Table of Content

20 October 2016, Volume 16 Issue 05

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The progress of current magnetic resonance imaging methods for predicting the response of breast cancer to neoadjuvant chemotherapy

ZHANG Mengdi, CHEN Jianyu, GONG Shu, LI Yong, ZHENG Guifen

2016, 16(05):  511-516.  DOI: 10.3969/j.issn.1009-976X.2016.05.001

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【Abstract】〓Reliable early assessment of breast cancer response to neoadjuvant therapy (NACT) would provide many benefits to personalize patient care, so the demand for accurate and noninvasive response biomarkers is increasing. Recently, MRI can assess the response according to the morphology changes, like tumor size, enhancement, et al. And now there are increasing numbers of promising MRI technology reflecting the change of tumor in micro-molecular level after neoadjuvant chemotherapy. These MRI technology includes DCE-MRI, MRS, DWI, IVIM. This review focuses on the role of MRI in predicting the efficacy of neoadjuvant chemotherapy for breast cancer.

Phosphatase of regenerating liver-3 promotes colon cancer cells proliferation and migration depends on paracrine IL-6/p-AKT/p-STAT3 signaling

LAI Wei, SHI Jinglong, LIN Xiangan, XU Heyang, LAN Qiusheng, CHU Zhonghua

2016, 16(05):  517-520.  DOI: 10.3969/j.issn.1009-976X.2016.05.002

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【Abstract】 Objective To investigate mechanism of cytokines of interleukin (IL)-6 in promoting the colorectal cancer cells proliferation and migration. Methods〓We used ELISA to detect the level of IL-6 in culture medium of TAMs after co-culture with control group:LoVo-PRL-3 (LoVo-P) andexperimental group:LoVo-Control(LoVo-C). Western blot was used to detect the proteins of p-AKT and p-STAT3. The migration and proliferation were measure by wound healing and MTS. Results〓Elisa assay displayed that the protein level of IL-6 of TAM/LoVo-P was higher than TAM/LoVo-C. Wound healing and MTS test both displayed that the migration and proliferation of LoVo-P were higher than LoVo-C when co-culture with TAM.Western blot reminded the proteins of p-AKT and p-STAT3 in LoVo-P were higher than LoVo-C after co-culture with TAMs. When we added different dosages of IL-6 (1、10、100 NG/ML) in culture medium of LoVo-P, the migration and proliferation were increased gradually, also the proteins of p-AKT and p-STAT3 gradient increased. Conclusion〓PRL-3 promotes colon cancer cells proliferation and migration depends on paracrine IL-6 signaling and up-regulate the proteins of p-AKT and p-STAT3.

Comparative study between different pancreaticojejunostomy methods in the incidence of pancreatic leakage

LI Qinghan, ZHEN Zuojun

2016, 16(05):  521-523.  DOI: 10.3969/j.issn.1009－976X.2016.05.003

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【Abstract】〓Objective〓To evaluate the incidence rate of pancreatic leakage relative to three different pancreaticojejunostomy methods. Methods〓Clinical data of 93 patients who underwent pancreaticoduodenectomy from May 2011 to May 2016 by the same surgeon were retrospectively analyzed. Of the cases, 42 cases were performed pancreatico-jejunal end-to-end anastomosis (Group A). And 51 cases underwent end-to-side anastomosis, in which, 36 (group B2) underwent end-to-side mucosa-to-mucosa anastomosis,while the other 15 (group B1) underwent end-to-side anastomosis because of the limited diameter of pancreatic duct. Results〓The incidence rate of pancreatic leakage in group A,group B1 and group B2 were 2.52%, 20% and 0.00% respectively,and there was significant difference between the three groups (P>0.05). Conclusion〓There was significant differences in the incidence of pancreatic leakage between the group A, group B1 and group B2. The incidence rate was high in the end-to-side anastomosis group (group B1). Appropriate anastomosis method should be selected according to the condition of pancreas in order to reduce the incidence rate of pancreatic leakage.

The different clinicopathological features of hepatitis b virus and hepatitis c virus related hepatocellular carcinoma after hepatic resection

