Effect of modified laparoscopic Bacon coloanal anastomosis in transanal totalmesorectal excision:A 8 cases report / 中国实用外科杂志

OBJECTIVE: To explore the effect of modified Bacon coloanal anastomosis in transanal total mesorectal excision(TaTME).METHODS: The clinical data of 8 patients with low rectal cancer treated with TaTME from January 2016 to January 2019 in the division of colorectal surgery of department of general surgery of Peking Union Medical College Hospital were retrospectively analyzed. Laparoscopic assisted modified Bacon coloanal anastomosis was used during operation. The incidence of postoperative complications including anastomotic leakage was observed and the anal function was evaluated.RESULTS: All 8 patients underwent operation successfully. The distance from the inferior margin of the tumor to the anal verge was(4.8 ±0.4) cm. The number of retrieved lymph nodes in postoperative pathological examination was(12.9±2.5). The mean time of first operation was(140.8±8.6) min, and the Second stage operation time was(39.1±9.6) min. The median time between the two operations was 19(13, 20) days, and the median hospital stay was22(17, 24) days. The median follow-up time was 16(4, 36) months. No anastomotic leakage occurred and the anal function was good after operation. Six patients had uncontrollable anal exhaust after operation, and two patients had occasional mucous or watery fecal incontinence after operation, but they were less than once a month. They could be improved by dietary structure adjustment and external sanitary pads.CONCLUSION: Laparoscopic-assisted modified Bacon operation in TaTME avoids anastomotic leakage, and reduces the incidence of anal incontinence after operation.However, the hospital stay is prolonged.

La cardiología nació con la ciencia médica moderna / Cardiology was born with the modern medical science

La ciencia médica moderna nació en la época posrenacentista y comenzó a afianzarse a mediados del siglo XVII por obra de físicos, fisiólogos y biólogos, quienes eran discípulos directos o indirectos de Galileo. El descubrimiento de la circulación sanguínea por Harvey se considera actualmente como el único adelanto en fisiología de principios del siglo XVII, comparable a los avances contemporáneos de las ciencias físicas. La historia de esta hazaña podría escribirse fácilmente desde el punto de vista del avance progresivo del conocimiento. Se ha afirmado con toda justicia que el descubrimiento de la circulación de la sangre es la primera explicación adecuada de un proceso orgánico y el punto de partida del camino hacia la fisiología experimental. Puede aseverarse, por lo tanto, que la ciencia médica moderna no surgió de manera subitánea y global, sino que se estructuró gradualmente desde mediados del siglo XVII, por la senda seguida por William Harvey, a la luz del pensamiento de Galileo.

Modern medical science was born in the post-Renaissance age and began to consolidate towards the middle of the XVII century thanks to physicists, physiologists and biologists, most of whom were direct or indirect pupils of Galileo. The discovery of blood circulation by Harvey is now considered the only progress in physiology at the beginning of the XVII century, comparable to the current advances seen in physical sciences. The history of this exploit could be written from view point of the progressive advance in knowledge. In his experiments, Harvey referred to the authentic not imaginary experiments, and put forward irrefutable quantitative arguments. We can therefore claim that his discovery of blood circulation was the first proper explanation of an organic process and the starting point leading to experimental physiology. So it seems justified to assert that modern medical science did not all rise suddenly, but was gradually structured starting from the middle of the XVII century following the path traced by William Harvey in light of Galileo's thought.

A Poética de Francis Bacon / The Poetic of Francis Bacon

A partir da perspectiva psicanalítica, a autora aborda a obra de Francis Bacon se utilizando de uma concepção estética que a reconhece como uma realidade ontológica. Dessa forma, considera que como obra de arte, são seus próprios elementos constitutivos, numa tensão interna, que são capazes de provocar efeitos ou as sensações que são o seu objetivo último conforme defendia Bacon. Em sua análise a autora examina e discute a dialética "tempo - espaço", revelada pelo poeta pintor, como sendo de especial interesse para a clínica psicanalítica na medida em que esclarece importantes questões relativas ao Real como impossível, tal como o compreendeu Lacan. A pintura de Bacon examinada como referência à "sublimação criacionista da pulsão de morte" permite, segundo a autora, vislumbrarmos o para além da cadeia significante. Conclui que a arte, assim como a clínica psicanalítica, supõe deslocamentos subjetivos que implicam corte - rompimento com a tendência unificadora e pacificadora de Eros.

