Adult ; China ; epidemiology ; Female ; Humans ; Low Back Pain ; epidemiology ; etiology ; Occupational Diseases ; epidemiology ; etiology

The study of sarcosaphagous insects is a subspecialty in forensic medicine based on the knowledge of entomology. It could help to determine the time of death, especially the postmortem interval in decomposed cases. This paper explores its history, species and erosion process of sarcosaphagous insects. It reviews the species identifying methods with molecular biology and entomological morphology. Details of its application in estimating postmortem interval in recent years and study of sarcosaphagous insects in the field of forensic medicine are summarized.
Animals ; Cadaver ; Death ; Diptera/physiology* ; Entomology/methods* ; Forensic Medicine/methods* ; Humans ; Larva/growth & development* ; Postmortem Changes ; Time Factors

OBJECTIVETo summarize the causes and treatment experiences of postoperative constipation recurrences of Hirschsprung disease.

METHODSClinical data of 37 cases receiving operation again for postoperative constipation recurrences of Hirschsprung disease were collected. The recurrent causes, reoperation procedures and therapeutic efficacy were analyzed.

RESULTSAmong 37 cases, the recurrent causes included insufficient resection of the intestine in 14 cases, co-existent intestinal neural hypogenesis in 6, gate syndrome in 5, and others in 12 cases. There was no postoperative death. Thirty-one cases (83.8%) were followed-up from 6 months to 11 years. The defecation frequency was 1-2 times per day in 15 cases, one times per two days in 7, one times per three days in 6 cases. Two cases could defecate with the help of laxative purgatives. Nobody had incontinence.

CONCLUSIONThe main cause of postoperative constipation recurrences of Hirschsprung disease is insufficient resection of the intestine,and reoperation can get better results.

Child ; Child, Preschool ; Constipation ; etiology ; surgery ; Defecation ; Digestive System Surgical Procedures ; methods ; Female ; Hirschsprung Disease ; surgery ; Humans ; Infant ; Male ; Recurrence ; Reoperation

OBJECTIVETo investigate the surgical outcomes after on transumbilical laparoscopic pull-through procedure for pediatric hypoganglionosis(HYP).

METHODSTwelve children with HYP had received transumbilical laparoscopic pull-through procedure from June 2009 to June 2010. Specially designed curved and elongated laparoscopic instruments were used during the procedures. All the patients were followed up over 10 months. Data were collected and analyzed. The diagnosis of hypoganglionsis was pathologically confirmed.

RESULTSNo conversions to laparotomy or traditional laparoscopic surgery were required and there were no damages to the abdominal blood vessels, intestine, ductus deferens, or ureters. The average duration of operation was 140 min. The mean intraoperative blood loss was 45 ml. The mean length of specimen was 40 cm. Postoperatively there were no complications such as anastomotic leak, anastomotic stricture, constipation, seepage, or fecal in continence. The average hospital stay after surgery was 9 days. During 10 to 22 months of follow-up(median 16 months), no postoperative recurrence was noticed. No obvious scar was seen 1 months after surgery.

CONCLUSIONIt is safe and effective for children with hypoganglionosis to undergo transumbilical laparoscopic pull-through procedure.

Anal Canal ; surgery ; Child ; Child, Preschool ; Colon ; surgery ; Female ; Hirschsprung Disease ; surgery ; Humans ; Laparoscopy ; methods ; Male ; Treatment Outcome ; Umbilicus ; surgery

OBJECTIVETo evaluate the postoperative outcomes of preserving the left colonic artery during laparoscopic anterior resection for rectal cancer.

METHODSThe clinicopathologic data of 91 rectal cancer patients (pathologic Stage II) undergoing laparoscopic anterior resection was retrospectively analyzed. During the surgeries, the left colonic artery was preserved in 40 patients (preserved group) and ligated in 51 patients (unpreserved group). The operating time, intraoperative blood loss, time to first flatus and defecation, duration of postoperative abdominal distension and pain, number of retrieved lymph nodes, ileum fistulation and anatomical leakage rate were compared between the two groups.

