1.A Comparative Study of Mini-invasive Percutaneous Nephrolithotomy and Ureteroscopic Lithotripsy Combined with Occlusion Devices for the Treatment of Upper Incarcerated Ureteral Stones
Yiliang HUANG ; Chao LI ; Liming AN
Chinese Journal of Minimally Invasive Surgery 2014;(11):1002-1004
Objective To compare the efficacy of ureteroscopic lithotripsy ( URL) combined with occlusion devices and mini-invasive percutaneous nephrolithotomy ( MPCNL) in the treatment of upper incarcerated ureteral stones. Methods A total of 89 patients with unilateral upper ureteral calculi were enrolled from April 2011 to July 2013, 42 of which were treated with MPCNL and 47 of which were treated by rigid ureteroscopic lithotripsy combined with occlusion devices. Resuts There were no significant differences in the success rate of primary lithotripsy (97.6% vs.95.7%, χ2 =0.000, P=1.000).No marked differences were detected in the stone clearance rate (97.5% vs.95.6%, χ2 =0.000, P=1.000), complication rate (7.1% vs.8.5%, χ2 =0.000, P=1.000) and operation time [(80.2 ±11.9) min vs.(65.1 ±10.9) min, t =6.248, P=0.000] between the two groups.The hospitalization time in the URL group was (3.5 ±1.5) d, which was obviously shorter than that in the MPCNL group , in which it was (7.3 ±1.5) d(t=11.931, P=0.000). Conclusion URL combined with occlusion devices can obtain satisfactory results as well as MPCNL in the treatment of upper ureteral calculi by proper case selection and careful operation performance .
2.Application value of the preoperative multi-slice spiral computed tomography for the repair of huge abdominal incisional hernia
Maimaitiming MAIMAITIAILI ; Sufu YU ; Yiliang LI
Chinese Journal of Digestive Surgery 2017;16(9):934-938
Objective To explore the application value of the preoperative multi-slice spiral computed tomography (MSCT) for the repair of huge abdominal incisional hernia.Methods The retrospective crosssectional study was conducted.The clinical data of 61 patients with huge abdominal incisional hernia who were admitted to the Xinjiang Uygur Autonomous Region People's Hospital from January 2012 to February 2016 were collected.All patients underwent preoperative MSCT and three-dimensional reconstruction to measure the percentage of volumes of the hernia sac and abdominal cavity and then selected the individualized surgical methods according to the percentage,and length of small intestine resected was calculated in patients undergoing initiative volume reduction combined with onlay repair.Observation indicators:(1) pre-and post-operative situations:percentage of volumes of the hernia sac and abdominal cavity,duration of preoperative hospital stay,surgical procedure,length of small intestine resected in patients undergoing initiative volume reduction combined with onlay repair,operation time and volume of intraoperative blood loss;(2) postoperative recovery situation:intraabdominal pressure at postoperative 48 hours,recovery time of postoperative gastrointestinal function,removal time of postoperative abdominal drainage-tube,postoperative complications and duration of postoperative hospital stay;(3) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative hernia recurrence and long-term complications up to March 2017.Measurement data with normal distribution were represented as (x)±s and measurement data with skewed distribution were described as M (range).Results (1) Pre-and post-operative situations:percentage of volumes of the hernia sac and abdominal cavity in 61 patients was 19% ± 4%,and duration of preoperative hospital stay was (7 ± 5) days.All the 61 patients underwent successful operation,including 48 receiving onlay repair and 13 receiving initiative volume reduction combined with onlay repair,without conversion to other surgery.Length of small intestine resected in 13 patients undergoing initiative volume reduction combined with onlay repair was (48±8)cm.Operation time and volume of intraoperative blood loss in 61 patients were (2.6 ± 0.8) hours and (82± 50) mL.(2) Postoperative recovery situation:intra-abdominal pressure at postoperative 48 hours,recovery time of postoperative gastrointestinal function and removal time of postoperative abdominal drainage-tube in 61 patients were (9.6 ± 2.9) mmHg (1 mmHg=0.133kPa),(2.1 ± 0.9) days and (3.5 ± 1.1) days,respectively.Twelve patients had postoperative complications,and grade Ⅰ intra-abdominal hypertension,grade Ⅱ intra-abdominal hypertension,incisional effusion,incisional infection,incisional sinus,mesh infection and urinary retention were respectively detected in 4,2,4,2,1,1,1 in patients undergoing the onlay repair and 2,1,1,0,0,0,0 in patients undergoing initiative volume reduction combined with onlay repair.Some patients had 2 or more of complications.There was no occurrence of abdominal compartment syndrome and perioperative death.Patients with complications were cured or improved by symptomatic treatment.Duration of postoperative hospital stay in 61 patients was (8±4)days.(3) Follow-up:all the patients were followed up for 6-36 months,with a median time of 19 months.During follow-up,2 patients with recurrence of huge abdominal incisional hernia received tentative follow-up,and were suggested to treat risk factors of recurrence firstly and then undergo reoperations.Other patients didn't have long-term complications.Conclusion MSCT can provide the accurate data of percentage of volumes of the hernia sac and abdominal cavity before repair of huge abdominal incisional hernia,it also has the important clinical value of choosing the individualized surgical method,preserving the maximum out of normal organs in initiative volume reduction combined with onlay repair and increasing surgical outcomes.
