSCLC patients with EGFR mutations..Recently,several foreign clinical studies show that gefitinib is active in patients with breast cancer, but present domestic related clinical researches are extremely rare. We describe the case of a patient that was diagnosed with metastatic breast cancer treated with gefitinib therapy.

Cholangioscopy-guided holmium laser lithotripsy for the treatment of pancreatic duct stones:ten-case report

Peng Yanbin, Hu Xiong, Guo Jun, Li Zeping, Li Zhenhua

2015, 15(02):  139-142.  DOI: 10.3969/j.issn.1009-976X.2015.02.004

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【Abstract】〓Objective〓To evaluate the clinical value of cholangioscopy-guided holmium laser lithotripsy for the treatment of pancreatic duct stones (PDSs). Methods〓Cholangioscopy-guided holmium laser lithotripsy was used in 10 patients with PDSs. Pancreato-jejunum Roux-en-Y anastomosis was performed after stone extraction. Results〓All surgical procedures were successfully performed and pancreatic duct stones were removed by the holmium laser. The duration of operation was 30~ 70 min (mean, 45 min). Postoperative recovery was smooth, no abdominal infection, hemorrhage, pancreatic leakage and death of the patient. Follow- up was conducted in all 10 cases for 4-36 months (mean, 11months). B-ultrasonography, abdominal CT and magnetic resonance cholangiopancreatography found no recurrent or residual stones, or pancreatic duct stricture. Conclusion〓Cholangioscopic holmium laser lithotripsy for the treatment of PDSs has advantages of minimal invasion, rapid recovery, satisfactory lithotripsy effects, simplicity of performance, and high reliability.

Clinical effect of laparoscopic and open resection of traumatic rupture of spleen

Luo Xiaofeng,Wang Zhenlong, He Tao, Yu Yong, Li Rong, Chen Boyi

2015, 15(02):  142-145.  DOI: 10.3969/j.issn.1009-976X.2015.02.005

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【Abstract】...Objective...To compare curative effects of laparoscopic splenectomy and open splenectomy fracture treatment on traumatic spleen,investigating the feasibility and safety of LS. Methods〓Forty-five cases of traumatic splenic rupture patients is divided into laparoscopy group (group LS, 18 cases) and open surgery group (group OS, 27 cases) according to the operation mode, Comparing two groups of operative time,.bleeding volume,.postoperative anal exhaust time,.postoperative hospitalization time and incidence of complications. Results〓The average operation time between of OS group and LS group is no statistically significant difference(P>0.05),.and the amount of hemorrhage,.postoperative anal exhaust time,postoperative hospitalization time and incidence of complications are better than those of group OS..which was statistically significant(P<0.05). Conclusion〓The clinical curative effect of traumatic splenic rupture by laparoscopic splenectomy is better than the traditional open surgery, which is feasible, safe and effective on clinical.

Effects of MiRNA-144 on invasive hepatocellular carcinoma

Huang Guanqun, Luo Jie, Zhou Rujian, Zhou Xinke, Jian Zhixiang

2015, 15(02):  146-148.  DOI: 10.3969/j.issn.1009-976X.2015.02.006

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【Abstract】〓Objective〓To investigate the role of miRNA-144 in invasive hepatocellular carcinoma. Methods〓52 cases of HCC tissues and corresponding adjacent cancer tissue were collected from the Guangdong Provincial People?蒺s Hospital of HCC tissue bank. miRNA-144 expression was detected by in situ hybridization in hepatocellular carcinoma and corresponding adjacent cancer tissues. The relationship between miR-144 expression level and clinical pathology was characterized. Online software was used to predict the potential target genes of miR-144. Results〓miR-144 was relatively highly expressed in invasive HCC comparing to adjacent cancer tissue. miR-144 was positively associated with liver tumor grade and early recurrence. Online software predicted SRF as one of the candidate target gene of miR-144. Conclusion〓miRNA profiles in hepatocellular carcinoma may be associated with tumor grade and early recurrence and could serve as potential prognostic marker.

