Objective To evaluate the feasibility,safety and efficacy of laparoscopic appendectomy for acute appendicitis with previous abdominal surgery.Methods The clinical data of 253 patients with acute appendicitis undergoing laparoscopic surgery was retrospectively studied from Feb.2009 to Jun.2012,including 177 patients without previous abdominal surgery (no previous abdominal surgery group,NPAS group),76 patients with previous abdominal surgery (previous abdominal surgery group,PAS group).Parameters studied were conversion rates,operation time,blood loss,complications rate,length of hospital stay and the intestine function recovery time between two groups.Results The conversion rates were no significant difference between NPAS group and PAS group.The operation time of NPAS group and PAS group was (40.5 ± 12.3) minutes and (62.6 ± 14.2) minutes (P ＜0.05).The blood loss,intestine function recovery time,complications rate,and length of hospital stay were no significant minutes between NPAS group and PAS group after operation (P ＞ 0.05).Conclusions Previous abdominal surgery prolongs the operation time of laparoscopic appendectomy,but history of abdominal surgery has no significant effect on laparoscopic surgical outcome,which may indicate that laparoscopic surgery for acute appendicitis with previous abdominal surgery is safe and effective and still has the adventages of less trauma,faster recovery.

0.05). ③The entrance point of screw was designed based on the obtained data. Sixty screws were all inserted into pedicles successfully. CONCLUSION: L1-5 superior margin root of spinous process locates in superior and inferior planes of vertebral pedicle with stable anatomic relationship; in addition, there are no significant differences between plain tomography and CT films. It provides anatomic data for pedicular operation.

Objective To explore the clinical characteristics of and surgical strategies for distal tibiofibular syndesmosis separation based on ankle axial CT scan.Methods From January 2009 to January 2016,63 patients with injury to the distal tibiofibular syndesmosis were treated.Their injuries were characterized according to the anatomic characteristics on their ankle axial CT scan images as pronation-extorsion type (28 cases),supination-extorsion type (11 cases) and abduction type (24 cases).Specific strategies of reduction and fixation depended on the specific characteristics of distal tibiofibular syndesmosis separation.After 12 months postoperatively,the reduction quality was assessed by Burwell-Charnley's radiological evaluation system and the function of ankle joint was assessed using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score system.Results The patients were followed up for 6 to 48 months (average,19.3 months).Anatomical reduction was achieved in 19 cases,good reduction in 7 and fair reduction in 2 in the pronation-extorsion type,yielding an excellent to good rate of 92.8％;anatomical reduction was achieved in 6 cases,good reduction in 4 and fair reduction in one in the supination-extorsion type,yielding an excellent to good rate of 90.9％;anatomical reduction was achieved in 17 cases,good reduction in 6 and fair reduction in one in the abduction type,yielding an excellent to good rate of 95.8％.By the AOFAS system,the pronation-extorsion type scored 88.6 points,the supination-extorsion type 89.4 points and the abduction type 86.6 points.Conclusion In the treatment of distal tibiofibular syndesmosis separation,reduction and fixation strategies should depend on analysis of the characteristics on the ankle axial CT scan,so as to achieve positive outcomes.

Objective To explore the clinical effect and feasibility of cold cycle microwave ablation combined with laparoscopic hepatectomy for hepatic hemangioma.Methods Thirteen cases of hepatic hemangiomas were treated with cold cycle microwave ablation combined with laparoscopic hepatictomy,and their clinical data were analyzed retrospectively from March 2015 to October 2017 in the First People's Hospital of Jiangxia District of Wuhan City,including 5 males and 8 females with an average age of 52 years and age range of 45-68 years.The course of disease was 18 months to 8 years,with an average of 4.2 years.The clinical data were retrospectively analyzed and the operation time,intraoperative blood loss,postoperative hospital stay,liver function changes and complications were recorded.The data were analyzed using SPSS 17.0 statistical software,and measurement data with normal distribution were expressed as mean ± standard deviation (Mean ± SD).Results The operations of the 13 cases were successful,including 7 cases of single hepatic hemangioma (the lesions were located in segments 11,111 and Ⅳ) and 6 cases of multiple hepatic hemangioma (the lesions were located in segments Ⅱ,Ⅲ,Ⅳ,Ⅶ and Ⅷ).No hepatic portal occlusion was performed during the operation.The operation time was (135.4 ± 35.8) min,intraoperative blood loss was (95.2 ± 22.7) ml,the postoperative hospital stay was (6.4 ± 0.8) d.On the first postoperative day,alanine aminotransferase was (354.2 ± 75.4) IU/L,and aspartate aminotransferase was (382.7 ± 68.5) IU/L,during the first week after surgery,alanine aminotransferase and aspartate aminotransferase both decreased to the normal range,and no serious complications such as bile leakage or hemorrhage occurred after surgery.No recurrence was observed after 6 to 12 months of follow-up.Conclusions Under the premise of strict control of surgical indications,laparoscopic cold-circulation microwave ablation combined with hepatectomy for hepatic hemangioma is safe and feasible.It can simultaneously treat multiple lesions,and cold-cycle microwave ablation can effectively reduce intraoperative bleeding with a minimally invasive effect.

