Correlation between cervical curvature and cervical disc bulging in young patients with neck pain / 中国骨伤

OBJECTIVE@#To explore the correlation between the curvature of the cervical spine and the degree of cervical disc bulging in young patients with cervical pain.@*METHODS@#The clinical data of 539 young patients with neck pain from January 2015 to December 2018 were retrospectively analyzed. There were 251 males and 288 females, aged 18 to 40 (32.2±6.3) years old. The cervical curvature and cervical disc bulging were measured by cervical X-ray and MRI. According to cervical curvature, the patients were divided into 175 cases of cervical lordosis group (cervical curvature > 7 mm), 163 cases of cervical erection group (0

The efficacy of preoperative portal vein embolization for extended hepatectomy: a meta-analysis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical value of preoperative portal vein embolization (PVE) for extended hepatectomy.</p><p><b>METHODS</b>A comprehensive Pubmed, Medline and Ovid database search to identify all registered literature on portal vein embolization. Meta-analysis was performed to assess the result of PVE.</p><p><b>RESULTS</b>A total of 9 literatures provided data sufficiently enough for analysis involving in 494 patients. The results showed that postoperative liver failure was higher in the non-PVE group than the PVE group, but there was no difference in postoperative mortality between the PVE and non-PVE group; in sub-category analysis of hepatocellular carcinoma and liver metastasis of colorectal cancer, there was no difference in postoperative 1, 3 and 5-year survival rate between the PVE group and non-PVE group; 1 literature about liver metastasis of colorectal cancer show there was significant difference in postoperative metastasis between the PVE and non-PVE group; several patients after PVE didn't performed hepatectomy due to disease progress.</p><p><b>CONCLUSIONS</b>PVE is a safe and effective procedure to prevent postresection liver failure due to insufficient liver remnant, but surgeon should be cautious to choose the patient for PVE.</p>

Function of portal pressure during operation on the choice of surgical approaches in portal hypertension / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship between perioperative free portal pressure (FPP) after devascularization or spleno-renal shunt operation added devascularization and rebleeding or encephalopathy in patients with portal hypertension, and evaluate the relationship between dynamic changes of FPP and surgical approaches.</p><p><b>METHODS</b>The clinical data of 170 patients with portal hypertension receiving devascularization or devascularization with spleno-renal shunt operation (combination group) from January 2001 to December 2007 were retrospectively analyzed. All patients were divided into three groups: low pressure group [L group, after devascularization FPP <or= 22 mm Hg (1 mm Hg = 0.133 kPa), n = 43], high pressure group (H group, FPP > 22 mm Hg, n = 60) and combination group (C group, n = 47). There was no significant difference in preoperative Child-Pugh score and pre-operation FPP (P > 0.05) among the three groups. Perioperative FPP, morbidity of rebleeding and encephalopathy were compared with each other.</p><p><b>RESULTS</b>The values of postoperative FPP were (27.1 +/- 1.9) mm Hg, (20.8 +/- 1.8) mm Hg and (21.5 +/- 2.2) mm Hg among the H group, L group and C group respectively. The rebleeding rates were 21.7%, 4.6% and 4.5% among the three groups respectively. All the values in H group were higher than those in L group and C group remarkably. The encephalopathy rate in C group (10.4%) was higher than that in L group (7.0%) or H group (3.3%), but there were no statistical significance (P > 0.05).</p><p><b>CONCLUSIONS</b>FPP after splenectomy and devascularization may be a basis of choice of surgical approaches in portal hypertension. The spleno-renal shunt operation should be performed in the patients when FPP is over 22 mm Hg after devascularization.</p>

Clinicopathologic Study of 23 Patients with Mucinous Cystadenoma or Cystadenocarcinoma of the Pancreas / 上海第二医科大学学报

Objective To investigate the diagnosis and treatment of mucinous cystadenoma and cystadenocarcinoma of the pancreas. Methods The clinical data of 23 patients with pancreatic mucinous cystadenoma or cystadenocarcinoma confirmed by pathology from May 1993 to October 2005 was retrospectively studied. Results Fifteen cases of mucinous cystadenoma, 4 cases of mucinous cystadenocarcinoma, and 4 cases of mucinous cystadenoma with malignancy were included in this data. Ultrasonography, CT, and MRI/MRCP displayed a cystic tumor in 73.7%, 68.8%, and 83.3% of all patients, respectively. The mean diameter of the tumors was 9.4 cm, and the maximum diameter of the tumors was 20 cm. Pancreaticoduodenectomy, distal pancreatectomy and splenectomy, local excision of cystadenoma and other procedures were performed according to the site of tumors. The resectable rate was 82.6%. Twenty-one patients (91.3%) were followed up. All of the 14 patients with mucinous cystadenoma were alive with the follow-up from 4 months to 11 years after operation. Two of the 4 cases of mucinous cystadenoma with malignancy were alive with the follow-up of 5 months and 4 years after operations, while the other 2 died with the survival time of 15 months and 18 months. One patient with mucinous cystadenocacinoma was alive 5 months after operation, while the other 2 died with the survival time of 7 months and 13 months. Conclusion Mucinous cystadenoma has a malignant tendency. As the mucinous cystadenocacinoma is a low malignant potential tumor, the resectable rate is high and prognosis is satisfactory. The excision of total tumor including the surrounding pancreatic tissue is the first choice of the treatment. Pancreaticoduodenectomy, distal pancreatectomy and splenectomy, and other procedures according to the site tumors is feasible.