Laparoscopic splenectomy and esophagogastric devascularization for treatment of portal hypertension in patients with liver cirrhosis: a clinical analysis of 38 cases

Li Liusheng, Cai Weihui, Chen Bin, Chen Jianjian

2015, 15(02):  149-152.  DOI: 10.3969/j.issn.1009-976X.2015.02.007

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【Abstract】〓Objective〓To explore the treatment effect and complication therapy of laparoscopic splenectomy and esophagogastric devascularization for portal hypertension. Methods〓The clinical data of 38 cases from January 2010 to March 2014 who underwent laparoscopic splenectomy and esophagogastric devascularization for liver cirrhosis and portal hypertension were analyzed. Results〓All operations in this study were performed successfully. The operation time was 238.42±75.25 min,.the blood loss during operation was 200.53±90.81 ml,.the total hospital stay was 22.71±7.19 d,.the postoperative hospital stay was 12.18±4.49 d,.and the recovery time of gastrointestinal function was 3.45±0.89 d. There were no significant differences in liver function between the preoperative and postoperative data. While the postoperative levels of PLT were significantly higher (48.2±19.7 vs. 227.5±80.5,P<0.001). During the follow-up, rebleeding occurred in 6 cases, hepatic encephalopathy occurred in 3 cases,.portal vein thrombosis occurred in 12 cases,.pancreas abscess occurred in 1 case..All complications were treated in conservative way and the patients got recovery. Conclusion〓Laparoscopic splenectomy and esophagogastric devascularization is a safe,.effective,.minimally invasive procedure for the management of portal hypertension.

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

Huang Meitai, Chen Huanwei

2015, 15(02):  153-155.  DOI: 10.3969/j.issn.1009-976X.2015.02.008

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【Abstract】〓Objective〓To compare the clinical efficacy of laparoscopoic gastroduodenal perforation repair and traditional open gastroduodenal perforation repair. Methods〓This was a prospective study in patients with gastroduodenal perforation in our hospital from June 2011 to June 2013. Thirty-five cases underwent laparoscopoic gastroduodenal perforation repair (laparoscopic group) and 31 received open gastroduodenal perforation repair (control group). The length of hospital stay, operative time,.anal exhaust time,..postoperative usage rate of analgesic drugs and incidence of postoperative complications were analyzed comparatively between two groups. Results〓All surgical procedures in both group were completed successfully and patients were cured..No case in the laparoscopic group transferred to open operation.Except the average operative time in laparoscopic group was longer than the control group, the length of hospital stay, anal exhaust time, postoperative usage rate of analgesic drugs and incidence of postoperative complications in laparoscopic group were lower than that of the control group. Conclusion〓Laparoscopic approach in the treatment of gastroduodenal perforation has better clinical effect than open gastroduodenal perforation repair.

Effect of intra abdominal pressure monitoring on early enteral nutrition in ICU patients

Wu Lixia, Rong Yongzhang, Zeng Jinying, Yu Jinhuo

2015, 15(02):  156-158.  DOI: 10.3969/j.issn.1009-976X.2015.02.009

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【Abstract】〓Objectives〓To investigate the effect of intra-abdominal pressure (IAP) monitoring technology on early enteral nutritionin in ICU patients. Methods〓Ninty-five ICU cases with early enteral nutrition were divided into the experimental group (n=48) and the control group (n=47). The patients in experimental group were treated with intra-abdominal pressure monitoring and routine enteral nutrition nursing strategy. The control group received enteral nutrition nursing trategy alone. The complications, the enteral nutrition days, the days of ICU stay, were recorded and analyzed in two group. Results〓The complications such as gastric retention, abdominal distension, reflux were significantly lower in experimental group than those in the control group (P<0.05). The enteral nutrition days and the ICU stay days in experimental group were less than those in the control group (P<0.05). Three cases in experimental group developed to MODS and 2 cases died. Ten cases in control group developed to MODS and 8 died. Conclusion〓IAP monitoring can be used as an index to guide the rational use of early enteral nutrition in critical patients.

Related factors of postoperative complications in elderly patients with gastric cancers

He Jiayong, Wang Guoliang, Zhang Huabin

2015, 15(02):  159-162.  DOI: 10.3969/j.issn.1009-976X.2015.02.010

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【Abstract】 Objective〓To investigate the related factors associated with postoperative complications in elderly patients with gastric cancer. Methods〓A retrospective data of 57 elderly patients with gastric cancer between Jan 2004 and Dec 2014 were studied. Postoperative complications and risk factors were analyzed. Results〓There were 18 cases of postoperative complications in all 57 patients (31%),including wound infection in 3 cases (5.3%), anastomotic leakage 2 cases (3.5%), abdominal wound disruption 2 cases (3.5%), duodenal stump fistula one case, early postoperative inflammatory intestinal obstruction 3 cases, intra-abdominal infection 2 cases, functional gastric atony one case, anastomotic bleeding one case, lung infection 3 cases. Preoperative comorbidities, tumor size, age and operative time were correlated with postoperative complications of gastric cancer (P<0.05). Conclusion〓Age and disease factors were influence factors of postoperative complications; elderly patients should pay attention to the observation and treatment of gastric surgery around the stage.

