1.A Comparative Study of Minimally Invasive Rotary Resection and Traditional Surgery in the Treatment of Mastitis
Chinese Journal of Minimally Invasive Surgery 2015;(12):1094-1096
Objective To investigate the clinical value of minimally invasive rotary resection in the treatment of mastitis with abscess formation. Methods A total of 93 cases with mastitis with abscess formation in our hospital from October 2010 to December 2014 were divided into two groups according to patients ’ willingness: one group was given ultrasound-guided Mammotome rotary surgery and drainage (minimally invasive group, n=45), the other underwent incision and drainage (control group, n=48).Surgical parameters, postoperative complications and patient satisfaction were compared between the two groups. Results The minimally invasive group was significantly superior to the control group in the operative time, blood loss, healing time, postoperative scar length and postoperative complications [(16.0 ±4.4) min vs.(30.6 ±6.8) min, t=-12.339, P=0.000;(8.5 ±2.3) ml vs.(12.7 ± 4.1) ml, t=-6.102, P=0.000;(10.1 ±1.9) d vs.(14.3 ±3.3) d, t=-7.595, P=0.000;(4.6 ±1.2) mm vs.(40.5 ± 11.8) mm, t=-20.913, P=0.000;8.9%(4/45) vs.25.0% (12/48), χ2 =4.232, P=0.040].Follow-up reviews at 3-6 postoperative months showed the comprehensive satisfaction of operation was significantly higher in the minimally invasive group (37/45, 82.2%) than that of control group (28/48, 58.3%) (χ2 =6.299, P=0.012). Conclusion For mastitis with abscess formation, minimally invasive rotary surgery has characteristics of minimal invasion, quick postoperative recovery, good cosmetic effects, few complications and high patients’ postoperative satisfaction.It deserves further clinical application.
2.Key advances in the clinical studies of ANCA-associated vasculitis
Journal of Medical Postgraduates 2016;29(3):323-326
Anti-neutrophil cytoplasmic antibodies( ANCA)-associated vasculitis ( AAV) has various clinical symptoms, thus various treatment schemes were used in clinics.To date, there has been no validated diagnostic criteria or treatment guideline for AAV.There are three aspects to be considered when assessing the treatment with AAV patients:staging of disease, distinction between disease activity and chronic damages, and quality of life ( QOL) .This review focuses on the latest classification of vasculitis, the rela-tion between disease stages and its severity, the importance of distinguishing active diseases from permanent damages, the therapeutic choices and the management of complications.
3.The preventive effect of hyaluronic acid on post-surgical pelvic and abdominal adhesion
Chinese Journal of Primary Medicine and Pharmacy 2015;22(3):332-333
Objective To explore the clinical effect of sodium hyaluronic acid on prevention of post-surgical pelvic and abdominal adhesion in gynecology.Methods 336 patients with pelvic and abdominal operation,using the double blind method for the patients and doctors,were randomly divided into the observation group (172 cases)and control group(164 cases).The experimental group was given hyaluronic acid in corresponding regions of the peritoneum,and the control group was not given any tissue adhesion prevention measures.Postoperative adhesions incidence and the change of serum CRP level of two groups were recorded.Results There was significant difference between the two groups in postoperative adhesions incidence (47.5% vs 19.8%,x2 =13.10,P < 0.01).The CRP level of the observation group changed significantly as compared with the control group after operation [(24.5 ±3.4)mg/L vs(12.7 ±3.9)mg/L(t =20.86,P<0.01)].Conclusion Hyaluronic acid in prevention of postoperative adhesion of pelvic and abdominal operation is effective on improving the serum level of inflammatory factors.
4.Key point of collaboration during the surgery of endoscopic guided vitrectomy for complicated ocular trauma
Chinese Journal of Practical Nursing 2013;29(33):17-19
Objective To summarize the key point of collaboration during the surgery of endoscopic guided vitrectomy for complicated ocular trauma.Methods From October 2010 to March 2013,a total of 25 cases(25 eyes) of complicated ocular trauma were treated by endoscopic guided vitrectomy.The the key point of collaboration was summarized.Results Surgeries of 25 cases (25 eyes) went smoothly,visual acuity improved,without enucleation cases.Postoperative complications were mainly secondary glaucoma and vitreous hemorrhage,and all were improved after treatment.Conclusions Endoscopic guided vitrectomy for the treatment of complicated ocular trauma is one of the effective means,and the advantage is that the surgery could be done when the refractive medium is opacity.
