2.Posterior indirect reduction and internal fixation and laminectomy in the treatment of thoracolumbar vertebrae burst fracture complicated with spinal cord injury
Chen HUANG ; Qionghua FENG ; Bo CAO ; Wei LIN ; Hai XU
Journal of Regional Anatomy and Operative Surgery 2017;26(3):204-208
Objective To explore the clinical effect of posterior indirect reduction and internal fixation and laminectomy in the treatment of thoracolumbar vertebrae burst fracture complicated with spinal cord injury.Methods Eighty patients with thoracolumbar vertebrae burst fracture and spinal cord injury treated in our hospital from March 2014 to March 2015 were selected as the objects,and they were divided into reset group and laminectomy group with forty cases in each group according to surgical method.All the patients were followed up for 1 year,the lumbar function of two groups at 1 week and 1 year after operation were observed respectively,and the pain degree was observed in 1month,3 months and 6 months after operation.The amount of bleeding,operation time,hospitalization time and fracture healing time were observed.Neurological function was assessed by classification criteria of the American Spinal Cord Injury Association(ASIA),and incidence of complications was figured in the two groups.Results The anterior heights of the injured vertebra were higher than those before the operation,and the Cobb's angles were lower than those before the operation,the differences were significant(P < 0.05);while there was no significant differences in the anterior heights of the injured vertebra between the two groups at 1 week and 1 year after operation(P > 0.05).VAS scores of the two groups after 1 month,3 months and 6 months decreased significantly when compared with the preoperative scores(P < 0.05),and VAS scores of each time in the reset group were significantly lower than those in the laminectomy group(P < 0.05).The amount of bleeding,operation time,hospitalization time and fracture healing time in the reset group were less than those in the laminectomy group (P < 0.05).The neurological function recovery of the two groups were significantly improved when compared with that before the operation(P <0.05).There was no significant difference in recovery of neurological function between the two groups(P > 0.05).The complication rate was 7.50% in the reset group,lower than 12.50% of the laminectomy group,the difference was significant (P < 0.05).Conclusion Posterior indirect reduction and internal fixation of lamina both have a certain effect in the treatment of thoracolumbar vertebrae burst fracture complicated with spinal cord injury.But posterior indirect reduction has less complications and less amount of bleeding,which is beneficial to postoperative recovery.
3.Clinical effect of totally laparoscopic radical resection for gallbladder cancer
Junyao XU ; Hai JIANG ; Zhimin YU ; Jun MIN ; Yajin CHEN
Chinese Journal of Digestive Surgery 2016;15(4):353-356
Objective To investigate the safety and feasibility of totally laparoscopic radical resection of gallbladder cancer.Methods The retrospective cross-sectional descriptive study was adopted.The clinical data of 30 patients who underwent laparoscopic radical resection of gallbladder cancer at the Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2013 to August 2015 were collected.The patients received synchronous hepatic segmental or extrahepatic bile duct resection according to the conditions of patients,and choledochojejunostomy was applied to patients undergoing extrahepatic bile duct resection.The patients accepted postoperative adjuvant chemotherapy according to the results of postoperative pathological examination.Observation indicators included (1) operation situations,including surgical procedures,operation time,volume of intraoperative blood loss and number of lymph node dissected,(2) postoperative situations,including time for outoff-bed activity,time for diet intake,time of drainage tube removal,occurrence of complications and duration of hospital stay,(3) results of postoperative pathological examination,including tumor stage and surgical margin,(4) postoperative adjuvant treatment,(5) follow-up situation including the survival of patients,tumor recurrence and metastasis.The follow-up using outpatient examination and telephone interview was performed to detect the survival of patients and tumor recurrence and metastasis up to December 2015.Count data were represented as average (range).Results All the 30 patients underwent successful laparoscopic radical resection of gallbladder cancer combined with hepatic S4b and S5 resection + lymph node dissection at N1 region.Six patients with obstructive jaundice caused by tumor invaded to extrahepatic bile duct underwent combined laparoscopic extrahepatic bile duct resection + Roux-en-Y hepaticojejunostomy,without perioperative death.The average operation time,average volume of intraoperative blood loss and average number of intraoperative lymph node dissected were 238 minutes (range,178-430 minutes),250 mL (range,200-600 mL) and 7 (range,4-15),respectively.(2) The patients got out-off-bed activity and normal diet intake at postoperative day 2,with a average time of drainage tube removal of 3 days (range,0-25 days) and an average duration of hospital stay of 5 days (range,3-28 days).Two patients with complications were cured by symptomatic treatment.(3) Results of postoperative pathological examination showed that all the patients received R0 resection,and pathological stage showed that 12 patients were detected in Ⅰ B stage,10 in Ⅱ stage,7 in ⅢA stage and 1 in ⅢB stage.(4) One patient in Ⅲ B stage (pT3N1 M0 stage) received gemcitabine + cisplatin chemotherapy and other patients didn't receive the adjuvant treatment.(5) All the patients were followed up for a median time of 16 months (range,4-32 months),without tumor recurrence and metastasis at Trocar puncture site.There were 25 patients with tumor-free survival and 5 patiens died of tumor recurrence.Conclusion Laparoscopic radical resection of gallbladder cancer is technically safe and feasible,with a satisfactory short-term outcome.
