OBJECTIVETo explore the efficacy of Ruiyun procedure for hemorrhoids (RPH) combined with Xiaozhiling injection in the treatment of hemorrhoids complicated with human immunodeficiency virus (HIV) infection and its influence on cellular immune function.

METHODSClinical data of 76 hemorrhoid patients, including 36 positive HIV and 40 negative HIV, undergoing RPH combined with Xiaozhiling injections in our center from January 2010 to December 2012 were retrospectively analyzed. Clinical efficacy and cellular immune function preoperative day 1, postoperative day 7, 30 were compared between positive and negative groups.

RESULTSRecurrence rates of positive group and negative group postoperative 6 months were 22.2% (8/36) and 22.5% (9/40), postoperative 1 year were 30.6% (11/36) and 30.0% (12/40) without significant differences (all P>0.05). Morbidity of postoperative complication was also not significantly different between two groups (P>0.05). According to HIV classification, peripheral lymph cell ratio, CD4 count, CD4/CD8, white blood cell count and neutrophil ratio were not significantly different between preoperative day 1 and postoperative day 7 in both groups (all P>0.05). Decreasing velocity and amplitude of CD4 in both groups from high to low was HIV III, HIV II, HIV I, HIV-, while after 30 days the increase of CD4 from high to low was HIV-, HIV I, HIV II, HIV III, which were significantly different as compared to postoperative day 7 (all P<0.05).

CONCLUSIONSRPH combined with Xiaozhiling injection in the treatment of hemorrhoids complicated with HIV infection is effective and safe. Postoperative inhibited cellular immune function can recover quickly.

CD4 Lymphocyte Count ; HIV Infections ; complications ; Hemorrhoids ; drug therapy ; surgery ; Humans ; Postoperative Complications ; Recurrence ; Retrospective Studies

BACKGROUND: When managing patients who require repeated venous access, gaining a viable intravenous route has been problematic. To improve the situation, various studies on techniques for venous access have been conducted. The aim of this study is to evaluate the clinical results of complications following totally implanted central venous access port (TICVAP) insertion. METHODS: A retrospective analysis was conducted on 163 patients, from December 2008 to March 2013. The occurrence of complications was studied in three separate periods of catheter use: the intraoperative period, postoperative period, and period during the treatment. RESULTS: A total of 165 cases of TICVAP insertions involving 156 patients were included in the final analysis. There were 35 complications (21%) overall. Among these, 31 cases of complications (19%) occurred during the treatment period and the other 4 cases were intraoperative and postoperative complications (2%). There were no statistically significant differences in age and gender of the patients between the two groups to be risk factors (p=0.147, p=0.08). Past history of chemotherapy, initial laboratory findings, and the locations of TICVAP insertion also showed no statistical significance as risk factors (p>0.05). CONCLUSION: Because the majority of complications occurred after port placement and during treatment, meticulous care and management and appropriate education are necessary when using TICVAPs.
Catheters ; Chemotherapy, Adjuvant ; Drug Therapy ; Education ; Humans ; Intraoperative Complications ; Intraoperative Period ; Postoperative Complications ; Postoperative Period ; Retrospective Studies* ; Risk Factors

OBJECTIVETo investigate the clinical effect and safety of somatostatin in the treatment of postoperative gastrointestinal bleeding in neonates.

METHODSA prospective randomized study was performed, and 126 neonates who underwent surgery for congenital gastrointestinal anomalies were randomly divided into control group, treatment group A, and treatment group B. The neonates in the control group were given routine postoperative hemostasis, and those in the treatment groups were given somatostatin in addition to the treatment for the control group. The neonates in treatment group A were given intravenous injection of somatostatin 0.25 mg as the initial dose and 0.25 mg/h for maintenance, and those in treatment group B were given continuous intravenous pumping of somatostatin at a dose of 3.5 μg/(kg·h). The clinical outcome and complications were compared between the three groups.

RESULTSCompared with the control group, the treatment groups had significantly shortened clearance time in occult blood test for gastrointestinal decompression drainage and a significantly lower degree of the reduction in 24-hour hemoglobin (P<0.05), while there were no significant differences between treatment groups A and B. Compared with the control group, treatment group A had significant reductions in heart rate (HR), respiratory rate (RR), blood pressure (BP), and SaO2 after one hour of treatment (P<0.05 ), but there were no significant differences at the other time points between the two groups (P>0.05). There were no significant differences in monitoring indices between the control group and treatment group B (P>0.05). No neonates in the control group experienced hypoglycemia reaction, and treatment group A had a significantly higher incidence rate of hypoglycemia (20%) than treatment group B (P<0.05).

CONCLUSIONSSomatostatin has a marked clinical effect and good safety in the treatment of neonates with postoperative gastrointestinal bleeding, and the administration of somatostatin by continuous intravenous pumping leads to fewer side effects.

Female ; Gastrointestinal Hemorrhage ; drug therapy ; Humans ; Infant, Newborn ; Male ; Postoperative Complications ; drug therapy ; Prospective Studies ; Somatostatin ; adverse effects ; therapeutic use

OBJECTIVETo study the mechanism of treatment of post liposuction seroma with Staphylococcal enterotoxin C injection.

