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Objective To investigate the difference in the clinical efficacy by thoracoscopy or thoracotomy for treating esophageal atresia.Methods Thirty-one cases of type-Ⅲ esophageal atresia undergoing surgical treatment from February 2015 to May 2018 at the Department of Pediatric Surgery of Fujian Provincial Maternity and Children's Hospital were included,and according to the different surgical methods they were divided into thoracoscopic group (15 cases) and thoracotomy group (16 cases).The operation duration,blood loss,postoperative chest drainage time,postoperative hospital stay and postoperative complications were analyzed between 2 groups.Results The mean time of operation was (181.33 ± 13.86) min in the thoracoscopic surgery group and (139.06 ± 10.98) min in the thoracotomy group,the thoracoscopie group had longer operation duration than thoracotomy group,and there was a significant difference in operation duration between two groups (t =9.44,P =0.000);mean blood loss was (3.07 ± 0.96) mL in the thoracoscopic surgery group and (5.06 ± 1.12) mL in the thoracotomy group,the thoracoscopic group had less amount of blood loss than thoracotomy group,and there was a significant difference in blood loss between two groups(t =-5.29,P =0.000);mean postoperative chest drainage time was (11.67 ± 1.34) d in the thoracoscopic group and (12.25 ± 1.06) d in the thoracotomy group,and there was no significant difference in postoperative chest drainage time between two groups (t =-1.34,P =0.19);mean time of postoperative hospitalization time was (15.20 ± 0.94) d in the thoracoscopic group and (16.00 ±0.96) d in the thoracotomy group,and there was a significant difference in the postoperative hospitalization time between two groups (t =-2.33,P =0.027);the anastomotic leak rates were 33.33％ (5 cases) versus 25.00％ (4 cases) with closed or open approaches,respectively;anastomotic stricture rates were 40.00％ (6 cases) versus 31.25％ (5 cases) with closed or open approaches,respectively.There was no significant difference in postoperative incidence of anastomotic fistula and anastomotic stenosis between two groups.Conclusions Compared with thoracotomy in the treatment of esophageal atresia,thoracoscopic approach has smaller incision and less bleeding,less chest deformity,short hospital stay postoperatively,so it is safe and effective.However,the surgeon must have experience in doing thoracoscopie operation.
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Objective To retrospectively analyze the differential diagnosis and treatment strategy of neonatal intestinal perforation caused by neonatal necrotizing enterocolitis (NEC) and Hirschsprung's disease (HD).Methods The clinical data of 42 cases with NEC and 22 cases with HD combined with intestinal perforation from January 2012 to January 2017 admitted at Fujian Provincial Maternity and Children's Hospital were collected,the proportion of premature infants,and the proportion of low birth weight infants,age of onset,preoperative clinical symptoms and surgical treatment was compared between the two groups.Results The proportion of premature infants[95.23％ (40/ 42 cases) vs.27.27％ (6/22 cases)],the proportion of low birth weight infant [90.48％ (38/42 cases) vs.45.45％ (10/22 cases)] and the age of onset [(14.48 ± 10.51) d vs.(3.18 ± 3.43) d] were statistically different between the NEC group and the HD group,and the differences were statistically significant(all P ＜ 0.05).There were significant differences in the presence of normal defecation before the operation [71.4％ (30/42 cases) vs.27.3％ (6/22 cases)],and in the the defecation characteristics at the onset[95.2％ (40/42 cases)vs.9.1％ (2/22 cases)] between the NEC group and HD group(all P ＜ 0.05).Among 42 cases of NEC patients,8 cases underwent intestinal anastomosis,and 34 cases underwent enterostomy because of the high risk of anastomosis.All of 22 patients with HD underwent double-lumen enterostomy.Conclusions The general conditions,preoperative manifestations and intraoperative findings of the children should be comprehensively analyzed for identification.Enterostomy is recommended for NEC intestinal perforation,but if the risk of anastomosis is high,then fistula should be performed.Double-lumen fistula should be recommended for HD intestinal perforation,and enterostomy should be recommended if the two cannot be clearly distinguished.