RESULTSThe surgeries were completed in all the 91 patients laparoscopically without conversion. There was no intraoperative complications including rectal perforation, injury to vessel or ureter in either group. The operating time, blood loss and number of retrieved lymph nodes were similar between the groups (P>0.05). Three patients in preserved group and 5 in ligation group received preventive ileum fistulation due to low rectal cancer. Anatomical leakage occurred in three patients of unpreserved group. The average duration of postoperative abdominal distension and pain was 2.14∓0.35 days in preserved group and 3.15∓0.42 days in ligation group. The time to first flatus and defecation was 37.15∓12.62 h and 3.16∓0.52 days in preserved group and 62.25∓11.75 h and 4.25∓0.75 days in ligation group. Postoperative hospital stay was 4.54∓0.42 days in preserved group and 6.23∓0.51 days in ligation group. Total hospitalization cost in the two groups was 34 525.32∓1206.36 Yuan and 41 215∓1051.32 Yuan, respectively. Significant differences were found the in duration of postoperative abdominal distension and pain, postoperative hospital stay, and total cost between the two groups (P<0.05).

CONCLUSIONDuring laparoscopic anterior resection for rectal cancer, preserving the left colonic artery effectively ensures the blood supply to the anastomosis and the remaining descending colon to promote the recovery of the patients after surgery.

OBJECTIVETo compare curative effects of various surgical procedures of bile duct stones.

METHODSTwo thousand nine hundred and fifty-five patients with intrahepatic bile duct lithiasis who had undergone various surgical procedures were analysed with Meta-analysis. Some of these cases were reported in Chinese Medical Journals from January 1990 to March 2001 and others were from Tongji Hospital.

RESULTSThere was a significant difference between curative effects of non-hepatectomy and that of hepatectomy (chi(2) = 62.945, P < 0.01), and the outcomes of hepatectomy were much better than those of non-hepatectomy with OR(S) equalled to 0.303 (0.222 - 0.413). There was not a significant difference between curative effect of interposed jejunum and that of hepatectomy (95% CI of RR from 0.98 to 1.04). All the other operation, effects were worse than hepatectomy (upper limit of 95% CI of RR < 1).

CONCLUSIONSHepatectomy is the most ideal surgery for intrahepatic bile duct stones and operation methods should be diversified since good effect could also be obtained when other operations are performed on suitable cases.

Bile Duct Diseases ; surgery ; Bile Ducts, Intrahepatic ; Choledochostomy ; statistics & numerical data ; Cholelithiasis ; surgery ; Follow-Up Studies ; Hepatectomy ; statistics & numerical data ; Humans ; Treatment Outcome

OBJECTIVETo study the low back pain(LBP) and its cause on female workers in flat-grained veneer wood industry.

METHODSBending posture was analyzed by observation and the prevalence of low back pain was investigated by physical examination and questionnaire among 299 female workers.

RESULTSThe prevalence of fatigue compliant in selecting, remending and sticking workers was 68.8%, 66.7% and 59.0%, respectively, which mainly involved in the part of low back. The prevalence of low back pain in selection (53.8%) and remending (58.7%) workers was higher than that in sticking workers (30.1%), which was in accordance with the tenderness between L4/L5 or L5/L6 and on the psoas major. Posture analysis indicated that the biggest bending range of selecting and remending workers (80 degrees ) was larger than that of sticking workers (60 degrees ), as well as the daily bending times[(4396+/-817), (1696+/-286), (1094+/-476)] and the time they kept bending[(6.5+/-0.6), (6.2+/-1.3), 4.5+/-0.9) h].

CONCLUSIONBending posture is common among female workers especially those who work in selecting and remending and might be the major causes for the high prevalence of LBP in flat-grained veneer wood industry.

Adult ; Female ; Humans ; Low Back Pain ; epidemiology ; etiology ; Occupational Diseases ; epidemiology ; etiology ; Posture ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Wood

Objective To observe the clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and hepatic artery infusion of autologous cytokineinduced killer (CIK) cells in treating clinical stage I hepatocellular carcinoma (HCC).Methods A total of 80 patients with confirmed HCC,who were treated with comprehensive interventional therapy during the period from January 2009 to May 2010,were enrolled in this follow-up study.The patients were divided into the study group (n=38),receiving TACE,RFA and autologous CIK cells therapy,and the control group (n=42),receiving TACE and RFA only.The quality of life (QOL),changes in immune function indexes,progression free survival (PFS) and survival rate were calculated,and the results were compared between the two groups.Results (1) QOL score:after the treatment the QOL score of the study group was significantly higher than that of the control group (P＜0.05).(2) Immune function:the post-treatment immune function values were different from the pre-treatment ones in both groups,the differences were statistically significant (P＜0.05);and the differences between the two groups were also statistically significant (P＜0.05),with the changes of the study group being more obvious.(3) PFS and survival rate:the median PFS of the study group and the control group was 48.0 and 40.1 months respectively,while the one-,2-,3-,5-year survival rates of the study group and the control group were 100％,89.5％,71.1％,55.3％ and 95.2％,88.1％,64.3％,28.6％ respectively.Both the median PFS and survival rate in the study group were higher than those in the control group.Conclusion In treating clinical stage I HCC,TACE combined with RFA and hepatic artery infusion of autologous CIK ceils can improve QOL of patients,strengthen patient's immune function,prolong the median PFS,and increase the overall survival rate.

