ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy of self-made gasbag double-cannula stool drainage device for prevention of anastomotic leakage following anterior resection.</p><p><b>METHODS</b>Clinical data of 169 rectal cancer patients in the 8th Affiliated Hospital of Sun Yat-sen University between October 2010 and October 2016 were retrospectively analyzed. Among them, a self-made gasbag double-cannula stool drainage device was placed in 71 patients(stool drainage group), and the remaining 98 patients were taken as control. After an anastomosis, the drainage device was transanally placed by the assistant and the distal tube of drainage device was stretched more than 15 cm from anastomosis. The gasbag was inflated to fully expand the intestine. The main tube was fixed on perianal skin with 7-0 suture, kept more than 3-5 cm outside the anus, and connected to the drainage bag. The incidence of anastomotic leakage was compared between the two groups.</p><p><b>RESULTS</b>The baseline data were similar between the two groups (all P>0.05). The differences in operative time, intraoperative blood loss, and time to bowel function recovery were not statistically significant (all P>0.05), however, time to oral intake and postoperative stay were shorter in stool drainage group as compared to the control group (both P<0.05). There was no perioperative death in both groups. In stool drainage group, there were 6 cases whose drainage device was pulled out within 48 hours due to intolerance. The ruptured gasbag was replaced 5 times and the tube was clogged by fecal material 21 times. After flushing, the tube did not recanalized and was pulled out in 3 cases. The incidence of anastomotic leakage in stool drainage group was significantly lower than that in the control group (2.8% vs. 11.2%, P=0.043). As for the low anastomosis (the distance to anal verge less than 5 cm), the incidence of anastomotic leakage in stool drainage group was also significantly lower than that in the control group (2.3% vs. 15.4%, P=0.028), while as for the high anastomosis, the difference was not statistically significant (3.6% vs. 3.0%, P=0.906). Logistic regression analysis revealed that the presence of a stool drainage device was an independent protective factor for anastomotic leakage (OR=0.316, 95%CI:0.114 ~ 0.769, P=0.003).</p><p><b>CONCLUSIONS</b>The self-made gasbag double-cannula stool drainage device effectively prevents anastomotic leakage after anterior resection of rectal cancer. However it is not suitable for those patients with high anastomosis.</p>
ABSTRACT
Objective:To investigate the reasons of anastomotic leakage following learning curve by laparoscopic anterior resection of rectal cancer.Methods:From December,2011 to March,2015,the clinical information of 179 patients in our hospital who underwent dixon of rectal cancer were collected.The patients were divided into a laparoscopic learning group,a laparotomy group and a laparoscopic group,The reasons of anastomotic leakage for each group were comparatively analyzed.Repeated cutting of anastomotic stoma was compared between the laparoscopic learning group and the laparoscopic group.The male,age,obesity,nutrition complications and the position of anastomotic stoma were compared among the 3 groups.Results:The rate of anastomotic leakage in the laparoscopic learning group was significantly higher than that in the laparotomy group and the laparoscopic group (P＜0.05).Repeated cutting was a significant risk factor in the laparoscopic learning group (P＜0.05),but not in the laparoscopic group.Except obesity,the four factors were significant risk factors in the laparoscopic learning group (P＜0.05).All of the five factors were not the significant risk factors in the laparotomy group and the laparoscopic group (P＞0.05).Conclusion:The operation technical shortcoming is the major factor in the learning of the laparoscopic anterior resection of rectal cancer.In order to reduce the rate of anastomotic leakage in the learning curve period,the selection of patients following the laparoscopic anterior resection of rectal cancer should avoid the following factors:male,older age,the low position of the tumor and the nutrition complications.
ABSTRACT
Objective To observe the MRI imaging manifestations of the ligaments and soft tissues around the atlanto-axial joint in children with atlanto-axial rotation instability.Methods Assigned into observation group were 50 children with atlantoaxial rotatory displacement who had been treated in our hospital from January 2013 to March 2014.Another 50 healthy children were chosen as a control group who underwent health check-ups during the same period in our hospital.Both groups received MRI examinations of the ligaments and soft tissues around the atlantoaxial joint using the same equipment and methods.MRI manifestations and characteristics of the ligaments and soft tissues around the atlantoaxial joint were analyzed and compared between the 2 groups.Results In the observation group,odontoid gap asymmetry appeared on both sides,with left shift in 32 cases and right shift in 18 cases.The MRI imaging PDWI sequence showed a significant better diagnostic sensitivity than the other sequences (T1WI,T2WI and SPAIR) (P ＜ 0.05).The MRI examinations on all the children with different sequences found 50 cases of degree Ⅰ lesion in the observation group and 4 cases of degree Ⅰ lesion in the control group,and 12 cases of degree Ⅱ lesion in the observation group and none degree Ⅱ lesion in the control group,showing a significant difference between the 2 groups regarding the diagnostic sensitivity of lesions of degrees Ⅰ and Ⅱ (P ＜ 0.05).Conclusions MRI can clearly show the rotation displacement of atlanto-axial joint associated with transverse ligament,alar ligament and lesions of the surrounding soft tissues.MRI has a dcfinite diagnostic value for atlanto-axial rotation displacements in children,especially those caused by transverse ligament tear after trauma.
