Objective To approach the effect of prosthetic valve at preventing reflux esophagitis.Methods After the total gastrectomy and esophagojejunostomy,interrupted suture was apphed to form a prosthetic valve at output and input beyond Braun's stoma.Results Only one got light reflux esophagitis in 15 patients.Conclusion Prosthetic valve can prevent reflux esophagitis,and the operation is convenient and safe,which is deserved to be in generalization and approach the latest method.

Objective: To investigate the short term clinical efifcacy of endovascular repair for complicated acute type Stanford B aortic dissection.
Methods: To retrospectively analyze the clinical data of 36 patients with complicated acute type Stanford B aortic dissection who received endovascular repair in our hospital from 2010-01 to 2014-06 including operational procedure and post-operative follow-up of CT angiography. There were 27 male and 9 female patients with the average age of 43.7 years (41-62) years.
Results: Successful operations were conducted in all 36 patients. 22 patients received endovascular repair combined with covering left subclavian artery (LSA),10 received endovascular repair combined with chimney technique, 2 received endovascular repair combined with vascular prosthesis bypass from left common carotid artery to LSA, 2 received endovascular repair combined with vascular prosthesis bypass from right common carotid artery to left common carotid artery, whose proximal parts were ligated. Viscera artery and lower extremity artery supply were restored gradually. No complication of endoleak occurred. There 30/36 (83.33%) patients were followed-up for 1 year, and 10 patients developed thrombus in full false lumen and 20 developed thrombus in partial false lumen after 1 year. Compared with pre-operative values, thoracic aortic true lumen volume increased in either thrombus in full false lumen (190 ± 68.7) ml vs, (125.3 ± 63.4) ml and thrombus in partial false lumen (166.2 ± 71.8) ml vs (110.1 ± 62.7) ml,P<0.001; thoracic aortic false lumen volume decreased (65.0 ± 67.4) ml vs (185.3 ± 66.6) ml and (132.3 ± 62.6) ml vs (224.5 ± 72.3) ml,P<0.001. Compared with pre-operative values, for patients with thrombus in full false lumen, the abdominal aortic true lumen volume increased (55.5 ± 12.4) ml vs (48.6 ± 12.2) ml,P<0.01; for patients with thrombus in partial false lumen, the abdominal aortic false lumen volume also increased (58.2 ± 21.5) ml vs (42.5 ± 18.5) ml,P<0.01.
Conclusion: For endovascular repair of complicated aortic dissection, covering LSA with chimney technique and hybrid operation of small incision could extend anchor zone and expand the range of endovascular repair which may improve the effect and reduce the complication for good short term effect.

With the continuous development of bone tissue engineering, a variety of emerging bone graft materials provided various methods for repairing bone defects. Early and rapid accomplishment of revascularization of materials interior after implantation of bone transplantation materials is a difficulty faced to bone tissue engineering. Blood vessels ingrowth provides the requisite netritional support for the regeneration reconstruction of bone tissue, for this reason, vascularization plays a significant role in bone tissue engineering. However,there is not a golden standard strategy of vascularization at present. Scaffold materials, cells and growth factors still are three indispensable elements in tissue engineering, and are cardinal points of the promoting vascularization strategies. Multiple growth factors or multiple cells combined with scaffolds, which are hot spots, have obtained excellent vascularization. This review focused on the comprehensive strategies for promoting the successful vascularization of tissue engineered scaffolds.
Bone and Bones ; blood supply ; Humans ; Neovascularization, Physiologic ; Tissue Engineering ; methods ; Tissue Scaffolds

Objective To compare the therapeutic effects of locking compression plate distal ulna hook plate (LCP-DUHP) and cannulated screws in the internal fixation for fractures of the fifth metatarsal base at zones Ⅰ and Ⅱ.Methods This retrospective study included 67 patients who had been treated for fractures of the fifth metatarsal base at zones Ⅰ and Ⅱ from July 2013 through December 2015.Of them,29 were treated by internal fixation with cannulated screws,including 17 men and 12 women with an average age of 46.6 years.There were 13 zone Ⅰ fractures and 16 zone Ⅱ fractures according to the Lawrence-Botte partition.The other 38 patients were treated by internal fixation with LCP-DUHP,including 20 men and 18 women with an average age of 33.7 years.There were 20 zone Ⅰ fractures and 18 zone Ⅱ fractures according to the Lawrence-Botte partition.The therapeutic effects were evaluated at the final follow-ups using visual analogue scale (VAS) for the affected feet,American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scoring system,and incidence of postoperative complications.Results All this series were followed up for 51 to 87 weeks (average,57weeks).There were no significant differences between the cannulated screws group and the LCP-DUHP group in terms of fracture healing time (13.9 ± 1.6 weeks versus 14.2 ± 1.8 weeks),VAS scores (4.9 ± 1.3 versus 4.8 ± 1.O) or AOFAS midfoot scores (87.9 ± 3.4 versus 88.6 ± 2.5) (P ＞ 0.05).Bony union was achieved in all.No implant failure was observed in this series.Conclusion Both LCP-DUHP and cannulated screws can lead to satisfactory therapeutic effects in the treatment of fractures of the fifth metatarsal base at zones Ⅰ and Ⅱ.

