Table of Content

20 June 2013, Volume 13 Issue 03

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Hot Meta of Japan hepatobiliary pancreatic annual congress in 2012

Gu Weili

2013, 13(03):  171-171.  DOI: doi:10.3969/j.issn.1009-976X.2

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Effect of high glucose and TNF-α on the differentiation of RAW264.7 cells to osteoclast

Hou Nianzong, Liu Wenzhou, Chen Binghao, Chen Hao, Aditya, Song Weidong

2013, 13(03):  172-176.  DOI: doi:10.3969/j.issn.1009-976X.2

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【Abstract】 Objective To observe the effect of high glucose and TNF-α on the differentiation process of RAW264.7 cells to osteoclasts. Methods RAW264.7 cell were cultured in  DMEM medium  under the  condition of normal,.high glucose(30 mmol/L) and TNF-α(10 μmol/L) respectively and RANKL(receptor activator of NF-κB ligand,.100 ng/mL).was added and used to induce the the differentiation process of RAW264.7 to osteoclast..After 9 days,.the TRAP positive cells after tartrate resistant acid phosphatase (TRAP) staining and the expression of CTR and MMP-9 detected by RT-PCR and Western Blot were compared among the three culture conditions of normal,.high glucose and TNF-α respectively. Results RANKL could induce the differentiation of RAW264.7 to osteoclasts under different culture conditions and the TRAP positive cells and the expression of CTR and MMP-9 were the most in the environment of TNF-α,.but the least of high glucose. Conclusions TNF-α can promote differentiation of RAW264.7 to osteoclast,.but high glucose is inhibitory,.which can explain bone damage of patients with typeⅠandⅡ diabetes. The induction of differentiation of RAW264.7 to osteoclast by RNAKL under different culture conditions of normal,.high glucose and TNF-α can simulate the process of differentiation of precursor cells to osteoclasts in the patients with diabetic foot.

Analysis of clinical pathological features of 130 patients with pT_1a and pT_1b breast cancer

Xu Juan, Zhu Caixia, Yang Jianmin, Chen Zhongyang, Lian Zhenqiang, Han Xiaorong

2013, 13(03):  177-180.  DOI: doi:10.3969/j.issn.1009-976X.2

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【Abstract】 Objective To study the clinical and pathologic characteristics of pT1a and pT1b breast carcinoma. Methods From Jan 1st, 2008 to Dec 31st, 2012, 130 patients with pT1a and pT1b breast carcinoma and 607 patients with pT1c and pT2 breast carcinoma were studied retrospectively. Clinical and pathologic factors including age,.menopausal status,.axillary lymph node metastasis, histologic grade, estrogen receptor (ER)/progesterone receptor (PR) expression, human epidermal growth factor 2 (HER-2) expression and Ki-67 index were analyzed using χ2 test. Results There was no significant difference between pT1a and pT1b breast carcinoma on all factors in this study(P>0.05). pT1a/pT1b breast carcinoma had significant lower histologic grade (G1: 59.2% vs 18.6% and 12.3%),.lower Ki-67 index.(73.8% vs 57.7% and 55.5%,those more than 14 percent) and less axillary lymph node metastasis.(86.9% vs 62.0% and 47.4%).compared with pT1c and pT2  breast carcinoma(P<0.01)..It had significant higher ER/PR expression.(76.2% vs 72.3% and 62.2%) compared with pT2 breast carcinoma (P=0.006) but not with pT1c breast carcinoma (P=0.408). HER-2 positive expression was lower but both with no significant difference (21.5% vs 22.3% and 29.7%). There was significant more patients aged younger than 35 in pT1a/pT1b breast carcinoma (21.5% vs 8.8% and 13.8%,.P<0.001 and P=0.042).while no significant difference on menopausal status. Conclusion pT1a and pT1b breast carcinoma likely have such characteristics as lower histologic grade,.lower Ki-67 index,.higher ER/PR expression and lower HER-2 positive expression compared with other larger invasive breast carcinoma..There isn?蒺t much difference between pT1a and pT1b breast carcinoma.