4.Susceptibility testing of yeasts to combination of amphotericin B and 5-flucytosine in vitro according to M27-A method
Hong CHEN ; Hai WEN ; Hong XU ; Wanqing LIAO
Academic Journal of Second Military Medical University 1981;0(04):-
This article is to study the interaction between amphotericin B and 5-flucytosine to yeasts in vitro. The checkerboard microdilution method was applied to study in vitro interaction according to M27-A method of NCCLS. Twenty-eight strains of yeasts were used for combination study. Compared with the single agents,there were significant reductions in the geometric mean of the minimal inhibitory concentration of the combination(P
5.Clinical application of RapIDYeast Plus system in identifying 150 clinically common yeasts
Hong XU ; Hai WEN ; Jianghan CHEN ; Xin HUANG
Academic Journal of Second Military Medical University 1982;0(02):-
Objective:To study the role of RapIDYeast Plus (RYP) system in identifying common clinical yeasts.Methods: The target strains were cultured and passaged twice on Sabouraud dextrose agar,and were fed to RYP system after 24-48 h incubation at 30℃.Results: One hundred and thirty-nine of the 150 target strains were identified to the level of species correctly,and 8 undetermined strains were confirmed by additional tests.It was found that 3 strains had been incorrectly identified by RYP system.The accuracy of RYP system was calculated as 92% without additional tests and 98% with additional tests.Conclusion: RYP system is suitable for routine tests in clinical microbiological laboratory;it can accurately identify more than 40 kinds of yeasts and yeast-like bacteria in clinical practice.
6.CT features of pediatric mediastinal neuroblastoma
Zhe CHEN ; Chongyong XU ; Hai WU ; Shifeng XIANG ; Qiande QIU
Journal of Endocrine Surgery 2013;7(6):498-501
Objective To investigate CT features of pediatric mediastinal neuroblastoma.Methods The CT performance of pediatric mediastinal neuroblastoma confirmed by clinical and pathology in 17 cases were retrospectively analyzed.The tumor growth pattern,size,density,degree of enhancement,invasion to the surrounding tissues and metastatic characteristics were observed,and the results were compared with pathological analysis.Results Among the 17 cases,2 were at the right posterior upper mediastinum,3 at posterior right middle and upper mediastinum,3 at the posterior right middle and lower mediastinum,1 at the posterior right lower mediastinum,3 at the posterior left middle mediastinum,3 at the posterior left middle and lower mediastinum,1 at the posterior left lower mediastinum,and 1 at bilateral posterior middle and lower mediastinum.The average tumor size was 6.3 ×4.3 cm,ranging from 2.3 ×2.0 cm ~ 12.6 ×4.0 cm.CT plain scan showed 8 cases with clear boundary and 9 case without clear boundary.13 cases were with inhomogeneous density and 4 cases with homogeneous density.8 calcification of grainy or strip was found in the tumor.10 cases were with pleural thickening and 5 cases with pleural effusion.6 cases were with tracheal or main bronchial compression,4 with cardiac compression,7 with pulmonary artery compression,and 1 with descending aorta compression were found.6 cases were with tumors crossing the midline,5 with intervertebral foramen growth,3 wrapped around the aorta,3 with rib attack damage,2 with rib compression deformation,2 with thoracic invasion,and 1 into the upper abdomen.10 cases were with mediastinal lymph nodes enlargement,10 with bone metastasis,4 with cervical lymph nodes enlargement,1 with liver metastasis,and 1 with cerebral metastasis.Enhanced CT scan was performed in 14 cases:11with inhomogeneous enhancement,and 3 with homogeneous enhancement.The average CT value of the 3 mild enhancement was 36 HU,ranging from 20 to 56 HU.The average CT value of the 8 moderate enhancement was 53 HU,ranging from 36 to74 HU.The average CT value of the 3 marked enhancement 72 HU,ranging from 56 to 88 HU.7 punctate vessels and 6 polycystic changes were found in the tumors.Conclusions Mediastinal neuroblastoma in children are with certain characteristics.CT findings with clinical manifestations can make a definite diagnosis.
