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Objective:To investigate the effect of continuous use of aspirin on gallbladder function and thromboembolism risk in the patients undergoing laparoscopic cholecystectomy. Methods:Totally 100 patients undergoing laparoscopic cholecystectomy from October 2010 to October 2014 were selected as the subjects. All the patients were given aspirin for a long time and randomly divided into two groups. The patients in the observation group were treated with aspirin continuously, and the control group suspended aspirin 7 days before the surgery and administrated aspirin continuously after the surgery. The perioperative thromboembolism,changes in gallbladder function and coagulation function, and intraoperative and postoperative differences in the indicators were compared between the groups. Results:The gallbladder volume in the observation group decreased, and the gallbladder contraction rate and emptying index were higher than those on the 7th day before the surgery(P < 0.05). The above indices were significantly better than those in the control group (P < 0.05). There was no significant change in the coagulation function after the treatment in both groups(P >0.05). There were no significant differences in the operative time,intraoperative blood loss, postoperative drainage and postoperative hospital stay between the groups (P > 0.05). The total incidence of perioperative thromboembolism in the observation group was 2.0%,which was significantly lower than that in the control group(P< 0.05).Conclusion:Continuous use of aspirin during laparoscopic cholecystectomy is beneficial to reducing the volume of gallbladder, promoting gallbladder emptying and reducing the risk of perioperative thromboembolism. The reasonable use has no obvious effect on the postoperative coagulation function.
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From the aspects of strengths,weaknesses,opportunities and threats,this paper analyzed external factors of the reorganizations and group building reform of public hospitals in Shanghai.Points made are as follows:Characteristics of individual hospitals should he respected instead of a generalized pattern for all;the role of the government to play in this regard should he guidance of an orderly competition,Strengthen Supervision,and promotion of the reform in property rights,These efforts will create a desirable environment for hospital groups;mid- and long-term goals for the reform should consolidate the independent legal entity status of such groups.
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@#Objective To evaluate the application of microscopic extended transsphenoidal approach in surgery for clival chordomas. Methods Nine patients with clival chordomas were managed by microscopic extended transsphenoidal approach from August 2007 to March 2008 with the assistance of neuro-navigation. Among those, 3-D stereoscopic virtual reality images of 4 cases were reconstructed successfully,which could identify the relationship between the tumors and surrounding structures and conduced to the operations. Results Total removal was achieved in 3 cases,which was confirmed by the imaging-scopy after the operations, subtotal removal in 6 cases. Because of the invasion of the subdural space by the tumor,CSF leakage occurred in 2 cases after the tumors were removed, which was cured by the reconstruction of the cranial base with the fat tissue and albumin gel. Conclusion The microscopic extended trans spbenoidal approach is a viable, minimally invasive alternative for surgical treatment of clival tumors. By this approach, the clivus including the anterior skull base and cavernous sinus can be exposed conveniently.
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Objective:To investigate the possible association between Thr241Met polymorphism in the DNA repair gene X-ray repair cross-complementing group 3 (XRCC3) with genetic susceptibility to glioma in a Chinese Han population living in Shanghai and the surrounding provinces in east China. Methods: Genotyping by a TaqMan assay was performed in 771 brain glioma patients living in Shanghai and the surrounding provinces (Jiangsu.Zhejiang, Anhui.etc. )and in 752 control participants matched in age and gender. The genotyping results of TaqMan assay and the association between Thr241Met polymorphism in the DNA repair gene XRCC3 with genetic susceptibility to glioma were statistically analyzed. Results: Genotypes of 1 468 subjects (760 with brain glioma and 708 were cancer-free control) were successfully performed by TaqMan assay, with the successful rate being 96.4%. Statistical analysis result showed that gene(C/T) and genotype(C/CT/CT/T) frequencies of XRCC3 were not significantly different between the glioma and cancer-free groups. Compared with the CC genotype, the variant TC(P = 0. 909; adjusted by age and gender OR = 0. 981; 95%CI = 0. 701-1. 371) or TT(P=0. 642; adjusted by age and gender OR = 0. 7; 95%CI = 0. 156-3. 146) genotypes of XRCC3 Thr241Met were associated with a non-statistically significant increase of glioma risk. Conclusion: The variant TC or TT genotypes of XRCC3 Thr241Met may not be risk factors for brain glioma in Chinese Han population living in Shanghai and the surrounding provinces in east China.