Table of Content

20 June 2015, Volume 15 Issue 03

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论文

Efficacy of perioperative simvastatin on systemic inflammatory response after cardiac valve surgery with cardiopulmonary bypass: a randomized control trial

Liu Jianyang, Tao Jun, Li Hongmu, Yang Yanqi, Hua Ping

2015, 15(03):  243-247.  DOI: 10.3969/j.issn.1009-976X.2015.03.002

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【Abstract】〓Objective〓To investigate the effect of simvastatin against systemic inflammatory response and organ damage in cardiac valve surgery with cardiopulmonary bypass (CPB). Methods〓130 patients who underwent cardiac valve surgery with CPB were randomly assigned to either a stain group(n=65) or a control group(n=65). Simvastain(20 mg) was administered preoperatively and postoperatively. The ICU detention time, time of using assisted ventilation, amount of urine, drainage in 24 hours after operation and left ventricular ejection fraction at 10 days postoperation were recorded. Plasma and left ventricular ejection fraction at 10 days postoperation were analyzed for troponin T (cTnT), isoenzyme of creatine kinase(CKMB), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), interleukin-8(IL-8), C-reactionprotein (CRP), blood urea nitrogen (BUN) and Creatinine(Cr). Results〓Simvastatin significantly reduced the time of using assisted ventilation ejection fraction was higher in the statin group than in the control group at 10 das postoperation(P<0.05), but there were no significant difference in ICU detention time, amount of urine and drainage in 24 hours after operation between the two groups(P>0.05). Simvastatin significantly reduced the lever of cTnT, CKMB, TNF-α, IL-6, IL-8, CRP, BUN, Cr(P<0.05). Conclusion〓Perioperative stain therapy can reduce the system inflammatory response and organ damage after CPB and improve the prognosis of patients.

Effect of the dosage of preoperative steroid use on post-operative complications in patients with inflammatory bowel disease

Huang Juanni, Ke Chuanfeng, Liang Liying, Ye Huiling, Chen Guangyuan

2015, 15(03):  248-255.  DOI: 10.3969/j.issn.1009-976X.2015.03.003

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【Abstract】〓Objective〓To investigate the relation between the risk factor of postoperative complications in patients with inflammatory bowel disease (IBD) and preoperative steroids usage, Methods〓We searched medical electronic database for full articles published since the year 1970 concerning postoperative complications in patients with IBD who undergone abdominal surgery. The perioperative patients with steroid or not were analyzed. Randomized effect or fixed effect was carried out depending on heterogenicity of the studies. Results〓A total of 28 retrospective studies met the inclusion criteria.Pooled analysis demonstrated an increased risk of total postoperative complications (OR=1.42, 95% CI: 1.61-1.75, P=0.0007) and infectious complications (OR=2.28, 95% CI: 1.49-3.49, P=0.0002) among patients using steroid preoperatively. Patients receiving higher dose of steroids (>20 mg/d) suffered from a higher risk of total complications (OR=1.45, 95% CI: 1.04-2.02, P=0.03) and infectious complications (OR=2.04, 95% CI: 1.05-3.95, P=0.04), compared with the lower group. Conclusion〓Total complications and infectious complications increased in IBD patients following preoperative steroid use after abdominal surgery. Preoperative dose of steroids under 20 mg/d could reduce this risk.

Pre-operative bevacizumab, capecitabine and radiation among patients with locally advanced rectal cancer

Wang Dongxia, Li Yuechun, Sun Yanqiu, Zhao Zhengjun, Zhao Yanhai, Li Xianming

2015, 15(03):  256-260.  DOI: 10.3969/j.issn.1009-976X.2015.03.004

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【Abstract】〓Objective〓To evaluate the safety and efficacy of pre-operative chemoradiation, using capecitabine and bevacizumab with standard doses of radiation, in patients with locally advanced rectal cancer. Methods〓Patients with locally advanced cancer were treated with capecitabine 825 mg/m2 twice daily on days 1-14 and bevacizumab 5 mg/kg on days 14, 1, 15 and 29, and radiation 50.4 Gy in 28 fractions including boost.Total mesorectal excision was performed 7-9 weeks after chemoradiation. Results〓Forty-two evaluable patients were enrolled, and 38 proceeded to definitive surgery. Eighteen patients (43%) had clinical T4 tumours and/or N2 tumours. Mean relative dose intensity was >90% for all systemic agents, and 97% for radiation. Grade 3/4 diarrhoea occurred in 10 patients (24%) and pain in 4 patients (10%) pre-operatively, while grade 3/4 pain, fatigue and infection were each reported among 5 patients (13%) post-operatively. Re-operation due to complications occurred in 4 patients (11%). Complete tumour regression (ypT0) was seen in 9 patients (23.7%) of which 2 had N1 disease (5.3%) and the pathological complete response (pCR) rate (ypT0N0) was 18.4%. Conclusion〓In this study, pre-operative bevacizumab added to capecitabine and radiation was safe and resulted in a promising tumour regression rate.

