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Objective To investigate the effects of dexmedetomidine combined with butorphanol on postoperative an-algesia and recovery for patient-controlled intravenous analgesia (PCIA) in parturients undergoing cesarean section. Methods Eighty-four parturients scheduled for elective caesarean section under spinal anaesthesia were randomly al-located into two groups. Control group: physiological saline infusion(0.5 μg/kg) after delivery and butorphanol (10 mg) in PCIA. Experimental group: dexmedetomidine (0.5 μg/kg) infusion after delivery and dexmedeto-midine (200 μg) with butorphanol (10 mg) in PCIA. Hemodynamic variables, the visual analogue score (VAS), the sedation score, side effects, the total pump-press number and additional analgesics cases were re-corded. The quality of recovery was evaluated by using a 40-item quality of recovery questionnaire(QoR-40) and a 9 questions fatigue score(FFS). Results Compared with control group,the VAS scores,the total pump-press number, the incidence of side effects and the FSS scores in experimental group was significantly decreased (P<0.05). In addition,the QoR-40 score at POD3 was significantly increased(P<0.05). Conclusions Dexmedeto-midine combined with butorphanol for PCIA after caesarean section decreases the consumption of butorphanol,pro-motes postoperative analgesia,alleviates fatigue,and improves postoperative recovery.
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BACKGROUND: Hip tuberculosis was second to that of the spine. A great number of cases were diagnosed hip tuberculosis every year. The early stage of hip tuberculosis is difficult to be diagnosed, and the X-ray images often show no abnormal signs. When there is an abnormal sign on X-ray, the extent of bone destruction is generally more than 50%. Selection of treatment methods for the patients with hip tuberculosis is the important issue in face of every clinician. OBJECTIVE: To review various types of research progress in clinical treatment of hip tuberculosis in recent years, and to provide reference for clinical treatment of hip tuberculosis. METHODS: We retrieved database of PubMed and CNKI for studies concerning clinical treatment of hip tuberculosis published from January 1969 to March 2017. Key words were "tubercular arthritis, hip, total hip replacement, treatment". After removal of repetitive or irrelevant articles, 42 articles were finally included. RESULTS AND CONCLUSION: (1) In the treatment, current emphasis was on mobility with stability at the hip. (2) Adults with advanced arthritis should be informed and discussed the various treatment modalities including the joint replacement. (3) With the development of artificial arthroplasty, total hip replacement was the preferred choice for patients with advanced hip tuberculosis. More and more surgeons were taking up the challenge of putting the total hip arthroplasty in the active stage of the disease.
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AIM:To observe the effect of simvastatin on myocardial tissue after renal ischemia-reperfusion in-jury and its mechanism .METHODS:A rat model of renal ischemia-reperfusion injury was prepared by clamping the bilat-eral renal arteries for 45 min.The rats (n=36) were randomly divided into sham operation group , renal ischemia-reperfu-sion (I/R) group and simvastatin group with 12 rats in each group.The content of serum creatinine (SCr), blood urea ni-trogen ( BUN) and myocardial tissue malondialdehyde ( MDA) , the myocardial activity of lactate dehydrogenase ( LDH) , creatine kinase (CK) and superoxide dismutase (SOD), and the myocardial protein expression of Bcl-2 and Bax were de-tected.RESULTS:Compared with sham operation group , the content of SCr , BUN and myocardial MDA , and the myo-cardial activity of LDH and CK in I/R group were significantly increased (P<0.05), and the activity of SOD was signifi-cantly decreased (P<0.05).Compared with I/R group, the content of SCr, BUN and myocardial MDA, and the myocar-dial activity of LDH and CK in simvastatin group were significantly decreased ( P<0.05 ) , while SOD activity was en-hanced (P<0.05).The protein expression of Bcl-2 and Bax in sham operation group was less than that in I/R group (P<0.05), and the protein level of Bax in simvastatin group was significantly lower than that in I /R group (P<0.05), while the protein level of Bcl-2 was increased (P<0.05).CONCLUSION:Simvastatin has a protective effect on the my-ocardium of the rats with renal ischemia-reperfusion injury , and the protective mechanism may be related to the elimination of free radicals by simvastatin , increase in the protein expression of Bcl-2 and decrease in the protein expression of Bax .
