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Objective:To investigate whether miR-548b-3p can regulate the malignant biological traits of hepatocellular carcinoma cells by down-regulating the expression of decoy receptor 3( DcR3). Methods:The miR-548b-3p levels in 5 common hepatoma cell lines Hep3b, HepG2, Huh7.5.1, PLC and 97H were detected by real-time fluorescence quantitative PCR. The experimental hepatoma cell lines were purchased from Shanghai Cancer Institute. The subcutaneous tumor formation experiment in nude mice included two parts: miR-548b-3p over expression group and down expression group. miR-548b-3p over expression experiment included Huh7.5.1- miR-548b-3p cell group and Huh7.5.1-NC cell group. The experimental group with low expression of miR-548b-3p included PLC- miR-548b-3p-sponge group and PLC-NC cell group, with 5 nude mice in each group. The nude mice used in the experiment were male Balb/c strain, body weight 20-25 g, 4-6 weeks old. Starbase software was used to predict whether there were binding sites between miR-548b-3p and DcR3. Dual luciferase reporting assay to verify whether DcR3 is the target gene of miR-548b-3p. Rescue experiments were conducted to verify whether the effects of miR-548b-3p on the proliferation, invasion and migration of liver cancer cells were realized through DcR3. Statistical analysis was performed using Graphpad Prism 9. Measurement data with normal distribution were expressed as mean±standard deviation( ± s), and t-test was adopted for comparison between general measurement data groups. Results:The relative expression level of 2 -ΔΔCt was used as the parameter for real-time fluorescence quantitative PCR comparison. Hep3b expression level was 1, HepG2 expression level was 0.902, Huh7.5.1 expression level was 0.712, PLC expression level was 1.293, and 97H expression level was 0.818. The final results showed that, The highest expression of miR-548b-3p was in PLC cells, and the lowest expression was in Huh7.5.1 cells. The subcutaneous tumor formation experiment of nude mice showed that after 4 weeks, the tumor volume of Huh7.5.1- miR-548b-3p was(444.77±142.34) mm 3, and that of Huh7.5.1-NC was(918.80±139.21) mm 3. The tumor volume of PLC- miR-548b-3p-sponge was(407.49±58.50) mm 3, and that of PLC-NC was(218.62±47.55) mm 3. The binding sites of miR-548b-3p and DcR3 were predicted by Starbase software. Dual luciferase assay showed that DcR3 was the target gene of miR-548b-3p. Rescue experiments verified that the effects of miR-548b-3p on the proliferation, invasion and migration of liver cancer cells were realized through DcR3. Conclusion:miR-548b-3p can regulate the proliferation, invasion, migration and other malignant biological traits of liver cancer cells, and it is achieved by down-regulating the expression level of DcR3.
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Objective To investigate the safety,feasibility,and efficacy of highly selective protective vagotomy in laparoscopic fundoplication.Methods Clinical data of 78 patients who underwent laparoscopic hiatal hernia repair plus fundoplication(short floppy Nissen procedure)for gastroesophageal reflux disease and hiatus hernia from January 2014 to December 2019 in our hospital were retrospectively analyzed.The patients were divided into two groups:the traditional operation group and the vagus nerve protection group.The operation time,blood loss during operation,hospital stay after operation and the incidence of postoperative complications were compared between the two groups.The GERD Q score,DeMeester score,lower esophageal sphincter pressure(LESP),and control of reflux symptoms at 6 months after operation in the two groups were analyzed.Results Both groups of surgeries were successfully completed,and there were no serious intraoperative side injuries.There was no significant difference between the traditionaloperationgroupandthevagusnerveprotectiongroupinoperationtime[(85.5±13.9)minvs.(88.3±18.6)min,t =0.729,P =0.468],intraoperative blood loss[(18.6±8.6)ml vs.(18.1±8.5)ml,t =-0.221,P =0.825],and postoperative transanal exhaust time[(2.0±0.7)d vs.(1.8±1.0)d,t =-1.227,P =0.224].The postoperative hospital stay in the traditional surgical group was significantly longer than that in the vagus nerve protection group[(9.4±3.0)d vs.(8.2±2.1)d,t =-2.172,P = 0.033].The incidence of surgical complications within 30 d after surgery in the traditional surgical group was 36.8%(14/38),which was significantly higher than that in the vagus nerve protection group[12.5%(5/40),χ2 = 6.267,P = 0.012].The traditional surgical group had a cure rate of 86.8%(33/48)at 6 months after surgery,which was not significantly different from the vagus nerve protection group[85.0%(34/40),Z =-0.232,P =0.816].There were no significant differences in GERDQscore,DeMeester score,LESP between the two groups at 6 months after surgery[(5.6±0.9)points vs.(5.8±0.8)points,t =1.232,P =0.222;(4.1±2.2)points vs.(4.2±2.2)points,t =0.261,P =0.795;(23.2±3.5)mm Hg vs.(23.5±3.8)mm Hg,t = 0.412,P = 0.681].Conclusion It is safe,feasible,and effective to apply the highly selective protective vagotomy in laparoscopic short floppy Nissen fundoplication to protect the vagus nerve.
