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1.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(8): 781-785, 2019 Aug 25.
Artigo em Chinês | MEDLINE | ID: mdl-31422618

RESUMO

Objective: To evaluate the feasibility and safety of transanal lateral lymph node dissection for mid-low rectal cancer. Methods: A descriptive case series research method was used. Clinical and pathological data of 5 mid-low rectal cancer patients who underwent transanal lateral lymph node dissection at Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University from November 2018 to May 2019 were retrospectively collected and analyzed. Of 5 cases, 4 were male and 1 was female with mean age of (43.2±13.2) years and mean body mass index of (21.2±2.6) kg/m(2); the mean diameter of tumor was (3.2±2.4) cm; the mean distance between tumor and anus was (6.3±2.5) cm; 3 received preoperative neoadjuvant chemotherapy. In preoperative TNM staging, 2 cases were T3N1M0, 1 was T3cN2aM0, 1 was T3cN2bM0, and 1 was T2N1M0. All the patients had no intestinal obstruction before operation. Surgical methods: (1) total mesorectal excision: using general transanal and transabdominal methods to mobilize and resect total mesorectum, and dissect No.252, No.253 lymph nodes; (2) transanal lateral lymph node dissection: dissect the adipose lymphoid tissue on the surface of the iliococcygeal muscle, the coccygeal muscle, and the obturator muscle (the No.283 lymph nodes) upward, and dissect No.263d and No.263p lymph nodes with fat tissue sequentially till the bifurcation of the internal and external iliac artery; (3) take out the specimen from anus, and make anastomosis between proximal colon and anal canal. Intraoperative and postoperative variables was observed. Results: All the 5 patients completed surgery successfully, and no patient needed to convert to open approach. The mean operative time was (295.6±97.7) minutes, and the median intraoperative blood loss was 70 (50-500) ml. The mean length of specimen was (12.9±3.0) cm, and the mean number of harvested lymph node was 30.4±9.9. The positive lateral lymph nodes were founder in 4 patients. The median distance between tumor and distal resection margin was 1.5 (1.2-8.0) cm. The resection margin in all the patients was negative. The mean time to postoperative flatus was (4.2±1.6) days, the mean postoperative spontaneous urination was (3.0±1.9) days, time to drainage tube removal was (5.6±1.9) days, and the mean postoperative hospital stay was (9.4±2.1) days. The postoperative TNM staging by pathology was 1 case with T1N0M0, 1 with T2N1M0, 1 with T3N2bM0, and 2 with T3N2M0. Five patients were moderately differentiated adenocarcinoma. Only 1 patient developed postoperative abdominal bleeding, who was healed after conservative treatment. The other 4 patients did not develop any perioperative complications, such as incision infection, presacral abscess, pelvic abscess, anastomotic leakage, or anastomotic stricture. Four patients underwent postoperative chemotherapy. All the patients were followed up for 2 to 28 weeks after surgery and they all felt well. The patients with stoma had fluent bowel. Conclusions: Transanal lateral lymph node dissection is feasible and safe in the treatment of mid-low rectal cancer, which can achieve the purpose of extended radical resection of mid-low movement rectal cancer. Moreover, this procedure is a new method to treat rectal cancer patients with lateral lymph node metastasis.


Assuntos
Adenocarcinoma/cirurgia , Excisão de Linfonodo/métodos , Linfonodos/patologia , Protectomia/métodos , Neoplasias Retais/cirurgia , Adenocarcinoma/patologia , Adulto , Canal Anal/cirurgia , Anastomose Cirúrgica , Colo/cirurgia , Estudos de Viabilidade , Feminino , Humanos , Laparoscopia , Linfonodos/cirurgia , Masculino , Mesentério/cirurgia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Retais/patologia , Estudos Retrospectivos
2.
Eur Rev Med Pharmacol Sci ; 22(6): 1798-1811, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29630129

RESUMO

OBJECTIVE: Non-cardiac surgery is associated with perioperative cerebral complications (delirium, postoperative cognition dysfunction, stroke). While rare, these complications can lead to disabilities and deaths. Information is ambiguous as to whether pharmacological preoperative treatment exerts neuroprotection. We wished to systematically assess potential modulation by statins, lidocaine, ketamine or magnesium sulfate of the relative risk of cerebral complications in noncardiac surgery. Selection of these pharmacological agents was based on their known neuroprotective abilities. PATIENTS AND METHODS: By searching Medline, EMBASE and Cochrane databases, we identified 4 suitable publications that collectively enrolled 1358 patients (intent-to-treat population), of which 679 patients were treated preoperatively with statins (404 patients on atorvastatin and 275 on rosuvastatin) and 679 patients with preoperative placebo. The reported cerebral outcome was stroke, assessed either within 30 days (4 publications) or 6 months (2 publications) after surgery. RESULTS: Episodes of stroke within 30 days and 6 months postoperatively were observed in several publications, enabling aggregate analyses. No modulation by statins of the relative risk of stroke at 30 days was observed (risk ratio 1.59, 95% confidence interval 0.08-30.97; p = 0.76). At 6 months, statins showed an insignificant trend toward neuroprotection (risk ratio 0.33, 95% confidence interval 0.05-2.10; p = 0.24). CONCLUSIONS: The available clinical data are still scarce. Our analyses indicate no protective effects by statins against perioperative stroke but some favorable trends toward delayed stroke. Further randomized trials are needed to unequivocally assess the neuroprotective potential of current pharmacological agents in non-cardiac surgery.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Ketamina/farmacologia , Lidocaína/farmacologia , Sulfato de Magnésio/farmacologia , Fármacos Neuroprotetores/farmacologia , Complicações Pós-Operatórias/prevenção & controle , Acidente Vascular Cerebral/prevenção & controle , Humanos , Período Perioperatório
3.
Phys Chem Chem Phys ; 19(26): 17121-17127, 2017 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-28636683

