1.Application of painless ward standardized pain management for patients with inguinal hernia after surgery
Qizhu FENG ; Haixia ZHAN ; Qi WANG
International Journal of Surgery 2017;44(3):178-181
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.
2.Effect of 23 G minimally invasive vitrectomy without irrigation in cataract ultrasonic phacoemulsification and trabeculectomy of phakic malignant glaucoma
Zhan-Feng, WANG ; Chang-Qin, XU
International Eye Science 2016;16(10):1879-1882
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.
4.Research progress in bevacizumab treatment of high grade glioma
Hailan WANG ; Zhengyu ZHAN ; Miao FENG ; Luxing ZHONG
Chinese Journal of Clinical Oncology 2013;(16):1001-1004
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.
5.Application and estimation of 3D Reconstruction system in clinical departments of hospital
Xiaohui WEI ; Yongfeng ZHAN ; Xue FENG ; Daquan WANG
Chinese Medical Equipment Journal 2017;38(4):136-139
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.
6.Biliojejunal bypass procedue by using silica gel tube combination with Bardport TM pump in treating the malignant biliary obstruction
Shaoping WANG ; Feng HUO ; Shilin ZHAN ; Guozhong CHEN
Chinese Journal of General Surgery 2001;0(08):-
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
8.Effects of esophageal cancer cell-derived exosomes on cancer cell migration and invasion and its mechanism research
Feng LIN ; Haijuan WANG ; Chunxiao LI ; Hui LI ; Ting WANG ; Peng NAN ; Haili QIAN ; Qimin ZHAN
Medical Journal of Chinese People's Liberation Army 2017;42(4):307-313
Objective To investigate the biological effects of exosomes secreted by KYSE410 cells on migration and invasion of KYSE410,KYSE510,YES2 cells and the possible mechanisms underlying the phenotype change.Methods The exosomes were isolated from the conditional supernatant of esophageal cancer cell line KYSE410 by ultracentrifugation.The morphology of exosomes was observed by transmission electron microscopy (TEM).Western blotting was used to detect the protein markers of exosomes.The uptaken of fluorescence-labeled KYSE410 exosomes by KYSE410,KYSE510 and YES2 was also recorded under confocal microscopy.Migration and invasion ability of the three esophageal carcinoma cell lines and the effects of exosomes from KYSE410 on migration and invasion of KYSE410,KYSE510 and YES2 cells were analyzed by Transwell chamber,respectively.The alteration of Wnt/β-catenin and PI3K/Akt pathway-related proteins were detected by Western blotting.Results The membrane structure of KYSE410 derived exosomes could be observed with its diameter ranged between 30-100nm.The invasion and migration ability of three esophageal cancer cells are KYSE410> KYSE510> YES2.KYSE410 exosomes promoted the migration and invasion of KYSE410,KYSE510 and YES2 cells.Conclusions Concentrated exosomes derived from the highly migratory and invasive esophageal cancer cell line KYSE410 promoted the migration and invasion potentials of itself and esophageal cancer cell lines KYSE510 and YES2,which possibly exerted the effects by activating Wnt/β-catenin and PI3K/Akt signaling pathways.
9.Current status of sorafenib in the treatment of advanced liver cancer
Zhengzheng WANG ; Kai WANG ; Jinxue ZHOU ; Qingjun LI ; Xiangyu ZHAN ; Feng HAN
Chinese Journal of Postgraduates of Medicine 2017;40(8):761-764
Sorafenib is the only molecular targeted drug therapy for advanced liver cancer recommended by the European Association for the study of liver diseases (EASL), American Association for the study of liver diseases (AASLD) and the United States Food and Drug Administration (FDA). As a multi kinase inhibitors, sorafenib can inhibit multiple signal transduction pathways of tumor cell proliferation and angiogenesis and obviously prolong the late stage of disease progression time and overall survival in patients with hepatocellular carcinoma (HCC). Criteria for evaluation of the efficacy of sorafenib in the treatment of advanced hepatocellular carcinoma (HCC) is increasingly perfect. The author gives a brief overview of the molecular mechanism, efficacy and safety and efficacy evaluation criteria of sorafenib in the treatment of advanced liver cancer.
10.Laparoscopic repair for hiatal hernia: report of 992 cases in a single center
Feng WANG ; Jimin WU ; Zhonggao WANG ; Zhiwei HU ; Xiulan ZHAN ; Changrong DENG
Chinese Journal of General Surgery 2016;31(9):732-735
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.