3.Effects of fetal anoxia and acidosis on superoxide dismutase
Xiaotian LI ; Mingming PAN ; Yiliang ZHUANG ; Weihong LIU
Chinese Journal of Obstetrics and Gynecology 2001;0(04):-
Objective To analyze the effects of fetal anoxia, respiratory and metabolic acidosis on the activity of antioxidation in fetal distress Methods Blood samples were taken from umbilical artery in 386 neonates for blood gas analysis and detection of the concentration of superoxide dismutase (SOD) Normal situation, anoxia, acidosis, respiratory acidosis, metabolic acidosis and mixed acidosis were diagnosed in all neonates according to the results of blood gas values, and the neonate asphyxia was diagnosed according to the Apgar scores (one minute) The effect of anoxia and acidosis to SOD were analyzed with multiple factor analysis of variation Results (1) Among the all 386 cases, 317 were normal, 31 with anoxia, 17 with acidosis, and 21 with both anoxia and acidosis Among the total cases of acidosis, 8 respiratory, 21 metabolic, and 9 mixed acidosis (2) The plasma levels of SOD of umbilical artery blood in anoxia, acidosis, both anoxia and acidosis, and normal sitution were (118 5?7 1) mmol/L, (122 0?11 4) mmol/L,(140 0?7 0)mmol/L, and (98 5? 2 6) mmol/L,respectively The results of unvariate analysis of variance showed that anoxia: F =4 999 ( P 0 05) (3) The plasma levels of SOD with respiratory acidosis, metabolic acidosis and mixed acidosis were (127 3?18 4) mmol/L, (126 0?8 1) mmol/L, (150 0?10 4) mmol/L The results of univariate analysis of variance showed that respiratory acidosis: F =4 404 ( P 0 05) Conclusion The superoxidation and antioxidation can be effected by factors like anoxia and acidosis, respiratory acidosis and metabolic acidosis However, the mechanisms of these effects are different. There is additive, but not synergistic effects among them
4.Harm of drug abuse ( drug driving ) on traffic safety in China
Guiyong CHEN ; Chao ZHANG ; Yiliang GUAN ; Wenjun LI ; Jihong ZHOU
Chinese Journal of Trauma 2012;28(1):8-11
Objective To investigate the harm of drug abuse of drivers on traffic safety and discuss the countermeasures.Methods Data were collected from sources including statistics of drug driving traffic accidents reported by mass media,inference analysis of the theoretical data,survey of outpatients in drug rehabilitation center,drug-related screening with drivers license during Shanghai World Expo 2010 Moat Security and integrated data from various areas.ResultsOf the over 10 million drug abusers including the registered and unregistered in China,more than 2 million drug abusers had drivers license,which greatly threatened the traffic safety.Conclusion Drug abuse (drug driving) has done great harm on traffic safety,which calls for appropriate preventive countermeasures.
