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Meta-analysis of end colostomy versus loop colostomy for preventive colostomy

Ye HAN ; Hong ZHAO ; Xingpo GUO ; Yichen SHEN

International Journal of Surgery.2013;40(8):515-519. doi:10.3760/cma.j.issn.1673-4203.2013.08.005

Objective To compare the complications of end colostomy and loop colostomy for preventive colostomy,then to evaluate which one is superior to the other.Methods Studies and relevant literatures comparing end colostomy with loop colostomy for defunctiong colostomy were searched by PubMed,Springer and Embase Library.The rates of complications were pooled and compared using a Meta analysis.The risk ratios were calculated with 95％ confidence intervals to evaluate the safety and efficacy of each teachnique.Results Six nonrandomized studies were included,with 1999 patients in total.The Meta-analysis of the non-randomied studies showed a lower risk of stoma retraction (RR:0.21,95％ CI:0.04 ～ 0.99,P =0.05) and stoma prolapse (RR:0.23,95 ％ CI:0.05 ～0.99,P =0.05) in the end colostomy group,but the higher risk of ischemia and necrosis (RR:5.08,95％ CI:1.94 ～ 13.22,P =0.05).No other statistically significant difference was observed for other complications.Conclusions Each type of defuncyioning stoma has its advantages and disadvantages.The study endorses end colostomy stoma over loop colostomy.However,there is not a strong evidence for the superiority of one colostomy over another for colostomy patients.So,large scale RCTs and high quality studies are needed.

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Clinical comparative study of two different surgical techniques for supination external rotation trimalleolar fractures

Yu LIANG ; Yue FANG ; Kunlong MA ; Chongqi TU ; Tianfu YANG

International Journal of Surgery.2013;40(8):537-540. doi:10.3760/cma.j.issn.1673-4203.2013.08.011

Objective To assess the outcomes of the surgical treatment of supination external rotation trimalleolar fractures,comparing the techniques of lateral plating and antiglide plating as described previously.Methods This is a retrospective review.A total of 31 patients meeting our inclusion criteria,with supination external rotation trimalleolar fractures surgically treated between 2009 and 2011,were studied.17 patients were treated with antiglide plating,whereas the remaining 14 patients underwent traditional lateral plating.They were followed up by a period ranging from 14 to 38 months(average,26 months).The functional results were evaluated with olerud and molander scoring system described previously.All the data including time to surgery,operating room time,tourniquet time,hospital stay and ankle joint function scores,were respectively analyzed in accordance with the complete randomized design t-test.Results There was no statistically significant in time to surgery,operating room,tourniquet time,hospital stay and ankle joint functional scores.Conclusions The outcome of the surgical management of supination external rotation trimalleolar fracture is comparable with both techniques.Our data do not support one technique over the other.

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Significance of ultrasound-guided core needle biopsy in diagnosis of thyroid nodules

Junfeng ZHAO ; Linxue QIAN ; Xiaoli ZHANG ; Xiaoqu TAN ; Yujiang LIU

International Journal of Surgery.2013;40(8):540-543. doi:10.3760/cma.j.issn.1673-4203.2013.08.012

Objective To explore the value of ultrasound-guided core needle biopsy (CNB) in diagnosis of thyroid nodules.Methods The clinical data of 395 patients with thyroid nodules who underwent ultrasound-guided CNB were retrospectively analyzed,and the results of CNB pathology of 278 patients who endured surgery were compared with postoperative wax pathology results.Results All patients completed CNB successfully and satisfaction rate for tissue samples was 100％.Local hematoma occurred in one case and relieved by conservative therapy.The CNB pathology results of 278 cases of patients were as follows:92 cases were malignancy,including 91 cases of papillary thyroid carcinoma,lcase of medullary thyroid carcinoma; 182 cases were benign,including lcase of parathyroid adenoma,48 cases of adenoma,and 133 cases of nodular goitre and other nodular affection.In 278 patients who underwent surgery,the CNB pathology results in 273 cases,including 90 malignancy cases and 183 benign cases,were consistent with postoperative wax pathology results and false positive occurred in 1 cases,ambiguous occurred in 4 cases.So the accuracy,sensibility,specificity,missed diagnosis rate,and misdiagnosis rate of ultrasound-guided CNB for differential diagnosis of thyroid malignant nodules from benign nodules were 98.20％ (273/278),95.79％ (91/95),99.45％ (182/183),4.21％ (4/95) and 0.55％ (1/183).Conclusion Ultrasound-guided CNB has important value on differential diagnosis of thyroid nodules.It is safe and effective.