Objective To observe the effectiveness of injecting mouse nerve growth factor ( mNGF) on the recovery of hand motor function among patients with cubital tunnel syndrome. Methods A total of 138 patients with moderate to severe cubital tunnel syndrome were randomly divided into groups designated as A, B and C, each of 46. Twenty micrograms of mNGF was injected daily 1 mm from the ulnar nerve at the cubital tunnel for the patients of group A and the injection site was moved 1 mm distally everyday along the nerve , but injected intramuscularly for those in group B. Those in group C received 500 μg of mecobalamin injected intramuscularly 3 times a week. The whole intervention consisted of two 4-week phases, with an interval of 2 months. Before and after the intervention, the function of internal hand muscles, hand function recovery rates and any electrophysiological changes in the ulnar nerve were measured and compared between the two groups. Results All of the patients showed significant improve-ment in hand muscle function and neuroelectrophysiology. The incidence of had muscle atrophy, Tinel′s sign, posi-tiveness in the paper clamping test and claw hand all significantly improved compared with before the treatment in all three groups. The average Disability of Arm Shoulder and Hand score in group A after the treatment was significantly higher than the group B and group C averages. The average ulnar nerve conduction velocity, incubation period and amplitude of group A after the treatment were all significantly better than before the treatment and better than the other groups′averages. After the treatment, the average hand function recovery in group A reached 91％, significantly high-er than in groups B ( 76％) and C ( 59％) . Conclusion Injecting mNGF next to the ulnar nerve is superior to in-jecting it intramuscularly in promoting the recovery of the ulnar nerve and hand function for patients with moderate to severe cubital tunnel syndrome.

Objective:To investigate the clinical efficacy of B-mode ultrasound guided percutaneous extensor tendon insertion reconstruction in the treatment of tendinous mallet fingers.Methods:A retrospective analysis was performed on the data of patients with mallet finger deformity admitted to the Department of Hand Surgery of Jinan People’s Hospital from February 2010 to January 2019. Under the guidance of B-mode ultrasound, the extensor tendon was sutured percutaneously with PDS II monofilament suture, pulled to the base of the distal phalanx, which was drilled with a 1.0 mm Kirschner’s wire to reconstruct the insertion of the extensor tendon. The active and passive extension angles of the affected fingers and the wound healing were observed after operation. Evaluation of finger function using Crawford’s method.Results:A total of 58 cases were enrolled, including 48 males and 10 females, aged 20-53 years. 49 patients were followed up for 6 to 15 months after operation, with an average of 11 months, and 9 patients were lost to follow-up. The active extension angle of the affected finger changed from 46.5°±7.2° before operation to 6.4°±0.5° after operation, and the difference was statistically significant before and after operation ( t=38.89, P<0.001). The passive extension angle decreased from 3.2° ±0.3°before operation to 0.9° ±0.2°after operation, and the difference was statistically significant before and after operation ( t=44.65, P<0.001). There were no complications such as exposed knots and skin necrosis. Evaluation by Crawford method: excellent in 29 cases, good in 12 cases, and fair in 8 cases. Conclusions:Percutaneous ultrasound-guided extensor finger tendon insertion reconstruction, minimally invasive surgery, in the treatment of tendon mallet finger function recovered well, and the effect was satisfactory.

Objective:To investigate the clinical efficacy of B-mode ultrasound guided percutaneous extensor tendon insertion reconstruction in the treatment of tendinous mallet fingers.Methods:A retrospective analysis was performed on the data of patients with mallet finger deformity admitted to the Department of Hand Surgery of Jinan People’s Hospital from February 2010 to January 2019. Under the guidance of B-mode ultrasound, the extensor tendon was sutured percutaneously with PDS II monofilament suture, pulled to the base of the distal phalanx, which was drilled with a 1.0 mm Kirschner’s wire to reconstruct the insertion of the extensor tendon. The active and passive extension angles of the affected fingers and the wound healing were observed after operation. Evaluation of finger function using Crawford’s method.Results:A total of 58 cases were enrolled, including 48 males and 10 females, aged 20-53 years. 49 patients were followed up for 6 to 15 months after operation, with an average of 11 months, and 9 patients were lost to follow-up. The active extension angle of the affected finger changed from 46.5°±7.2° before operation to 6.4°±0.5° after operation, and the difference was statistically significant before and after operation ( t=38.89, P<0.001). The passive extension angle decreased from 3.2° ±0.3°before operation to 0.9° ±0.2°after operation, and the difference was statistically significant before and after operation ( t=44.65, P<0.001). There were no complications such as exposed knots and skin necrosis. Evaluation by Crawford method: excellent in 29 cases, good in 12 cases, and fair in 8 cases. Conclusions:Percutaneous ultrasound-guided extensor finger tendon insertion reconstruction, minimally invasive surgery, in the treatment of tendon mallet finger function recovered well, and the effect was satisfactory.

