Urinary continence-related structures and intraoperative protective techniques in radical prostatectomy / 现代泌尿外科杂志

Radical prostatectomy (RP) is the standard treatment for patients with early-stage of prostate cancer,but often causes urinary incontinence and other complications, which harm patients’ quality of life. The protection and reconstruction of urinary continence-related structures during the operation are significant approaches to reduce the incidence of urinary incontinence and restore urinary continence. This article reviewed the surgical approaches of radical prostatectomy, anatomy of urinary continence-related structures (bladder neck, functional urethra, supporting structures, nerves and vessels) and the protective skills,hoping to provide reference for the treatment of early-stage prostate cancer.

Evaluation of reinforced plication as an alternative to resection in exotropia

Purpose: To evaluate the surgical efficacy of reinforced plication of the medial rectus muscle to resection as an effective muscle strengthening procedure in exotropia. Methods: This is a prospective randomized trial in patients with exotropia who underwent complete orthoptic evaluation followed by random assignment into two groups by using a computer?drawn random number table. Group 1 patients underwent standard resection with recession procedure, and group 2 patients underwent reinforced plication with recession procedure. Follow?up was performed at day 1, 1 week, 1 month, 3 months, and 6 months to assess the surgical efficacy. Results: A total of 80 patients were included in the study of which 39 were in group 1 and 41 in group 2. The mean age in group 1 was 23.48 ± 11.94 years and 23.29 ± 10.02 years in group 2. The mean preoperative deviation in group 1 for distance was 50.13 ± 11.95 PD and 50.12 ± 9.79 PD in group 2 (P = 0.499). In group 1 with a mean surgical dose of 5.27 mm medial rectus resection and 8.04 mm lateral rectus recession, a 7.11 ± 3.95 PD deviation was noted at the end of 6 months. Similarly, in group 2 with a mean surgical dose of 5.16 mm medial rectus plication and 8.16 mm lateral rectus recession, a 6.00 ± 2.46 PD deviation was noted at the end of 6 months. Between groups, ocular surface changes, inter?surgeon comparison, and exotropia subtypes did not reveal any significant differences. Conclusion: In our observation, the reinforced medial rectus muscle plication showed clinically comparable results as compared to the standard resection procedure at the end of 6 months. Therefore, this innovative modification can be considered as an alternative to standard resection

Meta-analysis of unilateral resection-recession versus plication-recession for exotropia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the effectiveness of unilateral lateral rectus recession-medial rectus resection(RR))and lateral rectus recession-medial rectus plication(RP)in the treatment of exotropia. METHODS: Evidence-based medicine research. A systematic database search was conducted Medline, Embase, Web of Science, the Cochrane Register of Controlled Trials and so on from August 2011 to August 2021. Related studies meeting the inclusion criteria were included in our study. The main outcome measures were as follows: success rate and postoperative deviation. Mean difference(MD)and odds ratio(OR)with 95% confidence interval(CI)were statistical analyzed as measurement data and continuous variables statistics. RESULTS: A total of two randomized controlled studies and five retrospective studies were included. The Meta-analysis results showed that the success rate of surgery was similar for RP group compared with RR group(OR=0.65, 95%CI:0.39-1.07, P=0.09). There was no difference in the incidence of poor postoperative prognosis of the two groups(the undercorrection and overcorrection rates)(OR=1.59; 95%CI: 0.92-2.74, P=0.10; OR=4.43; 95%CI: 0.69-28.18, P=0.12). There were no significant differences in postoperative deviation and the amount of external oblique drift(MD=0.75, 95%CI: -0.27-1.76, P=0.15; MD=-0.34, 95%CI: -1.30-0.63, P=0.50). CONCLUSION: The success rate of RP and RR surgery is close to the incidence of poor postoperative prognosis, moreover, there was no significant difference between the deviation and the amount of external oblique drift after the two surgeries, RP is an effective surgical procedure for the treatment of exotropia.