Study on urinary tract stone compositions for patients from Nanhai District in Guangdong: Report of 986 cases

Hu Ming, Cui Xuejiang

2013, 13(03):  181-183.  DOI: doi:10.3969/j.issn.1009-976X.2

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【Abstract】 Objective To provide theoretical basis of clinical personalized treatment and prev-ention recurrence for patients with urinary stones,.using infrared spectrum method to analyze the urinary stones composition in Nanhai District,.Guangdong Province.Method The urinary stones in 986 cases were excluded naturally or performed extracorporeal shock-wave lithotripsy,.which were analyzed by the infrared spectrum method.Results Urinary stones were more often found in male patients than that in female,.and the ratio was 1.34∶1 The incidence of urinary tract stones between 51-60 years old were higher than any other age stage. The upper urinary tract stones were more frequently found than the lower urinary tract stones,and the ratio was 9.49∶1. Six types of chemical components were detected in calculi.There were calcium oxalate monohydrate, calcium oxalate dihydrate, carbonated apatite, anhydrous uric acid, hexahydrate phosphate magnesium ammonium and cystine. Mixed components stones were found in 647 cases,.accounting for 65.6%. And calcium stones were found in 853 cases,.accounting for 86.51%. The detection rate of calcium oxalate was highest in all the chemical components,accounting for 77.38%,.followed carbonated apatite (5.27%) and uric acid composition (15.8%). Conclusion It is significant to analyze the urinary stone composition for investigating the cause of stones,.and preventing stone formation and recurrence.

The application of selective superior hemorrhoidal mucosa resection and anastomosis in severe hemorrhoid

Wan Renhui, Wen Yiqing, Deng Haocai

2013, 13(03):  184-188.  DOI: doi:10.3969/j.issn.1009-976X.2

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【Abstract】 Objective To assess the feasibility and safety of selective superior hemorrhoidal mucosa resection and anastomosis.(Tissue-selecting Therapy stapler,TST).in severe hemorrhoid. Methods One hundred and twenty severe hemorrhoid cases were randomly divided into TST group (60 cases).and procedure for prolapse and hemorrhoids.(PPH).group.(60 cases)..The clinical characteristics and perioperative general data were retrospectively analyzed..Moreover,.the curative effects and short-term outcome were evaluated between two groups. Results No statistical differences about demographic data were found between TST group and PPH group..Moreover less average operation time and blood loss were observed in the TST group and the cases in the TST group cost less postoperative hospital stay and hospitalization expenses. In the comparison of the curative effect, the difference had no statistical significance between two groups. The paining scores in postoperative 2 day and 4 day were less in the TST group. But no difference was found in postoperative 1 week. The scores of anal stenosis,.postoperative defecation and anal bleeding in postoperative 1 months in the TST group were better than PPH group. Conclusion The application of TST method for severe hemorrhoid is available, safe and effective. The TST surgery has a good clinical outcome and improves the postoperative subjective feeling and  quality of life.

Expericece in the treatment of for new onset rapid atrial fibrillation following cardiac surgery in 42 cases

Yu Xiaoli, Zhang Dongcheng, Lin Qinwen, Yu Tao, Qin Xianyu

2013, 13(03):  188-191.  DOI: doi:10.3969/j.issn.1009-976X.2

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 【Abstract】 Objective To summarize the experiences of management for new onset rapid atrial fibrillation (AF) following cardiac surgery in 42 cases. Methods From August 2002 to August 2012, 395 patients with sinus rhythm underwent cardiac operations,in which 42 patients developed new onset rapid AF following cardiac surgeries including 18 cases of coronary heart disease,15 cases of valvular heart disease,3 cases of coronary heart disease combined with valular heart disease,and 6 cases of congenital heart disease.These patients were treated with amiodarone both intravenously and orally under ECG monitoring and controled heart rate in a normal level at first and converted sinus rhythm positively along with anticoagulant therapy.Temporary pacemakers were placed during operations to set up a protective heart rate of 70 to 90 bpm.Those who administrated with β-blocker before operations continued its use. Results Normal sinus rhythm was restored in 32 patients within 24 hours and the others in the following four days..No cerebral infarction or death occurred. Conclusion The administration of amiodarone promotes the conversion to normal sinus rhythm from post-operative AF..Cautious adjustment of the dose should be made in the combined use of amiodarone and β-blocker in order to prevent bradycardia..The importance of the treatment for precipitating causes of AF should not be overlooked at the meantime.

