Table of Content

20 August 2020, Volume 20 Issue 04

Previous Issue    Next Issue

Original Articles and Clinical Research

Fusobacterium nucleatum promotes proliferation and migration of colorectal cancer cells by down-regulating of LCN2 expression

ZHU Chang, FU Yu-xiang, XIA Li-gang, LI Fang, HUANG Kai-bin, SUN Xiao

2020, 20(04):  411-415.  DOI: 10.3969/j.issn.1009-976X.2020.04.001

Asbtract ( )   PDF (2477KB) ( )  

References | Related Articles | Metrics

Objective To explore the effects and potential mechanism of Fusobacterium nucleatum （Fn） on colorectal cancer cells. Methods The subjects were from the patients who underwent colonoscopy in the outpatient department of Shenzhen People's Hospital. A total of 15 patients with colorectal cancer （grouped according to preoperative and postoperative） and 15 people with colonoscopy without colorectal diseasewere selected. qPCR was performed to detect the abundance of Fn in fecal samples. The proliferation, migration and invasion of colorectal cancer cells （HCT116, SW480） were detected by CCK-8 and transwell assay. The expression of related genes to colorectal cancercells was analyzed by whole transcriptome microarray after infecting with Fn. Screening and functional verification of significant differential genes. Results the composition of intestinal flora in operated group was close to that in healthy group. The Fn abundancein CRC group was significantly higherthan that in both operated group and healthy group. Fn can promote the proliferation, migration and invasion of colorectal cancer cells. Microarray analysis showed that LCN2 was the most differentially expressed gene after Fn infection in colorectal cancer cells. Overexpression of LCN2 inhibited the proliferation activity and migration and invasion ability of colorectal cancer cells, Fn reduced the inhibitory effect of LCN2 on colorectal cancer cells. Conclusion Fn can promote the proliferation and migration of colorectal cancer cells by down-regulating the expression of LCN2, which provide some supports for LCN2 to be a prevention and treatment target for Fn-related colorectal cancer

A clinical study of initial laparoscopic exploration in totally extraperitoneal herniorrhaphy for inguinal hernia

SONG Xiao-rui, LIN Qi-rui, ZHOU Wan-bang, ZHONG Li-ming, YIN Yao-xin, XIONG Pei, OU Xi, LIN Ze-wei, LIU Ji-kui, LIU Xiao-ping

2020, 20(04):  416-420.  DOI: 10.3969/j.issn.1009-976X.2020.04.002

Asbtract ( )   PDF (1270KB) ( )  

References | Related Articles | Metrics

Objective To investigate the clinical feasibility and superiority of initial laparoscopic exploration in totally extraperitoneal inguinal herniorrhaphy（le-TEP）. Methods From Jan. 2015 to Dec. 2018,consecutive 434 patients in Peking University Shenzhen Hospital were divided into conventional and modified TEP groups. Modified TEP（an initial laparoscopic exploration performed before TEP, le-TEP group） had been introduced in 226 patients and conventional TEP（TEP group）have been introduced in 208 patients. Information about registered patients includes general data,intraoperative and postoperative indicators, complications and recurrence rate were recorded. Results There was no statistically significant difference between two groups in terms of the general date,gas leakage rate,the operative transshipment rate,blood transfusion,the surgical time,the time of peritonealization of spermatic cord, the postoperative NRS pain score,the mean recovery time for general physical activities,postoperative mean hospital stay,short-term and long-term complications, the ture recurrent rate after operation. The detection rate of OCH （occult contralateral hernia） in le-TEP group（19.0%） was significantly higher than that in TEP group（2.4%）（P<0.001）. The combined laparoscopic procedures rate in le-TEP group（6.6%） was higher than that in TEP group（1.4%）（P<0.05）. The pseudo-recurrent rate after operation in le-TEP group（1.0%） was lower than that in TEP group（6.1%）（P<0.05）. Conclusion Le-TEP is safe and feasible, and is superior for increasing the detection rate of contralateral occult hernia,accomplishing the combination of other laparoscopic procedure easily and reducing the pseudo-recurrent rate of adult inguinal hernia.

Short-term results of self-expandable metallic stent as a temporary approach to elective operation for acute malignant colonic obstruction in elderly patients

ZHUANG Zhi-hao, OUYANG Qiu-wei, TAO Shi-ming, HUO Jing-shan, WU Min-han, HAN Xin-feng, HE You

2020, 20(04):  421-424.  DOI: 10.3969/j.issn.1009-976X.2020.04.003

Asbtract ( )   PDF (1253KB) ( )  

References | Related Articles | Metrics

Objective To evaluate the application value and analysis of self-expanding metal stent （SEMS） in patients with malignant intestinal obstruction. Methods The data of colon cancer patients with acute intestinal obstruction admitted by the author from 2014 to 2017 were selected. Twenty three patients （SEMS group） received SEMS treatment, and 31 patients （no-SEMS group） received emergency surgery without SEMS. All patients underwent radical resection. Results All patients were followed up for 30 days after operation. In the SEMS group, 16 cases were treated with laparoscopic radical surgery, and 7 cases were treated with open surgery. All patients in no-SEMS group underwent open surgery. The postoperative recovery of SEMS group was better than that of no-SEMS group, such as shorter bowel function time, shorter parenteral nutrition time, shorter hospital stay and total postoperative complications. But in the SEMS group, one case of intestinal perforation and two cases of SEMS displacement needed emergency treatment. Conclusion For malignant intestinal obstruction caused by colon cancer, SEMS as a bridge for elective surgery has good short-term effect, but we should try to avoid complications of SEMS operation.