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Objective:To investigate the expression of anti apoptosis inhibitor antibody in serum of patients with advanced primary liver cancer and its relationship with the prognosis after transcatheter hepatic arterial chemoembolization (TACE).Methods:One hundred and three patients with advanced primary liver cancer were selected from our hospital and treated with TACE. Serum anti-survivin antibody expression levels were detected 1 day before surgery and 1 month after surgery. To analyze the relationship between serum anti-survivin antibody level and short-term therapeutic effect, clinicopathological features and prognosis were analyzed.Results:the level of anti-survivin antibody in patients with disease remission was significantly lower than that in patients without disease remission (81.84±9.30 vs. 90.84±10.21, P<0.05), and the change of anti-survivin antibody in patients with disease remission was significantly higher than that in patients without disease remission (30.93±5.63 vs. 22.75±4.52, P<0.05). The changes of anti-survivin antibody before and after TACE were correlated with TNM stage, maximum tumor diameter and degree of differentiation ( P<0.05). The results of survival analysis showed that the postoperative survival of patients with △ reduced anti-survivin antibody was significantly better than that of patients without △ reduced anti-survivin antibody ( P<0.05). The area under the ROC curve was 0.850 in the prediction of one-year death value of patients with primary liver cancer by △ anti-survivin antibody. Conclusion:the difference of anti survivin antibody before and after TACE in patients with advanced liver cancer is closely related to the short-term and long-term prognosis.
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Objective:To explore the quality of life and psychological factors of patients with refractory gastroesophageal reflux disease (rGERD).Methods:From September 2016 to March 2019, 159 rGERD patients visiting the Department of Gastroenterology, Beijing Tongren Hospital Affiliated to Capital Medical University were retrospectively selected. According to the presence or absence of distal esophageal mucosal injury under gastroscopy, the patients were divided into refractory reflux esophagitis (RE) group (58 cases) and refractory non-erosive reflux disease (NERD) group (101 cases). The general data, the results of 24 h esophageal impedance pH, esophageal high-resolution manometry (HRM) and the scores of gatroesophageal reflux disease-questionnaire (GerdQ), 36-item short-form health survey (SF-36), self-rating anxiety scale(SAS) and self-rating depression scale (SDS) were recorded and compared between the two groups. Independent sample t test, rank sum test, chi-square test and multiple linear regression analysis were used for statistical analysis. Results:There were no significant differences in gender, age, abdominal circumference or body mass index between the two groups (all P>0.05). The incidence of extraesophageal symptoms of refractory NERD group was higher than that of refractory RE group (45.5%, 46/101 vs. 24.1%, 14/58), and the difference was statistically significant ( χ2=7.185, P=0.010). The episodes of gas reflux, weak-acid reflux and non-acid reflux were all more than those of refractory RE group (66.20 times, 45.20 times to 111.60 times vs. 38.40 times, 23.50 times to 59.63 times; 34.70 times, 9.05 times to 52.75 times vs. 6.35 times, 3.10 times to 24.00 times; 12.60 times, 2.15 times to 24.20 times vs. 2.15 times, 0 times to 10.30 times), GerdQ score of refractory NERD group was higher than that of refractory RE group (8.9±2.5 vs. 7.8±2.3), and DeMeester score, the symptom index and symptom association probability of refractory NERD group were all lower than those of refractory RE group (5.16, 1.75 to 14.48 vs. 15.19, 2.78 to 45.96; 33.3%, 0 to 