Objective To investigate the CT features and different risk CT findings of intestinal stromal tumor. Methods The CT imaging data of 25 cases of intestinal stromal tumor confirmed by pathology and compared with operative and pathologic findings were retrospectively studied. Analyzing the CT features based on Histopathologieal classification of the different risk groups and using chi-square test to compare the differences. Results There were 9 cases which tumors originated from the jejunum, and 13 cases from ileum, only 3 cases from duodenum. Among them, 2 cases were submucosal type, 13 cases were intramural type, and 10 cases were subserous type. The pathologic patterns of different risk which included high-risk, intermediated-risk, low-risk, and very low-risk were 12 cases, 7 cases, 5 cases and 1 cases respectively. A typical CT manifestations of intestinal stromal tumors were a outward growth of irregular or round soft tissue mass originated in small intestine which had clear boundary and the non-homogeneous density, which corresponding to necrosis, cystic change, mucoid degeneration and sinus or cavity. Mesenteric fat invaded by tumor showed high-density lines or points shape. The Enhancement of lesion was obvious and not homogeneous which showed little change in peak of enhancement between arterial phase and venous phase. Intestinal stromal tumors took 5 cm as the boundary which including different size, shape, density, and appearance vessel-like artery shadow at arterial phase between different risk groups(low, very low-risk group and intermediated, high-risk group) were statistically different (P ＜0.05), while enhanced degree without significant difference (P ＞ 0.05). Conclusion CT findings of small intestine stromal tumor have characteristics and CT features have significant difference between different risk groups. These features of more than 5 cm in diameter, non-homogeneous density, irregular shape and chaos appearance like vascular enhancement are showed in intermediated-high-risk group.

OBJECTIVETo explore a better operative approach to resect complicated pelvic retroperitoneal tumors.

METHODSA total of 28 patients with complicated pelvic retroperitoneal tumors who received surgical resection in our hospital from 2006 to 2010 were included in this study. The surgical operation was assisted with an arc-shaped transperineal incision in front of the apex of coccyx. The operation time, intraoperative blood loss, death toll and length of hospital stay of the patients were retrospectively analyzed.

RESULTSThe median operation time was 122.5 minutes. The median blood loss was 420 ml, and the median length of hospital stay of the patients was 17.5 days. There was no postoperative death in this group of patients.

CONCLUSIONWith the assistance of this arc-shaped transperineal incision in front of the apex of coccyx, the resection of pelvic retroperitoneal tumors can be effectively improved and the surgery risk is reduced.

Adult ; Aged ; Blood Loss, Surgical ; Coccyx ; surgery ; Epidermal Cyst ; pathology ; surgery ; Female ; Gastrointestinal Stromal Tumors ; pathology ; surgery ; Humans ; Length of Stay ; Male ; Middle Aged ; Neurilemmoma ; pathology ; surgery ; Pelvic Neoplasms ; pathology ; surgery ; Retroperitoneal Space ; Retrospective Studies ; Teratoma ; pathology ; surgery

OBJECTIVETo investigate long-term survival after multivisceral resection in patients with locally advanced right colon cancer.

METHODSThe clinical data and survival of 13 patients with locally advanced right colon cancer were retrospectively analyzed.

RESULTSThere were 8 males and 5 females with a mean age of 58.6 years. Location of the primary tumor included hepatic flexure(n=6), transverse colon(n=2), and ascending colon(n=5). Three patients had duodenal invasion alone, 9 had involvement of duodenum and other organs, and 1 had pancreas and stomach involvement. Right colectomy and pancreaticoduodenectomy and(or) resection of other organs were performed. The 1-, 3-, and 5-year survival rates were 69%, 54%, and 30%, respectively.

CONCLUSIONRight colectomy combined with multivisceral resection is a promising procedure for selected patients with locally advanced colon cancer.

Adult ; Aged ; Colonic Neoplasms ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the approach and efficacy of dealing the rectal ligament in resection of rectal cancer in obese male patients.

METHODSA total of 92 patients (BMI>25 kg/m(2)) undergoing resection of rectal cancer from December 2008 to December 2010 in Henan Tumor hospital were assigned into 2 groups according to the surgical technique, the modified group (paralleled clipping of rectal ligament, 48 patients) and traditional group (44 patients). Operative time, intra-operational bleeding, rectal ulceration, ureteral injury, mesorectal integrity, and positive rate of lateral margin of pelvic wall were compared between two groups.

RESULTSThe operative time was (66.9±99.8) min in modified group, which was significantly shorter than that in traditional group [(125.4±12.2) min, P=0.000]. Intra-operative bleeding was (160.3±27.2) ml in modified group and (150.5±28.5) ml in traditional group (P=0.093). Rectal ulceration rated were 0 and 18.2% (8/44), mesorectal disintegrity rates were 6.2% and 22.7%, pelvic infection rates were 2.1% (1/48) and 20.4 (9/44) in modified and traditional groups respectively, whose differences were all significant (all P<0.05). No ureteral injury and positive margin were found in both two groups.

