Objective To determine the effect of video-assisted retroperitoneal debridement in treatment of infected necrotizing pancreatitis.Methods The clinical data of patients with infected necrotizing pancreatitis was retrospectively analyzed.Heart rate,mean arterial pressure,body temperature and indicators for inflammatory response including level of WBC,CRP and procalcitonin before and after VARD treatment were compared.Results After VARD treatment,the heart rate (preoperative vs.postoperative 8 h,108 ± 22/min vs.95 ± 17/min),mean arterial pressure (preoperative vs.postoperative 12 h,66 ± 18 mmHg vs.79 ± 19 mmHg) and body temperature(preoperative vs.postoperative 24 h,38.3 ± 1.7 ℃ vs.37.3 ± 1.3 ℃) improved significantly (all P ＜ 0.05).Level of WBC [preoperative vs.postoperative 48 h,(13.8 ±6.6) × 109/L vs.(10.1 ±5.2) × 109/L],CRP(preoperative vs.postoperative 48 h,145 ± 88 mg/L vs.95 ± 4 mg/L) and procalcitonin (preoperative vs.postoperative 48 h,1.4 ± 0.7 μg/L vs.0.9 ± 0.4 μg/L) also decreased significantly(all P ＜ 0.05).Conclusions VARD therapy can significantly reduce systemic inflammation and improve the general condition of infected necrotizing pancreatitis patients.

Objective To investigate nutritional support in the treatment of cancer in recent years.Methods Seperately diSCUSS on application conditions of enteral nutrition and parenteral nutrition in the treatment of cancer and its advantages and disadvantages.Results Enteral nutrition can improve digestive funcdon,reduce costs and enhance immunity.Parenmral nutrition can supplement insufficiency of enteral niltrition and inhibit tumor growth by selecting the kinds of nuWients to support a normal body function.Conclusion Enteral nutrition combined witll parenteral nutrition iS a suitable means of nutritional support in the treatment ofcancer.

Animals ; Gene Expression Profiling ; Gene Silencing ; Hematologic Neoplasms ; genetics ; metabolism ; Hematopoiesis ; genetics ; Humans ; MicroRNAs ; metabolism ; physiology ; Neoplasms ; genetics ; metabolism ; Oligonucleotide Array Sequence Analysis ; T-Lymphocytes ; metabolism

Objective To determine risk factors for postoperative infectious complications for small bowel obstruction.Methods Retrospective analysis the clinical data from small bowel obstruction patients who admittedto our hospital between January 2006 and December 2012 who receiving surgical treatment.The independent risk factors for infective complications were detected by logistic analysis.Results One hundred and fifty-four patients received surgery for small bowel obstruction with infection rate 27.9％.Logistic analysis revealed that older people(≥65 years) (OR 6.71,95％ CI 3.15-16.33),intraoperative bowel rupture (OR 2.71,95％ CI 1.19-7.25),delay surgery(≥72 h)(OR 11.33,95％CI4.62-20.20) and operation time(≥180 min) (OR 2.90,95％ CI 1.26-9.83) were the independent risk factors for postoperative infective complications.Conclusions Postoperative infections were the common complications after surgery for small bowel obstruction.Early surgery,intraoperative soft operation to prevent bowel rupture may be effective measures to reduce postoperative infection.

Objective:To compare the short-term result of one-stage resection and anastomosis for patients with acute complete obstruction of the right and left colonic carcinoma.Methods:The clinical data of 80 patients undergoing emergency one-stage resection and anastomosis of acute complete obstruction for left and right colonic carcinoma were retrospectively analyzed.Results:Thirty-seven patients were operated on for obstructive carcinoma of the right colon,the mortality was 5.4%(2/37),the rate of complication was 21.6%(8/37),the mean hospital stay and cost was(31.6?12.8)d and(52794.9?60804.3)Yuan RMB,respectively.Forty-three patients were operated on for obstructive carcinoma of the left colon.the mortality was 2.3%(1/43),the rate of complication was 25.6%(11/43),the mean hospital stay and cost was(29.6?14.8)d and(50 192.8 ?39 727.4) Yuan RMB respectively.There was one case of anastomotic leakage in both groups.There were no significant differences of mortality and the rate of complication of the two groups.Conclusions:One-stage resection and anastomosis of acute complete obstruction of left colonic carcinoma can be performed as safely as in those with acute obstruction of right.Intraoperative decompression should be considered seriously in left colonic obstruction prior to the anastomosis following colonic resection.