5.Mechanisms and therapeutic methods of HCC with PVTT
International Journal of Surgery 2013;40(10):688-691
Hepatocellular carcinoma (HCC) is one of the most common cancers in the worldwide.In recent years,the development of imaging techniques has facilitated the detection of HCC at early stages.However,HCC has a high frequency of portal vein invasion,which is reportedly observed in 11% to 42% of patients with HCC.Portal vein tumor thrombus(PVTT) is a crucial factor that can worsen the prognosis of HCC because it can be wide dissemination of tumor throughout the liver and cause a marked deterioration of hepatic function.It was considered that is not appropriate with surgical treatment in the past,which is treatment conservative or even give up,most of the patients died within a few months.Even if the patients have a chance to surgical resection,and the most of patients combined with TACE,portal vein stent implantation or chemotherapy postoperative,some patients can be more prolonged survival,however,due to the small tumor thrombus and micro metastases have exist before the surgery and can not be checked out.it's difficult to clean up in the surgery,easily lead to HCC recurrence postoperative.However,with the constant awareness the PVTT formation mechanism and scientific technology progress,more and more new treatment techniques is applied to clinical.This view focuses on the portal vein tumor thrombus formation mechanisms and Classic Transcatheter Arterial Chemoembolization and new treatment methods such as:Helical tomotherapy,CIK cell therapy (cytokine-induced killer cell therapy),Chemoembolization and stent combined with iodine-125 seed.
6.Reducing effect of pulmonary recruitment on laparoscopic cholecystectomy-induced upper abdominal pain, shoulder pain, and incision pain
Journal of Medical Postgraduates 2015;(7):741-744
Objective Abdominal pain, shoulder pain, and incision pain after laparoscopic cholecystectomy ( LC) are com-mon complaints of the patients.This study was to observe the effects of pulmonary recruitment ( PR) in reducing post-LC abdominal pain, shoulder pain, and incision pain. Methods A total of 138 patients treated by LC were randomly assigned to a PR ( n=67) and a control group (n=71).The former underwent postoperatively five 5-second-long manual inflations of the lungs by positive pres-sure ventilation with 40 cmH2 O to discharge CO2 from the abdominal cavity, while the latter received traditional passive deflation of CO2 .At 6, 12, 24, and 48 h after surgery, we recorded the incidences of abdominal pain, shoulder pain, and incision pain and as-sessed the pain intensity using the visual analogue scale ( VAS) . Results Compared with the control group at 12 and 24 h after sur-gery, the PR group showed significant decreases in the incidence rate of upper abdominal pain (90.14%vs 74.63%and 91.55%vs 73.13%, both P<0.05), with VAS scores of 4.32 ±2.73 vs 2.72 ±1.67 and 4.04 ±2.55 vs 2.67 ±1.49 (both P<0.05), as well as in that of shoulder pain (56.34% vs 47.76% and 74.65% vs 56.72%, both P<0.05), with VAS scores of 3.68 ±3.10 vs2.61 ±1.97 and 4.15 ±3.23 vs 2.78 ±1.88, both P <0.05). However, no significant differences were observed in the incidence or severity of incision pain between two groups at any time points after surgery (P>0.05). Conclusion Pulmonary recruitment can re-duce the incidence rates and severity of upper abdominal pain and shoulder pain, but has no effect in alleviating incision pain following laparoscopic cholecystectomy.
7.The experimental research on the protective effect of SD rats′liver transplantation reperfusion ischemia-reperfusion injury(IRI) after GW3965 activation of liver X receptor preprocessing
International Journal of Laboratory Medicine 2015;(15):2237-2239
Objective To study the protective effect and mechanism of SD rats′liver transplantation reperfusion ischemia‐reper‐fusion injury(IRI) after GW3965 activation of liver X receptor preprocessing .Methods Separated Male SD(Sprague‐Dawley) 70 rats into 3 groups which were sham operation group (SO group ,14 rats) ,orthotopic liver transplantation group (OLT group ,28 rats) ,and GW 3965 preprocessing group(GW 3965 group 28rats) .The levels of serum transaminase ,plasma inflammatory factors (TNF‐α、IL‐1) ,the changes of hepatic pathology and inflammatory factor mRNA ,and the activities as well as its expressions of NF‐κB in hepatic tissue were observed ,after the operation .Results After 6 and 24 hours perfusion ,the levels of plasma inflammatory factors was expression ,serum transaminase ,the liver pathological injury degree and the activities as well as its expressions of NF‐κB in OLT group and GW3965 group were higher than those in SO group .While after reperfusion for 6 and 24 hours ,the levels of ser‐um transaminase ,plasma inflammatory factors expression ,the liver pathological injury degree ,inflammatory factor and the activities as well as its expressions of NF‐κB in GW3965 group were much lower than those in OLT group ,there were obvious differences (P<0 .05) .Conclusion After GW3965 activation of liver X receptor preprocessing ,the activities of NF‐κB and the emerging of downstream inflammatory mediator factors are reduced effectively and protect the liver after the ischemia reperfusion .