ObjectiveTo investigate prognosis and effect of rectovaginal fistula operation on patients' life quality.MethodsMedical data of 18 cases with rectovaginal fistula were analyzed retrospectively,and a follow-up was also made.ResultsAmong 18 cases,types were anal canal (1 case),low rectum (5 cases) and high rectum (12 cases). Three different kinds of surgical repair procedures were performed on these patients respectively,with 13 cases obtaining the first surgical repair successfully and 2 cases having the second surgical repair because of the fistula relapse. After operation,the general life quality and sexual life of patients improved.ConclusionThe rectovaginal fistula operation can deliver a good therapeutic effect,and evidently enhanced the life quality of patients.

Objective To study the clinical and image features of the aortic dissecting aneurysm(AD) combined with aberrant right subclavian arteries(ARSA),and to discuss the feasibility of endovascular repair for such disorder.Methods The clinical and image data of 4 patients,who suffered from AD combined with ARSA and admitted in the authors' service during 2004 to 2007,were retrospectively reviewed.All the 4 cases complained severe aches in their back,and one of them was companied with aches in upper abdomen.CT-exam showed that the first tear(gap) of AD located near or inside ARSA,the truncus aortae narrowed obviously.Four operational prescriptions were performed respectively for the 4 patients depending on the location of gaps and on the distance between the gap and ARSA.Results All the 4 cases received satisfy operation.A slight early leakage occurred in the first case without steal syndrome,and the lower blood pressure was 80 mmHg on right arm;for the second case,no leakage occurred with normal blood presser on both arms;for the third one a slight early leakage was companied with normal blood presser on both arms and for the fourth one a slight early leakage occurred without steal syndrome,and the lower blood presser was 60mmHg on right arm.Conclusion AD combined with ARSA is a rare case in clinic.The modus operandi of endovascular repair should be designed based on the situation of individual case considering the location of the first tear.Once the target area exposed is not wide enough for operation,subclavian artery bypass would be a right way in reduction of leakage complications and in increasing the opportunity for a successful operation.

This paper introduced the concept of humanistic therapy and its connotation and application in the field of surgery, the spiritual essence and the docking and bioethics.The authors also analyzed the perioperative patients need humanistic therapy, including technology, ethics, psychology, the needs of the practice; discusses the humanistic therapy in clinical practice,includes:practice conditions, personnel, measures and problems.

Animals ; Catechin ; analogs & derivatives ; pharmacology ; Disease Models, Animal ; Fatigue ; metabolism ; physiopathology ; Learning ; drug effects ; Male ; Memory ; drug effects ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; metabolism

ObjectiveTo explore the mechanism and prevention for the hypertension complicated by the retroperinoneal paraganglioma operation.MethodsBlood pressures were monitored during operations on 15 patients with retroperinoneal paraganglioma. Also,the reason and the prevention for the changed blood pressure were studied emphatically during operation.ResultsThe elevated blood pressure of 12 patients was detected during operation,and all dropped to a varied degree after operation,with 2 of them below the normal value.ConclusionThe retroperinoneal paraganglioma operation was liable to cause blood pressure elevated,which was related to the anesthesia induction and the operation stimulation of tumor. After the excision of the tumor,blood pressure of most of the patients dropped to some degree. Therefore,during the retroperinoneal paraganglioma operation,the blood pressure should be monitored closely,and the short-acting antihypertensives should be applied on time. Meantime,occurrence of hypotension was also considered after the excision of the tumor.

Objective To observe the effect sling exercise therapy (SET) and Tuina on radicular cervical spondylosis. Methods From August, 2015 to December, 2016, 72 patients with radicular cervical spondylosis were randomly divided into control group (n = 36) and trial group (n = 36), who accepted traction and SET+Tuina, respectively, for four weeks. They were measured F-wave conduction velocity with electromyogram from median nerve and ulnar nerve, somatosensory evoked potential (SEP), and current perception threshold (CPT) before and after treatment. The clinical ratio of improvement was calculated. Results The ratio of improvement was 83.33% in the trial group more than 58.33% in the control group (Z = 2.093, P < 0.05). F-wave conduction velocity increased in both groups after treatment (t > 12.059, P < 0.001), and increased more in the trial group than in the control group (t > 3.266, P < 0.01); while the latency of SEP decreased in N9 and N13 in both groups (t > 7.061, P < 0.001), and decreased more in the trial group than in the control group (t > 8.033, P < 0.001); the grade of CPT decreased in both groups (t > 8.895, P < 0.001), and decreased more in the trial group than in the control group (t = 8.913, P < 0.001). Conclusion The combination of SET and Tuina can promote the repair of nerve conduction of cervical spondylotic radiculopathy.

