Perioperative management and operative treatment of malignant tumor of anal canal merging severe abdominal protuberance / 中华胃肠外科杂志

Objective: To report the perioperative management and robot-assisted minimally invasive surgery results of one case with malignant tumor of anal canal combined with severe abdominal distention. Methods: A 66-year-old male suffer from adenocarcinoma of anal canal (T3N0M0) with megacolon, megabladder and scoliosis. The extreme distention of the colon and bladder result in severe abdominal distention. The left diaphragm moved up markedly and the heart was moved to the right side of the thoracic cavity. Moreover, there was also anal stenosis with incomplete intestinal obstruction. Preoperative preparation: fluid diet, intravenous nutrition and repeated enema to void feces and gas in the large intestine 1 week before operation. Foley catheter was placed three days before surgery and irrigated with saline. After relief of abdominal distention, robotic-assisted abdominoperineal resection+ subtotal colectomy+colostomy was performed. Results: Water intake within 6 hours post-operatively; ambulance on Day 1; anal passage of gas on Day 2; semi-fluid diet on Day 3; safely discharged on Day 6. Conclusion: Robotic-assisted minimally invasive surgery is safe and feasible for patients with malignant tumor of anal canal combined with severe abdominal distention after appropriate and effective preoperative preparation to relieve abdominal distention.

Evaluation of the Sensitivity and Specificity of the New Clinical Diagnostic and Classification Criteria for Kashin-Beck Disease, an Endemic Osteoarthritis, in China / 生物医学与环境科学（英文）

This study aimed to evaluate the sensitivity and specificity of the new clinical diagnostic and classification criteria for Kashin-Beck disease (KBD) using six clinical markers: flexion of the distal part of fingers, deformed fingers, enlarged finger joints, shortened fingers, squat down, and dwarfism. One-third of the total population in Linyou County was sampled by stratified random sampling. The survey included baseline characteristics and clinical diagnoses, and the sensitivity and specificity of the new criteria was evaluated. We identified 3,459 KBD patients, of which 69 had early stage KBD, 1,952 had stage I, 1,132 had stage II, and 306 had stage III. A screening test classified enlarged finger joints as stage I KBD, with a sensitivity and specificity of 0.978 and 0.045, respectively. Shortened fingers were classified as stage II KBD, with a sensitivity and specificity of 0.969 and 0.844, respectively, and dwarfism was classified as stage III KBD with a sensitivity and specificity of 0.951 and 0.992, respectively. Serial screening test revealed that the new clinical classification of KBD classified stages I, II, and III KBD with sensitivities of 0.949, 0.945, and 0.925 and specificities of 0.967, 0.970, and 0.993, respectively. The screening tests revealed that enlarged finger joints, shortened fingers, and dwarfism were appropriate markers for the clinical diagnosis and classification of KBD with high sensitivity and specificity.

Epidemiological characters of Kashin-Beck disease in nuclear families / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the epidemiological characters of Kashin-Beck disease (KBD) in nuclear families, and to probe the pathogenetic mechanism and its etiology.</p><p><b>METHODS</b>Clinical diagnosis was used to identify nuclear families in KBD areas. Based on the clinical manifestation of parents in the nuclear families, 4938 nuclear families were divided into four types. According to the seriousness in KBD areas, prevalence of offspring and family aggregation in low, middle and high prevalence areas were formed and data was analyzed.</p><p><b>RESULTS</b>(1) Type of nuclear family was associated to the degree of disease seriousness in the areas. (2) There was an aggregation of disease among the offsprings in the nuclear families of medium and high prevalence diseased areas. (3) There was an aggregation of offspring in the nuclear family of both parents or father alone who were suffered from KBD. (4) The prevalence of offspring in nuclear family of both parents with KBD was obviously higher than that in the nuclear family with single parent or neither having KBD.</p><p><b>CONCLUSION</b>The degree of diseased areas seemed to influence the seriousness of KBD in individuals. The prevalence of parents in nuclear families might play a role in the pathogenesis of KBD.</p>