Prognostic value of SUB1 in liver cancer patients

HUANG Yong-ping, TANG De-jun, LIU Dong, ZHANG Huan, TANG Guang-hua, DU Min, YANG Xiao-lan

2020, 20(04):  425-430.  DOI: 10.3969/j.issn.1009-976X.2020.04.004

Asbtract ( )   PDF (3246KB) ( )  

References | Related Articles | Metrics

Objective To analysis the expression levels of SUB1 in liver cancer by using TCGA and Oncomine database; then to evaluate the prognostic value of SUB1 in liver cancer patients; finally to analysis the cell pathways affected by SUB1 by applying Gene Set Enrichment Analysis （GSEA） and Gene Set Variation Analysis （GSVA）. Methods The RNA-seq data of liver cancer cohort were retrieved from TCGA database and the quality control and standardization proceed were implement next, the expression levels of SUB1 were contrasted in liver cancer tissues with adjacent tumors and also further analyzed and verified in the Oncomine database. The patients of liver cancer retrieved from TCGA database were divided into High expression SUB1 group and Low expression SUB1 group according to the median expression of SUB1, then overall survival （OS） analysis and relapse-free survival （RFS） analysis were performed; the methods of GSEA and GSVA were used to analyze the cell pathways regulated by SUB1. Results The expression of SUB1 in liver cancer tissues is higher than that in adjacent tissues, P<0.0001; liver cancer patients with high expression of SUB1 have lower OS and RFS than those patients with low expression of SUB1; high expression of SUB1 can activate cell cycle, DNA replication and other cell pathways. Conclusion SUB1 is highly expressed in liver cancer tissues, and SUB1 can be used as a prognostic marker for overall survival and disease-free survival in liver cancer patients. High expression of SUB1 activates cellular pathways such as DNA replication and cell cycle.

Experience of 3D laparoscopy in insulinoma surgery

YE Yong, WU Yuan-wei, LI Jun-long, HUANG Yun

2020, 20(04):  431-434.  DOI: 10.3969/j.issn.1009-976X.2020.04.005

Asbtract ( )   PDF (1753KB) ( )  

References | Related Articles | Metrics

Objective To investigate the application value of 3D laparoscopy in insulinoma surgery. Methods The data of ten patients with insulinoma treated by 3D laparoscopy from January 2017 to December 2019 in our hospital were retrospectively analyzed. The number of clamping errors per 100 times was counted by video review, and compared with 2D laparoscopy. Meanwhile, subjective feelings of the participants were investigated. Results All the 10 patients were successfully performed 3D laparoscopic surgery without conversion to open surgery. Number of clamping errors per 100 times were 7.85±1.67 times in 3D group and 18.96±4.48 times in 2D group, and the difference between two groups was statistically significant （P<0.05）. The subjective questionnaire indicated that 3D laparoscopy was superior to 2D laparoscopy in terms of field exposure and operation. Conclusion 3D laparoscopy is helpful for accurate operation and successful implementation of minimally invasive surgery for insulinoma.

Application value of laparoscopy in obstructive left colon cancer

ZHANG Ping, PENG Xiao-feng, LIN Jian-tao, WANG Jin-rui, CHEN Jin-xin, LIN Jun-ling

2020, 20(04):  435-439.  DOI: 10.3969/j.issn.1009-976X.2020.04.006

Asbtract ( )   PDF (2434KB) ( )  

References | Related Articles | Metrics

Objective To explore the safety and feasibility of laparoscopic technique in the treatment of obstructive left colon cancer. Methods Retrospective analysis of clinical data of 10 patients undergoing laparoscopic radical resection of left colon cancer from October 2018 to October 2019 in the Department of General Surgery,Guangdong Lufeng People's Hospital. Results Ten patients successfully completed laparoscopic radical resection of left colon cancer and did not switch to open surgery. The median surgery time is 171（132~230） min,median blood loss during surgery was 60 （20~250） ml. All 10 patients underwent one-stage resection, anastomosis and preventive ileostomy. The median abdominal incision length is 8 （9~10） cm, and the median lymphadenectomy is 17 （12~25）. The liquid diet was resumed on the first postoperative day, the median time for postoperative flatus was 1 （1~3） days, the duration of postoperative drainage tube removal was 1 （1~2） days, and the median postoperative hospitalization time was 7 （6~12） days. Conclusion Laparoscopy is safe and feasible in the treatment of obstructive left colon cancer, and has certain clinical application value.

The clinical analysis and research of combining levofloxacin with rifampicin treating lactating mammary abscess that infected by MRSA

ZHANG Hua-yao, YE Hua, LIN Si-yuan, LIU Hai-ping, ZHANG Zhi-yuan, LI Xiang-di, LIANG Bao-zhen, ZHANG Li-hua

2020, 20(04):  440-443.  DOI: 10.3969/j.issn.1009-976X.2020.04.007

Asbtract ( )   PDF (1250KB) ( )  

References | Related Articles | Metrics

Objective To value the effective and safety therapy of community breast abscess by MRSA infection that treated with rifampin plus levofloxacin and the therapy of its mechanism. Methods From January 2010 to December 2018,there were 86 breast abscess by MRSA infected. All the cases were divided into levofloxacin + rifampicin treatment group and vancomycin treatment group. The cure rate, the clearance rate of MRSA, treatment time, antimicrobial treatment cost and the adverse reactions of antibiotics were observed. The evofloxacin agar plate,rifampicinagar plate, levofloxacin combined with rifampicin agar plate were made respectively. The concentration of all the agar plates changed gradiently. And the MIC, MPV and MSW of each agar plate was cheeked. Results The cure rate of levofloxacin + rifampicin treatment group and vancomycin were 93% and 97% respectively（P>0.05）. MRSA clearance rate were 100% of two group. The treatment time of levofloxacin + rifampicin treatment group and vancomycin were 8.8 and 9.1 days respectively（P>0.05）. Antimicrobial cost of levofloxacin + rifampicin treatment group and vancomycin were 700 yuan and 2000 yuan respectively（P<0.05）. The incidence of adverse drug reactions rate of evofloxacin + rifampicin was 11.4%; incidence of adverse drug reactions rate of vancomycin was 12.2% （P>0.05）. Bacteria in vitro experiments show that levofloxacin and rifampicin can shrink their MIC, MSW, and MPV. The rifampicin was more obvious. Conclusion The patients who got breast abscess that infected by MRSA in community, treated with Rifampin combined with Levofloxacin therapy could get high cure rate,low cost,less side effects.It could be used as one of the important treatment of clinicians. Rifampin combined with Levofloxacin can reduce the MPV and narrow its MSW to treat MRSA.And it may be the important mechanism of the rifampin combined with Levofloxacin to treat MRSA.