ABSTRACT
Objective To evaluate early diagnosis by gastroscopy for the causes of gastroduodenal perforation after successful non-surgical treatment.Method Gastroduodenal perforation patients suspected of benign ulcer in origin on hospital admission undergoing successful non-surgical treatment were examined by gastroscopy within days after the closure.Results Among 284 patients undergoing gastroscopy,277 cases (97.5％) were diagnosed as gastroduodenal ulcer,3 cases (1.1％) as gastric carcinoma,1 case (0.4％) of duodenal diverticulum.There were not major complications developing after gastroscopy.Conclusion Early gastroscopy performed after closure by non-surgical treatment in gastroduodenal perforation patients is safe,helping make definite diagnosis for the cause of perforation.
ABSTRACT
Objective To research early pathological morphology and clinical significance of perforated duodenal ulcer (PDU) closed after non-surgical treatment. Methods Observed morphological changes of duodenal ulcer (DU) lesion with gastroscopy for 302 patients of PDU with non-surgical treatment in early period,when the perforation closed and measured up the clinical indicators during this hospitalization.Results There were 255 patients to be diagnosed with DU caused the perforation. These lesions were characteristic and shown the PDU closed at the bottom and the deep concave ulcers, except for 1 case which complicated by duodenal fistula. These ulcer types were diverse according to the time difference after treatment. No case of re-perforated ulcers or recurrence of peritonitis caused by gastroscopy. Conclusions Deep concave ulcer with A1 phase mainly is an early pathological manifestations of the DU after treated the PDU with non-surgical method characteristically. The wall of the closure of the serosal side is an original form closed perforated ulcer by non-surgical treatment. The risk of perforation associated with the following factors:( 1 )A single DU is located in the anterior wall region. (2)The shape of two kissing DU. (3)The diameter of DU ≥ 1.1 cm. In this case,early diagnosis by using endoscopy is a safe way.
ABSTRACT
In th is paper, an Extremely Low Frequency Multi-waveform Electromagnetic Field Generator has been developed with single chip computer, which provides pulsed, rectangular, triangular and sinusoidal magnetic field with the frequency range from 0-150 Hz and the intensity range from 0-50 mT. The application shows that the device is easy to operate and the parameters of magnetic fields are stable. It has provided successful application in the experiments on biological effects of magnetics and has obtained valuable result.
Subject(s)
Humans , Cell Differentiation , Radiation Effects , Cell Proliferation , Radiation Effects , Cells, Cultured , Electromagnetic Fields , Equipment Design , Magnetics , Osteoblasts , Radiation EffectsABSTRACT
The performance of extremely low-frequency electromagnetic fields (ELEF) can change the response of osteoblasts. In this study a kind of ELEF stimulator, which can radiate sinusoidal, rectangular, triangular and pulsed burst ELEF with frequency of 0-300 Hz and strength of 0-40 mT was developed. The neonatal rat calvarial osteoblasts were treated with the device. The effects of various ELEF stimulation on the osteoblast were evaluated by its proliferation and differentiation. The results demonstrated that rectangular and pulsed burst radiation (15Hz, 5mT) can positively change the proliferation of the osteoblast and inhibit its differentiation, but the sinusoidal one can significantly enhance its differentiation and decrease its proliferation.
Subject(s)
Animals , Rats , Animals, Newborn , Cell Differentiation , Radiation Effects , Cell Proliferation , Radiation Effects , Cells, Cultured , Electromagnetic Fields , Osteoblasts , Cell Biology , Radiation Effects , Rats, Sprague-Dawley , Skull , Cell BiologyABSTRACT
Eletromagnetic fields and mechanical factors affect the proliferation and differentiation of osteoblasts. More related publications can be found every year. The article reviewed the mechanisms of the affections of eletromagnetic fields and mechanical factors on calcium transition in the osteoblasts and compared their similarities and differences.
ABSTRACT
Objective To investigate of the biological effects of the extremely low frequency electromagnetic fields (ELFEMF),and to explore the effect of rectangular ELFEMF performance parameters on rat fetal skull osteoblast. Methods Different amplitude, frequency and duty cycle of rectangular ELFEMF were used on rat fetal skull osteoblast and the proliferation and differentiation of osteoblast were examined. Results There existed action windows of amplitude and frequency with regard to the biological effect of rectangular ELFEMF. The 15 Hz, 5 mT and 15% duty cycle could significantly promote the proliferation and decrease differentiation of the cells. Conclusion The proliferation and differentiation of osteoblast could be affected by rectangular ELFEMF characterized by its amplitude, frequency and duty cycle. This study indicated that rectangular ELFEMF of 15 Hz, 5 mT and 15% duty cycle was suitable for the proliferation and differentiation of osteoblast in vitro.