Objective To develop an interlocking-style vascular shunt device for the treatment of distal limb ischemia resulting from vascular disconnection and defect.Methods A one-way interlocking buckle was designed with the space between the clamping teeth being 0.5 mm,which prevented the device from moving backwards and fixed the vessel and shunt tube conveniently.The interlocking buckle combined with silicone tube was used to connect the two ends of the defected vessel,which was compared with conventional method by suture ligation and silicone tube by the tests on vessel bursting pressure and tensile biomechanics.Results The vessel repaired with the developed device behaved better than that by the conventional method in the tests on vessel bursting pressure and tensile biomechanics (P＜0.05).Conclusion The vascular shunt device can be used for the treatment of distal limb ischemia resulting from vascular disconnection and defect,and thus facilitates the vascular graft in rear hospital after evacuation.

Adolescent ; Adult ; Aged ; Brain ; blood supply ; diagnostic imaging ; Carbon Monoxide Poisoning ; diagnostic imaging ; Child ; Female ; Humans ; Male ; Middle Aged ; Tomography, Emission-Computed, Single-Photon

OBJECTIVETo introduce a better surgical approach for the resection of tumors involving the anterior and middle skull base and the fronto-orbito-ethmoidal area.

METHODSA "T" form incision was made in the fronto-orbito-ethmoidal region and along the nasal pyramid down. Parts of ethmoid sinus, lamina papyracea, fronto-orbito bone and behind wall of frontal sinus were resected in order to expose the tumors in the anterior skull base and the fronto-orbito-ethmoidal region. Then, the tumor was resected partly under the operation microscope, protecting the neighbouring important structures, for instance: optic nerve, internal carotid artery, sella, meninx, etc. The nasal pyramid was repaired and fixed to the frontal bone with titanium board and titanium nail in order to resume the appearance of a good face.

RESULTSThirteen patients received tumour resection through this approach. The patients were followed-up for 24 months, 11 patients showed no tumour recurrence, no severe complication, such as cerebrospinal rhinorrhea, meningoencephlocele, etc, in this series. The facial appearance was good.

CONCLUSIONSThe approach via the fronto-orbito-ethmoidal region is a good surgical procedure to resect the tumors involving the anterior and middle skull base and the fronto-orbito-ethmoidal area.

Ethmoid Bone ; surgery ; Female ; Frontal Bone ; surgery ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; surgery ; Orbit ; surgery ; Skull Base Neoplasms ; surgery

OBJECTIVETo retrospectively investigate the diagnosis and the outcome of Caroli's disease treated by surgical procedures.

METHODSThe clinical data of 68 patients with Caroli's disease treated by surgical procedures between 1996 and 2002 were reviewed, retrospectively.

RESULTSThe patients, with a M/F ratio of 1:1.35 and a mean age of 46, presented mainly with recurrent cholangitis. Of all the patients, 26 had a history of operation for cholelithiasis or cholangitis. On admission, the image investigations suggested that the lesions located at left lobe in 44 patients, right lobe in 9 patients, and whole liver in 15 patients. The coexisting cyst in common bile duct was found in 20 patients. The malignant transformation was found in 5 patients (8.8%). Hepatectomy was performed in 82.4% of patients, with a morbidity rate of 15.0% and mortality rate of 0 after the surgery. The long-term outcome of symptom-free in hepatectomy group was 90.2%, significantly higher than the 33.3% in non-hepatectomy group (P < 0.01) after a 3 to 10 years of follow-up.

CONCLUSIONSHepatectomy offers a curative procedure for local Caroli's disease, and liver transplantation is a good option for diffuse sufferers.

Adolescent ; Adult ; Aged ; Caroli Disease ; surgery ; Female ; Follow-Up Studies ; Hepatectomy ; Humans ; Liver Transplantation ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo evaluate the clinical value of (89)SrCl(2) (Ke xing Inc, Shanghai) as a palliative therapy modality for cancer patients with bone metastasis.

METHODSIn 504 cancer patients with painful limitation of movement due to bony metastasis, a dose of 1.48-2.22 MBq/kg (40-60 uCi/kg) iv infusion of (89)SrCl(2) was given.

RESULTSIn 97 patients (19.2%) there was no improvement in pain and life quality, 298 patients (59.1%) showed mild to moderate improvement (moderately effective), 109 patients (21.6%) became free of pain and were subsequently fully ambulatory (markedly effective). The pain relief appeared from D1-D46 after (89)SrCl(2) administration, most frequently from D5-D14. The palliative effect could last for about 56 days to 13 months. Repeated bone scans of some patients showed that the metastatic foci in the bone became smaller or even disappeared gradually after the administration of (89)SrCl(2). Approximately 55% of patients experienced grade I approximately III bone marrow depression attributable to (89)SrCl(2), which would return to the pre-treatment level within 3 approximately 9 months.