Comparison of the effects on percutaneous nephrolithotomy for huge renal calculus in prone and semisupine-lithotomy position

Xie Zhongbing, Zhou Renshi, Chen Zhong Xian, Huang Hai

2013, 13(03):  192-194.  DOI: doi:10.3969/j.issn.1009-976X.2

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【Abstract】 Objective To evaluate the clinical effect of percutaneous ephrolithotomy(PCNL) for huge renal calculus in different position: prone and semisupine-lithotomy position. Methods From March 2011 to March 2013,.a total of 84 patients with huge renal calculus underwent PCNL in different position: semisupine-lithotomy position (A group) and prone position (B). Operation time, blood loss, primary stone clearanceand complications were recorded and compared between two groups. Results PCNL was successfully completed in all the patients,.no one converted to open surgery. Single-tract PCNL was performed for 47 cases in semisupine-lithotomy groups, two tracts 1 case. The all patients in prone position group were treated with single-tract PCNL..The mean operation time in group A was less than that in group B..The stone free rate was 88.3% and 81.2% in semisupine-lithotomy group and prone position group respectively..One case appeared secondary bleeding in prone position group who was cured by conservative treatment. There were no severe complications occurred in both groups.Conclusion PCNL in semisupine-lithotomy position is an effective alternative for treating renal calculus..The semisupine-lithotomy position allows easier irrigation of stone fragments..It is more comfortable for the patient during operation and facilitates monitoring of anesthesia.

Comparison of clinical efficacy between TUPKEP and TUPKRP for the treatment of high-risk BPH patients

Cao Jiazheng, Pang Jian, Wu Ronghai, Cheng Zhouping, Lin Qiping, Lin Weiguang

2013, 13(03):  195-198.  DOI: doi:10.3969/j.issn.1009-976X.2

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【Abstract】 Objective To compare the clinical safety and efficacy between transurethral plasm-akinetic enucleation of prostate.(TUPKEP).and transurethral plasmakinetic resection of the prostate(TUPKRP)for treatment of high-risk patients with benign prostatic hyperplasia. Methods The clinical data of 128 cases with high-risk BPH treated with TUPKEP and TUPKRP were analyzed retrospectively. The operation time,.bleeding,.resected tissue weight of prostate,.bladder irrigating time, postoperative hospitalization time, complications, international prostate symptom score (IPSS), quality of life score (QOL), postvoid residua (PVR) and maximum flow rate (Qmax) were compared between two groups..Results Sixty-eight cases and 60 cases underwent TUPKEP procedure and TUPKRP procedure respectively..There was no significant differences observed basic factors in preoperative patients between the two groups (P>0.05). IPSS, QOL, PVR and Qmax were improved in the two groups after the operation.(P<0.01),.and there showed no significant difference between the two groups.(P>0.05)..The operation time,.bleeding,.bladder irrigating time,.and postoperative hospitalization time were significant shorter in TUPKEP than in TUPKRP.(P<0.05)..The resected tissue weight of prostate in TUPKEP was more than in TUPKRP (P<0.05). Conclusion There is no difference in clinical efficiency between two groups,.but TUPKEP has advantages in operation time,.bleeding, postoperative hospitalization time,.mean bladder irrigating time and complications and is an effective and safe therapy for high-risk BPH.

Analysis of the effects of palonosetron hydrochloride on preventing nausea and vomiting caused by PCEA

Li Yongxian, Zhang Haisheng, Li Jing

2013, 13(03):  199-201.  DOI: j.issn.1009-976X.2013.03.009

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【Abstract】 Objective To observe the effect of palonosetron hydrochloride on preventing post-operative nausea and vomiting (PONV) in patients treated with patient-controlled epidural analgesia (PCEA). Methods Sixty patients who had cholecystectomy under epidural anesthesia were randomly assigned into group C(palonosetron group,n=20),.group B.(droperidol group,n=20).or group A (control group,n=20)..Before operations,.0.25 mg of palonosetron hydrochloride,.2.5 mg of droperidol or 100 mL of saline was intravenously administered to patients in group C,.group B or group C,.respectively..5 mg of morphine plus 0.125% of bupivacaine in 100 mL of saline was used for PCEA..During the period of PCEA,.the incidence and severity of nausea and vomiting were recorded,.and when vomiting occurred,.the efficacy was evaluated after administrating antiemetics..Results The number of patients who had nausea and vomiting in group A, group B and group C was 13, 5 and one respectively. PONV incidence in group C was lower than that in group B or group A (P<0.001). There was significant difference between group B and group A (P=0.022)..Conclusion Preoperative administration of palonosetron hydrochloride can significantly decrease the incidence of PONV induced by PCEA in patients undergoing cholecystectomy.

