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Treatment and progress of the fixation of ribs of flail chest

International Journal of Surgery.2011;38(1):63-65. doi:10.3760/cma.j.issn.1673-4203.2011.01.020

Flail chest is the common chest trauma, which causes abnormal respiration and mediastinal swing affecting the respiratory and circulatory function after injury. Fixation of ribs of flail chest has been used for half a century, methods and equipment of which varied, and domestic and foreign scholars have verified its efficacy in clinical practice. This article summarizes its main great progresses.

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Advances in Zuckerkandl tubercle

Qingshan LIANG ; Hongliang JI ; Bo LI ; Xiangdong SUN ; Shaohua DANG ; Jing FENG

International Journal of Surgery.2011;38(1):53-56. doi:10.3760/cma.j.issn.1673-4203.2011.01.017

Zuckerkandl tubercle is the extension of thyriod gland. For the past few years, more and more surgeons and anatomists have become interested in it. Clinically, surgeons usually rely on specified anatomical landmarks to avoid injuries to the recurrent laryngeal nerve, including the laryngeal branches and the superior parathyroid in thyroid surgery, such as the bottom corner of the thyroid cartilage, the inferior thyroid artery, lower pole of thyroid, tracheoesophageal groove, suspensory ligament of thyroid gland and so on. As the specified landmarks, they have several common characteristics:on the one hand, their location should be constant; on the other hand, they should be easy to observe and touch, meanwhile convenient and practical.As a new anatomical landmark, Zuckerkandl tubercle is in accordance with the above characteristics and prevalent in the population. Therefore, Zuckerkandl tubercle could become an important landmark to identify the the recurrent laryngeal nerve, including the laryngeal branches and the superior parathyroid in thyroid surgery. This essay aims to briefly analyze the role of Zuckerkandl tubercle in thyroid surgery.

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Pancreatectomy combined with portal vein/superior mesenteric vein resection: the present condition, controversy and expectation

Dongdong CHU ; Jie WANG

International Journal of Surgery.2011;38(1):45-49. doi:10.3760/cma.j.issn.1673-4203.2011.01.015

Pancreatic cancer frequently infiltrates the portal vein system because of the close anatomical proximity between the head of the pancreas and the portal/superior mesenteric vein confluence,and the biological character of invasion. In these cases, pancreatectomy combined with portal vein/superior mesenteric vein resection is a potential treatment, but the outcome remains controversial. So far there is no significant evidence have shown that the pancreatectomy combined with portal vein/superior mesenteric vein resection improves the prognosis of pancreatic cancer patients. In order to establish clinical practice guidelines, as well as standardize operational indication and operational method, it is necessary to conduct large-scale, multicenter, randomized and controlled prospective clinical trials,and collect long-term follow up information.

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Development of the scavenger receptor B type Ⅰ research

Huaming TANG ; Zhengming LEI

International Journal of Surgery.2011;38(1):33-36. doi:10.3760/cma.j.issn.1673-4203.2011.01.011

Scavenger receptor B type Ⅰ (SR-BI) is a HDL receptor which fivst identified at molecular level. It can mediate the metabolism of cholesterol and other lipids between HDL and cells, involving in intestinal absorption of cholesterol, and mediate outflow of cholesterol from peripheral tissues to promote the selective uptake of cholesterol by the liver and transfer in liver cells, and then secrete cholesterol into the bile through the bile duct side of the membrane. This process can affect cholesterol levels in bile. In this review,we discuss the process of SR-BI-mediated cholesterol metabolism.

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Diagnosis and treatment of colonoscopic perforation

Daquan WANG ; Xuefeng ZHANG

International Journal of Surgery.2010;37(11):750-752. doi:10.3760/cma.j.issn.1673-4203.2010.11.011

Colonoscopy has become the most commonly used method to the diagnosis and treatment of colorectal diseases at present.Colonoscopic perforation is considered the most serious complication with high mortality, especially in the patients with certain risk factors and iatrogenic factors, despite of its low incidence.According to the clinical features in the period of perioperative colonoscopy, early detection of colonoscopic perforation is a prerequisite for successful treatment and the key to lower mortality.So far in the treatment,some methods can be selected, including conservative treatment, open surgery, laparoscopic surgery and endoscopy folders, etc.Clinical judgement and analysis of disease should be specific and accurate, but not to be generalized.Doctors should adopt reasonable and effective treatment options according to clinical performance, the size of perforation,intestinal readiness, time of diagnosis, colon primary lesion and so on.

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Surgical treatment for rectal prolapse

Hao WANG ; Yunfei GU

International Journal of Surgery.2010;37(11):747-749. doi:10.3760/cma.j.issn.1673-4203.2010.11.010

Rectal prolapse is a rare disease, has been attracting many surgeons to study it.Surgical treatment of rectal prolapse is currently more than 50 kinds, most of which are modifications of several basic modes treatment, depending on the doctor' s grasp on the patient anatomy.Currently comprehensive treatment of a variety of therapies is a more ideal way for the treatment of rectal prolapse.