Inhibitory effects of microRNA-126 on proliferation and apoptosis of human hepatocellular carcinoma cell line SMMC-7721 by targeting PIK3R2

Peng Jixiang, Wang Xiaokang, Lin Zhuoyuan, Wu Yongding, Ye Jianheng, Cai Zhiduan

2015, 15(03):  260-265.  DOI: 10.3969/j.issn.1009-976X.2015.03.005

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【Abstract】〓Objective〓To explore the influence of microRNA-126 (miR-126) on proliferation and apoptosisof human hepatocellular carcinoma cell line SMMC-7721 and evaluate the correlation between miR-126 and PIK3R2. Methods〓After transfection of microRNA mimics into SMMC-7721 cells,cell proliferation and apoptosis were assessed by CCK-8 assay and cell apoptosis assay. Expression of PIK3R2 was evaluated by quantitative real-time polymerase chain reaction and western blotting. Luciferase reporter assay was used to confirm the relationship between miR-126 and PIK3R2. Results〓The outcomes by CCK-8 assay and apoptosis assay revealed that transfection of miR-126 suppressed cell proliferation, induced cell apoptosis of SMMC-7721 cells. Ectopic overexpression of miR-126 caused significant decrease of protein level of PIK3R2 (P=0.0135). In addition, luciferase assay showed that miR-126 significantly weakened the normalized PIK3R2-3’ UTR luciferase activity (P=0.0016). Conclusion〓Overexpressed miR-126 can inhibit proliferation and promote apoptosis of hepatocellular carcinoma cells by downregulating PIK3R2, thus indicating its tumor suppressive function in hepatocellular carcinoma.

Ultrasound-guided percutaneous transhepatic gall bladder drainage for acute cholecystitis in patients with liver cirrhosis

Li Xiaohui, Ling Yunbiao, Zhong Yuesi

2015, 15(03):  266-268.  DOI: 10.3969/j.issn.1009-976X.2015.03.006

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【Abstract】〓Objective〓To investigate the effectiveness and safety of ultrasound-guided percutaneous transhepatic gallbladder drainage for acute cholecystitis in patients with liver cirrhosis. Methods〓There were 12 cases included in the retrospective study..All patients with liver cirrhosis and portal hypertension suffered from acute cholecystitis and received ultrasound-guided percutaneous transhepatic gall bladder drainage during December 2013 to December 2014. There were 7 cases with liver function of Child-pugh A, and 5 cases with Child-pugh B. Postoperative complications, inflammation resolution and improvement of liver fuction of the 12 cases were analyzed. Results〓All 12 cases achieved inflammation resolution of the gall bladder after ultrasound-guided percutaneous transhepatic gallbladder drainage,.and received laparoscopic cholecystectomy..Two cases presented with intraperitoneal hemorrhage, and cured with conservative treatment. All 12 cases presented with no other complication, and some cases presented with improvement of liver function. Conclusion〓Ultrasound-guided percutaneous transhepatic gallbladder drainage was safe and effective for acute cholecystitis in patients with liver cirrhosis, who can subsequently receive laparoscopic cholecystectomy safely.

The safety and clinical effect of preoperative oral carbohydrate intaking on primary liver cancer surgery: a randomized control trial

Deng Guorong, Chen Boyi, Li Rong, Liu Ningjiang, Li Chengcai, Huasng Zhijie,

2015, 15(03):  269-272.  DOI: 10.3969/j.issn.1009-976X.2015.03.007

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【Abstract】〓Objective〓To investigate the safety of preoperative oral carbohydrate loading and the effect on postoperative stress hyperglycemia as well as insulin resistance after elective liver cancer. Methods〓Sixty-one cases with liver cancer undergoing elective liver surgery were randomized into experimental group and control group. The patients in the experimental group were given 10% glucose 250 ml oral drink three hours before operation, while the ones in the control group were fasted overnight. The volume of gastric juices and perioperative blood glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR) were recorded and analyzed. Results〓None was found to have aspiration. The average gastric juice of experimental group and control group was 45.4±18.4 ml and 38.8±17.2 ml and no statistical difference was found between two groups. There were no significant difference between two groups in preoperative general information, liver function, blood glucose, insulin and HOMA-IR level (P>0.05). The liver function in the postoperative 5 days were similar between two groups, and the level of AST, ALT and total serum bilirubin were significantly lower in the experimental group in the postoperative 1 and 3 days (P<0.05). Moreover, the levels of fasting blood glucose, insulin, HOMA-IR in the experimental group were statistically lower in the postoperative 1, 3 and 5 days (P<0.05). Conclusion〓Ten percent glucose of 250 ml oral administration in 3 hours before operation was safe and it can significantly reduced postoperative stress hyperglycemia and insulin resistance.

Clinical analysis of three types of hilar cholangiocarcinoma treated by combined hepatic artery resection and hemihepatectomy

2015, 15(03):  273-276.  DOI: 10.3969/j.issn.1009-976X.2015.03.008

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【Abstract】〓Objective〓To explore the clinical outcome and the security of combined hepatic artery resection and hemi-hepatectomy in the patients with hilar cholangiocarcinoma (Bismuth IIIa, Ⅲb, Ⅳ). Methods〓Thirty cases with hilar cholangiocarcinoma were included in this study and their clinical data were analyzed retrospectively..Of them,8 patients underwent the surgery of right Hemihepatectomy as well hepatic arterectomy,19 cases of left hemihepatectomy, 2 cases of ultimate hepatectomy and one case of the caudate lobe resection. Results〓Pathological results showed adenocarcinoma in 22 cases, mucinous adenocarcinoma in 2 cases, adenosquamous carcinoma in 3 cases,.papillary adenocarcinoma in 2 cases and clear-cell carcinoma in one case. There were 5 cases with poorly differentiated carcinoma,.10 cases with moderately carcinoma and 15 cases with wel1 differentiated carcinoma..Complications occured in 13 case (13/30). Conclusion〓In the present paper,.we showed the combined hepatic artery resection and hemihepatectomy was a safe and had good outcomes,.which could increase the radical excision proportion.

