Table of Content

20 August 2018, Volume 18 Issue 04

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The silencing of forkhead box P3 gene inhibited expression of chemokines CXCL12，CXCL11， CXCR4 and CXCR7 in liver cancer cells

OU Xi1，ZHANG Guangtao1，TIAN Peikai2，CHEN Jingsen3，XU Zhe4，XIE Yong1，WANG Aihong1， LIU Jikui1, LIU Xiaoping1*

2018, 18(04):  371-376.  DOI: 10.3969/j.issn.1009-976X.2018.04.001

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［Abstract］ Objective To study the effects of forkhead box P3 （FOXP3） shRNA on chemokine/ chemokine receptor CXCL12 、 CXCL11 、 CXCR4 、 CXCR7 expression in liver cancer cells. Methods Two hepatoma cell lines SMMC-7721 and MHCC-97H cells were selected. Three FOXP3 interfering lentivirus encoding FOXP3 shRNA were designed：sh?FOXP3?1?pGreenPuro，sh?FOXP3?2?pGreenPuro and sh?FOXP3?3?pGreenPuro. SMMC?7721 and MHCC?97H cells were transfected with lentivirus vector encoding shRNA-FOXP3 respectively. q-PCR was used to detect the mRNA expression of FOXP3，of CXCL12，CXCL11，CXCR4 and CXCR7 at the protein levels． Results Three FOXP3 interfering lentivirus carriers were constructed accordingly，and the effect of sh?FOXP3?1 was the most obvious in reducing FOXP3 expression. The following experiments were carried out using sh-FOXP3-1. The expression of CXCL12，CXCL11，CXCR4 and CXCR7 at both mRNA and protein levels in sh?FOXP3?1 group decreased significantly compared with controls. Conclusion The silencing of FOXP3 can inhibit the expression of chemokine / chemokine receptor CXCL12，CXCL11，CXCR4 and CXCR7.

The Function of LncRNA RP11?321G12.1 in Breast Cancer

WANG Danlan1，2，HUANG Yongxin1，GUO Yanhua3，LI Yun1，ZHANG Yin1

2018, 18(04):  377-382.  DOI: 10.3969/j.issn.1009-976X.2018.04.002

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［Abstract］ Objective To study the function and mechanism of estrogen receptor?regulated long non?coding RNA RP11-321G12.1 in breast cancer. Methods In the previous study，estrogen receptor-regulated long non?coding RNAs were screened by bioinformatics analysis. In this study，after silencing RP11?321G12.1 by siRNA in ER positive breast cancer cell lines MCF7 and T47D，the effect of RP11? 321G12.1 on cell proliferation and cell cycle was investigated using plate colony formation assay and flow cytometry. The molecular mechanisms involved in RP11?321G12.1 in breast cancer were studied by q?PCR and western blot. Results Silencing of RP11?321G12.1 inhibited the proliferation of MCF7（P= 0.003）and T47D（P=0.001）；it also inhibited the cell cycle，showing as an increase in the ratio of G1 phase cells and a decrease in the ratio of S? phase cells. In the Hu-blocked release assay in T47D cell line，it was found that RP11-321G12.1 was positively correlated with the cell cycle G1 phase （P= 0.039）. Western blot experiments showed that silencing of RP11-321G12.1 can result a decrease inpositive breast cancer. When the ER-regulated lncRNA RP11-321G12.1 is silenced，the cell cycle progression can be inhibited by down-regulating the protein expression levels of the cell cycle-related proteins Cyclin D1 and Cyclin E2，so that the ratio of G1 phase cells is increased and the ratio of S phase cells is decreased. Cell proliferation was significantly inhibited.

Analysis of the clinical efficacy of rapamycin in infant hemangioma failed propranolol treatment

WU Zejian1，LIN Siping2，PAN Yu3，ZHU Guifeng1，YE Kelin1，CHEN Qinchang1, HUANG Zhiquan4

2018, 18(04):  383-385.  DOI: 10.3969/j.issn.1009-976X.2018.04.003

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［Abstract］ Objective To explore the clinical efficacy of rapamycin in the treatment of hemangiomas in patients who have failed propranolol treatment. Methods From January 2016 to January 2018，40 cases of propranolol in the outpatient clinic in the People s Hospital of Puning failed to be used for treatment. Children with hemangiomas are treated with rapamycin（total daily dose 0.1 mg/kg，once daily or divided into two doses daily for half?time use，3 months for a single course of treatment），and the size of the hemangiomas is observed and recorded. Color change and related side effects were used to evaluate its efficacy and safety. Results The effective rate was 92.5% in one month and 94.4% in three months. The related side effects were light and controllable. Conclusion Rapamycin is effective and has fewer side effects in children with hemangiomas who are refractory to propranolol.