Objective To evaluate the surgery timing for adhesive small bowel obstruction (ASBO).Methods A retrospective analysis was made on the clinical data of ASBO patients admitted to our hospital between January 2003 and December 2012 who received surgical treatment.According to surgery timing,patients were divided into three groups,early surgery group (＜ 36 h),mid-term surgery group (36-72 h) and late surgery group (≥ 72 h).The mortality,surgical site infection (SSI) rate and systemic infection rate were compared between groups.Result In this study,33,56 and 27 patients received early,middle and late surgery,respectively.The SSI rate in early surgery group was significantly lower than that in middle (6％ vs.25％,x2 =5.05,P =0.025) and late surgery group(6％ vs.30％,x2 =5.94,P =0.015).Though of not significant difference,the mortality and systemic infection rate in early surgery group were also lower than both middle and late surgery groups.Conclusions Early surgery might reduce the postoperative infectious complications and improve the outcome of patients with ASBO.

Objective To validate the accuracy of the determinant-based classification (DBC) for the severity of acute pancreatitis (AP).Methods Retrospective analysis the clinical data of 243 patients with acute pancreatitis who admitted to our hospital between January 2012 and December 2013.Length of total parenteral nutrition,length of ICU and hospital stay,operation rate and mortality was assessed,respectively in subgroup of mild,moderate,severe and critical acute pancreatitis according to DBC.Results Pancreatic or peripancreatic necrosis was present in 65 of the patients (26.7％).Transient and persistent organ failures were present in 26 patients (10.7％) and 9 patients (3.7％),respectively.On the basis of the DBC,178 (73.3％),35 (14.4％),21 (8.6％),and 9 (3.7％) patients were determined to have mild,moderate,severe,or critical AP,respectively.The different categories of severity for DBC system were associated with statistically significant and clinically relevant differences in length of total parenteral nutrition,length of ICU and hospital stay,operation rate and mortality.Conclusions The DBC accurately classify the severity of AP in subgroups of patients.

OBJECTIVETo investigate the feasibility of immediate breast and nipple-areola reconstruction after skin-sparing mastectomy.

METHODS24 patients who received skin-sparing mastectomy underwent immediate breast reconstruction with or without breast implants. The nipple-areola complex is also reconstructed with the skin paddle of the latissimus dorsi flap in one stage.

RESULTSAll the latissimus dorsi myocutaneous flaps survived completely. Partial necrosis happened in two reconstructed nipples which healed after dress changing. The follow-up period ranged from 6 to 12 months. 3 patients presented with capsular contracture (Baker I), with no necessary of surgical revision. The retraction rate of reconstructed nipples projection is 35.4% at 6 months postoperatively and 38.6% at 12 months postoperatively. 91.7% of patients were satisfied or very satisfied with the breast shape, while 83.3% were satisfied or very satisfied with the breast volume. All the patients considered the reconstructed nipple very good, while 91.6% were satisfied with the nipple projection. 91.7% considered immediate nipple reconstruction to be very important, and 8.3% considered it to be important. 66.7% considered the new breast could replace the breast they had lost, and 8.3% considered that it could not.

CONCLUSIONFor skin-sparing mastectomy, immediate breast and nipple reconstruction can achieve good aesthetic results.

Breast Neoplasms ; surgery ; Esthetics ; Female ; Humans ; Mammaplasty ; methods ; psychology ; Myocutaneous Flap ; transplantation ; Nipples ; surgery ; Superficial Back Muscles ; transplantation

Objective To evaluate the preliminary outcome of stable vitiligo treatment with ReCell(R )technique.Methods Six patients with stable vitiligo were treated with ReCell(R ) technique.In each patient,a thin razor-thickness cutaneous biopsy was harvested from uninvolved area near the vitiligo patches.It was then processed through the ReCell(R ) system and 1 ml autologous epidermal cell suspension was obtained.The lesion area was dermabraded using a diamond fraise wheel to the dermoepidermal junction.The cell suspension was then sprayed on the wound and covered with non-adhering dressings.Results The patients were followed up for 6 months.5 patients presented with repigmentaion in the treated area.There was no significant response in one patient who was diagnosed as systematic vitiligo.Conclusions The ReCell(R ) technique is an alternative treatment for stable vitiligo patients.The clinical outcome will be satisfactory when appropriate patients are selected.

Metastases to the breast from extramammary neoplasms are very rare, constituting 2.7% of all malignant breast tumours. The most common primary tumor metastatic to the breast is primary breast cancer. Rectal cancer metastasizing to the breast is extremely rare. We report a case of aggressive rectal carcinoma with metastasis to the breast.
Breast Neoplasms ; secondary ; Female ; Humans ; Middle Aged ; Rectal Neoplasms ; complications