The efficacy and safety of CT-guided radiofrequency ablation in the treatment of patients with recurrent small hepatocellular carcinoma at the top of the diaphragm

ZHANG Yi, LI Qiang, ZHAO Bin

2020, 20(04):  444-447.  DOI: 10.3969/j.issn.1009-976X.2020.04.008

Asbtract ( )   PDF (1261KB) ( )  

References | Related Articles | Metrics

Objective To explore the efficacy and safety of CT-guided radiofrequency ablation （CT-FRA） in the treatment of patients with recurrent small liver cancer at the top of the diaphragm. Methods Sixty-nine patients with recurrent small liver cancer at the top of the diaphragm from February 2013 to April 2015 in our hospital were selected, of which 36 cases were treated with CT-FRA as the CT-FRA group, and 33 cases were treated with laparoscopic radiofrequency ablation （L-FRA） as the L-FRA group. The average ablation time, active tumor residual rate, complications, hospitalization time, hospitalization cost, average survival time, and the local progression rate and overall survival rate of the tumor at 1, 3 years were compared between the two groups. Results There was no significant difference in average ablation time and active tumor residual rate between the two groups （P>0.05）; the hospital stay in the CT-FRA group was shorter than that in the L-FRA group, and the hospitalization cost was lower than that in the L-FRA group （P<0.05）; there was no significant difference in the local tumor progression rate and overall survival rate between the two groups at 1 and 3 years （P>0.05）. Conclusion CT-FRA and L-FRA are effective treatments for recurrent small hepatocellular carcinoma at the top of the diaphragm, but CT-FRA is relatively economical, simple, and safe.

Experience of RPH and PPH respectively combined with external stripping and internal ligation in the treatment of elderly patients with moderate to severe mixed hemorrhoids

HUANG Yu-bao, CHEN Zhi-yu, ZHOU Xiong

2020, 20(04):  448-451.  DOI: 10.3969/j.issn.1009-976X.2020.04.009

Asbtract ( )   PDF (1248KB) ( )  

References | Related Articles | Metrics

Objective To explore the clinical effect of Ruiyun procedure for hemorrhoids （RPH） and procedure for prolapse and hemorrhoids （PPH） respectively combined with external stripping and internal ligation in the treatment of elderly patients with moderate to severe mixed hemorrhoids. Methods A total of 100 elderly patients who were confirmed with moderate to severe mixed hemorrhoids in the hospital from January to December 2018 were enrolled in the study. According to the random grouping method, they were divided into control group （n=50） and observation group （n=50）. The control group were treated with PPH combined with external stripping and internal ligation, while observation group were treated with RPH combined with external stripping and internal ligation. Intraoperative and postoperative related indexes in both groups were observed and recorded. The results were compared and analyzed. Results The operation time, intraoperative blood loss and hospital stay of observation group were less than those of control group （P<0.05）. The postoperative pain time and wound healing time of observation group were significantly shorter than those of control group （P<0.05）. There was no significant difference in incidence of complications between the two groups （P>0.05）. There was no significant difference in anorectal pressure between the two groups before and after operation （P>0.05）. The score of anal incontinence scale （Wexner） in observation group was significantly lower than that in control group （P<0.05）. Conclusion RPH combined with external stripping and internal ligation can shorten the operation time, reduce intraoperative blood loss, reduce the incidence of postoperative complications, and improve anal function. It is effective in the treatment of elderly patients with severe mixed hemorrhoids.

Thrombolytic therapy for subacute deep venous thrombosis in lower extremity

LI Yong-hui, CHEN Zhi-bo, Chen Qin-chang, TIAN Zhen-luan, CHEN Zhen-hong, HUANG Kai

2020, 20(04):  452-455.  DOI: 10.3969/j.issn.1009-976X.2020.04.010

Asbtract ( )   PDF (1255KB) ( )  

References | Related Articles | Metrics

Objective To investigate clinical outcome of thrombolytic therapy for subacute deep venous thrombosis （sDVT） and to summarize our single-center experience. Methods During the period from 2014 to 2019, those patients who were diagnosed with sDVT and accepted thrombolytic therapy were included, and their clinical and follow-up data were retrospectively collected and analyzed. Results A total of 23 patients were involved, including 11 males and 12 females. The average age was 35.2±11.7 years old. Of these, thrombolytic therapy was performed in 8 patients via dorsalis pedis vein, and in 7 patients via popliteal vein. Femoral artery access was established in 1 patient, while femoral vein access in another patient. The remaining 6 patients experienced thrombolytic therapy via femoral vein in combination with popliteal vein. Assistant strategies included ballon dilation, stent implantation or thrombectomy were performed in 6 patients. During the period of thrombolytic therapy, 1 patient experienced gastrointestinal bleeding and recovered after conservative treatment. After thrombolytic therapy, angiography or ultrasound revealed that complete and partial thrombus dissolution was achieved in 6 and 8 patients, while no thrombus dissolution was found in 9 patients. Complete or partial thrombus dissolution was confirmed in all 6 patients accepted assistant strategies. The thigh and calf circumference were decreased by 2.8（2.4）cm （P=0.003） and 3.8（2.9） cm （P=0.001） after therapy, respectively. Conclusion Thrombolytic therapy is safe and effective for patients with sDVT. The access used for therapy should be established flexibly according to lesion range and thrombolytic effect. Assistant strategies, including balloon, stent and thrombectomy, can improve the effectiveness of thrombolytic therapy.

Clinical experience of single-port thoracoscopic surgery in the treatment of pulmonary sequestration

YE Jun, YANG Jie, GU Wei-quan, YANG Sheng-li, WANG Fei, XIAO Ye, ZHANG Xiao-wen, LUO Ling-jun, ZHAO Ning, WU Ling-ling

2020, 20(04):  456-459.  DOI: 10.3969/j.issn.1009-976X.2020.04.011

Asbtract ( )   PDF (1538KB) ( )  

References | Related Articles | Metrics

Objective To summarize the clinical experience of single - port thoracoscopic surgery in the treatment of pulmonary sequestration, and to evaluate the safety and effectiveness. Methods A total of 21 patients with pulmonary sequestration treated by single-port thoracoscopic surgery from January 2015 to May 2019 were retrospectively analyzed,including 10 males and 11 females, aged from 21 to 57 （39.5±9.2） years. The lesions of patients all located in the lower lung, including 13 cases in left lower lung and 8 cases in right lower lung. All cases were intrapulmonary sequestration except one were extrapulmonary sequestration. Lobectomy or segmental pulmonary resection was performed by thoracoscopy in 20 cases under general anesthesia with double lumen endotracheal intubation. One case was transferred to thoracotomy. Enhanced CT scan and 3D reconstruction were performed before operation. Results All operations were performed successfully, including 8 cases of severe adhesion of chest cavity. There were 20 patients underwent inferior lobectomy and 1 patient underwent posterior basal segment resection of the lower lung. The median operative time was （167.3±61.5） minutes, and the median intraoperative blood loss was （157.3±30.2） mL, the median postoperative catheter duration was （5.3±1.6） days, and the median postoperative hospital stay was （6.2±1.5） days. There were none death or serious complications occurred during the perioperative period. The follow-up time was 7~59 months, and there was no loss of follow-up. Reexamination of chest radiographs or CT showed no recurrence in all patients. Conclusion Single-port thoracoscopic surgery is safe and feasible in the treatment of pulmonary sequestration. Proper examination and assessment preoperative, and proper management of the abnormal vessel are the keys to successful operation.