Endoscopic management of bile leakage after laparoscopic operation of gallbladder and biliary tract

Fei Lin

2015, 15(03):  276-279.  DOI: 10.3969/j.issn.1009-976X.2015.03.009

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【Abstract】 Objective To explore the effectiveness of endoscopic treatment on bile leakage of post laparoscopic biliary surgery. Methods〓The clinical data of bile leakage in 40 patients with post biliary surgery were reviewed retrospectively. Results〓All patients were treated by endoscopy through duodenal papilla approach and all got cured. LOS (length of stay) ranged between 7 and 35 days, and ALOS (average length of stay) was 14.0±3.5 days. Conclusion〓Anomal-duodenal papilla, micro calculus incarceration are the important factors about non-iatrogenic medical of biliary peritonitis on biliary surgery. Endoscopic treatment is effective in the management of post-operative bile leakage.

Clinical observation of early blood purification combined with early digestive tract decontamination treatment on severe acute pancreatitis

Shen Lihan, Cai Lihua

2015, 15(03):  280-283.  DOI: 10.3969/j.issn.1009-976X.2015.03.010

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【Abstract】〓Objective〓To observe the therapeutic effect of early blood purification combined with early selective digestive tract decontamination (SDD) on treatment of severe acute pancreatitis. Methods〓A retrospective analysis was performed in the 39 SAP patients admitted to Dongguan People’s Hospital from March 2012 to March 2015. The patients were divided into intervention group (n=21) and control group (n=19). The patients of intervention group were treated with early blood purification combined with early SDD, and the controls received conventional treatment. Clinical outcomes of post-treatment were assessed, including the time of bladder pressure below 15 mmHg, the time of vasoactive drugs, the duration of mechanical ventilation, the days of ICU admission, the average hospitalization expenses and inhospital mortality. Results〓Compare to control group, the time of bladder pressure below 15 mmHg was decreased in the intervention group (6±0.9 d vs 9±1.8 d, P<0.05), meanwhile, the time of vasoactive drugs and ICU admission were significantly reduced, but there was not significantly difference between two groups in the duration of mechanical ventilation. There was significantly difference between two groups on the average hospitalization expenses (intervention group: 22±4.8, control group: 31±7.3, P<0.05). The inhospital mortality of intervention group was 9.5%, and 22.2% in control group. Conclusion〓Early blood purification combined with SDD can improve clinical symptoms, shorten ICU admission, and decrease mortality of SAP patients.

Effects of short-term intensive insulin therapy in patients with hyperglycemia on beta cell function in perioperative period

Li Shaoyu, Chen Genben, GuoLiandian, Hu Yugang

2015, 15(03):  283-285.  DOI: 10.3969/j.issn.1009-976X.2015.03.011

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【Abstract】〓Objective〓To explore the effect of short-term intensive insulin therapy in patients with hyperglycemia on beta cell function in perioperative period. Methods〓From January 2011 to July 2013 in our hospital, forty-five patients in perioperative period with hyperglycemia were underwent short-term intensive therapy (continuous subcutaneous insulin infusion, CSII group, n=25; multiple subcutaneous insulin injection, MSII group, n=20). The data of FBG, 2hPG, blood glucose GSP, beta cell function and insulin sensitivity index and the changes of TNF-α, IL-1β, CRP and APN were compared between the two groups. Results〓After the treatment, the patients of CSII group and MSII group showed significantly decreased FBG, 2hPG and GSP levels (P<0.05). Both CSII group and MSII group showed significantly lower FCP and Homa-IR levels, and higher Homa-β after treatment (P<0.05). CSII group demonstrated more significantly improvement compared with MSII (P<0.05). And the same changes of TNF-α, IL-1β, CRP, and APN levels were observed after treatment in CSII group compared with MSII group. Conclusion〓The continuous subcutaneous insulin therapy can effectively control blood glucose and improve islet function and insulin sensitivity,which is involved by reducing inflammation.

Management of 29 cases brain death organ donor in the Intensive Care Unit

Yang Yun, Zhou Lixin

2015, 15(03):  286-289.  DOI: 10.3969/j.issn.1009-976X.2015.03.012

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【Abstract】〓Objective〓To explore the management of potential organ donors after brain death in the Intensive Care Unit. Methods〓The clinical data of 29 cases of brain death organ donor from January 2012 to December 2013 in our Intensive Care Unit were analyzed retrospectively,including condition of pre-organ procurement,renal transplant recipients,liver transplant recipients and effect of renal transplantation on the recipients recived acute kidney injure(AKI) donors. Results〓Twenty-nine cases of brain death donor were managed for transplantation, including 40 kidneys,27 livers,4 hearts and 21 pairs of corneas. Renal delayed graft function occurred in 6 cases (15%) of renal transplant recipients. Acute rejection occurred in one case (2.5%) and internal iliac artery pseudoaneurysm also occurred in one case (2.5%) of renal transplant recipients, and the two cases subjected to nephrectomy. There was one case (2.5%) of renal transplant recipients death due to severe pneumonia. The recipients receive AKI kidney and non-AKI kidney had no significant difference on recovery of creatinine after operation and adverse event rates. There was one case (4%) of liver transplant recipients death due to multiple organ dysfunction syndrome. The rest of recipients were followed up and the grafts functioned well. Conclusion〓Better quality organs and transplant outcomes can be achieved by positive evaluation and management of the potential organ donor in the Intensive Care Unit.