SHU Miaojiang, KAN Heping

2016, 16(05):  524-529.  DOI: 10.3969/j.issn.1009-976X.2016.05.004

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【Abstract】〓Objective〓To investigate the role of hepatitis B virus (HBV) and hepatitis C virus (HCV) in clinicopathological features and pro gnosis of patients with hepatocellular carcinoma (HCC). Methods〓A retrospective analysis of clinicopathological data were performed in 355 patients with hepatocellular carcinoma who received hepatic resection in our hospital from 1995 to 2000. There were 163 HBV-related HCC patients included into HBV group and 73 HCV-related HCC patients included into HCV group,the other 119 non-HBV and non-HCV-related HCC patients were also included as control group (NBNC group). The impact of hepatic virus on clinicopathological features and prognosis of hepatocellular carcinoma were analyzed. Results〓HBV-HCC patients was characterized by young age, high male/ female ratio and high (AFP) level. HCV-HCC patients were associated with old age,low serum albumin level,high serum ALT level,and early-stage tumor. NBNC HCC were characterized by large tumor size,high incidence of vascular invasion and incomplete capsule since fewer NBNC-HCC patients received regular follow-up for liver diseases and hepatic tumors might be detected only after symptoms occurred. Median survival time for HBV-HCC and HCV-HCC were fifteen months and nineteen months. 1-, 3-, 5-, 7-, over all survival rates were 71.0%, 34.0%, 30.7%, 11.53% for HBV-HCC respectively and 90.3%,68.2%,41.9%, 31.41% respectively for HCV-HCC,respectively. The result suggested HCV-HCC patients had a longer survival time and better outcome than HBV-related patients(V2=10.92,P<0.001). Multivariate regression analysis showed the type of hepatic virus was a dependent of influential factors of prognosis. The post-operative death risk of HCC patients with hepatitis B virus was 1.5 times higher than that of the HCC patients without hepatitis virus infection (P=0.03), while the death risk of HCC patients with hepatitis C virus was 0.85 times lower than that of NBNC patients (P=0.58). Conclusion〓Significant difference existed in clinicopathlogical features and surgical outcome between HCC patients with hepatitis B virus and hepatitis C virus infections. HCV-related HCC patients can obtain a better surgical outcome compared to those with HBV-related hepatocellular carcinoma.

Comparison of efficacy and safety of combined endoscopic-laparoscopic methods for single-stage versus two-stage for patients with concomitant gallbladder stones and common bile duct stones

LIU Jun, LIU Yunhong, HE Junhui, MA Wengui, BAO Junchu, YAN Jieying

2016, 16(05):  530-534.  DOI: 10.3969/j.issn.1009-976X.2016.05.005

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【Abstract】 Objective〓To evaluate the efficacy,.safety of combined endoscopic-laparoscopic method for single-stage and two-stage treatment method for patients with gallbladder and CBD stones. Methods〓One hundred and four eligible patients were divided into 2 groups, single-stage laparoscopic common bile duct exploration plus laparoscopic cholecystectomy.(LCBDE+LC,n=55).or two-stage endoscopic retrograde cholangiopancreatography sphincterotomy plus laparoscopic cholecystectomy (ERCP/S+LC group,n=49). The surgical successful rate, postoperative complications and postoperative length of hospital stay were assessed. Results〓The two group were matched with regard to demographic and clinical parameters..Both LCBDE+LC and ERCP/S+LC had similar success rates.(90.0% vs 95.9%, P=0.309). However, the cases in the ERCP/S+LC group had higher rate of stone clearance(93.6% vs 80.0%,.P=0.046)..The two groups did not differ significantly in terms of postoperative complications..In addition,.no significant difference was observed in terms of postoperative hospital stay and overall cost. We observed the 6.0% (3/50) and 6.3% (3/48) cases in LCBDE+LC and ERCP/S+LC group with recurrent stone in the CBD during the postoperative follow-up period,.which had no statistical significance..Conclusion〓Single-and two-stage management for concomitant gallbladder and CBD stones had similar success rate,.postoperative complication incidence and long-term recurrence ration,.but ERCP/S+LC group had higher stone clearance rate..Hence ERCP/S+LC should be an optimal therapeutic approach for concomitant gallbladder and CBD stones.

Hepatectomy combined with adjacent invaded organ(s) resection for patients with huge primary hepatic carcinoma

SUO Zhijun, MIAO Dingding, ZHENG Yongbin, ZHANG Bixiang

2016, 16(05):  535-538.  DOI: 10.3969/j.issn.1009-976X.2016.05.006

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【Abstract】 Objective〓To evaluate the safety and feasibility of hepatectomy combined with adjacent invaded organ(s) resection for the patients with large primary hepatic carcinoma (PHC). Methods〓A total of 571 patients, with large PHC (≥10 cm in diameter) received hepatectomy, were studied retrospectively at Tongji Hospital, Huazhong University of Science and Technology. Of these patients,38 cases underwent hepatectomy in combination with adjacent organ(s) resection because tumor invasion was suspected during operation (combined resection group). Subsequent histological examination of the resected specimens provided evidence showing that 17 cases of these patients with adjacent organ(s) resection were tumor invasion (invasion group), and the other 21 cases were non-tumor invasion (non-invasion group)..100 patients were selected as controls from 533 patients with large PHC without extrahepatic invasion randomly..Results...The operative mortality rate of combined resection group, invasion group and non-invasion group was 5.9%,.4.8% and 3.0%,.respectively..The incidence of complications of these three groups after operation was 64.7%,.66.7% and 45.0%,.respectively..The 1-,.2-,.3- and 5-year survival rates of these three groups were 64.7%,.41.2%,.29.4%,.5.9%; 57.1%, 38.1%, 28.6%, 9.5% and 65.0%, 44.0%, 34.0%, 13.0%, respectively. There were no significant differences between patients with and without extrahepatic PLC invasion on operative mortality, incidence of complication and overall survival rate. Conclusion〓Hepatectomy combined with adjacent invaded organ(s) resection is safe and feasible, and similar effect between patients with and without adjacent invaded organ(s) was obtained.

