1.Diagnosis and treatment of intestinal lipoma
Chinese Journal of General Surgery 2001;0(09):-
Objective To analyze the main clinical manifestations of intestinal lipoma and discuss the treatment of intestinal lipoma.Methods The clinical data of 19 patients with intestinal lipoma treated in our hospital in recent 15 years were analyzed retrospectively.CT,ultrasonography,and colonoscopy were used in diagnosis.Local intestinal resection by laparoscopy and laparotomy were employde.Results Intestinal lipoma presented with a variety of symptoms including intestinal bleeding,abdominal pain,anemia,intussusception,and bowel obstruction.In 17 of the intestinal lipoma patients,the main clinical manifestations were change of bowel habits,abdominal pain and bloody stool;13 of them had intestinal intussusception or obstruction,and two patients were asymptomatic.Sixteen patients underwent colonoscopy,and seven of them were correctly diagnosed.Seventeen patients received surgical resection and recovered.The diameter of mass was 3-6.5 cm.The pathologic exam showed submucosal lipoma in 12 cases,two cases showed ulcer formation with erosion,2 cases had intermural lipoma and one case had atypical lipoma with potential malignant transformation.Two asymptomatic patients diagnosed by colonoscopic biopsy werre only followed up at regular intervals.Conclusions Imaging diagnosis and colonoscopy are helpful in the preoperative diagnosis of intestinal lipoma.The method of treatment is based on the size of the tumor and presence or absence of pedicle.Endoscopic electrosection is often used for tumor mass less than 3 cm in diameter,otherwise local intestinal resection is the treatment of chocie.
2.Application of inferior temporal muscle bone flap craniotomy in hypertensive cerebral hemorrhage patients with early hernia
Xiaoguo HUANG ; Qing XU ; Xiangjing MENG
Clinical Medicine of China 2016;32(8):701-703
Objective To explore the therapeutic effects of two kinds of operation mode of inferior temporal muscle bone flap craniotomy and traditional big bone flap craniotomy in treatment of hypertensive cerebral hemorrhage patients with early cerebral hernia?Methods Sixty?four cases patients of hypertensive cerebral hemorrhage with early cerebral hernia,treated in Huxi Hospital Affiliated to Jining Medical College from January 2011 to January 2015 were randomly divided into observation group ( 32 patients underwent temporal muscle bone flap craniotomy) and control group ( 32 patients underwent traditional big bone flap craniotomy)?The incidence rate of complications,mortality within 3 months,the excellent rate of GOS score on 6 months after the onset were compared?Results The mortality rate of 3 months after operation in the observation group was 9?4%( 3/32) ,in the control group was 12?5%( 4/32) ,the difference between the two groups was not significant (χ2=0?00(correction),P>0?05))?There were 7 cases had severe complications in the observation group,the incidence rate was 21?9%( 7/32 );there were 16 patients had serious complications in control group, the incidence rate was 50%( 16/32) ,the difference was statistically significant between the two groups(χ2=5?50,P<0?05)?There were 7 cases recovered well,8 cases were residual,the excellent rate of GOS score was 46?9%( 15/32) in the observation group;there were 4 cases recovered well,3 cases were residual,the excellent rate of GOS score 21?9%( 7/32) in the control group,the difference was statistically significant(χ2=4?27,P<0?05)?Conclusion For patients with hypertensive cerebral hemorrhage in basal ganglia region in the early stage of cerebral hernia,temporal muscle bone flap craniotomy hematoma removal can also effectively relieve the hernia, compared with traditional big bone flap craniotomy, can significantly reduce the incidence of complications, improve the prognosis of the patients.
