Effects of Suspension Exercise Therapy Combined with Soft Tissue Manipulation on Upper Limb Sensory Function in Patients with Radicular Cervical Spondylosis / 医用生物力学

bjective To observe the changes of upper extremity sensory function in patients with radicular cervical spondylosis and evaluate the treatment effect, by using the method of suspension exercise therapy (SET) and soft tissue manipulation. Methods A total of 72 patients with cervical spondylosis were divided into observation group (treated by SET combined with manipulation)and control group (treated by purely cervical traction) by simple random method. Both groups received 4-week continuous treatment for 6 times per week. The somatosensory evoked potential(SEP), current perception threshold (CPT) before and after the treatment in two groups were separatedly tested, and changes in visual analogue scale (VAS) pain scores of the affected limbs were examined, so as to determine the effective rate of treatment. Results After treatment, the latency of SEP was shortened mainly in brachial plexus potential N9 and cervical spinal potential N13 in two groups (P<0.05). The CPT levels and the VAS pain scores of the affected limbs were reduced in two groups (P<0.01), and the treatment effect in observation group was better that in control group (P<0.01)．Conclusion SET combined with soft tissue manipulation can effectively promote the repair of nerve sense function of cervical spondylotic radiculopathy.

Castor single-branch stent in treating Stanford type B aortic dissection with insufficient anchorage zone / 中华普通外科杂志

Objective:To evaluate Castor single-branch covered-stent in the treatment of Stanford B aortic dissection(TBAD)with insufficient anchorage zone.Methods:Clinical data of 25 TBAD patients (proximal healthy landing zone ≤15 mm) treated with Castor branched stent-graft at Weifang People's Hospital from Apr 2019 to Sep 2021 were analyzed retrospectively.The stent model was selected according to preoperative CTA examination and intraoperative angiography,the operation result and follow up data were reviewed.Results:The operation success rate was 100%,the mean operative time was (137.8±35.8)min, and the mean blood loss was (52.8±24.5)ml. There were 2 cases of internal leakage (IA) and it was disappeared after balloon dilation, Branched stent stenosis occurred in 2 cases and relieved by balloon dilatation. The mean follow-up time was 14.6 months, and the patency rate of branch stent was 100% during the follow-up period. The true lumen diameter of thoracic aorta was significantly expanded and the false lumen diameter was significantly reduced 3 months after surgery compared with that before surgery ( P<0.05). Conclusion:Castor stenting in the treatment of TBAD with insufficient proximal anchoring area is simple and feasible, with satisfactory short term clinical effect.

Diagnosis and treatment of insulinoma in 16 cases / 重庆医学

Objective To analyze and investigate the diagnosis method and treatment measures of insulinoma.Methods The clinical data in 16 cases of insulinoma in the hepatobiliary surgery of our institute from Dec.2008 to Dec.2015 were retrospectively analyzed.Results All cases had typical Whipple′s triad,the biochemical examination suggested that all cases had plasma glucose decrease and plasma insulin increase during the onset period.The imaging examinations included preoperative ultrasonography,enhanced CT,MRI,EUS and intraoperative ultrasound (IOUS).Their diagnosis positive rates were 56.3% (9/16),77.8% (7/9),80.0% (8/10),100.0%(2/2) and 100.0%(5/5) respectively.Sixteen cases all received surgical treatment,including local tumor excision in 6 cases,simple distal pancreatectomy in 3 cases,distal pancreatectomy plus splenectomy in 5 cases and pancreaticoduodenectomy(PD) in 2 cases.Plasma glucose level in all cases was significantly increased after tumor removal.Postoperative follow-up lasted for 1-5 years without recurrence and metastasis.Conclusion The first choice of insulinoma localization diagnosis is CT and MRI,intraoperative palpation combined with IOUS is the main method of intraoperative localization,and the surgical resection is the only effective method for treating this disease.

Risk factors for acute liver failure after radical surgery combined with hemihepatectomy for hilar cholangiocarcinoma / 临床肝胆病杂志

ObjectiveTo investigate the high-risk factors for acute liver failure after radical surgery combined with hemihepatectomy for hilar cholangiocarcinoma (HC). MethodsA retrospective analysis was performed for the clinical data of 126 patients who were admitted to Chongqing Cancer Institute and underwent radical surgery combined with hemihepatectomy for HC from January 2000 to December 2014, including sex, age, preoperative serum levels of total bilirubin (TBil) and albumin (Alb), preservation of hepatic artery blood supply or not, application of nonselective hepatic vascular occlusion or not, intraoperative blood loss volume, and time of operation. The chi-square test was used for comparison of categorical data between groups, and multivariate logistic regression analysis was performed to determine independent risk factors for acute liver failure after surgery. ResultsA total of 17 patients (13.49%) experienced acute liver failure, and 11 patients(873%) died. A preoperative serum TBil level of ＞200 μmol/L(OR=178,95%CI:105-304,P=0029), an intraoperative blood loss volume of ＞800 ml(OR=264,95%CI:133-395,P=0003), no preservation of hepatic artery blood supply（OR=357，95%CI：221-509，P=0002）, and application of nonselective hepatic vascular occlusion(OR=136,95%CI:079-178,P=0037) were independent risk factors for acute liver failure after surgery. ConclusionPreoperative biliary drainage, a reduced intraoperative blood loss volume, preservation of hepatic artery blood supply, and avoiding nonselective hepatic vascular occlusion have great significance in reducing acute liver failure after radical surgery combined with hemihepatectomy for HC.