Experience in surgical treatment of deep incision infection after tension-free inguinal hernia repair

WANG Dingping，CHEN Huanxin

2018, 18(04):  390-392.  DOI: 10.3969/j.issn.1009-976X.2018.04.005

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［Abstract］ Objective To analyze the case data on surgical treatment of patch infections afterlaparoscopic inguinal hernia repair. Methods The clinical data of 11 patients with mesh infections after tension-free hernia repair in our hospital from June 2010 to March 2017 were retrospectively analyzed. Four of 11 cases were transferred from lower?level basic hospitals. The surgical procedure included“flat mesh”+ plug hernioplasty in 8 cases，repair of anterior peritoneal space in two cases，plug hernioplasty in one cases. All patients were treated with conservative treatment for more than 3 months， and underwent the local debridement，patch removal and dressing. Results Wounds were primarily closed in 8 cases and 3 cases were delayed healing. Followed up for 6 months to 22 months after operation，no incision redness，pain，and no recurrence of hernia was found. Conclusion There are many reasons for tension-free hernia infection. Sufficient preoperative preparation，strict aseptic procedures，and careful postoperative observation are necessary for reducing the infection. Prolonged conservative treatment may be beneficial to reduce hernia recurrence.

The research on effect of somatostatin combined with jejunal nutrition tube on neonatal congenital intestinal atresia

BAI Jian，LIANG Jingwen，LI Qiuju，WANG Shaomei，LIANG Yuzhu，WU Minqiu

2018, 18(04):  393-396.  DOI: 10.3969/j.issn.1009-976X.2018.04.006

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［Abstract］ Objective To observe the effect of somatostatin combined with jejunal nutrition tube onneonatal congenital intestinal atresia. Methods Fifty neonates with congenital intestinal atresia were divided into control group and observation group by different treatment method. The control group was treated with single somatostatin，the observation group was treated with somatostatin combined with jejunal nutrition tube，and the changes of body mass and adverse reactions were compared between the two groups. Results There was no significant difference in surgical methods between the two groups （P> 0.05）. Compared with the control group，the length of hospitalization in the observation group was significantly shorter than that in the control group（P<0.05）. After 3，7 and 14 days of treatment，the increase of body mass in the observation group was significantly greater than that in the control group（P< 0.05）. The incidence of adverse reactions was 4.0%（1/25）in the observation group and 32.0%（8/25）in the control group（P<0.05）. The occult blood test of the observation group was significantly better than that of the control group （P<0.05）. Conclusion Somatostatin combined jejunum nutrition tube used in postoperative children with neonatal congenital intestinal atresia，it can improve the nutritional status of children，reduce the incidence of adverse reactions，has higher application value.

Effect of gallbladder retention on postoperative recurrence of intrahepatic and extrahepatic cholelithiasis

WU Zhiyang1， LI Gang1， CHEN Ming1， LIU Jingshan2， YANG Yulong3， LU Deguang1， CHEN Xiangqing1，XIE Weijie1，ZENG Jintao1

2018, 18(04):  397-399.  DOI: 10.3969/j.issn.1009-976X.2018.04.007

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［Abstract］ Objective To observe the preservation of gallbladder in patients with intrahepatic andextrahepatic cholelithiasis by comparing with the traditional method of cholecystectomy. Methods Thirty? seven patients with choledocholithiasis or with cholecystolithiasis were treated with choledocholithiasis and22 patients with intrahepatic cholelithiasis or cholelithiasis were treated with choledocholithotomy. Cholecystolithotomy （including partial hepatectomy）. Results The recurrence rate of intrahepatic choledocholithiasis was 4.54% and the recurrence rate of cholecystic choledocholithiasis was 2.7%，which was significantly lower than that of the literature. Conclusion The strategy of preserving the gallbladder in intrahepatic and extrahepatic calculi surgery does not increase the recurrence of intrahepatic and extrahepatic bile duct stones. The preservation of gallbladder function contributes to the integrity of the biliary system and may reduce the chance of recurrence of intrahepatic and extrabiliary calculi.

Effect of proximal minimally invasive gastrectomy for patients with early-stage proximal gastric cancer

ZHANG Wenxiang, WANG Jin, YANG Feng

2018, 18(04):  400-404.  DOI: 10.3969/j.issn.1009-976X.2018.04.008

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Objective To explore the effect of proximal minimally invasive gastrectomy for patients with early-stage proximal gastric cancer. Methods 100 patients with proximal gastric cancer who underwent surgery from January 2007 to January 2012 were enrolled, 50 of whom underwent proximal minimally invasive gastrectomy and 50 underwent total gastrectomy. Surgical conditions, complications, nutritional status, and Visik scores of gastroesophageal reflux were compared between the two groups.Results In terms of operating time, lymphatic cleaning, statistical significance was not showed on them between two groups (P>0.05). In terms of blood loss, volume of experiment group was less than that of control group, statistical significance was showed on them (P<0.05). Compared early and late complications, exhaust time, eating time between two groups, statistical significance was not showed on them (P>0.05). In gastric cancer pathological conditions, statistical significance was not showed on them between two groups (P>0.05).The statistical significance was not showed on preoperative and postoperative nutritional status between two groups (P>0.05). The Visik score of experiment group is significantly higher than that of control group, statistical significance was showed on them (P<0.05). Conclusion Proximal minimally invasive proximal gastrectomy is a reliable and safe choice for gastric cancer patients, patients have good postoperative recovery, it has a high incidence of gastroesophageal reflux, but it is worth in clinical application.

