Abscess ; surgery ; Foreign Bodies ; surgery ; Foreign-Body Migration ; Humans ; Thyroid Gland

This paper summarize the perioperative nursing of 12 newborns with thyroglossal cyst. The preoperative nursing measures focused on prone position,gastric tube feeding,close monitoring of vital signs and tracheal intubation as needed. If the TeSO2 was normal,oxygen therapy was not recommended. After the operation,continuously monitoring vital signs,respiratory care and use of sedatives as needed were carried out. As a result,all of the 12 infants recovered and discharged.

Objective To develop a biodegradable intestinal anastomose stent which have independence intellectual proper-ty rights and investigate the method by which clinicians could improve the research and development of the new surgical instruments.Methods SolidWorks software was used to turn the design ideas into 3D format on computer,and the engi-neering drawing was applied for patent before being submitted to manufacturers.Results Engineering drawing met the re-quirements of patent application and production,and then the model smoothly entered into animal experiments.Conclusion The clinicians can be studied and utilized some kinds of computer aided design(CAD) software so as to not only avoid lost of modifications during trial production,but also shorten the design cycle and improve production efficiency.

ObjectiveTo investigate the effect of early electro-acupuncture treatment on prevention of post-operative adhesions.Methods40 rabbits were randomly divided into 5 groups: normal control group, model group 1, model group 2, early electro-acupuncture group and later electro-acupuncture group with 8 animals in each group. Muscle adhesion model was established by operation. The early electro-acupuncture group was received the treatment from the 11th to 20th day after the operation; later electro-acupuncture group was from the 21st to 30th day after the operation. The weight, gait and range of motion (ROM) of animals were observed and analyzed.ResultsThe standing, walking and ROM of animals of the early electro-acupuncture group improved; but only few gait indexes improved and ROM not changed in the later electro-acupuncture group.ConclusionThe early electro-acupuncture treatment can prevent the post-operative adhesion of muscles, but not having effect on formed adhesion.

Objective To observe the synapse formation in hippocampal dentate gyrus, and the memory ability after transplanting bone marrow stromal cells (BMSCs) into lateral ventricle of ischemic brain injury rats. Methods BMSCs from femur of a Sprague-Dawley rat were cultured for 3 generations in vitro. 60 newborn Sprague-Dawley rats were divided into sham group (n=20), model group (n=20) and BMSCs group (n=20). The latter 2 groups were ligated the left common carotid artery, and the BMSCs group were injected BMSCs into the lateral ventricle 7 days after ligation. They were tested with Morris's water maze 8 weeks later, and then, the brains were immunohistochemical staining to detect synaptophysin (SY). Results The time of probe trial of acquisition phase (T1) and reveral phase (T2) decreased in the model group compared with the sham group (P<0.05), and increased in the BMSCs group compared with the model group (P<0.05). The integral optical density (IOD) of SY positive cells decreased in the model group compared with the sham group (P<0.05), and increased in the BMSCs group compared with the model group (P<0.05). Conclusion BMSCs implantation through lateral ventricle can improve the learning and memory ability of rats, which may associated with the synapse formation in dentate gyrus.

Objective To evaluate the effect of debridement hepatectomy with selective hepatopetal blood occlusion in the treatment of severe hepatic trauma.Methods The clinical data of 55 patients with severe hepatic trauma treated by debridement hepatectomy with selective hepatopetal blood occlusion were retrospectively analyzed.20,20 and 15 patients were with grade Ⅲ,Ⅳ and Ⅴ hepatic trauma respectively,combined with major peripheral hepatic vascular injury in 14 cases and with other trauma in 35 cases.Additional procedures including liver suture repair in 7 cases,perihepatic gauze packing in 3 cases,inferior vena cava repair in 5 cases,hepatic vein repair in 4 cases,hepatic vein ligation in 3 cases and hepatic artery ligation in 2 cases were performed.Other operations such as craniotomy debridement in 3 cases,cholecystectomy in 6 cases,T tube drainage of common bile duct in 4 cases,splenectomy in 5 cases,pancreatic tail resection in 2 cases,left kidney resection in 1 case,thoracic cavity closed drainage in 9 cases,partial small bowel resection or repair in 4 cases and stomach repair in 1 case were performed as needed.Results The operations were successful in 47 patients.Postoperative complications were observed in 19 cases (34.5％) including coagulation disorders in 1 case,postoperative abdominal bleeding in 2 cases,intestinal obstruction in 1 case,liver and renal dysfunction in 4 cases,abdominal infection in 3 cases,incision infection in 2 cases,pulmonary infection in 4 cases,pleural effuion in 10 cases.Death occurred in 8 patients (14.5％),the cause of death were hemorrhagic shock in 3 cases,combined with severe craniocerebral injury in 2 cases,septic shock in one case,and multiple organ failure in 2 cases.Conclusions Debridement hepatectomy with slective hepatopetal blood occlusion is an effective treatment for severe hepatic trauma.

