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Objective To verify the feasibility of discriminating tissue types in the anterior approach of the cervical spine by the Electrical impedance (EI) and decrease the rate of severe complications.Methods Six New Zealand white rabbits and 6 mini-pigs were performed standard anterior cervical surgery.The esophagus,carotid artery,tracheal cartilage,annular ligaments of trachea,longus colli muscle and anterior longitudinal ligament are classified as the prevertebral group;The cortical bone,cancellous bone,anulus fibrosus and nucleus pulposus are classified as the vertebral group.Once all the tissues were exposed completely,over the frequency range of 200-3 000 kHz (the frequency points were 200 kHz,400 kHz,600 kHz,800 kHz,1 000 kHz,2 000 kHz,3 000 kHz),the in vivo EI of prevertebral group and vertebral group were measured by a probe and a precision inductance-capacitance-resistance (LCR) meter;then the data were analyzed with IBM SPSS Statistics 22 software.At every frequency,Kruskal-Wallis test followed by all pairwise multiple comparisons was applied for all the four groups (the prevertebral group of rabbits,the vertebral group of rabbits,the prevertebral group of mini-pigs,and the vertebral group of mini-pigs),respectively.P values ＜ 0.05 were considered statistically significant.Results At every frequency,the results of Kruskal-Wallis test for all the four groups were significant,and the results of multiple comparisons were as follows.(1) In both miniature experimental animals and large experimental animals,the EI of the vertebral group tissues was significantly different at every investigated frequency (multiple comparisons).(2) In the miniature experimental animals,the EI between longus colli muscle and esophagus,carotid artery and annular ligaments of trachea,and tracheal cartilage and anterior longitudinal ligament had no significant difference at any frequency (multiple comparisons);significant difference could not be detected in the EI between anterior longitudinal ligament and annular ligaments of trachea at the frequencies of 2000-3 000 kHz (multiple comparisonsk) and could be detected at the frequencies of 200-1 000 kHz (multiple comparisons);for comparison of all other paired tissues of prevertebral group there were significant differences at all frequencies (multiple comparisonsk).(3) In the large experimental animals,the EI between longus colli muscle and esophagus,carotid artery and annular ligaments of trachea,and tracheal cartilage and anterior longitudinal ligament had no significant difference at any frequency (multiple comparisons),the same was true for the EI between annular ligaments of trachea and esophagus,carotid artery and anterior longitudinal ligament,and longus colli muscle and annular ligaments of trachea at the frequencies of 800-3 000 kHz,3 000 kHz and 3 000 kHz (multiple comparisons),respectively;for comparison of all other paired tissues of prevertebral group there were significant differences at all frequencies (multiple comparisons).Conclusion At certain frequencies,the EI among tissues was significantly different and could discriminate tissues in the anterior approach of the cervical spine.
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Objective To evaluate the safety and feasibility of retroperitoneal laparoscopic adrenalectomy for different diameter adrenal tumor.Methods The clinical dam of 61 patients who underwent retroperitoneal laparoscopic adrenalectomy from January 2009 to June 2013 were retrospectively analyzed,the patients were divided into A group (the diameter of adrenal tumor ＞ 6 cm,24 cases) and B group (the diameter of adrenal tumor 3-6 cm,37 cases) according to the diameter of adrenal tumor.The therapeutic effect was compared between 2 groups.Results All procedures were performed successfully.There were statistical differences in operative time and estimated blood loss between A group and B group [(138 ± 66) min vs.(106 ± 45) min and (324 ± 168) ml vs.(165 ± 50) ml] (P ＜ 0.05).There were no statistical differences in the rate of complication and blood transfusion between 2 groups (P ＞ 0.05).There was no statistical difference in hospital stay after operation between 2 groups [(6.7 ± 1.2) d vs.(5.4 ± 0.6)d] (P ＞ 0.05).A group was followed up for (22 ± 10) months,during which time no local recurrence was noted in 19 cases by B-mode ultrasonography,3 cases were missed,and 2 cases were alive with hydronephrosis or pancreatic cyst.B group was followed up for (24 ± 11) months,during which time no local recurrence was noted in 32 cases by B-mode ultrasonography,4 cases were missed,and 1 case was found with renal dysfunction.The pathology of most tumors in A group included medullary lipoma,pheochromocytoma and ganglioneuroma,in B group included adenoma,pheochromocytoma and medullary lipoma.Conclusion Minimally invasive and safe procedure for skillful surgeons in the treatment of tumor diameter larger than 6 cm.