3.Effects of siRNA targeting DDR2 on hepatic stellate cells
Guanglin ZHANG ; Meng LUO ; Yongwei SUN ; Qing XU ; Wei CHEN
Chinese Journal of General Surgery 2009;24(9):748-751
Objective To explore the effects of inhibiting DDR2 expression by siRNA on hepatic stellate cells and evaluate the role of DDR2 gene in hepatic fibrogenesis. Methods (1) Three pairs of chemically synthesized siRNAs targeting DDR2 were respectively transfected into HSC-T6 cells for evaluation of silence efficacy, and the most effective siRNA was used. (2) HSC-T6 cells were divided into three groups, group A served as normal controls, group B served as negative control and group C was RNA interference DDR2 (siRNA-DDR2) expression of HSC. The most effective RNA interference sequences targeting DDR2 gene was chosen to transfect HSC-T6 cells by plasmid transfection. The tendency of DDR2, α-smooth muscle actin(α-SMA) and collagen-Ⅰ mRNA expression were estimated using RT-PCR, and the protein expression of DDR2 was evaluated by Western blot. Meanwhile, MTT assay was employed to analyze the proliferation of HSC. Results (1) DDR2 siRNA, which began at nt 868, inhibited DDR2 gone expression stronger than the other two siRNAs. (2) After transfection of siRNA-DDR2, the mRNA expression of DDR2 (P<0.01) and α-SMA (P<0.01) significantly decreased compared with the normal group, and the protein expression of DDR2 also significantly decreased (P<0.01). In addition, the proliferation of HSC was also markedly suppressed as compared with the normal group (P<0.01). However, compared with the negative control group, none of them was markedly suppressed. Conclusion SiRNA targeting DDR2 significantly suppresses the activation, proliferation of HSC, and thus attenuates hepatic fibrogonesis in vitro.
5.Influence of lower limb movements on setup errors in radiotherapy for rectal cancer using kilovoltage cone-beam CT (KV-CBCT)
Yiran MENG ; Qing XU ; Zhen ZHANG ; Min GONG ; Jun REN
Chinese Journal of Radiation Oncology 2016;25(9):955-958
Objective To investigate the influence of fixation of both lower limbs with negative pressure vacuum cushion and fixation of both ankles with self-made foam mat on setup errors in radiotherapy for rectal cancer.Methods A total of 12 patients with rectal cancer were enrolled in 2014 and randomly divided into group A (using negative pressure vacuum cushion) and group B (using self-made foam mat).An offline registration analysis was performed for the images of 108 times (A,B group of 54 times) of kilovoltage cone-beam CT (CBCT) before and after treatment.Grey scale translation error registration was used,and the results of registration were analyzed.The setup errors in x-axis (left-right direction),y-axis (cranial-caudal direction),and z-axis (anterior-posterior direction) were compared between the two groups.Results There was no significant difference in the absolute setup error in the y-axis between the two groups (2.13±0.64 mm vs.2.61±1.17 mm,P=0.399),while group A showed significantly lower absolute setup errors in the x-axis and z-axis than group B (x-axis:1.51±0.28 mm vs.2.70±1.05 mm,P=0.039;with an error rate of 7.41% vs.42.59%;z-axis:1.10±0.29 mm vs.2.37±0.71 mm,P=0.002;with an error rate of 1.85% vs.35.19%).Conclusions In the radiotherapy positioning for rectal cancer,fixation of both lower limbs with negative pressure vacuum cushion effectively avoids the translation and rotation of both lower limbs,reduces absolute setup errors,and has higher accuracy than fixation of both ankles with self-made foam mat.
6.Effects of siRNA targeting ADAMTS2 gene on hepatic stellate cells
Zhiqiang SHI ; Meng LUO ; Qing XU ; Wei CHEN ; Hong ZHOU
Chinese Journal of Hepatobiliary Surgery 2012;18(3):205-210
Objective To explore the preventive and therapeutic role of silencing type Ⅰ rat platelet-binding protein motifs depolymerization protein-like metalloproteinase 2(ADAMTS2)by siRNA on experimental liver fibrosis in vitro.By studying the mechanism of siRNA silencing of ADAMTS2,we also aim to evaluate the feasibility of ADAMTS2 as a target for anti-liver fibrosis therapy.Methods Three pairs of siRNAs targeting ADAMTS2 mRNA 2237,2597 and 690 targets were designed and synthesized by utilizing RNA design software.The most effective siRNA was chosen to transfect HSC-T6 cell line to test the tendency of hepatic stellate cell(HSC)activation and ex pression of ADAMTS2,COL1α1,COL(I),α-SMA,TGF-β1,MMP-2 and TIMP-3.These were quantified using real time-PCR,Western blotting,and MTT assays.Results Of the same dosage and time of injection,siRNA 2237 inhibited ADAMTS2 gene expression significantly more than other siRNAs.siRNA-ADAMTS2 2237 markedly inhibited ADAMTS2 gene and protein expression of HSCT6 with more than 80% efficiency.Conversely,siRNA-ADAMTS2 2237 markedly reduced the gene and protein expressions of COL(I),α-SMA and TGF-β1 on HSC-T6 and inhibited the proliferation of HSC.Conclusions siRNA-ADAMTS2 2237 could effectively knockdown the gene and protein expression of ADAMTS2 in HSC-T6 cell lines.Silencing ADAMTS2 by siRNA significantly inhibited the activation,proliferation of HSC and the gene and protein expressions of COL(I),α SMA,and TGF-β1,and it may have a potential anti-fibrotic effect.ADAMTS2 might be an efficient target for anti-fibrotic therapy.
