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Objective To evaluate the etiology,therapeutic approaches and prognosis of orbital hypertelorism.Methods Clinical data of 23 cases were summarized with review ot the literature.Results All operations provided satisfactory cosmetic effects.All the patients were followed up for 6 months to 5 years,and no recurrence were observed.Conclusions A good cosmetic effect can be obtained by operation in orbital hypertelorism.The preschool period the best opportunity,and stable effects could be gotten and the psychological development of children has not been influenced.The intracranial and extracranial joint pathway orbit box osteotomy still has drawbacks and requires to be improved.The etiology of gene and molecular aspects need to be explored.
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Split spinal cord malformation(SSCM) is a rare neurological abnormality that spinal cord was separated in the sagittal plane.Based on the tissue element and type of thecal shvac,SSCM is classified into Ⅰ,Ⅱ and mixed type.Congenital spinal deformity(CSD) is caused by the vertebral body formed or segmented obstacles.CSD can be divided into 3 types:Ⅰ,Ⅱ and mixed type.Both of SSCM and CSD are diagnosed depending on clinical symptoms,X rays,computed tomography (CT),magnetic resonance imaging(MRI) and other examine.Genitourinary and cardiac ultrasound should be performed at the same time.Progression of spinal deformity and nerve injury are accompanied with the growth process of children with CSD and SSCM.Early surgery can avoid further injury of nervous system,prevent spinal deformity progress and obtain good correction.Segmental tissue removal,tethered cord release and spinal deformity correction are generally consisted into an individual operative plan at present.Traditional surgical option included 2 steps:tissue removal and tethered cord release are conducted at Ⅰ phase surgery;then conducted the spinal deformity correction at Ⅱ phase.However,some reports suggested that completed the process of tissue removal,tethered cord release and spinal deformity correction at one surgery also obtain a satisfied effictiveness.The aim of this research is to review and discuss the diagnosis of the SSCM with CSD and evaluate the treatment effectiveness of Ⅰ phase surgery instead of the traditional surgical option.
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Objective To investigate the effect of the early occupational therapy (OT) on depressive mood and activities of daily life in patients with stroke.Methods Retrospectively 80 cases of acute stroke patients in our hospital were randomly divided into the early occupational therapy group (40 patients) and control group (40 cases), and two groups of patients were given conventional medical and rehabilitation treatments.Early functional occupational therapy also included occupational therapy group, the personal activities of daily life, the secondary and vocational rehabilitation activities such as job.Hamilton depression scale (HAMD) and activities of daily living scale(ADL) were used to assess the incidence of depression and activities of daily life before and after treatment.Results Compared with the control group(17 cases/40 cases) ,the incidence of post-stroke depression of early occupational therapy group (5 cases/40 cases) was lower, and the difference was statistically significant (x2=5.2012, P＜0.05).The HAMD score of occupational therapy group(10.98±3.66) was lower than the control group(17.70±3.83), and the difference was statistically significant (t=8.0230, P＜0.05).The ability to daily life of occupational therapy group was higher than that in control group,and significantly difference was showed (58.17 ± ±25.82 vs 45.33±25.15, t=2.2530, P＜0.05).Conclusion Early occupational therapy can improve the activities of daily life and have a certain preventive effect on depressive mood in patients with stroke.
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Hemivertebra (HV) is a congenital spinal abnormality due to a defection of formation of one side vertebral.It is divided into 3 types according to whether it fusion with adjacent vertebral : fully segmented, semi-segmented and incarcerated.HV deformity is diagnosed depending on clinical symptoms, X rays, CT and other examine.Preoperative magnetic resonance imaging of the spine, genitourinary and cardiac ultrasound should be performed at the same time.Congenital scoliosis due to HV especially fully segmented is nonresponsive to bracing,operative treatment is the mainstay of care.The 3 basic operations are fusion in situ, convex growth arrest (epiphysiodesis), and HV resection.The single posterior approach or combined anterior and posterior approach of HV resection with instrumentation is the main method now.