Effect of vacuum-assisted closure treatment on expression of Bax and Bcl-2 protein in wound tissues of patients with AIDS

Zhu Xunrong, Zhong luluolin, Li Baojing, Hu Boyong, Sun Yu

2015, 15(02):  162-165.  DOI: 10.3969/j.issn.1009-976X.

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【Abstract】〓Objective〓To investigate the expression of Bax and Bcl-2 protein in the wound tissues in AIDS paitents and the effect of vacuum-assisted closure(VAC) on wound healing. Methods〓Forty AiDS patients with infective wound were selected and divided VAC treatment group (VAC group, n=20) and conventional dressing therapy group (control group, n=20). Bax and Bcl-2 protein expression were determined before treatment and in 3,7 and 14 days after different treatment, respectively. Results〓The VAC group had obvious healing effect, including the markedly effective in 17 cases, the effective in 2 cases, the ineffective in one, while the markedly effective was in 3 cases,the effective in 14 cases,the ineffective in 3 cases in conventional treatment group. There were no significant differences in Bcl-2 protein expression between two groups before treatment (P>0.05). Bcl-2 expression was increased significantly in VAC group than that in control group in 3,7,14 days after treatment(P<0.01). There were no significant differences in Bax protein expression between two groups before treatment, but level of Bax expression in VAC group was significantly lower than that in control group in 3,7,14 days after treatment(P<0.01). Conclusion In the present study, VA C treatment promoted wound healing in AIDS patients, which was associated with. Bcl-2 protein up-regulation and Bax down-regulation.

Clinical observation of recombinant human epidermal growth factor in wound healing after heamorrhoids surgery

Zhong Xiongdong, Lin Huanhui, Chu Zhonghua

2015, 15(02):  166-168.  DOI: 10.3969/j.issn.1009-976X.2015.02.012

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【Abstract】〓Objective〓To observe the clinical effect of epidermal growth factor (EGF) wet-wrap on wound healing after hemorrhoids surgery. Methods〓150 patients with mixed hemorrhoids treated at Sun Yat-sen Memorial Hospital and People?蒺s Hospital of Zhuhai from January 2011 to January 2014 were recruited in this study. All the 150 patients were underwent hemorrhoids surgery and randomly divided into two groups. 78 patients (experimental group) were changed dressing using epidermal growth factor solution gauze and 72 patients (control group) received change dressing using saline gauze. No oral drugs and other topical drugs were used during the wound healing. Wound healing was divided into four grades included cured, markedly effective, effective and invalid. The wound healing was evaluated at the fourteen day after treatment. Results〓The total effective rate of the experimental group was 98.72%, and the control group was 90.28%. The statistical analysis showed that the total effective rate between the two groups was significance different(P<0.05). The average healing time of the experimental group was 12.6±3.16 days (range from 11-16 days) and the control group was 17.9±5.23 days (range from 12-23 days)(P<0.05). Conclusion〓EGF wet wrap can promote skin wound repair, shorten the wound healing time.

Effects of LY354740 pretreatment on neurocognitive impairment induced by ketamine exposure in old mice

2015, 15(02):  169-171.  DOI: 10.3969/j.issn.1009-976X.2015.02.013

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【Abstract】〓Objective〓To evaluate the effects of LY354740 pretreatment on the learning and memory impairment induced by Ketamine in old mice. Methods〓Thirty-six healthy male C57BL/6 mice, aged 18 months, weighing 20-30 g, were randomized into 3 groups (n=12 each), ketamine group (group K), Ly354740 pretreatment group (group L), and control group (group C). In K and L groups, ketamine 30 mg/kg was injected intraperitoneally three times a day at 30-minute intervals for 2 weeks, while in group L, Ly354740 10 mg/kg was injected intraperitoneally at 30 min before the first injection of ketamine, and the group C was injected with the same dose of saline. Cognitive function was assessed using Morris water maze and open field tests after the administration of ketamine was finished. Results〓Compared with controls of group C, the animals in group K showed significantly prolonged escape latency, shortened time spent in the original platform and in the central area for the open field, likewise, the frequency of crossing the original platform was decreased (P<0.05). Compared with group K, the results above-mentioned were significantly meliorated in the Ly354740 pretreatment mice of group L (P<0.05). Conclusion〓Ly354740 pretreatment can attenuate cognitive dysfunction induced by chronic exposure to ketamine in old mice.

