1.Recent Progress of Studies on Endogenous Angiogenesis Inhibitive Factors and Their Possible Effect in Therapy of Hepatocarcinoma
Chinese Journal of Bases and Clinics in General Surgery 2003;0(02):-
Objective To introduce the possible effect of endogenous angiogenesis inhibitive factors in the therapy of hepatocarcinoma.Methods Recent relevant literatures were reviewed. Results Endogenous angiogenesis inhibitive factors can suppress the growth of tumor blood vessels,which might head off the development and metastasis of hepatocarcinoma effectively.This might provide a new approach to the therapy of hepatocarcinoma.Conclusion Recent studies on endogenous angiogenesis inhibitive factors will be helpful in the prevention and treatment of hepatocarcinoma.
2.Diagnosis and treatment of pharyngostoma and esophagostoma after anterior cervical spine surgery
Chinese Journal of Orthopaedics 2016;36(17):1085-1092
Objective To investigate the diagnosis,treatment and prevention strategies of pharyngostoma and esophagostoma caused by anterior cervical spine surgery.Methods A retrospective analysis were performed in 17 cases of anterior cervical operation complicated with pharyngeal and esophageal fistula from 1999 March to 2010 June,including 11 male cases and 6 female cases,aged from 7 to 67 years with the mean age of 44.23 years.16 cases (94%) got inflammation of anterior cervical surgery incision and throat pain.2 cases (11%) accompanied by high fever,whose body temperature was as high as 39.2° and incision particles or liquid flew after eating.17 cases underwent upper gastrointestinal radiography,and regular oral methylene blue.Barium overflew from fistula in 2 cases (11%) after upper gastrointestinal tract barium meal angiography,while methylene blue overflew from incision in 7 cases (41%) after oral methylene blue.Through X-ray examination,gas fistula before vertebral was visible in 14 cases (82%).A diagnosis can be made by outflow through fistula after barium esophagography or oral administration of methylene blue.For unknown but highly suspected pharyngeal and esophageal injury,operation can be confirmed if no improvement of symptoms was found after fasting,nasogastric or parenteral nutrition,and ant-infection treatment for 1 week.Results All of 17 patients underwent surgical treatment.During operation,fistula dot or small irregular shape can be seen in 8 cases;long stripe in 3 cases;boundary not clear or irregular in 2 cases;adhesion around the fistula of anterior cervical fascia,similar to tear in 1 case;two fistula in 1 case;fistula located in pharynx posterior wall or esophageal which was not clear or fistula of unknown reason in 2 cases (fascia might be not at the same side of incision or fascia was small and already closed).Pharynx posterior wall and esophageal fistula was found in 3 cases during surgical exploration,which was immediate sutured and placed with drainage tube.After 7 to 14 days,if flow was less than 30 ml,and no bacterial growth was found in 3 consecutive drainage fluids,we pull out the tube.Patients who underwent nasal feeding for 2 to 3 weeks,and then took liquid diets complained nothing,and cured after 1 month.12 cases underwent debridement,stitching fistula,irrigation and drainage tube placement instantly.The wash pipe was removed after 12 to 21 days and 3 consecutive drainage fluids showed no bacterial growth.Then 2 to 3 days later the drainage pipe was pull out.Two to three months later these patients healed.2 cases firstly underwent debridement and suture or part suture,and then the incision was opened and filled with nitrofurazonium gauze tamponade.Gradually pull out the filling gauze and change the dressing of wound.If the residual cavity was large or the drainage was pus,flush the wound with physiological saline once a day,then three times a week,and finally once a week.These patients healed after 6 to 12 months.Pharyngostoma or esophagostoma of all patients was found timely,and active surgical treatment was performed,so no obvious complications was found postoperatively.All 17 patients recovered and resumed diet after 1 to 12 months postoperatively.Conclusion Pharyngeal and esophageal fistula is a rare but severe complication after anterior cervical surgery,which seriously affect the effect of operation and even lead to death.Early diagnosis and active intervention can obtain satisfactory curative effect.
3.Comparison of various drainage methods for postoperative cerebrospinal fluid leakage in cervical vertebra
Liang MA ; Weibin SHENG ; Qiang DENG
Chinese Journal of Tissue Engineering Research 2013;(48):8413-8418
BACKGROUND:Numerous studies have demonstrated various therapeutic methods for cerebrospinal fluid leakage after spinal column surgery, including intraoperative and postoperative measures. Few studies addressed the therapeutic methods of cerebrospinal fluid leakage after cervical vertebra surgery using lumbar subarachnoid catheter drainage.
OBJECTIVE:To evaluate the therapeutic efficacy of sustainable drainage and lumbar subarachnoid catheter drainage for cervical postoperative cerebrospinal fluid leakage.