Objective To explore the impairment of time perception in patients with Parkinson's disease (PD).Method Thirty-two individuals with idiopathic PD were compared with 32 matched healthy controls using a time reproduction task.Result Compared with healthy controls for the 3-second duration reproduction task, PD patients in the setting of a delay by 1 s ( (2.78 ±0.31 ) s and (2.15 ±0.34) s,respectively) and a delay by 5 s ( (2.74 ±0.32) s and (2.08 ±0.37) s, respectively) showed impairment in time perception with a significant under-estimation of the duration ( t = - 7.459, - 7.533, both P ＜0.01 ).When compared with healthy controls for the 5-second duration reproduction task, PD patients in the setting of a delay by 1 s ( (3.99 ±0.39) s and (3.11 ±0.52) s) and 5 s ( (4.05 ±0.40) s and (2.96 ±0.54) s) also showed impairment in time perception with a significant under-estimation of the duration (t =-7.609 and - 9.120, both P ＜ 0.01 ).When compared with healthy controls for the 600-millisecond duration reproduction task, PD patients in the setting of delay by 1 s ((0.91 ±0.18) s and (0.90 ±0.18) s, respectively) and by 5 s ( (0.89 ± 0.16) s and (0.91 ± 0.17 ) s, respectively) did not have impaired time perception, and the difference was not significant ( t = 0.347, P = 0.730; t = - 0.519, P =0.606, respectively).Conclusion Our data indicates that time perception is impaired in PD patients.Impaired time perception is mainly an under-estimation of the time interval in seconds rather than milliseconds.

Objective To evaluate contrast-enhanced endoscopic uhrasonography(CE-EUS)in the differential diagnosis of pancreatic diseases.Methods Eighteen patients with suspected pancreatic neoplasms and chronic pancreatitis,which would be finally affirmed with EUS-FNA or histophathologic examinations,as well as five normal control subjects were enrolled and underwent CE-EUS by using ultrasonic contrast agent(sonovue,Bracco Co.,Italy).Characteristics of enhancement including form,echo and enhanced blood perfusion of the target areas were investigated in normal pancreas and various diseased ones.Results By CE-EUS,five cases of normal pancreatic parenchyma were presented as punctiform or claviform enhancement pattern with homogeneous distribution(type Ⅰ-Ⅱ);while two chronic pancreatitis cases were presented as claviform or plaquelike enhancement pattern with inhomogeneous distributition(type Ⅱ-Ⅲ).In addition,thirteen pancreatic carcinomas were presented as inhomogeneous punctiform or claviform enhancement(typeⅠ-Ⅱ)partially with border enhancement and with slow enter-in and fast wash-out phase.However,three benign insulinomas were presented as holo-plaquelike enhancement(type Ⅲ),and 2 with fast enter-in and fast washout phase.Besides,different enhancement intensity was identified in different diseases.Conclusion CEEUS,from which different enhancement pattern,phase and intensity would be shown in various pancreas,is a safe and feasible imaging modality in the differential diagnosis of pancreatic diseases.

OBJECTIVETo discuss the clinical effects of open reduction and internal fixation (ORIF) for treatment of patients with Lisfranc injury combined the second metatarsal base comminuted fracture.

METHODSFrom March 2007 to June 2012, 7 patients with Lisfranc injury combined the second metatarsal base comminuted fracture were treated including 5 males and 2 female aged from 22 to 51 years old (means 42 years), 4 of sprain and 3 of traffic injury. According Myerson classification, there was 1 case of type A, 3 of type B and 3 of type C. Kirschner wire was used to fix Lisfranc ligament placing from the medial cuneiform bone to the second metatarsal base during the operation. After the operation American Orthopaedic Foot and Ankle Society (AOFAS) criteria system were applied to evaluate the foot and ankle function. Preoperative and postoperative AP, lateral and oblique X-ray and CT scan were collected for radiographic evaluation.