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Objective To determine the effect of omental flap wrapping of pancreaticoduodenectomy on postoperative pancreatic fistula and intra-abdominal bleeding in patients undergoing pancreaticiduodenectomy through meta-analysis of published studies.Methods Articles about whether omental flap wrapping could prevent postoperative pancreatic fistula and intra-abdominal bleeding were searched in databases of MEDLINE,PUBMED and EMBASE.14 English article were found and according to including and excluding criteria,4 eligible articles with a total of 2971 patients were selected.Random effects model was used to analyze odds ratios and 95％ confidence intervals (CIs).Results 1129 patients were in omental wrapping group,and 1842 patients in nonomental wrapping group.Omental roll-up during pancreaticoduodenectomy could not prevent postoperative pancreatic fistula (OR =0.81,95 ％ CI 0.40～1.63,P＞0.05) or postoperative abdominal bleeding (OR=0.67,95％ CI 0.28～1.59,P＞0.05).The sensitivity analysis showed the pancreatic fistula rate was lower in the nonomental roll-up group than that in the omental roll-up group (OR=1.24,95％ CI 1.03～1.50,P＜0.05).Conclusions Omental wrapping can not decrease the risk of pancreatic fistula and abdominal bleeding after pancreaticoduodenectomy.Further randomized controlled trials are needed to identify the effect of omental wrapping technique for pancreaticoduodenectomy.
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Objective To observe the cerebral edema occurrence ,evolution and prognosis of intra-arterial thrombolytic recanali-zation in patients with acute ischemic stroke .Methods From October 2010 to October 2012 ,36 patients who underwent the intra-arterial thrombolytic therapy were cerebral recanalization .They were randomly divided into two groups :1-3 h group and >3-6 h group .The alteration of brain edema was observed by cranial CT .Their mRS .NHISS and BI were scaled and recorded before and after intra-arterial thrombolytic therapy .Results After intra-arterial thrombolytic therapy ,the occurrence rate of cerebral edema was 94% ,appeared at the onset of more than 1 hours in all patients .Long-term follow-up showed ,cerebral edema location appeared obvious cerebromalacia .Cerebral edema and clinical outcome had not significant difference between 1-3 h group and 3-6 h group . Conclusion Cerebral edema and loss of cerebral tissue occurred almost inevitability in patients who received intra-artery thromboly-sis and recanalized their cerebral artery .It indicates that good local circulation and general condition may be favorable factors that can gradually reduce brain edema .
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<p><b>OBJECTIVE</b>To evaluate the necessity of drainage after thyroidectomy for benign thyroid disorders.</p><p><b>METHODS</b>A total of 272 patients who underwent thyroidectomy for benign thyroid disorders were randomly divided into drainage group or non-drainage group. Operating time, postoperative stay time in hospital, comfort of neck assessed by visual analogue scale (VAS) on postoperative day (POD) 0 and POD1 were and the incidence of complications, including post-thyroidectomy bleeding, hematoma, seroma, wound infection, hoarseness, and hypoparathyroidism, were assessed and compared between two groups.</p><p><b>RESULTS</b>Both groups were similar in the mean age, the sex ratio and the underwent procedure types. There was no significant difference in the mean operating time between two groups (87.5 ± 32.0) min and (93.8 ± 30.1) min (t = 0.12, P = 0.45). The mean postoperative hospital stay time of non-drainage group (1.9 ± 0.3) d was significantly shorter than that of drainage group (2.6 ± 0.6) d (t = 1.45, P = 0.02). The mean VAS scores of neck comfort on POD0 and POD1 in non-drainage group were significantly high than those in non-drainage group(t = 2.67, P = 0.03 and t = 0.33, P = 0.006). There were no significant difference in postoperative complications, including permanent hoarseness and hypoparathyroidism, between two groups.</p><p><b>CONCLUSIONS</b>No drainage after thyroidectomy for benign thyroid disorders does not increase postoperative complications, with the increase in postoperative neck comfort, the decrease in hospital stay time and potential wound infections. The routine drainage is not necessary after thyroid surgery for benign disorders.</p>
