Objective To compare the efficacies of laparoscopic colorectal resection and conventional open surgery by collecting and investigating related studies with Meta-analysis.Methods Randomized controlled trials(RCT) on the outcomes of laparoscopic colorectal resection and conventional open surgery that published between January 1989 and March 2008 in English were collected and analyzed.The quality of the original investigations was evaluated,and the low-level reports were excluded.Then the odds ratio(OR) for the incidence of early postoperative small bowel obstruction between the two methods were calculated.ResultsTotally 12 studies including 3032 cases were analyzed.Among which,1522 patients received laparoscopy,33 of them developed early postoperative small bowel obstruction.1510 cases underwent open surgery,and 71 of these patients showed small bower obstruction before being discharged form hospital.The pooled OR was 0.46 with a 95% confidence interval of(0.30-0.69).Conclusion Compared with open surgery,laparoscopic colorectal resection is superior in the incidence of early postoperative small bowel obstruction.

Objective　Coronary artery bypass grafting (CABG)i n 13 patients was analyzed. Methods　9 patients were performed C ABG with cardiopulmonary bypass, 4 patients undergone off-pump coronary artery bypass(OPCAB). Among the 4 patients, 3 undergone transmyocardial laser revascula rization concomitantly. 2 patients with single-vessel disease, 3 with double-v essel disease, 7 with triple-vessel disease and 1 with left main coronary arter y disease. The average bypass per patient was 2.3. Results　All patients survived, 11 patients were angina free, 2 were angina relief. C onclusion　CABG is a safe operation, OPCAB may reduce blood transfusion and complication, patients recover more quickly after OPCAB compared with those with CABG.

There are 1?024 cases of severe head injury hospita lized． 917 of them were closed head injury (89, 55%), 107 of them were opening head injury(10.45%)． Results: good recover: 326(31.83%)．moderate disability: 185(18.07%), severe inability 139(13.50%), persistent vegetative state　59(5.75%), death 315 (30.76%)． Conclusion: The early diagn osis and treatment of sever head injury is beneficial to the outcome of these patients． Special trea tment to different phrase of severe head injury, especially the moderate hypothermia treatment, co uld improve the outcome of these patients．

Objective To investigate the effects of human amniotic membrane on the survival of the crossboundary perforator flap in rats through distal subcutaneous implantation.Methods From February,2016 to December,2016,38 SD rats weighing 270-300 g were randomly divided into experimental group and control group (n=19).A three-territory perforator flap (3 cm× 10 cm) with the iliac artery as the pedicel elevated on the right dorsum of the rats.Experiment group,a section of amnion was sutured to the distal subcutaneous of the flap and then the flap was sutured back to its donor site.Control group,after the flap elevated,directly sutured back to its donor site.The blood flow of the pedicel were detected by laser Doppler flowmetry at the day before surgery,1 day after surgery,3 and 7 days after surgery,with 3 rats in every group.When the rats were anesthetized,biopsies were taken from the choke area Ⅱ at the day before surgery,3 and 7 days after surgery,with 9 rats in every group.When the rats were anesthetized,HE was used to compare the diameter size of the artery and vein at the same site.At day 7,measure the survival area of the flap,and 3 of them observe the vessel of the flap by lead oxide-gelatine technique.Results The survival rate of the experimental group and the control group after 7 days were (89.09±4.23)％ and (74.56-±5.59)％ respectively,the experimental group was significantly higher than that of the control group (t=5.48,P=0.00).X-ray showed that 7 days after operation,the pedicel of iliac artery in the experimental group was bigger than that in the control group.The blood flow detection showed that the blood flow of the experimental group was higher than that of the control group (t=2.39,3.06;P=0.03,0.00,respectively) at day 1 and day 3 after surgery.Hematoxylin eosin staining showed that arteriovenous tube diameter at the Choke Ⅱ were gradually increased on the day3 and day7 after surgery in both group,but the experimental group diameter expanded multiple was higher than that of control group (t=3.52,3.50;P=0.02,0.02,respectively).Conclusion Human Amnion subcutaneous embedding may improve the blood flow of the vascular pedicle,expand the microvascular at Choke area Ⅱ,improve microcirculation,as a result to promote the survival of cross perforator flap,while the mechanism is needed to understanding.