Effects of intraoperative laryngeal nerve monitoring for early reoperation of residual thyroid after thyroidectomy in the patient with thyroid cancer

LI Hui1，LONG Miaoyun2，LI Honghao2

2018, 18(04):  405-408.  DOI: 10.3969/j.issn.1009-976X.2018.04.009

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［Abstract］ Objective To investigate the effects of intraoperative nerve monitoring on earlyreoperation of residual thyroid after 5 to 15 days of thyroidectomy for thyroid cancer，and the level of postoperative serum thyroglobulin， recurrent laryngeal nerve injury and parathyroid gland function. Methods We retrospectively analyzed the data of a group of patients with thyroid surgery from January 2010 to December 2016 in Sun Yat?sen Memorial Hospital of Sun Yat?sen University. The patients who met the inclusion criteria were assigned to the nerve monitoring group and the non-neural monitoring group according to whether the nerve monitoring was used during the operation. The postoperative temporary and permanent recurrent laryngeal nerve injury were recorded. The hypoparathyroidism，the 435 patients who met the inclusion criteria，including 227 in the nerve monitoring group and 208 in the non? neural monitoring group. The average preoperative serum Tg concentration in the nerve monitoring group was 18.66±2.3 ng/ml，and 17.43±1.4 ng/ml in the non?neural，which was not statistically significant（P<0.05）. Temporary hoarseness occurred in 18 cases（18/208，8.67%）in the non? neural monitoring group，and in 5 cases （5/227，2.2%）in the nerve monitoring group（P<0.05）. Non?neural monitoring group had permanent hoarseness in 4 cases（4/208，1.92%），and in one case（1/227，0.44%）in the nerve monitoring group（P>0.05）. Thirty?eight cases（39/208，18.75%）in non?neural monitoring group had transient hypoparathyroidism，and 17 cases（17/227，7.49%）in the nerve monitoring group（P< 0.05）；Four cases（4/208，1.92%）in non?neural monitoring group had permanent hypoparathyroidism， and two（2/227，0.88%）in the nerve monitoring group（P>0.05）. The average Tg concentration in the non?neural monitoring group was 2.82±0.2 ng/ml in 1 month after operation，and 1.37±0.2 ng/ml in the nerve monitoring group（P<0.05）. In the non? neural monitoring group，45.06%（94/208）patients had an average Tg concentration of less than 1 ng/ml at 1 month postoperatively，and 67.4%（153/227）in the nerve monitoring group （P<0.05）. Conclusion Intraoperative nerve monitoring for reoperation of residual thyroid after 5 days to 15 days of thyroidectomy in thyroid cancer patient can reduce the recurrent laryngeal nerve injury and hypoparathyroidism，improve the thoroughness of improving the thoroughness of thyroidectomy and cancer tissue resection.

Comparison of saline?linked diathermy and clamp crushing method in irregular hepatectomy

KUANG Naile1，ZUO Chaohai1，WU Junhua1，XU Jiena2，YU Jiexiong1

2018, 18(04):  409-413.  DOI: 10.3969/j.issn.1009-976X.2018.04.010

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［Abstract］ Objective To compare the clinical effects of saline-linked diathermy in irregular liver resection. Methods Saline?linked diathermy（experimental group）was used during hepatectomy for 61 patients，and clamp crushing method（control group）was used in 48 patients. The clinical data of two groups were analyzed retrospectively. The differences in intraoperative，postoperative and postoperative complications were compared between the two groups. Results All patients were successfully operated without perioperative deaths. The operative time，intraoperative blood loss，and surgical transfusion in the control group were 164.58±41.20 min，584.38±559.94 ml，and 17 cases，respectively，while in the experimental group were 159.43±43.93 min，178.52±153.46 ml（P<0.05），and 3 cases（P<0.05）. The time difference was not statistically significant （P>0.05）， but there were statistically significant differences in the number of surgical hemorrhages and blood transfusions（P<0.05）. There was no case of hilar occlusion in both groups. There was no significant difference in the levels of ALT，ALB and TBIL and hospitalization time between the two groups on the first day and the seventh day（P>0.05）. There was no significant difference in the incidence of postoperative complications such as bile leakage， postoperative infection，and liver failure between the two groups（P>0.05）. Conclusion Saline?linked diathermy is a practical liver resection method to reduce intraoperative bleeding and transfusion events during hepatectomy.

Clinical Comparison of Gemcitabine Combined Vinorelbine×8 Regimen Versus Gemcitabine Combined Vinorelbine×4 follow oral N ×4 Regimen as Chemotherapy for Metastatic Breast Cancer

ZHANG Kai，LUO Zhihui，HUANG Zhan，GONG Xumeng，CHEN Weiling

2018, 18(04):  414-417.  DOI: 10.3969/j.issn.1009-976X.2018.04.011

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ABSTRACT BACKGROUND&OBJECTIVE:. To compare the efficacy and toxicities of gemcitabine combined vinorelbine ( GN) ×8 regimen and gemcitabine combined vinorelbine ( GN) ×4 follow oral N ×4 regimen as chemotherapy for anthracycline- and taxane- resistant metastatic breast cancer(MBC) Patients and Methods:. 61 patients were treated by GN or GN×4— N regimen. Overall response rate( ORR) and 1- year survival of two groups were assessed after treatment RESULTS：CR was 6. 5% ( 2 /31) and PR was 29.0% (9 /31) in GN group. 2 patients ( 6.9% ) had a complete response( CR) and 8 patients ( 27.6% ) had a partial response( PR) in GN×4—N group. No statistically significant difference was observed in terms of ORR( 35.5% vs. 33.3%. , P =0.925) , or 1- year survival rate ( 67.7% vs. 65.5%, P =0.576) of the two groups. No patients died in correlated with the two regimens. Myelosuppression and gastrointestinaltract reaction were the most common toxicities. CONCLUSIONS:. GN and GN×4—N regimens are both well effective for patients with anthracycline- and taxane- resistant MBC. Drug- related toxicities are tolerable. Two regimens can be considered as salvage regimens for those patients.