Effects of adjunctive therapies of high-grade glioma on delaying recurrence time

Yang Yumin, Liu Zhiyi, Long Xiaodong

2015, 15(02):  172-174.  DOI: 10.3969/j.issn.1009-976X.2015.02.014

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【Abstract】〓Objective〓To investigate the effects of postoperative concomitant therapies of high-grade glioma (gamma knife, radiotherapy, chemotherapy, synchronization chemoradiation) on delaying median relapse time and assess the clinical significance of postoperative concomitant therapy. Methods Sixty-four patients with recurring high-grade glioma patients in Deyang People's Hospital between Jan 2008 to Dec 2013 were included in the study. Of them, 28 patients were treated with only operation (A group), 36 patients treated with postoperative concomitant therapy (B group). In B group, 10 patients were treated with postoperative gamma knife(I group), 4 patients received postoperative radiotherapy (Ⅱ group), 3 patients received postoperative chemotherapy (Ⅲ group), 19 patients were treated with postoperative synchronization chemoradiation (Ⅳ group). Analyse the median relapse time among the groups. Results〓The median relapse time is 7.804 months in A group, 13.431 months in B group; 11.450 months in Ⅰ group, 8.000 months in Ⅱ group; 13.167 months in Ⅲ group, 15.659 months in Ⅳ group. It has statistical significance between A group and B group, also between A group and Ⅳ group. But it has no statistical significance among A group and other groups. Conclusion〓Synchronization chemoradiation is effective for postponing median relapse time of High-grade glioma.

Prospective study of the intensive insulin therapy for severe traumatic brain injury

Feng Jianhang,Li Jianhua,Lin Qiurun,Wu Yiyi,Hu Juqiang,Li Huiyi,Zhang Yuanhong

2015, 15(02):  175-178.  DOI: 10.3969/j.issn.1009-976X.2015.02.015

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【Abstract】〓Objective〓To compare the outcomes between intensive insulin therapy (IIT) and conventional insulin therapy(CIT) in patients with severe traumatic brain injury. Methods〓A retrospective study was preformed, including 116 severe traumatic brain injury patients complicated with stress hyperglycemia from our hospital during Jan 2012 to June 2014. The patients were paired and divided into two groups according to the condition, age and gender. The patients in group A were treated with IIT regimen and those in group B received CIT. The mortality, neurological function, nosocomial infection and hypoglycemia were recorded, analyzed and cpmpared between two groups. Results〓There was no statistical significance of the mortality between group A and B. Group A was associated with a lower incidence of nosocomial infection than group B. The neurological functional recovery of group A was better than that of group B. The hypoglycemia risk of group A was higher than that of group B. Conclusion Intensive insulin therapy can reduce nosocomial infection and have benefit in the neurological recover, but takes a risk of hypoglycemia.

Experience in treating chronic subdural hematoma through single hole drilling and double tube drainage

Meng Wenjie, Qin Huarong, Huang Yongpeng, Wu Jie, Ou Guijie

2015, 15(02):  178-180.  DOI: 10.3969/j.issn.1009-976X.2015.02.016

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【Abstract】〓Objective〓To report the experience in treating chronic subdural hematoma by burr hole craniostomy and drainage. Methods〓A retrospective data from June 2011 to March 2014 in 69 cases with chronic subdural hematoma patients were analyzed. All 69 cases were treated by drilling single hole or two-tube drainage. Results〓Clinical symptoms and signs disappeared in 58 of 69 cases, and were improved in 11 cases. No death was reported. CT imagine showed the hematoma was reduced obviously or even disappeared after two-tube drainage for 1-7 days. Ten cases complicated with intracranial hematoma cavity pneumatosis and a small amount of effusion and recovered in 3 months of followed-up. No recurrence was found. Conclusion〓By single-hole drilling and two-tube drainage for treating chronic subdural hematoma, the patients can get clinical effect well and less complications.

A case report and analysis of malignant hyperthermia in operation

Zeng Jianfeng, Li Li, Wang Zhi

2015, 15(02):  181-184.  DOI: 10.3969/j.issn.1009-976X.2015.02.017

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【Abstract】〓Objective〓To explore the method of diagnosis and treatment of malignant hyperthermia. Methods〓After reviewed the literature, we made a discussion of the treatment, prognosis of malignant hyperthermia combined with this case report. Results〓The patient was rescued, and the operation was completed successfully. Conclusion〓Early detection, rapid rescue and department cooperation raise the success rate for rescuing malignant hyperthermia patients.

