2.Video-assisted retroperitoneal debridement for the treatment of infected necrotizing pancreatitis
Feng CAO ; Jia LI ; Ang LI ; Yu FANG ; Fei LI
Chinese Journal of General Surgery 2015;30(1):4-6
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.
3.Clinical implications of thyrotropin receptor antibody measurement
Yu YANG ; Ang ZHENG ; Chao LIU ; Keying CAI
Chinese Journal of Endocrinology and Metabolism 2011;27(4):360-364
It has been 50 years since the discovery of thyrotropin receptor autoantibody (TRAb). Advances in the knowledge of thyrotropin receptor ( TSHR) structure and function, combined with the elucidation of TSHR signaling and TSHR-autoantibody interaction have greatly facilitated our understanding of TRAb and their clinical applications. Measurement of TRAb activity plays an important role in the diagnosis of Graves' disease ( GD) and Graves' opthalmopathy. It has also been well recognized that TRAb is an effective predictor of GD relapse or remission after antithyroid drug and radioactive iodine treatment. TRAb test is of particular help in pregnant women and lactating mothers with recent iodine load, where radioactive iodine or technetium tests are contraindicated. In addition, it is useful in the diagnosis and differential diagnosis of fetal and neonatal hyperthyroidism as well as some rare forms of thyrotoxicosis in clinical practice. Accumulating evidence also indicates the possible correlation between thyroid cancer occurring in GD patients with positive TRAb and adverse outcomes. However, further innovation and standardization of TRAb tests are required to help pave the way for clinical applications.
4.Prevention of postoperative cerebrospinal fluid leakage with absorbable hemostatic fluid gelatin.
Li-tai MA ; Hao LIU ; Quan GONG ; Li TAO ; Yu Ang BEI ; Gan-jun FENG
China Journal of Orthopaedics and Traumatology 2015;28(8):717-721
OBJECTIVETo explore the effectiveness of absorbable hemostatic fluid gelatin in preventing postoperative cerebrospinal fluid leakage.
METHODSThe clinical data of 17 patients with dura mater tear were retrospectively analyzed from March to September in 2003. There were 16 males and 1 female, aged from 16 to 67 years old with an average of (39.6 ± 15.4) years. The injury site was at cervical vertebrae in 1 case, thoracic vertebrae in 9 cases, thoracolumbar junction in 4 cases, lumbar vertebrae in 3 cases. There were burst fracture in 4 cases and fracture-dislocation in 13 cases. According to ASIA grade, 12 cases were grade A, 2 cases were grade B, 2 cases were grade D, 1 case were grade E. Two cases caused by traffic accident, 10 by high falling, 4 by heavy parts crash, 1 by stairs fell during the earthquake. Absorbable hemostatic fluid gelatins were used to plug the dura mater tear,in order to prevent postoperative cerebrospinal fluid leakage. Postoperative drainage were recorded every day.
RESULTSOf 17 patients, 15 cases did not develop with cerebrospinal fluid leakage. Two cases develop with cerebrospinal fluid leakage after operation and their drainage were removed at 6 to 7 days after operation. In all cases, no complications related with cerebrospinal fluid leakage occurred, such as headache, dizzy, fever,neck resistance, rash, incision disunion, incision infection, hematoma, neurologic symptoms aggravation. No abnormal phenomena was found on incision surrounding at follow-up of 9 months.
CONCLUSIONUsing absorbable hemostatic fluid gelatin to plug the dura mater tear during operation is an effective method in preventing postoperative cerebrospinal fluid leakage.
Adolescent ; Adult ; Aged ; Cerebrospinal Fluid Leak ; prevention & control ; Female ; Gelatin ; administration & dosage ; Hemostatics ; administration & dosage ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control
5.A Clinical Observation on 8 cases with Primary Non-Transitional Cell Carcinoma of Bladder.