Application of surgical procedure of transverse incision and subcutaneous tissue traction to underbelly surgery

LI Ling1，2，LI Haibo2，CHEN Yuhang2，LI Ruihua2，3

2018, 18(04):  418-424.  DOI: 10.3969/j.issn.1009-976X.2018.04.012

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［Abstract］ Objective To investigate the application of an incision along skin line and subcutaneoustissue traction to underbelly surgery. Methods 262 cases of lower abdomen surgery were assigned to observation group including inguinal hernia repair，appendectomy，and hydrocele of hydrocele. This surgical procedure was performed through an incision along skin line and subcutaneous tissue and retraction in our hospital from July 2010 to December 2017. Another 278 patients who underwent conventional surgical incision were used as controls. Incision healing and adverse reactions were recorded and compared between the two groups. Results In patients of observation group，wound infection，wound hematoma，and local edema were less than that in the conventional incision group，and the average suture removal time was shortened，and the scar width was also reduced，and all P value were less than 0.05. Conclusion The transverse incision has a small scar and cosmetic incision. The subcutaneous tissue retraction through transverse incision can avoid damage to the vessels，thus reducing subcutaneous hematoma，wound infection and complications.

The significance of deep laryngeal nerve lymph node dissection in the operation of papillary thyroid carcinoma

HAN Bin，WANG Donglai，LI Peng，ZOU Li，WEI Wei

2018, 18(04):  421-424.  DOI: 10.3969/j.issn.1009-976X.2018.04.013

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［Abstract］ Objective To investigate the necessity and significance of deep laryngeal lymph nodedissection in the operation of papillary thyroid carcinoma. Methods From May 2017 to March 2018，102 cases of thyroid papillary carcinoma （right or bilateral） were treated with radical resection， including lymph node dissection of the superficial and deep layer of the recurrent laryngeal nerve in the right central region. The superficial and deep lymph node metastases were compared after operation. The clinical data of the patients age，sex，tumor size，the invasion of the envelope，the combination of Hashimotos thyroiditis and the lymph node metastasis of the larynx were analyzed and compared with the lymph node metastasis. Results （1）The rate of the deep lymph node metastasis of the right recurrent laryngeal nerve in the central area was 23.5% ，the superficial metastasis was 61.8% ，the proportion of the deep lymph node metastasis only and the non superficial metastasis was 1.3% ，and the total lymph node metastasis rate in the right central area was 65.7%.（2）There was no significant difference in the rate of the deep lymph node metastasis of the recurrent laryngeal nerve in the patient s age，sex，the invasion of the envelope and Hashimoto s thyroiditis，but it was closely related to the size of the lump， the number of lesions，the metastasis of the anterior larynx lymph nodes，and the metastasis of the superficial lymph node of the right laryngeal nerve，P < 0.05. Conclusion On the right or bilateral of a certain rate of the deep lymph node metastasis of the recurrent laryngeal nerve，in order to ensure the radical operation of the radical operation，it is necessary not only to clean the superficial laryngeal nerve，but also to clear the deep lymph nodes，especially when the tumor is larger，multifocal and there is a anterior larynx and superficial lymph node metastases.

The application of transversus abdominis plane block in total abdominal hysterectomy surgery

HONG Yu1，YE Hua2，LIU Jiayi1，PENG Shuling1

2018, 18(04):  425-427.  DOI: 10.3969/j.issn.1009-976X.2018.04.014

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［Abstract］ Objective To investigate the application of the transversus abdominis planeblock（TAPb） in surgery of total abdominal hysterectomy. Methods Fifty patients were divided into two groups （n=25）：the transverse abdominal planar block （TAPb group） and the control group. After intubation，B-ultrasonically guided bilateral transverse abdominal plane block were performed，while TAPb was not done in control group. Both groups received patient?controlled intravenous analgesia after operation. The differences in monitoring indicators were compared between the two groups. Results The awake time，postoperative VAS score，the exhaust time，the first time of getting up and the time of hospitalization of the patients in the TAP group were significantly lower than those in the control group. Conclusion Transversus abdominis plane block （TAPb） in the open hysterectomy can provide fast anesthesia recovery in patients with，and less postoperative pain，early ambulation and reduce the time of hospital stay.