Clinical value of blood sugar monitoring for perioperative period insulinoma resection

Guo Mingyan, Fu Yanni, Zhao Yifan, Fu Ganglan, Shen Zhiwen, Hu Chuwen

2013, 13(03):  202-204.  DOI: j.issn.1009-976X.2013.03.010

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【Abstract】 Objective To investigate the perioperative management for surgical removal of pancreatic insulinoma. Methods From November 2011 to October 2012,.the clinical data of 18 patients with insulinoma treated by surgical operation were analyzed retrospectively. Results Six male and 12 female patients with Whipple‘s triad were included into this study..Of 18 cases, fifteen patients received open tumor enucleation, and 3 cases received laparoscopic resection of the tumor. Patients underwent open surgery were anesthetized by general anesthesia combining with epidural block..Those underwent laparoscopic surgery received general anesthesia only. The patients were divided into 2 groups:.C group (n=10), patients received 50% GS continuous infusion and blood sugar was measured in every 15 min. 50% GS infusion ended 30 min before the removal of the tumor. NC group (n=8), patients didn’t receive 50% GS continuous infusion but just received 50% GS 50 mL intravenous injection when blood sugar was lower than 2.8 mmol·L-1. Vital signs were steady and blood sugar of patients in C group was controlled more stable than that NC group(P<0.05). Conclusion 50% GS infusion with repeat blood sugar monitoring intraoperatively would prevent dramatic hypoglycemia before and after tumor removal.

Logistic regression analysis on correlated factors of bile leakage after laparoscopic choledoch-otomy with exploration and primary suture

Li En,.Wu Zuguang,.Li Zhiwang,.Liu Hongtao,.Chen Kai

2013, 13(03):  205-207.  DOI: j.issn.1009-976X.2013.03.011

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【Abstract】 Objective To explore the risk factors of bile leakage after laparoscopic choledochotomy with exploration and primary suture. Methods The clinical data of 19 patients with bile leakage and 52 without bile leakage after laparoscopic choledochotomy with exploration and primary suture were studied retrospectively..And the related risk factors of bile leakage were analyzed with unconditional multivariate Logistic regression analysis. Results Bile leakage after primary suture were associated with the body metabolic index,.manner of common bile duct incision,.level of serum albumin and diabetes, which were statistically significant differences between two group(P<0.05) and the improper manner of common bile duct incision was the most important factor. Conclusion The strict indication control and the correct surgical procedure are the keys to reduce bile leakage occurrence after primary suture on common bile duct.

Percutaneous transhepatic gallbladder drainage combined with laparoscopic cholecystectomy in the treatment of acute sappurative cholecystitis

Huang Meitai,Chen Huanwei

2013, 13(03):  208-210.  DOI: j.issn.1009-976X.2013.03.012

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【Abstract】 Objective To investigate the effect and potential advantages on percutaneous transh-epatic gallbladder drainage (PTGD) combined with laparoscopic cholecystectomy (LC) in the treatment of acute severe cholecyctitis. Methods Retrospective analysis was made on the clinical data of 82 cases of PTGD and two-stage LC for patients with acute severe cholecystitis from Jan 2009 to Sep 2012. Results PTGD was performed successfully for all patients..The symptoms of abdominal pain were relieved 2-4 h after operation,.and the temperature decreased to normal level 48-72 h after operation..Postoperative massive hemobilia happened in one case and the bleeding stopped by emergently interventional therapy of selective hepatic artery embolization..And all cases were performed LC 30 days after PTGD,.in which 2 patients were transferred to open cholecystectomy(2.4%). No patient had severe complication or died after PTGD and LC. Conclusions With the low conversion to open surgery and less complications,.PTGD combined two-stage LC is simple,.effective and safe for treatment of acute suppurative cholecystitis.

Effect of platelet-rich plasma on the treatment of hard agglut wounds

Chen Jianmin, Chen Li'an, Chen Zifeng, Huang Jiongfeng, Yuan Ting

2013, 13(03):  210-213.  DOI: j.issn.1009-976X.2013.03.013

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【Abstract】 Objective To investigate the effect of platelet-rich plasma (PRP) on treatment for hard agglut wounds. Methods From October 2010 to March 2012, 32 patients with chronic wounds were received the treatment with PRP gelatin gel. The PRP preparation derived from 30 mL of venous blood was placed on the wound,and then the wound was covered with Vaseline gauze and sealed up with a kind of medical membrane for 7 days before next dressing change. Three times was one course. The wound healing was evaluated by observation of wound surface and measurement of wound area before and two months after treatment. Results The wounds had an obvious improvement with fresh tissue after one treatment course, without further exudate. The wound volume changed from 9.5±4.7 mL (V1, before the treatment) to 1.7±0.9 mL (V2, after two months of treatment) (P<0.05). Among 32 patients, the cure rate was 31.2% and the effective rate was 93.8%. Conclusion Platelet-rich plasma is an effective and practical method in treatment of the chronic wounds.