Clinical observation of diaphragm plication after pediatric congenital heart disease surgery / 中国小儿急救医学

Objective:To analyze the risk factors of performing diaphragm plication(DPL) after congenital heart disease(CHD) surgery as well as the timing and clinical efficacy.Methods:Data regarding children underwent open heart surgery at Shanghai Children′s Medical Center from January 2017 to December 2019 were reviewed.According to whether DPL was performed after CHD operation or not, the children were divided into DPL group and non-diaphragm plication(NDPL)group.Clinical data including age, surgery, cardiopulmonary bypass(CPB)temperature and time of two groups were compared, meanwhile the risk factors of DPL surgery were analyzed.Based on the median of 8 days between open heart surgery and DPL, children in DPL group were divided into early surgery group(less than 8 days), and delayed operation group(no less than 8 days). The parameters of comparison included ventilator using time, hospital stay time, hospitalization expenditure, postoperative infection to evaluate the timing of DPL and effect.Results:There were 10 309 children after CHD, including 95 in DPL group and 10 214 in NDPL group.In DPL group, there were 52 males(54.7%) and 43 females(45.3%), with age 147(52, 318) d, weight(5.5±4.1) kg, height(56.8±25.6) cm, CPB time(136.8±93.4) min and aortic occlusion time(62.5±50.2) min.Compared with NDPL group, DPL group had younger age, shorter height, lighter weight, higher incidence of preoperative special treatment, higher proportion of reoperation, lower CPB temperature, longer CPB time and longer aortic occlusion time.There were significant differences between two groups( P<0.05). Multivariate Logistic regression analysis showed that younger operative age( OR=0.998, 95% CI 0.998~0.999, P<0.001), staging operation( OR=72.977, 95% CI 39.096~136.211, P<0.001), long CPB time( OR=1.006, 95% CI 1.002~1.011, P=0.008), and pulmonary venoplasty( OR=4.219, 95% CI 2.132~8.350, P<0.001) were independent risk factors for DPL after CHD.Early surgery group had lower postoperative infection rate(43.59% vs. 88.38%, P=0.007), shorter ventilator duration[168.0(99.5, 280.5) h vs.309.9(166.2, 644.5) h, P=0.029], shorter hospital stay duration[27.00(20.75, 35.00)d vs.37.00(28.00, 53.00)d, P<0.001], and lower hospitalization cost[158.36(128.99, 203.11) thousand yuan vs.232.95(174.54, 316.47) thousand yuan, P<0.001] than delayed operation group. Conclusion:Younger age, staging operation, long CPB time, and pulmonary venoplasty are independent risk factors for DPL due to diaphragmatic paralysis after pediatric CHD surgery.Early surgical intervention is beneficial for the recovery of children.

Effects of plication procedures in special cases of Peyronie's disease: a single-center retrospective study of 72 patients / 亚洲男科学杂志(英文版)

General recommendations regarding surgical techniques are not always appropriate for all Peyronie's disease (PD) patients. Therefore, the purpose of this study was to investigate the effects of plication procedures in PD patients with severe penile curvature and the effects of early surgical correction in patients who no longer have progressive deformities. The clinical data from 72 patients who underwent plication procedures were analyzed in this study. Patients were divided into Groups A and B according to the curvature severity (≤60° or >60°) and Groups 1 and 2 according to the duration of disease stabilization (≥3 months or <3 months). At the 1-year follow-up, 90.0% (36/40) and 90.6% (29/32) patients reported complete penile straightening, and 60.0% (24/40) and 100.0% (32/32) patients reported penile shortening in Groups A and B, respectively. No curvature recurrence occurred in any patient, and no significant differences were observed in postoperative International Index of Erectile Function-Erectile Function domain (IIEF-EF), erectile pain, sensitivity, or suture knots on the penis whether such outcomes were grouped according to the curvature severity or the duration of stabilization. However, the duration from symptom onset to surgical management in Group 1 was significantly longer than that in Group 2 (mean ± standard deviation [s.d.]: 20.9 ± 2.0 months and 14.3 ± 1.2 months, respectively, P < 0.001). The present study showed that the plication procedures seemed to be an effective choice for the surgical treatment of PD patients with severe penile curvature. In addition, the early surgical treatment seemed to benefit those patients who already had no erectile pain and no longer exhibited progressive deformity.

