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Progress of bariatric surgery on treatment of obesity and type 2 diabetes

Zhaoyang YAN ; Zhongtao ZHANG ; Hua MENG

International Journal of Surgery.2014;41(10):698-700. doi:10.3760/cma.j.issn.1673-4203.2014.10.016

Obesity and type 2 diabetes are common chronic diseases which severely threatens human's health and lives.In addition to behavioural and medical approaches,the bariatric surgery is increasingly being valued by medical workers.There are many kinds of surgical method of the bariatric surgery,but by far the most popular ones are Laparoscopic sleeve gastrectomy and Laparoscopic sleeve gastrectomy.The mechanism of the surgery may related to gastrointestinal hormones and fat metabolism,but no final conclusion has yet been reached on this matter.This paper is a literature review on the effect and mechanism of bariatric surgery.

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Progress in diagnosis and treatment of gastrointestinal neuroendocrine tumors

Xuetong JIANG ; Daorong WANG

International Journal of Surgery.2014;41(10):700-705. doi:10.3760/cma.j.issn.1673-4203.2014.10.017

Gastrointestinal neuroendocrine tumor is a group of heterogeneous tumors and was considered as a rare tumor.According to the data of recent years,its incidence has been increased significantly.The clinical manifestations of gastrointestinal neuroendocrine tumors are varied,and serum chromogranin-A is considered the most important biomarker of both non-functioning and functioning neuroendocrine tumors.The traditional imaging examination and somatostatin receptor scintigraphy are helpful to diagnosis.Its treatments include surgery,biological treatment,radionuclide therapy and chemical therapy.The aim of this paper is to summarize briefly the clinical symptoms,diagnostic methods and treatment options of gastrointestinal neuroendocrine tumors.

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The research status of the risk factors associated with thoracic aortic dissection

Jian ZHU ; Zizi ZHOU ; Shuibo ZHU

International Journal of Surgery.2014;41(10):705-708. doi:10.3760/cma.j.issn.1673-4203.2014.10.018

Thoracic aortic dissection was a catastrophic disease with change quickly,and the characteristic of thoracic aortic dissection was acute onset,complex,progress rapidly,difficult to diagnosis,and highly misdiagnosis rate.So the fatality rate of thoracic aortic dissection was high,which easy caused medical disputes.Even so,the cause of the formation of thoracic aortic dissection in detail is not clear,and many risk factors associated with the occurrence of thoracic aortic dissection.These including high blood pressure,gender (male),aortic normal aging,drug using,atherosclerosis,genetic disease and inflammatory diseases,etc.

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Application of anterior internal fixation plus vacuum sealing drainage in the treatment of ulnar and radial fractures of Gustilo type Ⅲ

Dingxiang HU ; Ruiqing ZHENG ; Daqiang LIN ; Fang HE

International Journal of Surgery.2014;41(11):730-733. doi:10.3760/cma.j.issn.1673-4203.2014.11.004

Objective To investigate the clinical effect of anterior internal fixation plus vacuum sealing drainage in the treatment of ulnar and radial fractures of Gustilo type Ⅲ.Methods Twenty-eight patients with open ulnar and radial fracture of Gustilo type Ⅲ were managed from April 2007 to March 2014,and were divided into four groups(n =4).Group A were managed with external fixator and conventional changing dressings.Group B were managed with internal fixation and vacuum sealing drainage.Group C were managed with external fixator and vacuum sealing drainage.Group D were managed with internal fixation and conventional changing dressings.Result Twenty-eight cases were adopted telephone follow-up for 6 to 27 months.The soft tissue recovery time of each group respectively was (20.5 ± 2.37) days,(14.7 ±2.16) days,(15.6 ±2.17) days and(19.7 ±2.18) days.The hospital stay of each group respectively was (9.7 ± 2.54) weeks,(4.7 ± 1.46) weeks,(5.2 ± 2.34) weeks and 8.6 ± 2.16) weeks.The fracture healing time of each group respectively was (19.6 ± 2.74) weeks,(13.1±1.84) weeks,(18.1 ±2.54) weeks and (14.7 ± 1.74) weeks.There was significant difference of these data between the two groups(P ＜ 0.05).Conclusions Anterior internal fixation plus vacuum sealing drainage is a better way to treat ulnar and radial fractures of Gustilo type Ⅲ.The technique has short period,less complications,less painful and less expense.