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Research progress of the new tumor suppressor gene SLC5A8

Na CHEN ; Xiaoshi JIN

International Journal of Surgery.2013;40(8):547-550. doi:10.3760/cma.j.issn.1673-4203.2013.08.014

Current research suggests that SLC5A8 is a new candidate tumor-suppressor gene whose expression is reduced or deficient in human thyroid cancer,esophageal cancer,gastric cancer,colon cancer and acute myeloid leukemia.The gene is in human chromosomes 12q13-23,and encoding proteins that belongs to the members of the family of sodium/glucose transporters.It is sodium-coupled carrier that transfer short chain fatty acid,lactic acid,nicotinic acid and iodide.The exon 1 of GPG island methylation and histone acetylation can make SLC5A8 gene express silenced and promote the occurrence of tumor.of all transporter substrates of SLC5A8 expresses,butyrate,propionate and pyruvate function as histone deacetylase inhibitors and can be mediated apoptosis of many kinds of tumor cells,which may be the mechanism of inhibiting tumor.

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Carbon nanoparticles to protect the parathyroid gland in the thyroid surgery

Junzhong YUE ; Zhihua LONG ; Qing XU

International Journal of Surgery.2013;40(8):550-552. doi:10.3760/cma.j.issn.1673-4203.2013.08.015

In the thyroid surgery,parathyroid and laryngeal recurrent nerve injury is the most common complications.With the deepening understanding of the laryngeal recurrent nerve anatomy and surgical skills,laryngeal recurrent nerve injury incidence decline,and the prevention of complications of thyroid operation has turned to protect the parathyroid gland from laryngeal recurrent nerve protection.The technique of carbon nanoparticles labeled lymph nodes can effectively protect the parathyroid gland in thyroid surgery.

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Regneration of degenerated intervertebral dise with bone marrow mesenchymal stem cells: current status

Chaoqun YUAN ; Hailong ZHANG

International Journal of Surgery.2013;40(8):553-556. doi:10.3760/cma.j.issn.1673-4203.2013.08.016

Bone marrow mesenchymal stem cells (BMSCs) is a good seed cell,and it is widely used in intervertebral disc tissue engineering research.The improvement of cellular scaffolds,cell factors and further understanding of intervertebral disc (IVD) cell pathophysiology and BMSCs biology have laid the foundation for cell-based therapies for IVD degeneration.However,BMSCs repairing IVD is still in the early stage of research,at present there are still many problems,one of the most prominent is the survival of transplanted cells.This review mainly introduces the current research status of BMSCs in IVD tissue engineering.

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Progress of DNT cells on immunotherapy

Yue ZHAO ; Jiong CHEN

International Journal of Surgery.2013;40(8):557-561. doi:10.3760/cma.j.issn.1673-4203.2013.08.017

Regulatory T cells play an important role in regulating immune responses.Recently,a novel immune Treg cell with phenotype TCRαβ + CD3 + CD4-CD8-NK1.1-was known as the Double-negative T cells (DNT).DNT cells are able to suppress CD4 + and CD8 + T cells,B cells as well as NK cells and dendritic cells(DCs) and play an important role in regulating immune responses in models of autoimmunity,infection,inflammatory disease,transplantation and tumor immunity.Now DNT cells have already become a hot point in the research of the immunotherapy.This article mainly introduces the possible sources of DNT cells and the mechanisms of their functions.