CONCLUSIONThe approach of paralleled clipping of rectal ligament around the rectum meets the principle of TME, which is simple, safe and effective.

Adult ; Aged ; Humans ; Ligaments ; surgery ; Male ; Middle Aged ; Obesity ; complications ; Rectal Neoplasms ; complications ; surgery ; Rectum ; surgery

AIMTo investigate the excretion of beta-elemene from the respiratory tracts in male Spraque-Dawley rats.

METHODSAfter a single administration of beta-elemene to rats at the dosage of 75 mg x kg(-1) (i.v. or i.p.), the exhaled gases were collected and concentrated at various time points. The residues were analyzed by gas chromatography.

RESULTSA minor amount of unchanged beta-elemene was excreted via rat respiratory tracts after iv and ip administration of a single dose. The cumulative excretion were 1.41% and 0.51% respectively.

CONCLUSIONThe results demonstrated that unchanged beta-elemene excretes from rat respiratory tracts, but may not be the main elimination pathway in rats.

Animals ; Chromatography, Gas ; Curcuma ; chemistry ; Infusions, Parenteral ; Injections, Intravenous ; Male ; Plants, Medicinal ; chemistry ; Rats ; Rats, Sprague-Dawley ; Respiratory System ; metabolism ; Sesquiterpenes ; administration & dosage ; isolation & purification ; pharmacokinetics

OBJECTIVETo investigate the anatomic characteristics of splenic flexure, surgical techniques, and oncologic outcomes in 52 patients with non-obstructive splenic flexure colon cancer.

METHODSClinical data of 52 patients with non-obstructive splenic flexure colon cancer from March 2004 to March 2011 in the Department of General Surgery at the Henan Province Tumor Hospital were analyzed retrospectively.

RESULTSThere were 37 patients of regular type, 5 of mobile type, and 10 of adhesive type. All the patients received radical operation. Eighteen patients received pre-small intestine anastomosis, including 12 cases with regular type, 4 with mobile type, and 2 with adhesive type. The difference in pre-small intestine anastomosis among the three types was not statistically significant(P=0.062). In addition, 32 cases received retro-ileum anastomosis. There were no significant differences in operative time, intraoperative blood loss, number of lymph node dissection and positive lymph node, and postoperation complication rate among the three types. Follow up was available in all the cases. Five-year survival rates of cases with regular type, mobile type and adhesive type were 62.5%, 59.2% and 58.7% respectively(P>0.05).

CONCLUSIONSRadical resection can provide satisfactory survival for splenic flexure colon cancer patients. The anatomy of splenic flexure does not affect the type of anastomosis. Retro-ileum anastomosis is a simple and effective method for reconstruction after radical resection of the tumor.

Adult ; Aged ; Anastomosis, Surgical ; Colon, Transverse ; anatomy & histology ; pathology ; surgery ; Colonic Neoplasms ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo evaluate the association of early diarrhea(postoperative day 1 to 7) and anastomotic leakage after low anterior resection for rectal cancer.

METHODSClinical data of 192 cases (group A, tumor from the anal verge 4-7 cm) from May 2004 to May 2007 and 236 cases(group B) from July 2007 to May 2010 in our hospital who received low anterior resection of rectal cancer were analyzed retrospectively.

RESULTSIn group A, the incidence of early postoperative diarrhea was 19.3%(37/192), of which 9 cases were treated with anti-diarrhea drugs. The morbidity of anastomotic leakage in patients with diarrhea was significantly higher than those without early diarrhea(16.2% vs. 5.2%, P<0.05). In group B, the incidence of early postoperative diarrhea was 16.5%(39/236). All the patients were treated with anti-diarrhea drugs. There was no difference in the morbidity of anastomotic leakage between patients with diarrhea and those without early diarrhea(16.2% vs. 5.2%, P<0.05). There was no difference in early diarrhea between groups A and B(P>0.05). However, the incidence of anastomotic leakage in patients with early diarrhea was lower in group B(P<0.05).

CONCLUSIONSEarly diarrhea after the low anterior resection of rectal cancer may indicate anastomotic leakage. Treatment of early postoperative diarrhea may reduce the risk of anastomotic leakage.

Adult ; Aged ; Anastomotic Leak ; etiology ; Diarrhea ; complications ; etiology ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Rectal Neoplasms ; surgery ; Retrospective Studies

OBJECTIVETo evaluate the therapeutic effects of trans-abdominal-mediastinal drainage tube on the prevention of esophagogastric or esophago-jejunal anastomotic leakage.

