Observation of clinical effect of posterior surgical treatment for spinal stenosis with lumbar degen-erative de novo scoliosis / 临床外科杂志

Objective To investigate clinical effect of surgical treatment for spinal stenosis with lumbar degenerative de novo scoliosis with spinal stenosis.To discuss selection of operation methods and ranges of fusion.Methods 27 patients of degenerative scoliosis with spinal stenosis were treated by oper-ation.We performed posterior decompression on the segments and selected fusion,then performed correc-tion deformity.Measured Cobb 's angle,lumbar lordosis angle,the distance between C7 plumb line (C7PL),upper edge of S1 vertebral body(SVA),and the distance between C7PL and center sacral verti-cal line(CVA)after operation and final follow up were compared with preoperative data.JOA score system were used to evaluate clinical effects.The SF-36 questionary was used to evaluate the patients'life quality before and after operation as well.Results All patients were followed up with an average of 20 months. Preoperative,postoperative and final follow up,Cobb's angle was(22.1 ±10.5 )°,(10.2 ±7.3)°and (10.4 ±4.8)°,respectively;lumbar lordosis angle was(21.2 ±10.3)°,(25.7 ±12.2)°and(25.3 ± 12.3)°,respectively;SVA was(7.5 ±6.1)cm,(0.6 ±3.1)cm and(0.5 ±2.4)cm,respectively;CVA was(6.9 ±5.3)cm,(2.8 ±1.3)cm and(2.9 ±1.2)cm,respectively.There was significant difference in data before and after operation(P >0.05).JOA score was 10.8 ±1.4,21.3 ±2.4 and 23.5 ±2.3,re-spectively;All domains of SF-36 score were significantly improved postoperatively(P <0.05).Conclu-sion For surgical treatment with limited decompression,pedicle screw fixation and fusion will be effective methods for degenerative scoliosis with spinal stenosis,individualized surgery design should be made ac-cording to clinical symptoms,signs and imaging features.

Application of preoperative nutritional risk screening in perioperative nutrition support for colorectal cancer patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the guidance role of preoperative nutritional risk screening in perioperative nutrition support for colorectal cancer patients in order to provide evidence for the rational clinical application of nutrition support.</p><p><b>METHODS</b>Nutritional risk screening was carried out in 290 hospitalized colorectal cancer patients from The Fourth People's Hospital of Wuxi City, Tongji Hospital of Tongji University and The Second Hospital of Soochow University with the nutritional risk screening(NSR) 2002 score summary table. Postoperative bowel function recovery and associated nutritional indices were compared between patients who received preoperative nutrition support according to the risk screening results and those who did not.</p><p><b>RESULTS</b>Among 110 patients at nutritional risk, 65 received perioperative nutrition support and had faster recovery of intestinal function [time to first flatus (2.3±0.5) d vs. (3.3±0.5) d, time to first defecation (3.5±0.5) d vs. (4.6±0.6) d, semi-fluid intake (10.1±1.2) d vs. (12.4±2.2) d], shorter postoperative stay [(15.7±1.1) d vs. (18.8±1.4) d], and higher albumin, prealbumin and transferrin [(33.2±4.5) g/L vs. (26.0±4.0) g/L, (0.28±0.05) g/L vs. (0.16±0.04) g/L, (1.92±0.33) g/L vs. (1.75±0.45) g/L] at 7-day postoperatively (all P<0.05) as compared to those without perioperative nutrition support(n=45). While among 180 cases without nutritional risk, there were no significant differences in the above indices between patients who received preoperative nutrition support and those who did not (all P>0.05).</p><p><b>CONCLUSION</b>It is important to evaluate the nutritional risk in hospitalized patients with colorectal cancer, and to carry out nutrition support actively for those at nutritional risk.</p>

The clinical epidemiology of deep venous thromboembolism in the lower extremities / 中华普通外科杂志

Objective To investigate the risk factors and clinical characteristics of deep venous thromboembolism (DVT) of the lower extremities in Chinese people. Methods The clinical manifestations and risk factors in 2742 DVT patients diagnosed by phlebography were retrospectively studied. Results DVT made up 22.39% of all the venous diseases of the lower extremity. The most common clinical presentations of DVT were swelling and pain (92. 34% ), varicose vein ( 32. 57% ), pigmentation (24. 95% ) and ulceration( 18.45% ). The left lower extremity was more frequently involved. The whole limb type was 60. 09%, 80. 23% DVT patients had identified risk factors including age over 40 years old (76. 29% ), history of major surgery ( 12. 18% ) and severe trauma ( 8.42% ), pregnancy and the puerperium ( 4. 87% ). The history of general surgery ( 26. 05% ), vascular surgery ( 23. 35% ), gynaecoiogy and obstetrics (20. 96% ), orthopaedics ( 16. 47% ) and urinary surgery (7.49%) was among the most common surgery. Primary hypercoagulable syndrome was identified in 0. 22% DVT patients. Conclusion DVT makes up 22. 39% of the disease of veins of the lower extremity. The most common clinical presentations of DVT were swelling and pain. The most common risk factors were age over 40 years, major surgery, severe trauma. Primary hypercoagulable syndrome is a heritage risk factor for DVT pathogenesis.