Effects of sevoflurane combined with remifentanil on cognitive function in elderly patients after laparoscopic surgery

LIN Zonghang，HUANG Xuefang，FU Baojun，ZHANG Bin，YANG Xiuhuan，CHEN Qingmei，HUANG Yuqiong，LI Heng

2018, 18(04):  428-432.  DOI: 10.3969/j.issn.1009-976X.2018.04.015

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［Abstract］ Objective To investigate the influence of different concentration and duration ofsevoflurane inhalation anesthesia on postoperative cognitive function in elderly patients undergoing minimally invasive surgery. Methods 128 patients who were scheduled for totally extraperitoneal herniorrhaphy surgery，age 65 to 75 years old，ASA Ⅱ～Ⅲ ，were divided into 4 groups according to the duration and concentration of sevoflurane inhalation：1.5% and ≤1.5 h group（LS group，n=33）， 1.5% and ≥3 h group（LL group，n=30），3% and ≤1.5 h group（HS group，n=34），3% and ≥3 h group （HL group，n=31）. The mini-mental state examination （MMSE） was utilized to assess the cognitive function the day before the surgery and 1 d，7 d，14 d after the surgery. Patients peripheral venous blood samples were collected immediately before the introduction（T0），1 h（T1），6 h（T2）and 24 h（T3）after the operation. The plasma levels of IL?6 and S100? β protein were measured by enzyme? linked immunosorbent assay（ELISA）. Results The difference of MMSE scores in four groups at 1 d， 7 d，14 d after the surgery have no significance（P<0.05）. The incidence rate of cognitive decline in HL group at 7 d after surgery was higher than the other three groups（P<0.05）. Compared with LS group，0.05）. Compared with LL group，the levels of IL? 6 and S100? β protein in HL group at T1 and T2 were significantly higher（P<0.05）. Compared with HS group，the concentrations of IL?6 and S100? β protein in HL group at T1 and T2 were significantly higher （P<0.05）. Conclusion Inhalation of 1.5% sevoflurane combined with remifentanil has little effect on cognitive function in elderly patients after minimally invasive surgery，and has high safety.

Application of different?concentration mepivacaine in lumbar plexus block for patients undergoing single lower limb surgery

YUAN Yuan，HUANG Haiming，YE Xijiu，LUO Jianwei

2018, 18(04):  433-437.  DOI: 10.3969/j.issn.1009-976X.2018.04.016

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［Abstract］ Objective To observe the clinical efficacy and safety of the three different concentrations of mepivacaine hydrochloride during lumbar plexus block for patients undergoing single lower limb surgery. Methods Seventy-five adult patients with ASA Ⅰ- Ⅱ ，undergoing single lower limb surgery，were randomly divided into 3 groups including 0.25% ， 0.5% and 0.75% （n=25）， according to the concentration of mepivacaine. All patients were performed lumbar plexus block guided by ultrasound and nerve stimulator. 35 ml of 0.25% mepivacaine was injected in group 0.25% ，35ml of 0.5% mepivacaine in group 0.5% ，and 35 ml of 0.75% mepivacaine in group 0.75%. The onset time，duration，blocking extent and the occurrence of adverse events were recorded after lumbar plexus block. Results The onset time of sensory block in the three groups was 23.7±3.8 min，15.5±3.4 min，10.2±3.1 min，respectively， with significant difference between any two groups（P<0.01）. The duration of sensory and motor block in group 0.75% were longer than that of group 0.5%（P<0.01）. The onset time of motor block in group 0.75% was shorter than that of group 0.5%（P<0.01）. The blocking extent of group 0.5% or group 0.75% was greater than that of group 0.25%（P<0.05），with no significant difference between group 0.5% and group 0.75% . All patients in group 0.5% or group 0.75% completed the surgery only under nerve complete the surgery for poor outcome of nerve blockade. No complications such as local anesthetic poisoning， epidural block， postoperative neurological dysfunction were observed. Conclusion Mepivacaine hydrochloride can be used safely and effectively in lumbar plexus block for adult patients undergoing single lower limb surgery. And the concentration of 0.5%- 0.75% can achieve satisfactory blocking outcomes.

Enfluence of the timing of permanent lumbar drainage therapy on shunt?dependent hydrocephalus in patients with aneurysmal subarachnoid hemorrhage

HE Jingsi1，LIU Da2，TAN Xiaosui1，GUAN Yaocong1

2018, 18(04):  438-440.  DOI: 10.3969/j.issn.1009-976X.2018.04.017

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［Abstract］ Objective To analysis of the effect of timing of permanent lumbar drainage afteraneurysmal subarachnoid hemorrhage on shunt-dependent hydrocephalus in patients. Methods A retrospective analysis was performed in 178 patients with aneurysmal subarachnoid hemorrhage from September 2015 to September 2017. According to the length of the lumbar drainage after subarachnoid hemorrhage，the patients were divided into three groups，group A（within 24 hours，n=56），group B（between 24 hours to 72 hours，n=79），group C（more than 72 hours，n=43）. Shunt?dependent hydrocephaluswas recorded. Results The shunt-dependent hydrocephalus occurred in the three groups：5 patients in group A（8.9%），8 patients in group B（10.1%），and 12 patients in group C（27.9%）. There was a significant difference in the incidence of shunt-dependent hydrocephalus between the three groups（P< 0.05）. Conclusion Continuous lumbar drainage should be performed as early as possible after aneurysmal subarachnoid hemorrhage to preventing from shunt?dependent hydrocephalus.