Plicatura gástrica laparoscópica: seguimiento a largo plazo / Laparoscopic gastric plication: long-term follow-up

Resumen Introducción: La experiencia internacional no ha logrado reproducir los resultados de los primeros trabajos de plicatura gástrica laparoscópica (PGL). Objetivo: Analizar los resultados a largo plazo de pacientes sometidos a PGL. Materiales y Método: Estudio prospectivo y descriptivo, se incluyeron pacientes obesos adultos que cumplieron criterios universales para cirugía bariátrica. Se registraron datos epidemiológicos, comorbilidades, tiempo operatorio, estadía hospitalaria, porcentaje de pérdida de exceso de IMC (% PEIMC), complicaciones posoperatorias y resolución de comorbilidades. El seguimiento se efectuó con controles periódicos anuales hasta el año 2020. Resultados: Se inició la selección de pacientes durante el año 2010. Se realizaron 26 intervenciones desde enero de 2011 hasta mayo de 2012. Todas las pacientes fueron de género femenino. El IMC preoperatorio promedio fue 38,8 kg/m2 (DS 3,8). El % PEIMC promedio al año, 3 años y 9 años de posoperado, fue 62,2% (DS 27,1), 40,2% (DS 24,5) y 28% (DS 31,9), respectivamente. Las complicaciones, basadas en la clasificación de Clavien-Dindo (CD), durante los primeros 30 días de posoperatorio fueron 21 pacientes con tipo I, 1 con tipo II, y 2 pacientes con complicaciones tipo IVa. A los 9 años de posoperado, 9 pacientes presentaban efectos adversos tipo I. No hubo mortalidad. Hasta los 3 años hubo corrección de comorbilidades. Se objetivaron 3 pacientes diabéticas al final del estudio, 2 de ellas previamente sanas. Conclusiones: El % PEIMC a largo plazo fue insuficiente. El porcentaje de complicaciones es mayor que en otras técnicas. No recomendamos la realización de la PGL.

Background: The international experience has failed to reproduce the first studies of laparoscopic gastric plication (LGP). Aim: The objective is to analyze the outcomes after 10 years of follow-up of patients subjected to LGP. Materials and Method: Prospective and descriptive study, in which obese adult patients who met universal criteria for bariatric surgery were included. Epidemiological data, comorbidities, operating time, hospital stay, percentage of excess BMI loss (% EBMIL) and resolution of comorbidities were collected. The follow-up was realized by annual periodic controls until 2020. Results: Patient selection began in 2010. A total of 26 interventions were performed from January 2011 to May 2012. All patients were female. The average preoperative Body Mass Index (BMI) was 38.8 kg/m2 (SD 3.8). The average % EBMIL at 1st, 3rd and 9 th postoperative years was 62.2% (SD 27.1), 40.2% (SD 24.5) and 28% (SD 31.9), respectively.Complications, based in Clavien Dindo classification, during the first 30 postoperative days was: 21 patients with type I, 1 type II, and 2 patients with complications type IVa. At 9 th postoperative year, 9 patients presented adverse effect type I. There was no mortality. Until the 3rd year there was correction of comorbidities. Three diabetic patients were observed at the end of the study, 2 previously healthy. Conclusions: The long term % EBMIL was insufficient. The percentage of complications is higher than in other techniques. We do not recommend the LGP.

