ABSTRACT
Most foreign bodies are often discharged without obvious symptoms after swallowing, but some may be misdiagnosed and stay in the body, resulting in serious complications. Different diagnostic methods should be integrated to diagnose such patients. Once diagnosed, they should be treated as soon as possible if necessary. The authors reported a case of retention in the body for 6 years after swallowing a wooden chopstick, resulting in the insertion into the psoas muscle after duodenal perforation, complicated by abdominal abscess. During the operation, endoscopic assisted laparoscopic foreign body removal was performed, and the patient showed good prognsis, which provided references for the diagnosis and treatment of the disease.
ABSTRACT
Objective To explore the application value of vacuum sealing drainage (VSD) in wound repair after resection of pilonidal sinus.Methods The retrospective cross-sectional study were conducted.The clinical data of 11 patients with pilonidal sinus who were admitted to the China-Japan Union Hospital of Jilin University from April 2015 to June 2016 were collected.All the patients received resection of pilonidal sinus after preoperative antibiotic therapy,and then received postoperative VSD and regular treatments of anti-infection and dressing changes.Observation indicators:(1) treatment situations:surgical procedures,operation time,volume of intraoperative blood loss,gross specimens,results of postoperative pathological examination,postoperative treatment (VSD),growth condition of granulation tissue,duration of hospital stay and treatment expenses;(2) follow-up situations:cases with follow-up,follow-up time,wound healing,postoperative complications and disease recurrence.Follow-up using outpatient examination and telephone interview was performed to detect the wound healing,postoperative complications and disease recurrence up to July 2017.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M(range).Results (1) Treatment situations:all the 11 patients underwent successful surgery for pilonidal sinus.The operation time and volume of intraoperative blood loss were respectively (79 ± 19) minutes and (10 ± 4) mL.Observation of gross specimens of 11 patients:hairs were scattered within the resected lesions in 7 patients,and hairs didn't found in 4 patients.Results of postoperative pathological examination of 11 patients:there were acute and chronic inflammation accompanied with granulation tissues in the subepithelial fibrous tissues,and discrete multinucleated giant cell reaction.Of 11 patients undergoing VSD,9 received VSD material changes for 3 times,2 received VSD material changes for once,and wounds were not sutured after VSD removal.The new granulation tissues of 11 patients were found at (5.9±1.3) days postoperatively.The duration of hospital stay and treatment expenses were respectively (33.3±8.3) days and (37 790± 8 811) yuan.(2) Follow-up situations:11 patients were followed up for 12-18 months,with a median time of 14 months.The wound healing time was (41.0±9.0)days.Of 11 patients with follow-up,10 were in the primary healing,1 who was complicated with wound infection and abscess of wound deep surface underwent sacral wound incision and drainage,gauze packing and routine dressing change,and then wound healed completely.There was no recurrence in 11 patients during the follow-up.Conclusions The VSD has great application value in managing wounds after resection of pilonidal sinus,with a lower incidence of wound infection and smaller scar,and it is worth recommending to patients with wide wounds,high tension and serious infection.
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To determine the clinical significance of silent mating type information regulation 2 homolog 1 [SIRT1] expression in Hepatocellular Carcinoma [HCC] and its association with P53 and Yes-associated protein 2 [YAP2] expression. Observational study. Department of General Surgery, China-Japan Union Hospital of Jilin University, Changchun, China, from January 2000 to January 2010. Tissue microarray technique and immunohistochemistry were conducted to detect the expression of SIRT1, P53 and YAP2 proteins in 300 self-paired HCC samples. Associations with clinicopathologic manifestations were analyzed, overall survival analysis and multivariate analysis were performed. By tissue microarray technique and immunohistochemistry on 300 self-paired HCC samples, it was found that SIRT1, P53 and YAP2 were significantly overexpressed in HCC tumor tissues compared with adjacent non-tumor tissues. SIRT1 immunostaining localized both in the nucleus [145/300, 48.3%] and the cytoplasm [70/300, 23.3%], and the overexpression of nuclear SIRT1 was positively related to the overexpression of P53 and YAP2. Survival analysis showed that nuclear SIRT1, P53 and YAP2 overexpression predicted poor overall survival while cytoplasmic SIRT1 overexpression predicted longer overall survival. Multivariate analysis showed nuclear SIRT1 and P53 overexpression as independent tumor promoters while cytoplasmic SIRT1 overexpression as an independent tumor suppressor. SIRT1 was overexpressed in HCC and the expression was positively related to P53 and YAP2 expression. As the nuclear SIRT1 functions as a tumor promoter and cytoplasmic SIRT1 functions as a tumor suppressor, the role of SIRT1 in HCC should be reconsidered