Fourteen neonatal diabetes mellitus(NDM)patients were recruited. 9 patients were treated with glyburide and the other 5 with insulin. ABCC8, KCNJ11, and INS genes were sequenced in 6 of them. Gene mutations were found in 2, 1, and 1 cases in these genes, respectively. One case with 6q24 hypomethylation and another without known mutation were also found. 8 out of 9 patients treated with glyburide reached euglycemia(88.9%). The other 5 patients with insulin therapy either died or lost contact. The results suggest that glyburide therapy is effective in neonatal diabetes mellitus, while insulin therapy may contribute to poor compliance.

Objective To summarize the experience of surgical treatment of ascending aortic aneurysms and aortic dissections. Methods From February 2001 to October 2005, 31 patients including 26 male, 5 female, aged 41.3 years old (range 14-72) received surgical management. Twenty cases were diagnosed as ascending aortic aneurysm and aortic root aneurysm, 8 as Standford A dissection, 3 as Stanford B dissection. Twenty-one patients underwent classic Bentall procedure in which VSD repair was carried out in 1 case, mitral valvoplasty in 2 and mitral valve replacement in 2; Four patients underwent modified Bentall procedure (coronary button technique); Three patients underwent Wheat procedure; The remaining 3 patients with Stanford B dissection underwent graft replacement of descending aorta. Results There was no death during hospital stay that lasted 13-46 d with an average of 16.4 d after operation. The mean clinical follow-up was (21?18.5) months (range 1-63 months). One patient died without describable cause two years later. One patient had ascending aorta-pulmonary artery fistula at color Doppler examination half a year later. One patient was detected rupture of distal anastomoses half a year after operation and underwent stent-graft, SG. Conclusion The surgical treatment of aortic aneurysms and aortic dissections could be carried out safely based on the accurate diagnosis, specific surgical strategy and fine technique.

OBJECTIVE: To observed the prevention efficacy of secretory otitis media after radiation therapy by the Myrtol Standardized Enteric Coated Soft Capsules. METHOD: Sixty patients with nasopharyngeal carcinoma who Diagnosis without secretory otitis media before radiation therapy were divided into experimental group and control group, 30 cases in each group. After the start of radiation therapy ,the experimental group patients oral the Myrtol Standardized Enteric Coated Soft Capsules, each 0.3 g, 3 times a day, 7 days a course of treatment, oral the medication three months, the patients in the control group received no treatment. 3 months and 6 months after the end of radiation therapy, whether there is a difference comparison of experimental group and the control group in symptoms, signs, pure tone audiometry and tympanogram change. RESULT: Seventeen patients (18 ears) (56.67%, 17/30) in the control group were suffering from secretory otitis media, 7 patients (7 ears) (23.33%, 7/30) in the experimental group were suffering from secretory otitis media. The difference between the two groups was statistically significant (P < 0.01). 17 patients (17 ears) in the control group and 7 patients (7 ears) in the experimental group were suffering from tinnitus. 20 patients(20 ears) in the control group and 9 patients (10 ears) in the experimental group have ear choking feeling. The difference between the two groups was statistically significant (P < 0.01). The air conduction hearing threshold of the experimental group before radiation therapy is (7.5 +/- 2.0) dB HL and the air conduction hearing threshold of the control group patients is (8.3 +/- 4.0) dB HL. The difference between the two groups was not statistically significant (P > 0.05). 3 months after radiation therapy,the gas conductive hearing threshold of the experimental group is (25.6 +/- 3.0) dB HL, but the data in the control group is (40.7 +/- 5.0) dB HL. The difference between the two groups was statistically significant (P < 0.01). CONCLUSION Patients with nasopharyngeal carcinoma oral the the Myrtol Standardized Enteric Coated Soft Capsules before radiation therapy can effectively reduce the incidence of secretory otitis media after radiotherapy, it can prevent the occurrence of secretory otitis media.
Adult ; Aged ; Aged, 80 and over ; Carcinoma ; Drug Combinations ; Female ; Humans ; Male ; Middle Aged ; Monoterpenes ; therapeutic use ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; Otitis Media with Effusion ; etiology ; prevention & control ; Radiotherapy ; adverse effects