7.Comparison of injecting tissue glue and lauromacrogol in modiifed sandwich method with synchronization or sequential ligation for esophageal and gastric variceal
Hai LIN ; Xiaoguang XU ; Fangxi XUE ; Xingtian CHEN ; Feng TIAN
China Journal of Endoscopy 2017;23(2):6-9
Objecive To evaluate and compare the efficacy of injecting tissue glue and lauromacrogol in modified sandwich method combined with synchronous ligation for patients with esophageal and gastric variceal.Methods 42 cases of patients with esophageal and gastric variceal were randomly divided into synchronous treatment group (22 cases) and sequential treatment group (20 cases). Both group received modiifed sandwich method for gastric varices (lauromacrogol-tissue adhesive-lauromacrogol). Synchronous treatment group meanwhile received synchronization ligation for esophageal varices, but sequential treatment group received sequential ligation after one week. The hemostasis rate, effective rate of varices, rebleeding and complications rate were analyzed.Results There were no signiifcant difference in hemostasis rate, effective rate and rebleeding rate between two groups. The incidence of complications, such as chest and abdominal pain, fever, transient bacteremia were equal between these two groups. No patients had ectopic embolism. The number of ligation device in synchronous treatment group was more than sequential treatment group (8.19 ± 2.01 vs 7.81 ± 1.78,P > 0.05), and the rate of esophageal varices disappearance was inferior to sequential treatment group (59.09% vs 70.00%), however, there were no statistical difference (P > 0.05).Conclusion Endoscopic injection of tissue glue and lauromacrogol synchronization ligation is safe and effective for esophageal and gastric variceal with low complication rates. This method could reduce gastroscopy times and medical expenses, and is worthy of further investigating.
8.Susceptibility Testing of 28 Strains of Yeasts to the Combination of Antifungal Drugs in vitro
Hong CHEN ; Hai WEN ; Hong XU ; Wanqing LIAO
Chinese Journal of Dermatology 1995;0(03):-
Objective To study the interaction between antifungal drugs to yeasts in vitro.Methods The in vitro interaction of antifungal drugs was detected with checkerboard microdilution method based on M27-A of NCCLS for28strains of yeasts.Results There was a significant reduction in the geometric means of MICs by the combinations of antifungal drugs to the yeasts compared with the individual agents(P
9.Establishing the System of Academic Assessment and Evaluation on Introduced Talented Personnel
hai-ying, ZHU ; li-jin, CHEN ; xu-ming, ZHU
Journal of Shanghai Jiaotong University(Medical Science) 2006;0(09):-
Objective To evaluate the system of academic assessment and evaluation on introduced talented personnel so as to establish a consummate talented personnel introduction mechanism and to further standardize the introduction work. Methods On the basis of referring to document papers and soliciting management as well as human resource experts iteratively,the research method of expert consultation was adopted.(Results)The index system of academic assessment and evaluation on introduced talented personnel in school of medicine was preliminary established,and the objective index and subjective evaluation were scientifically combined to form the method of academic assessment and evaluation on introduced talented personnel. Conclusion Through simulative assessment and evaluation as well as probational demonstration,there exits definite scientificality and applicability on this academic assessment and evaluation index system,and it can provide a properly objective evaluation and essential reference foundation in the aspect of introducing more advanced talented personnel in the near future.
10.Expression of CD_64 in Neonatal Infection Disease and Its Clinical Significance
xi -xi, XU ; ling-zhi, CHEN ; qing, CHEN ; hai-bin, XU ; man-hua, BAD
Journal of Applied Clinical Pediatrics 2003;0(10):-
Objective To study CD64 expression in neutrophilic granulocyte and its clinical effect in neonatal infection disease. Methods CD64 was detected among 59 neonatal patients(septicemia group 34 patients, local infection group 25 patients)hospitalized in our neonatal department diagnosed as neonatal infection disease in 48 h after hospitalized,2 weeks after therapy, then the results were compared with 27 patients as non - infection disease during the same period. Results CD64 in septicemia group was (6156. 21?3643. 32) molecula per cell,in local infection group was (2176.19 ? 946. 32)molecula per cell, in non- infection group was (2176. 19 ? 946. 32) molecula per cell.There were significant differences among three groups (all P0.05). Conclusions CD64 expression increases in bacterium infection disease. It is more obvious in widespread infection desease.and it can be the mark in early diagnosis of neonatal infection disease.