BACKGROUNDReadmission rates after pancreaticoduodenectomy (PD) for malignant diseases have a significant impact on survival rate. Identification of risk factors for readmission may improve discharge plans and postoperative care. Data exist on the morbidity and mortality of patients undergoing PD, but there are few reports about hospital readmissions after this procedure. Our aims were to evaluate the proportion and reasons for readmissions after PD for malignant diseases, the factors influencing readmissions, and to analyze the relationship between readmission rate and survival rate.

METHODSFour hundred and thirty-six patients, who had undergone PD for malignant diseases in our centre from October 1999 to October 2009, a 10-year period, excluding perioperative (30-day) mortality, were identified. All readmissions within 1 year following PD were analyzed with respect to timing, location, reasons for readmission and outcome. We reviewed the hospitalization and readmissions for patients undergoing PD, and compared patients requiring readmission to patients that did not require readmission.

RESULTSOne hundred and forty-five patients (33.26%) were readmitted within 1 year following PD, for further treatment or complications. In those cases, diagnoses associated with high rates of readmission included radiation and/or chemotherapy (48.96%), progression of disease (11.72%), infection (11.72%), gastrointestinal dysfunction/obstruction (6.20%), surgery-related complications (2.76%) and pain (4.14%). The proportion of T4 in readmission group was lower than no readmission group (P < 0.05). The proportion of node positive cases in readmission group was much higher than no readmission group (P < 0.01). The number of readmission for complications reduced gradually in the first three months, and reached a second peak in the sixth and seventh month. Median survival was lower for the readmission group compared with the no readmission group (21 versus 46 months, P = 0.024).

CONCLUSIONThese results may assist in both anticipating and facilitating postoperative care as well as managing patient expectations.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Pancreaticoduodenectomy ; adverse effects ; Patient Readmission ; statistics & numerical data ; Postoperative Complications

OBJECTIVETo determine the efficacy and safety of combined L-carnitine and acetyl-L-carnitine therapy in infertile males with oligoasthenozoospermia.

METHODSOne hundred fifty patients with oligoasthenozoospermia were randomized selected into treatment and control groups. The treatment group with 90 patients were given L-carnitine (2 g/d) and acetyl-L-carnitine (1 g/d) orally, twice a day. The patients in control group were given Vitamin E 100 mg plus Vitamin C 100 mg, tid. The oral therapy lasted three months and patients accepted sperm analysis every one month. The L-carnitine level in seminal plasma was examined by high performance liquid chromatography (HPC). Side effects as well as pregnant rate were observed.

RESULTSIn the treatment group, 85 patients out of 90 finished the three month treatment. Female spouses of 10 patients (11.6%) achieved pregnancy. Moreover, their forward motile sperm per ejaculation, total motile sperm, as well as the concentration of L-carnitine in seminal plasma were increased significantly (P < 0.01). In control group, 53 patients out of 60 completed three months therapy. Two pregnancy (3.7%) was observed. Though some increase was seen in number of forward motile sperm and total motile sperm per ejaculation, the changes were not statistically significant (P > 0.05). The difference of the pregnant rate between two groups was statistically significant. No side effects were found.

CONCLUSIONCombined treatment with L-carnitine and acetyl-L-calmitine can be an effective and safe option for treating oligoasthenozoospermia by means of significantly improving forward motile sperm and total motile sperm per ejaculation, as well as increasing pregnant rates.

Acetylcarnitine ; administration & dosage ; adverse effects ; Administration, Oral ; Adult ; Carnitine ; administration & dosage ; adverse effects ; Double-Blind Method ; Drug Administration Schedule ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Oligospermia ; drug therapy ; Pregnancy ; Pregnancy Rate