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Objective To probe into the treatment method of filter channel obstruction after trabeculectomy. Methods Filter channel obstruction occurred in 25 eyes within one month after trabeculectomy,and they were retrospectively analyzed. According to different parts of obstruction,they were divided into three types namely inner obstruction, middle obstruction and outer obstruction. Patients with inner ob-struction were given miosis, separation of the anterior synechia, and expansion of peripheral iris incision when necessary. Patienrts with mid-dle obstruction were given reconstruction of the trabecular incision. Patienrts with outer obstruction were given conjunctiva or sclera flap dis-section within 1 month afer trabeculectomy. Results Postoperative IOP ( intraocular pressure) decreased significantly compared with preop-erative IOP. The IOP stabilized at 13~21 mmHg in the fallowing 6~12 months after operation. Conclusion Taking appropriate measures could restore the filtration function within one month after trabeculectomy when the incision adhesion was not very close.
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Objective To analyze the efficacy of different treatment methods for end-stage hepatic alveolar echinococcosis combined with obstructive jaundice.Methods A retrospective study was conducted on the diagnosis and treatment of 55 patients with end-stage hepatic alveolar echinococcosis combined with obstructive jaundice managed from January 2000 to January 2013 at the First Affiliated Hospital of Xinjiang Medical University.The patients were divided into two groups according to the treatment options:group A,the palliative surgery group (n =38,69.1％) using palliative resection and biliary decompression ; and group B,the interventional group (n =17,30.9％) using percutaneous transhepatic cholangial drainage (PTCD).We analyzd the general data,preoperative and postoperative liver function,operation time,blood loss,average hospital stay,duration of postoperative tube drainage of abscess cavity,degree of lesion with invasion into the first porta hepatis,progressive lesion,continuous invasion and/or distant metastasis,biliary complications,mortality,and cumulative survival rates.The t-test or t'-test was used to analyze continuous data and the chi-square test was used to analyze categorical data.Parallel log rank test and Kaplan-meier method were used to calculate survival rates in survival analysis.Results When compared with group B,group A had significantly longer operative time,more blood loss,and longer average hospital stay (P ＜0.05).The postoperative total bilirubin,direct bilirubin,γ-glutamyl transpeptidase and alkaline phosphatase,aspartate aminotransferase,alanine aminotransferase were significantly higher than in group B (P ＜0.05).The level of post operative albumin was lower in group A than in group B.The two groups of patients (A and B) had similar background including general data (gender,age,nation),preoperative liver function,duration of postoperative tube-drainage of abscess cavity,degree of lesion-invasion into first porta hepa tis,progressive lesion-invasion and/or distant metastasis,biliary complications,mortality,cumulative survival rates and survival curves.Conclusions Interventional treatment is an effective treatment for end-stage hepatic alveolar echinococcosis combined with obstructive jaundice.It has the advantages of minimal invasiveness,simplicity,safety and repeatability.It may replace traditional palliative surgery in the future.
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Objective To determine the effect of age,body figure and risk framing in making treatment decision for female patients with breast cancer.Methods Two groups of healthy female:one group of 60 female ages 18-24 from undergraduate student and the other group of 60 female ages 35-60 from the university community.Healthy women imagined that they had been diagnosed with breast cancer and received information regarding lumpectomy versus mastectomy and recurrence rates.Participants indicated whether they would choose lumpectomy or mastectomy and reasons.Results The different concern levels of body appearance between younger and older women influences treatment selection of lumpectomy versus mastectomy.Facing the risk information,older women were unlikely to select the breast conserving operation.Conclusions The factors of age and the attention to body figure would effect the choice of breast conserving operation or mastectomy.Risk information on the selection of treatment would not affected directly,but the effects of risk information on younger and older female is different.Nurses should provide the age-appropriate information who recently have been diagnosed with breast cancer regarding treatment alternatives to ensure their active participation in the decision-making process,female who have different levels of investment in body figure also may have different concerns about treatment,and should be alert on empathetic of such concerns.
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Objective To explore more safe and effective method for the treatment of common bile duct stones combined with cavernous transformation of the portal vein (CTPV).Methods We report 2 cases of post-treated patients in this series.In order to avoid severe bleeding caused by dissection of bile duct,we applied different methods to remove common bile duct stones compared with traditional operation.We removed common bile duct stones in one patient through cystic duct approach during operation.Two years later,we performed endoscopic duodenal incision (endoscopic sphincterotomy,EST) for him because of lower common bile duct stenosis with sand like stone.Another patient,on the other hand,we conducted the duodenal papilla incision during operation and removed common bile duct stones with choledochoscope through the bottom of common bile duct.Result Of the two patients,all of the three kinds of operation had good curative effects.Conclusions For the patients with common bile duct stones combined with CTPV,we should select appropriate treatments to avoid dissection of bile duct in front of the dilated and tortuous collateral veins during the operation,which is the key to guarantee the safety and success of the operation.EST is the preferred method of the treatment.Open operation with choledochoscopy via cystic duct approach or duodenal papilla incision through distal common bile duct to perform stone extraction also appears to be effective and safe.