Subject(s)
Female , Humans , Male , Body Fluids , Drainage , Hematoma , Hoarseness , Hypoparathyroidism , Neck , Neck Dissection , Pain Measurement , Postoperative Complications , Postoperative Period , Prospective Studies , Thyroid Diseases , General Surgery , ThyroidectomyABSTRACT
<p><b>OBJECTIVE</b>To research the role of lymph tracers to protect parathyroid in surgery for papillary thyroid carcinoma.</p><p><b>METHODS</b>Patients with papillary thyroid carcinoma who met selected criteria were enrolled in this study. Patients were divided into carbon nanoparticle group, methylene blue group, and conventional surgery group.</p><p><b>RESULTS</b>No significant complication occurred in the patients of carbon nanoparticle and methylene blue groups. In carbon nanoparticle group, methylene blue group and conventional surgery group, the mean numbers of parathyroid glands detected during surgery were 3.1 ± 0.3, 2.9 ± 0.4 and 2.3 ± 0.3 (F = 3.78, P < 0.01) , the rates that parathyroid was cut mistakenly were 1.37% (2/146) , 2.62% (2/97) and 7.14% (6/84) respectively (χ(2) = 17.372, P < 0.05) ; and the incidence of postoperative hypocalcemia were 10.4% (5/48) , 9.1% (3/33) and 17.5% (7/40,χ(2) = 0.671, P = 0.037) .</p><p><b>CONCLUSION</b>Thyroid lymphography technique is helpful to protect from the injury to the parathyroid glands in surgery.</p>
Subject(s)
Humans , Hypocalcemia , Lymphography , Parathyroid Glands , ThyroidectomyABSTRACT
<p><b>OBJECTIVE</b>To investigate the feasibility of using intravascular loopless monopole antenna (ILMA) to image atherosclerosis plaque in a porcine model with 3.0T magnetic resonance imaging (MRI).</p><p><b>METHODS</b>Atherosclerosis model was established by feeding high fat diet combined with balloon catheter injury to the endothelium in 6 pigs. After 3 months, animals underwent MRI and ILMA examination. The ILMA was invasively inserted to the distal part of abdominal vein and bilateral common iliac veins. MR sequences including T1 weighted imaging (T1WI), T2WI were obtained. MR image data were transferred to post-processing station. Luminal border and external elastic membrane of the vessel were reconstructed based on the MR images. After co-register these images, vessel area, lumen area, vessel wall area and plaque burden in the same lesions imaged by different modality were calculated and compared. Finally, all animals were scarified and hematoxylin eosin (HE) staining was performed in the targeted vessels. Diagnostic accuracy of MR in delineating vessel wall and detecting plaque were analyzed and calculated by comparing with pathological results.</p><p><b>RESULTS</b>The atherosclerotic model was successfully established in all 6 pigs. Good agreement of delineating vessel area, lumen area vessel, wall area and plaque burden were found between MRI and pathology with r value of 0.98, 0.95, and 0.96, respectively (P < 0.001). Compared with pathological findings, the plaque component in corresponding area imaged by MR was as follows: sensitivity and specificity of detecting lipid plaque were 77% and 69%, kappa value was 0.75 ± 0.19 (P < 0.01); sensitivity and specificity on detecting fibrotic plaque were 78% and 73%, Κ value was 0.78 ± 0.18 (P < 0.01). The sensitivity and specificity of detecting calcified plaque were 100%. ILMA results showed that the average lumen area was 49.72 mm(2), average vessel area was 124.08 mm(2), and the average vessel wall area was 74.37 mm(2), ILMA slightly overestimated these indexes as compared with pathological results.</p><p><b>CONCLUSION</b>The results showed that ILMA could be used to image deepened artery and atherosclerotic plaque. Detected plaque size, vessel area, lumen area vessel, wall area, and plaque burden were comparable to pathological findings. It may thus provide an alternative method for detecting atherosclerotic plaque in future research work.</p>
Subject(s)
Animals , Disease Models, Animal , Magnetic Resonance Angiography , Methods , Plaque, Atherosclerotic , Diagnosis , Swine , Swine, MiniatureABSTRACT