Value of transcranial Doppler in the prognosis of sever traumatic brain injury

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

2015, 15(03):  290-293.  DOI: 10.3969/j.issn.1009-976X.2015.03.013

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【Abstract】〓Objective〓To study the value of transcranial Doppler(TCD)in the prognosis of the patients with severe traumatic brain injury. Methods〓The prospective study included 62 severe traumatic brain injury patients from our hospital during Feb. 2013 to Oct. 2014, whom act as case group, and the data of the middle cerebral artery(MCA)blood flow was detected by TCD in the 1,3 7,14 and 21 days after the patients suffering from brain injury or operation. The peak systolic velocity (Vs), end diastolic velocity (Vd) and pulsatility index were observed. A total of 44 health people who accepted TCD scan in the same period were as control group. The data of case group were compared with that of control group. Results〓The velocity of brain blood flow was changing in the 1st day after injury or operation. Vs and Vd were declining to the lowest in the 7th day, and would gradually recover from then. But the trend of PI was contrary to above data. Vs was a protective factor for the severe traumatic brain injury in the 7th day. Conclusion〓The brain blood flow velocity detected by TCD can reflect the change and prognosis of intracranial pressure in the patients with sever traumatic brain injury,and has an important guiding value of the treatment for those patients.

Lumbar puncture and cerebrospinal fluid replacement surgery for severe traumatic brain injury with the treatment of subarachnoid hemorrhage

Chen Xuejiang, Dang Wei, Liang Rongfang

2015, 15(03):  294-296.  DOI: 10.3969/j.issn.1009-976X.2015.03.014

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【Abstract】〓Objective〓To investigate the lumbar puncture and cerebrospinal fluid replacement for treatment of traumatic brain injury with subarachnoid hemorrhage. Methods〓Fifty?鄄five cases of severe traumatic brain injury patients with subarachnoid hemorrhage underwent surgical treatment of lumbar puncture and cerebrospinal fluid replacement (observation group) from Jan 2012 to Mar 2014. Another 55 cases who received conventional treatment were chosen as control group. Bloody cerebrospinal fluid (BCSF) clearance time, complications, clinical efficacy were evaluated and compared between two groups. Results〓BCSF clearance time were 8.13±1.25 d, 9.37±1.49 d respectively in observation and control group and there was difference between two groups (P<0.05). Infarction, hydrocephalus, epilepsy incidence in observation group were 0, 1.82%, 3.64%, respectively and were 9.09%, 12.73%, 14.55% in control group(P<0.05). The rate of good by GOS score in observation group GOS was 52.73%, and 25.45% in control group (P<0.01). Severe disability rate, plant survival and mortality rates were 14.55%, 1.82%,0, respective in observation, and, 30.91%, 14.55%, 7.27% in control group (P<0.05). Conclusion〓Lumbar puncture and cerebrospinal fluid replacement therapy for severe traumatic brain injury with subarachnoid hemorrhage can reduce the incidence of complications, improve the prognosis.

Correlation between electrolyte disorders and different types of operations during the preoperative period

Chen Meixian, Ye Xijiu, Lu Fuding, Yang Tao

2015, 15(03):  297-299.  DOI: 10.3969/j.issn.1009-976X.2015.03.015

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【Abstract】〓Objective〓To investigate the correlation between electrolyte changes and different types of operations by blood gas analysis, so as to provide some clues for early interventions. Methods 995 surgical cases were collected in the Sun Yat-sen Memorial Hospital from January 2012 to April 2013. The arterial blood samples of patients undergoing different types of operations were collected and sent for blood gas analysis by ABL800 analyzer at the beginning of the operations. Different type of electrolyte disorders occurred in different types of operations were noted,and statistic analysis were made by SPSS 13.0. Results〓Hypokalemia,hyperkalemia,hypocalcaemia,and hypercalcemia were correlated with the types of operations (P<0.05), while the association between serum sodium disorders and the types of operations was not significantly different(P>0.05). Hypokalemia and hypocalcemia were common seen in hepatobiliary surgical cases,gastrointestinal surgical cases and gynecological surgical cases. Otherwise, the association between ages and the types of electrolyte disorders was not significantly different (P>0.05). Conclusion〓Perioperative electrolyte disorders were closely related to the types of operations. More attention should be paid to electrolyte changes of patients undergoing hepatobiliary surgery,gastrointestinal surgery or gynecological surgery so that we can correct the electrolyte disorders in time.

Effect of different dose of dexmedetomidine on recovery period in patients undergoing breast cancer surgery

Zhou Liangjun, Wang Shouping, Chen Xiaotong

2015, 15(03):  300-304.  DOI: 10.3969/j.issn.1009-976X.2015.03.016

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【Abstract】〓Objective〓To evaluate the efficacy of different dose of dexmedetomidine on recovery period in patients undergoing breast cancer surgery. Methods〓Eighty ASA I or Ⅱ patients undergoing modified radical mastectomy under endotracheal general anesthesia were assigned into four groups(n=20,.each)...Dexmedetomidine or equal volume of normal saline was injected intravenously 30 min before the end of operation respectively. In control group (group C), 0.9% normal saline was injected intravenously and different dose of dexmedetomidine was injected intravenously in group D1, D2 and D3 respectively (0.2 μg/kg, 0.5 μg/kg and 0.8 μg/kg). Volume control ventilation was used during operation until extubation. The time of opening eyes after operation and extubation time were recorded. Riker sedation-agitation scale and Ramsay sedation scale were recorded at the time of extubation. MAP and HR were recorded at the time of extubation (T1), 2 min after extubation (T2), 5 min after extubation (T3), 10 min after extubation (T4). Results〓Compared with group C, there were no significant differences in the time of opening eyes after operation and extubation time in group D1 and group D2, while significantly prolonged in group D3 (P<0.01). The score of Riker sedation-agitation scale in most patients in group C was 5 at the time of extubation with fast HR and high MAP. Compared with group C, the incidence of agitation was significantly decreased in group D2 and D3 (P<0.01), and cardiovascular adverse reactions significantly decreased at T1-T4. The score of Ramsay sedation scale was 2-4 in group D2. There were no significant differences in HR and MAP in intra-group D2 comparison during T0-T4 (P>0.05). The percentage of Ramsay sedation scale 5-6 was 70% in group D3, indicating excessive sedation. Conclusion〓Intravenous injection of moderate dose of dexmedetomidine (0.5 μg/kg) 30 min before the end of operation can prevent agitation caused by the endotracheal tube during recovery period in patients undergoing breast cancer surgery without delayed awakening.