60.0% vs. 57.5%, 40.5% to 78.0%; 87.8%, 0 to 97.8% vs. 94.0%, 82.7% to 98.2%); and the differences were statistically significant ( Z=-5.548, -5.384 and -4.338, t=3.306, Z=-2.607, -4.313 and -2.468; all P<0.05). The esophageal distal contractile integral of refractory NERD group was lower than that of refractory RE group (334.0 mmHg·s·cm, 182.5 mmHg·s·cm to 492.0 mmHg·s·cm vs. 399.0 mmHg·s·cm, 216.5 mmHg·s·cm to 756.3 mmHg·s·cm, 1 mmHg=0.133 kPa), and the difference was statistically significant ( Z=-2.204, P=0.030). There were no significant differences in lower escophageal sphincter or the length of peristaltic interruption between the two groups (both P>0.05). There were no significant differences in physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health or reported health transition of SF-36 score between refractory NERD group and refractory RE group (all P>0.05). Among 159 patients with rGERD, 98 patients (61.6%) had anxiety and 55 patients (34.6%) had depression. The SAS score of refractory NERD group was higher than that of refractory RE Group (52.6±5.8 vs. 47.0±8.8), and the difference was statistically significant ( t=4.794, P<0.05), however there was no significant difference in SDS score between the two groups ( P>0.05). The results of multiple linear regression analysis showed that GerdQ score in rGERD patients was positively correlated with DeMeester score, gas reflux, weak acid reflux, SAS score and SDS score ( r=0.201, 0.228, 0.171, 0.229 and 0.276; all P<0.05). Conclusions:Among the patients with rGERD, the reflux symptoms are more severe in refractory NERD patients, which may be related to non-acid reflux, gas reflux, esophageal motor disorders, and psychological abnormalities, especially anxiety.
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Objective To analyze the safety and efficacy of laparoscopic radical resection of colorectal cancer for elderly patients over 70 years old. Methods From January 2014 to January 2017,a retrospective analysis of the patients with radical surgery for colorectal cancer in Department of General Surgery,Beijing Anzhen Hospital,Capital Medical University was performed. According to the patient′s age, the patients were divided into ≥70 years old group (68 cases) and＜70 years old group (84 cases). The preoperative clinical data of the two groups were analyzed. The surgeons strictly followed the standard lymph node cleaning and the principle of no tumor for colorectal cancer radical operation. The surgical conditions, pathology,short-term efficacy and the follow-up conditions of the two groups were compared. Statistical analysis was performed using SPSS 20. 0. The normal distribution of the data was expressed as Mean±SD,and the t-test was used for comparison between the group. The count data was compared using the χ2 test or the Fisher exact probability method. Results The operation was successfully completed in both groups. In the group of≥70 years old,2 cases were converted to open due to extensive adhesion of the abdominal cavity,no perioperative death. Compared with the＜70 years old group,≥70 years old group had more hypertension and coronary heart disease, respectively ( 38. 2%( 26/68 ) vs. 14. 3%( 12/84 )), and the difference was statistically significant ( P＜0. 05 ) . There was no significant difference in intraoperative blood loss and operation time between the two groups (P＞0. 05) . There was statistically significant difference in incidence of postoperative cardiovascular events between the groups (26. 4%(18/68) vs. 7. 14%(6/84)χ2＝ 6. 428, P＝0. 010) . However,there were no significant differences between the two groups in implications,rate of death and the time stayed in hospital. (P＞0. 05). Conclusion Laparoscopic radical resection for colorectal cancer patients over 70 years old is safe and feasible with strict indications and attention to perioperative management.
