Drugs, Chinese Herbal ; therapeutic use ; Dyspepsia ; drug therapy ; Humans ; Medicine, Chinese Traditional

BACKGROUND:Aclassical orthognathic schemefor mandibular prognathism includespreoperative cephalometric analysis,acquiring modulus, facebow transfer, modelsurgery, making occlusion plate.This process is cumbersome,complex,andproneto have bias. Moreover, orthognathic effects are difficult to be predicted, which is a majordifficultyindoctor-patientcommunication.
OBJECTIVE:To summarize and analyze the use of three-dimensional scanning techniques in the treatmentand diagnosisof mandibular prognathism, including principle, application and relative merits, thusprovidingreference forapplying to theclinic.
METHODS:Papers addressing the use of three-dimensional scanning techniques in thediagnosisand treatment of mandibular prognathism were retrieved by computer in Wanfang and PubMed databases with the key words of “three-dimensional scanning, class III,orthognathic, mandibular prognathism” in Chinese and English, respectively. A total of 48papers were included for review.
RESULTS AND CONCLUSION:Compared with the traditional technology,the three-dimensional scanning technology has high accuracy and efficiency in the diagnosis and treatment of mandibular prognathism, and candirectlycapture the 3D geometry of objects for modeling, colection and measurement of biological data, which provides a reliable monitoring method for postoperative assessment andfolow-up. Compared with the CT,thethree-dimensional scanning technology cannot show the internal structure and separate hard and soft tissues, which should be reasonably chosen according to practical data.

Objective To explore feasibility of laparoscopic hepatectomy for hepatic hemangioma.Methods Twelve patients were treated by laparoscopic hepatectomy, including left lateral lobectomy in 5 cases and local liver resection in 7 cases. Three cases of hepatic hemangioma associated with gallbladder stone were performed cholecystectomy synchronously. Results Laparoscopic procedures were successfully performed in all 12 cases. The mean operative time was 155 min. The mean blood loss was 230 mL. The mean postoperative hospital stay was 8 days. The pospostoperative recovery was smooth except that 1 case had pulmonary infection. During a follow-up of 6-20 months for 12 cases,there were no recurrence. Conclusion Laparoscopic hepatectomy for hepatic hemangioma is safe and feasibile with good effect under the condition of strict indication selection and experienced surgeons operating.

Objective To explore ffie effects of magnesium isoglycyrrhizinate injection,polyene phosphatidylcholine(PPC)and reduced glutathione(GSH)in patients with liver cirrhosis accompanied by benign obstructive jaundice after surSery.Methods Fifty-nine patients with liver cirrhosis and benign obstructive jaundice caused by gallstones were selected,and all of them were treated with magnesium isoglycyrrhizinate injection and GSH preoperatively.Thirty-one odd number patients received magnesium isoglycyrrhizinate injection,PPC and GSH treatment(group A)after surgery immediately,28 even number patients still continued to be treated with magnesium isoglycyrrhizinate injection and GSH(group B).The plasma alanine aminotransferase(ALT),aspartate aminotramsferase(AST),total cholesterol(TBIL)and cholinesterase(ChE),and prealbumin at the time of 1,3 and 7 day after surgery were compared between the two groups.Results Seven patients were excluded from this research including 3 cases in group A,4 cases in group B.The plasma ALT,AST,TBIL of the group A at postoperative 3,7 day[(193 ± 48)and(63 ± 17)U/L,(194 ± 57)and(54 ± 19)U/L,(99 ± 20)and(28 ± 9)μmol/L]were significantly lower than those of the group B[(235 ± 50)and(103 ± 33)U/L,(235 ± 64)and(82 ± 22)U/L,(127 ± 45)and(43 ± 18)μ mol/L,respectively](P＜ 0.05),whereas the plasma ChE and prealbumin of the group A[(3781 ± 294)and(4405 ± 469)U/L,(0.22 ± 0.07)and(0.30 ± 0.04)g/L]were significantly higher than those of the there were obvious differences of the plasma ChE and prealbumin at postoperative 3 or 7 day compared with those at postoperative 1 or 3 day in the group A(P ＜ 0.05).But this were improved at postoperative 7 day compared with those at postoperative 3 day in the group B(P＜ 0.05).Conclusion Combined treatment of magnesium isoglycyrrhizinate injection,PPC and GSH can be more effective to reduce the injury of the liver cells and promote the recovery of liver function for patients with liver cirrhosis and obstructive jaundice.

Objective To discuss the consequences of CT image quality in two different contrast enhancement ways of high pressure syringe. Methods 100 cases by using high-pressure syringes of Lightspeed 16-raw spiral CT and Stellant D-type high-pressure syringe of Medrad, the dose of constrast medium was 4.0 ml/s and the total dose was 80 ml, which was divided into A and B group enhancement scanning. The canalis singularis high pressure syringe was used in 50 cases of A group that no isotonic Na chloride flush, in contrast to 50 samples of B group that were underwent the double isotonic Na chloride flush. The method of evaluation is double-blind observation. Results The number of positive is 40 samples which has radioactive constructed defect in A group. The masculine proportion is 80%. The number of the negative is 10 samples. The proportion is 20%. Correspondingly, the number of radioactive constructed defect in the B group is 24 samples(48%), and the negative number is 26 samples(52%, P

