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Objective:To investigate the feasibility and safety of single-position robotic assisted laparoscopic anterograde bilateral inguinal lymphadenectomy for penile cancer.Methods:The clinical data of 6 patients with penile cancer admitted to our hospital from January 2019 to January 2020 were retrospectively analyzed. The mean age was (52.0±8.6)years old. The pathology was primary focal squamous cell carcinoma, with 2 cases of high differentiation, and 4 cases of medium differentiation. All the 6 patients underwent single-position robotic assisted laparoscopic anterograde bilateral inguinal lymphadenectomy. Preoperative physical and imaging examinations indicated bilateral inguinal lymph node enlargement, and no distant metastasis was found in all of the 6 patients. The supine position was taken, with the head low and feet high about 15°, the legs straight and separated as far as possible in the shape of "Chinese eight" . The da Vinci robotic patient cart was placed between legs of the patient, after inserting the trocars. The external boundary of bilateral inguinal lymph node dissection was the line between the anterior superior iliac spine and 20 cm lower, the inner boundary was the pubic tubercle and its 15cm medial lower measurement, and the line between the inner boundary and the external lower edge was the lower boundary.Results:All the 6 operations were successfully completed without transfer to open surgery. Both sides of the inguinal lymph nodes were dissected at the same time. The space establishment and trocar insertion were performed simultaneously. There was no need for mobile robotic arm system during the operation. The average operative time was (105.0±20.5) min, and the amount of intraoperative blood loss was less than 50ml, the average hospital stay was(7±3) days. An average of(15.0±2.5) lymph nodes were dissected on each side. Intraoperative freezing suggested single positive lymph nodein 2 patients and no positive lymph node in 4 patients. There was no skin necrosis, 1 case of delayed wound healing, and 2 cases of lymphatic leakage. All patients were cured by conservative treatment. The 6 patients were followed up for 12-14 months, and there was no recurrence or metastasis.Conclusions:Single-position robotic assisted laparoscopic anterograde bilateral inguinal lymphadenectomy can achieve the expected surgical outcome, and has fewer perioperative complications. The surgery is safe and effective.
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Objective To evaluate the clinical efficacy and safety of dual shockwave lithotripter in treating urinary calculi.Methods Data of 371 cases treated with Direx-Magna dual shockwave lithotripter was retrospectively collected from July 2016 to June 2017,including 263 male and 108 female.Their age ranged from 15 to 66 years old (mean 36.5 ± 11.0).There was 117 patients with kidney stone,183 patients with upper ureteral and 71 patients with middle or lower stone.The average diameter of stones was (11.3 ± 1.5)mm (ranging 6.9-16.3 mm).The lithotripter was set at 60 times/min/head.Comparative analysis was made between 106 cases in dual mode and 265 cases in single mode.Comparative items included shock frequency,treating time,treating energy,pain scale,stone clear successive rate and complication.Patients were followed by KUB or NCCT at 1 and 2 weeks after the procedure.Stone clear successfully was defined as stone free or with fragment ＜4 mm.Results The overall success rate was 87.3％ (324/371).Among the patients who failed in first session,21 cases were successful with a second session,7 cases were treated with retrograde intrarenal surgery.There were 19 cases lost.Clavien grade Ⅲ complication rate was 0.8％ and no server grade complications.The average treating time was (25.2 ± 8.4) minutes and the average shock was (1419 ±440)times.The dual shockwave subgroup achieved higher success rate [93.4％ (99/106) vs.84.9％ (225/265),P ＜ 0.05] with less treating time [(15.7 ± 3.8) min vs.(29.0 ± 6.5) min],lower energy [(8.9 ± 2.0) kV vs.(10.7 ± 2.8) kV] and fewer shocks (833 ± 149 vs.1 654 ± 261),compared with that of the single shockwave subgroup (P ＜ 0.01).Also,pain scales and other complications were less than those of single shockwave subgroup (P ＜ 0.01).Conclusions Our study shows the new dual shockwave lithotripsy is safe and effective in both dual and single shock wave mode.Dual mode has higher success rate and fewer complications.