Korean Journal of Urology 1983;24(4):613-617
Eight patients with primary non-transitional cell carcinoma of the bladder during the period from January 1978 to December 1982 were reviewed, and following results ware obtained. 1. Primary non-transitional bladder carcinomas were 8 cases (11%) of 52 bladder carcinomas. 2. The age distribution was from 28 years to 72 years. Male to female ratio was 5 to 3. 3. Hematuria was presented in all cases, dysuria in 2 cases, frequency in 2 cases, lower abdominal pain in 2 cases. 4. Histopathological findings showed squamous cell carcinoma in 3 cases, adenocarcinoma in 3 cases, undifferentiated carcinoma in 1 cases, carcinosarcoma in 1 cases. According to 2Iewett classification, the degree of invasion was stage C in 5 cases, stage B2 in 1 case, stage B1 in 1 case and stage A in 1 case. 5. Five cases arised on lateral wall, 3 cases on dome, 1 case on posterior wall and 1 case on trigone. Four cases were nodular in type. 2 cases were papillary and 2 cases were smooth surface round pedunculated mass. Five cases were single and 3 cases were multiple. 6. 1) In stage C of adenocarcinoma, partial cystectomy was made in 1 case, radical cystectomy with ureteroileocutaneostomy in 1 case, partial cystectomy with postoperative irradiation in 1 case. In former two case, tumor metastasized to periaortic lymphnodes and lumber vertebrae after 6 months post-operatively. 2) Partial cystectomy was performed in 1 case of carcinosarcoma in stage A, tumor recurrence or metastasis did not occur after 1 year post-operatively. 3) In 2 cases of squamous cell carcinoma of stage C, preoperative irradiation with total cystectomy and ureterocutaneostomy was made in 1 case, total cystectomy with ureterocutaneostomy in 1 case and partial cystectomy with 5-FU instillation into the bladder was performed in 1 case of stage B2. In all cases, we couldn't follow up post-operatively. 4) In stage B1 of undifferentiated carcinoma, radical cystectomy with ureteroileocutaneostomy was performed. This case also couldn't be followed up.
Abdominal Pain
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Adenocarcinoma
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Age Distribution
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Carcinoma
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Carcinoma, Squamous Cell
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Carcinosarcoma
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Classification
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Cystectomy
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Dysuria
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Female
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Fluorouracil
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Follow-Up Studies
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Hematuria
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Humans
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Male
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Neoplasm Metastasis
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Recurrence
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Spine
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Urinary Bladder*
6.The Effect of Antiepididymal Rabbit Serum on Rat Epididymis.
Korean Journal of Urology 1983;24(5):707-712
Evidence of antigenicity of testis and semen has been presented since Landsteiner (1899), Metchinikoff (1900) and Metalnikoff (1900) first demonstrated the induction of a spermatoxic antibody in animals sensitized with testicular homogenates or semen. Interest in the field of male accessory sex gland began longtime ago, when the first cross-reaction between extracts of prostate, seminal plasma were demonstrated. Saline extracts of prostatic secretion from bulls, tested by double agar diffusion technique showed four antigens common to serum proteins and spermatozoa. The seminal vesicle have been found to have three to five antigens, also with common reactivity to spermatozoa. Attempts have been made to induce cross-immunologic damage in the testes by repeated immunization of mice with epididymal extracts (free of sperm) plus adjuvant and it was claimed that spermatogenesis was adversely effected and fertility of females was markedify reduced following mating with immunized male (Shethye and Rao, 1968; Kim and Kim, 1982). Rabit antiserum produced against the tissue protein of rat epididymis and seminal vesicle was capable of immobilizing and agfflutinating the sperm of both animals and the rabbit antiserum against complex antigen of epididymal tissue protein and seminal vesicle tissue protein of rat was most potent on sperm immobilization and agglutination of both animals (Cha and Kim, 1975). The purpose of this study is to observe the effect of rabbit anti-rat epididymal serum on epididymis and spermatogenesis in rat. The results were as follow; 1. The intraluminalspermatozoa of epididymis were decreased in number but immature sperm cells were much more noted than normal control group. The interspaces of epididymal ducts were widened and infiltrated with mononuclear cells and congestion in some places. There was no definite degenerative changes on epididymal epithelium. 2. Spermatogenesis was mildly to moderately impaired in the experimental group whereasit was unaffected in the control group. Degeneration and exfoliation were found in the germinal cells of seminiferous tubules. Intraluminal Spermatozoa of seminiferous tubules were decreased in number.
