Objective To investigate the efficacy of sodium hyaluronate on reducing adhesions in patients undergoing peritoneal cavity surgery. Methods Peritoneum and the surface of the related organs was coated with 3～15 ml sodium hyaluronate gel before closing the peritoneal cavity. Findings on 23 reoperations out of 1 360 sessions of primary abdominal surgery with sodium hyaluronate were compared with that of 26 reoperations without the use of sodium hyaluronate in their first episode of laparotomy during the same period. Results The severity of adhesion was graded as 4 degrees. In treatment group, adhesion Ⅰ?,Ⅱ?,Ⅲ?,Ⅳ? were in 11,9,3 and 0 cases, respectively. Compared with adhesion Ⅰ?,Ⅱ?,Ⅲ?,Ⅳ? in 1,5,17 and 3 cases in control group,respectively( P

Objective To compare the values of a screening methods by OC-Hemodia and chemical fecal occult blood test (COB) for colorectal cancer in elderly people. Methods The screening programme targeted colorectal cancer in old people was conducted on 1 100 participants aged 60-92 years (mean was 81.3 years). All subjects received OC-Hemodia and COB examinations. Positive subjects were examined by colonoscopy and/or barium enema. Out of 1 100 subjects 1 046 were followed up in the next five years. Results Among 1 100 subjects, 231 subjects (21.0%) were positive by OC-Hemodia test and 159 subjects (14.5%) were positive by COB. There was a significant difference in positive rate between OC-Hemodia test and COB (P

Objective To study the killing effects of fractional proteins from Microtus fortis (Mf) serum on schistosomula of Schistosoma japonicum. Methods Mf serum proteins were separated into albumin and globulin by means of salt out of ammonium sulfamate. The globulin was then separated into 4 big and 12 small fractional proteins through Sephacryl S-300 column chromatography and electrophoresis elution. The killing effects were observed in vitro in cultivation in which the purified fractional proteins and schistosomula of S. japonicum were incubated together for 48 h. Results The mortality rate of schistosomula acted by Mf globulin was 59.2% and when added with complements was 68.4%. The killing effects of the 2nd and 3rd big fractional proteins were the same as that of Mf globulin. Three small fractional proteins (3.2, 3.3, 3.4) showed the higher killing effects which made the mortality rate of schistosomula 45.1%, 57.6% and 67.2%, respectively. The fractional protein of 100-135 kDa also showed the same killing effect as that of Mf globulin. Globulin from BALB/c mice sera had no significant effect on schistosomula. There was no significant difference in the mortality rate of schistosomula acted by both albumins. Conclusions Mf globulin has significant killing effects on schistosomula of S.japonicum in vitro and 100-135 kDa fractional protein may be an important effective molecule.

renal dysfunction.Logisitic regression showed that cardiovascular disease and hypoalbuminemia were correlated with perioperative death rate significantly. Conclusions Improving the perioperative management is very important for lowering the perioperative mortality in elderly patients with digestive tract disease.

Objective To investigate the clinical value of transanal endoscopic microsurgery (TEM) for the treatment of elderly patients with colorectal adenoma.Methods Totally 21 patients with colorectal villous adenoma underwent TEM from Dec.2007 to Sep.2010.The distance of adenoma from the anal verge was 4-20 cm (average 8.9 cm) and tumor size was 1.1-3.5 cm (average 1.9 cm).There were 12 cases with tubular adenoma and 9 cases with villous adenoma according to pre-operative diagnosis by colonoscopy and endoanal ultrasonography (EUS).Appropriate position and posture were dictated by the location of the tumor under general anesthesia.A special rectoscopy was inserted into the anus with CO2 insufflation to keep the rectum open.Under the stereoscopy and lapaoscopy-type instruments,the tumor was completely resected (submucosal or full-thickness excision) using a 5 mm ultrasonic dissector.The operative wound was closed with intra-lumen continuous sutures.Results The tumor was completely removed with negative resection margins in all the 21 patients (submucosal excision in 12 cases and full-thickness excision in 9 cases).The operating time was 40-100 min (average 76 min) and the intraoperative blood loss was 10-80 ml (average 50 ml).The post-operative stay was 2-10 d (average 4.5 d).The postoperative pathological stages were pT0 in 16 cases and pTia in 5 cases.The postoperative pathological diagnosis were tubular adenoma in 12 cases,villous adenoma in 9 cases,low-grade intraepithelial neoplasia (IN) in 5 cases and high-grade IN in 5 cases.Follow-up checkups in the 20 patients for 2-20 months (average 11 months) revealed no local recurrence.Conclusions TEM is safe and effective with little complication for the treatment of elderly patients with colorectal adenoma.Pre-operative EUS is very important for TEM.

OBJECTIVETo evaluate the effect of simultaneous open prostatectomy and preperitoneal inguinal herniorrhaphy.

METHODSTwenty-one patients with benign prostatic hyperplasia(BPH) and inguinal hernia, underwent simultaneous suprapubic or retropubic prostatectomy and preperitoneal inguinal herniorrhaphy through Pfannenstiel's incision. In 4 cases with bigger inguinal mass, hernia repair was performed with polypropylene meshwork (PPM).

RESULTSThe 21 patients were followed up for 6 months to 7 years. There were 2 cases of recurrence (9.5%), with no morbidity and mortality in the other 19 cases.

CONCLUSIONSOpen prostatectomy and preperitoneal inguinal herniorrhaphy can be performed during the same session without increasing infection and recurrence. The operation method is simple and the effect is positive, especially for older men.

Aged ; Hernia, Inguinal ; surgery ; Humans ; Male ; Middle Aged ; Prostatectomy ; methods ; Prostatic Hyperplasia ; surgery