Objective To investigate the effects of painless ward standardized pain management on pain control and postoperative recovery of patients with inguinal hernia after surgery.Methods From January 2015 to January 2016,44 cases of inguinal hernia in Department of General Surgery,First People's Hospital of Huainan,control group (22 cases) and observation group (22 cases) were retrospectively studied.The patients in observation group underwent painless ward standardized pain management and those in control group underwent traditional pain mnanagement model.Pain score after surgery,time for get out of bed after surgery,postoperative intestinal exhaust time,duration of night sleep,and satisfaction degree for pain-control were comparrd between two groups of patients.Results For pain score after surgery,the observation group 3 h after operation,postoperative 1 d,2 d pain score respectively (3.46 ± O.56),(2.72 ± O.21),(2.20 ± O.43) points,the control group 3 h after operation,postoperative 1 d,2 d pain score respectively (4.48 ± 1.52),(3.55 ± 0.40),(2.80 ± 0.40) points,there were significant difference between two groups (P ＜ 0.05).For sleep time,the observation group on the day of surgery,postoperative 1 d,2 d sleep time respectively (5.23 ± 0.98) h,(6.57 ± 0.54) h,(7.50 ± 0.54) h,the control of sleep time of 2 d group on the day of surgery,postoperative 1 d,respectively (4.35 e 1.28) h,(5.17 ± 0.45) h,(6.72 ± 0.61) h,there were significant difference between two groups (P ＜ 0.05).The satisfaction rate of pain control in the observation group was 86.3％,which was higher than that of the control group 50.0％ (P ＜ 0.05).The observation group first ambulation time,anal ventilation time,hospital stay were (10.5 ± 2.0) h,(16.8±2.1) h,(6.6±1.4) d,the control group for the first time,ambulation time,anal ventilation time,hospital stay were (15.9 ± 3.O) h,(22.6 ± 3.3) h,(7.5 ± 1.2) d,there were significant difference between two groups (P ＜ 0.05).However,there was no difference between the two groups in the total cost of hospitalization.Conclusions Application of painless ward standardized pain management for patients with inguinal hernia after surgery can shorten time for get out of bed after surgery,postoperative intestinal exhaust time,prolong duration of night sleep,improve satisfaction degree for pain-control during hospitalization.

AIM: To investigate the efficacy of 23G minimally vitrectomy without irrigation in cataract phacoemulsification and trabeculectomy of malignant glaucoma, and to analyze such compound operative procedures for phakic malignant glaucoma.
●METHODS:A total of 21 phakic malignant glaucoma patients (21 eyes) underwent anterior vitrectomy without irrigation by using 23G vitrectomy. During surgical course phacoemulsification with anterior and posterior continuous circular capsulorhexis, trabeculectomy combined with iridectomy would be completed. lntraocular pressure, anterior chamber depth changes and postoperative complications were observed after the operation.
●RESULTS:ln the three-month follow-up, intraocular pressures were reduced from ( 57. 18 ± 6. 18 ) mmHg to (16. 15 ± 2. 43 ) mmHg, there was statistical difference compared with pre - operation ( P < 0. 001 ). The preoperative anterior chamber depth (ACD) was (0. 88± 0. 25) mm, the postoperative ACD was (2. 44±0. 37) mm 3mo later, there were significant difference (P<0. 001). The best corrected visual acuity improved significantly, no serious postoperative complication appeared.
● CONCLUSION: The compound surgical method of anterior vitrectomy combined with phacoemulsifier and trabeculectomy can effectively treat phakic malignant glaucoma. Early diagnosis and early compound surgery may effectively reduce the intraocular pressure of malignant glaucoma.

Adult ; Cerebrospinal Fluid Rhinorrhea ; Female ; Humans ; Sphenoid Sinus ; pathology

Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma

Objective To study a simple and effective internal bilioenterostomy for the malignant bile duct obstruction.Methods 58 obstructive jaundice patients caused by advanced carcinoma were divided into 2 groups(1)Bridge bilioenterostomy(BBES) group.Biliojejunal bypass procedue by using silica gel tube inserted into dilated bile duct and jejunum respectively combination with Bardport TM pump was performed on 25 patients .The biliary sludge were washed away through Bardport TM pump by injecting normal saline, antibiotic and 5-fluorouracil.(2)Control group.33 patients were treated with traditional biliojejunostomy. Results There was no difference in alleviating jaundice between the two groups ,but in BBES group the cholangitis rate (20.83%)and recurrent jaundice rate (9.52%) were much lower than those in control group ( 51.61% and 32.14% respectively, P

Glioma is the most frequently observed primary tumor of the central nervous system in adults. Among the glioma cases, more than three quarters of patients suffer from high-grade gliomas. High-grade glioma is not only a high-degree malignant tumor but is also an easily recurring disease after surgery with a very poor prognosis. Radiotherapy plus concomitant chemotherapy after operation is the standard treatment strategy for high-grade gliomas, which could increase the survival rate of patients. However, the curative effect is really not satisfactory because it could only guarantee a limited survival time. Over the recent years, molecular-targeted treatment has increasingly drawn the attention of scholars with the continuous development in glioma treatment, thereby becoming the hotspot among researchers. Vascular endothelial growth factor (VEGF) is highly expressed in glioma and in the tissues surrounding the cancer cells. VEGF could regulate tumor growth by inducing endothelial cell proliferation, growth, migration, and by increasing the vascular permeability. Hence, VEGF becomes an effective target for the treatment of glioma. Bevacizumab is a monoclonal antibody that can specifically prevent the combination of VEGF and its receptor, thereby inhibiting the formation of tumor blood vessels. At the same time, bevacizumab can normalize the tumor blood vessels, improve the permeability of blood vessels, and increase the effectiveness of drug concentration in the tumor tissues, thereby achieving anticancer efficacy. In this paper, the mechanism of bevacizumab is introduced. The research progress in the application of bevacizumab alone, as well as in combination with chemotherapy or other drugs, for the high-grade glioma treatment will be summarized.