<p><b>BACKGROUND</b>Noninvasive detection of vulnerable plaque has a significant implication for prevention and treatment of atherosclerotic diseases. The aim of this study is to investigate the difference between vulnerable plaques and stable plaques in magnetic resonance (MR) images.</p><p><b>METHODS</b>Atherosclerosis was induced in twenty male New Zealand white rabbits by high cholesterol diet and balloon injury of the abdominal aorta. After baseline (pre-triggering) MR imaging (MRI) scan, the rabbits underwent pharmaceutical triggering with Russell's viper venom and histamine to induce atherothrombosis, followed by another MRI scan 48 hours later (post-triggering). Rabbits were euthanized to obtain pathological and histological data. The results of MRI were compared with those of pathology and histology.</p><p><b>RESULTS</b>MRI showed that abdominal aorta of the rabbits had pathological change of atherosclerosis in different degrees. Seventy-five plaques were analysed, among which 14 had vulnerable thrombi and 61 stable. Thrombosis was identified in 7 of 11 rabbits by post-triggering MRI, the sensitivity and K value of MR in detection of vulnerable plaque was 71% and 0.803 (P < 0.05). MRI data significantly correlated with the histopathological data in fibrous cap thickness (r = 0.749) plaque area (r = 0.853), lipid core area (r = 0.900). Compared with stable plaques, vulnerable plaques had a significantly thinner fibrous cap ((0.58 ± 0.27) mm vs. (0.95 ± 0.22) mm), larger lipid core area ((7.56 ± 2.78) mm(2) vs. (3.29 ± 1.75) mm(2)), and a higher ratio of lipid core area/plaque area ((55 ± 16)% vs. (27 ± 17)%), but plaque area was comparable in two groups on MRI. The ratio of lipid core area/plaque area was a strong predictor of vulnerable plaques.</p><p><b>CONCLUSION</b>MRI could distinguish vulnerable plaques from stable plaques in a rabbit model of atherothrombosis and may thus be useful as a noninvasive modality for detection of vulnerable plaques in humans.</p>
Subject(s)
Animals , Male , Rabbits , Aorta, Abdominal , Pathology , Disease Models, Animal , Magnetic Resonance Imaging , Methods , Plaque, Atherosclerotic , Pathology , Thrombosis , DiagnosisABSTRACT
Clinically nonfunctioning pituitary adenomas are the most common types among pituitary adenomas. These tumors are usually diagnosed in their later stages due to the absence of clinical symptoms and detectable hormonal hypersecretion. Although these tumors are benign, they are hard to be completely removed during neurosurgery due to the massive invasion into the surrounding tissues at diagnosis. Furthermore, relapse is common. In recent years, medical treatment of pituitary adenomas has witnessed a rapid development. New medications have shown certain effectiveness in reducing the tumor size and improving the clinical symptoms.
Subject(s)
Humans , Adenoma , Drug Therapy , Pituitary Neoplasms , Drug TherapyABSTRACT
<p><b>BACKGROUND</b>With features of high tissue contrast, MRI can be used for the qualitative and quantitative evaluation of atherosclerosis plaques. In this study we investigated the development of atherosclerosis plaque with high resolution 3T MRI in a rabbit model and compared the findings with the histopathological results.</p><p><b>METHOD</b>Twenty male New Zealand white rabbits were randomly allocated into an experimental group (n = 16) and a control group (n = 4). Atherosclerotic lesions were induced in the abdominal aorta by balloon injury and cholesterol feeding. Multiple sequences MRI examination (ToF, T1WI, T2WI, and CE T1WI) were performed at the 2nd, 3rd, and 4th months after aortic denudation. Vessel wall thickness, total vessel area, lumen area, and vessel wall area were recorded. Plaque components were analyzed using histological results as a standard reference.</p><p><b>RESULTS</b>Seventeen rabbits (14 in the experimental group and 3 in the control group) received all three MR examinations. Gradually, from 2 months to 4 months, vessel wall thickness and area in the experimental group increased significantly compared with the control group (P < 0.01). In the lumen area progressive stenosis was not found, even a slight dilation had developed in the experimental group. Lipid, fibrotic and calcified plaques can be differentiated by MR image. According to histological results, MRI had good performance in detection of lipid plaque.</p><p><b>CONCLUSION</b>MRI can be used to monitor progression of atherosclerosis and differentiate plaque components.</p>
Subject(s)
Animals , Male , Rabbits , Aorta, Abdominal , Pathology , Magnetic Resonance Imaging , Methods , Plaque, Atherosclerotic , Pathology , Random AllocationABSTRACT