7.The effect of different surgical procedures for cardia carcinoma on postoperative anastomotic stoma complications:a report of 156 cases
Chunhui JIANG ; Lei GU ; Bin ZHANG ; Qing XU ; Meng LUO
Chinese Journal of General Surgery 2000;0(11):-
Objective To investigate the effect of different operations for cardia carcinoma on the postoperative anastomotic stoma complications.Methods Between December,2000 and May,2007,the clinical data 156 patients with carcinoma of gastric cardia who received different operations were analyzed retrospectively.Results The thoracoabdominal incision was performed in 57 cases,abdominal incision in 68 and left thoracic incision in 31 cases.The occurrence rate of anastomotic stoma complications in the patients with thoraco-abdominal,abdominal and left thoracic incision was 7.0%(4/57),7.4%(5/68),and 12.9%(4/31),respectively.The occurrence rate of anastomotic stoma complications in the patients using 25 mm end-end autosuture was 4.2%(4/95),in using of the 28mm autosuture group was 16.1%(P=0.0102).Conclusions The occurrence rate of anastomotic stoma complications can be reduced by choosing correct operation methods and using autosuture correctly.
8.Survey on Psychological Conditions and Quality of Life in Premenopausal Breast Cancer
Lijun MENG ; Yiting LI ; Qing XU ; Fei LIU ; Fubiao HUANG
Chinese Journal of Rehabilitation Theory and Practice 2013;19(8):785-787
Objective To investigate the psychological conditions and the quality of life of premenopausal breast cancer patients. Methods 5 Level-Three Grade-I hospitals in Beijing were selected to conduct outpatient surveys on premenopausal breast cancer patients who returned for further consultation between October 2010 to September 2012. Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) as well as Functional Assessment of Cancer Therapy-Breast (FACT-B) were used. Investigated breast cancer patients were divided into two groups: long-term condition group (more than 3 years after surgery) and short-term condition group (less than 3 years after surgery).Differences between the two groups in SAS, SDS and FACT-B were compared. Results 65 quality questionnaires returned, including 35 from the long-term condition group and 30 from the short-term condition group. The scores of SAS and SDS were significantly lower in the long-term condition group than in the short-term condition group (P<0.001). The scores of FACT-B was significantly higher in the long-term condition group than in the short-term condition group (P<0.001). Conclusion The breast cancer patients more than 3 years after surgery are in better psychological status and quality of life.