METHODS64 cases with post liposuction seroma were treated with Staphylococcal enterotoxin C injection or routine procedures. The exudate of those patients was collected to analyze the ratio, pH value, cell species and numbers, and the value of TP, ALP, LDH, AST, ALT, gamma-GT, ADA, ApoB, TC.

RESULTSThe ratio, numbers of lymphocyte and mesothelial cells and TP, LDH, ADA, TC value in exudate in Staphylococcal enterotoxin C group were significantly higher than those in control group.

CONCLUSIONSThe effect of Staphylococcal enterotoxin C injection on the exudate of seroma may be related to the non-inflammation reaction.

Enterotoxins ; therapeutic use ; Female ; Humans ; Lipectomy ; adverse effects ; Postoperative Complications ; drug therapy ; metabolism ; Seroma ; drug therapy ; etiology ; metabolism

Percutaneous coronary intervention has been the main effective method for coronary heart disease recently, but the post-operative complications became the main factors to limit its curative effect. Considering the understanding on traditional Chinese medicine (TCM) syndromes of post-interventional therapy and the advance of pharmaceutical research we suggest that evolution law of TCM syndrome types should be hold intensively and practical therapies and formulae should be established under the guidance of TCM basic theory.
Animals ; Coronary Disease ; drug therapy ; surgery ; Humans ; Medicine, Chinese Traditional ; methods ; Postoperative Complications ; drug therapy ; etiology ; pathology

OBJECTIVETo systematically evaluate the efficacy and safety of preoperative administration of cyclooxygenase-2 (COX-2) inhibitor on pain occurring with total knee arthroplasty (TKA).

METHODSWe electronically searched PubMed, Cochrane Library, EMBASE, CNKI, CBM, Wanfang data from inception to March 15, 2014 and manual searched journal of library collection to identify randomized controlled trials (RCTs) about preoperative administration of COX-2 inhibitor on pain occurring with TKA. The methodological quality of the included RCTs was assessed and the data were extracted according to the Cochrane Handbook 5.1.0. Meta-analysis was performed by using RevMan 5.2 software.

RESULTSA total of 6 RCTs involving 228 patients were included. The results of meta-analyses showed that: (1) Efficacy: The visual analog scale (VAS) of post-operation at 12-hour (WMD = -0.60, 95% CI -0.83 to -0.37, P < 0.000 01) and 24-hour (WMD = -0.74, 95% CI -1.29 to - 0.19, P = 0.008) was decreased when COX-2 inhibitor was used before operation. And compared with control group, experimental group decreased the modified numerical pain rating scale (MNPRS) at 24-hour (WMD = -0.50, 95% CI -0.70 to -0.30, P < 0.000 01), 48-hour (WMD = -0.55,95% CI -0.65 to -0.45,P < 0.000 01) under quiescent conditions, and the same result at 24-hour (WMD = -0.82, 95% CI -1.26 to -0.38, P <0.000 01), 48-hour (WMD = -0.71, 95% CI -0.82 to -0.60, P < 0.000 01) under active conditions. The morphine consumption postoperatively were fewer in experimental group at the first day (WMD = - 1.35, 95% CI -1.92 to -0.79, P < 0.000 01) and the second day (WMD = -1.60, 95% CI -2.68 to -0.52, P = 0.004). (2) Safety: COX-2 inhibitor could lessen the incidence of postoperative pruritus (RR = 0.35, 95% CI 0.15 to 0.84, P = 0.02), but not statistically decrease of nausea and vomiting (RR = 0.83, 95% CI 0.54 to 1.28, P = 0.40) and exhaustion (RR = 0.63, 95% CI 0.05 to 7.67, P = 0.72).

CONCLUSIONThe current evidence indicated that preoperative administration of COX-2inhibitor can effectively improve the effect of postoperative analgesia, reduce the consumption of morphine and lessen the incidence of pruritus. Due to the limited quantity of the included studies and the evidence with limited strength,further high-quality RCTs are needed to verify the aforementioned conclusion.

Arthroplasty, Replacement, Knee ; Cyclooxygenase 2 Inhibitors ; therapeutic use ; Humans ; Pain, Postoperative ; drug therapy ; Postoperative Complications ; prevention & control ; Pruritus ; prevention & control

We report on nine years experience of surgical treatment of mediastinal tumors in 47 patients. Their ages ranged from 5 to 67 years with an average of 36.4 years and the sex ratio of male and female was 1:1.5. The most frequent symptom was chest pain(27.7%), followed by ptosis(14.9%), general weakness(12.8%) and eight patients(17.0%) were asymptomatic. The most prevalent location of the tumor was anterosuperior mediastinum(63.8%). Pathologically, thymoma(32.9%) was the most common tumor, followed by cyst(21.3%), neurogenic tumor(17.0%), germ cell tumor(12.8%), and mesenchymal tumor(6.4%). Complete removal was achieved in 41 cases of all benign tumors and 3 cases of malignant tumors. All the malignant tumor patients were treated with chemotherapy, radiotherapy or both after surgery. Postoperative complications developed in 4 cases and there was no operative death.
Drug Therapy ; Female ; Germ Cells ; Humans ; Male ; Mediastinal Neoplasms ; Postoperative Complications ; Radiotherapy ; Sex Ratio ; Thorax