<p><b>OBJECTIVE</b>To analyze the clinicopathological characteristics and prognosis of familial gastric cancer and to improve the treatment outcome.</p><p><b>METHODS</b>Clinical data of 67 patients with familial gastric cancer and 820 patients with sporadic gastric cancer in the Second Affiliated Hospital of Dalian Medical University from 1995 to 2005 were retrospectively analyzed.</p><p><b>RESULTS</b>Compared to sporadic gastric cancer, the percentage of familial gastric cancer patients less than 45 years old was higher (34.3% vs. 14.6%). Early gastric cancer(23.9% vs. 13.8%), diffuse gastric cancer(79.1% vs. 29.0%), and lymph node metastasis (91.0% vs. 70.9%) were more common in patients with familial cancer(P<0.05). The 5-year survival rate of familial gastric cancer patients was lower than that of patients with sporadic gastric cancer(20.5% vs. 45.1%)(P<0.05).</p><p><b>CONCLUSIONS</b>Familial gastric cancer has characteristics of younger onset age, advanced disease staging, higher positive lymph node ratio and poorer prognosis. Therefore, early diagnosis should be emphasized in the management of familial gastric cancer.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Pedigree , Prognosis , Retrospective Studies , Stomach Neoplasms , Genetics , Pathology , General Surgery , Survival RateABSTRACT
<p><b>OBJECTIVE</b>To explore the external fixation for treatment of supracondylar femoral fractures after total knee replacement.</p><p><b>METHODS</b>From June 2005 to July 2007, 7 cases of supracondylar femoral fracture after total knee replacement were treated with external fixation included 4 males and 3 females with an average age of 71 years ranging from 55 to 85 years. The fracture healing were observed and the knee function were evaluated by the HSS scoring.</p><p><b>RESULTS</b>All patients were followed-up for 6 to 23 months with an average of 12.5 months. The fracture healing time was from 6 to 12 weeks after operation (averaged 8.5 weeks). During the followed-up period, there were no infection and loosening, only one case occurred nail crossing delayed healing of skin. The HSS knee score was (60.6 +/- 16.0) before treatment and (77.6 +/- 11.6) after treatment according to HSS knee score criteria, the results were excellent in 2 cases, good in 4, and fair in 1.</p><p><b>CONCLUSION</b>Application of external fixation for treatment of supracondylar femoral fracture after total knee replacement, especially in poor physical condition, high age patients is a more appropriate treatment.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Arthroplasty, Replacement, Knee , External Fixators , Femoral Fractures , General Surgery , Fracture Fixation , Methods , Postoperative Complications , General Surgery , Recovery of Function , Treatment OutcomeABSTRACT
Objective To investigate the diagnosis and treatment for biliary papillomatosis. Methods 23 patients who were pathologically diagnosed as biliary papillomatosis and treated in our hospital from Jan. 2003 to Mar. 2008 were enrolled in this study. Their ages, genders, clinical manifestations, diagnostic approaches,histopathological findings, intraoperative findings, treatments and prognosis were analyzed retrospectively. Recal manifestations were abdominal pain (83.3%) and obstructive jaundice (72.2%). All the patients were diagnosed pathologically through intraoperative frozen section. No patient was diagnosed preoperatively. Anatomically, solitary lesion was observed in 10 patients (43.5%) and multiple lesions in 13 patients (56.5%), with a median tumor size of 2.6 cm. Microscopically, carcinomatous change was found in one patient, mild atypical hyperplasia in three, and medium atypical hyperplasia in one. Therapies mainly included radical excision and palliative external drainage. All but one patient recovered well postoperatively. This patient had anastomotic leak. All 23 patients were followed up with a mean period of 34 months. During the follow-up, three patients died as a consequence of biliary malignancy, one patient had the recurrence and others without recurrence. Conclusions Biliary papillomatosis is very difficult to diagnose preoperatively and the definitive diagnosis mainly depends on intraoperative and postoperative pathologic examination. To obtain a better prognosis, management should be aimed at radical excision. Intraoperative cholangioscopic evaluation and frozen section are strongly recommended to guide the choice of appropriate therapeutic approach.