The application of VAV-ECMO in the rescue of severe cardiopulmonary dysfunction caused by multiple trauma： a case report and experience sharing

SHI Fen-mei, MAI Han-tao, HAO Peng, HE Qing, ZHANG Ke-lin

2020, 20(04):  460-462.  DOI: 10.3969/j.issn.1009-976X.2020.04.012

Asbtract ( )   PDF (1706KB) ( )  

References | Related Articles | Metrics

Objective To explore the feasibility and risk control of VAV-ECMO in the treatment of severe cardiopulmonary dysfunction caused by multiple trauma. Methods Based on the analysis of the clinical characteristics, diagnosis and treatment of a case of severe cardiopulmonary dysfunction caused by multiple trauma in our hospital, and combined with domestic and foreign literature, the feasibility and risk of VAV-ECMO in the treatment of severe cardiopulmonary dysfunction caused by multiple trauma were evaluated. Results Post-traumatic coagulation dysfunction is a difficult problem in ECMO treatment, and VAV-ECMO is a new method to rescue severe cardiopulmonary dysfunction caused by multiple trauma. Conclusion VAV-ECMO provides a new method for rescuing severe cardiopulmonary dysfunction caused by multiple injuries, and risk assessment is the key.

Effects of minimal invasive surgery treatment on postoperative neurological function recovery and complications in patients with hypertensive intracerebral hemorrhage

GU Wei-ting, ZHAO Jun-wen, ZHAO Dong-ming, CHENG Kan, CAI Yu

2020, 20(04):  463-467.  DOI: 10.3969/j.issn.1009-976X.2020.04.013

Asbtract ( )   PDF (1332KB) ( )  

References | Related Articles | Metrics

Objective To analyze the effects of minimal invasive hematoma removal on postoperative neurological function recovery and complications in patients with hypertensive intracerebral hemorrhage. Methods From June 2017 to May 2020, 38 patients with hypertensive intracerebral hemorrhage in our hospital were selected and divided into craniotomy group （n=26） and minimal invasive group （n=12） according to different surgical methods. Minimal invasive group was given microinvasive hematoma removal, and craniotomy group was given an approximately 6 cm×8 cm bone window craniotomy. The clinical efficacy, surgical status, clinical neurological deficit scale （NDS） score and ability of daily living scale （ADL） score and the occurrence of complications were compared between the two groups. Results The total improvement rate of patients in minimal invasive group was higher than that in craniotomy group （91.67% vs. 73.07%） （P>0.05）. The operative time and intraoperative blood loss in minimal invasive group were significantly less than those in craniotomy group （P<0.05）. There was no significant difference in the hospital stay and hematoma clearance rate between the two groups （P>0.05）. At 3 months after surgery, the NDS scores in the two groups were significantly lower than those in the same group before surgery （P<0.05）, and the ADL scores were significantly higher than those in the same group before surgery （P<0.05）. The NDS score in minimal invasive group was significantly lower than that in craniotomy group （P<0.05） while the ADL score was significantly higher than that in craniotomy group （P<0.05）. The total incidence rate of complications such as intracranial infection, pulmonary infection and rebleeding between two groups had no significance （P<0.05）. Conclusion Compared with craniotomy group, minimal invasive surgery treatment is safer and more effective in treating hypertensive intracerebral hemorrhage, and it has better recovery of postoperative neurological function and fewer complications.

Application of deep neuromuscular blocking in obese patients undergoing robot-assisted laparoscopic radical prostatectomy

CHEN Mei-xian, YANG Xue-ying, LIAO Zhao-xia, YE Xi-jiu, LU Fu-ding

2020, 20(04):  468-471.  DOI: 10.3969/j.issn.1009-976X.2020.04.014

Asbtract ( )   PDF (1253KB) ( )  

References | Related Articles | Metrics

Objective To investigate the application advantages of deep neuromuscular block in obese patients undergoing robot-assisted laparoscopic radical prostatectomy. Method Forty-eight obese patients undergoing robot-assisted laparoscopic radical prostatectomy were randomly divided into moderate neuromuscular block group （group M） and deep neuromuscular block group （group D）. Patients ingroup M were induced with cisatracurium 0.15~0.2 mg/kg iv, followed by cisatracurium 5 mg iv at an interval of about 45 min. Patients in group D was given 0.6 mg/kg rocuronium at induction, and then in the maintenance of anesthesia, rocuronium was given 0.6 mg/kg iv before skin incision and pumped 5~10 μg/（kg·min） when neuromuscular block began to recover. The following targets werecompared between the two groups： the intubation time, the wake-up time, VAS pain score and the incidence of agitation after extubation. The blood gas analysis was performed before induction （T₀）, 1 hour after the operation （T₁）, at the end of the operation （T₂） and before leaving the PACU（T₃）, and the levels of lactic acidas and blood glucose were compared between the two groups. Results Compared with group M, the intubation time and resuscitation time in group D were shorter, and the VAS pain score and the incidence of agitation after extubation were also lower. At the time of T₂ and T₃, the levels of lactic acid and blood glucose in group D were lower than group M. The differences between the two groups were statistically significant （P < 0.05）. Conclusion Compared with the moderate neuromuscular block, applying the strategy of deep neuromuscular block could shorten the intubation time, accelerate the recovery, reduce postoperative pain and agitation stress in obese patients undergoing robot and laparoscopic assisted radical prostatectomy.