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Objective To evaluate the clinical efficacy and safety of dual shockwave lithotripter in treating urinary calculi.Methods Data of 371 cases treated with Direx-Magna dual shockwave lithotripter was retrospectively collected from July 2016 to June 2017,including 263 male and 108 female.Their age ranged from 15 to 66 years old (mean 36.5 ± 11.0).There was 117 patients with kidney stone,183 patients with upper ureteral and 71 patients with middle or lower stone.The average diameter of stones was (11.3 ± 1.5)mm (ranging 6.9-16.3 mm).The lithotripter was set at 60 times/min/head.Comparative analysis was made between 106 cases in dual mode and 265 cases in single mode.Comparative items included shock frequency,treating time,treating energy,pain scale,stone clear successive rate and complication.Patients were followed by KUB or NCCT at 1 and 2 weeks after the procedure.Stone clear successfully was defined as stone free or with fragment ＜4 mm.Results The overall success rate was 87.3％ (324/371).Among the patients who failed in first session,21 cases were successful with a second session,7 cases were treated with retrograde intrarenal surgery.There were 19 cases lost.Clavien grade Ⅲ complication rate was 0.8％ and no server grade complications.The average treating time was (25.2 ± 8.4) minutes and the average shock was (1419 ±440)times.The dual shockwave subgroup achieved higher success rate [93.4％ (99/106) vs.84.9％ (225/265),P ＜ 0.05] with less treating time [(15.7 ± 3.8) min vs.(29.0 ± 6.5) min],lower energy [(8.9 ± 2.0) kV vs.(10.7 ± 2.8) kV] and fewer shocks (833 ± 149 vs.1 654 ± 261),compared with that of the single shockwave subgroup (P ＜ 0.01).Also,pain scales and other complications were less than those of single shockwave subgroup (P ＜ 0.01).Conclusions Our study shows the new dual shockwave lithotripsy is safe and effective in both dual and single shock wave mode.Dual mode has higher success rate and fewer complications.
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Objective To evaluate the diagnostic value and safety of domestic electromagnetic navigation bronchoscopy (ENB) guided transbronchial lung biopsy (TBLB) for peripheral pulmonary lesions.Methods Sixty-four patients with peripheral pulmonary lesions shown by thoracic CT in Zhongshan Hospital,Fudan University between Jul.and Dec.,2014 were collected.The patients were randomly assigned to test group (underwent ENB in combination with X-ray guided TBLB) and control group (underwent X-ray guided TBLB).The final diagnosis was confirmed by pathologic examination of surgically removed lesions or by 24 months clinical follow-up.The operative time as well as the intraoperative and postoperative complications were also recorded.Results Sixty-four patients had 70 peripheral pulmonary lesions.There was no difference in age,sex,the lesion size or location between the two groups.Pathology results showed that the diagnostic yield of test group and control group were 88.6％ and 62.9％,respectively,with statistical significance (P =0.012).Subgroup analysis showed that if the lesion's diameter was ≤2 cm,the diagnosis yield of test group was higher than control group (66.7％ vs.20.0％,P =0.266);if the lesion was ＞2 and ≤3 cm,the diagnosis yield of test group and control group were 100 ％ and 81.8 ％,respectively (P =0.485).But if the lesion was＞3 cm,the diagnostic yield of the 2 group was significantly different (94.4 ％ in test group,63.1％ in control group,P =0.042).Mean operation duration of the 2 group was (966 ± 372)s and (1 040 ± 470) s,respectively,with no statistical difference (P =0.600).However,there was statistical difference between the 2 groups on the X-ray time needed to find the pulmonary lessions [(7.0 ± 4.8)s vs.(37.0 ± 37.5) s,P =0.008).There was no pneumothoraxes and excessive bleeding in patients undergoing ENB.Conclusions Compared with X-ray guide TBLB,ENB guided TBLB for peripheral pulmonary lesions has a certain degree of security,and has superiority in reducing the X-ray time required to find the lesion and improving diagnostic yield especially when the lesion's diameter was ＞3 cm.
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ObjectiveTo investigate the application of remifentanil and etomidate target controlled infusion anesthesia in operation for esophageal cancer and observe its effects on hemodynamics.Methods Sixty patients of esophageal cancer were divided into control group and observation group by random digits table with 30 cases each.The observation group was given remifentanil and etomidate for induction of the general anesthesia,while the control group was given remifentanil and propofol.The changes of mean arterial pressure(MAP),heart rate(HR),postoperative spontaneous breathing recovery time,waking time,extubation time were observed.ResultsMAP after induction was lower than that lying for 10 minutes after entering operating room in two groups (P ＜ 0.05),and observation group was lower than control group (P ＜ 0.05).MAP,HR after 5 minutes extubation were higher than those lying for 10 minutes after entering operating room(P ＜ 0.05 ),and observation group was higher than control group (P ＜ 0.05 ).The postoperative spontaneous breathing recovery time,waking time,extubation time in observation group [ (5.3 ± 1.5 ),(6.4 ± 2.1 ),(8.4 ± 2.5 ) min ] were shorter than those in control group [ ( 16.9 ± 8.7 ),(21.3 ± 7.7),(23.7 ± 5.8)min],and there were significant differences (P ＜0.05).ConclusionRemifentanil and etomidate target controlled infusion anesthesia in operation for esophageal cancer can maintain the stability of blood concentration and hemodynamics,shorten the recovery time,and improve the quality of anesthesia recovery and safety.