The techniques and clinical efficacy of carrying out necrosis tissue clearance and catheter drainage by laparoscopic surgery in patients with severe acute pancreatitis

ZHANG Yanxiang, CHEN Xiaowu, ZHU Dajian, JU Yongle, LU Guangsheng, GENG Yan, ZHOU Wei

2016, 16(05):  539-542.  DOI: 10.3969/j.issn.1009-976X.2016.05.007

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【Abstract】〓Objective〓To investigate the techniques and clinical efficacy in severe acute pancreatitis(SAP) catheter drainage by laparoscopic surgery. Methods〓The clinical data of 54 patients with SAP,.who were admitted to the First People's Hospital of Shunde and underwent the early laparoscopic surgery catheter drainage from January 2007 to December 2014,.were retrospectively analyzed. Results〓Of the 54 cases, one case was converted to open surgery because of bleeding, one case was underwent the abdominal incision repair because of intestinal damage. The operation time ranged from 102 to 185 min and the average was 128 min..Fifty cases were cured,.and the hospitalization time was 17-106 days(the median time was 30.5 days)..Four cases were died, in whom one case died of multiple organ failure, one case died of pancreatic cancer and two cases died of delayed abdominal bleeding and hemorrhagic shock. The time of death were 4 days, 21 days, 33 days and 36 days, respectively. One case underwent the second laparoscopic surgery in 32 days after the first operation because of pancreatic abscess..Three cases became to pancreatic pseudocyst..One case was cured with conservative treatment..Two cases were cured after puncture and drainage. Conclusion〓Early laparoscopic surgery catheter drainage can effectively improve the prognosis of SAP,.and becomes an effective method of treatment.

Intraductal papillary mucinous neoplasm of pancreas with acute cholangitis as the initial symptom: case report and literature review

JING Yuanyuan, WU Leichao, FENG Jian, JIAO Huabo

2016, 16(05):  543-545.  DOI: 10.3969/j.issn.1009-976X.2016.05.008

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【Abstract】〓Objective〓To summarize experienceofthe diagnosis and treatment of intraductal papillary mucinous neoplasm of the pancreas. Methods〓One case of intraductal papillary mucinous neoplasm of the pancreas in our hospital was reported and analyzed the treatment. Results〓The patients with acute cholangitis as the main clinical manifestations,and theintraductal papillary mucinous neoplasm of the pancreas was confirmed by combined imaging examination and duodenal endoscopy and retrograde pancreatic duct angiography. duodenopancreatectomy was performed and illuminated a clear type of mixing head of pancreaticintraductal papillary mucinous neoplasms of the pancreas. Conclusion〓The diagnosis of intraductal papillary mucinous neoplasm of the pancreas is feasible by clinical manifestations combined imaging examination and endoscopy.

Evaluation of microRNA-21 expression in serum and stool as a potential biomarker for diagnosis of colorectal cancer:a meta-analysis

LI Yang, ZHEN Chaohui, HUANG Kai, TAN Yan, LI Furong, LING Kai, ZHANG Yue, YU Xiaofang

2016, 16(05):  546-552.  DOI: 10.3969/j.issn.1009-976X.2016.05.009

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【Abstract】〓Objective〓To assess the diagnosis value of microRNA-21 in tissues, feces, serum, and plasma for systematic diagnosis of CRC using Meta-analysis. Methods〓Databases, including Cochrane library, PubMed, EMbase, Google Scholar, and Chinese National Knowledge Infrastructure, were scanned to retrieve relevant articles focusing on microRNA-21 in CRC diagnosis. Articles were then filtered according to the PRISMA statement and assessed by quality assessment of diagnosis accuracy studies-2. Sensitivity (SEN), specificity (SPE), positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR) were pooled using fixed-effects model or random-effects model. Summary receiver operating characteristic (SROC) curve and area under the curve (AUC) were used to estimate the overall diagnostic performance. Results〓A total of 15 studies, comprising 1268 CRC patients and 910 healthy controls, were enrolled in this meta-analysis. For serum miR-21, the pooled DOR, SEN, and SPE were 13.97 (95% CI: 8.44-23.11), 0.73 (95% CI: 0.69-0.77), and 0.83 (95% CI: 0.76-0.89), respectively; for plasma miR-21, the pooled DOR, SEN, and SPE were 8.03 (95% CI: 3.30-19.52), 0.67 (95% CI: 0.60-0.73), and 0.76 (95% CI: 0.69-0.81), respectively; and for fecal miR-21, the pooled DOR, SEN, and SPE were 7.06 (95% CI: 2.17-22.95), 0.33 (95% CI: 0.28-0.37), and 0.91 (95% CI: 0.88-0.93), respectively. Moreover, the AUC values of serum, plasma, and fecal miR-21 in CRC diagnosis were 0.8701, 0.8295, and 0.6742, respectively. Conclusion〓Circulation miR-21 demonstrates good diagnostic performance, and serum samples are better than plasma samples in CRC diagnosis. For fecal miR-21, the sensitivity is unsatisfactory, but the specificity is favorable in predicting CRC patients.