The role of suboccipital retrosigmoid approach in surgical treatment of CPA meningiomas

CHEN Panlong

2018, 18(04):  441-444.  DOI: 10.3969/j.issn.1009-976X.2018.04.018

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［Abstract］ Objective To discuss the role of suboccipital retrosigmoid approach in surgical treatment of cerebellopontine angle （CPA） meningiomas. Methods We reviewed the cases with the CPA meningiomas in our hospital from January 2004 to December 2015. A total of 53 patients underwent microsurgery through suboccipital retrosigmoid approach for CAP meningiomas and their clinical data were analyzed retrospectively including surgical approaches，efficacy and complications. Results In these 53 cases，tumor was completely resected in 48, subtotal removed in the other 5. All patients were followed up for 30 months to 8 years after the operation，in whom the preoperative symptom and sign disappeared in 32 patients，relieved in 7. The cranial nerve deficit was unchanged in 3 and new neurological deficit was present in 11. Conclusion Suboccipital retrosigmoid approach is a classic approach for the CPA lesions. It offers an excellent exposure to CPA region.

Contribution of cooperative effect of local mild hypothermia therapy and intravenous infusion of butylphthalide on the treatment of 32 patients with cerebral infarction after the micro? invasives surgery for hypertension?induced hemorrhage

HUANG Lihang1，DUAN Chuanzhi2，HUANG Qijin2

2018, 18(04):  445-448.  DOI: 10.3969/j.issn.1009-976X.2018.04.019

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［Abstract］ Objective To determine the cooperative effect of LMH and intravenous infusion of butylphthalide on the treatment of 32 patients with cerebral infarction. Methods Nine-four cases with cerebral infarction after the micro-invasive surgery were randomly divided into 3 groups. Clinical outcomes and Ischemia volume were assessed. Results Compared with LMH group and butylphthalide group，NIHSS scores in cooperative treatment group were significantly decreased respectively at 14?day and 30-day. Compared with LMH group and butylphthalide group，hematoma volume in cooperative treatment group was significantly decreased at 3? day. Compared with LMH group，hematoma volume in cooperative treatment was markedly decreased at 7?day. Compared with LMH group，ischemia volumes in other 2 groups were significantly decreased at 14-day. Conclusions Combined LMH therapy and survival in the ischemic penumbra region.

Assessment of renal hemodynamics in patients undergoing extracorporeal shock wave lithotripsy

CAO Zhaohui1，FU Zhongdai2，HE Jiefang1

2018, 18(04):  449-452.  DOI: 10.3969/j.issn.1009-976X.2018.04.020

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［Abstract］ Objective To investigate the influence of on extracorporeal shock wave lithotripsy（ESWL）on renal blood flow index. Methods Forty?eight patients from August 2016 to April 2018 were included in the study. The mean age was 50.3±14.1 years. The spectrum of blood flow of both the treated and the opposite kidney was investigated by using color Doppler ultrasonography including resistive index（RI），pulsatility index （PI） and acceleration time （AT）. Results The ESWL treatment caused a statistically significant increases of the RI in the ipsilateral kidney as well as in the opposite kidney（P<0.001 vs pre-ESWL）. The RI decreased after 92 hours after ESWL. PI substantially increased afterESWL in both kidneys（P<0.001 vs pre?ESWL），and decreased after 92 hours. There were statistically significant correlations shown between RI and age （r=0.562，P<0.05）. Conclusion ESWL for renal stones causes temporary impairment of the renal perfusion in both ipsilateral and contralateral kidneys. The patients age may be the main factor.

A new type of catheter design and comparison with ordinary rubber catheter in the urinary system infection rate during catheterization

LIANG Tao，LIU Jingping，LIANG Rongfang，WU Bin，ZHAN Qiance

2018, 18(04):  453-455.  DOI: 10.3969/j.issn.1009-976X.2018.04.021

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［Abstract］ Objective To report a self-made urethral catheter application and comparison with ordinary rubber catheter. Method Fifty?two cases with urethral injury（28 cases using self?made urethral catheter and 24 cases using normal rubber urethral catheter）and 58 cases without urethral injury（26 cases using self?made urethral catheter and 32 cases using normal rubber urethral catheter）were involved in this project. At the 3th，5th，10th day after catheterization，midstream urine were collected for urobacteriology culturing. Results In the patients with urethral injury， there were no statistical differences in urinary system infection between cases using self-made urethral catheter and using normal rubber urethral catheter at 3th and 5th day（P=0.149，and 0.054），but the rate was statistical difference in patients using normal rubber urethral catheter at 10th day（P=0.031）. The patients without urethral injury， there were no differences of urinary system infection rate between cases using self?made urethral catheter and using normal rubber urethral catheter at 3th，5th，10th day（all P>0.05）. Conclusion The self-made urethral catheter not only could be better than normal rubber urethral catheter used in catheterization，but also could reduce the urinary system infection rate during catheterization.

Clinical application of 3D printing navigation templates in total knee arthroplasty

WANG Lihui，ZANG Xuehui，YE Pei，GAO Lihua

2018, 18(04):  456-459.  DOI: 10.3969/j.issn.1009-976X.2018.04.022

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［Abstract］ Objective To analyze clinical efficacy of 3D printing navigation templates in total kneearthroplasty（TKA）. Method From March 2016 to October 2016，30 patients with TKA were divided into navigation template group and conventional group. The navigation template group used 3D printing individual navigation templates to assist the operation，and the conventional group used the traditional TKA method. The two groups were matched for age，gender，body mass index （BMI）， hemoglobin concentration，knee society score（KSS）. Then the hemoglobin concentration，operation time， postoperative drainage，KSS score were compared between the two groups before and after operation. Results All patients were followed up for 12?25 months，with an average of 19 months，during which no infection or prosthesis loosening or deep venous thrombosis was found. The navigation template group had a significantly shorter operation time，a less postoperative drainage，a less hemoglobin concentration drops and a higher KSS score than those in the conventional group（P<0.05）. Conclusion The application of 3D printing navigation template in TKA can achieve better clinical efficacy by saving operation time， reducing bleeding and improving joint function.