METHODS:923 patients underwent cervical spine surgery in the Department of Spinal Surgery, the First Affiliated Hospital of Xinjiang Medical University, China from June 2009 to October 2012. There were 24 cases of postoperative cerebrospinal fluid leakage with an incidence of cerebrospinal fluid leakage of 2.6%(24/923). The dural laceration that could not be repaired or be found induced cerebrospinal fluid leakage. Of them, 12 cases received lumbar subarachnoid catheter drainage (catheter group), and 12 cases received sustainable drainage (drainage group).
RESULTS AND CONCLUSION:Compared with the drainage group, the duration of cerebrospinal fluid leakage was significantly shorter in the catheter group (P<0.05). In the catheter group, one case affected cerebrospinal fluid infection. In the drainage group, two cases experienced cerebrospinal fluid cyst and one case suffered from cerebrospinal fluid infection. They were cured by symptomatic treatment. A total of 24 cases were fol owed up for 9-12 months. None of them affected cerebrospinal fluid leakage, cerebrospinal fluid infection or cerebrospinal fluid cyst. Results demonstrated that lumbar subarachnoid catheter drainage in the treatment of cervical postoperative cerebrospinal fluid leakage has a good effect.
4.Surgical Treatment for Complete Transposition of the Great Areteries
Sheng DENG ; Yongbo LIU ; Jinfen LIU
Journal of Medical Research 2009;38(8):106-108
Objective To report the experience of surgical treatment of 4 patients with complete transposition of great areteries (TGA). Methods 4 cases received arterial switch operation and senning operation from November 2004 to January 2008, including 1 case of TGA without VSD(TGA - IVS), 3 TGA with VSD (TGA -VSD), 2 TGA with Mild pulmonary valve stenosis. Results There no death during the operation or postoperation. Patients were followed up from 5 months to 3years. All the patients got better ,grew faster and cyanosis relieved apparently. 2 patients had mild to moderate mitral regurgitation preoperatively. I patient had mild mitral regurgitation post-operatively and 1 patient had no mitral regurgitation. There was no aortic stenosis or pulmonary valve stenosis after operation. I patient assis-ted respiration for 62 days after operation because of old age. All the patients recovered smoothly after operation. Conclusion Using arte-rial switch operation and senning operation to correct complete transposition of great artery could get satisfying operative results, and the ar-terial switch operation will also get good effect in older children with better left ventricular development.
5.The role of TGF-?_1 and HGF in chronic hepatitis B with early renal impairment
Xinwen SONG ; Cunliang DENG ; Yunjian SHENG
Chinese Journal of Practical Internal Medicine 2001;0(10):-
Objective To investigate the role of transforming growth factor-?_1 (TGF-?_1)and hepatocyte growth factor(HGF)in the pathogenesis of early renal impairment in patients with chronic hepatitis B(CHB).Methods The serum levels of TGF-?_1 and HGF of 44 patients with CHB and 20 healthy people were measured by specific-ELISA,and the urine levels of ?_1-microglobulin (?_1-MG)and microalbumin (mALB)were tested by RIA.Results The serum levels of TGF-?_1 and HGF in the patients with CHB were significantly higher than those in the control (P
6.Cholecystectomy in patients with liver cirrhosis and biliary tract diseases:a report of 40 cases
Bo CHEN ; Sheng HE ; Jingyu DENG
Chinese Journal of General Surgery 2001;0(08):-
10 000mL. Six cases developed ascites postoperatively. There was no mortality or bile duct injury. The average hospital stay was 15d.Conclusions Intraoperative bleeding and bile duct injuries are the major dangers of (cholecystectomy) in patients with liver cirrhosis, and packing of gallbladder bed with pedicle of greater omentum is a satisfactory method of hemostasis.
7.Application of transthoracic echocardiography in interventional treatment of congenital heart diseases
Dan DENG ; Ming CHANG ; Sheng DING
Medical Journal of Chinese People's Liberation Army 2001;0(10):-
Objective To study the value of transthoracic echocardiography (TTE) in interventional treatment of congenital heart diseases. Methods TTE was used to identify patients with atrial septal defect (ASD, n=26), ventricular septal defect (VSD, n=23) or ductus arteriosus (PDA, n=16). They received interventional treatment with domestic made nitinol occluder. The TTE was then used to monitor the entire process of the surgery and to assess the effect of the surgery. Results The treatment with indigenous nitinol occluder failed in five patients, including two with ASD, two with VSD, and one with PDA. The other sixty-one patients were freated successfully with the occluder. Once the procedure was completed, those patients were found to have neither abnormal valvular regurgination as shown by TTE, nor any shunt flow around the occluder as shown by both TTE and angiocardiography. One month later, TTE demonstrated that the position of all the occluclers remained stable, and no residual leakage or shunt was detected by TTE in all of the sixty-one patients, and the same results were obtained after three months. However, two days after the surgery, ECG showed that three of the patients with VSD suffered from different degrees of atrioventricular block on the second postoperative day, but they eventually recovered after treatment. The successful rate of the procedure was 93.8% (61/65). Conclusions Transthoracic echocardiography may play an important role at three stages (pre-, during- and after), i.e. to select the most suitable patients before the procedure, accurately identify the location, and release of the occluder at the end of the operation; and finally, it serves as a promising method to evaluate the treatment result in patients during their follow-up period.