Objective:To investigate the clinical efficacy of B-mode ultrasound guided percutaneous extensor tendon insertion reconstruction in the treatment of tendinous mallet fingers.Methods:A retrospective analysis was performed on the data of patients with mallet finger deformity admitted to the Department of Hand Surgery of Jinan People’s Hospital from February 2010 to January 2019. Under the guidance of B-mode ultrasound, the extensor tendon was sutured percutaneously with PDS II monofilament suture, pulled to the base of the distal phalanx, which was drilled with a 1.0 mm Kirschner’s wire to reconstruct the insertion of the extensor tendon. The active and passive extension angles of the affected fingers and the wound healing were observed after operation. Evaluation of finger function using Crawford’s method.Results:A total of 58 cases were enrolled, including 48 males and 10 females, aged 20-53 years. 49 patients were followed up for 6 to 15 months after operation, with an average of 11 months, and 9 patients were lost to follow-up. The active extension angle of the affected finger changed from 46.5°±7.2° before operation to 6.4°±0.5° after operation, and the difference was statistically significant before and after operation ( t=38.89, P<0.001). The passive extension angle decreased from 3.2° ±0.3°before operation to 0.9° ±0.2°after operation, and the difference was statistically significant before and after operation ( t=44.65, P<0.001). There were no complications such as exposed knots and skin necrosis. Evaluation by Crawford method: excellent in 29 cases, good in 12 cases, and fair in 8 cases. Conclusions:Percutaneous ultrasound-guided extensor finger tendon insertion reconstruction, minimally invasive surgery, in the treatment of tendon mallet finger function recovered well, and the effect was satisfactory.

Objective:To investigate the clinical efficacy of B-mode ultrasound guided percutaneous extensor tendon insertion reconstruction in the treatment of tendinous mallet fingers.Methods:A retrospective analysis was performed on the data of patients with mallet finger deformity admitted to the Department of Hand Surgery of Jinan People’s Hospital from February 2010 to January 2019. Under the guidance of B-mode ultrasound, the extensor tendon was sutured percutaneously with PDS II monofilament suture, pulled to the base of the distal phalanx, which was drilled with a 1.0 mm Kirschner’s wire to reconstruct the insertion of the extensor tendon. The active and passive extension angles of the affected fingers and the wound healing were observed after operation. Evaluation of finger function using Crawford’s method.Results:A total of 58 cases were enrolled, including 48 males and 10 females, aged 20-53 years. 49 patients were followed up for 6 to 15 months after operation, with an average of 11 months, and 9 patients were lost to follow-up. The active extension angle of the affected finger changed from 46.5°±7.2° before operation to 6.4°±0.5° after operation, and the difference was statistically significant before and after operation ( t=38.89, P<0.001). The passive extension angle decreased from 3.2° ±0.3°before operation to 0.9° ±0.2°after operation, and the difference was statistically significant before and after operation ( t=44.65, P<0.001). There were no complications such as exposed knots and skin necrosis. Evaluation by Crawford method: excellent in 29 cases, good in 12 cases, and fair in 8 cases. Conclusions:Percutaneous ultrasound-guided extensor finger tendon insertion reconstruction, minimally invasive surgery, in the treatment of tendon mallet finger function recovered well, and the effect was satisfactory.

Objective To compare the effects of different anesthetics on the recovery of neurologi-cal function after intracranial aneurysm embolization. Methods One hundred patients of both sexes with aneurysmal subarachnoid hemorrhage, aged more than 18 yr, with body mass index of 18. 5-24. 0 kg∕m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ and WFNS grade Ⅰ-Ⅳ, with the thick-ness of subarachnoid hemorrhage more than 4 cm, were divided into 2 groups (n= 50 each) using a random number table: propofol group (group P) and sevoflurane group (group S). After anesthesia induction, group P received intravenous infusion of propofol 100-300 μg·kg-1 ·min-1 , while the end-tidal sevoflu-rane concentration was maintained at 1. 4％-3. 5％ in group S. Immediately before induction (T0 ), imme-diately after the end of induction (T1 ), immediately after successful embolization of aneurysm (T2 ) and at 1, 2, 3 and 5 days after surgery (T3-6 ), central venous blood samples were collected for determination of plasma neuron-specific enolase and S100β protein concentrations by enzyme-linked immunosorbent assay. The development of postoperative cerebral vasospasm and delayed ischemic neurological deficit was recorded. The patients were followed up, and the Glasgow outcome score and occurrence of newly developed cerebral infarction were recorded within 6 months after surgery. Results There was no significant difference in the concentrations of plasma neuron-specific enolase and S100β protein at each time point, incidence of postop-erative cerebral vasospasm and delayed ischemic neurological deficit, or Glasgow outcome score and inci-dence of newly developed cerebral infarction within 6 months after surgery between two groups (P>0. 05). Conclusion Propofol and sevoflurane exert no effect on the recovery of neurological function after intracra-nial aneurysm embolization.