2.Surgical indications of polypoid lesions of the gallbladder:a clinical analysis of 33 1 cases in Xinjiang Uygur Autono-mous Region,China
Journal of Clinical Hepatology 2014;30(11):1144-1147
Objective To explore the clinical characteristics and surgical indications of polypoid lesions of the gallbladder (PLG).Meth-ods The clinical data of 33 1 patients with PLG who underwent surgery in Department of General Surgery from August 2008 to December 2013 were analyzed retrospectively.Comparison of ratios between two groups was analyzed by chi -square test.Results Among the 331 surgical cases,there were 13 cases with adenomatous polyps (3.9%)and 318 cases with non-adenomatous polyps (96.1%).After com-paring the clinical characteristics of the two groups,significant differences were observed in the following parameters:sex (χ2 =6.2,P =0.013),age (≥40/<40)(χ2 =3.90,P =0.048),sizes of polyps (≥10 mm/<10 mm)(χ2 =77.4,P <0.000 1),number of le-sions (multiple/solitary)(χ2 =6.2,P =0.013),PLG basal width (≥6 mm/<6 mm)(χ2 =111.8,P<0.000 1),and presence or absence of concomitant calculi (χ2 =7.5,P =0.006).Conclusion Clinical symptom is considered an indication for surgery.For most of the gallbladder polyps,the risk of malignant transformation is extremely low.Other surgical indications for gallbladder excision include age≥40 years,single polyps measured ≥10 mm in diameter,polyp basal width ≥6 mm,recent rapid polyp growth,and tumor-associated factors such as polyps with calculi.
3.Evaluation of anterior transposition of the inferior oblique muscle with and without resection in the treatment of dissociated vertical deviation
Hui DUAN ; Zhaowen LUO ; Zhihe SUN
Chinese Journal of Postgraduates of Medicine 2011;34(15):23-25
Objective To assess the clinical effect of anterior transposition of the inferior oblique muscle (ATTO) with and without resection in the treatment of dissociated vertical deviation (DVD). Methods Thirty-six patients ( 59 eyes ) with DVD were divided into the standard group ( 30 eyes) and the resection group (29 eyes) by random digits table undertaking ATIO with and without a 7-mm resection. The vertical deviation degree in primary position and the eyeball motility were recorded and evaluated. Results The vertical deviation degree in primary position were 0△-10△ (3.5 △± 2.7△) after 3 months operation in the standard group,while 0△-12△ (3.3△±3.6△) in the resection group. There were no significant differences between two groups (P> 0.05). In the standard group, 2 cases revealed +2 inferior oblique muscle overaction (IOOA), 7 cases revealed +1 and 21 cases revealed 0 after 3 months operation. In the resection group, 1 case revealed +2 IOOA, 4 cases revealed +1 and 24 cases revealed 0 after 3 months operation. There were no significant differences between two groups(P> 0.05 ). The presence or absence of IOOA did not influence the result of ATIO for either group. Conclusions ATIO is an effective treatment for DVD and can be used to treat DVD in patients without IOOA. A 7-mm resection with the standard ATIO has no advantage to improve the surgery outcome.
4.Applications of intravenous balanced propofol sedation with fentanyl in elderly patients during combined gastroscopy and colonoscopy procedures
Qingfeng LUO ; Hongjun DUAN ; Le XU
Chinese Journal of Geriatrics 2012;31(6):488-490
Objective To evaluate the safety of intrvenous balanced propofol sedation with fentanyl in elderly patients during combined gastroscopy and colonoscopy procedures.Methods Totally 877 elderly patients aged (76.4 ± 8.5) years received intravenous propofol and fentanyl sedation during gastroscopy or/and colonoscopy procedures were assigned to groups:294 cases with only gastroscopy,257 cases with only colonoscopy and 326 cases with combined gastroscopy and colonoscopy.50 g Fentanyl and 0.5-1.0 mg/kg propofol were intravenously administered in the patients.The peripheral oxygen saturation,arterial pressure and heart rate were monitored and recorded during procedures.Results There were no procedure-related perforations and sedationassociated severe complications and mortalities,and no one need stop endoscopy procedures in all the patients.The average dosage of propofol in combined,gastroscopy and colonoscopy groups were (100.4±38.5) mg,(130.4±50.5)mg and (170.3± 60.3)mg,respectively.There were no significant differences in heart rate,arterial pressure and rate of cardiovascular events among groups (P>0.05).The rate of respiration events in the above groups were 9 cases(3.1%),6 cases(2.3%)and 13 cases(4.0%),respectively (P>0.05).Decrease of peripheral oxygen saturation was mainly induced by the aspiration of oral secretions and snoring.Conclusions Intravenous balanced propofol sedation provides safe and effective sedation in the elderly undergoing combined gastroscopy and colonoscopy.
