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Table of Content

    20 June 2010, Volume 10 Issue 03
    Clinical study of the laparoscopic and traditional operation for children’s indirect inguinal hernia
    2010, 10(03):  0-0. 
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    Clinical study of the laparoscopic and traditional operation for children’s indirect inguinal hernia Zhu Ying-chang1 Chen Lieh-uan 1Wang kun 1 Xiong hai-bo 1 Liang xiong 1 Li Yan-ling2 1 Department of General Surgery I, Nanhai People’s Hospital,Nanfan Medical University,Foshan,528000,China 2 Nanhai Maternity And Child Care Hospital, Foshan,528000,China 【Abstract】 Objective To compare surgical outcomes between laparoscopic high ligation and conventional procedure in the treatment of inguinal hernia. Methods High ligation of the hernial sac was performed in 120 patients with indirect inguinal hernia from January 2007 to December2009. Twenty-seven patients were treated laparoscopically by using a hooked needle (Laparoscopic Group), whereas conventional open procedure was conducted in 93 patients (Conventional Group).  Main outcome measures included operating time, estimated blood loss, length of incision, hospitalization length, operative complications and total expenditure. Results Compared to the Conventional Group, the Laparoscopic Group presented shorter operating time, less blood loss, less operative complications, shorter hospitalization length, higher total expenditure, and the precise effect. Conclusions Compared to conventional procedure, laparoscopic high ligation of hernial sac has advantages of minimal invasion, less pain, quicker recovery, shorter hospitalization, and better cosmetic results. It is an ideal procedure for treating pediatric indirect inguinal hernia. 【Key Words】 pediatric Indirect inguinal hernia; mini-laparoscopy; traditional operation; comparison
    Intestinal anastomosis performed with the nickel-titanium temperature-dependent memory-shape device: report of 36 case.
    2010, 10(03):  0-0. 
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    [Abstract] Objective To summarize our preliminary experience of Compression anastomosis clip (CAC) for intestinal anastomosis. Methods 36 case undergoing intestinal anastomosis were performed by using CAC from January 2008. All the patients received side-to-side anastomosis including small intestino-small intestinal anastomosis in 15 case, ileo-colon anastomosis in 10 case and colono-colon anastomosis in 11 case. Results The techical success was achieved in all case. Allcase had no serious complications such as leakage or obstruction and discharged from hospital after recovery. The time for CAC, first post-operation flatus, the clip expelled with stool was 9.6±2.8 minites, on the 3.5±1.4th day, on the 13.1±6.8th day, respectively. Concussion It is a safe, simple and practicable to use CAC for intestinal anastomosis. [Key word] Compression anastomosis clip, Intestinal anastomosis
    Combined nutrition treatment on a severe undernourished patient
    LIU Zhong-hui
    2010, 10(03):  0-0. 
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    The experience of treating appendicitis for the renal transplantation patients(4 cases)
    2010, 10(03):  0-0. 
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    Abstract Objective To summary the experience in dealing with appendicitis for the renal transplantation patient Methods We retrospective analysis the course of treating the appendicitis for the renal transplantation patients. Result Among 4 patients, 3 patients were gangrenous appendicitis, another was acute suppurative appendicitis. 3 patients were suffered the wound infection after operation. Conclusion For the renal transplantation patients, the appendicitis were rapid development, difficult diagnose, high wound infection, and would be treated more carefully.
    Endoscope Holmium Laser Urethrotomy for the treatment of Male Urethral Stricture and Atresia
    2010, 10(03):  0-0. 
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    Abstract:   Objective   To explore the effect and safety of endoscope holmium laser urethrotomy for the treatment of male urethral stricture and atresia. Methods 17 cases of urethral stricture or atresia ranged from 0.5 to 3.0 cm (mean lenth 1.4 cm) admitted from 2007.4 to 2009.11 were underwent holmium laser urethrotomy by endoscope. The average duration of urethral catheter was 2~4weeks.   Results The operating time was 30~90 minutes, mean was 40 minutes. All 17 cases were succeeded with free micturition and good stream of urine after extubation of catheter . No urinary incontinence, urethral fistula or impotence occurred. The mean maximum urinary flow rate was increased observably, from 6.5(2.8~11.5) ml/s preoperatively to 20.4 (16.6~25.3) ml/s postoperatively. Good urination, no recurrence was found and residual urine was less than 20ml within 3~18 months follow up. Conclusion Endoscope holmium laser urethrotomy is an effective and safe procedure for urethral stricture and atresia, could be deserved to popular with well short term effect,mini trauma and less complications. Key words: holmium laser; urethral stricture; male
    The operation of the anterior approach decompression with bone graft and internal fixation for thoracolumbar burst fracture
    2010, 10(03):  0-0. 