9.The evaluation of fetal nasal bone absence at second and third trimester and its relationship with chromosomal abnormalities
Jia, LU ; Hua, MENG ; Yuxin, JIANG ; Qing, DAI ; Zhonghui, XU ; Meng, YANG ; Yunshu, OUYANG ; Yixiu, ZHANG
Chinese Journal of Medical Ultrasound (Electronic Edition) 2014;(6):502-507
Objective To evaluate the ultrasonic characteristics of nasal bone absence at 16-34 weeks of pregnancy referring to fetal chromosomal anomalies. Methods The ultrasonic findings of the 20 fetuses with nasal bone absence at second or third trimester in Peking Union Medical College Hospital were reviewed referring to chromosomal karyotyping and labor induction or birth outcomes. Results The ultrasound features of the 20 fetuses including:(1) There were 17 fetuses showed bilateral nasal bones absence. The sonographic features were absence of hyper echo of nasal bone underneath the skin on either sagittal or transverse section. There were 5 fetuses showed multiple abnormalities:Four fetuses showed cardiac abnormalities (three showed atrioventricular septal defect, one showed ventricular septal defect, one showed ventricular septal defect with abnormal great vessels). One fetus showed duodenal obstruction′double bulbs′. The other minor abnormalities including short femur and humerus, increasing echogenetic bowels, aberrant right subclavian artery, mild unilateral ventriculomegaly, mild renal pelvic ectasia, outreached tongue, abnormal gestures of hands. (2) There were 3 fetuses showed unilateral nasal bone absence. The sonographic features were absence of hyper echo of either nasal bone on transverse section but with hyper echo on sagittal section. Two fetuses showed cardiac abnormalities (one fetus showed atrioventricular septal defect, one showed ventricular septal defect). The other minor abnormalities including short femur and humerus, hyper echogenetic bowels, increasing thickness of nuchal translucency or nuchal fold. Twelve fetuses were induced labor but only one had biopsy showed accordant result with ultrasound. (3) Karyotyping results:there were 9 of trisomy 21, 1 of 4p-and 7 of normal karyotype fetuses showed bilateral nasal bone absence. There were 2 of trisomy 21 and 1 of normal karyotype fetuses showed unilateral nasal bone absence. (4) Birth outcomes and follow-up:twelve fetuses induced labor but only one fetus had biopsy. Eight fetuses were born until term and 5 fetuses showed normal in follow-up. The results of twelve fetuses showed concordant with ultrasonic ifndings. Conclusions Characteristics of the nasal bone absence are absence of bilateral or unilateral nasal bones. If we ifnd nasal bone absence in prenatally ultrasound screening, the karyotyping should be recommended in order to detect chromosomal abnormalities especially trisomy 21.
10.Correlation and regression analysis of placenta volume at 11-13+6 weeks of pregnancy with newborn baby weights, placenta weights and volumes at birth
Jia, LU ; Qing, DAI ; Hua, MENG ; Yuxin, JIANG ; Zhonghui, XU ; Meng, YANG ; Yunshu, OUYANG ; Yixiu, ZHANG
Chinese Journal of Medical Ultrasound (Electronic Edition) 2015;(2):142-147
Objective The aim of the study was to determine the placenta volume (PV) at 11-13+6 weeks of gestation by three-dimensional ultrasound (3DUS) in combination with birth weight, placenta weight, placenta volume at birth and maternal age, body mass index (BMI) additionally. Methods From June 2011 to July 2012, placental volumes were prospectively measured by VOCAL (Virtual Organ Computer-aided Analysis) method in 129 normal pregnancies of Peking Union Medical College Hospital at 11-13+6 weeks of Gestation, multiples of the median was calculated (MOM) after logarithmic10 transformation referring to different crown-rump length (CRL) groups. The normal pregnancies were selected without any combinations or fetal abnormalities, then recorded the birth weights, placenta diameters and thicknesses and placenta weight at delivery. The maternal basic status was also concluded in the study. Results Correlation analysis results: (1) The transformed placenta volume MOM showed a significant correlation (Spearman rho=0.200, P<0.05) with birthweight but not with placenta weight or placenta volume calculated as ellipsoid (Spearman rho=0.164, 0.112 respectively, P>0.05). (2) The birthweight showed significant correlations with placenta weight, placecnta volume and maternal BMI (Spearman rho=0.478, 0.361, 0.259 respectively, P<0.01). (3) The placenta weight at birth showed a significant correlation with placenta volume at birth (Spearman rho=0.467, P<0.01) and maternal BMI (Spearman rho=0.198, P<0.05). Regression analysis results: (1) Birth weight (g)=1136.9+1530.9×MOM+45.3×BMI-15.0×maternal age (r=0.29, P=0.01<0.05). (2) Placenta weight (g)=88.1+315.3×MOM+10.0×BMI+0.1×maternal age (r=0.27, P=0.02 <0.05). Conclusions The placental volume at 11-13+6 weeks of gestation has significant correlation with birthweight. This might assist in the identification of the high risk pregnancies caring large or low for gestational age fetuses.