5.Laparoscopic total mesorectal excision for low rectal cancer of 126 cases
Jian ZHANG ; Chengyu LUO ; Yufei DUAN
Clinical Medicine of China 2012;28(4):429-431
Objective To study the feasibility of laparoscopic total mesorectal excision(TME) for low rectal cancer.Methods Laparoscopic total mesorectal excision was performed in 126 patients with low rectal cancer according to TME principle.Results The operation time was 95 - 180 min,with an average time of ( 117 ± 21 ) min,the amount of bleeding 50 - 200 ml,with an average amount of (90 ± 27 ) ml.2 - 3 days after surgery,gastrointestinal function was restored.Hospital stay was 6 - 14 days,with an average of (8 ± 2)days.Four cases converted to open surgery,the conversion rate for laparotomy was 3.2%.The proportion of sphincter-preserving operation was 95.24% (120/126).No instant or delayed injury of ureters,large bleeding in front of sacrum and other operation-related severe complications happened intra-and after operation.Conclusion Laparoscopic surgery for low rectal cancer is safe and feasible.
6.Investigation of the state of health and family function of the elderly in the pension institutions and its relativity analysis
Wuchun LUO ; Yinhua SU ; Gongxiang DUAN
Chinese Journal of Practical Nursing 2010;26(8):20-23
Objective To know about the state of the elderly' health and their family function and their relationship in the pension institutions so as to provide the basis of promoting the eldedy' health status for the nurses in the pension institutions.Methods Two hundred and sixty elderly were investigated according to their perceived health status and family function with self-rated health measurement scale and APGER in the pension institutions in Hengyang city,and data were analyzed.Results The average selfrated health score of the elderly in pension institutions was (243.95±64.13),accounted for 55.44% of the total.The score of family function was (5.64±2.57),accounted for 56.40% of the total.The score of dimensions of family function was positively correlated with the total score of self-rated health score,mental health and social health.Conclusions The total score of self-rated health score of the elderly in pension institutions is a little lower.A majority of the elderly has different levels of family function disorder,the effect of family function on the elderly' s mental health and social health is bigger than that of the elderly' s physical health.
7.Effects of Jinzhuyalong Ershiwuwei coral capsule on PLA2 in degenarated cervical intervertebral discs
Yan JIAO ; Hong DUAN ; Xiaoyang LUO
International Journal of Traditional Chinese Medicine 2013;(7):610-612
Objective To study the anti-inflammation mechanism of Jinzhuyalong Ershiwuwei coral capsule on cervical spondylosis by investigating Jinzhuyalong Ershiwuwei coral capsule on PLA2 in degenerated cervical intervertebral discs.Methods 60SD rats (SPF) were divided into a control group (15),a medicine model control group (15),a medicine modle 1 group (15),and a medicine model 2 group (15) by random lottery; Medicine model 1,2 groups were given Jinzhuyalong Ershiwuwei coral capsule powder 0.33 × 5 g/kg 0.66×5 g/kg,and added 1 ml distilled water dilution lavage,l/d,90 d,The unbalance of power cervical spondylosis animal models were chosen and C4~5 neck intervertebral discs were taken after 90 days.Millipore colorimetry methods were used to measure PLA2 activity in C4~5 cervical intervertebral discs.Results The PLA2 activity of the cervical intervertebral disc (12.37 ± 4.21) IU/mg · min-1 in the model group was significantly higher than the control group(2.56± 1.19)IU/mg· min-1 (P<0.05).The cervical intervertebral disc PLA2 activity of medicine model group 1 (8.56± 2.13)IU/mg · min-1 and medicine model group 2 (5.58 ±2.39)IU/mg· min-1 was lower than the model control group(12.37±4.21)IU/mg· min-1,with significant differences (both P<0.01).Conclusion Jinzhuyalong Ershiwuwei coral capsule could down regulate PLA2 activity in degenerated cervical intervertebral discs,and also decrease the production of some inflammaroty mediators.