8.Exploration and Reform of Infectious Disease Teaching
Cunliang DENG ; Yunjian SHENG ; Wen CHEN
Chinese Journal of Medical Education Research 2006;0(10):-
Problems and insufficiency in Infectious Disease teaching were analyzed and several improvement measures were proposed to emend the teaching outline,to strengthen the construction of teaching material,to improve teaching staff quality and to improve class and experiment teaching quality.
9. Preparation of dextran nanogel conjugates of HCPT with acid-sensitive spacer and its properties
Chinese Pharmaceutical Journal 2012;47(12):965-970
OBJECTIVE: To synthesize a new drug delivery system of polyaldehyde Dex coupled with SA-10-HCPT and to study the HCPT release in vitro and the anti-tumor activity in vivo. METHODS: The new drug delivery system was prepared by polyaldehyde Dex coupled with SA-HCPT, grafted with mPEG-adipic dihydrazide monohydrazone and cross-linked with adipic dihydrazide. RESULTS: The conjugate formed micelle with a diameter of 100 nm in water,which could achieve passive targeting of tumor tissue concentration. The drug loading efficiency achieved 5.63%. The drug release processes accorded with kinetic equation Rc=Atn1/(B+Ctn2) in the buffer solution. The release rate of HCPT from this conjugate in pH 5.4 buffer was much higher than that in the environment of pH 7.4 and pH 4.5. The tumor inhibition of the conjugate was similar to that of HCPT while the toxicity in vivo was significantly reduced. CONCLUSION: The structure of the conjugate is unstable in acidic environment, and the drug is released pH-sensitively. The mice survival rate is significantly improved because of the significant slow-release property. Therefore, the conjugate can be developed as a novel prodrug.
10.Clinical efficacy of one-stage transforaminal debridement, interbody fusion and posterior instrumentation for treatment of thoracolumbar spinal tuberculosis
Weibin SHENG ; Tao XU ; Qiang DENG
Chinese Journal of Orthopaedics 2016;36(11):672-680
Objective To discuss the clinical efficacy and surgical indications of one?stage transforaminal debridement, interbody fusion combined with posterior instrumentation for thoracolumbar spinal tuberculosis. Methods All of 34 patients with thoracolumbar spinal tuberculosis were retrospectively analyzed,treated by one?stage transforaminal debridement, interbody fusion and posterior instrumentation from June 2010 to April 2013, including 21 males and 13 females, aged 21 to 64 years old, av?erage 38.2 years. All patients were treated by preoperative quadruple antituberculosis drugs therapy for 2-4 weeks, postoperative regular chemotherapy for 12-18 months. Preoperative and postoperative changes in clinical symptoms, nervous function, the situa?tion of the erythrocyte sedimentation rate (ESR) and C?reactive protein (CRP) with strict follow?up, as well as other related compli?cations were observed. The spinal fusion rate and fusion situation, changing of the physiological curvature, as well as loosening or breaking of the internal fixation device were detected through regular imaging examination. Results The surgery duration time was 60-150 min, average 110 min, and the blood loss was 80-550 ml, average 320 ml. Cerebrospinal fluid leakage occurred in one case. All of the operations were completed successfully without nerve or spinal cord injuries. Postoperative follow?up time was 1 to 4 years, average 2.5 years. Clinical symptoms improved significantly in three months after operation. The visual analogue scale (VAS) improvement rate was about 93%. All patients' ESR and CRP returned to normal levels at the last follow?up. The Kirkaldy?Willis function score showed that the total fine rate was 94%. 12 cases of patients had various degrees of neurological dysfunction before operation, which were back to normal at the final follow?up, except one case of ASIA class B turned to C. Inci?sion fistula formation happened in one case at the third months after surgery, and the wound was healed after debridement. All pa?tients got solid fusion between vertebral body, and there was no graft absorption or collapse, pseudarthrosis, tuberculosis recur?rence, and loosening or breaking of internal fixation devices. Cunclusion One?stage transforaminal debridement, interbody fu?sion and posterior instrumentation is a simple, effective and safety surgical approach, which has great application value for surgi?cal treatment of patients with thoracolumbar spinal tuberculosis.