Prognostic analysis on patients with hypertensive cerebral hemorrhage after surgical treatment

Yao Kaili

2013, 13(03):  214-217.  DOI: j.issn.1009-976X.2013.03.014

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【Abstract】 Objective To explore the factors influencing the prognosis of patients with hype-rtensive cerebral hemorrhage after operation. Methods Seventy-six patients diagnosed as hypertensive cerebral hemorrhage after surgery were retrospectively analyzed..Risk factors influencing the prognosis of patients include age, body mass index (BMI), haematoma volume, systolic pressure on admission, preoperative GCS values,.ventricular blood whether or not,.pulmonary infection as independent variables, and functional independence measure(FIM) after 3 months as dependent variable. Grouped measurement data was used t-test and f-test,continuous measurement data used linear correlation analysis, screened the influencing factors of prognosis of patients, then the valuable influencing factors were filtrated and formulated with multiple regression analysis model and their contribution were compared. Results The factors including BMI,.haematoma volume,.preoperative GCS values,.systolic pressure on admission,.pulmonary infection were associated with the prognosis of patients undergoing operation. Conclusion It is suggested that BMI,.haematoma volume,.preoperative GCS values, systolic pressure on admission, pulmonary infection are the critical predicted index of prognosis. More attentions should be paid to strengthen the treatment, disease control and prevention to them in clinic.

Necessity of exposure and protection of parathyroid glands during thyroidectomy

Huang Yingkai,.Hong Haobo,.Lin Renqu

2013, 13(03):  218-220.  DOI: j.issn.1009-976X.2013.03.015

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【Abstract】 Objective To investigate the necessity of exposing and protecting parathyroid glands during thyroidectomy. Methods A total of 164 cases that underwent surgical treatment for nodulargoiter or thyroid cancer were randomly divided into two groups,.exposed group and non-exposed group. For non-exposed group.(n=76),.the posterior capsule of thyroid was reserved and the parathyroid glands were not explored during operation. For exposed group(n=88),.the parathyroid glands were exposed and protected from devasation..After operation,.the level of serum calcium was monitored and the function of parathyroid glands was tested dynamically.Results Postoperative incidence of hypopar-athyroidism in patients with exposing and protecting parathyroid glands was significantly lower than that in patients without exposing and protecting parathyroid glands(P<0.05). Conclusion During thyroidectomy, exposing and protecting the parathyroid glands would effectively decrease the incidence of postoperative hypoparathyroidism.

Effect of unilateral combined spinal-epidural anesthesia in elderly patients with hip joint operation

Zeng Zhiwen,Yu Runying,Zhang Yuenong,Zhong Yutinga,Lin Yuehuaa,Wang Wenx

2013, 13(03):  221-223.  DOI: j.issn.1009-976X.2013.03.016

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【Abstract】 Objective To explore the clinical effect of hip-joint replacement surgery in 80 years or older patients under unilateral combined spinal-epidural anesthesia. Methods A total of 130 cases in our hospital from 2009 to 2011 undergoing hip joint operation, at the age of 80-96, ASA Ⅱ-Ⅲ,.were randomly divided into control group(n=65) and observation group(n=65). In the observation group,.L3-L4 puncture with unilateral combined spinal-epidural anesthesia were applied,.and L2-L3 puncture using epidural anesthesia was applied in the control group..Anesthetic effects of the two groups were observed..Results The onset time and total-block time of anesthesia in the observation group was significantly faster than that in the control group(P<0.05). The heart rate in two groups of patients before and after anesthesia had no significant change..The systolic pressure,.diastolic pressure,.mean arterial pressure after anesthesia in controls fluctuated much more than that in control group.(P<0.05)..The anesthetic effect in the observation group was better than control group. Conclusion Unilateral combined spinal-epidural anesthesia has the advantages of quick effect, analgesia and muscle relaxation effect. With little respiratory and circulatory side effect, the methods can be used safely and effectively in the anesthesia for elderly patients.