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Objective@#To investigate the difference in the clinical efficacy by thoracoscopy or thoracotomy for treating esophageal atresia.@*Methods@#Thirty-one cases of type-Ⅲ esophageal atresia undergoing surgical treatment from February 2015 to May 2018 at the Department of Pediatric Surgery of Fujian Provincial Maternity and Children′s Hospital were included, and according to the different surgical methods they were divided into thoracoscopic group (15 cases) and thoracotomy group (16 cases). The operation duration, blood loss, postoperative chest drainage time, posto-perative hospital stay and postoperative complications were analyzed between 2 groups.@*Results@#The mean time of operation was (181.33±13.86) min in the thoracoscopic surgery group and (139.06±10.98) min in the thoracotomy group, the thoracoscopic group had longer operation duration than thoracotomy group, and there was a significant difference in operation duration between two groups (t=9.44, P=0.000); mean blood loss was (3.07±0.96) mL in the thoracoscopic surgery group and (5.06±1.12) mL in the thoracotomy group, the thoracoscopic group had less amount of blood loss than thoracotomy group, and there was a significant difference in blood loss between two groups(t=-5.29, P=0.000); mean postoperative chest drainage time was(11.67±1.34) d in the thoracoscopic group and (12.25±1.06) d in the thoracotomy group, and there was no significant difference in postoperative chest drainage time between two groups(t=-1.34, P=0.19); mean time of postoperative hospitalization time was(15.20±0.94) d in the thoracoscopic group and (16.00±0.96) d in the thoracotomy group, and there was a significant difference in the postoperative hospitalization time between two groups (t=-2.33, P=0.027); the anastomotic leak rates were 33.33% (5 cases) versus 25.00% (4 cases) with closed or open approaches, respectively; anastomotic stricture rates were 40.00%(6 cases) versus 31.25% (5 cases) with closed or open approaches, respectively.There was no significant difference in postoperative incidence of anastomotic fistula and anastomotic stenosis between two groups.@*Conclusions@#Compared with thoracotomy in the treatment of esophageal atresia, thoracoscopic approach has smaller incision and less bleeding, less chest deformity, short hospital stay postoperatively, so it is safe and effective.However, the surgeon must have experience in doing thoracoscopic operation.
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Objective@#To retrospectively analyze the differential diagnosis and treatment strategy of neonatal intestinal perforation caused by neonatal necrotizing enterocolitis (NEC) and Hirschsprung′s disease (HD).@*Methods@#The clinical data of 42 cases with NEC and 22 cases with HD combined with intestinal perforation from Ja-nuary 2012 to January 2017 admitted at Fujian Provincial Maternity and Children′s Hospital were collected, the proportion of premature infants, and the proportion of low birth weight infants, age of onset, preoperative clinical symptoms and surgical treatment was compared between the two groups.@*Results@#The proportion of premature infants[95.23%(40/42 cases) vs.27.27%(6/22 cases)], the proportion of low birth weight infant[90.48%(38/42 cases) vs.45.45%(10/22 cases)]and the age of onset [(14.48± 10.51) d vs.(3.18±3.43) d]were statistically different between the NEC group and the HD group, and the differences were statistically significant(all P<0.05). There were significant differences in the presence of normal defecation before the operation[71.4% (30/42 cases)vs.27.3%(6/22 cases)], and in the the defecation characteristics at the onset[95.2% (40/42 cases)vs.9.1%(2/22 cases)]between the NEC group and HD group(all P<0.05). Among 42 cases of NEC patients, 8 cases underwent intestinal anastomosis, and 34 cases underwent enterostomy because of the high risk of anastomosis.All of 22 patients with HD underwent double-lumen enterostomy.@*Conclusions@#The general conditions, preoperative manifestations and intraoperative fin-dings of the children should be comprehensively analyzed for identification.Enterostomy is recommended for NEC intestinal perforation, but if the risk of anastomosis is high, then fistula should be performed.Double-lumen fistula should be recommended for HD intestinal perforation, and enterostomy should be recommended if the two cannot be clearly distinguished.