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Objective To analyze our experience in laparoscopic common bile duct ( CBD) explo-ration using a 5 mm choledochoscope through a micro-incision at the junction between the cystic duct and the CBD for patients with choledocholithiasis and cholecystolithiasis. Methods From January 2014 to May 2018, laparoscopic common bile duct exploration through a micro-incision at the cystic duct-CBD junction was performed in 77 patients with choledocholithiasis and cholecystolithiasis at Beijing Tongren Hospital, Capital Medical University. Results Laparoscopic common bile duct exploration was performed successfully through a micro-incision in 77 patients with primary suturing of the micro-incision. The range of operation time, blood loss, and hospital stay were 65～150 min, 10～50 ml, and 4～9 d respectively. Seven patients developed minor bile leakage postoperatively and were treated successfully after 3 ～7 days of conservative treatment. Conclusion Common bile duct laparoscopic exploration using a choledochoscope for choledocho-lithiasis and cholecystolithiasis through a micro-incision at the junction of cystic duct and CBD was a safe and effective method.
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Objective To investigate the correlation between esophageal motility abnormalities and the characteristics of gastroesophageal reflux in patients with different subtypes of refractory gastroesophageal reflux disease (rGERD).Methods From September 2015 to May 2016,a total of 100 rGERD patients were collected,all of whom received gastroendoscopy examination,high resolution manometry (HRM) and 24 h impedance-pH monitoring.According to the results of gastroendoscopy examination,the patients were divided into refractory non-erosive reflux disease (NERD) group and refractory reflux esophagitis (RE) group.Abnormal esophageal motility and pathological gastroesophageal reflux of each group were analyzed.Chi-square test,t test and sum-rank test were performed for comparison,the correlation factors were analyzed by multivariate unconditional Logistic regression.Results Among the 100 patients with rGERD,there were 83 cases in refractory NERD group and 17 in refractory RE group.The episodes of weak acid and gas-liquid mixed reflux of refractory NERD group were both significantly higher than those of refractory RE group (80.2±56.9 vs 44.8± 13.7,56.0± 25.6 vs 25.2±16.1);and the differences were statistically significant (t=3.202 and 2.229,both P＜ 0.05).The DeMeester score,acid reflux episodes and the percentage of reflux time of refractory NERD group were all significantly lower than those of refractory RE group (24.2±8.5 vs 56.8±3.0,21.4± 11.8 vs 35.9 ± 32.6,(7.1 ± 1.6) ％ vs (16.2 ± 8.8) ％),and the differences were statistically significant (t=-2.820,-2.230 and-2.604;all P＜0.05).However,the average resting pressure of lower esophageal sphincter was higher than that of refractory RE group ((7.9±5.6) mmHg (1 mmHg=0.133 kPa) vs (4.5±2.2) mmHg),and the difference was statistically significant (t=2.443,P＜0.05).Patients with esophageal motility disorders of refractory NERD group and refractory RE group were 58 cases (69.9 ％) and 12 cases (12/17),respectively,and the difference was not significant (P＞0.05).Compared with refractory RE group,the ratio of intermittent contraction was higher (1/17 vs 26.5％,22/83) and the peristaltic contraction disorder was lower in refractory NERD group (11/17 vs 43.4％,36/83);and the differences were statistically significant (x2 =3.389 and 2.587,both P ＜ 0.05).The results of multivariate non-conditional Logistic regression analysis showed that intermittent contraction and gas reflux were risk factors of the incidence of pathological weak acid reflux (odd ratio (OR) =3.139 and 1.254,both P＜0.05),while body mass index and gas-liquid mixed reflux were the risk factors of the occurrence of pathological acid reflux (OR =1.302 and 1.026,both P＜ 0.05),whereas the distal contractile integral was a protective factor (OR=0.998,P＜0.05).Conclusion Esophageal dysmotility is common in patients with rGERD,and the dysmotility disorders are different in patients with different subtypes,which may be related to the different reflux characteristics.