Breast-conserving surgery in the treatment of 20 cases with diffuse breast tuberculosis

Xiao Zelin, Liu Jiajie, Gao Jianqi

2013, 13(03):  224-226.  DOI: j.issn.1009-976X.2013.03.017

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【Abstract】 Objective To explore the clinical efficacy of breast-conserving surgery in treating diffuse tuberculosis of the breast. Methods A retrospective data was dnalyzed in the prognosis of conserving surgery in 20 cases with breast tuberculosis diffuse. Results Seven cases healed by first intention,.2 cases with poor wound healing had healed after debridement,.and.11 cases healed after wound dressing in hospitalization or outpatient. All the cases recovered with no skin ischemic necrosis or recurrence in the following 12 months. Conclusion Breast-conserving surgery combined with regular anti-tuberculosis treatment is an effective way to treat the diffuse tuberculosis of the breast with abscess, burst, sinus, which can meet the aesthetic needs of the patients and improve the quality of life.

Comparative study of ropivacaine and bupivacaine for anesthesia in elderly patients with lower limb operation

Xiao Shenghong, Chen Guorong, Liu Xianbao, Zhan Hong

2013, 13(03):  226-228.  DOI: j.issn.1009-976X.2013.03.018

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【Abstract】 Objective To investigate the anesthesia effect of middle-dose ropivacaine and bupiva-caine for lower limb operation in aged patients. Methods Fifty of agedtranscervical fracture patients who underwent surgical treatment were randomized into ropivacaine groupand bupivacaine group (n=25 each). The patients were given combined spinal epidural anesthesia (CSEA) by injection of 0.5%ropivacaine 2.5 mL or 0.5%bupivacaine 2.5 mL through subarachnoid cavity..During the anesthesia,2% lidocaine was added when the anesthesia effect was insufficiency. During the operation, the status of respiration and circulation were monitored for the evaluation of anesthesia effect and adverse reaction. Results The differences of anesthesia effect, maximum blockage plane and adverse reaction were insignificant between the two groups.(P>0.05)..The decrease of blood pressure was obvious in bupivacaine group(P<0.05). Ropivacaine group was slow in starting sensation blockage and had short duration,.and had mild motion blockage.(P<0.05).compared with those in bupivacaine group). Conclusion Both ropivacaine and bupivacaine had anesthetic effect for lower limb operation in aged patients. Ropivacaine is more suitable for the aged patients for its less effect on circulatory system, mild motion blockage and rapid recovery of motion blockage.

Thoracoscopic Nuss procedure for the treatment of children's pectus excavatum(report of ten cases with literature review)

Chen Mingbin

2013, 13(03):  229-232.  DOI: j.issn.1009-976X.2013.03.019

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【Abstract】 Objective To investigate the efficacy and security of thoracoscopic Nuss procedure for treatment of children with pectus excavatum. Methods From April 2008 to December 2012, ten patients with pectus excavatum were treated with thoracoscopic Nuss procedure. Through two small incisions in the side of the chest,a concave steel bar was slipped under the sternum, through the incisions in the side of the chest..The thoracoscope was used to help guide the bar. Results The operation was completed successfully in all of 10 cases,.and a support plate was reserved to support the bar and keep it in place..The operative time was 40-105 min,.average 65 min,.the average amount of bleeding during surgery 9.5 mL..No severe complications occurred. Through the followed-up of 3 to 36 months,.the recent excellent rate was 100%. Conclusion Thoracoscopic Nuss procedure is effective and safe for children with funnel chest,.but the long-term effects need to be further observed.

Discussion of curative effects on thoracoscopic radical resection of early stage lung cancer

Hui Gang, Wu Da, Liu Jixian, Xie Yuancai, Ye Yiwang

2013, 13(03):  233-235.  DOI: j.issn.1009-976X.2013.03.020

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【Abstract】 Objective To investigate the safety, efficacy and operation indication of the thoracos-copic radical resection for early stage lung cancer. Methods From August 2009 to August 2012,83 patients with early stage lung cancer underwent thoracoscopic radical resection..There were 47 male and 36 female, an average age of 55.5 years old. The surgical procedure and approach were similar to conventional open lobectomy. Results All operations were carried out safely. Operative time was 70-380 min, intraoperative blood loss was 80-900 mL. There were no operative death or serious operative complications. There were 3 patients transferred to open thoracotomy. Postoperative pathological results included adenocarcinoma in 53 patients,.squamous carcinoma in 28 patients and sarcomatoid carcinoma in 2 patients..The average postoperative follow-up time was 6.7 months,.and three cases with lung adenocarcinoma were found liver and brain metastases on 3-9 months after operation. Conclusion Thoracoscopic radical resection of lung cancer is a safe and feasible surgical procedure compared with conventional open thoracic surgery..It is a safe,.effective and feasible method for treatment of non-small cell lung cancer.