8.Clinical application and new progress of optical coherence tomography in detecting lamina cribrosa structure
Haomin LUO ; Dengming ZHOU ; Xuanchu DUAN
Chinese Journal of Ocular Fundus Diseases 2021;37(2):153-157
The lamina cribrosa (LC) is a complicated collagenous meshwork of trabeculae and laminar pores contain capillaries, nerves and neurogliocytes, which provides structural and nutrient support to the retinal ganglion cell axons as they exit the eye. The intraocular pressure causes direct damage or deformation and remodeling of LC, leads to axoplaxmic transport and blood supply disturbance. The preponderance of evidence suggests that LC is the principal site of glaucomatous damage. The development of optic coherence tomography (OCT) technology has improved the imaging quality of deep structures of the optic nerve head and makes it possible to detect LC. The quantitative research indexes of LC structure include LC depth, laminar curvature, laminar thickness, prelaminar tissue, laminar pore, laminar defect and hemodynamics. To improve the understanding of LC structure, explore the characteristics of LC and understand the biomechanical and hemodynamic pathogenesis of glaucoma, which would be contribute to the application of big data research in the diagnosis and treatment of glaucoma.
9.Effect analysis of cataract surgery with transparent corneal incision in different direction by dual channel vision quality system
Jian CHEN ; Linghui LUO ; Guoping DUAN
Recent Advances in Ophthalmology 2017;37(3):251-254
Objective To investigate the effects of cataract surgery with transparent corneal incision in different directions,and discuss the application of dual channel visual quality analysis system in the evaluation of visual quality before and after cataract surgery.Methods Sixty-four patients (64 eyes) with cataract phacoemulsification combined with intraocuiar lens (IOL) implantation were enrolled in our hospital from January to May in 2016,and randomly divided into 2 groups:Group A with corneal incision in the temporal side of the eyes,group B with upper corneal incision.All the cases were examined with standard logarithmic optical acuity and dual-channel optical quality analysis system.The visual acuity,MTF cutoff,Strehl ratio (SR),objective scattering index (OSI) and contrast ratio were compared between the two groups.The OQAS values were 100%,20% and 9%.Results (1) The visual acuity and corrected visual acuity of all patients increased gradually from postoperative 1 day to 1 week (P <0.05),and the visual acuity gradually stabilized after 1 week.The uncorrected visual acuity and corrected visual acuity at postoperative 1 day and 1 week in group A were significantly higher than those in group B at the same time point(P < 0.05).There was no significant difference in uncorrected visual acuity and corrected visual acuity between the two groups at postoperative 1 month and 3 months (P > 0.05).(2) At postoperative 1 day and 1 week,the OSI values of two groups were higher than those before operation,and all the time points were statistically significant (all P < 0.05).The OSI values of group A at postoperative 1 day(2.81 ±0.89) and 1 week(1.98 ±0.73) were significantly lower than those of group B at 1 day(3.46 ± 1.17) and 1 week(2.61 ± 1.20) (all P < 0.05).There was no significant difference in OSI between postoperative 1 month and 3 months (all P > 0.05).The OV9% values of the two groups were increased at postoperative 1 day,1 week,1 month and 3 months,and all the time points were statistically significant(all P<0.05).The value of OV9% in group A at postoperative 1 day(0.29 ±0.09),1 week(0.33 ±0.12),1 month (0.37 ± 0.14) and 3 months (0.42 ± 0.17) were significantly higher than those in group B at 1 day (0.24 ± 0.10),1 week (0.27 ± 0.09),1 month (0.31 ± 0.09) and 3 months (0.34 ± 0.14),which was statistically significant (all P < 0.05).The MTF,SR,OV100% and OV20% values of all the patients were not statistically significant (all P > 0.05).Conclusion In the operation of cataract with the temporal and transparent corneal incision,the postoperative intraocular scattering is small,early visual recovery is fast and the visual quality is high.The long-term effect needs further study.Dual channel visual quality analysis system can further quantify the visual quality parameters,has certain advantage in visual quality assessment.
10.The diagnosis and treatment of 65 patients with abdominal aortic aneurysm
Zhiquan DUAN ; Yingwei LUO ; Qiang ZHANG
Chinese Journal of General Surgery 2000;0(11):-
Objective To summarize our experience of the diagnosis and treatment in patients with abdominal aortic aneurysm(AAA).[WT5”HZ]Methods [WT5”BZ]From 1980 to 1999 sixty five AAA patients were hospitalized with 40 cases of general type, 18 cases of rupture type,4 cases of inflammatory type and 3 cases of infective type. In situ artificial graft transplantation was performed in 62 cases and nonanatomy pathway in 2 cases. The remaining one with inflammatory type was treated by interventionel therapy.[WT5”HZ]Results [WT5”BZ]57 cases were cured and were followed up from 1 to 12 years without complications.Death occurred in 7 cases.[WT5”HZ]Conclusions [WT5”BZ]The abdominal pulsate mass should draw much attention. Ultrasound is the selected examination and DSA, helix CT are accurate image appliance. It can elevate the curative ratio and decrease the mortality through rational operation based on the location, type and individual condition of AAA patients.