Objective To evaluate the efficacy of surgical repair for non-circumferential defect of bile duct in Mirizzi syndrome.Method The clinical data of 32 patients with Mirizzi syndrome with non-circumferential defect of bile duct were repaired using the patient's own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap.Results All the patients were operated success fully.There was no operative mortality.The defects in the bile duct were repaired using gallbladder pedicle flap in 25 patients,umbilical venous flap in 5 patients and omental flap in 2 patients.There were 2 patients who developed postoperative complications.There was one postoperative bile leakage in a patient who was repaired using an umbilical venous flap.The other complication was residual bile duct stones.The patient with postoperative bile leakage was drained through a drainage tube which was removed after 7 days.The residual bile duct stones were removed by endoscopy through a T-tube sinus after 9 months.All patients were confirmed by T-tube cholangiography after 9 to 12 months to have no stones,bile duct stenosis or any other abnormalities.The T-tube was then removed.All patients were followed -up for 1 to 5 years.All patients had no cholangitis,abdominal pain,jaundice or fever.Conclusions Using the patients' own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap to surgical repair the defect in the bile duct of patients with Mirizzi syndrome was effective.This surgical treatment is a good choice.

Objective To investigate etiology and clinical features of acute pancreatitis (AP) in young patients. Methods In total, 423 patients with AP admitted to Renmin Hospital of Wuhan University, Wuhan, Hubei province during January 2006 to December 2009 were retrospectively analyzed, 55 cases aged 34 years or less as young group and another 55 cases aged more than 34 years as middle- and elderly-age group. Their etiology, clinical features and illness scores based on some standard criteria were assessed. Results Proportion of varied etiologies of AP in young group was different from that in middle- and elderly-age one (x2 = 17. 107, P = 0. 009) , mainly as biliary and idiopathic pancreatitis in young group and as biliary and alcoholic pancreatitis in middle- and elderly-age one. Incidence of diet-related and idiopathic pancreatitis were higher in young group than that in middle- and elderly-age one ( x2 =4. 853, P = 0. 028 and x2=4. 274, P = 0. 039 ). Scores of the acute physiology and chronic health evaluation II ( APACHE II ) , Ranson criteria and the bedside index for severity in acute pancreatitis ( BISAP) were all lower in young group than those in middle- and elderly-age one (t = 5. 381 , P = 0. 000; t = 4. 388 , P = 0. 000 and t=3. 083, P = 0. 003 ) . There was no statistically significant difference in scores of computed tomography severity index ( CTSI) between young group and middle- and elderly-age one (t = ±0. 750, P > 0. 05 ) . Recurrence rate of AP was lower in young group than that in middle- and elderly-age one ( x2 =4. 251, P = 0. 039). Cholecystitis was more complicated in young group, pregnancy was more complicated in young group (x2 =4. 151 , P =0. 042) , and elevated blood glucose was more complicated in middle- and elderly-age one (x2 = 13. 285 , P = 0. 000 ) . Conclusions Etiology of AP varies in young patients with more dietary factors, occurrence of systemic complications and risks for death are lower in young group than those in middle- and elderly-age one, and there was no statistically significant difference in local complications and severity of illness between the two groups.

Objective To study the results of laparoscopic approach in the treatment ot gallbladder and common bile duct stones.Method The authors reviewed data of 60 patients with gallbladder and bile duct stones treated laparoscopically.Results All the 60 patients treated with laparoscopic cholecystectomy and laparoscopic transcystic common bile duct exploration (LcTDE) were successful.There were 1 bile duct stone in 32 patients,and 2 to 6 bile duct stones in 28 patients.The operation time was (38.7±15.1) min and the hospitalization time was (5.5±2.1) days.One patient developed biliary fistula postoperatively which healed after 7 days of conservative treatment.One patient had bile duct residual stone which was treated by ERCP.The remaining patients were well.Conclusion Laparoscopic transcystic common bile duct exploration using a mini incision and primary suturing of the bile duct was simple,safe and efficacious.

Objective To analyze characteristics of severe liver trauma and efficacy of different surgical procedures. Methods Clinical data of 109 patients with severe liver trauma treated in the recent 10 years were retrospectively analyzed. Debriding suture was performed in 32 patients, gauze tamponade in 5, debridement hepatectomy in 59 and anatomical hepatectomy in 13 patients. Results In all the 109 patients, 92 were cured and 17 died. The dead patients included 3 with grade Ⅲ trauma,9 with grade Ⅳ trauma, and 5 with grade V trauma. Among the dead patients, there were 3 patients with simple liver injury (17.6%) and 14 with associated injury (82.4%). Conclusion Right hepatic serious damage is the main type of severe liver trauma and is always complicated with associated injury and needs emergency treatment. Application of the most appropriate surgical approach according to the traumatic condition is important to promote the successful rate of treatment.