Ultrasound guided popliteal vein catheter thrombolysis for acute lower extremity deep venous thrombosis / 中华普通外科杂志

Objective To evaluate the feasibility and efficacy of ultrasound-guided popliteal vein catheter thrombolysis for acute deep venous thrombosis of the lower extremity.Methods Clinical data were retrospectively analyzed on 120 patients of unilateral acute lower extremity deep vein thrombosis from April 2010 to April 2013.60 cases were included in systemic thrombolytic group; 60 cases into catheter directed thrombolysis group.Thrombolysis rate and limb swelling reduction rate were calculated and compared between the two groups.Results Due to limb swelling rate,in systemic thrombolysis group:Thigh swelling reduction rate was (77 ± 9) ％ ; Leg swelling reduction rate was (70 ± 11) ％,while in catheter directed thrombolys group,that was (87 ± 5) ％,and (80 ± 9) ％,respectively (P ＜ 0.05).The thrombolysis rate in systemic group was (59 ± 14)％,that was (71 ± 13)％ in catheter directed thrombolysis group (P ＜ 0.05).Conclusions Ultrasound guided precutaneous catheter popliteal vein thrombolysis significantly improves the short-term outcome of deep venous thrombosis in terms of leg swelling reduction rate and thrombolysis reduction rate.

Clinical effect of preoperative visualization technique-guided pedicle screw fixation on multi-segmental lumbar fracture and dislocation / 实用医学杂志

Objective To analyze the clinical effect of pedicle screw fixation in the treatment of multi-segmental lumbar fracture and dislocation under the guidance of visualization technique. Methods A total of 21 patients with multi-segmental lumbar fracture and dislocation were selected from November 2012 to November 2013. Before the screw implantation, the structure of bilateral pedicle was observed through Mimics software and the implantation parameters were measured. The position of pedicle screws by postoperative CT scan, operation time, and the satisfaction of the patients were assessed. The percentages of anterior vertebral height and Cobb′s angle were measured before operation, 2 weeks and 8 months after operation. Results All patients were satisfied with informed consent score and the way of pedicle screw and the selection of plant were more reasonable. With better screw position, shorter operative time and less blood loss and adverse reactions, pedicle screw fixation achieved good effect. Conclusion With high security and considerable clinical value, pedicle screw fixation in the treatment of multi-segmental lumbar fracture and dislocation under the guidance of visualization technique has exact and good effecct.

Ehlers-Danlos syndrome: case and pedigree report and review / 中华预防医学杂志

<p><b>OBJECTIVE</b>To report a case and a firstly described pedigree with Ehlers-Danlos syndrome in China.</p><p><b>METHODS</b>Clinical materials of a case of Ehlers-Danlos syndrome type IV and a pedigree of 6 members with 4 generations were analyzed. Dilated internal jugular vein in the proband was removed operatively. The diagnosis, surgical treatment, and postoperative complications were retrospectively summarized. Etiology, clinical characteristics and classification of Ehlers-Danlos syndrome were also analysed.</p><p><b>RESULTS</b>Vessels of the proband in the pedigree were crisp and easily lacinated during the precedure for removal of his internal jugular vein. Repeat postoperative hemotomas were found though complete stanching was made during operation. The patient successfully recovered after prompt debridement in operative theatre and needle sucking. The other 5 members of the pedigrees all had the triads of Ehlers-Danlos syndrome, but no combined vascular diseases were found in them.</p><p><b>CONCLUSIONS</b>Though the morbidity rate was extremely low, green attention should be paid to the high mortality rate and complication of Ehlers-Danlos syndrome during surgical management of in patients with Ehlers-Danlos syndrome type IV. Surgeons should be aware of the ponderance of its complications and combined diseases to avoid fatal intraoprative vascular lacination and incontrollable hamorrhage.</p>

Reoperative complications in patients with benign thyroid disease / 中国普通外科杂志

Objective To evaluate the complication rate of secondary surgery in patients with benign thyroid disease. Methods From June 1992 to June 2003, 65 patients underwent reoperation. Operative procedures. pathology and complications were reviewed. Results The first surgery was unilateral in 27 cases (41.5%), bilateral in 38 (58.5%). Reoperation identified carcinoma in 8 cases with complications developed in 8 cases and left over permanent in 1 case (1.5%). Conclusion The complication rate of second operation is higher than that of first thyroid surgery, but still acceptable.