Agar
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Agglutination
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Animals
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Blood Proteins
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Diffusion
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Epididymis*
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Epithelium
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Estrogens, Conjugated (USP)
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Female
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Fertility
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Humans
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Immobilization
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Immunization
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Male
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Mice
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Prostate
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Rats*
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Semen
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Seminal Vesicles
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Seminiferous Tubules
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Spermatogenesis
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Spermatozoa
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Testis
7.Comparison of one-stage resection and anastomosis of acute complete obstruction of right and left colonic carcinoma
Feng CAO ; Yajun WANG ; Fei LI ; Yu FANG ; Ang LI ; Jia LI ; Yupeng ZHANG
Chinese Journal of Current Advances in General Surgery 1999;0(03):-
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.
8.Primary resection and anastomosis with intraoperative colonic defecation in left colonic cancer with complete obstruction
Xiaoan WANG ; Yajun WANG ; Fei LI ; Yu FANG ; Ang LI ; Dongbin LIU ; Jiabang SUN
International Journal of Surgery 2009;36(5):305-307
Objective To assess the value of primary resection and anastomosis with intraoperative colonic defecation in the patients with obstructive left colonic cancer. Methods From January 2000 to January 2008, 39 patients undergoing emergency laparotomy for left colonic cancers with complete obstruction were analyzed retrospectively. Results The patients were 25 males and 14 females, with a median age of 68.5 years (range: 57~78 years). The primary tumors were located at splenic flexure (3/7.7%), descending colon (8/20.5%), sigmoid colon (15/38.5%), boundary of sigmoid colon and rectum (8/20.5%), and superior segment of rectum (5/12.8%). Primary resection and anastomosis with intraoperative colonic de-fection were performed in 18 patients with left hemicolectomy, 13 patients with sigmoid colectomy and 8 pa-tients with anterior resection. Early complications included wound infection in 4 patients (wound disruption in 1 patient) and pulmonary infection in 5 patients. One patient complicated with anastomotic leakage and intra-abdominal abscess died of tumor metastasis after reoperation. Another one died of respiratory failure secondary to pulmonary infection. Morbidity and mortality was 25.6% and 5.1% respectively. Conclusion Primary resection with intraoperative colonic defecation can be applied to patients with malignant colonic complete obstruction with good operative results.
9.A study on the surgery timing for adhesive small bowel obstruction
Yu FANG ; Feng CAO ; Jia LI ; Ang LI ; Diangang LIU ; Fei LI
Chinese Journal of General Surgery 2015;30(2):108-110
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.
10.Primary resection and anastomosis without intraoperative colonic irrigation in left colonic cancer with complete obstruction
Xiaoan WANG ; Yajun WANG ; Fei LI ; Yu FANG ; Ang LI ; Dongbin LIU ; Jiabang SUN
Chinese Journal of Emergency Medicine 2009;18(7):744-746
Objective To assess the value of primary resection and anastomosis without intraoperative irrigation in the patients with obstructive left colonic cancer. Method Between January 2000 and January 2008, 93patients underwent primary resection and anastomosis for colonic cancers were analyzed retrospectively. Primary resection and anastomosis without intraoperative colonic irrigation (decompression by manual defecation) was performed in 43 patients with obstructive left colonic caner and traditional left-sided colectomy in 50 cases without obstruction. Both groups of patients were comparable in terms of gender, nutritional status, underlaying disease, tumor location and stage, etc ( P = 0.83,0.13,0.29,0.51,0.38). The average age of the patients with colonic obstruction was significant older than that of the cases without obstruction (61.2 ± 8.6 vs. 58.1 ±7.8, P =0.010).The operative results were compared between patients with obstructive colonic cancer and cases without obstruction.Results The mean hospital stay of the primary anastomosis group and traditional left-sided colectomy group were (16.6±7.8) d and (12.4±5.4) d respectively, and the former was significant longer than the latter (P =0.002). The costs of hospitalization in the two groups were (50192.8 ± 39727.4) RMB and (46489.3 ±29543.1)RMB respectively (P = 0.04) . The morbidity and mortality in the two groups were 25.6% (11/43) vs. 18%(9/50) (P =0.375) and 2.3% (1/43) vs. 2.0% (1/50) (P =0.714) respectively, and there were no significant difference between the two groups. Conclusions Primary resection and anastomosis without intraoperative colonic irrigation (decompression by manual defecation) compares favorably with traditional left-sided colectomy in safety and efficiency for left colonic cancer with obstruction.