Elbow arthroscopy-assisted reduction and percutaneous fixation for treatment of the humeral lateral condyle fracture in children

ZHU Weirong，CHEN Qiming，YANG Fuzhou，FANG Qin，LUO Jinhui

2018, 18(04):  460-462.  DOI: 10.3969/j.issn.1009-976X.2018.04.022

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［Abstract］ Objective To investigate the effect of the treatment of the humeral lateral condylefracture in children under Elbow arthroscopy. Methods Sixty?four cases of the humeral lateral condyle fracture were randomly divided into open reduction group and arthroscopy group，each group of 32 cases. Results All the 64 patients were followed up for 12?24 months postoperatively，with average of 17.15±5.12 months. The amount of bleeding in the arthroscopy group and the open reduction group was 40.5±8.5 ml and 110.5 ± 15.5 ml，the length of incision was 0.95 ± 0.30 cm and 6.95 ± 1.50 cm，and the visual analogue pain score （VAS） was 3.85 ± 1.35 and 7.85 ± 2.05 respectively on the third day after the operation，and the differences were statistically significant. According to Mayo score，the total fine rate was 84.4% in the open reduction group and 96.9% in the arthroscopy group，and the difference between the two groups was statistically significant. In the open reduction group，there were 3 cases of elbow joint varus deformity，5 cases of nail path infection. However there were one case of elbow joint varus deformity in arthroscopy group. There was a statistically significant difference in postoperative complications between the two groups. Conclusion Arthroscopic reduction and percutaneous internal fixation for the treatment of humeral lateral condyle fractures in children has advantages of less trauma and fewer complications.

Characteristics，causes and treatment of early complications after anterior cervical spine surgery

WANG Hui1， SUN Jianchao2， ZHENG Chaoshun2， HONG Junming2， WANG Xiaofei2， HUANG Dongsheng2，LI Chunhai2，YE Wei2

2018, 18(04):  463-467.  DOI: 10.3969/j.issn.1009-976X.2018.04.024

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［Abstract］ Objective To investigate the characteristics，causes，countermeasures and preventivemeasures of early complications after anterior cervical spine fusion and fixation. Methods A retrospective analysis of 391 cases with anterior cervical spine surgery were performed from January 2010 to December 2016 in Sun Yat?sen Memorial Hospital of Sun Yat?sen University. There were 321 cases of cervical spondylosis，54 cases of cervical spine trauma（fracture or dislocation，spinal cord injury），11 cases of cervical spondylosis，and 5 cases of cervical spine infection. The characteristics，causes and treatment of early postoperative complications were summarized and analyzed. Results Among 391 cases，a total of 28 cases（7.2%）occurred complications. The incidence of complications was different in cases with different cervical spine diseases and in different segments. Among the cases with complications，6 cases with dysphagia still occurred one week after the operation and 5 cases recovered completely after symptomatic treatment，but 1 case did not recover；2 cases with spinal cord injury became worse after the operation and 1 case totally recovered after posterior cervical decompression，but1 case died；3 cases with hematoma compression were treated with emergency operation to remove hematoma and recovered；17 cases recovered after symptomatic treatment，including 4 cases withrespiratory tract infection，3 cases with delayed wound healing，1 case with cerebrospinal fluid leakage ， 1 case with urinary retention，1 case with deep venous thrombosis of lower extremity，1 case with acute myocardial infarction and 1 case of pneumothorax. Conclusion The severity of cervical spine disease and the number of segments affect the occurrence of cervical complication. Severe complications after surgery can lead to serious consequences. Comprehensive evaluation of preoperative patients，strict preoperative preparation，intraoperative operation close coordination of assistant，and strict postoperative observation are the key points to reduce complications.

The research progress of circular RNA in colorectal cancer

CHU Ziqiang，LIU Lu

2018, 18(04):  468-472.  DOI: 10.3969/j.issn.1009-976X.2018.04.025

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［Abstract］ Colorectal cancer（CRC）is the third most common malignancy in the world and the fourth leading cause of cancer-related deaths. Circular RNAs are novel long-chain non? coding RNAs that are widely present in eukaryotes and are spliced by a variety of mechanisms. Early circular RNAs were ignored as a by?product of gene expression and had no biological function. Recent studies have confirmed that circular RNAs play an indispensable role in many life activities and that abnormal expression in CRC tissues plays a significant role in proliferation，invasion，metastasis and apoptosis of the tumor cells. Exploring the mechanism of action of the circular RNA in colorectal cancer will contribute to the early diagnosis，treatment and prognosis of CRC. This article will focus on the latest research progress of circular RNA in colorectal cancer，thus providing new ideas for the diagnosis and treatment of CRC.