5.Analysis of the efficacy of laparoscopic Toupet fundoplication treatment of hiatal hernia combined with gastroesophageal reflux disease
Zhi WANG ; Fuzeng SU ; Cheng ZHANG ; Huiling LI ; Yiliang LI ; Zhi DU
Journal of Chinese Physician 2016;18(8):1172-1175
Objective To explore the efficacy of laparoscopic Toupet fundoplication treatment of hiatal hernia combined with gastroesophageal reflux disease.Methods Forty one patients' medical record information of hiatal hernia combined with gastroesophageal reflux disease that underwent laparoscopic Toupet fundoplication were collected in Xinjiang Uygur Autonomous Region People's Hospital from October 2012 to October 2015.Thirty six cases were adopted pure hiatal hernia suture,2 cases were used biological patch repair,1 case used Johnson PHY patch repair,1 case used Bade patch repair,and 1 case used Tyco hiatal hernia dedicated anti-blocking patch repair.These patients were carried out 24 hours esophageal pH monitoring,esophageal manometry,gastroesophageal reflux disease questionnaire (GERDQ) score and postoperative complications before surgery and 6 months postoperative.The clinical efficacy of laparoscopic Floppy Nissen fundoplication treatment of hiatal hernia combined with gastroesophageal reflux disease was retrospectively analyzed.Results There was no perioperative deaths and serious complications during perioperation.The reflux symptoms were significantly improved postoperative.There was significantly lower in reflux time [(1.40 ± 2.10) h],the number of reflux (29.83 ± 19.71),acid reflux time percentage [(6.47 ± 8.79) %],and DeMeester score (7.28 ± 7.38) than the preoperative [(2.04 ± 1.91) h,(120.40 ±82.72),(9.90 ±9.27)%,and (28.23 ±42.16),respectively].GERD Q scale score (7.18 ± 1.33) was significantly lower than preoperative (10.91 ± 2.02) with statistically significant difference (P <0.05).lower esophagealsphincter (LES) pressure [minimum resting breathing (7.24 ± 6.86) mmHg,and mean resting breathing (12.91 ± 6.89) mmHg] was significantly increased than preoperative [(0.70 ±6.15) mmHg,and (7.33 ± 7.72) mmHg,respectively].Residual pressure [average (8.16 ± 3.82) mmHg,and maximum (16.10 ± 12.05)mmHg] was significantly increased than preoperative [(4.36 ±4.77) mmHg,and (7.49 ± 5.15) mmHg,respectively].Relaxation rate [(58.50 ± 25.47) %] was significantly reduced than preoperative [(62.27 ± 27.55) %].However,swallowing invalid [(11.25 ± 21.04) %]was increased than preoperative [(6.36 ± 10.26)%],with statistically significant difference (P <0.05).The median follow-up was 10 months,and there was no recurrence during follow-up.ConclusionsLaparoscopic Toupet fundoplication can effectively inhibit reflux symptoms,and increase LES pressure,which is worthy of promotion.However,there is slightly higher incidence of postoperative dysphagia.
6.Totally minimally invasive Ivor-Lewis esophagectomy with manual pursestring and per-thoracic port placement of anvil in patients with thoracic esophageal cancer
Yiliang ZHANG ; Longfei MA ; Xiao MA ; Hecheng LI ; Yawei ZHANG ; Jiaqing XIANG ; Haiquan CHEN
Chinese Journal of Thoracic and Cardiovascular Surgery 2013;29(11):641-643,648
Objective Totally MIIE with per-oral placement of anvil has been reported elsewhere,but MIIE with manual pursestring and per-thoracic port placement of anvil has been seldomly reported.The feasibility of the latter technique was proved in this study.Methods Patients with mid-lower thoracic esophageal cancer were prospectively treated with totally MIIE at Shanghai Cancer Center of Fudan University from Feberay 28,2013 to August 31,2013.Laproscopic intracorporeal construction of the gastric conduit and needle catheter J-tube were performed in the first stage of MIIE.In the second stage a hand sewn pursestring was made with endostitch system and the anvil of EEA stapler was inserted via the tenth inter costal port prior to the intrathoracic anastamosis.Short-term clinicopathologic outcomes were collected.Results 39 cases were treated with totally MIIE,media age 61 years,ranged 48-69 years,10 females and 29 males.There was 1 conversion to open surgery.The median duration of operation was 245 minutes.The median intraoperative blood loss was 210 ml.All the patients were margin negative and staged from pT1N0M0 to pT3N2M0.The average lymph node yields were 16.5 per patient.The median postoperative hospital stay was 7 days.There was no mortality.Perioperative morbidity occurred in 4 patients (10%).2 patients were complicated with late stage gastric paralysis which began 2 or 3 days after oral feeding and both recovered in 1 month.1 patient was with minor anastamotic leakage which was endoscopically demonstrated on the 14th day postoperatively and the patient recovered in 1 month post leakage.1 patient was complicated with severe pneumonitus and ARDS; the ICU stay of that case was 19 days and the recovered patient was discharged 27 days postoperatively.Conclusion MIIE with regular EEA stapler and intrathoracic anastamosis is feasible in patients with thoracic esophageal cancer.Prospective randomized clinical trials could be conducted to compare the open procedure and totally MIIE with regular EEA stapler.