Mammotome biopsy system for diagnosis and minimally invasive excision of intraductal papilloma

Wang Hong, Chenwei Rong, Zhou Jie

2013, 13(03):  236-239.  DOI: j.issn.1009-976X.2013.03.021

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【Abstract】 Objective To investigate the value of Mammotome system in the treatment of intr-aductal papilloma without nipple discharge..Methods Twelve women with breast cystic-solid lesions without nipple discharge underwent B-US-guided 8-gauge Mammotome biopsy. Interval US surveillance was performed at a median time of 17 months (range 10-41 months)..Results All tumors were removed accurately with satisfactory cosmetic outcomes..All of them were histologically diagnosed as intraductal papilloma..No clinically significant complications occurred. Conclusions The US-guided Mammotome biopsy provides an accurate pathologic diagnosis and successful complete excision of cystic-solid breast tumors..It appears to be an effective treatment in intraductal papilloma patients without nipple discharge.

Complications of gasless video?鄄assisted thyroidectomy by the anterior chest wall approach

Cao Hailing, Hong Yun, Wang Hao, Li Songming

2013, 13(03):  239-242.  DOI: j.issn.1009-976X.2013.03.022

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【Abstract】 Objectives To analyze the complications and the reasons, and to evaluate the safety and feasibility of gasless video-assisted thyroidectomy by the anterior chest wall approach..Methods A total of 428 cases underwent gasless video-assisted thyroidectomy by the anterior chest wall approach,.in whom 359 cases received unilateral thyroidectomy and 69 cases bilateral thyroidectomy. Results All of the operations were completed without open thyroidectomy..There were 9 cases of postoperative transient hoarseness,2 cases of operative tracheal injury,2 cases of postoperative ecchymoma,one case of dermatic injury and one case of recurrent hyperthyreosis..Conclusion The surgical procedure of gasless video-assisted thyroidectomy by the anterior chest wall approach is safe and feasible.

Clinical experience of the application of tension-free hernioplasty on giant incisional hernia of abdominal wall

Fu Jiyong, Huang Yihua

2013, 13(03):  243-245.  DOI: j.issn.1009-976X.2013.03.023

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【Abstract】 Objective To summarize the clinical experience of tension-free incisional hernioplasty with artificial material repairing giant incisional hernia of abdominal wall. Methods From December 2006 to December 2011, the clinical data of 53 patients with giant incisional hernia of abdominal wall were analyzed retrospectively. Results All cases underwent giant abdominal incisional hernia tension-free hernioplasty with polypropylene mesh. All the patients were cured and discharged. The complications occurred in 14 cases, including postoperative incision subcutaneous fluid in 4 cases, wound infection in 5 cases, hypoalbuminemia in 3 cases, active bleeding in 2 cases. The average of hospital stay was 9.5 days. Postoperative follow-up time ranged from 1 to 5years, without recurrence. Conclusion The giant incisional hernioplasty with applying artificial mesh is a safe and reliable method. The modified SUBLAY repair method (Bridge) has fewer complications, low recurrence rate, and helps to improve success rate of surgical operation.

Clinical value of multi-slice CT 3D reconstruction in perioperative esophageal foreign body

Zhang Jianzhong, Jiang Qun, Huang Zhankun

2013, 13(03):  246-248.  DOI: j.issn.1009-976X.2013.03.024

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【Abstract】 Objective To investigate the role and significance of the multi-slice CT 3D recons-truction in perioperative esophageal foreign body. Methods In a retrospective review of 51 cases in our hospital from Feb..2007 to Nov..2012,.the SCT 3D reconstructions were used to detect the foreign body and its description, location, size, quantity, relationship with esophagus, esophageal perforation and infection..Based on these,.the optimal surgical treatment were selected and complications were diagnosed by the multi-slice CT 3D reconstruction. Results Fifty patients were successfully removed the foreign body through fiber gastroscopy,.hard esophagoscopy,.lateral neck incision and chest surgical approach,.respectively,.according to the images of the SCT scan..The abnormal shadows around esophagus disappeared under the guidance of multi-slice CT 3D reconstruction during the treatment of the patients with perforation of esophagus. Conclusion SCT 3D reconstruction has high clinical value for the diagnosis and treatment esophageal foreign body,.including high sensitivity for finding foreign body,the operation choice and the directions for diagnosing and treating complications.