Perioperative management and complications prevention and treatment of recipients in liver transplantation / 中华消化外科杂志

After more than 40 years of development, the techniques of liver transplanta-tion have gradually matured, which make liver transplantation become the effective means for the treatment of patients with end stage liver disease. Preoperative evaluation of donors and recipients, intraoperative management, monitoring and treatment of complications such as postoperative immune rejection and infection are all important contents of perioperative management of liver transplantation. With the development and mature of surgical techniques and the expansion of the scope of indications, perioperative management and complications prevention and treatment of liver transplantation need to be explored and optimized. The authors analyze the latest literature reports at home and abroad, investigate the perioperative management and complications prevention and treatment of recipients in liver transplantation combined with clinical practice.

Effects of patients' understanding and choice of surgical types on postoperative outcomes of Peyronie's disease: a single-center retrospective study of 108 patients / 亚洲男科学杂志(英文版)

Surgical correction can be considered for treating patients with a chronic phase of Peyronie's disease (PD) and persistent penile curvature. In clinical practice, some patients pay too much attention to surgical complications and refuse the recommended feasible surgical types. Meanwhile, they require operations according to their preferences. This study aimed to evaluate the effects of patients' own choice of surgical type on postoperative satisfaction. This retrospective study analyzed data from 108 patients with PD who underwent surgical correction according to doctors' recommendations or patients' own demands. The objective and subjective surgical outcomes were assessed. Patients' understanding of the disease was analyzed using a questionnaire survey. Objective measurements of surgical outcomes, including penile straightening, penile length, and sexual function, in patients who received the recommended surgery, were similar to those in patients who did not accept the recommended surgery. However, subjective evaluations, including erectile pain, discomfort because of nodules on the penis, and decreased sensitivity in the penis, were more obvious in patients who did not follow doctors' recommendations. In addition, a questionnaire survey showed that understanding PD and the purpose of surgery of patients who did not follow doctors' advice were inappropriate, as they did not conform to the principle of treatment. The present study showed that surgical correction seemed to be an objectively effective option in the management of patients in the stable chronic phase of PD. Low patient satisfaction might be related to patients' lack of correct understanding of the disease and its treatment strategy as well as unrealistic expectations.

Management of residual penile curvature after penile prosthesis placement / 亚洲男科学杂志(英文版)

Residual penile curvature is a common situation following the implantation of a penile prosthesis in patients with Peyronie's disease. Currently, there is a variety of options for the correction of residual curvature, including penile modeling, plication techniques, as well as tunical incision/excision with or without grafting. A literature search of PubMed and Medline databases was conducted from 1964 until 2020, using search terms for all articles in the English language. In this article, we provide a review of the techniques and the outcomes, according to the published literature.

Thoracoscopic surgery versus traditional open surgery for infants with congenital diaphragmatic eventration: A retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective    To compare and analyze the treatment effect of thoracoscopic surgery and traditional open surgery on infants with congenital diaphragmatic eventration, and summarize the experience of thoracoscopic surgery in infants with congenital diaphragmatic eventration. Methods    We retrospectively analyzed the clinical data of 105 children with congenital diaphragmatic eventration who received operation in the Department of Cardiothoracic Surgery of Children’s Hospital of Chongqing Medical University from January 2010 to January 2019. The patients were divided into an open group and a thoracoscopic group according to the operation methods. There were 41 patients in the thoracoscopic group, including 30 males and 11 females, with an average of 13.42±11.08 months (range: 1 d to 3 years). There were 64 patients in the open group, including 44 males and 20 females, with an average age of 8.21±9.33 months (range: 15.0 d to 1.6 years). The operation time, intraoperative bleeding volume, postoperative mechanical ventilation time, hospital stay and other operation indexes as well as the mortality, recurrence rate and complication rate of the two groups were observed. Results    The operation indexes such as operation time, intraoperative bleeding volume, postoperative mechanical ventilation time, thoracic drainage time, CCU stay and hospital stay of the thoracoscopic group were better than those in the open group (P<0.05). There was no statistical difference between two groups in postoperative diaphgram muscles descent, postoperative feeding time or patients needing thoracic drainage (P>0.05). The incidence of postoperative complications in the thoracoscopic group (19.51%) was lower than that in the open group (23.44%, P>0.05), and the difference in mortality and recurrence rate between the two groups was not statistically significant (P>0.05). Conclusion    Both thoracoscopic diaphragmatic plication and traditional open surgery can effectively treat congenital diaphragmatic eventration, but compared with traditional open surgery, thoracoscopic diaphragmatic plication has the advantages of shorter operation time, less trauma, more rapid recovery and fewer complications, so it should be the first choice for children with congenital diaphragmatic eventration.