Evaluation between transurethral electroresection of prostate and transurethral plasmakinetic enucleation of the prostate for patient with benign prostatic hyperplasia

FENG Chuan-shun, LIU Yun-fei, PENG Nai-xiong, DENG Ling, WANG Xi-sheng

2020, 20(04):  472-475.  DOI: 10.3969/j.issn.1009-976X.2020.04.015

Asbtract ( )   PDF (1251KB) ( )  

References | Related Articles | Metrics

Objective To investigate the sexual function and clinical changes of transurethral electroresection of the prostate and transurethral plasmakinetic enucleation of the prostate on patients with prostatic hyperplasia. Methods 86 patients with prostatic hyperplasia from January 2016 to January 2018 were selected and divided into two groups. The 42 patients in control group received transurethral electroresection and the 44 patients in the observation group received transurethral plasmakinetic enucleation of the prostate. The sexual function and clinical changes in related indicators was observed after treatment. Results In the observation group, operation time was 65.4±15.8 min, intraoperative blood loss was 231.3±77.5 ml and catheter indwelling time was 5.5±0.6 d. In control group, operation time was 76.8±16.9 min, intraoperative blood loss was 346.2±81.4 ml and catheter indwelling time （6.0±0.7） d, the observation group was better than the control group, the difference is statistically significant （P<0.05）. In observation of the group, the ED rate and the retrograde ejaculation rate were lower, the difference between the two groups has statistical significance （P<0.05）. Conclusion Compare with TURP, TPKEP has less intraoperative blood loss and no negative influence on the quality of sexual function.

Short term follow-up of 1470 nm laser vaporization on benign prostatic hyperplasia over 75 years old

WEN Jian-hui, ZOU Wei-bo, YANG Zhi-tian

2020, 20(04):  476-479.  DOI: 10.3969/j.issn.1009-976X.2020.04.016

Asbtract ( )   PDF (1250KB) ( )  

References | Related Articles | Metrics

Objective To investigate the results of 1470nm laser vaporization on benign prostatic hyperplasia in patients over 75 years old. Methods In this study, 62 patients who underwent transurethral 1470 nm laser vaporization in our hospital from May 2017 to April 2019 were selected as the subjects. The changes of international prostate symptom score （IPSS）, maximum flow rate （Qmax）, post-void residual volume （PVR） and quality of life （QOL） in one year after operation were recorded, including those with PVR>50 ml and prostate volume>50 mL. Results In all 62 patients, 58 （93.5%） had significant symptom relief within one month, the average IPSS and QOL scores decreased significantly, and remained unchanged throughout the follow-up period.The average PVR decreased from nearly 150 mL before operation to 32 mL （6 months） and 30 mL （12 months）, the average Qmax increased from 11.2 mL/s to 14.1 mL/s at one month, and reached 14.2 mL/s at 12 months. There was no significant difference between the above parameters of patients with PVR>150 mL and prostate volume >50 mL （P>0.05）. Conclusion 1470 nm laser enucleation of prostate can improve the lower urinary tract symptoms and quality of life of patients with BPH. The volume of prostate and the amount of residual urine before operation do not affect the effect of operation.

Clinical study on testicular blood supply and spermatogenic function during laparoscopic transabdominal preperitoneal repair

WU Yong-quan, SHI Yi-jun, DENG Jing, ZHANG Zhou-wen, ZHANG Cai-yun

2020, 20(04):  480-483.  DOI: 10.3969/j.issn.1009-976X.2020.04.017

Asbtract ( )   PDF (1252KB) ( )  

References | Related Articles | Metrics

Objective To clinical study on testicular blood supply and spermatogenic function during transabdominal preperitoneal repair （TAPP）. Methods A total of 41 cases received from June 2017 to January 2019 in this hospital on TAPP were collected. The sperm concentration, sperm motility, serum follicle stimulating hormone （FSH）, serum inhibin B, testicular volume and peak systolic velocity （PSV） of testicular artery were compared before, 7 days and 6 months after operation. Results There was no significant differences in sperm concentration, sperm motility, FSH, serum inhibin B and testis volume between the patients 7 days and 6 months after operation, the levels of PSV of testis artery of patients at 7 days after operations was significantly different from those before and 6 months after operation. Postoperative hematoma and prolonged operation time are risk factors of abnormal testicular blood supply. Conclusion TAPP has no significant effect on testicular spermatogenesis.

Transperineal prostate biopsy and transrectal prostate biopsy in the diagnosis of prostate cancer

YUAN Xiao-xu, QIU Jian-guang, ZHU Yu-mo, LIN Xuehua, PANG Guo-fu, DENG Jian, XIE Qun

2020, 20(04):  484-487.  DOI: 10.3969/j.issn.1009-976X.2020.04.018

Asbtract ( )   PDF (1257KB) ( )  

References | Related Articles | Metrics

Objective To compare the positive rate and complications of transperineal and transrectal prostate biopsy in the diagnosis of prostate cancer. Methods from January 2017 to December 2019, 187 patients underwent transrectal prostate biopsy and 68 underwent transperineal prostate biopsy. Results the positive puncture rate was 34.7% in the transrectal group and 29.4% in the transperineal group, there was no statistical difference between the two groups （P>0.05）. After biopsy, the incidence of hematuria was 40.1% in the transrectal group and 42.6% in transperineal group, the incidence of urinary retention was 6.9% and 7.3%, the incidence of rectal bleeding was 1.1% and 0%, respectively, with no statistically significant difference （P>0.05）. After puncture, the incidence of infection was 9.1% an 1.5% the incidence of perineal swelling was 2.6% and 13.2%, respectively. There was a statistical difference between the two groups （P<0.05）. Conclusion Ultrasound-guided transrectal and perineal prostate biopsy is an effective method for the diagnosis of prostate cancer. There was no significant difference with the positive rates between groups, but each group had its own specific complication.

Effect of different types of unstable intertrochanteric fractures on early postoperative motion

ZHOU Mi

2020, 20(04):  488-491.  DOI: 10.3969/j.issn.1009-976X.2020.04.019

Asbtract ( )   PDF (1286KB) ( )  

References | Related Articles | Metrics

Objective To assess the impact of uniform anti-rotational proximal femoral intramedullary nail （PFNA） use on patient mobility status with the treatment of two different unstable intertrochanteric femur fracture groups of geriatric patients. Methods 126 patients with unstable intertrochanteric fracture （ITF） in our hospital from June 2018 to July 2019 were selected as the research objects. The patients underwent proximal femoral anti rotation intramedullary nail （PFNA） and assigned to two groups according to AO classification, group 1： A2.2 and A2.3; group 2： A3.1 and A3.2. The demographic data of the patients, postoperative complications, follow-up, mortality status, postoperative reduction, tip-apex distance （TAD）, and the Parker-Palmer mobility （PPM） score were evaluated. Results There were no statistically significant differences between the groups in terms of gender,age,affected side, ASA score, anesthesia type, duration of hospitalization, duration of surgery, TAD values, reduction values, or mortality rate. The mobility scores of group 1 patients were significantly higher than those of group 2 （P<0.05）. Conclusion There were not relationship found between the TAD values and the reduction status of the patients, but the PPM scores of the A3 cases were determined to be significantly worse. Therefore, fractures with a preoperative classification of AO type A3 can be expected to have worse results than A2 ITF fractures.