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It is usually a challenge to repair the abdominal wall defect to general surgeons. With developing of materials science, the use of mesh provides a novel method of primary closure of abdominal wall defects in this set-ting. Recently , biological mesh has been reported to reconstruct abdominal wall successfully. This review is to in-troduce the recent status and progress on its biological characteristics,animal experiments and clinical Study.
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OBJECTIVE To strengthen the management for preventing and controlling nosocomial infection.METHODS The normal work in this field according to the standards of Ministry of Health was summarized.RESULTS Changing the cognition of management of nosocomial infection to comprehend the meaning of management of nosocomial infection.CONCLUSIONS We can control nosocomial infection and ensure medical safety with the recognition of the leader,consummating organization,perfecting system,normalizing management,cooperating among departments,staff's effort and ensuring supply.
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<p><b>OBJECTIVE</b>To study whether previously intravenous injection of anisodamine can prevent endotoxemia of heat stroke of rats.</p><p><b>METHODS</b>Experimental animals were randomly divided into two groups, their average artery pressure, heart rate, survival time, survival rate and rectal temperature were measured at an environmental temperature of 38 degrees C-40 degrees C and 50%-60% retative humidity. Blood samples for endotoxins analyses were taken both before and after heat-stress.</p><p><b>RESULTS</b>During heat stress, the animals of rectal temperature of the experimental and control groups continuously increased and two hours later, separately to (42.7 +/- 0.6) degree C and (43.1 +/- 0.5) degree C, without statistic difference(P > 0.05), and to (44.6 +/- 0.4) degree C and (44.2 +/- 0.3) degree C prior to death, with statistic difference(P < 0.05). Before the experiment, the contents of endotoxins of portal vein blood were (45.7 +/- 5.2) pg/ml and (42.6 +/- 5.4) pg/ml, and that of systemic blood was (14.8 +/- 4.5) pg/ml and (13.9 +/- 7.2) pg/ml, without statistic difference(P > 0.05). Two hours later, the contents of portal vein blood separately increased to (122.2 +/- 16.7) pg/ml and (49.7 +/- 10.2) pg/ml, obviously higher than that before heat-stress(P < 0.01). And there were clear statistic difference between the two groups(P < 0.01). The changing tendency of the heart rhythm is almost the same in two groups, that is, first rose and then fell. But it is without statistic difference before and two hours later(P > 0.05): before heat-stress, the average artery pressures were (13.3 +/- 0.6) kPa and (13.6 +/- 0.5) kPa, without statistic difference(P > 0.05), and two hours later, were (9.6 +/- 0.5) kPa and (8.6 +/- 0.6) kPa, with obvious statistic difference(P < 0.01). The survival time of the animals were (166.5 +/- 16.9) min and (144.5 +/- 18.2) min with obvious statistic difference(P < 0.01), the survival rate of heat stressed rats in the experimental group were obviously higher than control group(P < 0.01 or P < 0.05).</p><p><b>CONCLUSIONS</b>Anisodamine can prevent endotoxemia in rats suffering heat stroke.</p>
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Animals , Rats , Blood Pressure , Body Temperature , Endotoxemia , Endotoxins , Blood , Heat Stress Disorders , Drug Therapy , Mortality , Hot Temperature , Solanaceous Alkaloids , Therapeutic Uses , Survival RateABSTRACT
Three hundred and one piglets of Suzh ong line 1 and 2 were chosen for halothane test(HT), with the halothane positive rate of 1.33%. 34 halothane negative(HN) piglets were randomly selected for gen otype testing and 6 of them were found to be heterozygous. The results showed th at genotype frequencies of HalNN, HalNnand Halnn w ere 81.26 %, 17.4% and 1.33%, respectively, while the frequencies of N gene and n gene wer e 89.97% and 10.03%, separately. 4 pigs with genotype Halnn gave worst meat quality appearing 3 typical and 1 slight PSE meat. Pigs with genotype Hal N Nor HalNndid not show PSE meat. 208 offspring from 20 HN sows mat ed wit h halothane positive(HP) boars, 21 piglets from 4 litters were HP, with low dail y gain, low feed efficiency and bad meat quality but high dressing percentage, l arge loin-eye area and high lean meat percentage.