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Objective To investigate the effect of secondary transurethral electrocision for recurrent superficial bladder cancer.Methods One hundred and twenty patients with recurrent superficial bladder cancer were divided into experiment group and control group by random mechanical sampling method with 60 cases of each.Experiment group underwent secondary transurethral electrocision at 4 weeks after initial transurethral electrocision and received mitomycin bladder perfusion chemotherapy,control group patients underwent initial transurethral electrocision and received mitomycin bladder perfusion chemotherapy.The two groups' follow-up cystoscopy at 3-month intervals,the follow-up time was 6-34 (18.6 ± 6.5) months,the recurrence was compared between each other.Results Within the follow-up period,the recurrence rate in experiment group was significantly lower than that in control group [21.7％(13/60) vs.63.3％(38/60),P＜0.01].Of all the recurrent patients,high grade rumor (G2 and G3 grade) was mainly,the recurrence rate of high grade tumor in experiment group was significantly lower than that in control group [26.2％ (11/42) vs.70.0％(35/50),P ＜ 0.01].Conclusions Secondary transurethral electrocision can reduce the recurrence rate of superficial bladder cancer (especially for the high grade tumor),it can exactly make the classification of malignant tumors and find residual tumor.So it is valuable in the clinical treatment.
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OBJECTIVE: To probe into the drug resistance of gram negative bacilli in patients with lower respiratory infection and to analyze the application of antibacterials in the department of respiratory disease.METHODS: Routine drug susceptibility test was conducted by K-B disk agar diffusion method,and the DDDs and consumption sum of the antibacterials were analyzed as well.RESULTS: Pseudomonas aeruginosa which was susceptible to Meropenem took the lead with 22.1% among all the gram negative bacilli in patients with lower respiratory infection,followed by E.coli(20.7%) and Klebsiella(15.1%).Quinolone and third generation cephalosporins took the lead on the DDDs list in the treatment of gram negative bacilli in patients with lower respiratory infection.CONCLUSION: Hospital should intensify the monitoring of gram negative bacilli in patients with lower respiratory infection and analyzing of the application of antibacterials so as to guide clinicians for a rational use of antibacterials.
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Objective To study the expression of Survivin and the relationship with proliferative activity in pancreatic carcinoma(PC).Methods The expression of SurvivinmRNA was investigated by reverse(transcriptase) polymerase chain reaction(RT-PCR) in 62 cases of PC samples,12 cases of chronic(pancreatitis)(CP) samples,and 10 cases of normal pancreatic tissue samples.Meanwhile,the expression of proliferative cell nuclear antigen(PCNA) was detected by immunohistochemical assay.Results The(expression) of Survivin gene was detected in a significantly greater proportion in PC(74.2%) than CP(0/12) and normal pancreatic tissue(0/10)(P
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Objective To introduce a new extracapsular approach for thyroidectomy in patients with surgical thyroid disease. Method Clinical data of 104 cases undergoing this procedure were retrospectively analyzed. Results From May 1990 to May 2000, 104 patients underwent either total or subtotal thyroidectomy by extracapsular approach. One patient suffered from postoperative temporary recurrent laryngeal nerve palsy. No morbidity such as postoperative thyroid crisis, hemorrhage leading to airway compression, permanent hypoparathyroidism nor mortality developed. Conclusion The total extracapsular approach for thyroidectomy is safe, less of complication and effective.