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Objective To analyze the predictive factors of fever after percutaneous renal stone surgery,and to provide reference for clinical treatment.Methods A total of 147 patients underwent percutaneous nephrolithotomy in after operation was chosen in the Department of Urology in our hospital from January 2014 to January 2016.According to the existence of fever,patients were divided into fever (n =25,heating rate 17.0％) and control (n =122) groups.Preoperative information were collected,including age,gender,preoperative serum creatinine,stone size and shape,the involvement of calyceal number,water,urine culture results,operative time,blood loss,intraoperative perfusion volume,pyonephrosis,puncture channel length,hospitalization time and other information including intraoperative,postoperative information including fever,and postoperative renal fistula complications if there is information.SPSS 18.0 was used for statistical analysis.Results The fever group stone surface area,CT value affected calyx number,stone shape,stone properties,the involvement of calyceal number,degree of hydronephrosis,operative time,intraoperative blood loss,intraoperative perfusion,hospitalization time,and renal fistula complication rates were higher than the control group (P ＜ 0.05).There were no significant differences between two groups (P ＞0.05).The results of Logistic regression analysis found that the stone surface area (OR =5.19),stone,stone shape (OR =7.86) properties (OR =3.87),operation time (OR =5.68),intraoperative perfusion (OR =5.24),and renal fistula complications (OR =2.65) for the influence factors of fever.Conclusions The stone surface area is large,stone nature infection stones,stone shape for staghorn calculi,longer operation time,and intraoperative perfusion of large renal fistula complications were more prone to postoperative fever in postoperative.
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Objective To investigate the correlation between human papilloma virus(HPV) 16/18 infection and the expression of Rb and p16 protein in bladder cancer tissue,and to analyze the relationship between HPV infection and the incidence of bladder cancer.Methods The expression of HPV16/18 E6 and E7 gene encoded protein,RB and p16 were detected by immunohistochemical method in 40 cases of bladder cancer and 40 cases of normal bladder tissues,and the correlation between them and pathological grading,stage of international union of cancer(UICC),whether recurrence or not after receiving surgery was analyzed.Results In bladder cancer tissues,HPV16/18 E6 and E7 gene encoded protein,RB and p16 positive rates were 65%,47.5%,42.5%,compared with the positive rate of normal bladder tissue samples(22.5%,92.5%,87.5%),the differences were statistically significant(P0.05).The expression of HPV16/18 E6 and E7 gene encoded protein and Rb,p16 protein were not significantly correlated(P>0.05),The expression of Rb and p16 protein were negatively correlated(P<0.05).Conclusion HPV 16/18 infection is related to the occurrence and development of bladder cancer,but its mechanism might not be related to the abnormal expression of Rb and p16 protein.
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<p><b>OBJECTIVE</b>To investigate the impact of preoperative oral liquid carbohydrate on postoperative insulin resistance (IR) in gastric cancer patients undergoing elective resection, and to examine the association of IR index (homeostasis model assessment, HOMA-IR) with tumor necrosis factor-α (TNF-α).</p><p><b>METHODS</b>Between January 2013 and September 2013, 35 patients undergoing elective resection for gastric cancer were prospectively enrolled and randomized into two groups. Patients in trial group (n=18) received oral 500 ml of 10% glucose solution two hours before surgery. Patients in control group (n=17) were asked to fast for 8-12 hours before operation. About 300 mg of rectus abdominis and subcutaneous fatty tissues was removed before the closure of abdominal wall. Blood samples were collected to measure the serum concentration of TNF-α with double antibody sandwich ELISA in perioperative period (3-hour before operation, end of operation, 1-day and 3-day after operation). HOMA-IR was calculated on preoperative 3-hour and postoperative 1-day. Western blotting was used to detect protein expression of TNF-α. Correlation of HOMA-IR with TNF-α was examined.</p><p><b>RESULTS</b>HOMA-IR on the first day after surgery was not different from that at 3-hour before surgery in trial group (P=0.090), which was significantly lower than that in control group (P=0.000). In trial group, serum TNF-α at the end of operation was higher than that at 3-hour before surgery, which declined rapidly on the first day after surgery and had no significant difference compared with that on the third day after surgery. In control group, serum TNF-α at the end of operation was also higher than that before surgery, which rose to the peak on the first day after surgery and was still higher than that at 3-hour before surgery. The TNF-α protein expression in muscle tissues of trial group was higher than that of control group (P=0.001), while no significant difference was observed between two groups in adipose tissues (P=0.987). Correlation analysis showed that HOMA-IR was positively correlated with TNF-α on the first day after surgery (r=0.832, P=0.000).</p><p><b>CONCLUSION</b>Oral intake of liquid carbohydrate 2 hours before surgery can reduce the level of TNF-α, which is likely to improve the postoperative insulin resistance.</p>