Clinical report in 26 patients with thoracic gastrointestinal fistula after esophagus cancer operation

Wei Wei, Li Yongsheng, Zhong Biao, Li Peijian

2015, 15(02):  184-186.  DOI: 10.3969/j.issn.1009-976X.2015.02.018

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【Abstract】〓Objective〓To investigate the cause, diagnosis and treatment of thoracic gastrointestinal fistula after esophagus cancer operation. Methods〓Esophagectomy was performed in 427 patients with esophageal cancer from January 2007 to December 2013 in our hospital. Gastrointestinal fistula occurred post-operatively in 26 patients..Of them with gastrointestinal fistula,7 patients underwent reoperation and 19 cases received conservative treatment including gastrointestinal decompression, thoracic cavity washing,vomica and gastric juice drainage. Enteral nutrition support by duodenal nutrition tube were performed in all 26 patients. Results〓The rate of TGF was 6.09% (26/427), including 6 gastric remnant fistula and 20 gastroesophageal anastomotic fistula. Seven patients with reoperation were cured due to finding in 3 days. Fourteen cases were cured in 19 patients with conservative treatment and 5 died. Conclusion〓Esophageal reconstruction should be performed in the patients of early fistula which happens in 3 days after operation. Vomica drainage, adequate gastric juice drainage, thoracic cavity washing and active enteral nutrition support are necessary for treatment of thoracic gastrointestinal fistula after esophagus cancer operation.

Clinical values of thoracoscopic surgical treatment combined with fast track surgery in lung cancer surgery

Zhang Xigui, Li Taidong, Ni Wu, Mao Anyun, Lin Yuchao, Liang Guolian

2015, 15(02):  187-190.  DOI: 10.3969/j.issn.1009-976X.2015.02.019

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【Abstract】 Objective〓To evaluate effects of thoracoscopic surgical treatment combined with application of fast-track surgery principles on lung cancer surgery. Methods〓A total of 80 patients who underwent radical resection of pulmonary carcinoma between August 2013 and August 2014 were selected, and divided into observation group and control group with 40 patients in each group. The patients in observation group were treated through the application of fast-track surgery principles, while the controls were treated with thoracoscopic chest surgery. The pain recording at 1 d, 3 d, 7 d, and 14 d after operation was scored by visual analogue scale (VAS). The postoperative retention times of urinary catheter and chest tube,times to passage of gas by anus,lengths of stay,and incidence of complications were counted. And the serum interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) contents were assayed at 1 d, 3 d, 7 d, 10 d, and 14 d after admission. Results〓The patients of the observation group had shorter retention times of urinary catheter and chest tube, time to passage of gas by anus, and length of stay than those of the control group (all P<0.05). The patients of the observation group had lower incidence of postoperative cardiovascular diseases, postoperative infection, and pulmonary infection than that of the control group(P<0.05). The patient of both groups had improved VAS scores at 3 d and 7 d after the surgeries compared with those at 1 d after the surgeries,and the patients of the observation group had greater improving extents than those of the control group(P<0.05). The difference in VAS score at 14 d after the surgeries was statistically insignificant between the patients of the two groups (P>0.05). The differences in serum IL-6 and TNF-α levels at 1d after the operation were statistically insignificant between the patients of the observation group and control group (P>0.05), but the patients of the observation group had significantly lower serum IL-6 and TNF-α levels at 3 d,.7 d,.10 d,.and 14 d than those of the control group.(all P<0.01). Conclusion Thoracoscopic surgical treatment combined with rapid recovery in patients with lung cancer surgery can effectively shorten the postoperative extubation time and length of stay, lighten the degrees of injury and pain, with a lower postoperative complication incidence and faster postoperative recovery.

Application of video-assisted coronary artery bypass

Chen Haisheng, Liu Shenghua, Wu Liyin, Lin Qiuwei, Li Bin, Zhang Xiong

2015, 15(02):  191-193.  DOI: 10.3969/j.issn.1009-976X.2015.02.020

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【Abstract】〓Objective〓To study clinical application of video-assisted coronary artery bypass. Methods〓During September 2005 to July 2013, left internal mammary artery was harvested and video-assisted coronary bypass was performed in 9 cases (male 5 and female 4) with coronary disease. The anastomoses of left internal mammary artery to left anterior descending was performed without cardiopulmonary bypass in 8 cases..Atrial septal defect repair and the anastomoses of right internal mammary to right coronary artery were performed with cardiopulmonary bypass in 1 case. Results〓The whole surgical procedure of video-assisted coronary artery bypass were completed successfully. The time of internal mammary artery harvesting was 31-47 min (39.3±5.9 min). The time of the anastomoses of internal mammary to coronary artery was 6-7 min (5.2±1.4 min). The time of staying in ICU was 2-4 days. All cases were discharged 9-12 days. Conclusion The short-term effect of harvesting internal mammary artery and video-assisted coronary artery is satisfactory.