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    Objective : To analyze the therapeutic effect of anterior approach decompression with bone graft and internal fixation in the treatment of thoracolumhar burst fractures. Methods:A retrospective review of anterior approach decompression with bone graft and internal fixation surgically managed thoracolumbar burst fractures from May 2000 to March 2005 was performed. There were 47 males and 11 females;and the age of the patients were from 18 to 51 years with an average of 36.6 years. Fracture segments are as follows :The fractures were located at T10 in 1 patient, T11 in 4, T12 in 13,L1 in 18,L2 in 11,L3 in 2 ,T12 ~L1 in 6,L1~2 in 3. All patients were treated with anterior approach decompression with bone graft and internal fixation. Results :All cases were followed up for an average of 13.5 months. The nerve function was improved of grade I and more according to the Frankel Grading. Bone block has been integrated in the center, with no evident correction loss , pseudoarthrosis or implant failure by imaging studies. Conclusion:The operation of the anterior approach decompression with bone graft and internal fixation for thoracolumbar burst fracture has advantages of complete decompression. It can restore the anterior-middle spinal column and improve its stability.
    Application of bi-level positive airway pressure ventilation with laryngeal mask on anodynia fibreoptic bronchoscopic treatment in middle-age and aged people
    2010, 10(03):  0-0. 
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    【Abstract】 Objective To investigate the safety and feasibility of application of bi-level positive airway pressure ventilation with laryngeal mask on anodynia fibreoptic bronchoscopic treatment in middle-age and aged people. Methods Twenty patients were enrolled. All cases were induced and maintained for general anesthesia with propofol , sufentanil and atracurium , and were ventilated with bi-level positive airway pressure via laryngeal mask .Laryngeal mask of appropriate size was chose according to body weight, then HR, mean arterial pressure (MAP) and SpO2 were recorded at the moments in pro-anesthesia(T1), before the bronchofiberscope inserted airway(T2), 5 min after the bronchofiberscope inserted (T3),1 min after operation completed(T4) and 5 min after patients were awoken. Recorded the complications in operation . Results HR of T1 and T5 was (96.7±10.6) bpm , (92.6±8.1) bpm ,respectively(p>0.05).MAP of T1 and T5 was (103.8±9.1)mmHg , (99.6±6.7) mmHg , respectively(p>0.05). SpO2 of T1 and T5 was (95.2±2.0)%, (97.7±1.2)% , respectively(p<0.01). In all the cases, had no any bucking, body movement, reflux, aspiration and hypoxia was observed . No patient reported awareness during operation , and they were satisfactory at the general anaesthesia . Conclusion It seemed that it is safe and comfortable to apply the bi-level positive airway pressure ventilation with laryngeal mask on anodynia fibreoptic bronchoscopic treatment , it is also profit for doctor to accomplish the operation .
    Clinical effects of percutaneous transhepatic gallblader drainage performed before laparoscopic cholecyctectomy in acute severe cholecyctitis
    2010, 10(03):  0-0. 
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    Objective To eveluate the effect and potential advantages of percutaneous transhepatic gallblader drainage (PTGD) performed before laparoscopic cholecyctectomy (LC) in acute severe cholecyctitis. Methods One hundred and thirdy five patients of acute severe cholecyctitis who had been performed LC were retrospectively analyzed in five years. The patients were classified into 3 groups: group 1, patients who underwent an LC without preoperative PTGD (n=45); group 2, patients who underwent an LC one week after PTGD (n=38); group 3, patients who underwent an LC one month after PTGD (n=52). The clinical data were analyzed, and the effect of PTGD was evaluated. The conversion rate to open cholecystectomy, the postoperative complication rate and the operative effect after LC in each group were compared. Results The complications and clinical improvement were no significant difference between group 2 and group 3 (P>0.05). The conversion rates of LC were 22.2% (10 cases) in group 1, 18.4% (7 cases) in goup 2 and 3.8% (2 cases) in group 3, which was lower in group 3 than in group 1 and group 2 (P<0.05). The operation time of LC was 95.7±30.5min in group 1, 76.7±29.8min in group 2 and 60.4±15.6min in group 3, and it was the shortest one in group 3 (P<0.05). The postoperative complicaion rates were 17.7% (8 cases) in group 1, 13.2% (5 cases) in group 2 and 3.8% (2 cases) in group 3, which was also the lowest in group 3 (P<0.05). Conclusion Delayed LC after PTGD in acute severe cholecyctitis is a safe and effecive treatment. It can lower the conversion and complication rates. One month was appropriate for the time between PTGD and LC.
    The Study of the Change of Urinary L/M and Its Function in Severe Intra-abdominal Infection
    2010, 10(03):  0-0. 