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Caenorhabditis elegans is a very important model organism in life sciences. C. elegans has been widely used in research on life sciences, especially in drug screening and the mechanism of drugs, thanks to some of their prominent characteristics, including a short life,short generation cycle, and easy culture and observation. Aging is a complex process, which is the result of multiple factors. There are mainly three types of anti-aging signal pathways in C. elegans, including insulin-insulin-like growth factor-1 signal pathway, diet-restricted signaling pathway and mitochondrial respiratory chain/ATP synthesis pathway. In this paper, we reviewed the aging models based on the above three signaling pathways and the progress in anti-aging drugs based on the above aging models. In addition, a number of C. elegans models of aging-related neurodegenerative diseases can be obtained by using transgenic or chemical mutagenesis. Thus, this paper reviewed the transgenic models of C. elegans associated with neurodegenerative diseases, including theα-synuclein transgenic model of Parkinson disease, theβ-amyloid deposition model of Alzheimer disease, and the polyQ of Huntington disease, and summa?rized the effective drugs based on the above disease models. This review will provide reference for the study of C. elegans in the future screening of anti-aging drugs and drug screening for the prevention and treatment of neurodegenerative diseases.
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Objective To investigate the relationship between metabolic syndrome (MS) and early recurrence of benign prostatic hyperplasia (BPH) after prostatectomy in the elderly.Methods A total of 152 men aged 65 to 88 years with prostatectomy for more than 5 years were enrolled from August 2008 to March 2013.Blood pressure,body weight,body height,body mass index (BMI) and international prostate symptom score (IPSS) were detected.Levels of fasting blood glucose (FBG),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),prostate specific antigen (PSA) and maximum urinary flow rate (Qmax) were determined.The correlation of MS-related parameters with prostate volume,IPSS and Qmax were evaluated.Results BPH recurrence rate was significantly higher in patients with MS than without MS (11/26 vs.27/126,x2=12.76,P＜0.001).PSA level,prostate volume and IPSS were significantly higher or larger in the MS group than in the non-MS group [(1.96±0.82)μg/L vs.(1.81±0.90)μg/L,(28.26±5.50) ml vs.(22.38±4.00)ml,(11.12±3.18)vs.(7.11±2.37),F=28.654,44.41,38.56,respectively,P＜0.001],while Qmax value was significantly lower in the MS group than in the non-MS group [(14.77±5.29) ml/s vs.(19.80±4.70) ml/s,F=59.48,P＜0.001].The liner regression analysis showed that in postprostatectomy recurrence group,PV and IPSS had significantly positive correlations with levels of FBG and TG,and BMI (P＜0.05),and had significantly positive correlations with BMI and FBG in non-recurrence group (P＜0.05),while Qmax had a significantly negative correlation with BMI,systolic blood pressure and FBG in the two groups (P＜0.05).Conclusions There is a significant relationship between MS and higher BPH recurrence in elderly patients.
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Bronchiolitis obliterans (BO) designates a clinical syndrome of chronic airflow obstruction associated with inflammatory changes in the small airways.The presentation of pediatric patients is persistent cough,wheezing and activity intolerance after severe respiratory tract infection.The reasons are as follows:severe respiratory tract infection,heart-lung transplantation,bone marrow transplantation,Stevens-Johnson Syndrome,connective tissue disease,inhalation or ingestion of toxic substances,drug factors and so on.The diagnosis of bronchiolitis obliterans is mainly based on the clinical manifestations,high-resolution CT and pulmonary function test,lung biopsy is the golden standard for diagnosis.The early stage is the key period of clinical treatment,most take the continued use of corticosteroids and bronchodilators,combining with other support treatment.This article reviews the etiology,pathogenesis,pathology,clinical manifestations,laboratory examinations,diagnosis,differential diagnosis and treatment of bronchiolitis obliterans in children.