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<p><b>OBJECTIVE</b>To investigate and research WHOQOL-BREF evaluation of the clinical effect of application of moxibustion for treatment of knee osteoarthritis, to provide clinical according for the treatment.</p><p><b>METHODS</b>From January 2007 to June 2008, 90 cases of knee osteoarthritis were randomly divided into treatment group and control group. In treatment group there were 45 cases included 16 males and 29 females with an average age of (62.5 +/- 7.4) years; the average course was (26.5 +/- 14.6) months; Lysholm score of knee function before treatment was (65.5 +/- 3.5) hours on average. In control group, there were 45 cases included 11 males and 34 females with an average age of (62.5 +/- 9.3) years;the average course was (24.6 +/- 16.6) months; Lysholm score of knee function before treatment was (66.3 +/- 2.3) hours on average. Applied Quality of Life Scale WHOQOL-BREF in line with the inclusion criteria of the study evaluation. While applied Lysholm scoring of knee joint for supporting the evaluation criteria. All data were statistical analyzed by package SPSS 11.5.</p><p><b>RESULTS</b>Moxibustion was applied to treat the knee osteoarthritis and the quality of life was evaluated according to the WHOQOL-BREF scale score. The scores of the physical state, psychological state, as well as their own general health status of subjective feeling, and so on in treatment was significantly higher than that in control group (P < 0.05). According to Lysholm scoring, the score in treatment group was significantly higher than that of control group, too (t = 0.65, P < 0.05).</p><p><b>CONCLUSION</b>Application of moxibustion for treatment of knee osteoarthritis is a simple, economical and practical, and can avoid the further development of the disease, but also to improve the joint function and improve quality of life.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Moxibustion , Osteoarthritis, Knee , Pathology , Therapeutics , Quality of Life , Treatment Outcome , World Health OrganizationABSTRACT
<p><b>OBJECTIVE</b>To compare therapeutic effects between moxibustion and infrared therapy for the treatment of knee osteoarthritis.</p><p><b>METHODS</b>From January 2007 to June 2008 period, 65 patients with knee osteoarthritis were divided into treatment and control groups randomly uniform random number table generated from SAS statistical software. Among 35 patients in the treatment group, 17 patients were male and 18 patients were female, ranging in age from 45 to 75 years, with an average of (61.2+/-6.4) years; the course of disease ranged from 9 to 43 months, with a mean of (23.6+/-13.8) months; the preoperative Lysholm score ranged from 19 to 28 scores, averaged (24.3+/-3.3) scores. In the control group, there were 30 patients, including 13 males and 17 females, ranging in age from 47 to 79 years, with an average of (62.5+/-9.3) years; the course of disease ranged from 8 to 45 months, with a mean of (24.6+/-16.6) months; the preoperative Lysholm score ranged from 20 to 29 scores, averaged (25.9+/-3.0) scores. The patients in the treatment group were treated with moxibustion, and the patients in control group were treated with infrared therapy. All the patients were followed up for 4 weeks. The Lysholm scores were compared between the two groups.</p><p><b>RESULTS</b>According to Lysholm score for clinical efficacy, treatment group got (87.5+/-5.6) scores and the control group were (85.9+/-3.5) scores, the Lysholm score of the treatment group was higher than that of the control group (P<0.05). Among pain score, joint flexion and extension score, joint stability score, and up and down stairs score, the pain and joint stability scores of patients in the treatment group were higher than those of control group (P<0.05).</p><p><b>CONCLUSION</b>Compared with infrared therapy, moxibustion treatment for knee osteoarthritis can get better joint function, which is effect to alleviate the patient's pain, improve joint stability, improve the efficacy, and is valued to be promoted.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Moxibustion , Methods , Multicenter Studies as Topic , Osteoarthritis, Knee , Therapeutics , Treatment OutcomeABSTRACT
Objective To summarize the experiences of "three holes and one hook in the end(TOE)" laparoscopic cholecystectomy(LC) in 1 260 cases and to investigate the operation procedures,technical points and the prevention of complications.Methods The data of 1 260 patients suffering from chronic calculous cholecystitis,acute calculous cholecystitis,atrophic cholecystitis,gallbladder polyps etc.,who were admitted to this hospital and treated by TOE from March 1999 to March 2008 were included and analysed retrospectively in this study.Results One thousand two hundred and sixty of cases were cured,including 1 252 cases of succeeding LC(99.37%),conversions to open in 8 cases,no death,no bile duct injury,with intraoperative hemorrhage in 3 cases,umbilicus infection in 2 cases,gallbladder fossa hydrops in 3 cases,with operation time for 8-60 min(mean 38.5 min) and hospitalization for 3-7 d(mean 5 d) after surgery.During the follow up of 1 002 cases for 1 to 7 years(mean 3.5 years),there were no complications such as bile fistula,bile duct stricture,residual stones of biliary duct,etc..Conclusion TOE is worthy of application and promotion for the excellent effectiveness,few complications,rapid recovery and safety.