7.Influence of Shenmai injection on immune function in the treatment of locally advanced non-small cell lung cancer patients with concurrent chemoradiotherapy
Yiliang MENG ; Xiaohua LI ; Guangyou HUANG ; Chengle HUANG ; Shengwu HUANG ; Jianxian CHEN ; Xuesong ZHENG ; Ganque DENG
Chinese Journal of Primary Medicine and Pharmacy 2012;(23):3531-3532
Objective To observe the effect of Shenmai injection combined concurrent chemoradiotherapy on immune function in patients with locally advanced non-small cell lung cancer.Methods A total of 80 patients with locally advanced non-small cell lung cancer were randomly divided into treatment group and control group.In treatment group,40 patients received simultaneous three-dimensional conformal radiotherapy combined with TP(docetaxel+cisplatin)chemotherapy,while given Shenmai injection in the process of concurrent chemoradiotherapy.In control group,40 patients only received chemoradiotherapy.The changes of T cell subsets were observed between the two groups.Results It showed no significant differences in percentages of CD+3,CD+4,CD+16CD+56and CD+4/CD+8 ratio between two groups pre-treatment(all P>0.05).There were no significant adverse reactions occurred after received Shenmai injection in treatment group.Conclusion It play an important role in improving immune function of patients with locally advanced non-small cell lung cancer who received Shenmai injection combined concurrent chemoradiotherapy.
8.Effects of Recombinant Human IGF-1 on Kidney in Diabetic Rats
Kangmei ZHOU ; Xiaotian LI ; Yiliang ZHUANG ; Guangxing ZHOU ; Guoqiang WU ; Linlin SHEN ; Youming YANG
Fudan University Journal of Medical Sciences 2000;27(3):197-200,221
PurposeTo observe the effects of rhIGF-1 on kidney in diabetic rats. MethodsUsing biochemistry, radioimmunoassay, molecular biology (RT-PCR). Results(1) 24 h UAER,24 h uriary volume in rhIGF-1 group is lower than that of diabetic control group; (2) The level of sertan IGF-1 ,kidney IGF-1 and IGF-1 mRNA in diabetic control group is lower than that of normal control group;The level of serum IGF-1 in rhIGF-1 group is higher than that of diabetic control group;no differences were found in the levels of kidney IGF-1 and kidney IGF-1 mRNA between diabetic control group and rhIGF-1 group; (3) The level of serum GH in diabetic control group is higher than that of normal control group; The level of serum GH in rhIGF-1 group is lower than that of diabetic control group; (4) rhIGF-1 might have some protective effects on diabetic nephropathy via electron microscope. ConclusionsrhIGF-1 doesn't increase the damage of diabetic kidney tissue.
9.Correlation between VEGF-C/D expressions in tumor associated macrophages and lymph node metastasis in colon cancer
Yan LI ; Yong JIANG ; Liqun SHI ; Aixue SHI ; Yiliang PENG ; Houjie LIANG
Journal of Third Military Medical University 1984;0(02):-
Objective To discuss the correlation between the VEGF-C/D expressions in tumor associated macrophage (TAM) and lymph node metastasis in colon cancer. Methods Forty-five colon cancer samples proven pathologically to be adenocarcinoma were stained by immunohistochemical method for VEGF-C/D and CD68. The correlation of VEGF-C/D expressions, macrophage counting and lymph node metastasis were analyzed statistically. Results The expressions of VEGF-C/D were detected in TAMs. VEGF-C expression was obviously higher in the samples with lymphatic metastasis. VEGF-C expression in colon cancer was related to the number of TAMs. Conclusion TAMs are important in the lymph node metastasis, because they can express VEGF-C/D and affect the lymphangiogenesis of colon cancer.
10.An experimental study of isolation of SD rat adipose-derived stem cells using suspended explant culture method
Qin LIU ; Liping WANG ; Fang CHEN ; Xiaoming LI ; Yiliang ZHU ; Yi ZHANG
Chinese Journal of Immunology 2017;33(8):1197-1200
Objective:To isolate SD rat adipose-derived stem cells(ASCs)by suspended explant culture method.Methods: The healthy rat inguinal fat pads were obtained.The SD rat ASCs were isolated by suspended explant culture method and explant adherent culture method.The growth status and morphology were observed.The growth curve and cell surface markers CD29,CD44,CD45 of the 3rd passage cells were analyzed respectively by CCK-8,immunocytochemistry;the 3rd passage cells were induced individually by adipogenic differentiation medium and osteogenic differentiation medium,and cells were examined by oil red O staining and alizarin red staining.Results: The SD rat ASCs obtained by the two methods exhibited a spindle-shaped appearance and could rapidly expand.The cell growth curves were typical of S type.Immunocytochemistry analysis revealed that the third passage of SD rat ASCs were positive for CD29,CD44,but were negative for CD45.SD rat ASCs were positive for oil red O staining at 14 days after adipogenic induction,and positive for alizarin red staining at 14 days after osteogenic induction.Conclusion: Isolation of SD rat ASCs by suspended explant culture method is successfully established.The method is simple.It provides a new method for the isolation of SD rat ASCs in vitro.