Objective To investigate the clinical characteristics of idiopathic retroperitoneal fibrosis (IRF) and its diagnosis and treatment. Methods Data of 27 IRF cases admitted into our hospital during recent 8 years were retrospectively analyzed. Result The main clinical manifestations of IRF included abdominal pain, lumbago, mass in retroperitoneal cavity and ureteral obstruction. The main diagnostic approach to IRF was the image examination. Preoperative correct diagnosis was established in 85 2% of cases. Ureterolysis and wrapping up with the omentum was performed in 21 cases of ureteral obstruction. Two cases suffering from renal artery (RA) stenosis were relieved with arteria renalis lysis. One superior mesenteric artery (SMA) stenosis was managed by arterial lysis. Twenty six cases were cured and one case died postoperatively. Conclusion IRF has nonspecific clinical manifestations. The preoperative diagnosis depends on the image characteristics. The treatment mainly consists of the relief of the obstructive symptoms.

Objective To study the anatomical characteristics of ascending aortic and aortic arch in adult Chinese. Methods From Sep 2006 to Sep 2007, we retrospectivly reviewed 388 volunteers undergoing thoracic aorta CTA in our institution. We measured the diameter of ascending aorta, aortic arch, and branch vessels of aortic arch respectively in AW4.2 work station. CHESS statistical software was used to analyze data. Results The aortic diameter above coronary artery (CA) (D1), the level at origin of brachiocephalie trunk (BCT) ( D3 ), the halfway of the AA( D2 ), the level at origin of LCCA( D4 ) , the level at origin of LSA ( D5 ) and the level at distal origin of LSA ( D6 ) respectively are: ( 34 ± 5 ) mm; ( 33 ± 4) mm; ( 34 ± 5 ) mm; ( 30 ± 4) mm; ( 28 ± 3 ) mm; ( 26 ± 3 ) mm. The diameters of two level between the origin of BCT and RSA are ( 13. 1 ± 1.9) mm, ( 12. 8±2. 3) mm, respectively. The diameter of two level at LCCA is ( 8. 7 ± 1.5 )mm and ( 7. 9 ± 1. 0) mm respectively. The diameter of two level between the origin of LSA and L-vertebral arteryis (10.7±1.7) mm,(9.3±1.3) mm, respectively. Conclusion The data of the diameter and length of ascending aort and vasculature arising from the arch abtained by CT topography in Chinese volunteers are very useful for clinical practice.

Objective To compare the therapeutic effect of endovascular repair (EVAR) and open surgical repair(OSR) of abdominal aortic aneurysm in high-risk patients. Methods The clinical data of 55 patients from 1998 to 2008 with infrarenal abdominal aortic aneurysm who received surgical treatment were analyzed by using the customized probability index. The perioperative and short term advantages and disadvantages of OSR group (n=20) were compared with EVAR group (n=35). Results All patients in OSR group were followed up, 94% patients in EVAR group were followed up, the mean follow up time were 75 and 70 months respectively. (1) Compared to OSR group, the EVAR group had shorter operation time [(3.1±0.6) h vs (4.9±0.9) h, P<0.05], (2) EVAR group had shorter ICU and hospital stay after operation and less blood loss (P<0.01), (3) Compared to OSR group, the EVAR group had lower mortality within 30 d(2.86% vs 15%), (4)the EVAR group had lower peri-operative complications(17% vs 40%), (5) The main complications of EVAR were endoleak (8.57%), (6) The main complications of OSR was cadiovascular incidence(25%). Conclusions Endovascular treatment, indicated for AAA in high-risk patients, can cut down the perioperative incidence of cadiovascular events, mortality and complications. CPI is useful to estimate the perioperative incidence of cadiovascular events, mortality and complications, and can be used to guide the therapeutic method.

Objective To evaluate aneurysm sac pressure monitoring during endovascular repair (EVAR)of abdominal aortic aneurysm. Methods From April 2006 to May 2007,12 patients with abdominal aorta aneurysm underwent endovascular aneurysm repair.The average max-diameter of the aneurysm WR8(5.83±0.95)cm.The sac pressure was monitored during the whole process of the operation.The correlation between the pressure and endoleaks and long-term outcomes was observed during follow-up.Results Before the stentgraft was delivered.sac pressure was equal to the systemic blood pressure in all the 12 cases.After the EVAR wag finished,the sac systolic pressure dropped by＞40% in 11 cases,among which sac blood pressure bropped by ≥50% in 7 cases.sac pressure did not change in 1 case.In all the 12 cases,pulse pressure diminished by＞30%,and＞75%in 6 cages.During the follow-up,there were no endoleaks and death.In 5 Cases.with sac systolic pressure drop＞50%,the max-diameter of the aneurysm decreased by 1.6～3.1 mm,while in one c88e,in which sac pressure had no change the postoperative maxdiameter of the aneurysm has increased by 3.2 nma. Conclusion Abdominal aorta aneurysm sac pressure monitoring during EVAR helps to predict the change of the sac pressure after EVAR,and to detect the endoleaks.