CONCLUSION(89)SrCl(2) is effective and safe for the relief of bone pain and improvement of quality of life in cancer patients with painful bony metastasis.

Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms ; complications ; radiotherapy ; secondary ; Breast Neoplasms ; pathology ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Pain Measurement ; Pain, Intractable ; etiology ; radiotherapy ; Quality of Life ; Strontium Radioisotopes ; therapeutic use

OBJECTIVETo study the efficacy and safety of multimodal prevention of postoperative venous thromboembolism for hip fractures.

METHODSFrom March 2009 to July 2011, preoperatively, patients were assigned to two groups on the basis of an assessment of their risk factors. One hundred and twelve patients were considered to be low risk, involving 47 males and 65 females,with an average age of (72.40 +/- 13.29) years ranging from 42 to 88,and were managed with aspirin (100 mg once daily for 14 days) as well as intermittent gasing compression devices. Twenty-six patients were considered to be high risk, involving 12 males and 14 females with an average age of (78.50 +/- 12.76) years ranging from 65 to 84,and were managed with low-molecular-weight heparin (0.4 ml,subcutaneous injection once daily for 14 days) and intermittent gasing compression. All patients were underwent Doppler ultrasonography within 24 hours before hospital discharge. All patients were followed-up for 3 months postoperatively. The incidence of deep venous thrombosis of lower limb, pulmonary embolism, gastrointestinal hemorrhage were recorded.

RESULTSOverall, there were no fatal pulmonary embolism, 1 case of symptomatic pulmonary emboli in low risk group, and none were detected in the high-risk group. Deep venous thrombosis was detected in association with 6 (6.25%) of the 112 procedures in the low-risk group and 2 (7.69%) of the 26 operations in the high-risk group. Paitents were selected in opened reduction and internal fixation, the quantity of bleeding, decrease of hemoglobin, hematoma rate, and gastrointestinal hemorrhage rate of low risk group were (538.10 +/- 390.20) ml, (30 +/- 19) g/L, 0, and 1 (1.03%) respectively; those of the high-risk group were (585.95 +/- 403.96) mL, (32 +/- 20) g/L,1 (4.76%), (4.76%), there were no significant different between the two groups, all P > 0.05.

CONCLUSIONThere were no statistic significances between the aspirin as well as intermittent gasing compression devices and the low-molecular-weight heparin and intermittent gasing compression in preventing venous thromboembolism (VTE) in postoperative postoperative venous thromboembolism for hip fractures. However, there are potential advantages to reduce complications of bleeding and cardiovascular disease. Multimodal prevention of postoperative venous thromboembolism can protect postoperative patients with hip fractures.

Adult ; Aged ; Aged, 80 and over ; Female ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Risk ; Venous Thromboembolism ; prevention & control

OBJECTIVETo discuss the impact of number of retrieved lymph nodes and lymph node ratio(LNR) on the prognosis in patients with stage II and III colorectal cancer.

METHODSClinicopathological data of 507 patients with stage II and III colorectal cancer were analyzed retrospectively. Follow-up was available in all the patients.

RESULTSThe total number of retrieved lymph nodes was 5801, of which 1122 had metastasis. There was a positive correlation between metastatic lymph nodes and retrieved lymph nodes(r=0.171, P<0.01). In stage II colorectal cancer there was a significant difference in 5-year survival rate between patients with more than 12 lymph nodes retrieved and those with less than 12 lymph nodes retrieved(P<0.01). LNR also affected the 5-year survival rate of patients with stage II and III colorectal cancer(P<0.05). In patients with similar LNR, the 5-year survival rate differed significantly among different regions of lymph node metastasis(P<0.05). LNR influenced the prognosis independent of the number of lymph nodes retrieved.

CONCLUSIONSThe number of retrieved lymph nodes is a prognostic factor for stage II and III colorectal cancer. More than 12 lymph nodes should be retrieved for better staging and prognosis. LNR is also a prognostic factor in stage II and III colorectal cancer. Regions of lymph nodes metastasis should be considered when evaluating the prognosis of patients using LNR.

Colorectal Neoplasms ; diagnosis ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; pathology ; Male ; Neoplasm Staging ; Prognosis ; Retrospective Studies

OBJECTIVETo evaluate the efficiency of navigation system for orbital wall reconstruction in unilateral orbital fractures.

METHODSFifteen patients (7 male and 8 female) with unilateral orbital fracture underwent orbital reconstruction with the help of intraoperative navigation system. The average age was 34.3 ± 9.5 years. All patients underwent spiral CT scanning preoperatively, and the CT data was imported to the BrainLab navigation system (Germany, BrainLab company). The orbit of the intact side was mirrored to the opposite side as the reference for pre-operative planning. The titanium mesh was mounted on the resin template made by rapid prototyping machine based on the mirrored CT data. When the injury was limited, the hydroxyapatite sheet was used for the orbital wall reconstruction. During the operation, the real-time navigation helped to ensure precise placement. The re-establishing result was assessed based on the postoperative CT data with the following four variables: the volumetric difference between the bilateral orbit, the volume of the herniated soft tissue, the global projection and the discrepancy between the simulated and the achieved position of the reconstructed orbital wall. The reconstructive discrepancy was measured only in the titanium plate grafting cases.