Objective:To explore the appropriate use of a self-developed scoliosis rehabilitation robot in treating adolescent idiopathic scoliosis (AIS), and also its safety and effectiveness.Methods:The scoliosis rehabilitation robot consists of a closed-loop pneumatic control system and multi-segment torso, pelvis and upper extremity fixation devices. It provides three-dimensional synchronous correction. Eighteen AIS subjects first received 30min of robot-assisted treatment using the maximum tolerable orthotic force. The angles of their spinal processes were evaluated using ultrasound before the treatment and after 30 seconds, 5 minutes and 30 minutes of treatment, then 5min later. In a second 30sec course of treatment the transverse orthotic force was 10%, 15%, 20%, 25%, and 30% of the patient′s body weight. Any adverse effects were observed and recorded.Results:The robot ran smoothly and could apply intelligent and precise correction. No severe adverse effects were reported. The mean correction of the spinal process angles showed a significant cumulative effect with treatment time, reaching 104% at 30min. The mean process angle correction increased with the applied force. Force at 25% of the patient′s weight produced an average correction of 104% in patients with mild AIS and 65% in those whose AIS was moderate.Conclusion:The scoliosis rehabilitation robot is safe and immediately effective. Setting the transverse force at 25% of a patient′s weight gives the best corrective effect with mild AIS. Moderate AIS requires more force.

Objective To investigate the application of pedicled tunica vaginalis flap cover new urethra in redo and second-stage hypospadias repair.Methods Retrospective analysis was performed in 45 redo hypospadias repair cases,aged from 1 year 3 months to 9 years 4 months (median 5 years 3month).All patients were divided into urethral dehiscence after hypospadias repair (group A) and the second stage surgery of two-stage hypospadias repair (group B) based on medical history.According to the site of dehiscence,the group A were further divided into midshaft urethral dehiscence (A1) and glans and distal urethral dehiscence with urethral opening located on midshaft (A2).After new urethra was completed,the appropriate size of the pedicledtunica vaginalis flap was transferred to cover the new urethra.Results There was no scrotal hematoma occurred in all 45 cases,and somecomplications occurred,including scrotal swelling in 1 case,high-riding testicle in 2 cases,penile clockwise torsion in 1 case,urethrocutaneous fistula in 6 cases.All the 45 cases were followed up for 1 to 4 years,with mean of 1.8 years.One more urethrocutaneous fistula occurred in group A2 and 1 more urethrocutaneous fistula with urethral stricture occurred in group B.There was no penile curvature and urethral diverticulum occurred in all cases.Conclusions Pedicled tunica vaginalis flap could be used as waterproofing layer to cover new urethra in redo hypospadias repair and presented a low incidence rate of postoperative complications.

Objective:To discuss the clinical significance of structural chest zones for gynecomastia.Methods:A total of 687 gynecomastia patients, aged from 14 to 45 years old, with an average age of 27.0, were admitted to the Department of Plastic Surgery, Huashan Hospital Fudan University from January 2012 to December 2018. Simon classification was used to record. Conduct Simon classification according to the preoperative measurement of the chest. Surgical area design, photo analysis, breast ultrasound examination and Derriford appearance scale evaluation were conducted as well. Six zones can be divided as follows: zone 0 nipple-areola zone, zone 1 gynecomastia zone, zone 2 accessory-breast zone, zone 3 lateral-roll zone, zone 4 IMF(inframammary fold) zone, zone T relative-contraindication zone. Positive and lateral images of the chest were taken before and one week, one month, three months, six months, and 12 months after the operation, and the preoperative and postoperative changes of each structural zone were compared. At the follow-up of 12 months after the operation, patients’ satisfaction was counted.Results:687 patients, according to Simon classification, were divided toⅠ degreein 65 cases, Ⅱa degree in 257 cases, Ⅱb degreein 194 cases, Ⅲ degree in 171 cases. Before operation, except for Simon Ⅰ degree in 65 cases showed just raised to 0 zone, most of the rest of the patients contains 1 zone raised, 2-4 zones come in different patients. After liposuction and glandular stripping were performed in different zones, postoperative follow-up was conducted one week, one month, three months, six months, and 12 months after the operation. The dynamic observation was made of the change process of chest shape shaping during the follow-up, whether there were postoperative complications, poor local shape, or bad regional shape. Evaluation results of patient satisfaction 12 months after surgery: among the 687 patients, there were 634 patients with 10 points of satisfaction, and 53 patients with 8-9 points, including 48 patients of zone 0 and zone 1, three patients of zone 3, and 2 patients of zone 4.Conclusions:The structural chest zones of gynecomastia provides plastic surgeons and male patients with simple, intuitive, and highly recognized preoperative evaluation, which can provide appropriate, simplified, and accurate guidance for the selection of surgical methods.