Comparison of oxaliplatin-based and irinotecan-based regimen in the first-line treatment of KRAS mutation advanced colorectal cancer

YE Weipeng, CHEN Yanxian, WANG Huizhong, LI Weiyu, YANG Qiong, XIE Derong

2016, 16(05):  553-556.  DOI: 10.3969/j.issn.1009-976X.2016.05.010

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【Abstract】〓Objective〓Some researches found that KRAS mutation advanced colorectal cancer may predict sensitivity to oxaliplatin. This acticle enlarge more samples based on previous research. Objective to investigate which is the better regimen for KRAS mutation advanced colorectal cancer. Methods〓Between 2005 and 2016, 112 advanced colorectal cancer patients with KRAS mutation were retrospectively analyzed. Of them 72 patients received first-line oxaliplatin-based chemotherapy while 40 patients received iriontecan-based chemotherapy. The primary endpoint was overall survival, the secondary endpoints were disease control rates and progression-free survival. Results〓Median overall survival was 24.9 months for oxaliplatin and 26.5 months for iriontecan (P=0.978), with DCR was 69.4% and 62.5%, respectively (χ2=0.561,P=0.454). Median progression-free survival was 8.5 months for oxaliplatin and 8.5 months for iriontecan which had no statistical significance (P=0.412). Conclusion It was demonstrated that oxaliplatin-based chemotherapy and iriontecan-based chemotherapy in the first-line had similar efficacy in patients with KRAS mutation advanced colorectal cancer.

Value of dynamic detection of PCT on early diagnosis of infection after minimally invasive esophagectomy

ZHANG Meng, JIN Xiaoyan, TANG Yong

2016, 16(05):  557-559.  DOI: 10.3969/j.issn.1009-976X.2016.05.011

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【Abstract】〓Objective〓To evaluate the value of dynamic detection of procalcitonin (PCT) in early diagnosis of infection after minimally invasive esophagectomy. Methods〓Sixty-eight patients as a observation group who underwent minimally invasive esophagectomy in department of cerebral surgery of Sun Yat-sen Memorial Hospital between June 2015 to June 2016 and 30 cases of normal physical examination as healthy group over the same period were enrolled in this retrospective study. PCT in blood of the patients undergoing surgery were detected on the first, second, third and fifth day after the surgery. Infection occurred in 10 patients out of the group, which were divided into an observation group and the others were divided into a control group. Differences of PCT among the three groups were statistically analyzed using SPSS 12.0 software package. Results〓On the first day after operation, PCT in the observation group and control group was higher than the healthy group,.which showed statistical difference(P<0.05),.but it has no statistical difference between observation group and control group..On the second day,.the PCT of the observation group was higher than control group, which showed statistical difference(P<0.05)..And on the third and the fifth day,.the PCT of the observation group was higher significantly than control group, which showed statistical difference (P<0.01)..Between the control group and healthy group,.there was statistical difference on the first and second day after operation(P<0.05), but it has no statistical difference on the third and fifth day after operation..Conclusion〓A dynamic detection of PCT is value to the early diagnosis of infection after minimally invasive esophagectomy..When PCT is more than 2.06 μg/ml on the second day after operation, the patient may be infected by bacteria. We should start the contrapuntal treatment as early as possible.

Diagnostic value of shear wave elastography in different diagnosis of cervical lymph nodes

RUAN Jingliang, LIANG Ming, XU Xiaolin, TIAN Jing, YANG Haiyun, LUO Baoming

2016, 16(05):  560-563.  DOI: 10.3969/j.issn.1009-976X.2016.05.012

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【Abstract】〓Objective〓To explore the diagnostic value of shear wave elastography (SWE) in the differential diagnosis of cervical lymph nodes using Receiver Operating Characteristic (ROC) Curve. Methods Totally 76 patients with 120 cervical lymph nodes underwent preoperative conventional ultrasonography and SWE. The differences of SWE quantitative parameters between benign and malignant cervical lymph nodes were compared. The standard of reference was histopathology. ROC curves of SWE quantitative parameters were drawn and the area of under curve was pairwise compared. Results〓The AUCs of elasticity value ratio, mean elasticity value and maximum elasticity value were 0.838, 0.828 and 0.812, respectively. The differences of pairwise comparison of three quantitative parameters had not statistical significance. Conclusion〓All of three SWE quantitative parameters had diagnostic value in the differential diagnosis of cervical lymph nodes. These three quantitative parameters had equal diagnostic performance.

Specific skin changes caused by chemotherapy: cases report and literature review

DING Lin LI Qingjian WANG Ying CHAI Jie JIANG Zhimin YAO Herui

2016, 16(05):  564-569.  DOI: 10.3969/j.issn.1009-976X.2016.05.013

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【Abstract】〓Cancer has remained to be the first cause to death for Chinese residents, with its incidence and mortality increasing year by year. Chemotherapy is the main systemic therapy for cancer patients, which frequently causes skin toxicity. This side effect hardly poses threats to lives, thus often neglected. However, skin toxicity usually influences the quality of life and leads to the decrease or pause of chemical drugs, which harms the curative effect. Hereby we report four rare skin changes led by chemotherapy in our department and review the relevant articles.