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Objective To study the perioperative nursing care of minimally invasive operation in the neurosurgical treatment of laterial flexure spasmodic torticollis (LaFST).Methods Minimally invasive operation was used to treat LaFST.The relationship of inducing factors and emotional factors with clinical manifestation of LaFST was investigated.To give perioperative psychological nursing,operation nursing and rehabilitation training and instruction.Results 72 cases were recovered (81.8％) among 88 cases.12 cases(13.6％) were markedly effective.4 cases(4.6％) showed progress.Conclusions The minimally invasive surgical treatrnent of selective resection of cervical spasmodic muscles and selective neurotomy of cervical nerve for LaFST is safe and effective.Strengthening of perioperative nursing and postoperative rehabilitation instruction is very important for patients' early recovery.
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Objective To explore the curative effects of operation in treatment of subacute thyroiditis.Methods The clinical data of 87 patients with subacute thyroiditis were retrospectively analyzed.According to the treatment methods,87 patients were divided into the operation group 39 cases and the medical treatment group(conservative group) 48 cases.Patients were followed up for 6 months after treatment.The clinical effect 1 week after the end of treatment was compared between the two groups.The thyroid functionat 6 months after the end of treatment was compared.Results The incidence rate of thyroid hyperfunction (hyperthyroidism) of the operation group was 33.33％,which was significantly higher than 8.33％ in conservative group,the difference was statistically significant (x2 =8.554,P =0.003).The effective rate of short-term treatment of operation group and the conservative group was 89.74％ and 93.75％,the difference was not significant (x2 =0.467,P =0.495).After 6 months of treatment,the normal rate of thyroid function between the two groups had no statistically significant difference(x2 =4.947,P =0.084).In the conservative group,3 cases were diagnosed as thyroid carcinoma complicated with hyperthyroidism.Conclusion For patients with refractory subacute thyroiditis or cannot exclude malignant tumors,operation can achieve good effect and less complications.
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Objective:To investigate the surgical treatment of adult Hirschsprung's disease (AHD). Methods: A retrospective clinical analysis was proceeded in 7 cases of AHD treated in our hospital from January 2003 to May 2008. There were 3 males and 4 females with an age ranged from 18 to 53 years,including three cases with general segment type,two cases with short segment type,one case with long segment type and one case with whole segment type. All cases were received the modified Duhamel operation. Results: All cases had satisfactory outcome without serious complications,such as soiling, blind pouch syndrome, fecal incontinence and sexual disorder in male patients. Pelvic hydrops occurred in one case and anastomotic inflammation occurred in another case,and both were cured by intensive therapy. Conclusion: The Modified Duhamel Operation is an effective and safe procedure for AHD. Through this procedure the postoperative recurrence rate is reduced, as well the sexual function and the defecate function are remained .
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Objective To evaluate the non-operation treatment of the severe acute pancreatitis(SAP).Methods 218 cases of SAP were analyzed retrospectively.Early operation was adopted before 1998(n=96)and early non-operation treatment was applied after 1998(n=122).Results 25 of 96 cases in operation group died (26.1%),while 9 of 122 cases in non-operation group died(7.4%).The complications was higher than in non-operation group(P＜0.01).Conclusion Early non-operation treatment is necessary for the early stage of SAP.
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12)is good after nonoperative treatment above 2 years.
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OBJECTIVE To investigate the clinical pathologic features and therapeutic tools of pulmonary cryptococcosis.METHODS The clinical data about 16 cases of pulmonary cryptococcosis which were diagnosed by histopathologic examinations were reviewed.The survey data recorded over a 15-year period,from 1982 to 2007,were summarized.We analyzed their clinical situations,radiographic manifestations,final diagnosis and therapeutic tools.RESULTS The majority of the patients were middle-aged males.The health condition of the most of the patients was good before infection.six months to five years after surgery and antifungal theragy,no relapse,dissemination and death were observed.CONCLUSIONS The majority of primary pulmonary cryptococcosis patients have not underlying diseases,and their radiography manifestations show single or multiple nodular shadows,tumor shadows and infiltrative shadows.The limited pathological change can be excised and applied with the antifungal drugs.Fluconazole is the first-choice drug for curing pulmonary cryptococcosis.