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Objective@#To discuss the surgical treatment and efficacy of endoscopic nipple-sparing mastectomy with skin lifting system (ENSMSLS) followed by immediate breast reconstruction.@*Methods@#ENSMSLS was conducted on 21 patients followed by immediate breast reconstruction with implant via axillary incision from August 2014 to January 2016 in Oncology Center, Beijing Tongren Hospital, Capital Medical University. These 21 patients were frequency matched with 21 patients, who received nipple-sparing mastectomy via loop periareolar incision from November 2012 to May 2015 in the same center. These 21 patients formed the control group. The operation data of two groups were compared by t test and Fisher′s exact test.@*Results@#Differences in operation time ((185±43) minutes vs. (165±33) minutes, t=1.778, P=0.101), amount of bleeding ((60±48) ml vs. (75±57) ml, t=-0.535, P=0.329), and drainage ((240±112) ml vs. (201±91) ml, t=1.238, P=0.233) between these two groups of patients were not statistically significant. There was no nipple necrosis recorded in the ENSMSLS group, while there were three cases (14.3%) recorded in the control group. Two cases (9.5%) of nipple transposition were recorded in the ENSMSLS group, while five cases (23.8%) were recorded in the control group. Differences in nipple necrosis and nipple transposition were statistically significant (0 vs. 5, P=0.001). There were 16 cases (76.2%) of excellent appearance recorded in the ENSMSLS group, while there were 11 cases (52.4%) recorded in the control group. There were 5 cases (23.8%) of good appearance recorded in the ENSMSLS group, while there were 9 cases (42.9%) recorded in the control group. There was no case of fair appearance in the ENSMSLS group, while there was 1 case (4.8%) recorded in the control group. Difference in postoperative appearance was statistically significant (P=0.001).@*Conclusions@#ENSMSLS significantly decreases the possibility of nipple necrosis and nipple transposition. This technique avoids visible incisions of breast. It also enhances the aesthetic appeal of reconstructed breasts.
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[Summary] The mechanisms of gastroesophageal reflux disease ( GERD) include abnormal antireflux function and esophageal mucosa attacked by regurgitation .Gastroesophageal flap valve ( GEFV) located in the gastroesophageal junction is one mechanism of the antireflux barrier .An increased GEFV grade is associated with an increased incidence of erosive esophagitis and Barrett ’ s epithelium.With abnormal esophageal acid exposure and prevalence of a mechanically defective sphincter , patients usually have severe symptoms and lower efficiency of medication .Therefore , GEFV is valued in the diagnosis and treatment of GERD .This review summarized the relationship between GEFV and GERD .
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Objective To assess of feasibility and effectiveness about clinic skill test in the five clinical examination. Methods In our hospital, 23 medical students of 2006 grade seven-year systerm were divided into group A and group B. After clinical practice, the theory test and five clinical examination were completed in both groups, and group A un-derwent clinical skills competition, the results were taken for two independent samples t test, set α=0.05. Group A was taken the practical examination and clinical skills competition, results were taken for two related samples t test, set α=0.05. Results Group A had successful completion in practical assessment and five clinical examination. The results of theory test and five clinical examination had no significant difference in two groups (P>0.05), and clinical skills com-petition results had significantly difference in two groups (P=0.001). In group A, practical assessment and clinical skills competition results had no significantly difference(P>0.05). Conclusion The five clinical examination and practi-cal examination is applicable, which constitute "5+X" pattern. Through the practical examination, can promote the clinic skill of medical students.