RESULTSThere were no serious complications such as infection, graft rejection and optic nerve injury in any case. Preoperatively, the average degree of enophthalmos was (3.5 ± 1.6) mm, the average volumetric difference between the injured and the unaffected orbit was (4.5 ± 1.8) ml, and the average volume of the herniated orbital soft tissue was (2.1 ± 0.7) ml. Postoperatively, the three values were respectively reduced to (1.3 ± 0.6) mm, (1.8 ± 0.9) ml and (0.7 ± 0.3) ml. The discrepancy of the medial and inferior wall were (2.5 ± 0.6) mm and (2.1 ± 0.4) mm.

CONCLUSIONSThe intraoperative use of navigation system for the orbital wall reconstruction in unilateral orbital fractures can provide reliable accuracy and achieve satisfactory results.

Adult ; Computer Simulation ; Enophthalmos ; diagnostic imaging ; etiology ; surgery ; Female ; Humans ; Male ; Orbit ; diagnostic imaging ; surgery ; Orbital Fractures ; complications ; diagnostic imaging ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgery, Computer-Assisted ; Surgical Mesh ; Titanium ; Tomography, X-Ray Computed

OBJECTIVETo explore the effective therapeutic method in the treatment of idiopathic sudden hearing loss (ISHL).

METHODSOne hundred and eighty-eight cases of ISHL were randomized into a warming-promoting needling group (74 cases), a conventional acupuncture group (56 cases) and a medication group (58 cases). In the conventional acupuncture group, the conventional needling technique was applied to Baihui (GV 20), Fengchi (GB 20), Yifeng (TE 17), Tinggong (SI 19), Touqiaoyin (GB 11) and Zhigou (TE 6) on the affected side. The treatment was given 5 times each week. Totally, the treatment of 6 weeks was required. In the warming-promoting needling group, on the basic treatment as the conventional acupuncture group, the warming-promoting needling technique was applied to Fengchi (GB 20). In the medication group, the intravenous drop with salvia injectio and mecobalamin was prescribed, once per day, for 10 days totally. Meanwhile, Erlong Zuoci Wan was prescribed for oral administration, 8 pills each time, three times a day for 30 days continuously.

RESULTSAll of the three therapeutic methods achieved the effect on ISHL. The total effective rate was 89.2% (66/74) in the warming-promoting needling group, which was better than 62.5% (35/56) in the conventional acupuncture group and 53.4% (31/58) in the medication group (both P<0.01).

CONCLUSIONThe warming-promoting needling techinque achieves the significant efficacy on ISHL. The hearing improvement is superior to that treated with either the conventional needling technique or medication.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adult ; Female ; Hearing Loss, Sudden ; therapy ; Humans ; Male ; Middle Aged ; Needles ; Treatment Outcome

OBJECTIVETo compare the efficacy of computer-navigated surgery and the 3-D skull models and guide plates for the treatment of unilateral delayed zygomatic fractures.

METHODSEleven patients with unilateral delayed zygomatic fractures were treated by computer-navigated surgery (test group) and another 12 patients were treated by 3-D skull models and guide plates as the control group. Quality of reduction was assessed by examination of postoperative axial CT scans through zygomatic arch, the malar prominence and the width of zygomatic arch were measured in both groups.

RESULTSThe difference between bilateral malar prominence was (0.94 ± 0.73) mm in the test group and (1.88 ± 1.82) mm in the control group, there was no significant difference between the two groups (P > 0.05). The difference between bilateral width of zygomatic arch was (0.77 ± 0.51) mm in the test group, less than (3.00 ± 1.81) mm in the control group (P < 0.05). Excessive malar prominence was observed in 6 cases (6/11) in the test group and in 7 cases (7/12) in the control group, whereas malar depression was observed in 5 cases (5/11) in the test group and in 5 cases (5/12) in the control group. Overcorrection of the width of zygomatic arch was observed in 6 cases (6/11) in the test group and in 12 cases (12/12) in the control group, whereas under correction was observed in 5 cases (5/11) in the test group and in 0 cases (0/12) in the control group.

CONCLUSIONSIn the treatment of unilateral delayed zygomatic fractures, symmetry of malar prominence can be achieved by application of computer-navigated surgery or the 3-D skull models and guide plates. Symmetry of the width of zygomatic arch achieved with the computer-navigated surgery is better than that achieved with 3-D skull models and guide plates.

Adult ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed ; Young Adult ; Zygoma ; diagnostic imaging ; surgery ; Zygomatic Fractures ; diagnostic imaging ; surgery