PURPOSE: To assess the efficacy and toxicity of the preoperative radiotherapy with or without chemotherapy in locally advanced rectal cancer. METHODS: Forty three Patients (clinically diagnosed stages above or equal to Astler-Coller stage B2 without distant metastasis) were assigned to preoperative radiotherapy alone arm (n=16) or combined preoperative radiotherapy and chemotherapy arm (n=27). Preoperative radiotherapy of 4500 cGy to whole pelvis +/- 540 cGy boost to primary site and concurrent chemotherapy of 2 cycles of 5-FU (500 mg/m2) and leucovorin (20 mg/m2) were used. Fifteen patients of preoperative radiotherapy alone arm and 19 of combined arm received surgical resection after preoperative treatment. RESULTS: During the preoperative treatment, no significant complication was developed in both groups. Pathologic results were as follows; complete remission 1, B1 1, B2 6, C1 2, C2 5 in preoperative radiotherapy alone arm and complete remission 2, B1 8, B2 4, C2 3 D2 in combined arm. Postoperative complications were delayed perineal would healing in three patients, intestinal obstruction in three patients (one managed by conservative medical treatment, two by surgical treatment). CONCLUSION: The combined preoperative radiotherapy and chemotherapy arm was more effective in pathological response and lymph node negativity rate that the preoperative radiotherapy alone arm. Both the preoperative radiotherapy alone arm and the combined arm were generally well tolerated and did not result in an increased postoperative morbidity.
Arm ; Drug Therapy* ; Fluorouracil ; Humans ; Intestinal Obstruction ; Leucovorin ; Lymph Nodes ; Pelvis ; Postoperative Complications ; Radiotherapy* ; Rectal Neoplasms*

PURPOSE: More than half the Korean gastric cancer patients are diagnosed at a late stage. An understanding of the clinicopathological characteristics of advanced cases is warranted, especially in order to give tailor-made treatments. METHODS: Ninety-five Borrmann type 4 gastric cancer patients, who received surgical treatment at the Department of Surgery, Hanyang University Hospital during the period between June 1992 and December 2001, were enrolled in this study. Several clinicopathological profiles of these Borrmann type 4 gastric cancers were compared to those of Borrmann types 1, 2, and 3. Thereafter, univariate and multivariate survival analyses on the type 4 were performed. RESULTS: Compared to the other macroscopic types, Borrmann type 4 gastric cancer patients showed several significant features: as for clinicopathological factors; there was a prominence of female, young-aged patients, a larger tumor size, higher rates of entire stomach cancer and late stage cases, and as for treatment-related factors; there was a higher rate of non-resection cases, combined organ resections, positive marginal state, non-curatively treated case, and more postoperative complications. The prognosis of Borrmann type 4 gastric cancer was found to differ according to the type of operation, depth of invasion, nodal status, distant metastasis, and curability (P=0.0000) from the univariate survival analysis. No independent prognostic factor was found from the multivariate survival analysis. CONCLUSION: The majority of Borrmann type 4 gastric cancer are diagnosed at a late stage, which results in a poor prognosis. To improve the curability of the operation, combined organ resection should be considered, when feasible. There were no long-term survivors in the cases with peritoneal seeding or malignant ascites. It is for these cases that we have to exert our efforts, in order to improve their QOL, but not from over-surgery or intensive chemotherapy.
Ascites ; Drug Therapy ; Female ; Humans ; Neoplasm Metastasis ; Postoperative Complications ; Prognosis ; Stomach Neoplasms* ; Survivors

OBJECTIVETo explore the safety and efficacy of Shaobei injection in the management of I(-II( degree rectal prolapse.

METHODSA total of 80 patients eligible for the inclusion criteria were divided into 2 groups: 40 patients in the treatment group (treated with Shaobei injection) and 40 cases in the control group (treated with Xiaozhiling) respectively. The short-term efficacy was identified by the length of rectal prolapse and the depth of rectocele demonstrated by the defecography while the long-term efficacy was evaluated by the length of rectal prolapse. In addition, the safety was assessed by the occurrence of postoperative complications.

RESULTSThe variation of the lengths of rectal prolapse and the depth of rectocele demonstrated by the defecography at the sixth month follow up in the two groups did not reach significant difference (P>0.05). After 2 year follow up, 37 patients (92.5%) in the treatment group and 35 cases(87.5%) in the control group was cured. Therefore, there was no significant difference in the long term efficacy between the two groups (P>0.05). The adverse events in the therapy group(10%) was less than that in the control group (45%)(P<0.01).

CONCLUSIONSShaobei injection in the management of I(-II( degree rectal prolapse has a similar efficacy of short-term and long-term higher safety compared to Xiaozhiling injection.

Defecography ; Female ; Humans ; Injections ; Postoperative Complications ; Rectal Prolapse ; drug therapy ; Rectocele