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The prevention and treatmernt of modial siming tablets in circuar mixed hemorrhoid postoperative edeme

Yan WU

International Journal of Surgery.2010;37(11):743-744. doi:10.3760/cma.j.issn.1673-4203.2010.11.008

Objective To observe the effect of Diosmin Tablets about the prevention and treatment of edema that breaks out after a circular mixed hemorrhoids operation and the role of fibrosis on edema.Methods Having 120 cases of circular mixed hemorrhoid patients, Acco 60 cases were randomly divided into treatment group and the others were in comparison group.Both groups were outside the cut line of circular mixed hemorrhoid ligation within the injection, after these operations do conventional anti-inflammatory, hemostasia and local Ma Ying Long musk hemorrhoids ointment medication.The next day of the operation, the treatment group take a dose of Diosmin tablets 1.5 g bid 4 d, then changing the dose 1 g bid 3 d.ResultsThe incidence of edema, treatment group was 6.6% and the other group was 30%.edema in the incidence of the two groups were significantly different(P ＜ 0.01).The treatment group non-fibrosis, but the other group have 4 patients getting fibrosis.The two sets of rate about edema fibrosis were significantly different(P ＜ 0.01).Conclusion Diosmin Tablets can effectively do prevent and disperse circular mixed hemorrhoid postoperative edema.

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Prognostic effect of number of lymph nodes sampled in patients with stage Ⅰ non-small cell lung cancer

Zhengxing LIAO ; Feng TIAN ; Dong CHANG ; Min GONG ; Yujun TONG

International Journal of Surgery.2010;37(11):735-739. doi:10.3760/cma.j.issn.1673-4203.2010.11.006

Objective To investigate the prognostic effect of quantity of lymph node(LN)resected in operations of patients with stage Ⅰ non-small cell lung cancer(NSCLC).Methods The clinical, pathological and follow-up data of 74 patients with stage Ⅰ NSCLC who were treated with surgery from January 1998 to December 2002 Beijing Friendship Hospital, Affiliated to Capital Medical University were reviewed retrospectively.Grouping the patients, according to the quantity of lymph node resected, the Kaplan-Meier method and Cox proportional hazards model was used for univariate analysis and multivariate analysis of factors with prognostic effect.Results The five year survival rate and disease-free survival(DFS)rate of these 74 patients were 64.9% and 47.3%.The univariate analysis showed that tumor size(P =0.016),T-staging (P =0.008)and extent of lymph node dissection(P =0.013)could influence the survival rate.The 5-year OS and DFS rates of patients with less than 6 LNs resected were less than the other group(more than 6 LNs)apparently.The multifactorial analysis indicated that other than staging, the quantity of lymph node resected was also an influence factor of prognosis.Conclusions The OS rate of patients has positive correlation with quantity of lymph node resected in operations.Six LNs must be resected leastways in operations of patients with stage Ⅰ NSCLC.

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Brain injury and β-amyloid precursor protein, β-amyloid protein

Shukai WU ; Junyan CHEN ; Hongzhi GAO

International Journal of Surgery.2011;38(1):59-62. doi:10.3760/cma.j.issn.1673-4203.2011.01.019

As a transmembrane protein, β-amyloid precursor protein(β-APP) distributes extensively in the central nervous system, has the effect of neurotrophic, and neuroprotective, promote neurite growth and synaptogenesis, β-amyloid(Aβ) is the digestion products of its precursor-APP in the pathological conditions, and it is the main component of senile plaques-the main pathological changes of Alzheimer' s disease (AD), its toxic effects can also induce neuronal apoptosis, The expression of the two proteins after brain injuried has a close relationship with the injury, cognitive dysfunction, Alzheimer' s disease and the pathophysiological changes of central nervous system. To explore its expression in the brain after traumatic brain injury can determine the degree of injury, assess the prognosis and open up new avenues for the treatment of traumatic brain injury.

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Application of laparoscopic and endoscopic cooperative surgery in treatment of gastric stromal tumor

Weiqing QIU ; Hui CAO

International Journal of Surgery.2011;38(1):31-33. doi:10.3760/cma.j.issn.1673-4203.2011.01.010

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor in the GI tract. Surgical resection of the local disease is the gold standard therapy. In recent years, in virtue of the development of minimal invasive surgery such as laparoscopic surgery and endoscopic surgery, laparoscopic and endoscopic cooperative surgery (LECS) has been applicable for treatment of gastric GIST. This article reviewed the recent advances in LECS in treatment of gastric GIST.

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