Treatment outcomes of three-dimensional printing technology for Sneppen Ⅱ talus fracture by juniorversus senior physicians

DU Rui, YANG Jia-lin, ZHU Xiao-dong, DENG Ming-ming, SUN Guang-chao, YIN Gang, FU Bing-jin

2020, 20(04):  492-495.  DOI: 10.3969/j.issn.1009-976X.2020.04.020

Asbtract ( )   PDF (1685KB) ( )  

References | Related Articles | Metrics

Objective To analyze the effect of 3D printing in the treatment of Sneppen Ⅱ talus fracture. Methods From March 2016 to August 2018, 28 patients with Sneppen Ⅱ talus fracture were randomly divided into 4 groups： junior traditional group （Group A）, junior 3D group （Group B）, senior traditional group （Group C） and senior 3D group （Group D）. Each group had 7 patients, 28 patients. In group B and D, 3D printing technology was used to print 3D model of talus before operation. Before operation, simulated operation was performed and appropriate operation approach was made. The time of preoperative conversation, the recognition and satisfaction of patients and their families, the times of intraoperative fluoroscopy, the amount of intraoperative bleeding, the time of operation, the excellent rate of postoperative Maryland score and the incidence of postoperative complications were analyzed. Results Compared with group A, group B and group D, the time of preoperative conversation, the recognition and satisfaction of patients and their families, and the excellent and good rate of AOFAS scores were all lower than those of group A and group C, the difference was statistically significant （P<0.05）; the time of operation, the times of intraoperative fluoroscopy, the amount of intraoperative bleeding and postoperative complications were significantly reduced in group B and group D, the difference was statistically significant （P<0.05）, and group C and group D had no difference There was no significant difference （P>0.05）. Conclusion 3D printing technology is helpful to the junior doctors in the treatment of Sneppen Ⅱ type talus fracture. It can shorten the growth years of the junior doctors and help the senior doctors.

How to treat the Hotchkiss-type Ⅲ radial head fracture in “terrible triad of elbow”cases：open reduction and internal fixation or radial head prosthetic replacement?

ZHENG Wei-kun, TANG Jun-fen, GE Tao, CAI Wei-shan

2020, 20(04):  496-502.  DOI: 10.3969/j.issn.1009-976X.2020.04.021

Asbtract ( )   PDF (3576KB) ( )  

References | Related Articles | Metrics

Objective To explore the clinical outcomes for Hotchkiss-type Ⅲ radial head fracture in “terrible triad of the elbow” （TTE） cases treated with two surgical methods, namely, open reduction and internal fixation （ORIF） and radial head prosthetic replacement （RHPR）. Methods Twenty-three TTE cases with Hotchkiss-type Ⅲ radial head fracture, identified from a prospective database, were divided into two groups base on the treatment of radial head fracture. Twenty-three of them underwent the fixation with microplate and the others were treated with RHPR. All the patients were followed for at least one year, and outcomes were assessed and compared base on operation-related situations, the Mayo elbow function score, the cost-effect analysis, satisfaction score and life quality score. Results There were no significant differences in mean incision length and intraday VAS between the two groups, but the operation time was shorter for RHPR than ORIF （72.15±4.95 vs 83.60.±7.93, P<0.001）. For Mayo score in one-year follow-up after the operation, the total score, pain score and range of motion were all better for RHPR than ORIF （91.15±6.81 vs 79.50±10.39, P=0.004, 39.23±7.59 vs 31.50±8.51, P=0.032, 18.85±2.19 vs 16.00±3.16, P=0.019）, but no significant difference were found in stability or activity of daily life. The ORIF group yield better benefit-index in the cost-effect analysis because they consume much less than the RHPR （21.96±3.00 vs. 19.13±1.55, P=0.008, 3.63±0.26 vs. 4.77±0.21, P<0.001）, and they also shows a better mean satisfaction-score （100.60±4.84 vs. 92.69±4.91, P=0.001）. But no significant difference was found in daily life quality questionnaire between the two groups. Conclusion ORIF and RHPR were both effective in reconstruction and recovering elbow function when used to treat Hotchkiss-type Ⅲ radial head fracture in TTE cases. RHPR showed better outcomes in terms of Mayo score, but ORIF showed better benefit-index and satisfaction score.

Observation and analysis of two kinds of autogenous arteriovenous fistula in elderly hemodialysis patients

PENG Yan-bin, CHU Yun-feng, CHEN Zhong, WAN Sheng-xiang, XIAO Ying-feng

2020, 20(04):  503-506.  DOI: 10.3969/j.issn.1009-976X.2020.04.022

Asbtract ( )   PDF (1255KB) ( )  

References | Related Articles | Metrics

Objective To observe and analyze the application of autogenous arteriovenous fistula （AVF） in elderly hemodialysis patients. Methods The clinical data of elderly patients with hemodialysis treated with in hand microsurgery of Peking University Shenzhen hospital from June 2012 to June 2018 were collected. According to the type of vascular access, they were divided into two groups： radio cephalic arteriovenous fistula（RC-AVF group, n=161） andulnar-basilar arteriovenous fistula （UB-AVF group, n=32）. By inquiring the inpatient medical records, outpatient records, follow-up records, and color Doppler ultrasound （DUS） before and after vascular access （AV）, we observed and recorded the information of fistula maturity, dysfunction, lumen stenosis. Results Of 176 cases, 92 （47.7%） used central venous catheterization （CVC） for hemodialysis before AV, with an average duration of 134.8±66.2 days. There were no significant differences in age, gender, blood pressure, laboratory examination, etiology of ESRD and associated diseases between the two groups; 14 cases （7.4%） gave up VA, 21 cases （10.8%） died due to various reasons; 28 cases （14.7%） could not use VA due to venous fistula dysfunction, and 13cases （6.8%） underwent secondary or modified operation. There was no significant difference between RC-AVF group and UB-AVF group. The postoperative complications of AVF were thrombosis, hematoma formation, infection, aneurysmal formation, luminal stenosis and venous aneurysmal dilation. Age, peripheral vascular disease and radial artery diameter are related to the death of elderly patients after establishing AV and the related factors leading to failure or abandonment of AVF were related to age, peripheral vascular disease and radial artery diameter. Conclusion AVF was safe and effective with low complications. Doctors can choose the operation method according to the experience and the specific situation of patients.