Analysis of sentinel lymph node biopsy by blue dye trace method for breast cancer patients after neoadjuvant chemotherapy

LIU Yuan, GUI Yifei, LIAO Wenyong, HUANG Yanping, LIU Lingli

2016, 16(05):  569-573.  DOI: 10.3969/j.issn.1009-976X.2016.05.014

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【Abstract】〓Objective〓To assess the feasibility of sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) in breast cancer patients. Methods〓Sixty-nine patients with breast cancer were subjected to pre-operative NAC from 2012-01-01 to 2015-06-30 in Liuzhou Worker's hospital, and their clinical data of sentinel lymph node biopsy (SLNB) from axillary lymph node dissection (ALND) were analyzed. SLN identification rates and false negative rate of the patients were assessed. Results〓The identification rate for SLNB was 85.5%. The false-negative rate was 18.2%. Grouping the patients according to axillary lymph node (ALN) state before treatment, the size of the tumor,.location of the tumor,.the age of the patients and the injection site of blue dye,.the identification rates of ALN (-) group and ALN(+) group were 96.7% and 76.9% (P=0.049) respectively,.and had nothing to do with the left factors mentioned above. There was no statistical difference of the false-negative rate in different states of all the factors. Conclusion〓SLNB by blue dye trace method is feasible in ALN (-) breast cancer patients who have received NAC, while there are some risks for ALN (+) patients. Increasing the number of SLN might elevate the reliability of SLNB in patients after NAC.

Management and prognosis of liver metastasis in breast cancer patients: a report of 163 cases

LI Jie, XU Xiangdong, SHAO Nan, LIN Ying, LI Xiaoxi, WANG Shenming, LV Weiming

2016, 16(05):  574-579.  DOI: 10.3969/j.issn.1009-976X.2016.05.015

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【Abstract】〓Objective〓To assess the clinical characteristics, treatment and prognostic factors of liver metastasis in breast cancer patients. Methods〓One-hundred and sixty-three breast cancer patients with liver metastasis were included in this study from January 2006 to January 2016. The clinical, pathological and treatment information was collected, and the factors related to the survival were evaluated. All statistical analyses were performed using R software. Results〓The median overall survival of breast cancer with liver metastases was 29.5 (95%CI: 27.8-31.7) months, the median overall survival Group A (initial Stage Ⅳ patients with liver metastases) was 22.1 (95%CI: 17.8-25.1) months, while the median overall survival Group B (relapse with liver metastases) was 34.1 (95%CI: 30.6-37.6) months (P=1.83×10-10). If the patients had opportunity to perform local therapy, the prognosis became much better: the median overall survival extended from to 26.4 months to 33.0 months (P=9.95×10-3); 1 years, 2 years, 3 years survival rate in Group B are also significantly higher than Group A (Group A: 79.44%, 40.54%, 9.20%; Group B: 98.94%, 84.92%, 40.54%).In univariate analysis, the factors of hormone receptor status, Her-2 expression, Ki67 proliferation, molecular classification, whether multiple liver metastases were limited, and local therapy opportunity were associated with the prognosis of breast cancer patients with liver metastasis.(P<0.05). In multivariate analysis, the factors of high Her-2 expression, multiple liver metastases were not limited, and no opportunity to do local therapy were independent predictors of poor survival after lung metastases (P<0.05). Conclusion〓The prognosis of breast cancer patients with liver metastasis is poor. We should pay more attention to the liver screening in order to early detection and early treatment. The preferred treatment is systemic comprehensive treatment. For patients with isolated single liver metastases and good response to systemic treatment, local therapy can obtain good effect.

Reason and treatment of seroma after laparoscopic inguinal hernia repair

ZHUANG Zhehong, ZHANG Jianbao,LIANG Zhihao, ZHANG Donghui, TAN Shicheng, HE Kui

2016, 16(05):  580-583.  DOI: 10.3969/j.issn.1009-976X.2016.05.016

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【Abstract】 Objective To discuss the reasons and treatment of seroma formation after laparoscopic inguinal hernia repair (LIHR). Methods〓A total of 251 cases in our hospital from April 2012 to June 2016 were included in the cohort. All patients underment LIHR and their data were retrospective analyzed. The incidence and severity of seroma in one month after operations was observed. Results〓Forty-two patients were suffered from seroma after LIHR in this during period and most of them got well without any intervention except three patients were subjected to drainage by puncture and compression therapy. Seroma after LIHR were associated with age, surgical approach and severe concomitant diseases. Conclusion〓Pay attention to aged patients and their concomitant diseases in perioperative period and choose the best treatment.

Investigation of adverse effect of menstrual cycle on thyroid surgery

ZHAO Guangfeng, ZHU Yifan

2016, 16(05):  584-586.  DOI: 10.3969/j.issn.1009-976X.2016.05.017

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【Abstract】 Objective〓To evaluate the effect of menstrual cycle on perioperative bleeding in patients undergoing thyroid surgery. Methods Retrospectively survey was performed in 33 patients(perimenstrual period,observation group) underwent thyroid surgeries in our hospital from March 2012 to December 2014. Another 75 patients over the same time during non-menstrual period were assigned to control group. The coagulation function, duration of procedure, blood loss during operation and amount of postoperative drainage between the two groups were observed and analyzed. Results〓There were no significant differences of preoperative coagulation function. Blood loss and postoperative drainage in observation group were 7.6 ml, 5.1 ml, and 4.8 ml, 3.1 ml in the control group and there were the statistical conferences between two groups. However, the operation time, complications recovery time between were not comparable. Conclusion〓The menstrual period isn't affect operation planning for thyroid surgery.