Study of transcutaneous electrical nerve stimulation on postoperative pain relief and reduction of analgetic requirement in orthopedic patients

ZOU Yanxian，XIE Hongyan，LIU Shanshan，XIE Yanying

2018, 18(04):  473-476.  DOI: 10.3969/j.issn.1009-976X.2018.04.026

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［Abstract］ Objective To investigate the effect of transcutaneous electrical nerve stimulation （TENS）on postoperative pain relief and reduction of analgesic requirement for elderly patients with frac? tures. Methods Sixty?five elderly patients（age>65 years old）who underwent orthopedic open surgery were enrolled and divided into two groups：TENS-treated group（TENS group，34 patients），and no TENS?treated group（control group，31 patients）. All patients underwent patient?controlled analgesia two days after surgery. Visual analogue scale（VAS）was used to assess postoperative analgesic requirements and pain intensity changes，and analgesic?related side effects were recorded. Results The consumption of fentanyl was lower in the TENS?treated group than in the non?TENS?treated group at 24 and 48 hours after surgery（all P values <0.05）. In the same time，the opioid?related side effects in TENS treatment group were significantly less than those in the non?TENS treatment group and the number of emergency medications was reduced. Conclusion TENS treatment can reduce postoperative analgesia in elderly patients with fractures，and can be used as an auxiliary treatment for postoperative analgesia.

Selection of the most suitable postures in the early stage after general anesthesia for gynecological neoplasms

ZHOU Leiping，XU Jing，LI Hui，ZHU Shuping

2018, 18(04):  477-479.  DOI: 10.3969/j.issn.1009-976X.2018.04.027

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［Abstract］ Objective To investigate the effects of different body positions on vital signs，pain，drainage，pressure sores in patients with gynecologic tumors during abdominal surgery for general anesthesia within 6 hours after general anesthesia. Methods 300 patients with gynecologic tumors who underwent general anesthesia were divided into control group and observation group，150 cases in each group. The patients in control group were placed with a postoperation posture of lying in horizontal position without pillow for 6 hours，and those in observation group were with step-by-step semi-recumbent position in 6 hours after operation. The heart rate，respiration，vomiting，dizziness，shoulder and back pain，pressure sores，irritability，and patency of the drainage were observed，recorded and compared between two groups. Results There were no significant differences in the incidence of heart rate，blood pressure，vomiting，dizziness and headache between the observation group and the control group（all P values >0.05）. There were statistically significant differences in the incidence of shortness of breath，irritability，patency of the drainage，neck and shoulder，and low back pain between the two groups（all P values <0.05）. Conclusion Gynecologic tumors patients undergoing general anesthesia and placing a position of step-by-step semi-recumbent position in 6 hours after operation have lower incidence of postoperative adverse reactions，which helps improve nursing care quality.

Analysis of perioperative enhanced recovery after surgery nursing effect of laparoscopic right hemihepatectomy

XIANG Meihuan1，CHEN Junyi1，LI Baoqi1，LIN Xiaojuan2，ZHONG Jingyi2

2018, 18(04):  480-484.  DOI: 10.3969/j.issn.1009-976X.2018.04.028

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［Abstract］ Objective To investigate the nursing effect of perioperative ERAS in laparoscopic right hepatectomy. Methods Sixty? eight patients who underwent laparoscopic right hemihepatectomy in our hospital from October 2016 to December 2017 were selected and grouped according to admission order. In the control group，34 cases were treated with traditional nursing methods. The nursing program ERAS group（34 case）was based on the addition of ERAS care to the control care program. The postoperative hospitalization days，VAS scores，the first time of expelling flatus and getting up，score of self-care ability，risk of venous thrombosis，and patient satisfaction with care were compared between the two groups of patients. Results Compared with the control group，the first time of bed?out，the first anal exhaust time and the length of hospital stay were effectively reduced in the ERAS group. The VAS score was lower than that of the control group；the Barthel index score and nursing satisfaction were higher than the control group，P<0.05，the differences were statistically significant. The risk assessment and complications of postoperative venous thrombosis in the two groups was not statistically significant. Conclusion The clinical effect of ERAS nursing in patients after laparoscopic right hepatectomy is safe and stable，which can speed up the recovery time of patients，shorten hospital stay，with no increase in complications，and high patient satisfaction.

Effects of sedation with dexmedetomidine hydrochloride in patients undergoing intravenous anes? thesia for gastroscopy

XU Haiyan，JIAN Liqin，CHENG Shuang，LIU Weihua

2018, 18(04):  485.  DOI: 10.3969/j.issn.1009-976X.2018.04.029

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［Abstract］ Objective To investigate the sedative and analgesic effect and safety of dexmedetomidine in painless gastroscopy. Methods Sixty patients who underwent painless gastroscopy were enrolled in the observation group and the control group. The former was pumped with dexmedetomidine 0.1 mg/kg and the latter with propofol 1.5 mg/kg. The vital signs，sleep，intraoperative operation，waking time and Ramsay score were used to observe and record the sedative and analgesic effects in two groups of patients during gastroscopy. Results The sleep，operation time and awaking time in observation group were shorter than that in control group. The Ramsay score of the observation group was higher than that of the control group（P<0.05）. The differences of vital signs between two groups were not statistically important（P>0.05）. Conclusion Dexmedetomidines in painless gastroscopy is a reliable and safe in sedation andanalgesia，and the vital signs are stable. With special care，the examination can be completed smoothly.