Clinical efficacy of diaphragmatic plication in the treatment of diaphragmatic paralysis after congenital heart defect operation / 中国胸心血管外科临床杂志

@#Objective    To investigate the timing and clinical efficacy of diaphragmatic plication in the treatment of diaphragmatic paralysis after congenital heart disease (CHD) operation. Methods    From January 2013 to February 2019, 30 children with CHD who were treated in Fuwai Hospital were collected, including 17 males and 13 females with a median age of 19.5 (3, 72) months. There were 6 patients with bilateral diaphragmatic paralysis (bilateral group) and 24 patients with unilateral diaphragmatic paralysis (unilateral group). The clinical data of the two groups were compared. Results    Among the 6 bilateral diaphragmatic paralysis patients, 2 underwent bilateral diaphragmatic plication, and the other 4 patients continued their off-line exercise after unilateral diaphragmatic plication. Patients in the unilateral group had shorter ventilator use time (266.77±338.34 h vs. 995.33±622.29 h, P=0.001) and total ICU stay time (33.21±23.97 d vs. 67.33±28.54 d, P=0.008) than those in the bilateral group. One patient died in the bilateral group, and there was no statistical difference between the two groups (P=0.363). There was no statistical difference in the ICU stay time after diaphragm plication between the two groups (11.68±10.28 d vs. 29.83±27.73 d, P>0.05). Conclusion    Diaphragmatic plication is an effective treatment for diaphragmatic paralysis after CHD operation once the conservative treatment failed. The prognosis of bilateral diaphragmatic paralysis is worse than that of unilateral diaphragmatic paralysis. Strict control of indications for surgery is beneficial to the early recovery of patients.

Posterior Plication of the Ascending Aorta to Relieve Tracheal Compression after Aorto-Left Ventricular Tunnel Repair / 日本心臓血管外科学会雑誌

A nine-month-old boy with a prenatal diagnosis of aorto-left ventricular tunnel (ALVT) and aortic valve disease underwent an urgent ALVT patch closure approximately 2 h after birth. The patient subsequently developed airway compression due to the progressive dilatation of the ascending aorta postoperatively associated with aortic regurgitation and stenosis. After 9 months of prolonged respiratory symptoms following the ALVT repair, he underwent a posterior plication of the ascending aorta. After plication, the tracheal compression and respiratory symptoms improved. A computed tomography (CT) scan 1 month after surgery revealed significant free space between the aorta and the trachea, which relieved the aortic compression. Posterior plication of the ascending aorta is achieved by resecting the posterior aortic wall adjacent to the airway. It is the procedure of choice for longer and more effective relief of airway compression compared to other procedures such as anterior aortopexy, the lateral sliding technique, and side clamp plication.

Treatment of mild congenital ptosis by plication of the levator complex / 中华整形外科杂志

Objective@#To investigate the clinical effect of the plication of the levator complex for the treatment of mild congenital ptosis.@*Method@#From October 2017 to October 2018, 33 patients with mild congenital ptosis were treated with the method of the plication of the levator complex. The postoperative ptosis correction upper eyelid curvature and the occurrence of postoperative complications were analyzed.@*Results@#All patients were followed up for 3 to 12 months. 31 patients had complete correction and 2 patients were mild under-correction. Thirty-one patients had good surgical results, eyelid symmetry, natural curvature of the upper eyelid, and all patients had natural closure of the eyelid within 3 months after surgery. All patients had no serious complications such as keratitis. Two patients with undercorrection had revision surgery after 3 months, and the results were satisfactory.@*Conclusions@#The operation of under through plication of the levator complex for the mild congenital ptosis is simple, the operation is satisfactory, and the complications are few.