Effect of ozone combining with VSD on breast abscess

CHENG Bin, CHENG Haiyan, LV Yuanyuan

2016, 16(05):  586-588.  DOI: 10.3969/j.issn.1009?鄄976X.2016.05.018

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【Abstract】 Objective〓To introduce the application of ozone and compare clinical effect combined incision and vaccum suction with ozone in treatment of breast abscess. Methods〓Forty patients with acute mastitis and breast abscess were performed surgical drainage,.in which 20 cases underwent incision and vacuum suction.(VSD group),.another 20 cases were treated by using a combined treatment of VSD plus ozone (VSD+ozone group). The clinical effect between two groups were compared. Results〓All cases were cured in two group..The healing time of breast abscess in VSD+ozone group was shorter than that in VSD group,.and no side effect was found in VSD+ozone group. Conclusion〓The ozone combing with negative pressure drainage has an advantage over the traditional VSD alone in treatment of breast abscess.

Treatment of gynecomastia with mastoscopic surgery

YAO Xiaojun, LIU Feng, TANG Zifeng, LIAO Jialing

2016, 16(05):  589-591.  DOI: 10.3969/j.issn.1009-976X.2016.05.019

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【Abstract】〓Objective〓To investigate the feasibility and technique of mastoscopic procedure in treating gynecomastia. Methods〓Form March 2014 to May 2016, 36 cases of gynecomastia were treated with mastoscopic subcutaneous mastectomy. Results〓Thirty-six cases were successfully operated.Postoperative complications included one case skin necrosis around the mastoscopic operation hole and two cases of temporary subcutaneous emphysema. No severe complications were observed. Conclusion Compared with conventional operation, Mastoscopic subcutaneous mastectomy for gynecomastia is safe, effective and minimally invasive.

Implantation of totally implantable venous access port via internal jugular vein in chemotherapy for breast cancer

WANG Peishun, ZHOU Xinchuan, ZHOU Jun, WANG Rui, LI Shuqin, BI Tieqiang

2016, 16(05):  592-594.  DOI: 10.3969/j.issn.1009?鄄976X.2016.05.020

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【Abstract】 Objective〓To summarize up the effect of totally implantable venous access ports (TIVAP) implanted via internal jugular vein on chemotherapy for breast cancers. Methods〓A retrospective review was conducted on 96 patients undergoing a TIVAP implantation for breast cancer chemotherapy at our hospital from June 2013 to December 2015. Surgical and long-term complications were analyzed. Results〓All TIVAPs were implanted successfully. There were one case of cardiac arrhythmia, one case of hematoma, two case of pneumothorax, two cases of catheter occlusion, three case of catheter-related infection and one case of catheter rupture. The patients were followed up for a median of 15 months (4-30 months). TIVAP worked well without leakage, pneumothorax, infection, or pinch-off syndrome. Conclusion〓Implanting totally implantable venous access port via the internal jugular vein is feasible and safe in patients with breast cancer.

Clinical comparison of antibiotic treatment and appendectomy for the treatment of acute uncomplicated appendicitis

CHEN Liuxiang, TENG Fanwu, ZHAN Xiaofeng

2016, 16(05):  595-598.  DOI: 10.3969/j.issn.1009-976X.2016.05.021

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【Abstract】〓Objective〓To analyze and compare the clinical effect and safety of antibiotic therapy and appendectomy for the treatment of acute uncomplicated appendicitis (AUA). Methods Patients who met the inclusion and exclusion criterions were assigned to two groups, antibiotic group (108 cases) and surgery group (111 cases). The cases in the antibiotic group received classes of antimicrobial agents plus metronidazole and the ones in the surgery groups received appendectomy and perioperative antibiotic treatment. The treatment effect was regarded as the primary outcome. The other clinical effects were compared between two groups. Results〓All the cases in the surgery group underwent successful appendectomy, leading to a success incidence of 100%. Moreover, the ones in the antibiotic group had a successful treatment incidence of 77.8% (84/108). The intention to treatment analysis yielded a difference in treatment efficacy of two groups of 22.2%, which was within the range of prespecified noninferiority margin of 24%. Hence efficacy of antibiotic treatment was similar to surgery. Moreover, the cases in the antibiotic group had favor outcomes in the fields of complications, expenses, visual analog scale (VAS) for pain feeling during hospital stay. Conclusion The patients with AUA received antibiotic treatment had a similar curative effect than the ones following appendectomy. Moreover, the AUA patients with antibiotic treatment had less pain, recovered faster and spent less.

Conservative management of pediatric trigger thumb and fingers used steroid injection

ZHANG Jianfa,LIU Shangli

2016, 16(05):  599-601.  DOI: 10.3969/j.issn.1009-976X.2016.05.022

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【Abstract】〓Objective〓To investigate feasibility of conservative treatment on hand flexor tenosynovitis of children. Methods〓Twenty-nine consecutive fingers of 25 children scheduled for management of diprospan injections were included in this cohort. Twenty-two patients were treated by using diprospan intrathecal injection and other three patients using triamcinolone acetonide. Injection method was once a week/one week and totally three time in one course. Results〓The follow-up data was obtained on all consecutive patients and information was collected at an average of 1.5 year (6 months-8 years) after injection. The excellent rate was 80% and the good result was 20% in which there was an indurate node in the hand. None was performed surgical management. Conclusion〓Conservative treatment of pediatric trigger thumb and fingers used steroid injection is an effective method.

