Objective To investigate the effect of obesity on the early complications after esophageal cancer operation.Methods Clinical data of 327 patients who had esophageal cancer operation in our hospital from August 2012 to September 2015 were retrospectively analyzed.The patients were divided into 4 groups:lean group(n =75), normal group(n =120),overweight group(n =103)and obesity group(n =29)by body mass index(BMI).The impact of obesity on early complications of esophageal carcinoma after surgery was analyzed.Results The operation time of the lean group,normal group,overweight group and obesity group were (257.8 ±52.6 )min,(289.3 ± 48.7)min,(321.5 ±55.9)min,(367.9 ±50.2)min respectively.The operation time was increased with the increase of BMI (F =13.397,P =0.000).The incidence rates of incision infection,empyema,hoarseness,diaphragmatic hernia,postoperative bleeding,chylous fistula,pulmonary complication were 5.3%,1.3%,1.3%,1.3%,2.7%, 2.7%,16.0% in the lean group,5.0%,1.6%,1.6%,1.3%,1.6%,1.6%,17.5% in the normal group,5.8%, 1.9%,0.9%,1.9%,1.9%,1.9%,1.9% in the overweight group,10.3%,3.4%,0.0%,3.4%,3.4%,0.0%, 13.8% in the obesity group.No significant differences were found about the hospital days,wound infection,empyema, hoarseness,diaphragmatic hernia,operation hemorrhage,chylous fistula,pulmonary complications among the 4 groups (all P >0.05 ).The incidence rates of cardiovascular complications and anastomotic leakage after operation were 0.0%,4.0% in the lean group,1.9%,5.0% in the normal group,6.8%,9.7% in the overweight group,13.8%, 17.2% in the obesity group.The incidence of cardiovascular complications,postoperative anastomotic leakage increased with the increase of BMI.The differences of the four groups were statistically significant(F =1.675,1.054, all P <0.05).Conclusion Obesity can increase the incidence of early postoperative complications in patients with esophageal cancer.But obesity is not a contraindication of surgery for esophageal cancer,but obese patients should be more carefully treated in the perioperative period.

Objective To observe therapeutic effects of compounded zedoary turmeric oil suppository com-bined with microwave therapy on cervical erosion. Methods Women with cervical erosion were randomly divided in-to two groups: single microwave therapy group (control group) and compounded zedoary turmeric oil suppository com-bined with microwave therapy group (observation group). The chnical cure rate, obvious effective rate and ineffective rate were compared between two groups. Results In mild erosion, the clinical cure rate, obvious effective rate and ineffective rate were 87.8%, 12.2% ,0 respectively in the observation group. In tbe control group were 85.7%, 14.3%,0 respectively, and there was no significant difference between them (P >0.05); In moderate erosion, were 86.1%, 12.8%, 1.2% respectively in the observation group; were 60.9%, 31.9%, 7.2% respectively in the control group and there was significant difference between them (P < 0.01); In severe erosion, were 59.4%, 34.4%, 6.2% respectively in the observation group; were 29.17%, 41.7%, 29.2% respectively in the control group, and there was significant difference between them (P < 0.05). Conclusion Single microwave therapy to the mild erosion was suf-ficient; nevertheless, compounded zedoary turmeric oil suppository combined with microwave therapy to moderate and severe erosion was better than single microwave therapy.

0.05). Retention rate was 97.5% (117/120) in Gyn IUD group and 90.0% (108/120) in ML IUD group, with statistically significant difference (P

[Objective]To study the application and clinical results of the adjustable erternal fixation of ankle joint(AEFA) in orthopedic surgery.[Method]From January 1999 to May 2005,45 cases(55 feet)of equinovarus deformity were treated with orthopedic surgery.In order to preventent the deformity relapsion,the patients were assigned to two groups.The A group(26 cases,32 feet)patients were treated with the adjustable erternal fixation of ankle joint(AEFA).The B group(19 cases,23 feet)patients were treated with plaster immobilization.The orthopedic surgery effect and functions of ankle joint were studied and tested with independent sample t test and x~2 test.[Result]Thirty-eight cases were fellowed-up for 3 months to 9 years(averaged 19 months).There were significant difference between the two groups in the functions of ankle joint.[Conclusion]The new apparatus can effectively prevent the foot-drop deformity and enhance the function of ankle joint.

Serum tartrate-resistant acid phosphatase-5b (TRAP-5b) is a marker reflecting bone absorption. The results showed that serum TRAP-5b level was higher in postmenopausal than that in premenopausal normal women (P

Objective To discuss the clinical effect of artificial pneumothorax combined with intercostal nerve block in alleviating chest pain occurring during and after percutaneous microwave ablation (MWA) for subpleural lung malignancy.Methods A total of 30 patients with subpleural lung malignancy were randomly and equally divided into group A (n=10),group B (n=10) and group C (n=10).The patients in group A received both artificial pneumothorax and intercostal nerve block before MWA.The patients in group B only received artificial pneumothorax before MWA,and the patients in group C only received intercostal nerve block before MWA.The degree of pain was evaluated by visual analogue scale (VAS) score during MWA,immediately after MWA and at 6 h,12 h and 24 h after WMA.The side effects after MWA were recorded.Results During MWA,no statistically significant differences in VAS scores existed between each other among the three groups (P=0.885).The VAS scores determined at 6 h,12 h and 24 h after MWA in group C were significantly increased (P=0.014,P=0.006 and P=0.006 respectively).No patient in group A and group B developed symptoms of chest tightness after artificial pneumothorax was performed.After treatment,a small amount of asymptomatic residual pneumothorax was still observed in 6 patients of group A and group B,which disappeared spontaneously in about one week.Another patient still showed massive pneumothorax even after thoracic gas suction,and the patient recovered after thoracic closed drainage for three days.No other serious complications related to artificial pneumothorax occurred.Conclusion Artificial pneumothorax combined with intercostal nerve block can effectively relieve the chest pain occurring during and after MWA in patients with subpleural lung malignancy,and clinically this technique is quite safe.(J Intervent Radiol,2017,26:269-273)