Clinical application of reinforced laryngeal mask airway in neurointerventional emergency treatment

Chen Zhicong, Peng Jun, Bao Yanan, Huang Shaonong, Liu Zhiheng

2015, 15(03):  304-307.  DOI: 10.3969/j.issn.1009-976X.2015.03.017

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【Abstract】〓Objective〓To observe the clinical effect of reinforced laryngeal mask airway on neurointerventional emergency operation. Methods〓Sixty patients scheduled for neural interventional treatment under general anesthesia were randomized into two groups: group T (tracheal intubation) and group L (reinforced laryngeal mask airway)..SBP,.HR, SPO2 and BIS in both group were recorded at different time points as following: immediately before and after anesthesia induction (T1 and T2),.1 min after endotracheal tube placement or laryngeal mask airway insertion (T3), femoral artery puncture (T4), the end of the operation (T5) and immediately after extubation (T6). Emergence time from anesthesia, consumption of propofol and remifentanil, the success rate of first insertion and total insertion were recorded or calculated. Also,.the occurrence of possible adverse effects such as bucking, regurgitation and aspiration,.laryngeal spasm and emergence agitation were recorded..Results Compared with group T, the value of SBP and HR of group L decreased significantly at T3, T6 (P<0.05). In group T, at the time points T3 and T6, the value of SBP was obviously higher and HR was significantly faster than that at T1 (P<0.01), while there was no such difference in group L. Compared with group T, the recovery time was significantly shorter (P<0.05), and the consumption of propofol and remifentanil,the incidence of postoperative bucking and emergence agitation were reduced obviously in group L, (P<0.05), while the value of SPO2 and BIS, the success rate of first insertion and total insertion, along with the incidence of regurgitation and aspiration, laryngeal spasm had no statistically difference between two groups. Conclusion〓The application of reinforced laryngeal mask airway in neurointerventional emergency treatment can not only maintain the stability of hemodynamics during intubation and extubation, but also shorten recovery time with less adverse effects.

Effect of ultrathin flap through axillary skin crease incision for treatment of axillary osmidrosis

Liang Weiqiang, Ji Chenyang,Zhang Jinming, Yao Yuanyuan,Chen Yuhong, Zhang Jiaqi

2015, 15(03):  308-310.  DOI: 10.3969/j.issn.1009-976X.2015.03.018

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【Abstract】〓Objective〓To evaluate the clinical therapeutic effect of ultrathin flap through axillary skin crease incision for the treatment of axillary osmidrosis. Methods〓From April 2012 to August 2014, 87 patients underwent the removal of apocrine sweat glands in the axillary superficial fascia through one to two incisions with 2.5 to 3 cm length on the axillary crease, and the surgical procedure remained the subdermal vascular network for ultrathin flap. Results〓All patients healed well without hematoma, hydrops, infections, incision dehiscence or flap necrosis, except two patients with slight surgical margins cracks and one case with slightly scar hypertrophy. Followed up for 6 to 12 months, almost all the body odours disappeared with axillary hair decrease. Conclusion〓The procedure of ultrathin flap through axillary skin crease incision is a safe and effective method to treat axillary osmidrosis with high success rate and few complications.

The correlation between inflammatory markers and bone turnover markers in acute Charcot neuro-osteoarthropathy

Chen Binghao, Song Weidong

2015, 15(03):  311-315.  DOI: 10.3969/j.issn.1009-976X.2015.03.019

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【Abstract】〓Objective〓To investigate the correlation between serum level of inflammatory markers and serum level of bone turnover markers in patients with acute Charcot neuro-osteoarthropathy (CNO). Methods〓Data of 15 patients with acute CNO in our hospital from January 2010 to December 2014 was retrospectively analyzed. Serum level of inflammatory markers and bone turnover markers were recorded and correlation analyses were conducted. Results〓Levels of serum TNF-α, β-crosslaps, N-MID osteocalcin (N-MID.Os), procollagen type I amino-terminal propeptide (PINP) and bone alkaline phosphatase (BALP) were increased in acute CNO patients. Serum TNF-α was positively correlated to β-crosslaps, N-MID.Os, PINP and BALP, while IL-10 was negatively correlated to N-MID.Os, PINP and BALP. In addition, IL-6, IL-8 and IL-1β were not associated with bone turnover markers. Conclusion〓The abnormal level of TNF-α and bone turnover markers in acute CNO patients revealed inflammatory joint disease with bone metabolism derangement. The correlationship of TNF-α and bone turnover markers might specifically be found in acute CNO patients, which could be valuable in early clinical diagnosis of CNO.