METHODSA total of 79 patients underwent thoraco-abdominal radical resection for gastric cardia cancer, with high risk of leakage of the anatsomosis, from Aug. 2007 to Aug. 2011 were included in this study. They were assigned into 2 groups. Forty one patients had trans-abdominal-mediastinal drainage tube (improvement group) and 38 patients were without the mediastinal drainage tube (control group). The clinical data of all the 79 patients were reviewed and the therapeutic effects of the two treatment approaches were compared.

RESULTSThere was anastomotic leakage in four patients of the improvement group. They were with stable vital signs and the median hospital stay was 29.3 days. There was anastomotic leakage in five cases of the contol group and all of them had high fever and chest tightness. One among those five patients had transdermal placement of thoracic drainage tube and was cured, and four among those five patients had second debridement operation, with 3 cured and one death case. Except the one death case, the median hospital stay of the control group was 53.4 days, significantly longer than that of the improvement group (P < 0.05).

CONCLUSIONSAlthough putting trans-abdominal-mediastinal drainage tube can not prevent the leakage of esophagogastric or esophago-jejunnal anastomosis, it can reduce the systemic inflammatory responses, death and painful suffering of the patients caused by anastomotic leakage.

Aged ; Anastomosis, Surgical ; adverse effects ; Anastomotic Leak ; etiology ; prevention & control ; Cardia ; Drainage ; methods ; Esophagus ; surgery ; Female ; Humans ; Jejunum ; surgery ; Length of Stay ; Male ; Middle Aged ; Stomach ; surgery ; Stomach Neoplasms ; surgery

BACKGROUND: Benzalkonium chloride has been used in dental restorative materials to enhance the long-lasting antibacterial properties of materials. OBJECTIVE: To evaluate the antibacterial activity of benzalkonium chloride on oral common pathogenic bacteria in vitro. METHODS: The agar diffusion method was used to determine the inhibitory effects of antibacterial agents, 0.1% benzalkonium chloride, 3% H2O2and 5.25% sodium hypochlorite, on five kind of oral pathogens, Porphyromonas gingivalis (P.g), Prevotella intermedia (P.i), Actinobacillus actionmycemcomitans (A.a), Streptococcus mutans (S.m) and Enterococcus faecalis (E.f). The tube dilution method was used to detect the minimal inhibitory concentration of benzalkonium chloride against the five bacteria mentioned above. RESULTS AND CONCLUSION: The antibacterial effect of 0.1% benzalkonium chloride on P.g was not significantly different from that of 3% hydrogen peroxide (P＞0.05), while 0.1% benzalkonium chloride showed better effect on P.i than 3% hydrogen peroxide (P＜0.05). On P.g and P.i, the antibacterial effect of 0.1% benzalkonium chloride was worse than that of 5.25% sodium hypochloritethe ( P＜0.05). The antibacterial effect of 0.1% benzalkonium chloride on A.a and S.m was better than that of 3% hydrogen peroxide (P＜0.05), and similar to that of 5.25% sodium hypochlorite (P＞0.05). The antibacterial effect of 0.1% benzalkonium chloride on E.f was better than that of 3% hydrogen peroxide (P ＜ 0.05), but worse than that of 5.25% sodium hypochlorite (P ＜ 0.05). The minimal inhibitory concentration of benzalkonium chloride to P.g, P.i, A.a, S.m, E.f was 16, 2, 4, 2, 4 mg/L, respectively. To conclude, 0.1% benzalkonium chloride has strong antibacterial effects on P.g, P.i, A.a, S.m and E.f.

Objective To observe the changes of nerve fibers of internal capsule and motor function in patients with thalamic hematoma treated by minimally invasive procedures using diffusion tensor imaging (DTI).Methods Twenty-two patients with thalamic hematoma were randomized into minimally invasive treatment group (MI group) and medication treatment group (MT group).The patients in MT group were given conventional medical treatment,and those in MI group were performed intracranial hematoma elimination by the minimally invasive procedures within 24 h of admission and medical treatment was also given.The patients in both MI group and MT group underwent a whole-brain DTI on admission and 2 weeks after the admission.The integrity of corticospinal tract (CST) in the internal capsule ipsilateral to the hematoma side and the contralateral side and their fractional anisotropy (FA) values were determined.The modified National Institutes of Health Stroke Scale (mNIHSS) were performed on admission,2 weeks and 1 month after onset of initial hemorrhage.Results DTI showed that fibers in the internal capsule ipsilateral to the hematoma either decreased in number or interrupted because of hematoma-induced damages in both groups,and the CST FA values on admission were significantly lower (0.432±0.022 and 0.410±0.028 for MI and MT groups,respectively) than the control values.The number of fibers and the FA values of CST in the internal capsule 2 weeks after the hematoma being evacuated were increased significantly as compared with those on admission.As FA values of CST in internal capsule increased,the mNIHSS scores decreased after the surgery and the motor function improved gradually.Conclusion Minimally invasive procedures for thalamic hematoma evacuation can effectively reduce the degree of injury to the motor function,and DTI can observe the changes of CST after the surgery directly.