1.Clinical analysis of 10 cases treated with laparoscopic repair for abdominal giant incisional hernia
Jie SUN ; Xianzhi CHEN ; Congyu WANG ; Qi WANG
Chinese Journal of Primary Medicine and Pharmacy 2014;(16):2466-2467,2468
Objective To explore the operational methods and clinical effect of laparoscopic repair of ab -dominal incision hernia .Methods The clinical data of 10 cases with abdominal giant incisional hernia undergone laparoscopic repair were retrospectively analyzed .Results All the cases were successful .Operative time ranged from 85 to 180 minutes,with an average of 150 minutes.The bleeding was 40-120mL during the operation .Postoperative hospital stay was 6-14(average 8) days.3 cases developed pain in operation area after operation and were better after 1-2 months.The seroma was observed in 1 case witch cured by puncture treatment .No incisional infection ,bleeding, intestinal fistula,intestinal obstruction ,or death was observed during the follow-up.In the follow-up after 4 months to 4 years,no recurrence was occurred .Conclusion The laparoscopic repair of abdominal giant incision hernia using composite patch is a safe and effective method ,which is worthy of clinical application .
2.Analysis of multiple factors correlated with the six months prognosis of comprehensive function in patients with stroke
Wenke FAN ; Yongshan HU ; Wenhua CHEN ; Xiaobing WANG ; Anlong CHEN ; Yi WU ; Congyu JIANG
Chinese Journal of Physical Medicine and Rehabilitation 2008;30(3):176-179
objective To investigate the multiple early variables that influenced the 6th months prognosis of comprehensive function in patients with stroke.Methods Two hundreds and eleven patients of primary cerebral infarction and primary cerebral hemorrhage in Shanghai were divided into treated group and controlled group randomly.Patients in the treated group were given standardized tertiary rehabilitation,while those in the controlled group received normal internal medicine treatments but without standardized tertiary rehabilitation.Twenty seven early variables were collected with regard to the patients'medical history,physical examination,scores with CNFD,S-FMA and MBI at the time of enrollment.The patients'FCA scores at the ends of the 6th months after stroke were used as the comprehensive functional outcome.Stepwise multiple regression analysis applied to analyze the data.Results Stepwise multiple regression analysis revealed that therapeutic regimen,CNFD scores,age,diabetes mellitus,SFMA scores,smoking and labour intensity predicted comprehensive functional outcome at the ends of the 6th months after stroke.Conclusion Certain early variables predict the long-term comprehensive functional prognosis of stroke patients.Therapeutic regimen,CNFD scores and age were significant predictors.
3.Predictive value of preoperative pelvic floor electrophysiological parameters on early urinary incontinence following radical prostatectomy
Shuhui YU ; Jianing HAN ; Lijun ZHONG ; Congyu CHEN ; Yunxiang XIAO ; Yanbo HUANG ; Yang YANG ; Xinyan CHE
Journal of Peking University(Health Sciences) 2024;56(4):594-599
Objective:To explore the predictive value of preoperative pelvic floor electromyography(EMG)parameters for the risk of urinary incontinence after prostate cancer surgery.Methods:This study retrospectively analyzed the medical records of 271 patients who underwent radical prostatectomy in the urology department of Peking University First Hospital from January 2020 to October 2022.The data included patient age,body mass index(BMI),international prostate symptom score(IPSS),prostate-specific antigen(PSA)levels,Gleason score,type of surgery,urethral reconstruction,lymph node dis-section,nerve preservation,catheterization duration,D'Amico risk classification,American Society of Anesthesiologists(ASA)score,Charlson comorbidity index,postoperative duration,prostate volume,and pelvic floor EMG parameters(pre-resting mean,fast muscle mean,and slow muscle mean scores).Independent risk factors affecting early postoperative urinary incontinence were identified through multiva-riate Logistic regression analysis.The predictive efficacy of pelvic floor EMG results was evaluated by cal-culating the area under the receiver operating characteristic(ROC)curve,and the optimal threshold for early postoperative urinary incontinence was determined based on the Youden index and clinical signifi-cance.Results:The study included 271 prostate cancer patients,with an 81.9%rate of voluntary urinary control post-surgery.The median score for fast pelvic floor muscles was 23.5(18.2,31.6),and for slow muscles,it was 12.5(9.6,17.3).Among the patients,179(66.1%)did not preserve nerves,and 110(40.6%)underwent urethral reconstruction.Advanced age and low fast muscle scores were identified as independent risk factors for urinary incontinence.Patients aged ≤60 had 5.482 times the voluntary urinary control rate compared with those aged ≥70(95%CI:1.532-19.617,P<0.05).There was a significant correlation between fast muscle scores and urinary incontinence recovery(OR=1.209,95%CI:1.132-1.291,P<0.05).When the optimal threshold for preoperative fast muscle score was set at 18.5,the ROC sensitivity and specificity were 80.6%and 61.2%,respectively.Con-clusion:Preoperative pelvic floor EMG parameters show good predictive accuracy and clinical applicabili-ty for the risk of urinary incontinence after prostate cancer surgery.These parameters can be used for ear-ly identification of urinary incontinence risk,with age and fast muscle scores being important predictors.