From the psychoanalytic perspective, the author discusses the work of Francis Bacon by using a aesthetic conception that recognizes it as an ontological reality. Thus, consider that as a work of art, their own constituents, in internal tension, are capable of causing effects or sensations that are its ultimate goal as advocated by Bacon. In his analysis, the author examines and discusses the dialectic "time - space," revealed by the poet/painter, as being of particular interest to the psychoanalytic clinic once itt clarifies important issues related to Real as impossible, as Lacan understood. Bacon's painting examined by reference to the "creationist sublimation of the death drive" allows us, according to the author, to glimpse beyond the significant chain. The author concludes that art, like the psychoanalytic clinic, assumes subjective displacements implies in cutting - breaking with the trend of an Eros that unifies and pacifies.

William Harvey y los inicios de la ciencia médica moderna / William Harvey and the beginnings of modern medical science

El Renacimiento no hizo más que preparar el terreno para el surgir de la ciencia médica moderna. Ésta nació, de hecho, en la época posrenacentista y comenzó a afianzarse a mediados del siglo XVII por obra de físicos, fisiólogos y biólogos, que eran discípulos directos o indirectos de Galileo. El descubrimiento de la circulación de la sangre por Harvey se considera hoy día como el único adelanto en fisiología de principios del siglo XVII, comparable a los avances contemporáneos de las ciencias físicas. La historia de esta hazaña podría escribirse fácilmente desde el punto de vista del avance progresivo del conocimiento. En sus investigaciones, Harvey se refería a experimentos auténticos, no imaginados. y aducía irrefutables argumentos cuantitativos. Se ha afirmado con justicia que su descubrimiento de la circulación sanguínea fue la primera explicación adecuada de un proceso orgánico y el punto de partida del camino hacia la fisiología experimental. Sin embargo, la segunda monografía del sabio de Folkestone acerca de la generación de los animales, publicada en 1651, mientras que en algunos pasajes da la impresión de corresponder al razonamiento científico moderno, muestra en otros pasajes aseveraciones confusas, vagas y caprichosas, rescoldo de la era precientífica de la que el autor no había salido por completo. Puede aseverarse, por tanto, que la ciencia médica moderna no surgió de manera subitánea y global, sino que se estructuró gradualmente desde mediados del siglo XVII siguiendo la senda trazada por William Harvey a la luz del pensamiento de Galileo.

Modern medical science was born in the post Renaissance age and began to consolidate towards the middle of the XVII century thanks to physicists, physiologists, and biologists, most of whom were direct or indirect pupils, of Galilei. The discovery of blood circulation by Harvey is now considered the only progress in physiology at the beginning of the XVII century, comparable to the current advances seen in physical sciences. The history of this achievement could be written from the view point of the progressive advance in knowledge. In his experiments, Harvey referred to the authentic, not the imaginary experiments, and put forward irrefutable quantitative arguments. We can therefore claim that his discovery of blood circulation was the first proper explanation of an organic process and the starting point leading to experimental physiology. Nevertheless, the second monograph of the english researcher, dealing with the generation of animals, published in 1651, has some passages that correspond to modern scientific reasoning yet in others he includes confused, vague and capricious assertions compatible with the prescientific era that the author was not able to escape completely. In conclusion, it seems justified to assert that modern medical science did not all rise suddenly, but was gradually structured starting from the middle of the XVII century following the path traced by William Harvey in light of Galilei's thought.