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Mechanisms of acute pancreatitis with complications of ALI and ARDS

Lijian CUI ; Ruixia LIU ; Chenghong YIN

International Journal of Surgery.2013;40(8):561-565. doi:10.3760/cma.j.issn.1673-4203.2013.08.018

Acute pancreatitis happens rapidly and leads to patient's condition changing swiftly.Acute pancreatitis may be complicated by acute lung injury (ALI) and acute respiratory distress syndrome (ARDS),or even multiple organ dysfunction syndrome,and the mortality rate has been high.The mechanism of acute pancreatitis with complications of ALI and ARDS is intricate.It involves the uncontrolled inflammatory response,the damage and apoptosis of cell,the role of trypsin,the imbalance of coagulation and fibrinolysis,etc.These respects interrelate with each other,forming a complex network.Further study of mechanism of acute pancreatitis complicated with ALI and ARDS will supply more new target for clinical diagnosis and treatment.

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Clinical study of laparoscopic treatment of inguinal hernia in children

Qingyang BAI ; Zhiheng WAN ; Lihong CHOU

International Journal of Surgery.2013;40(9):589-592. doi:10.3760/cma.j.issn.1673-4203.2013.09.006

Objective To investigate the laparoscopic treatment of ki-67 inguinal hernia in children compared with traditional surgical superiority.Methods Sixty cases of pediatric hernia clinical data were retrospectively analyzed,divided into two groups,one group was treated with traditional surgical (n =30),and another using laparoscopic surgery(n =30).Compare the difference of surgical results,postoperative recovery,and postoperative complications.Results Laparoscopic surgery over traditional surgery in operative time,blood loss,postoperative pain,postoperative ambulation time,gastrointestinal recovery time,hospital stay time comparison,P ＜ 0.05,there is a significant difference; postoperative pain,scar,postoperative complications,recurrence rate,etc.Compare,P ＜ 0.05,there are significant differences.Conclusions Laparoscopic surgery over traditional surgery in shorter operative time,less bleeding,postoperative pain,postoperative ambulation earlier,gastrointestinal recovery time is short,shorter hospital stay,wound scar subtle,fewer complications,recurrence rate low,so the treatnent of pediatric inguinal hernia laparoscopic surgery has the advantages of minimally invasive.

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Comparation of video-assisted thoracoscopic surgery and open-chest operation on surgery trauma

Jinlong WANG ; Qiong SONG

International Journal of Surgery.2013;40(9):595-598. doi:10.3760/cma.j.issn.1673-4203.2013.09.008

Objective By means of control test,to compare the surgical trauma and perioperative recovery between video-assisted thoracoscopic surgery(VATS) and conventional thoracotony for lobectomy.Methods Eightysix non-small cell lung cancer patients who had undergone operations from April 2010 to April 2011 were chosen.According to operative mcthods,the patients were divided into two groups:video-assisted thoracoscopic surgery group(VATS) and open chest group(OT).The protein and hormone level of serum Cortisol(Cor),growth hormone (GH),triiodothyronine (T3),tetraiodothyronine (T4),C-reactive protein (CRP) were selected as indexes to investigate the surgical trauma on non-small cell lung cancer patients.The duration of operation,quantity of lymph node dissection,chest tube duration,postoperative hospital stay,postoperative complications were chosen as indexes to measure operation result and perioperative recovery.Results Under the condition that patients undergone the same operation level(lobectomy + Systemic lymph node dissection),there was no ststistical significance in preoperative level of serum Cor,GH,T3,T4,CRP.The postoperative concentrations of serum Cor,GH,T3,T4,CRP on the 1 d,2 d,3 d and 7 d were lower in VATS group,and there were obvious statistical significance(P ＜0.01).And there were obvious statistical significance in duration of operation (P ＜ 0.01),postoperative hospital stay(P ＜ 0.01),quantity of lymph node dissection (P =0.477).There were no obvious statistical significance in chest tube duration (P =0.508),postoperative complications (P =0.787).Conclusions VATS lobectomy is able to achieve a same result for radical treatment outcone and safety to routine open chest lobectomy in patients.Compared witt routine open chest lobectomy,VATS lobectomy has less surgical trauma,much rapid recovery,it should be recommended for patients with non-small cell lung cancer.

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