Risk factors associated with developing lower extremity deep venous thrombosis after laparoscopic operation of gynecology malignant tumor

Zou Guofang, Hu Hongbo, Xu Hongyan, Luo Pingxiang

2015, 15(02):  193-197.  DOI: 10.3969/j.issn.1009-976X.2015.02.021

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【Abstract】 Objective〓To explore the risk factors of deep venous thrombosis in lower limbs (LDVT) following laparoscopic surgery for gynecologic malignancies. Methods〓The clinical data of between the operation mode, operation time, body mass index (BMI), age, hypertension, diabetes, serum triglyceride (TG), cholesterol (CHOL) and postoperative LDVT formation by using univariate analysis and logistic multivariate regression analysis. Results〓The incidence of LDVT among the total cases was 22 patients during hospitalization and the incidence rate was 9.09%. Univariate analysis and logistic multivariate regression analysis showed age, hypertension, diabetes, extensive hysterectomy subtotal + double attachment + pelvic lymph node dissection, operation time >3 hours were the risk factors for the formation of LDVT (P<0.05). Conclusion〓Gynecological malignant tumor after laparoscopic operation is prone to LDVT. Clinical risk factors in patients with predisposing factors taking active intervention is very necessary.

Outcomes of blood biochemical levels and bone turnover markers after zoledronic acid intravenous drip in 24 hours

2015, 15(02):  198-201.  DOI: 10.3969/j.issn.1009-976X.2015.02.022

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【Abstract】〓Objctive〓To observe the effect of blood biochemical levels and bone turnover markers after zoledronic acid intravenous drip in the patients with postmenopausal osteoporosis. Methods〓This study were retrospectively analyzed 148 inpatient women with osteoporosis confirmed by bone mineral density examination during 2012 to 2014 in our department..The serum levels of calcium, phosphorus, creatinine, C-terminal crosslinking telopeptide of type I collagen (S-CTX), N-terminal propeptide of type I collagen (PINP) were detected and analyzed before and 24 hours after the injection of zoledronic acid were analyzed. Results〓The female patients were 65.98±9.53 years old. The concentration of serum calcium, phosphorus, creatinine, creatinine clearance, S-CTX and PINP was 2.29±0.10 mmol/L, 1.13±0.15 mmol/L, 80.84±13.7 μmol/L, 53.94±13.96 mL/min, 0.32±0.24 ng/mL,.and 44.98±27.89 ng/mL before injection and 2.13±0.14 mmol/L,.1.11±0.15 mmol/L, 85.71±12.78 μmol/L, 50.78±12.98 mL/min, 0.176±0.165 ng/mL, 45.60±26.79 ng/mL 24 hours after injection..The variation of serum calcium was decreased(P<0.05)..Fifty-five patients appeared hypocalcemia and 12 patients had a creatinine clearance lower than 35 mL/min,.but had no clinical symptoms. By contrast, the variation of serum phosphorus and creatinine was statistically significantly (P<0.05), but all the date are in normal range. The concentration of S-CTX was significantly decreased after the injection (P<0.05). The variation of PINP was not significant (P=0.65). This indicated that the injection of zoledronic acid can inhibit the activity of osteoclast immediately and has no immediate effect on the activity of osteoblast, and can cause hypocalcemia for a short time and has little influence on phosphorus metabolism and the renal function. Conclusion The injection of zoledronic acid can significantly inhibit bone resorption, and it is safe and effective.

Study on the correlation between the Substance P levels and the severity of progression in old patients with knee osteoarthrosis

Zhou Zhengmao, Lin Zhelong, Zhang Guangming

2015, 15(02):  201-204.  DOI: 10.3969/j.issn.1009-976X.2015.02.023

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【Abstract】〓Objective〓To evaluate the relationship between Substance P levels in the synovial tissue of the human knee joint and the severity of progression in patients with knee (osteoarthritis, OA) OA. Methods〓A total of 212 OA patients and 115 controls were enrolled in the study (control group). The symptomatic severity of OA was assessed by the Legusue grading system. The OA group was divided into 3 groups, Mild OA group (A1, n=57), Mediate OA group (A2, n=87), and Severe group (A3, n=50). The severity of pain was assessed by Western Ontario McMaster University Osteoarthritis Index (WOMAC). Synovia Substance P levels were measured by enzyme-linked immunosorbent assay (ELISA). Results〓The levels Substance P in the synovial tissue were significantly higher in OA patients compared with controls. Substance P levels were positively correlated with WOMAC-pain scores (r=0.265, P<0.05) and Legusue grades (r=0.785, P<0.05) in OA patients. Conclusion〓The raised substance P levels might act as an important indication in the pathogenesis of OA.