RESUMO

The maximum content of cation vacancies in perovskites determines the maximum adjustment to the physical properties. By using the classical criterion of the tolerance factor, we put forward a new method to obtain the maximum content of cation vacancies in perovskites. The effective ionic radius was calculated using the weighted average method, and the limit of tolerance factors was used to determine the maximum value of the cation vacancies. The calculated results of the La1-xMnO3 and La0.75Sr0.25Mn1-yO3 materials coincide with experimental results. For application, [(A1)1-x(A2)x]1-z1(B1B2)X3 or [(A1)1-x(A2)x](B1B2)1-z2X3 (X = O, F, Cl, Br, I) inorganic and hybrid organic-inorganic perovskite materials with vacancies at the A or B sites were predicted successfully, which provides a new method to improve the physical properties of perovskite materials.

4.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 31(15): 1164-1167, 2017 Aug 05.
Artigo em Chinês | MEDLINE | ID: mdl-29798350

RESUMO

Objective:To explore the CT, MRI manifestations of the polyp of maxillary sinus cavernous hemangioma. To summarize the imaging characteristics and it may assist doctors to diagnose infarcted angiomatous polyps in maxillary sinus with further developing.Method:A retrospective analysis of the CT, MRI manifestations and clinical analysis about 27 cases confirmed by surgery pathology who are maxillary sinus cavernous hemangioma.Result:Twenty-seven cases were unilateral diseases, and clinical manifestations were nasal congestion. Twenty-seven cases were proceeded CT scan, of which 9 cases of double-phase dynamic enhanced CT examination, 11 cases with MRI examination, of which 6 cases with MRI enhanced examination. CT scan showed unilateral maxillary sinus full of mixed density and involving the nasal cavity, maxillary sinus abnormal expansion of deformation, with local bone resorption damage in 27 cases, but without violation the adjacent tissue. CT enhanced scan of lesions shows that the spotted blood vessels were significantly enhanced and progressive enhancement. MRI can clearly identifylesions and obstructive sinusitis and morbid shape was irregular with mixed signal. T2WI showed high and low mixed ring signals, and the edge of the irregular low signal ring, with enhanced nodules and patchy unevenly enhanced.Conclusion:Most polypof maxillary sinus cavernous hemangioma clinical manifestations are unilateral nasal obstruction. CT shows the maxillary sinus irregular expands and compression bone absorption with a prompt action to this disease.Vascular-like enhancement and progressive enhancement are characteristic enhanced CT manifestations of this disease. MRI can better show the lesion range. T2WI with high and low ring mixed signals, low ring signals, and mostly enhanced nodules, uneven enhancement of plaqueare characteristic imaging manifestations.


Assuntos
Hemangioma Cavernoso/diagnóstico , Seio Maxilar/diagnóstico por imagem , Pólipos Nasais/diagnóstico por imagem , Nariz/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Pólipos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
5.
Yao Xue Xue Bao ; 25(10): 769-76, 1990.
Artigo em Chinês | MEDLINE | ID: mdl-2099592

RESUMO

Artificial calculus bovis (ACB) is widely used in dispensing Chinese Traditional Patent Medicine as a substitute for Calculus bovis. Photodecomposition rule of ACB sample irradiated with three different light sources was studied by diffuse reflectance spectrophotometry (DRS) in this paper. The results show that, the photodecomposition rate curves of the ACB sample irradiated by all three light sources are composed of two straight lines of different slopes, indicating that they are of two-step apparent first order reaction, the apparent photodecomposition constants in the first steps are about twice as high as those in the second steps. The ACB sample has the fastest photodecomposition rate when irradiated with the UV mercury-arc lamp and the second with the fluorescent mercury-arc lamp and slowest with the iodine-tungsten lamp. In these three light sources apparent photodecomposition constants of ACB sample are respectively: K1, 2.7629 x 10(-5), 4.4132 x 10(-6); k2, 1.2176 x 10(-5), 2.0684 x 10(-6), 1.4357 x 10(-6) (lx-1.h-1). The apparent constants are independent of the product of the radiation intensity and the irradiation time, but the irradiation time is in inverse ratio of the radiation intensity to get the same proportion of the sample photodecomposition. The fading time of the ACB sample under different radiation intensity can be predicted with the kinetic equations reported. The fading time of ACB sample if directly exposed to light in bright room is 1.6 days.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Bilirrubina/efeitos da radiação , Materia Medica , Combinação de Medicamentos , Estabilidade de Medicamentos , Luz
6.
Zhonghua Yi Xue Za Zhi ; 69(7): 385-8, 28, 1989 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-2598094

RESUMO

From the research on diseased tissues of the skin, we found that there are evidences of microcirculatory damages at the following sites: (1) Arterial limbs; (2) Venule limbs (3) All Loops (4) Top of Loops (5) Skin Papilla. On the other hand. We have observed such atypical loops, under microcirculatory microscope and recording color TV, as: (1) big fishhook-like (2) dumb-bell like (3) glomerular (4) hemorrhagic (5) vascular (6) big tadpole-like (7) net-like (8) papillar edema. For clinical diagnosis and treatment, studies on cutaneous microcirculation may prove to be helpful.


Assuntos
Pele/irrigação sanguínea , Adulto , Feminino , Humanos , Masculino , Microcirculação/patologia , Microcirculação/fisiopatologia , Pessoa de Meia-Idade , Flebite/patologia , Doença de Raynaud/patologia , Tromboangiite Obliterante/patologia
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