Effect of fluid warming in patients undergoing open gastrointestinal tract cancer resection

YANG Xue-ying, ZHANG Xue-rong, XU Yong-teng

2020, 20(04):  507-511.  DOI: 10.3969/j.issn.1009-976X.2020.04.023

Asbtract ( )   PDF (1275KB) ( )  

References | Related Articles | Metrics

Objective To observe the effect of intraoperative fluid warming on tissue perfusion and recovery period of patients undergoing open gastrointestinal tract cancer resection. Methods Sixty ASAⅠorⅡpatients undergoing selective open gastrointestinal tract cancer resection were randomized into two groups （n=30 each）：control group and fluid warming group. The patients in the control group used conventional heat preservation measures during operation, while the patients in the fluid warming group used a fluid warmer （41℃） to keep infusion warming on the basis of conventional heat preservation measures during operation. The changes of nasopharyngeal temperature, ScvO₂, ABL were recorded at the time of 10 min before anesthesia induction, beginning of operation （T₁）, 1 h after the begin of operation （T₂）, 2 h afterthe begin of operation （T₃）, and at the end of operation （T₄） were recorded in the two groups. The time of respiratory recovery, extubation and PACU stay were observed. Meanwhile, shivering, restlessness, RS score, RSS score and patient satisfaction to anesthesia were also compared between the two groups. Results Compared with the control group, the nasopharynx temperature and ScvO₂ of the intervention group at T₂, T₃ and T₄ were higher （P<0.05）. And the ABL was lower, but the difference was not statistically significant; Compared with the control group, the time of respiratory recovery, extubation and PACU stay in the intervention group were also shorter, the incidence of shivering and restlessness were lower （P<0.05）. Conclusion Intraoperative fluid warming can ensure good tissue perfusion in patients undergoing open tract cancer resection, is conducive to rapid anesthesia recovery, significantly reduce the occurrence of shivering and restlessness in patients during anesthesia recovery period, and improve the patient satisfaction to anesthesia, which is worth popularizing.

PCV-VG and VCV mode correct trendelenburg posture study on the effect of laparoscopic ventilatory function

WU Yao-bin, TAN Yi-ping, ZHU Hai-bin, DENG Qiu-hong, YE Feng-qing

2020, 20(04):  512-516.  DOI: 10.3969/j.issn.1009-976X.2020.04.024

Asbtract ( )   PDF (1265KB) ( )  

References | Related Articles | Metrics

Objective To study the effects of pressure-controlled volume-assured ventilation （PCV-Vg） and volume-controlled ventilation （VCV） on airway pressure and respiratory cycle indexes during laparoscopic surgery in Trendelenburg. Methods Forty patients with ASAI and II who underwent elective laparoscopic surgery at the low head and high position were enrolled. The random number table method was divided into VCV group （n=20） and PCV-VG group （n=20）. After induction of anesthesia, the target tidal volume （VT） was 8 ml/kg in both ventilation modes, and the respiratory rate was adjusted to avoid hypercapnia. Calculate the peak and average inspiratory pressure, dynamic compliance, expiratory VT, oxygenation index and physiological ineffective cavity. Recorded at T1 5 minutes after induction of anesthesia in supine position, T2 after 5 minutes of pneumoperitoneum stabilization, 30° of pneumoperitoneum 15 min and 60 min after the low foot high are recorded as T3 and T4, respectively. Results The peak inspiratory pressure of PCV-VG group was significantly lower than that of VCV group, and the dynamic compliance was significantly higher than that of VCV group. Conclusion In patients undergoing laparoscopic surgery under Trendelenburg, PCV-VG was able to provide lower peak inspiratory pressure and greater dynamic compliance than VCV, and may have some protective effects on lung ventilation.

Subtotal petrosectomy for middle ear diffuse inflammatory infection with cholesteatoma： our experiences

ZOU Tuan-ming, CHEN Jun-ming, LIU Zhen, SUN Kai, WANG Bo-chen, CHEN Kang-song, YU You-jun

2020, 20(04):  517-521.  DOI: 10.3969/j.issn.1009-976X.2020.04.025

Asbtract ( )   PDF (3104KB) ( )  

References | Related Articles | Metrics

Objective To introduce the method of filling the mastoid cavity of middle ear with pedicled temporalis muscle flap without sealing the external auditory canal and observe the postoperative effect. Methods Six cases of adult patients with cholesteatoma with unilateral diffuse inflammatory infection of the middle ear were performed Subtotal Petrosectomy, ear cavity forming, filling with pedicle temporalis flap middle ear mastoid cavity, eustachian tube closed at the same time, but not sealing the external auditory canal, observe the postoperative complications, the dry ear time. Results All 6 patients had no cerebrospinal fluid leakage or intracranial infection, 4 patients had dry ears 3 months after the operation, 2 patients had dry ears 6 months after the operation, 1 patient had local recurrence of cholesteatoma 1 year after the operation, but no ear pus, and was cleaned regularly under ear endoscopy. Conclusion Subtotal Petrosectomy is an effective method for the treatment of diffuse inflammatory infection with cholesteatoma in the middle ear. Filling the mastoid cavity of middle ear with pedicled temporalis muscle flap, sealing the eustachian tube can effectively prevent the occurrence of related complications and secondary infection of middle ear mastoid process, and unsealing the external auditory canal is good for postoperative follow-up.