RESULTSAll patients were followed up from 12 to 20 months (16.8 months in average). According to AOFAS criteria system, 3 cases were excellent result,3 good, 1 fair. All the wounds were primary healing without skin necrosis, infection, Kirschner loose,broken, or other complications.

CONCLUSIONKirschner wire had good clinical efficacy for fixing Lisfranc ligament injury with the second metatarsal base comminuted fracture, and could avoid arthrodesis.

Adult ; Bone Wires ; Female ; Humans ; Male ; Metatarsal Bones ; injuries ; surgery ; Middle Aged ; Tarsal Joints ; injuries ; surgery ; Wound Healing

OBJECTIVETo evaluate the effect of capsule endoscopic examination in the diagnosis of vascular malformation of small intestine and discuss the operative method of this disease.

METHODSThe clinical data of 11 cases of vascular malformation of small intestine by the capsule endoscopic diagnosis were analyzed retrospectively.

RESULTSAll of the 11 cases received operation with the assistance of intra-operative endoscopic examination, and 10 cases were confirmed to suffer from vascular malformation of small intestine postoperatively. The methods of operation included dot-resection, wedge-shaped resection and segmental resection.

CONCLUSIONSThe capsule endoscopic examination is optimal for the diagnosis of vascular malformation of small intestine. Dot-resection, wedge-shaped resection and segmental resection with the assistance of intra-operative endoscopic examination for the surgical intervention of this disease are recommendable.

Adult ; Aged ; Arteriovenous Malformations ; complications ; diagnosis ; surgery ; Endoscopy, Gastrointestinal ; methods ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; surgery ; Humans ; Intestine, Small ; blood supply ; Male ; Middle Aged ; Retrospective Studies

Objective To evaluate the accuracy and clinical application of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in diagnosis of occupying lesions in upper digestive tract and its pe-ripheral areas. Methods The data of 64 patients who underwent EUS-FNA for occupying lesions in upper di-gestive tract, between July 2006 and December 2007, were retrospectively analyzed. Results EUS-FNA was successfully performed on 62 patients, with a success rate of 96.88%. The overall diagnostic accuracy, sensi-tivity, specificity, positive predictive value and negative predictive value of EUS-FNA for occupying lesions in upper digestive tract and its peripheral areas were 88.71%, 86.54%, 100.00%, 100.00%, and 58.82%, respectively. There was no significant difference between the foei larger and smaller than 3cm (P > 0.05), re-garding the diagnostic accuracy and average puncture numbers. Diagnostic accuracy of those with real-time cy-tolngical evaluation was significantly higher than those without (P=0.029), and the puncture numbers were less (P=0.001). Among the total 99 punctures, the positive diagnostic accuracy of those with 5ml negative pressure suction was significantly higher than those of 10 ml (P = 0.044). Conclusion EUS-FNA is a safe and applicable approach to diagnosis of occupying lesions in upper digestive tract and its peripheral areas with higher diagnostic accuracy, sensitivity, specificity and positive predictive value. Moreover, the real-time cyto-logical evaluation and adequate negative pressure might facilitate the diagnosis accuracy.

This prospective study was conducted to assess the rate of resolution of second trimester placenta previa in women with anterior placenta and posterior placenta,and that in women with and without previous cesarean section.In this study,placenta previa was defined as a placenta lying within 20 mm of the internal cervical os or overlapping it.We recruited 183 women diagnosed with previa between 20+0 weeks and 25+6 weeks.They were grouped according to their placenta location (anterior or posterior) and history of cesarean section.Comparative analysis was performed on demographic data,resolution rate of previa and pregnancy outcomes between anterior group and posterior group,and on those between cesarean section group and non-cesarean section group.Women with an anterior placenta tended to be advanced in parity (P=0.040) and have increased number of dilatation and curettage (P=0.044).The women in cesarean section group were significantly older (P=0.000) and had more parity (P=0.000),gravidity (P=0.000),and dilatation and curettage (P=0.048) than in non-cesarean section group.Resolution ofprevia at delivery occurred in 87.43％ women in this study.Women with a posterior placenta had a higher rate of resolution (P=0.030),while history of cesarean section made no difference.Gestational age at resolution was earlier in posterior group (P=0.002) and non-cesarean section group (P=0.008) than in anterior group and cesarean section group correspondingly.Placenta location and prior cesarean section did not influence obstetric outcomes and neonatal outcomes.This study indicates that it is more likely to have subsequent resolution of the previa when the placenta is posteriorly located for women who are diagnosed with placenta previa in the second trimester.