Prospective investigation of infectious incidence after shock wave lithotripsy in patients without risk factors

LI Dongxia, ZHENG Hao, ZHENG Xiaoqing, WEI Shengwei

2016, 16(05):  601-604.  DOI: 10.3969/j.issn.1009-976X.2016.05.023

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【Abstract】〓Objective〓To investigate the infectious complications of extracorporeal shock wave lithotripsy in patients without associated risk factors. Methods〓We performed a prospective cohort study between March 2011 and August 2014. The patients who subjected to extracorporeal shock wave lithotripsy and were not found infectious risk factors were included in the study. All patients underwent urine culture three days before the procedure and seven days after lithotripsy. No patient received antibiotics. Results〓122 patients with a mean age of 52±10 years met inclusion criteria. A total of nine patients (7.4%) underwent extracorporeal shock wave lithotripsy with a previously placed Double-J stent. After lithotripsy urine culture was positive in seven patients (6.1%), of whom one (0.87%) presented with symptomatic urinary infection and the remaining showed no symptoms. Urosepsis did not develop in any case. The age in the patient was an independent risk factor for bacteriuria after lithotripsy. Conclusion〓The incidence of infectious complications after extracorporeal shock wave lithotripsy in patients without risk factors is low. This leads us to conclude that without defined risk factors antibiotic prophylaxis is not justified. Elder patients were more at risk for bacteriuria after extracorporeal shock wave lithotripsy and more at risk developing infectious complications.

Clinical observation and complication management of standard channel percutaneous nephrolithotripsy with pneumatic and ultrasonic power under B-type ultrasound guidance in management of renal and upper ureteral calculi

YOU Hongke, DONG Gonghang, YIN Yonghua

2016, 16(05):  605-607.  DOI: 10.3969/j.issn.1009-976X.2016.05.024

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【Abstract】 Objective〓To evaluate the clinic efficacy and safety with PCNL under B-type ultrasound guidance in management of renal and upper ureteral calculi. Methods〓The clinical date of 175 cases treated by standard channel PCNL were analyzed retrospectively. Results〓The punctures were completed successfully in all cases, and 150 of 175 cases were performed in one-session, 25 cases were performed successfully in two-session. The mean operation time was 130 (80 to 180) mins, and the mean hospital stay was eight days. The stone-free rate was 91%. Postoperative complications were seen in 23 PCNL, included postoperative bleeding in 6(1 case needed transfusion during and after operation), fever in five, malignant hypertension in one, hemopneumothorax in four, urinary injury in two, perfusion fluid extravasation in five. Conclusion〓Standard channel PCNL with pneumatic and ultrasonic power under B-type ultrasound guidance is a safe and effective procedure in management of renal and upper ureteral calculi.

General anaesthetic under surgery of Kasabach-Merritt phenomenon: experience and case report

YI Xing, YE Xijiu

2016, 16(05):  608-610.  DOI: 10.3969/j.issn.1009-976X.2016.05.025

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【Abstract】 Kasabach-Merritt syndrome (KMS) is a rare clinical disease, which is mainly characterized by large hemangioma with thrombocytopenia. There is no unified standard of treatment and a good radical cure method, and the main method is symptomatic treatment. Most KMS occur in infants and even in neonates. The patients may be accompanied by thrombocytopenia and consumption coagulopathy. For those cases of surgical resection, surgery and anesthesia risk is very high. This paper reports a case of neonatal KMS, discuss anesthesia in children and experience of the authors.

Curative effect of combination of thymosin,.transfer factor and nimesulide on nonspecific costochondritis

ZHU Zhenghe

2016, 16(05):  611-612.  DOI: 10.3969/j.issn.1009-976X.2016.05.026

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【Abstract】〓Objective〓To explore the effect of combining thymosin, transfer factor with nimesulide on treatment of nonspecific costochondritis. Methods〓134 patients with costochondritis between January 2010 and June 2012 were included in the cohort and were assigned to nimesulide group (n=67) and observation group treated by combination of thymosin, transfer factor and nimesulide. The curative effect was compared between the two groups. Results〓The overall efficiency rates were 95.5% (64/67) and 53.7%(36/67) in observation group and nimesulide group respectively,.and there was the statistical significant difference between the two groups. Conclusion The combination approach of thymosin,.transfer factor and nimesulide showed better efficiency than single nimesulide alone in treatment of nonspecific costochondritis.

Research progress of bone morphogenetic protein in the repair of articular cartilage

WU Baojie, YU Shenghua, CHEN Huirun, HU Hansheng

2016, 16(05):  618-621.  DOI: 10.3969/j.issn.1009-976X.2016.05.028

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【Abstract】〓Articular cartilage injury is a common disease, which can cause the formation of osteoarthritis that makes people’s lives terrible. Articular cartilage has a limited capacity for spontaneous repair, due to its avascular nature and absence of progenitor cells and the effective method to repair damaged articular cartilage has not yet been established. At present, the research of the growth factor to promote the repair and restoration of articular cartilage are becoming more and more popular and BMP is the special factor that can induce bone formation, thus it has obvious effect for the repair of articular cartilage. But It is still in the research stage and a lot of problems still remained unsolved be solved. So it is very necessary to review the repair of articular cartilage defect with bone morphogenetic protein.