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Objective To summrize the effects of various treatment methods,including operation,transcatheter arterial embolization(TAE),and percutaneous ethanol injection(PEI) on hepatic cavernous hemangioma(HCH),in order to select an optimal therapy strategy for HCH.MethodsClinic data of 47 patients with 58 hepatic hemangiomas treated in our hospital in recent 10 years were analyzed retrospectively.Results There were 26 males and 21 females with mean age 42?2 5 years(10～72 years old)in this series.The diameters of these lesions were 3～21 5cm(mean diameter 8 5?1 8cm).Of them,obvious symptoms appeared in 39 patients,malignancy could not excluded in 6,and the size of HCH increased rapidly in 2.Operations were performed in 40 patients,including 2 patients failed to PEI;TAE was conducted in 7cases.There was no mortality or major morbidity occurred in the operative patients,except right pleual effusion in one case and subdiaphragmatic fluid collections in another case(2/40).Neither is mortality nor morbidity seen in the TAE treated case.Conclusions Operation is an effective procedure for HCH.But for more diffuse lesions or lesions located in special region,TAE is a more favorable alterative selection.Because PEI has risk of hemorrhage and hardener injection under ultrasonography guide has uncertain outcome,so it should be chosen cautiously.
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Objective To evaluate the effectiveness of venous external valvuloplasty in treatmeant of moderate or severe incompetent deep venous valve.Methods 54 patients with moderate and severe primary incompetent deep venous valve underwent anterograde and retrograde venous angiography of lower limbs, the angiography showed that reflux degree were 2～4grade. 54 patients were divided into two groups.The first group patients(n=32) without serious injured free margin of venous valve leaves were treated by venous external valvuloplasty,the other group patients with serious injured free margin of valve leaves(n=22),were other treatment.Results The showed excellent curative effect,were obtained better effect 29(90.6%) of the 32 cases were 3(9.4%) of 32 cases.The symptoms of all patients were disappearance and ulcer were close up. The colour Doppler ultrasonography had shown that blood was not flow backwards in the vein.Conclusions The authors believe that the good results may be expected in the opration of venous external valvuloplasty in patients with moderate and severe primary incompetent deep venous valve whose free margin of valve leaves were not serious injured .
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Objective To study the clinical characteristics and x-ray traits of pulmonary sequestration,in order to guide preoperative diagnosis and proper treatment.Methods Data of PS patients in this hospital in ten years were summarized and analyzed.Results The pathology after operation proved that the preoperative error diagnosis rate is 71% (10/14).All patients recovered after operative treatment.The diagnosis rate can be improved by examination of CT and X-ray.Conclusions It is difficult to make a definite diagnosis before operation though PS has its relevant clinical appearances and features of X-ray. The PS cases can be made successfully diagnosed and treated dy surgery.Attention should be paid to manage the unusual artery in operation.
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According to the law,signing the operation agreement between patient and hospital before operation is one of the most important parts of legal treatment.It discusses the importance of the effect,error regions in applying and modeling the operation agreement before operation.It discusses the function of operation agreement in protecting both patients' and medical staff's right,reducing medical disputes and strengthening the confidence of patients against diseases from the point of view of ethics.At the same time it analyses how to perfect and regulate the content and procedure of the agreement and have a good relationship between doctors and patients.
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From January 1985 to June 1992, 34 patients with acute necrotizing pancreatitis proved by operation and pathology were admitted. The patients consisted of 10 males and 24 females, aged 1～72 with an average age of 43.8years. The time from onset to operation was 10～63 hours (average 30.7 hours). All patients underwent pancreatic capsulotomy, mobilization of pancreatic bed, and necrosectomy with the exception of one treated by subtotal pancreatectomy. Twenty-nine cases were cured, the average hospital stay was 77.4 days. Five patients died with a mortality of 14.7 per cent. We take the view that all patients with acute necrotizing pancreatitis should be early operated when the diagnosis is established, and necrosectomy proved to be a simple, easy, safe and effective mode of operation.