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Objective To study the clinical effect of laparoscopic vaginoplasty using pedicled ileal and sigmoid colon segment.Methods From January 2004 to December 2009,105 cases undergoing laparoscope-assisted vaginoplasty using a vascularized pedicled intestinal flap were studied retrospectively.Operation time,blood loss in operating,bowel movement after operation,postoperation hospital duration,side effect,and artificial vagina were compared between two surgical management.Results The vaginoplasty were preformed successfully in all 105 cases.There were 48 patients treated by aparoscopeassisted ileal vaginoplasty and 57 patients treated by laparoscope-assisted sigmoid colon vaginoplasty.The values of the operation time [(141 ±22) minutes versus (159 ± 18) minutes,P =0.000],blood loss in operating [(42 ±6) ml versus (83 ± 14) ml,P =0.000],bowel movement after operation (36 ±9) hours versus (68 ±8)hours(P =0.000),and postoperation hospital duration [(9.8 ±2.0) days versus (11.1 ± 1.3) days,P =0.004] in the sigmoid colon vaginoplasty group were longer or higher than those in ileal vaginoplasty group (P ＜ 0.05).No intraoprative complication occurred.There were four postoperative complications:2 cases with intestinal obstruction in sigmoid colon vaginoplasty group,1 case with urethral orifice stenosis and 1 case with vaginal-rectal fistula in ileal vaginoplasty group.At follow-up of 6-62 months,all artificial vaginas had a capacity of over two fingers in wideness and 12-15 cm in length.Vaginal discharges resembled a milky white water or mucus without odour.Fifty-five patients with sexual intercourse reported satisfactory results.Six patients complained vaginal stenosis:5 patients in ileal vaginoplasty group and 1 patient in sigmoid colon vaginoplasty group.Conclusions Laparoscope-assisted vaginoplasty using pedicled ileum or sigmoid colon segment are both the effective ways in forming vagina.The latter management takes more time and blood loss while operating,yet the incidence of vaginal opening contracture appeared to be decreasing trend.
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Objective To study the clinical effect of gasless-laparoscopic vaginoplasty using sigmoid colon segment.Methods Clinical data of 119 cases undergoing laparoscopic or gasless-laparoscopic vaginoplasty using a vascularized pedicled sigmoid colon segment in Beijing Anzhen Hospital from January 2007 to December 2010 were reviewed retrospectively.Those patients were classified into 57 cases with laparoscopic sigmoid colon vaginoplasty and 62 cases with gasless-laparoscopic sigmoid colon vaginoplasty.The operation time,blood loss in operating,bowel movement after operation,postoperation hospital duration,side effect,and artificial vagina were compared between laparoscopic and gasless-laparoscopic group.Results The vaginoplasty were preformed successfully in 119 cases.The mean operation time of were (159 ± 18) min in laparoscopic group and (146 ± 17) min in gasless-laparoscopic group,respectively,which reached statistical difference (P ＜0.01).The blood loss in operating were (83 ± 14) ml and (86 ± 13)ml,bowel movement after operation were (68 ± 8) hours and (68 ± 11) hours,and postoperation hospital duration were (11.1 ± 1.3) days and (11.4 ± 1.9) days respectively in laparoscopic group and gasless-laparoscopic group.No significant difference were found in the blood loss in operating,bowel movement after operation,and postoperation hospital duration between two groups (P ＞ 0.05).No intraoperative complication occurred.There were two cases with incomplete adhesive intestinal obstruction at 15-20 days postoperatively,which one was in laparoscopic group and one was in gas-less laparoscopic group.At 6-50 months of following up (median time 12 months),all artificial vaginas had a capacity of over two fingers in wideness and 12-15 cm in length.Vaginal discharges resembled a milky white water or mucus without odour.Eighty-five patients with sexual intercourse reported satisfactory feeling.One patients complained vaginal stenosis in laparoscopic group.Conclusion Gasless-laparoscopic vaginoplasty using sigmoid colon segment is an alternative feasible and practical treatment.