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<p><b>OBJECTIVE</b>To summarize the clinical characteristics, diagnosis and treatment of gastric neurogenic tumors.</p><p><b>METHODS</b>Clinical data of 11 patients with gastric neurogenic tumors confirmed by pathology, operation and immunohistochemistry were analysed retrospectively.</p><p><b>RESULTS</b>There were 7 males and 4 females with a median age of 55.5 years. The main manifestations were gastrointestinal hemorrhage, abdominal pain, upper abdominal discomfort and anaemia. Nine patients underwent gastroscopy and only one case was confirmed by the examination. Two patients were diagnosed during operation. Eight patients were submitted to subtotal gastrectomy, three were partial gastrectomy. All patients were followed up, and perioperative death occurred in one patient because of respiratory failure, recurrence occurred in two patients. Other patients with long- term follow- up had a good prognosis.</p><p><b>CONCLUSIONS</b>Gastric neurogenic tumors have no specific clinical characteristics preoperatively, and the misdiagnosis rate is high. Once the diagnosis of gastric neurogenic tumors is made, an operation should be performed as early as possible.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Neoplasm Recurrence, Local , Neoplasm Staging , Prognosis , Retrospective Studies , Stomach Neoplasms , Diagnosis , Pathology , General SurgeryABSTRACT
Inconspicuous penis is a group of symptoms that can make penis body not be showed normally instead of a kind of simple disease. They are presented with conclude concealed penis, buried penis, webbed penis and trapped penis. Most of them are resulting from congenital abnormality except the trapped penis. The diminutive penis caused by hypospadia and intersex and micropenis resulted from endocrine disease does not belong to this category. Pathological changes of concealed penis, buried penis and webbed penis are congenital but trapped penis is caused by acquired reasons. It's not difficult to make the diagnosis by the pathological and clinical manifestations. According to different age's indication, type and severity of the disease, corresponding surgery method ought to be chosen and the curative effect can be obtained.
Subject(s)
Child , Humans , Male , Penile Diseases , Diagnosis , Therapeutics , Penis , Congenital AbnormalitiesABSTRACT
<p><b>AIM</b>To study the chemical constituents of Dioscorea parviflora.</p><p><b>METHODS</b>The chemical constituents were isolated by silica gel and RP-18 column chromatography, and their chemical structures were elucidated by IR, NMR and MS.</p><p><b>RESULTS</b>Eleven steroides have been isolated from EtOH extract of Dioscorea parviflora and identified as isonarthogenin 3-O-alpha-L-rhamnopyranosyl-(1-->2)-beta-D-glucopyranoside (I), diosgenin-diglucoside (II), prosapogenin A of dioscin (III), dioscin (IV), deltonin (V), deltoside (VI), methyl deltoside (VII), diosgenin 3-O-beta-D-glucopyranosyl (1-->3)-beta-D-glucopyranosyl-(1-->4)-[alpha-L-rhamnopyranosyl-(1-->2)]-beta-D-glucopyranoside (VIII), parvifloside (IX), methyl parvifloside (X), diosgenin (XI), and a mixture of beta-sitosterol and stigmasterol.</p><p><b>CONCLUSION</b>Compound X is a new compound. Compounds VII and X were methyl ethers of VI and IX, respectively, and may be produced during isolation. Compound I is isolated from Dioscorea L., and II, IV from Dioscorea parviflora for the first time.</p>