Effect of vascular transplantation on treating incomplete skin and soft tissue injure in the limbs

Li Jingping, Luo Zikang Wang Gang

2015, 15(03):  316-318.  DOI: 10.3969/j.issn.1009-976X.2015.03.020

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【Abstract】〓Objective〓To report the experience of vascular transplantation for treating incomplete skin tissue injury. Methods〓Twenty-two cases with incomplete avulsion injury of extensive skin were admitted in our hospital and treated by soft tissue grafts in situ implant and vascular transplantation by using superficial veins of the forearm after debridement. The clinical experience and effect were recorded and reported. All cases were tracked over an average follow-up of 3 months. Results〓All 22 cases got recovery. Of them, the skin flaps after vascular transplantation completely survived in 15 cases, and 7 cases had the irregular necrosis on the margin of 0.5-1.5 cm, without a large area of necrosis. Conclusion〓Vascular grafting can increase the survival chance of skin flap, implant in situ and the surgical procedure is simple.

Clinical analysis of localized pigmented villondular synovitis treated by synovectomy under arthroscopy

Yin Haidong, Song Yang, Du Qingjun, Huang Mingguang

2015, 15(03):  319-322.  DOI: 10.3969/j.issn.1009-976X.2015.03.021

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【Abstract】〓Objective〓To investigate the method and the clinical effect of arthroscopic therapy on localized pigmented villondular synovitis of knee. Methods〓The clinical material and therapy were reviewed retrospectively in 10 cases with localized pigmented villondular synovitis of knee confirmed by the MRI images, biopsy, surgery and pathology from September 2008 to May 2014. Follow-up of 9 months to 68 months, the functional recovery such as the postoperative knee pain, swelling and range of motion were evaluated according to the Lysholm knee functional score. Results〓All of 10 patients have no complications occurred in the postoperative follow-up period, and 2 patients relapse. The Lysholm knee functional score was 91.80±5.28 points, and obviously higher than which before surgery(47.50±16.28, P<0.01). Conclusion〓Arthroscopic therapy is an effective treatment with less invasion, fast recovery, and better function on localized pigmented villondular synovitis.

One stage debridement and vacuum sealing drainage (VSD), two stage reduction and fixation on the treatment of open calcaneal fractures

Chen Guanghui, Wang Hongwei, Ruan Meishu, Wu Qiong

2015, 15(03):  323-326.  DOI: 10.3969/j.issn.1009-976X.2015.03.022

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【Abstract】〓Objective〓To evaluate the clinical effect of staged operation treatment for open calcaneal fractures. Methods〓From June 2006 to June 2012, 15 cases with open calcaneal fractures were treated with one stage debridement and vacuum sealing drainage (VSD), then two stage of skin grafting or flap repair and fracture reduction and internal fixation. The complications and joint function were evaluated by Ankle hind foot scale from USA Association of foot and ankle surgery (AOFAS). Results〓All patients were followed up after operation, and the average follow-up time was 12.8 months (6 months -36 months). Partial incision necrosis happened in 3 patients, partial plate exposure occurred in one case, healing after dressing change and VSD treatment. All fractures healed. The average healing time was 4 months. The average AOFAS ankle hindfoot scale was 79.3 points (64-90 points), including excellent in 3 cases, good in 8 cases, fair in 4 cases, with excellent and good rate 73.3%. Conclusion〓Staged operation strategy for open calcaneal fractures can reduce complications. The initial effect is good.

Effect of the arthroscopy-assisted treatment on tibia plateau fracture with internal fixation

Wang Shuibing, Wang Guoliang, Huang Junwen

2015, 15(03):  327-329.  DOI: 10.3969/j.issn.1009-976X.2015.03.023

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【Abstract】〓Objective〓To observe the effect of arthroscopic treatment for tibia plateau fractures. Methods〓Forty-five patients with tibia plateau fractures were divided into control group and observation group: the control group (n=19) was treated with traditional open reduction and fixation, and observation group(n=26) was treated with fracture reduction and fixation under arthroscopy. Preoperative and postoperative Lysholm score was assessed. The effect of the fixation under arthroscopy, hospital stay, and postoperative adverse situation were also evaluated. All patients were followed up for 6 to 18 months. Results〓The patients in obejenation group had shorter haspital stay than that of control group (P<0.05). Preoperative Lysholm score was significantly lower than in patients with postoperative patients (P<0.01). The Lysholm score of observation was significantly higher than control group (P<0.05). Conclusion〓The arthroscopy treatment is better than traditional open reduction and fixation in tibia plateau fracture, which can be used as a preferred method for tibia plateau fracture.

Clinical effect of proximal femoral nail antirotation fixation with salmon calcitonin in treatment of unstable intertrochanteric fractures in the elderly

Huang Dongyong, Huang Yuanyuan, Li Donglian, Huang Shiguang, Chen Min

2015, 15(03):  330-334.  DOI: 10.3969/j.issn.1009-976X.2015.03.024

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【Abstract】〓Objective〓To observe the effect of proximal femoral nail antirotation (PFNA) with salmon calcitonin on the treatment of unstable intertrochanteric fractures in the elderly. Methods〓Ninety elderly patients with unstable intertrochanteric fracture were chosen and divided into 3 groups (A, B and C). The patients in group A received open reduction with DHS, and group B got closed reduction with PFNA. The patients in group C underwent closed reduction and salmon calcitonin after the operation. The clinical efficacy in and after the treatment were compared between three groups. Results〓The patients in group B got a better effect in and after the operation and had less complications than in group A. Patients in group C showed less time in the fracture restoration than those in group B (P<0.05). Conclusion〓PFNA fixation for unstable intertrochanteric fractures in the elderly has the better clinical effect. Salmon calcitonin is helpful to union of fracture after PFNA fixation.