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@#Objective To investigate the related factors of postoperative pulmonary complications with abdominal operation. Methods 193 cases after abdominal operation were reviewed. The age, smoking history, surgery duration, surgical site, pulmonary function, artery blood gas analysis, and the incidence of post-operative pulmonary complications were analyzed. Results Pulmonary complications were found in 29 cases. The age was higher and surgery duration was longer in patients with pulmonary complications than those without pulmonary complications (P<0.05). The patients with abnormal forced expiratory volume in the first second (FEV1)%, FEV1/ forced vital capacity (FVC)%, maximum ventilatory volume (MVV)% and smoking history before operation were in higher risk for post-operative pulmonary complications (P<0.05). There was significant difference in artery blood gas analysis between the 2 groups (P<0.05). Conclusion The age,smoking history, surgery duration and pulmonary dysfunction may be the risk factors of pulmonary complications after abdominal operation,while it is important to monitor the blood gas analysis.
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Objective To discuss the influential factors of postoperative pulmonary complications in elder patients accepted abdominal operation. Methods The clinical data of 95 cases accepted abdominal operation were analyzed retrospectively,and all the patients aged over 60. These patients were divided into two groups based on whether they had pulmonary complications or not. Seven relative factors including the age,sex,smoking history,surgery duration ,operation place,pulmonary function,anesthesia were analyzed and the relationship between these factors and the incidence of postoperative pulmonary complications were explored,too. Results Among the 95 patients,19 cases had pulmonary complications. The surgery duration in patients with pulmonary complications ((3.4 ± 1.1)h)were significantly higher than in those without pulmonary complications ((2. 6 ± 0. 9)h)(P ＜0.05). We also found significant differences in the comparison of FEV1%(59.2 ±9.5),FEV1/FVC(61.3 ±7.7)% ,MVV%(59.3 ±8.6)% in the group with pulmonary complications,with FEV1%(79.7 ± 11.5)%、FEV1/FVC(73.2 ±8. 3)% 、MVV%(74. 2 ±6. 4)% in the group without pulmonary complications. The epigastric operation and general anesthesia before operation were risk factors for post-operative pulmonary comphcations(P ＜0. 05). Conclusions Surgery duration,operation place,pulmonary dysfunction and anesthesia may be the risk factors of pulmonary complications after abdominal operation.
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Objective To study the clinical characteristic and treatment of colorectal cavernous angioma and laparoscopic proctosigmoidectomy in colorectal cavernous angioma. Methods Clinical data of 8 colorectal cavernous angioma cases were analyzed. Results Cavernous hemangioma located in the rectum in 4 cases,in the proctosigmoid in 3 cases,and in the proctosigmoid and descending colon in one case.Under definite diagnosis,all cases underwent laparoscopic colorectomy,the postoperative recovery was satisfactory,and there was no postoperative mortality. Conclusions Colorectal cavernous angioma is rare,and usually be misdiagnosed.It commonly involves sigmoid and rectum.Laparoscopic proctosigmoidectomy is an effective way to deal with the disease.
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OBJECTIVE Discuss the cooperative relationship between The Office of Nosocomial Infection Control("the Office") and the Center for Disease Control and Prevention("the Center") in hospital.METHODS The cooperative relationship between the Office of Nosocomial Infection Control and the Center were analyzed,the third degree A Class hospitals in Beijing area.RESULTS 25 hospitals had set up Centers.Among them,there are special stuff in charge of the report of the infection in 17 hospitals which had the Office with the function of the Center.So far,none of the Offices with the function of the Center can operate all the functions of the office.CONCLUSIONS The setup of the Center is to detect and control infectious disease on the basis of nosocomial infection control.
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Objective To improve the animal model of hypertrophic scars for studying their pathology. Methods Twenty nude mice were divided randomly into two groups of 10. In group one every mouse received a full thickness piece of human skin grafted into the subcutaneous tissue of their hack. After the graft had survived 14d after transplantation, a burn was caused on the graft with a heated copper cylinder. The mice in the second group received the transplant but no burn. The status of the grafts and scars was observed, and histological examinations of the grafts were performed. Results Nine mice in group one survived, of which eight developed obvious and persistent hyper-trophic scars after the burns. These were hard and rose above the surrounding skin. Eight nude mice survived in group two, of which only six developed hypertrophic sear analogues after transplantation. Histological examinations showed abundant collagen deposition and inflammatory infiltration in all sears. Conclusion The similarity, repeat-ability, certainty, and survival rate of this improved hypertrophic scar model are superior to those reported previously. This improved animal model can induce obvious and persistent scarring that can be used to observe the whole proce-dure of hypertrophic scarring, so it is a useful tool for studying hypertrophic scars.