Clinical and complication assessment of CO₂ laser-assisted endoscopic surgery for T1-T2 laryngeal cancers

LV Ling-yan, HUANG Meng-meng, WANG Yu-zhi, WANG Xing-jie

2020, 20(04):  522-526.  DOI: 10.3969/j.issn.1009-976X.2020.04.026

Asbtract ( )   PDF (1265KB) ( )  

References | Related Articles | Metrics

Objective To study the effect, experience and complications of CO₂ laser-assisted endoscopic surgery in the treatment of early laryngeal cancer. Methods Eighty-eight patients with early laryngeal cancer （T1-T2） admitted to Liaocheng Second People's Hospital （the Affiliated to Shandong First Medical University） from November 2014 to November 2019 were retrospectively studied. All patients underwent CO₂ laser-assisted endoscopic surgery. The clinical effect, postoperative functional recovery and complications, as well as the relationship between complications and recurrence rate were analyzed. Results There were no complications such as accidental injury and massive bleeding. During two years of follow-up, 11 cases （12.50%） relapsed, and the recurrence time was 16.8±8.9 months. Local recurrence occurred in 10 cases （11.36%）： 5 cases were treated with TLM again （1 case of type Ⅱ, 1 case of type Ⅲ and 3 cases of type V）, 2 cases were treated with RT, 1 case of supracricoid type was treated with open surgery, and 2 cases were treated with adjuvant radiotherapy after total laryngectomy. Pathological stage, anterior commissural invasion and depth of tumor invasion were correlated with local recurrence （P=0.035, P=0.017, P=0.025, respectively）. Other parameters were not statistically significant. Conclusion CO₂ laser-assisted endoscopic surgery for laryngeal cancer has the characteristics of good recovery of laryngeal function, short hospitalization time and low complications; pathological stage, anterior commissural invasion and depth of tumor invasion are associated with recurrence.

Temozolomide therapy for refractory pituitary adenomas

FENG Zi-ze, WU Yi, LI Zhi-bin, DONG Jia-jun, GU Ji-yong, PENG Yi-long.

2020, 20(04):  527-530.  DOI: 10.3969/j.issn.1009-976X.2020.04.027

Asbtract ( )   PDF (2675KB) ( )  

References | Related Articles | Metrics

Objective To investigate the efficacy of temozolomide in refractory pituitary adenomas. Methods Three patients with non-functional pituitary adenoma or acromegaly, or Cushing's disease was retrospectively reviewed and analyzed with the literature. Results The patient with invasive nonfunctional pituitary adenoma were responded to 12 months of the temozolomide treatment. The tumor size continue to be stable at 1 year follow-up. In the patient with acromegaly, there was a decrease in the tumor size without a concomitant decline in the GH concentration aftersixcyclestreatment. For the patient with Cushing's disease, hypercortisolism remained with the tumor size stable. Conclusion Temozolomide may play a role in controlling the tumors size. However, the short-term treatment could not achievehormonal responsesin patients with acromegaly or Cushing's disease. Further research is needed in the future.

Construction of an precise rehabilitation platform for empty-nest elders after total knee arthroplasty base on the “Internet united medical treatment combination” pattern

ZHENG Wei-kun, TANG Jun-fen, GE Tao, CAI Wei-shan

2020, 20(04):  531-534.  DOI: 10.3969/j.issn.1009-976X.2020.04.028

Asbtract ( )   PDF (1250KB) ( )  

References | Related Articles | Metrics

Objective To explore the feasibility of establishing an accurate family rehabilitation platform after total knee arthroplasty （TKA） in the empty- nest elderly group based on the “Internet united medical treatment combination” pattern, and to investigate the platform’s recovery-promoting efficacy and medical benefits. Methods The empty-nest elders who performed the first unilateral TKA in our hospital were recruited. According to the differences of follow-up mode after discharge from the hospital, they were divided into two groups： 29 cases in the experimental group, accepting the rehabilitation guidance from the home rehabilitation platform based on Internet communication and regional medical network and the outpatient service of our hospital; 24 cases in the control group and they accept routine outpatient follow-up for rehabilitation advice. The knee function score （HSS）,and the daily life quality score （SF-36） of the two group were evaluated before and 6 months after the operations, and the satisfaction scores（EUROPE scale） of them were counted 6 months after the operations, too. Results No statistically significant differences was found in HSS and SF-36 between the two groups before the operation., but the experimental group enjoyed superior HSS score, SF-36 score and satisfaction score than the control group at 6 months after operation（87.74±3.44 vs. 84.24±3.52; 735.06±11.68 vs. 725.88±9.80; 99.58±4.06 vs. 95.68±3.66; P<0.05）. Conclusion Relying on the “Internet united medical treatment combination” pattern, it is practical and feasible to construct a TKA postoperative family accurate rehabilitation platform in the empty-nest elderly group. The platform is effective in improving the postoperative knee function and the quality of life for them, and is conducive to doctor-patient communication.

Review

Research progress of local anesthesia for preperitoneal space repair in elderly inguinal hernia

LI Jia-qi, JIANG Hai-ping

2020, 20(04):  535-539.  DOI: 10.3969/j.issn.1009-976X.2020.04.029

Asbtract ( )   PDF (1275KB) ( )  

References | Related Articles | Metrics

Inguinal hernia is a common disease in general surgery because of its high incidence in elderly patients. As the elderly are often associated with circulatory and respiratory diseases, the choice of surgical methods and anesthesia should be more careful and targeted, and individualized treatment should be implemented.This paper will review the development history of inguinal hernia surgery, discuss the development of various inguinal hernia surgery, and focus on the local anesthesia of the preperitoneal space hernia repair of various representative surgery in the elderly inguinal hernia research progress.In the past 10 years, there have been more than 500 cases of local anaesthesia preperitoneal space hernia repair in author department, and accumulated lots of clinical experience. Now, author combine domestic with foreign literature reports and my own surgical experience, this paper reviews the progress of local anaesthesia preperitoneal space hernia repair in the treatment of inguinal hernia.

Multifunctional mechanism of neuropilins in tumor

LIU Xiang-mei, XU Wei-guo

2020, 20(04):  540-544.  DOI: 10.3969/j.issn.1009-976X.2020.04.030

Asbtract ( )   PDF (1276KB) ( )  

References | Related Articles | Metrics

Neuropilins （NRPs） are transmembrane glycoproteins that regulates embryo tissue development, homeostasis, and cancer progression. The purpose of this review article is to discuss the function and potential mechanism of NRPs in various cancers, especially in the multifunctional cytokine transforming growth factor-β1 （TGF-β1） signaling pathway and Epithelial-Mesenchymal Transition （EMT）. The characteristics of cancer stem cells （CSC） and the role of drug resistance regulation, explore how NRPs regulation can promote cell plasticity, tumor progression and metastasis. Finally, discuss the broad application prospects of NRPs in targeted therapy.