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Humans , Carbohydrates , Fasting , Insulin Resistance , Postoperative Period , Prospective Studies , Stomach Neoplasms , Tumor Necrosis Factor-alphaABSTRACT
Objective To investigate the effect of oral intake of 10%glucose solution before surgery on the perioperative safety and postoperative insulin resistance in patients undergoing resection for gastric cancer. Methods Between March 2012 and December 2012,36 patients undergoing elective resection for gastric cancer were enrolled and randomized into three groups. Patients in group A were given 500ml of 10%glucose solution for oral intake two hours before surgery. Patients in the group B were given distilled water instead of glucose. Patients in the group C were asked to fast for 8 hours before operation. Patient′s wellbeing scores on a visual analogue scales (VAS) were recorded. Blood samples were collected to measure. Homeostasis model assessment (HOMA) was applied to assess the status of insulin resistance (HOMA-IR) and insulin sensitivity index (ISI) according to the level of blood glucose and the serum concentration of insulin. The gastric residues before anesthesia and the time of exhaustion and defecation were also recorded. Results The gastric residues were not increased significantly after the intake of 10%glucose solution (P > 0.05). Intake of 10% glucose solution before surgery relieved thirst and hunger (P 0.05). The HOMA-IR levels postoperative immediately, on the first day and the third day after surgery were lower in group A than that of group B and group C (P < 0.05), but the ISI levels were higher significantly (P < 0.01). Conclusion Intake of 10%glucose solution 2 hours before surgery for gastric cancer is be safe , which can relieve preoperative thirst and hunger, and improve postoperative insulin resistance.
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Objective Summarize the clinical experience on the improved intramedullary nail therapy for the fraction of femurand tibia,to improve the skill. Methods The modified intramedullary nail has been used for frac-tion-cure on 64 cases of which 29 are femur fraction and 35 tibin fraction through the period. Results All the pa-tients were recovered within 4 months without any joint malfunction or syndromes. Conclusion The far-end aiming of the modified intrameduUary nail could maintain a 100 % precision, which out down the surgery operation time and reduce bleeding. Remain the advantage of previous intrarnedullary nail is beneficial to bone fraction concrescence and function recovery.
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Objective To investigate the operative indications and the therapeutic effect of the pedide screw fixation used for treating multiple fractures of the thoracolumbar spine. Methods 16 cases of multiple fractures of the thoracolumbar spine were chosen to be treated by open reduction through posterior approach and pedicle screw fixation. 10 cases were the fractures involved adjacent segments,4 cases were the fractures with one intact vertebral segment between them,2 cases were the fractures with two intact vertebral segments between them. Results The patients were followed up for 12～36 months,with an average of 21.5 months. After the operations,function of moat of the injured nerves had beeu improved or restored. The vertebral height of the fractured segment showed no signifi-cant loss. The materials of internal fixation found no loosening or fracturing at the end of follow-up. Conclusion Fractures of multi-segment of thoraeolumhar vertebrae can cause serious instability and are required for timely treat- ment. The method of the internal fixation with pedicle screw-rod fixation system through posterior approach, fol- lowed by limited decompression, can reconstruct the stability of the vertebrae and promote the recovery of the im- paired neurological functions.
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Objective The aim of this study was to demonstrate the effectiveness of the procedure for the prolapse and haemorrhoids in management of haemorrhodis.Methods Analyze the data of sixty-two consecutive patients with third or fourth degree hameorrhoids treated by the procedure for the prolapse and haemorrhoids.Results The median surgical time was 15 minutes,the median postoperative hospital stay was 2.3 days,median time to retum to normal activity was 6.8 days.Five patients need postoperative analgesic,on postoperative bleeding,eighteen patients had acute urinary retention.Fifty-six(90.32%) of the patinets had been followed up to 6 weeks,fifty patients were satisfied with the results of the procedure.Conclusion The procedure for the prolapse and haemorrhoids is a safe and effective treatment for severe haemorrhoids and with the advantages of shorter time of operation and inpatient stay,earlier return to normal activity.
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Objective To review the clinical experiences of Kugel herniorrhaphy.Methods Fifty-eight patients with sixty-two groin hernia were performed with Kugel patch.Results Mean operating time was 25min.The patients could walk in fifty hours and work in five days after operation,respectively.No recurrence or discomfort was found during a fellow-up of 1～36 months.Conclusions Kugel herniorrhaphy is a minimally invasive,tension-free,almost sutureless,and total inguinal repair.The leaning curve is about 10 Kugel herniorrhaphy.