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Objective To study the distribution and clinicopathological characteristics between VEGF-C and pefitumoral lymph vessels density(PLVD) in breast cancer tissue, and to investigate the development and the mechanism of breast cancer-related lymphoedema (BCRL). Methods VEGF-C and VEGFR-3 were detected by using immunohistochemical technique for the detection of VEGF-C and its receptor VEGFR-3 in forty-seven breast cancer specimens. We measured the patients' circumferences of bilateral upper limbs to determine whether there was lymphoedema and made classification in the follow-ups. Results VEGF-C was positive in 33 out of 47 cases. PLVD significantly increased in VEGF-C positive groups (30.39±10. 46) than in negative groups (23.16±11.67) (P<0.05). VEGF-C semi-quantitative score was in a positive correlation with PLVD (r=0.334). The positive expression rate (42.55%) and semi-quantitative score (3.68±1.59) of VEGF-C increased in the lymph node positive group than in the negative group, PLVD increased in the lymph node positive group compared with that in negative group (32.12±10.29 vs. 24.82±11.06), P<0.05. The risk of lymphoedema increased in the VEGF-C negative group (5/14) compared with that in the positive group (3/33) (P<0.05). Conclusion VEGF-C has a high rate of positive expression in breast cancer, and is positively correlated with PLVD. High expression of VEGF-C can reduce the risk of BCRL in breast cancer.
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Objective To explore the safety and effectiveness of using low molecular weight heparin (LMWH) in place of warfarin for anticoagulation in patients with a previous cardiac valve replacement. Methods We reviewed 70 patients hospitalized from Jan 2002 to Apr 2009 undergoing abdominal surgery who have had a previous cardiac valve replacement and had been on warfarin anticoagulation therapy. LMWH began to replace warfarin for anticoagulation 3 clay before the surgery in 33 cases, while the other 37 patients simply ceased to use any anticoagulant since 3 days before the surgery. Postoperative bleeding and embolism risk were compared between these two groups. Results There were 2 patients suffering from postoperative bleeding in the operative field in LMWH group, while there was no postoperative bleeding in patients on anticoagulant suspension group (χ~2=0.641, P>0.05). There was no valve embolism occurred in these two groups. Conclusions It is a safe way to stop using warfarin with LMWH taking the task for perioperative anticoagulation in patients with a history of cardiac valve replacement 3 days before an elective abdominal surgery. This protocol decreases the risk rate of valve embolism not at the expense of increasing postoperative bleeding.
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Objective To study clinical effect of vaginoplusty with sigmoid colon by laparoscopic surgery. Method Clinical data of 45 cases with laparuscopic vaginoplasty using a vuscularized pedicled sigmoid colon flap were reviewed, including 41 cases with congenital absence of vagina and 4 cases with male pseudohermaphroditism. Operation time, blood loss, the anatomical and functional newly forming vagina were evaluated. Results The sigmoid colon colpopoiosis was preformed successfully in all 45 cases. The range of operation time was 135-245 minutes and the mean time was 157 minutes. The mean blood loss was 82 ml during operation. The artificial vaginas had excellent cosmetic outcome, including adequate vaginal length, good lubrication, and appearance and physical functions similar to natural vagina. A vaginal mould was employed for more than 3 months in 34 cases, achieving a good dilatation of the artificial vagina. Twenty-five patients with satisfied sexual intercourse were reported. Conclusion Laparoscopic vaginoplasty using a vuscularized pedicled sigmoid colon flap is a feasible and ideal management.