Advances in the research of LAP⁺CD4⁺T cells

Ying Jiecao, Liu Xiaoping

2013, 13(03):  249-252.  DOI: j.issn.1009-976X.2013.03.025

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【Abstract】 Having a suppressive effect on immune response, regulatory T cells (Tregs) play an important role in the maintenance of homeostasis. Treg cells are necessary both to maintain self-tolerance and prevent the onset of autoimmune disease. The Treg cells studied previously were mainly divided into three subpopulations: CD4+CD25+T cells, Th3 cells and Tr1 cells. These T cells exert the immune suppressive function by producing some kinds of cytokines, such as IL-10 and TGF-β, with the ability of immune suppressive. Recently, LAP+CD4+T cells have been identified as a new subset of Treg cells and a population with regulatory function both in vitro and in vivo. This regulatory function is partly mediated by TGF-β and IL-10. In animal experiments, these cells have been shown to affect the genesis and development of some diseases, such as autoimmune disorder and inflammatory disease. A few researches implied that these cells also play an important role in tumor progression in patients with cancer.

Recent study on totally extraperitoneal patch (TEP)

Chui Tianyou, Yuan ZhaoLin, Xu Deli, Huang Binghong, Ye Yinting

2013, 13(03):  253-256.  DOI: j.issn.1009-976X.2013.03.026

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【Abstract】 Objective There are as many as 150 different surgical approaches for inguinal hernia. In recent years, laparoscopic techniques have been applied to hernia repair.Totally Extraperitoneal Patch, TEP, is one of the more commonly used procedure, thus, this article is going to summarize the techniques and effectiveness of this surgery. Methods Search and obtain relevant articles from WanFangData,.Pubmed. Results The selection of surgical approach is also affected not only by the advantages and disadvantages but also by the surgeon’s familiarity with the surgery. Conclusion TEP has its place in hernia repair with its effectiveness and development prospects.

New progress in the diagnosis and treatment of gallbladder polyp

Wang Haoa，Xiong Pei

2013, 13(03):  256-259.  DOI: j.issn.1009-976X.2013.03.027

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【Abstract】 With the wide popularity of B-ultrasonography imaging technology,.PLG detection rate is higher and higher, has become a common disease of biliary surgery. Currently on PLG treatment is mainly surgery, and so far no effective way to identify the nature of PLG before the surgery, thus makes the most patients without malignant change tendency of PLG imposed unnecessary cholecystectomy. In view of this, this article will to review the relationship of PLG and malignant transformation, and to understand the risk factors of PLG and its malignant transformation, so as to determine surgical indications of prophylactic cholecystectomy has a certain clinical significance.

Application of stimulating-emeryency teaching combined combine with TBL in cervical spine injury fixed handling

Lei Wenxiong, Wu Gang

2013, 13(03):  260-261.  DOI: j.issn.1009-976X.2013.03.028

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【Abstract】With the attention of the sports injury,.fixed handling operation of cervical spine injury is becoming an important and essential emergency skill that the emergency physician have to master. Based on the fact that the traditional training method didn't show a satisfied effect on medical students, in order to improve the situation and meet the demand of training objective, a pattern of simulation emergency combined with Team-Based Learning (TBL) in teaching fixed handling operation for cervical spine injury brings a good teaching effect.

Cultivation of scientific research ability of clinical postgraduates with the concept of translational medicine

Peng Ningfu, Yang Yufeng, Liao Yingyang, Li Lequn

2013, 13(03):  262-264.  DOI: j.issn.1009-976X.2013.03.029

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【Abstract】Out of joint is rising between clinical practice and basic research within the current postgraduate educational system. Application of the concept of translational medicine to the postgraduate education will be beneficial to the formation of a novel training mode. Translational medicine is a two-way training system between basic research and clinical medicine..This article gives a discussion on the means of training postgraduates by optimization of teaching system,.clinical skill training,.basic scientific research training,.clinical problem extraction,.humanistic quality training,.and project application and participation to promote their transformation ability which benefit patients finally.