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    In order to study the changes of urinary lactulose/mannitol ratio(L/M) in patients with severe abdominal infection, and its role in the pathological process, we observed 57 adult patients with severe intra-abdominal infection continuously. All the patients were divided into the survival group and death group retrospectively, and we observe the APACHE-II score and urinary L/M on the 1st, 3rd, 7th day. In the end, we recorded the SICU length of stay, total hospital days, hospital costs, the prognosis of patients, and mortality. In the survival group, urinary L / M and APACHE-II scores lowed with the time going on(P <0.05); however in the death group, they raised up (P <0.05). In addition, the urinary L/M of death group was significantly higher than the survival group at each time point(P <0.05). Furthermore, APACHE-II scores of death group were significantly higher than the survival group at every time point(P <0.05). On the 1st, 3rd, and 7th days, the urinary L/M levels were positively correlated with APACHEII scores, and the correlation coefficients were0.392、0.539 and 0.584respectively. The urinary L/M on the enrollment also had a significantly correlation with SICU length of stay, total hospital days, and hospital cost respectively with a correlation coefficient of 0.674、0.364 and 0.587. In one word, we could saythat urinary L/M plays an important role in the pathogenesis of severe intra-abdominal infection, which makes patients sicker, prolongs hospital stay, increases patient care burden, and improves case fatality rate due to severe abdominal infection.
    Analysis of The Multiple Factors of Postoperative Wound Infection for Acute Appendicitis
    2010, 10(03):  0-0. 
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    【Abstract】 Objective To explore the different factors of postoperative wound infection of acute appendicitis. Methods Retrospective analyse 736 patients of acute appendicitis in our hospital from January 2004 to January 2009, and 35 cases are wound infection, to contrast and analyse the relationship between wound infection and sex, patient onset age, onset time, emergency intervention time, incision, pathology, white blood cell level. Results 35 cases occurred wound infectionin in patients, infection rate was 4.75% (35/736).The results show us postoperative the wound infection in acute appendicitis unrelated to sex and the drainage tube indwelling or not(P> 0.05), but have the relationship with age, the duration of disease, incision, operation time, white blood cell level, and pathology (P <0.05). Conclusion The patients with long disease time and operation, seriously inflammation have high wound infection rate; improve the preoperative diagnosis and surgical skills,shorten the time of surgical intervention and operation time,Strengthening the nursing observation would reduce the infection rate effectively.
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    Clinical application of interventional ultrasound therapy in thyroid benign nodules
    2010, 10(03):  170-171. 
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    【Abstract】 Objective To evaluate the clinical application value of interventional ultrasound therapy in thyroid benign nodules. Methods 246 patients with thyroid benign nodules were treated with Percutaneous ethnol injection(PEI)and radioactive colloidal chromium phosphated-32(RCCP)under the guidance of ultrasound, and the therapeautical results were evaluated 3 m and 12m post-treatment. Results Both ethnol and radioactive colloidal chromium phosphate-32 had significant effects in reducing the nodule size, the total effective rate was 91.8% , 93.4%and91.9% , 96.8%post 3m and 12m respectively, there was no obvious difference(P>0.05).But there was better effect in the solid lesion than in the others, the total effective rate was 100% and 85.0% respectively post 12m therapy(P<0.01).But for the solid lesion,PEI was superior to RCCP, the effective rate was90.9% and 77.8%(P<0.05),but no difference between both methods in cyst lesions. Conclusion Interventional ultrasound therapy had practical clinical value in the treatment of thyroid benign nodules.

    The analysis of the treatment of keeping kidneys about urinary tract stones with giant hydonephrosis with 38 cases
    2010, 10(03):  214-215. 
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    Urethrascopic treatment of closed urethral injury ( 16 cases)
    2010, 10(03):  218-219. 
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    [Abstract] Objective: To investigate the application of urethrascopic realignment in closed urethral injury. Methods: A retrospective study of 16 cases of closed urethral injury from June 2001 to June 2009 by endoscopic treatment was carried out . Results: 16 patients were successfully treated by endoscope, were followed for 6 months to 2 years, 12 patients with smooth urination, urine no apparent difference than before, 4 patients, 3 cases of pelvic fracture injuries, 1 cases of urethral bulb completely broken removed catheter 1 week -2 months after the emergence of different levels of urinary thinning, transurethral imaging revealed varying degrees of urethral stricture, urethral expansion to 2-4 months after the smooth urination. All patients in this group without erectile dysfunction. Conclusion: Urethrascopic treatment is effective to closed urethral injury with little trauma, shorter surgery time and fewer complications and so on.

    Comparison of the effect of Laparoscopic and open surgery for varicocele
    2010, 10(03):  220-222. 
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