Objective:To compare the effect of midcaudal combined approach and the cephalic middle approach in laparoscopic complete mesocolic excision (CME) in the treatment of right colon cancer complicated with incomplete intestinal obstruction.Methods:From January 2014 to January 2019, 90 patients with right colon cancer complicated with incomplete intestinal obstruction admitted to the Third People′s Hospital of Dalian were retrospectively analyzed.All patients underwent laparoscopic right hemicolectomy, CME plus D3 lymph node dissection.According to the choice of different surgical approaches, 44 patients were treated with the midcaudal combined approach (observation group) and the other 46 patients were treated with cephalic middle approach (control group). The intraoperative, postoperative and complications of the two groups were compared statistically.Results:Compared with the control group, the bleeding volume in the observation group was significantly reduced ((105.3±22.6) ml vs.(309.6±28.0) ml, t=13.698), the operation time was significantly shortened ((165.2±17.9) min vs.(219.5±21.5) min, t=8.327), and the differences were statistically significant (all P<0.05). There were no significant differences in the number of lymph nodes dissected ((21.4±7.8)vs.(20.4±6.6), t=0.534), the proportion of lymph nodes dissected≥12(86.4%(38/44)vs.84.8%(39/46), χ 2=0.208), the complications after operation(6.8%(3/44)vs.10.9%(5/46), χ 2=0.318), the length of hospital stay after operation ((11.8±1.6) d vs.(12.5±2.3) d, t=0.986), the difference was statistically significant (all P>0.05). Conclusion:It is safe and feasible to use the middle caudal approach in laparoscopic CME for right colon cancer complicated with incomplete ileus. Compared with the cephalic middle approach, it can reduce thebleeding volume and shorten the operation time.

Objective To investigate surgical interventions for periprosthetic joint infection (PJI) after total knee arthroplasty and characteristics of prognosis.Methods Sixty-two patients with PJI after total knee arthroplasty from January 2000 to November 2016 were reviewed retrospectively,included with 17 males and 45 females.The mean age was 66.0± 10.2 years old (37-85).Fourty-nine patients were diagnosed with osteoarthritis,9 with rheumatoid arthritis,2 with secondary ankyloses after suppurative arthritis and 2 with hemophilia arthritis.Forty-one patients underwent unilateral total knee arthroplasties,and 21 bilateral total knee arthroplasties.Characteristics of PJI,including infection types,existence of sinus tract,infectious pathogen,surgical intervention and patients' prognosis,were collected.Results Twenty-four patients underwent open debridement with prothesis retention.In the 14 successful cases,medial time interval between primary total knee arthroplasty and debridement was 33 days.One case of positive Methicillin resistant Staphylococcus aureus culture of joint aspiration,and 1 case formed sinus tract.In 10 cases of failed debridement,the medial time interval was 270 d.Intra-articular culture presented 4 cases of antibiotic resistant bacteria,and 6 cases formed sinus tract.Except for one patient gave up treatment and another received arthrodesis,the other 8 failed cases were all treated with revisions.In 46 revisions,nine patients underwent one-stage revisions.The mean time interval between primary total knee arthroplasty and revision was 15.9± 14.5 d.Intra-articular culture presented 3 cases of antibiotic resistant bacteria,and 1 case formed sinus tract.In the other 37 two-stage revisions,the mean time interval was 1 045.7±1 044.1 d.Intra-articular culture showed 15 cases of antibiotic resistant bacteria,and 12 cases formed sinus tract.The mean follow-up duration was 73.9±48.2 months.At the last follow-up,all patients were free of antibiotics treatment.The mean Knee Society Score (KSS) was 85.9±4.3 after successful open debridement with prothesis retention.The KSS of one-stage revision patients was 78.5±3.3,while that of two stage revision patients was 65.7±7.4.Statistical difference was found among groups (P＜0.05).Conclusion For PJI within 3 weeks after total knee arthroplasty without sinus tract or intra-articular culture of antibiotic resistant bacteria,open debridement with prosthesis retention could be recommended.One stage revision could be applied in infectious cases which appeared between 3 weeks to 1 month after primary surgery or in cases with unstable prostheses found in open debridement.For infectious cases longer than 1 month after primary procedure or those with sinus tract,severe soft tissue deficiency,intra-articular culture of antibiotic resistant bacteria,two-stage revision could be recommended.

OBJECTIVETo explore the psychometric performances and applicability of SF-36v2 in assessment quality of life among urban residents in Chengdu.

METHODSDuring Oct. to Dec., 2012, 2 186 adult urban residents with clear mind and well self-express were recruited in the study by multistage stratified cluster sampling method in Chengdu urban area. The survey questionnaires included general health condition and quality of life, which was adopted the SF-36v2. Internal consistency reliability, test-retest reliability and construct validity were all analyzed as indicators of the psychometric performance.

RESULTSThe survey released 2 186 questionnaires, with 2 182 ones returned and 2 178(99.8%) met the data standard. The scores of 8 scales in SF-36v2, including physical function (PF), role-physical (RP), bodily pain (BP), general health (GH), vitality (VT), social function (SF), role-emotion (RE) and mental health (MH), were 89.15 ± 17.56, 85.18 ± 22.52, 76.64 ± 17.80, 64.13 ± 19.56, 70.39 ± 17.31, 86.43 ± 17.35, 87.79 ± 19.24 and 80.61 ± 13.49, respectively; the floor effects were 0.28%, 0.41%, 0.23%, 0.28%, 0.09%, 0.05%, 0.14% and 0.23%, respectively; and the ceiling effects were 51.38%, 60.60%, 58.08%, 0.83%, 2.94%, 50.32%, 64.00% and 3.95%, respectively. The item-convergent validities were all achieved the standard (r = 0.40) except the item MH5 (Have you been happy?), and the total scaling success rate of item-convergent validity was 97.14%. The scales' success rates of item-discriminant validities for the SF, VT and MH scales were 93.75%, 56.25% and 97.50% respectively, while the rates of others were 100.00% and the total success rate was 96.43%. The internal reliability ranged from 0.724 to 0.974 across all the scales, except for SF (r = 0.603) and VT (r = 0.697). The two-week test-retest reliability ranged from 0.610 to 0.845. Within factor analysis, two common factors were confirmed, separately representing physical health and mental health, altogether contributing 64.4% of the total variance.

CONCLUSIONAs a revised version of SF-36v1, the SF-36v2 seemed to be more preferable in layout for questions and answers and could reduce the ceiling and floor effect. Additionally, it also showed comparatively well reliability and validity. And thereby we believed the SF-36v2 could be applied to assess the life quality among urban residents in Chengdu.

Adult ; China ; Data Collection ; Factor Analysis, Statistical ; Health Surveys ; Humans ; Psychometrics ; Quality of Life ; Reproducibility of Results ; Research Design ; Surveys and Questionnaires ; Urban Population