Operative cooperation in tongue reconstruction with anterolateral thigh flap after tumor ablation

SHA Liujuan, LUO Ling, LIANG Min, MAI Shaoxing, LI Jingsong, HU Lixuan

2016, 16(05):  626-627.  DOI: 10.3969/j.issn.1009-976X.2016.05.031

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【Abstract】 Objective To summarize the perioperationive nursing approach for patients undergoing tongue repair by anterolateral thigh flap after tumor ablation. Methods〓Thierty-eight patients with tongue cancer underwent glossectomy and tongue repair by the anterior lateral thigh flap sensitive myocutaneous (ALTF) with vastus lateralis muscle to reconstruct the oral defect. The preoperative and intraoperative nursing experience were collected and summarize up. Results〓All 38 anterolateral thigh flaps survived except one had partial necrosis which healed in secondary after a debridement. Patients had favorable appearance, swallowing and language function. Conclusion〓Preoperative instruments preparation, acquaintance of surgical procedures and cooperation, strict sterile and non-neoplasm touch technology were important step for successful operation.

Role of healthcare integration model in reducing the VAP incidence in ICU patients

MO Hongping, OUYANG Xia, TAN Zhuojun, ZOU Zijun, XU Fengqin

2016, 16(05):  628-630.  DOI: 10.3969/j.issn.1009-976X.2016.05.032

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【Abstract】 Objective To explore the role of healthcare integration model in reducing the incidence of patients of ventilator associated pneumonia (VAP). Methods〓VAP patients from ICU in 2014 was used as a control group,and those in 2015 was assigned to observation group. The implementation of integrated health care and the use of scientific management methods after the incidence of VAP in ICU patients were performed in observation group. Results〓the implementation of health care integration, the incidence of VAP from before 28.11‰ to 21.58‰improvement (P<0.05). Conclusion〓the implementation of healthcare integration model and the use of scientific management methods can reduce the incidence of VAP in patients with ICU.

Analysis on the influencing factors of carrying out nursing quality circles and measures

LI Yingya, GE Jun, LI Yan

2016, 16(05):  630-632.  DOI: 10.3969/j.issn.1009-976X.2016.05.033

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【Abstract】 Objective To investigate the influencing factors of carrying out nursing quality control circles (QCs) and analyze the active countermeasures. Methods〓A total of 64 clinical nurses participating in QCs were included in the study, and investigate the willingness to join in the activity by self-designed questionnaire. Binary logistic regression was used in statistical analysis. Results Lacking of support from colleagues and unwilling ask for help from nursing department were the main influencing factors and were negative related with nurses’ will to take part in QCs activities. Conclusion〓There are lots of factors in activities of QCs, it is necessary to work out right measures, so that the QCs can be run successfully.

Effect of infrared irradiation on abdominal incision healing in gastro-enteric tumor patients

CHEN Sukai, MAI Peishan, HONG Qingqi

2016, 16(05):  633-635.  DOI: 10.3969/j.issn.1009-976X.2016.05.034

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【Abstract】 Objective To observe the therapeutic effects of infrared in abdominal incision healing of gastro-enteric tumor patients postoperative. Methods〓250 gastro-enteric tumor patients were assigned to two groups, control group and experimental one. The average healing time of abdominal incision, infection ratio of incision, and the average in-hospital cost were observed. For control group patient, the abdominal incision was routinely disinfected with Iodophors q2d till the stitches were removed and for experimental group patient, irradiation of the incision with infrared ray lamp for 20 minutes twice a day was added in addition. Results〓The average healing time of abdominal incision of experimental group patient was 6.92±1.81 days, which was significantly shorter than that (7.99±3.91 days) of control group patient (P<0.01). The infection ratio of incision of experimental group patient was significantly lower than that of control group patient with 2.19% vs 11.50% (P<0.05). And the average in-hospital cost of experimental group patient was not higher than that of control group patient with 5.61±0.70(ten thousand yuan) vs 5.64±0.73 (ten thousand yuan) (P>0.05). Conclusion〓Irradiation can shorten the average healing time of the abdominal incision of gastro-enteric tumor patients postoperative, and can lower the infection of incision, but not increase the average in-hospital cost.

Perioperative nursing for patients undergoing laparoscopic incisional hernia repair

LIU Yu, WANG Yucui, ZHOU Haiyan

2016, 16(05):  635.  DOI: 10.3969/j.issn.1009-976X.2016.05.035

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【Abstract】 Objective〓To summarize perioperative nursing experience for patients undergoing laparoscopic incisional hernia repair. Methods〓The laparoscopic mesh repair was performed for 46 patients with incisional hernia from January 2010 to December 2014 in our hospital, the clinical effects of nursing intervention were retrospectively analyzed. Results〓All operations were successfully performed without severe morbidity and mortality. The operative time was 64-184 min (mean, 102±26 min). Postoperative complications included abdominal distension (4 cases), seroma (3 cases), pain in operative area (6 cases). No incisional infection or mesh rejection occurred. The postoperative hospital stay ranged from 4 to11 days (mean, 6.7±1.2 days). No recurrence occurred during the follow-up period of 6-31 months (mean, 21.4 months). Conclusion〓The implementation of perioperative individualized nursing intervention for patients undergoing laparoscopic incisional hernia repair can effectively improve the treatment effect, reduce postoperative complications and accelerate the recovery of patients.