Clinical analysis of the percutaneous catheter drainage for the treatment of breast abscess during lactation

Zhang Guangyan, Chen Yujie, Huang Mei, Jin ning, Tang Dan, Xu Wentao

2015, 15(03):  334-337.  DOI: 10.3969/j.issn.1009-976X.2015.03.025

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【Abstract】〓Objective〓To investigate the feasibility and clinical advantage of percutaneous catheter drainage of breast abscesses. Methods〓The clinical data of 60 patients with breast abscesses during lactations were retrospectively studied from August 2011 to June 2014. Among the 60 cases, 21 patients underwent catheter drainages (catheter group) and the other 39 cases were carried out traditional incisions (traditional operation group). Results〓There were no significant differences between two groups in age, onset time, and unipar or not. The postoperative recovery times of the patients who underwent catheter drainages and traditional incisions were 6.29±1.93 and 26.9±12.0 days, respectively, and the former was shorter than the latter (P<0.001). Among the 21 patients who underwent percutaneous catheter drainages, 19 cases continued to suckle children, while the 39 patients operated with traditional incisions had to terminate breast-feeding processes. Conclusion〓The treatment of percutaneous catheter drainage displays better clinical outcome than the traditional incision in the recovery time, the aesthetic level and the ability to resume breastfeeding.

Difference of the chemosensitivity of the breast cancer cells between two dimensional and three dimensional in vitro models

2015, 15(03):  338-341.  DOI: 10.3969/j.issn.1009-976X.2015.03.026

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【Abstract】〓Objective〓To compare the difference of the epirubicin sensitivity of the breast cancer cells between three dimensional soft agar and chitosan scaffold models. Methods〓The growth curve of breast cancer cells separately cultured in three dimensional soft agar and chitosan scaffold models were recorded by cell counting and colony counting assay, then the epirubicin sensitivity of breast cancer cells were measured by MTT assay and colony counting assay, and the IC50s of these cells were calculated by IC50 calculating software and the difference between the IC50s was analyzed by t test. Results〓Both in three dimensional soft agar and chitosan scaffold models, the breast cancer MCF-7 and 231 cells could reach a good growth state; the IC50s of the breast cancer cells between three dimensional soft agar and chitosan scaffold models were not significantly different (P>0.05). Conclusion〓The chemosensitivity of breast cancer cells are not different in three dimensional soft agar and chitosan scaffold models, which indicate that the three dimensional growing environment doesn’t significantaly impact the the chemosensitivity of breast cancer cells.

Application of echocardiography in minimal invasive occlusion of atrial septal defect

Wu Liwen, Lu Shihong, Kuang Yongfang

2015, 15(03):  342-344.  DOI: 10.3969/j.issn.1009-976X.2015.03.027

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【Abstract】〓Objective〓To explore the value of echocardiography in minimal invasive occlusion of atrial septal defect (ASD). Methods〓Forty-three patients with ASD were admitted in Qingyuan People's Hospital between July 2013 and December 2014, which were confirmed by TTE. Of them, 31 cases were screened and underwent minimal invasive occlusion surgery. TEE was used for guiding and monitoring in occluding procedure, and TTE was also used for postoperative follow-up. Results〓Thirty-one patients got successful occlusion guided by TEE. There were no postoperative complications. One 3- mm residual shunt in one patient was found in followed-up at 3 months after operation. Conclusion Echocardiography plays an important role in screening ASD cases before the minimal invasive occlusion, real-time monitoring during the occlusion, and evaluating effect after occlusion.

Treatment of 30 patients with thyroid microcarcinoma

Yu Jiexiong, Zuo Chaohai, Kuang Naile, Wu Junhua

2015, 15(03):  345-347.  DOI: 10.3969/j.issn.1009-976X.2015.03.028

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【Abstract】〓Objective〓To report the experience in treatment of thyroid microcarcinoma (TMC). Methods〓A total of 30 cases of TMC undergoing surgical treatment in our hospital from May 2010 to May 2014 were reviewed retrospectively. Results〓Twenty-four cases (80.00%) were found by intraoperative frozen section and 6 cases (20.00%) were diagnosed by pathological examination after operation. Total resection of the affected lobe and isthmus and selective neck dissection (VI) was performed in 14 cases. Subtotal thyroidectomy was performed in 3 cases. Total resection of the affected lobe, isthmus and neck dissection was performed in 7 cases. Subtotal thyroidectomy and neck dissection was performed in one case. There was no mortality in operation or postoperative complication. All of the cases is no recurrence. Conclusion〓With regard to thyroid microcarcinoma, one side lobectomy is a better therapy choice. Neck lymph node excision should be taken if there is local infiltration or if neck lymph node is palpable.

Regulatory effects of PRL-3 on epidermal growth factor signaling pathways in colorectal cancer

Huang Weihua, Lai Wei, Lan Qiusheng, Zhang Yang, Chu Zhonghua

2015, 15(03):  348-350.  DOI: 10.3969/j.issn.1009-976X.2015.03.029

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【Abstract】〓Objective〓To observe protein tyrosine phosphatase -3 (PRL-3) related regulatory function on epidermal growth factor (EGFR) signaling pathway in colon cancer LoVo cells. Methods After PRL-3 was transfected to LoVo cells (hereinafter referred to as LoVo-P) for 48 h, phosphorylation of EGFR protein expression and phosphorylation of MEK1/2 (p-MEK1/2), Erk1/2 (p-Erk1/2), Msk1/2 (p-Msk1/2) from MEK-ERK pathway were detected by Western blot assay. Results〓After transfected PRL-3, LoVo cells activated MEK-ERK channel. LoVo-C had an ability to activate phosphorylation of EGFR and Western-Blot showed an increase of 72.0% when compare with control group LoVo cells. High PRL-3 expression also induced to expression of p-MEK1/2, p-Erk1/2, p-Msk1/2. Conclusion〓In colon cancer cells, PRL-3 involved EGFR signaling pathway regulation by activation of phosphorylation of EGFR.