Left ventricular aneurysm repair: off-pump linear plication versus on-pump patch plasty

Abstract Objective: The study aimed to compare the clinical outcomes of simplified linear plication and classic patch plasty in patients with left ventricular aneurysm (LVA). Methods: We retrospectively reviewed 282 patients undergoing LVA repair between 2006 and 2016. After propensity score matching, 45 pairs of patients receiving LVA surgery were divided into either a patch group (on-pump endoventricular patch plasty) or a plication group (off-pump linear plication). Then, their early surgical outcomes and long-term survival were compared in two matched groups. Results: The heart function improvement at discharge was similar in the two matched groups, while patients in the patch group more commonly suffered from low cardiac output syndrome (P=0.042) with higher proportion of intra-aortic balloon pumping assistance (P=0.034) than patients in the plication group. Compared with patients in the patch group, the patients in the plication group had shorter recovery times, regarding to mechanical ventilation, intensive care unit stay, and hospital stay (P<0.001, P<0.001, and P=0.001, respectively). No significant difference was found in the long-term survival (P=0.62). Conclusions: Off-pump linear plication presented acceptable results in terms of early outcomes and long-term survival. For high-risk patients, the simplified LVA repair technique may be an option.

Tratamiento endoscópico subcutáneo de la diastasis de músculos rectos y de otros defectos de línea media / Subcutaneous endoscopic repair of diastasis recti and other midline defects

Antecedentes: la diastasis de rectos constituye la separación de la línea media o línea alba, originada en una laxitud de las fibras entrecruzadas de la aponeurosis de ambos músculos rectos. En la actualidad se discute su corrección quirúrgica, existiendo una multiplicidad de factores que lo justifican. Objetivo: analizar la factibilidad y la seguridad del abordaje endoscópico subcutáneo para efectuar la plicatura de músculos rectos, y la corrección de otros defectos de la línea media, en pacientes sin lipodistrofia abdominal. Material y métodos: entre marzo de 2014 y febrero de 2017 fueron abordados por esta vía 42 pacientes con diastasis asociada a otros defectos de línea media. Se analizaron datos demográficos, características de la diastasis, tamaño de los defectos, tiempo operatorio, estadía hospitalaria y complicaciones. El dolor posoperatorio se midió mediante una escala visual análoga, y se valoró la morbilidad y recurrencia mediante ultrasonografía. Resultados: 42 pacientes fueron intervenidos por vía endoscópica. Un 76% fueron de sexo femenino, con una edad promedio de 39 años. En el 93% de los casos, la diastasis fue supraumbilical e infraumbilical, y su tamaño promedio fue de 5,5 cm. Los defectos asociados en su mayoría fueron hernia umbilicales. No se registraron complicaciones intraoperatorias, con un tiempo quirúrgico promedio de 80 minutos. La intensidad de dolor posoperatorio fue de 4,1 puntos. La morbilidad más asociada fue el seroma. Conclusiones: la reparación endoscópica subcutánea de la diastasis de rectos, asociada a otros defectos de la línea media, es factible y segura de realizar. Aporta ventajas estéticas considerables, permitiendo su corrección con complicaciones mínimas.

Background: Diastasis recti is the separation of the midline or linea alba due to laxity of the intercrossed fibers of both aponeurosis of the rectus abdominis muscles. Although the surgical correction of this condition is still under debate, many factors justify it. Objective: The aim of this study was to analyze the feasibility and safety of the endoscopic subcutaneous approach for plication of the rectus muscles associated with other midline defects repair in patients without abdominal lipodystrophy. Material and methods: Between March 2014 and February 2017, 42 patients underwent subcutaneous endoscopic repair of diastasis recti and other midline defects. The demographic data, the characteristics and size of the defects, the surgical time, hospital stay and complications were analyzed. Postoperative pain was measured using a visual analogue scale. Ultrasound was used to evaluate morbidity and recurrence. Results: A total of 42 patients underwent the endoscopic approach; 76% were women and mean age was 39 years. In 93% of the cases, diastasis was supraumbilical and infraumbilical, with a mean size of 5.5 cm. Umbilical hernias were the most common associated defects. No intraoperative complications were reported. Mean surgical time was 80 minutes; the intensity of posoperative pain was 4.1 points and seroma was the most common complications. Conclusions: Subcutaneous endoscopic repair of diastasis recti and other midline defects is a feasible and safe procedure that allows the simultaneous correction of both conditions with minimal complications and esthetic benefits.