Comparison of proximal humerus locking plate and anatomical plate for Neer three-and four-part of proximal humeral fractures

Zhu Haodong, Cai Xinxin, Guo Yunfeng, Zheng Baisheng, Zhou Zhuoqian

2015, 15(02):  205-207.  DOI: 10.3969/j.issn.1009-976X.2015.02.024

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【Abstract】〓Objective〓To investigate the effect of proximal humerus locking plate and proximal humerus anatomical plate on complex 3- and 4-part fractures of the proximal humerus (Neer classification) in the elders. Methods〓151 cases of proximal humeral fractures were included in the study and divided into proximal humerus anatomical plate group (A group, n=65 cases) and proximal humerus locking plate group(B group, n=86 cases) according to different operation methods. The patients of A group underwent fracture fixation by anatomical plate and those in B group received fracture fixation by locking proximal humerus plate. The treatment effect was evaluated in two groups and compared between two groups by Neer score and Constant score. Results〓The mean humerus healing time of B group was significant superior to A group (P<0.05). Neer score, constant score, pain, function, activity and total score of shoulder in B group were significant superior to those in A group in 1 year and 2 years after operation (P<0.05). Conclusion〓Proximal humerus locking plate and proximal humerus anatomical plate could be used for three-and four-part of proximal humeral fractures in the elders, but proximal humerus locking plate has andvantage for humerus healing time, functional rehabilitation.

Effect of combined anterior and posterior approach operation in treatment of complicated acetabular fractures

Zeng Qingping, Huang Jianbin, Zhang Min, Lei Xueming

2015, 15(02):  208-211.  DOI: 10.3969/j.issn.1009-976X.2015.02.025

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【Abstract】〓Objective〓To investigate the clinical effect of combined anterior and posterior approach operation on treating complicated acetabular fractures. Methods〓The clinical data of 18 patients with complex acetabular fractures in our hospital were retrospectively analyzed. All cases were treated by combined anterior and posterior approach operation. According to Matta standard and D’Aubigine assessment,the clinical effects of fracture reduction and hip function were evaluated. Heterotopic ossification was assessed by Brooker standard, and all complication rate were observed. Results〓Anatomic reduction was in 12 cases, satisfactory reduction in 6 cases, no satisfactory reduction. D’Aubigine asscessment of excellent and good rate was 94.4%. One case complicated with heterotopic ossification..Complication included in one traumatic arthritis and one femoral head necrosis patients. Conclusion〓Combined anterior posterior approach operation in the treatment of complex acetabular fracture can explose operative field, enhance the anatomic reduction rate and clinical effect, improving joint function significantly, and decrease complication rate, which is worthy of further popularization.

Clinical research of stone encrustation on double J stent after operation of upper urinary tract

Cui Xuejiang, Hu Ming, Xu Xun, Guan Lixian, Yang Yunjie, Zhao Zhenhua

2015, 15(02):  212-215.  DOI: 10.3969/j.issn.1009-976X.2015.02.026

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【Abstract】〓Objective〓To investigate the elements of stone encrustation on double-J stent in patients underwent upper urinary tract surgery and the risk factors of stone formation postoperatively. Methods〓560 patient with double T stent were included in the study..The incidence of stone formation on double J tube shell in different indwelling time,.urine pH,.urine infection were investigated..The ingredient of urinary calculus was analyzed by infra-red sepectrometry. Results〓In 138 cases indwelling double J tube within one month, there were 14 cases with stone encrustation, accounting for 10.1%. In 258 cases indwelling double J tube for one month to three months, there were 31 cases with stone encrustation,.accounting for 12.0%..In 102 cases indwelling double J tube for three months to six months, there were 32 cases with stone encrustation, accounting for 31%. In 62 cases indwelling more than half a year, there were 26 cases with stone encrustation, accounting for 41.9%. Of 432 cases with calcium oxalate, 56 cases were found stone encrustation, accounted for 13%. Of 89 cases with uric acid component, 56 cases were found stone encrustation, accounted for 62.9%. Those cases with the urine PH less than 6.5, and with urine infection, had a higher incidence of stone encrustation on double J stent. Conclusion〓Longer residence time of double J tube, acidic environment, combined with urinary system infection are the risk factor for stone encrustation in patients underwent operation of upper urinary tract. Shortening the indwelling time, alkalizing the urine can prevent stone formation.