Objective To report our experiences in difficult laparoscopic cholecystectomy (LC). Methods The clinical data of 201 cases of difficult LC performed from March 2006 to December 2008 were analyzed retrospectively,and the surgical operation approaches were summarized. The cases included 107 patients with pyknotic conglutination around the gallbladder or gallbladder triangle area,38 patients with gallbladder neck stone,11 patients with suppuration or gangrene of the gallbladder,18 patients with atrophy of the gallbladder,and 17 patients with operation history in the upper abdomen. Results The LC was completed in 193 of the cases,the other 8 cases were converted to open surgery. The causes for conversion to open surgery included intractable bleeding at the gallbladder triangle in 3 patients,the gallbladder being covered by stomach,colon and duodenum in 1,gallbladder gangrene in 1,bile leakage resulted from slightly lacerations of the posterior wall at the confluence of the gallbladder and bile duct in 2,and frozen likeness of the gallbladder triangle in 1. The complications of LC included intestinal obstruction (1 case),pulmonary infection with respiratory dysfunction (1 case),and postoperative bleeding (1 cases). No extrahepatic bile duct injury and death occurred in this series. Conclusions For difficult LC,we must abide by the rules as follows: to dissect as far as possible adjoin to the gallbladder;to discriminate the tissues or organs before cutting it;to execute LC in combination with mute and acuminate dissection and antegrade and retrograde approach for resection;to make pneumoperitoneum through a small incision for patients with history of operations in the upper abdomen. Only obey the laparoscopic surgical principle and use correct surgical approaches,can we reduce the incidence rates of complications and conversion to open surgery.

Objective To analyze the clinical diagnosis and therapeutic effect of primary middle lobe lung cancer,in order to provide evidence for clinical diagnosis and treatment.Methods The clinical data of 45 cases of primary middle lobe lung cancer treated by surgery from January 2002 to January 2007 were ana- lyzed retrospectively.The operation style includes:simple middle lobectomy 12 cases(26.7 %),middle or up- per lobectomy 10 cases(22.2 %),right lung total resection 5 cases(11.1%).Chest exploration was done on 2 cases(4.44 %),palliative resection or vedged resection 2 cases(4.44 %).Results 1 case died from lung in- fection and respiratory failure(2.22 %).15 cases with arrhythmia (33.3 %), 1 case with chylothorax were cured after conservative treatment.The survival rate of 1,3,5 year were 82.1%,64.3 %,32.1% respectively. Conclusion The treatment of primary middle lobe lung cancer is dominated by regular lobectomy. It is difficult to perform middle lobectomy,so double or total lobectomy is done generally.Owing to the more postoperative complications, it should be cautious to perform sleeve resection.It should be avoided to do vedged resection for primary middle lobe lung cancer in order to lessen local recurrence.

Alloys ; adverse effects ; Cobalt ; adverse effects ; Dust ; Humans ; Occupational Exposure ; adverse effects ; Tungsten ; adverse effects

Objective To investigate the effects of preoperative nutrition support on postopreative clinical outcome in patients with nutritional risk with pancreaticoduodenectomy.Methods Forty six patients with pancreaticoduodenectomy complicated with malnutrition from June 2011 to September 2013 in Department of Hepatobiliary and Lapoaroscopic Surgery of People's Hospital of Wuhan University were randomly divided into experimental group (n =23) and control group (n =23) with random number table,patients in experimental group received preoperative nutrition support,but patients in control group did not receive preoperative nutrition support.The preoperative and postoperative nutritional status,the incidence of postoperative complications,the length of hospital stay,and the cost of hospitalization in the two groups of patients was compared.Results In terms of intra-operative blood loss and the operative time,experimental group was significantly lower than those in control group [(340 ±90)min vs (420 ± 104)min,(761 ± 100)ml vs (901 ± 150)ml,P＜0.01],on the 1st day of preoperation,the 1st day,7th day and 14th day of post operation,the levels of serum albumin was significantly higher than those in control group [(30.6 ± 1.8) g/L vs (24.6±2.2) g/L on the,P＜0.05];and on the 1st day of pre-operation,the 1st day,7th day of post operation,the levels of transferrin were significantly higher in experimental group than in control group [(3.23 ± 0.65) g/L vs (2.38 ± 0.49) g/L on the,P ＜ 0.05);the rate of post operative complication were significantly lower in experimental group than that in control group (52.2％ vs 21.7％,P=0.000);the postoperative anal exhaust time was earlier in experimental group than that in control group [(6.4 ± 0.6) d vs (9.5 ± 0.6) d,P =0.000),and the length of hospital stay was shorter in experimental group [(20.1 ± 6.5) d vs (26.7 ± 9.5) d,P =0.014),and the cost in experimental group was lower [(99 ± 13) thousand yuan vs (115 ± 13) thousand yuan,P =0.000),however,the cost of nutrition support between the two groups was not significantly different (P =0.210).Conclusions Preoperative nutrition support is helpful to reduce the incidence of postoperative complications,shorten the length of hospital stay,to save medical costs for patients with pancreaticoduodenectomy.

Objective To analyze the CT features of hepatic artery and morphology changes of the liver in patients with cavernous transformation of the portal vein (CTPV). Methods Thirteen patients of CTPV without malignant hepatic tumor or other diseases being able to cause changes of hepatic artery such as cirrhosis and hepatophyma were collected. CT data was analyzed, and the arterial and morphology changes of the liver were observed. Results Left and (or) right hepatic arteries were found dilated in 10 patients (76.92%), and unusual flake like enhancement was found in artery phase in 3 patients (23.08%). Atrophy-hypertrophy complex (AHC) could be found only in 1 patient (7.69%). Conclusion Dilatation of hepatic artery manifests more hepatic artery blood supply, while obvious AHC is hardly found in CTPV.