Application value of laparoscopic gastric plication combined with duodeno-jejunal omega switch in modified adjustable gastric banding / 中华消化外科杂志

Objective@#To explore the application value of laparoscopic gastric plication (LGP) combined with duodeno-jejunal omega switch (DJOS) in modified adjustable gastric banding.@*Methods@#The retrospective and descriptive study was conducted. The clinical data of a female 46-year-old patient who had failure to undergo the adjustable gastric banding in the Hospital of Ludwig Maximilian University from December 2016 to December 2018 were collected. LGP and DJOS were performed in two-stages after completion of preoperative examinations. Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up using outpatient examiantion and telephone interview was performed to collect the information of body mass index (BMI), insulin therapy, and long-term complications until December 2018. Count data were represented as absolute numbers.@*Results@#(1) Surgical and postoperative situations: the patient underwent LGP in the first stage and DJOS in the second stage successfully. For the LGP, the operation time, time of intestinal reconstruction, volume of intraoperative blood loss, time to first flatus, time to drainage tube removal, time to resume to normal diet, and duration of postoperative hospital stay were 96 minutes, 58 minutes, 210 mL, 32 hours, 48 hours, 42 days, and 3 days, respectively. For the DJOS, the above indicators were 148 minutes, 117 minutes, 260 mL, 47 hours, 72 hours, 21 days, and 7 days, respectively. There was no complication occurred in either LGP or DJOS. (2) Follow-up: the patient was followed up for 24 months after LGP. The BMI of this patient decreased to 45.3 kg/m2 at 6 months after LGP, and decreased to 37.2 kg/m2 at 18 months after DJOS. Insulin therapy was discontinued. There was no long-term complication such as malnutrition, dumping syndrome, or biliary reflux.@*Conclusion@#LGP combined with DJOS can enrich treatment methods of obese patient with BMI >50 kg/m2, which offers a safer surgical procedure option for patients after gastric binding.

Application value of laparoscopic gastric plication combined with duodeno-jejunal omega switch in modified adjustable gastric banding / 中华消化外科杂志

Objective To explore the application value of laparoscopic gastric plication (LGP) combined with duodeno-jejunal omega switch (DJOS) in modified adjustable gastric banding.Methods The retrospective and descriptive study was conducted.The clinical data of a female 46-year-old patient who had failure to undergo the adjustable gastric banding in the Hospital of Ludwig Maximilian University from December 2016 to December 2018 were collected.LGP and DJOS were performed in two-stages after completion of preoperative examinations.Observation indicators:(1) surgical and postoperative situations;(2) follow-up.Follow-up using outpatient examiantion and telephone interview was performed to collect the information of body mass index (BMI),insulin therapy,and long-term complications until December 2018.Count data were represented as absolute numbers.Results (1) Surgical and postoperative situations:the patient underwent LGP in the first stage and DJOS in the second stage successfully.For the LGP,the operation time,time of intestinal reconstruction,volume of intraoperative blood loss,time to first flatus,time to drainage tube removal,time to resume to normal diet,and duration of postoperative hospital stay were 96 minutes,58 minutes,210 mL,32 hours,48 hours,42 days,and 3 days,respectively.For the DJOS,the above indicators were 148 minutes,117 minutes,260 mL,47 hours,72 hours,21 days,and 7 days,respectively.There was no complication occurred in either LGP or DJOS.(2) Follow-up:the patient was followed up for 24 months after LGP.The BMI of this patient decreased to 45.3 kg/m2 at 6 months after LGP,and decreased to 37.2 kg/m2 at 18 months after DJOS.Insulin therapy was discontinued.There was no long-term complication such as malnutrition,dumping syndrome,or biliary reflux.Conclusion LGP combined with DJOS can enrich treatment methods of obese patient with BMI ＞50 kg/m2,which offers a safer surgical procedure option for patients after gastric binding.

