ObjectiveTo investigate the therapeutic effect of acupoint pressing plus gentle moxibustion on lower limb swelling after total knee arthroplasty.MethodOne hundred and twenty patients diagnosed with knee osteoarthritis who required unilateral total knee arthroplasty were allocated, in order of operations, to observation and control groups, 60 cases each. After the operation, all the patients received routine nursing care including elastic bandage pressure dressing, operated-on limb elevation, early knee immobilization, local ice compress, intermittent pneumatic compression, active ankle pump and quadriceps contracting-relaxing exercise, CPM mechanical exercise, use of elastic stockings and oral administration of rivaroxaban. The observation group received postoperative acupoint pressing plus gentle moxibustion additionally. Limb circumferences 10 cm superior and inferior to thepatella were measured and operated-on limb pains were scored (using the VAS) in the two groups of patients before, on the day of and at one, three, five, seven and fourteen days after the operation. Knee joint range of motion (ROM) was measured before and at three,seven and fourteen days after the operation.ResultThe incidence of swelling was 47.46% in the observation group and 67.24% in the control group. The duration of swelling was (7.31±3.19) days in the observation group and (10.92±3.12)days in the control group. There were statistically significant differences in the VAS score and operated-on knee joint range of motion between the two groups of patients at the same time points after the operation (P<0.05).ConclusionAcupoint pressing plus gentle moxibustion can effectively intervene in lower limb swelling and promote the recovery of knee joint function after total knee arthroplasty.

Objective To evaluate the effects of laparoscopic radical resection of mid-low rectal cancer on sexual and urinary functions of male patients. Methods The clinical data of 150 patients with mid-low rectal cancer who were admitted to the PLA General Hospital from May 2006 to March 2009 were retrospectively analyzed. Sixty-eight patients were allocated to laparoscopic group and 82 to open group. The incidences of erectile and ejaculatory dysfunction and the short- and long-term urinary dysfunction of patients in the 2 groups were compared seperately at 6 and 12 months after the operation. All data were analyzed using the chi-square test. Results The incidences of erectile and ejaculation dysfunction at 6 months after operation, incidence of ejaculation dysfunction at 12 months after operation, and long-term urinary dysfunction were 15% (10/68), 16% (11/68), 10% (7/68) and 0 in the laparoscopic group, and 22% (18/82), 23% (19/82), 21% (17/82) and 2% (2/82) in the open group, respectively, no significant difference between the two groups was found (x2 = 1. 285, 1. 137, 3. 013, 1.681, P>0. 05). The incidences of erectile dysfunction at 12 months after operation and short-term urinary dysfunction were 7% (5/68) and 4% (3/68) in the laparoscopic group, and 17% (14/82) and 20% (16/82) in the open group, respectively, a significant difference between the two groups was observed (x = 4. 565, 5.930, P <0.05). Conclusion Laparoscopic radical resection of mid-low rectal cancer can reduce the injury of pelvic autonomic nerve and improve the life quality of patients.

The first few cases of colonic surgery using Da Vinci surgical system were reported in 2002;since then,Da Vinci surgical system has gradually been used in several centers for rectal cancer and with favorable outcomes.Laparoscopy has opened a new era in modern surgery,however,the inherent limitations of traditional laparoscopic surgery may cause certain difficulties during manipulation,especially in the demanding field of colonic laparoscopic surgery,which prolonged the learning curve.The advantages of Da Vinci surgical system include stable camera platform,three-dimensional imaging,excellent ergonomics,tremor elimination,ambidextrous capability,motion scaling,and instruments with multiple degrees of freedom.Low rectal region was regarded as the"forbidden zone"for laparoscopy,so we applied the Da Vinci surgical system in low anterior resection for rectal cancer.Because of mulyiquadrant operations in low anterior resection of rectal cancer,moving the robotic cart twice during the operation is necessary,which increased the operation time.In order to solve the problem,many surgeons use conventional laparoscopy for vessel ligation and flexure mobilization,and adopt the Da Vinci surgical system only in the lower quadrant of the abdomen.We present a technique that allows for the complete isolation of the mesorectum from the same position of the robotic cart,during the process,the enhanced dexterity and precise dissection offered by the Da Vinci surgical system were fully utilized.