From March 1982 through December 1083, free transplantation of the perichondrium was used to repair the cartilagenous surface of interphalangeal joints in 5 cases of traumatic comminuted fracture. Of these 5 cases, the injury involved proximal interphalangeal joint of index fingers in 2 cases, proximal interphalangeal joint of the middle finger in 2, and carpometacarpal joint of the thumb in 1. The perichondrium was harvested from the 8th or 9th costal synchondrosis.X-ray film showed growth of new smooth cartilage surface, and the movement of the joints ranging from 10 to 30 degrees was observed 3 months after operation. Points to be observed in operation are: (1) About 0.5 cm of the recipient site of the phalange should be bitten away to expose the cancellous bone, thus a surface with better blood supply was created to receive the perichondrial transplant; (2) The recipient surface was reshaped into an articular surface so that no dead space was left between the recipient surface and the graft: (3) The transplanted perichondrium should be anchored onto the bone under certain amount of tension to insure close contact with the bony surface; (4) Immobilization should be enforced for 3 weeks post-operatively.

Objective To study the clinical,pathological and genetic features of myofibrillar myopathy caused by BAG3 gene mutation.Methods The clinical features and pathological findings of a patient with myofibrillar myopathy were analyzed.Genomic DNA of the patient was extracted from peripheral blood and the next generation sequencing was performed to explore the mutation of genes about myopathies.Results The patient presented with nine-year-old onset myopathy characterized by progressive difficulty for squatting,rigid spine and muscle atrophy in the limbs symmetrically.Peripheral neurogenic damages were found on electromyography.On muscle biopsy,myogenic and neurogenic damages with rimmed vacuoles appeared,and the deposited materials were positive for sarcoglycan,dystrophin-R and dystrophin-C.There was a reported heterozygous mutation in the exons of the BAG3 gene (c.626C ＞ T).Conclusion There is no specificity of clinical manifestation in myofibrillar myopathy,and the diagnosis of this disease mainly depends on muscle biopsy and genetic screening.

AIM To investigate the preventive effects of Shangke Huangshui Gauze (Scutellariae Radix,Coptidis Rhizoma,Phellodendri chinensis Cortex,etc.) on vascular crisis after digital replantation.METHODS Sixty-eight cases of patients with amputated digits meeting the inclusion criteria were randomly divided into observation group (36 cases with 57 fingers) and control group (32 cases with 54 fingers),the former was wet-dressed with Shangke Huangshui Gauze,the latter was bandaged with sterile dry gauze.The observation and comparison were made between the two groups on four coagulation indexes,visual analog scores (VAS),improvement of swelling degrees,the occurrence rates and survival rates of vascular crisis after operation,together with the evaluation of efficacy and adverse reaction.RESULTS In the observation group,the 7th day after operation,the prothrombin time,activated partial thromboplastin time,international normalized ratio,thrombin time and swelling improvement rate were higher than those in the control group;but the fibrinogen and postoperative 4 days' VAS pain score were lower than those in the control group.The incidence rates of vascular crisis and adverse reaction in the observation group were lower than those in the control group,and the survival rate of replanted fingers was higher than that in the control group.CONCLUSION Shangke Huangshui Gauze can prevent the occurrence of vascular crisis after digital replantation to a certain extent without obvious adverse reaction.

AIM To investigate the effects of Sanqi Huayu Oral Liquid (Notoginseng Radix et Rhizoma,Corydalis Rhizoma) on femoral shaft comminuted fracture caused by trauma in perioperative period of high-risk groups.METHODS One hundred and twenty patients meeting the inclusion criteria were randomly and equally divided into treatment group and control group.The control group was treated by low molecular weight heparin calcium injection,while the treatment group was additionally given Sanqi Huayu Oral Liquid.Two groups' levels of serum IL-6,TNF-α and D-D were detected on pre-operation and the 1 st,3rd,7th after operation,respectively.Additionally,the adverse drug reactions were also observed.RESULTS There were no statistically significant differences in the levels of serum IL-6,TNF-α and D-D between the two groups before operation.The first day after operation,the levels of serum IL-6,TNF-α and D-D between the two groups showed increasing trends,which had similar elevated levels without statistically significant differences.The third day after operation,the levels of serum IL-6,TNF-α and D-D between the two groups presented downward trends,but those in the treatment group were decreased more markedly with statistically significant differences.Furthermore,the seventh day after operation,the levels of serum IL-6,TNF-α and D-D between the two groups were lower than those before the operation,and these indices in the treatment group were lower than those in the control group with statistically significant differences.CONCLUSION Sanqi Huayu Oral Liquid can not only effectively reduce the levels of serum IL-6,TNF-α and D-D in perioperative period of high-risk groups,but also prevent the formation of deep vein thrombosis.