Short-term Surgical Outcomes of Rectus Muscle Plication and Resection in Intermittent Exotropia

PURPOSE: To evaluate the efficacy and safety of medial rectus muscle plication compared to resection, coupled with antagonist muscle recession, as treatments for intermittent exotropia (IXT). METHODS: We retrospectively reviewed the charts of IXT patients treated by a single surgeon and followed-up for at least 6 months between September 2016 and February 2017. The patients were divided into three groups: a bilateral lateral rectus muscle recession (BLR) group, a unilateral lateral rectus recession with medial rectus plication (R&P) group, and a unilateral lateral rectus recession with medial rectus resection (R&R) group. Serial changes in ocular alignment at 4–24 weeks after surgery were compared among the groups. In addition, the operative times were assessed. RESULTS: We included 119 patients (mean age 6.65 ± 2.79 years). The preoperative exodeviation was 29.81 ± 7.31 prism diopters (PDs) and did not differ among the groups. The R&P group exhibited significantly less postoperative deviation than the BLR group. The operative time was significantly less for the R&P group (25.77 ± 9.29 minutes) than the R&R group (28.97 ± 5.74 minutes). The success rates were identical among groups at 6 months; no severe adverse events were recorded apart from one case of dellen that improved after application of a topical agent. CONCLUSIONS: Plication may reduce the risk for anterior segment ischemia to a level lower than the risks associated with other procedures, and also facilitate reoperation if necessary. We found that R&P took less time but had success rate similar to BLR and R&R. Thus, medial rectus muscle plication for IXT patients is a valuable alternative procedure when the external rectus muscle requires strengthening.

Clinical effect of orbital fat replacement combined with orbicularis oculi muscle flap folding for correction of severe upper eyelid depression with multiple eyelid / 中华医学美学美容杂志

Objective To explore the method and effect of orbital lateral fat replacement combined with orbicularis oculi muscle flap for correction of severe upper eyelid depression with multiple eyelid.Methods From January 2014 to January 2017,26 patients with severe upper eyelid sag with multiple eyelid were treated in Department of Plastic Surgery,Huai'an Second People's Hospital,including 18 cases of multiple physiological sag eyelid,improper operation on the formation of 8 cases of multiple eyelid eyelid sag.All the patients adopt outside orbital fat reset with the orbicularis muscle flap folded for the treatment.Results The follow-up time was 6 months to 1 year,with an average of 8.5 months.23 patients with upper eyelid sag with multiple eyelid were rectified,3 cases of upper eyelid depression associated with multiple eyelid depression alleviated,multiple eyelid disappeared,including 5 cases of preoperative patients with mild ptosis,and symptoms improved after surgery.Conclusions The orbital lateral fat replacement combined with orbicularis oculi muscle flap folding is a safe and effective treatment for upper eyelid depression with multiple eyelid.

Application of zebrafish in field of pharmacy / 中国药理学通报

Zebrafish (Danio rerio) is a simple biological labora-tory animal, with similar biological structure and physiological functions to mammals. Almost transparent embryos, in vitro de-velopment of embryos and up to 87% of human genetic similari- ties enable a wide application of zebrafish in the field of pharma-ceutical research. In this paper, we have studied the application of zebrafish in drug metabolism, the research of Chinese medi-cine, the evaluation of drug toxicology and safety, the screening of drugs and the discovery of new drugs, the research of regener- ative drugs, so as to provide new ideas of zebrafish in the field of pharmacy.