Clinical study on combination of laparoscopy and colonoscopy in treating sessile colonic polyps

Chen Jinghong, Yin Duoxiao, Li Haifeng, Lin Shuwen, Li Xiufen

2015, 15(03):  351-353.  DOI: 10.3969/j.issn.1009-976X.2015.03.030

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【Abstract】〓Objective〓To discuss the feasibility and clinical effect on combination of laparoscopy and colonoscopy in treating sessile colonic polyps. Methods〓Twenty-two cases of sessile colonic polyps patients, which failed to be resected by colonoscopy, received the treatment of combination of laparoscopy and colonoscopy. Of these patients, 10 cases with laparoscopic-assisted colonoscopic polypectomy, 8 cases with colonoscopy assisted laparoscopic partial colon resection; the other 4 cases underwent colonoscopy assisted laparoscopic segmental colon resection. Results〓All the 22 cases were successfully operated without complications or conversion to open surgery. The mean operation time was 101.6 minutes (55-182 minutes), the mean blood loss was 26.1 ml (10-60 ml), the mean recovery time for gastrointestinal function was 30.7 hours (20-50 hours), and mean hospital stay was 7 days (5-10 days). The patients were followed up for a mean of 16.9 months (5-30months). No recurrence was found. Conclusion〓The treatment of combined laparoscopy and colonoscopy is effective and safe for patients with colonoscopically unrespectable sessile colonic polyps.

Progress of microwave coagulation therapy on hepatic hemangioma

Zhang Peidong, Huang Zejian, Wu Xinqiang, Liu Kairui, Zhang Lei

2015, 15(03):  354-356.  DOI: 10.3969/j.issn.1009-976X.2015.03.031

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【Abstract】〓The recent progress in microwave coagulation therapy (MCT) of hepatic hemangioma was reviewed, with a focus on microwave coagulation, treatment modalities, complications,and prevention strategies. The foundation for the standardization of MCT of hepatic hemangioma was laid. The standardization of MCT will help to promote its clinical application and development as an important minimally invasive technique for hepatic hemangioma.

Advance in the animal models of hepatocellular carcinoma and cholangiocarcinoma

Zhang Yu, Zhang Dawei, Xue Ping

2015, 15(03):  357-360.  DOI: 10.3969/j.issn.1009-976X.2015.03.032

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【Abstract】〓Animal model is a fundamental and useful tool in tumor research. As a substitute, it provides a good condition for the researching of etiology, pathology, physiology and micro environment in tumor progress. The efficacy of new treatments can also be verified by tumor model preclinically. Hepatocellular carcinoma and cholangiocarcinoma confirmed as two subtypes of primary liver cancer, the methods for constructing animal models have both similarities and differences which will be summary analyzed in this article.

Nursing of non-heparinized CRRT treatment in postoperative patients with cerebral hemorrhage

Chen Yuye, Lv Qunyu, Zeng Gumei, Liang Yanmei

2015, 15(03):  364-366.  DOI: 10.3969/j.issn.1009-976X.2015.03.034

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【Abstract】〓Objective〓To evaluate on the effective nursing management and the effect of continuous renal replacement therapy (CRRT) with non-heparinization on the postoperative cerebral hemorrhage patients. Methods〓Fifty-eight patients underwent CRRT treatment were included in th study. Of then, 30 cases admitted from Jan 2012 to Jan 2014 were served as group A, which adding the soak time of the pipe piercing in heparin to 45 min, and using the improved method of flushing pipe with normal saline during the therapy period. Twenty-eight cases from January 2010 to December 2012 were as group B, in whom the routine clinic management of the CRRT without heparin were used. The filter service life and the change in coagulation function and platelet count were compared between two groups. Results〓The service life of filter in group A was longer than that in group B (P<0.05). No bleeding complication happened in all 58 patients. There were no differences in coagulation function and platelet count between two groups. Conclusion〓non-heparin CRRT treatment in postoperative cerebral hemorrhage patients is feasible and is helpful to prolong the filter working life, but need to increase the soaked time of piercing filter and use the improved method of flushing pipe.

Clinical research on Functional Reconstruction of Bladder After SCI by Comprehensive Rehabilitation Training

Wu Na, Chu Weiying, Ouyang Suqin

2015, 15(03):  372-374.  DOI: 10.3969/j.issn.1009-976X.2015.03.037

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【Abstract】 Objective To investigate the clinical efficacy of comprehensive rehabilitation training to functional reconstruction of neurogenic bladder after spinal cord injury. Methods〓Seventy-one patients with neurogenic bladder were divided into two groups,.the experimental group (n=36) and the control group (n=35). The patients of experimental group received intermittent catheterization and comprehensive rehabilitation training including Crede Manual Massage,.flagellation on the suprapubic region, the method of trigger point and electroacupuncture. The controls were treated by indwelling catheterization and comprehensive bladder function training. The efficacy was compared between two groups. Results〓Urinary tract infection in experimental group was lower than that in control group. The volume of bladder and residual urine level trended to normal. Conclusion〓Using comprehensive rehabilitation training and intermittent catheterization for SCI patients with neurogenic bladder are helpful to enhance SCI patient’s quality of life.