Risk factors of sepsis derived from post-percutaneous nephrolithotomy

Wu Guozhong, Sun Zhongkai, Zhong Baowen

2015, 15(02):  215-218.  DOI: 10.3969/j.issn.1009-976X.2015.02.027

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【Abstract】〓Objective〓To investigate risk factor of post percutaneous nephrolithotomy (PCNL) sepsis. Methods〓A retrospective analysis from June 2004 to June 2014 was performed in 9332 cases with kidney stones. All patients underwent surgical procedure of percutaneous nephrolithotomy and postoperative urinary-derived sepsis was found in 93 cases. The age, gender, presence of urinary tract infection, and preoperative percutaneous renal surgery time and a series of factors associated with sepsis were analyzed. Results〓Through a one-way factor analysis, female patients (P<0.05), stones> 20 mm (P<0.05), history of diabetes (P<0.05), not the use of antibiotics (P<0.05) and preoperative percutaneous nephrolithotomy were associated with PCNL sepsis. Multivariate regression analysis showed that female patients (P<0.05), history of diabetes (P<0.05) were risk factors for PCNL sepsis. Of 93 cases, 82 were cured, 11 died of disseminated intravascular coagulation and multiple organ dysfunction. Conclusion〓Women and history of diabetes are risk factor to induce to PCNL sepsis. The high-risk patients deserve the standard preoperative antibiotic preparation.

Expression and clinical significance of CD8+CD28-T cells for renal carcinoma patients underwent nephrectomy

Li Huaqiang, Yuan Jian, Tang Yunfeng, Chen Shaona

2015, 15(02):  219-221.  DOI: 10.3969/j.issn.1009-976X.2015.02.028

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【Abstract】〓Objective〓To investigate the expression and clinical significance of CD8+CD28-T cells for patients with renal carcinoma undergoing nephrectomy. Methods〓Fifty-two patients who underwent radical prostatectomy were collected as research objects (group A). Flow cytometry was used to test peripheral blood CD8+CD28-T cells before and after operation, interleukin 10 (IL-10), and transforming growth factor beta 1 (TGF-beta 1) content. The correlation between the three levels and of tumor stage was analyzed. The patients with renal hamartoma (group B) and normal people (group C) served as controls. Results〓The CD8+CD28-T cells number, expression of IL-10 and TGF-beta 1 in group A were significantly higher than the other two groups, but had no statistical difference between the group B and group C. Preoperative levels of CD8+CD28-T cells, IL-10 and TGF-beta 1 in the patients with stage III were significantly higher than those with stage I and stage II(P<0.05). Postoperative levels of CD8+CD28-T cells,IL-10 were increased and TGF-beta 1 content was decreased in patients with stage III than that of preoperative period (P<0.05), but no difference in patients with stage I and stage II between pre- and post-operation. Correlation analysis showed that the CD8+CD28-T cells, IL-10 and TGF-beta 1 and tumor stage showed significant positive correlation (P<0.05) and the related degree was CD8+CD28-T cells > TGF-beta 1> IL-10. Conclusion〓The increases of CD8+CD28-T cells and cytokines levels could be a new immune mechanism of kidney carcinoma, and the former could identify kidney cancer and benign tumor, evaluate the operation effect.

The research progress in the relationship between liver metastases of colorectal cancer and HBV infection, liver fibrosis

2015, 15(02):  222-227.  DOI: 10.3969/j.issn.1009-976X.2015.02.029

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【Abstract】〓Objective〓Colorectal cancer is one of the most common human malignancies, and the liver metastase of colorectal cancer is the main reason for death and disability. Multi-clinical analysis confirmed that HBV infection and cirrhosis decrease risk of liver metastasis in patients with colorectal cancer, but there is still no certain mechanism to explain the clinical phenoenon. In this paper, it is described that the possible related mechanism through epigenetic, tumor microenvironment and immunity.

Research of platelet-rich plasma in osteopathic medicine

2015, 15(02):  228-231.  DOI: 10.3969/j.issn.1009-976X.2015.02.030

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【Abstract】〓Platelet-rich plasma(PRP) is a popular research topic in the latest ten years. PRP can promote tissue repair as an autologous plasma products with super-physiological concentration of platelets and various growth factors. Currently, PRP has been used in some clinical fields such as oral application,cosmetic surgery,general surgery,.orthopedics and sports medicine,.among which much attention has been focused on orthopedic research..The results of orthopedic-related cytology testin vitro,animal experiments in vivo and clinical studies suggest that PRP can effectively promote bone and soft tissue repair,good for bone disease treatment,.but some are also reported the opposite conclusion, or lack of clinical evidence. Therefore, many problems of PRP research need to be solved and more research is needed to explore.