Objective To investigate the application of 3D reconstruction system in the clinical departments of the hospital.Methods 3D reconstruction system had its architecture,main features,working flow and principle of auto preprocessing software introduced,and then applied to auto preprocessing of PACS images to realize auto reconstruction,which had the function of 3D post processing.Results 3D reconstruction system gifted the doctor in clinical departments with the access to the images and after treatment,and changed the traditional working mode in imaging department.Conclusion Fusion imaging has 3D reconstruction as the main technique,which eliminates the deficiency in reading radiological images and innovates medical service mode.

Objective To evaluate laparoscopic splenectomy through amputation of secondary splenic pedicles.Methods From February 2010 to March 2016 33 patients underwent laparoscopic splenectomy.Patients were followed up by outpatient examination and telephone interview.Follow-up period ended in April 2016.Results All the 33 patients successfully underwent laparoscopic amputation of secondary splenic pedicle splenectomy.The operation time and volume of intraoperative blood loss were (155 ± 42) min and (210 ± 50) ml.Three patients had postoperative complications including two with ascites sand one with small amount splenic fossa bleeding.All the patients were followed up for a median time of 21 months (range,1-65 months).During the follow-up,1 patient died of hepatic encephalopathy and 32 patients were doing well.Conclusion Laparoscopic amputation of secondary splenic pedicle splenectomy is safe and feasible.

Objective To investigate the clinical efficacy of precise liver resection of liver tumors adjacent to the main pipeline.Methods The retrospective and descriptive study was conducted.The clinical data of 22 patients who underwent precise resection of liver tumors adjacent to the main pipeline in the Affiliated Tumor Hospital of Zhengzhou University between December 2014 and June 2016 were collected.According to preoperative precise evaluation and fully intraoperative exposed tumors,different methods of blood flow occlusion were choosed timely,and then precise resection of the liver was evaluated based on tumor location and size,relationship between tumor and blood vessels and the degree of liver cirrhosis.The operation procedures,operation time,time of liver resection,volume of intraoperative blood loss,number of patients with perioperative blood transfusion,postoperative complications,duration of postoperative hospital stay and follow-up were observed.The follow-up was performed by outpatient examination and telephone interview up to September 2016.Tumor recurrence of patients with hepatocellular carcinoma (HCC) was monthly detected by alpha-fetoprotein retest and color Doppler ultrasound of the liver or computed tomography (CT) within 3 months postoperatively.Tumor recurrence of patients with cholangiocarcinoma was monthly detected by tumor marker retests,color Doppler ultrasound of the liver or CT,and then patients without tumor recurrence received reexamination once every 2 months after 3 months.Patients with liver hemangioma were followed up once every 2-3 months and once every 6 months after half a year,and follow-up included the liver function,ultrasound and other imaging examinations to detect the tumor recurrence.Measurement data with normal distribution were represented as-x±s.Results All the 22 patients underwent successful precise resection of liver tumors.Twenty patients received intraoperative ultrasound localization.Blood flow occlusion of 22 patients:Pringle was conducted in 6 patients,treatment of the corresponding hepatic pedicle in 3 patients,selective hepatic blood flow occlusion in 8 patients,total hepatic blood flow occlusion in 2 patients and non-hepatic portal occlusion in 3 patients.Precise resection of the liver of 22 patients:1 patient underwent right trisegrnentectomy,2 underwent left hepatectomy,2 underwent segment Ⅳ a resection of the liver,2 underwent segment Ⅳ resection of the liver,3 underwent segment Ⅴ resection of the liver,3 underwent segment Ⅷ resection of the liver,1 underwent middle lobe resection of the liver and 8 underwent partial resection of the liver.Operation time,time of liver resection,volume of intraoperative blood loss and number of patients with perioperative blood transfusion were (213±39) minutes,(57± 19) minutes,(518± 98) mL and 3,respectively.Of 22 patients,5 with postoperative complications were improved after symptomatic treatment,including 2 with effusion at surgical site,2 with right pleural effusion and 1 with bile leakage.The duration of postoperative hospital stay of 22 patients was (8.9± 1.6)days.Twenty-one patients were followed up for 3-20 months,with a median time of 12 months.Two of 22 patients had recurrence during the follow-up,and no recurrence at surgical site was detected.Conclusion Precise resection of liver tumors adjacent to the first and second hepatic hilum is safe and feasible,with the advantages of less intraoperative bleeding and low incidence of postoperative complications.

Objective To evaluate the effectiveness and complications of laparoscopic repair for hiatal hernia.Methods The clinical data of 992 patients with hiatal hernia undergoing laparoscopic repair from Jan 2008 to June 2014 were collected and analyzed.Postoperative symptom scores,postoperative complications,recurrence rate and satisfaction were evaluated.Results 858 cases were followed up,including type Ⅰ HH accounting for 79.8％,type Ⅱ for 1.3％,type Ⅲ for 17.1％,type Ⅳ for 1.8％ respectively.HH repaired with mesh in 520 cases.The overall improvement rate was 96.2％.Postoperative symptom scores significantly decreased.Recurrence of anatomy and symptoms were 31 and 15 cases respectively.Short-term and long-term of postoperative complications were 35.8％ and 5.6％ respectively.Excellent,fair and poor result were achieved in 91.8％,4.3％,3.9％ of postoperatively follow-up cases,respectively.Conclusion The laparoscopic approach for repair of hiatal hernias is of minimally invasive,lower recurrence rate,less complications and high satisfaction.