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Analysis of the risk factors acute kidney injury after off-pump coronary artery bypass surgery

Jianzhong GUO ; Dalian LI ; Zhiguang CHENG ; Yongchao CUI ; Yingying LI ; Yong ZHANG

International Journal of Surgery.2014;41(11):747-750. doi:10.3760/cma.j.issn.1673-4203.2014.11.009

Objective Univariate analysis and multivariate risk factors of early acute kidney injury on off-pump coronary artery bypass grafting are performed.Methods Analyzed retrospectively the clinical date of 261 patients who underwent off-pump coronary artery bypass surgery between Jan 2011 to Dec 2013.According to the clinical diagnostic ctriteria,261 patients were divided into AKI group (n =29) and NAKI group(n =232).There were 22 males and 7 females with an age of (68.74 ± 10.27) years in the AKI group,there were 179 males and 53 females with an age of (66.26 ± 9.82) years in the NAKI group.we summarize the clinical date,including blood pressure,left ventricular ejecting fraction,diameter of the left ventricle and serum creatinine before operation,and observed postoperative complications etc.Evaluated the factors for AKI Using Logistics regression analysis statistical methods.Results Among all the patients,the incidence of AKI was 11.11％ (29/261),1 patients died in all the patients for AKI.The statistical analysis revealed that the serum creatinine after operation,anesthesia time,and perioperative blood transfusion were the risk factors for acute injury after off-pump coronary artery bypass surgery.Conclusion AKI is the most common complication of off-pump coronary artery bypass surgery.we should carefully evaluate risk factors and enhance protection of the renal function and reduce the risk of AKI occurred.

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Correlation between the expression of periostin and Epithelial-mesenchymal transition markers in colorectal cancer

Leilei YAN ; Jing YAO ; Xuebing YAN ; Yu WANG

International Journal of Surgery.2014;41(11):750-754. doi:10.3760/cma.j.issn.1673-4203.2014.11.010

Objective To investigate the correlation between the Periostin and Epithelial-Mesenchymal Transition(EMT) markers(E-cadheirn and N-cadheirn) in colorectal cancer(CRC),and analyze the relationship between the expression of Periostin and clinicopathological parameters.Methods The expression of Periostin,Ecadheirn and N-cadheirn in 106 cases with primary CRC tumors and corresponding normal tissues were detected by Immunohistoehemistry and the results were analyzed.Results The expression of Periostin,E-cadheirn and N-cad-heirn in tumors were significantly high expression than those in corresponding normal tissues(62/106 vs 21/106,x2 =34.027,P ＜ 0.05 ;43/106 vs 89/106,x2 =42.480,P ＜ 0.05 ; 66/106 vs 19/106,x2 =43.382,P ＜ 0.05).The expression of Periostin in tumors was associated significantly with tumor differentiation,tumor invasion,lymph node metastasis and distance metastasis (x2 =7.752,P =0.007; x2 =5.008,P =0.031 ; x2 =10.227,P =0.002;x2 =8.001,P =0.006).It was negatively correlated with E-cadherin expression (r =-0.435,P ＜ 0.001),but positively correlated with N-cadherin expression (r =0.213,P =0.028).Conclusion Periostin may promote the occurrence and development of CRC by participating in EMT program.

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Common complication and progress of Percutaneous endoscopic lumbar discectomy

Shan ZHAO ; Hailong ZHANG ; Xin GU ; Xiaofei GUAN ; Shisheng HE

International Journal of Surgery.2014;41(11):780-783. doi:10.3760/cma.j.issn.1673-4203.2014.11.018

Percutaneous endoscopic lumbar discectomy belongs to minimally invasive spine operation Its superiority includes smalleroperation wound,less bleeding,shorter hospital day,and earlier return to function,conpared with the traditional operation.At the same time,percutaneous endoscopic lumbar discectomy has complications,as the open operation.This paper reviews its common complications,diagnosis,prevention and control.

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Advancement in researches of the effects of perioperative analgesia on immune function of cancer patients

Jianyu ZHU ; Weidong JIA

International Journal of Surgery.2014;41(12):845-849. doi:10.3760/cma.j.issn.1673-4203.2014.12.016

Perioperative immunosuppression exists in cancer patients are as a result of their own disease,and postoperative pain inhibit immunological function.The effective postoperative analgesia can relieve the suppression of cell-mediated immunity,as well as reducing tumor recurrence and metastasis.However,diverse range of analgesic agents and techniques have a different impact on immune function.This article reviews the influence of various analgesic agents and techniques on the perioperative immune function of cancer patients so as to provide more suitable analgesia techniques,which is beneficial for regulating of immune balance,lessening tumor recurrence and improving prognosis.

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Compared the clinical effect with X-ray or B ultrasound guided puncture target calyces of treatment upper urinary calculi in MPCNL

Hongfeng DAI ; Shunhui YUAN ; Zehui LI ; Zhipeng LI ; Lijie FU ; Jinkun LI

International Journal of Surgery.2015;42(1):16-19. doi:10.3760/cma.j.issn.1673-4203.2015.01.006

Objective To compare with the efficiency between X-ray or B ultrasound guided puncture target calyces of treatment of upper urinary calculi in MPCNL.Methods From October 2010 to October 2012,we have a retrospective analysis of the 116 cases in urological department in the second affiliated hospital of Kunming Medical University,it had the sugery that was MPCNL.Selected 116 cases as the research object,(8 patients were lost to follow-up).With X-ray locating (48 cases),B ultrasound locating (53 cases),and compared with preoperative,intraoperative and postoperative clinical objective indicators of two different methods.Results X-ray locating (48 cases),the mean age was (44.86 ± 12.84) years; the mean Stone diameter(1.43 ±0.70) cm; Stone is located in the upper calyx in 1 case,the middle of calyx in 23 cases,under the calyx in 8 cases,the upper ureter in 16 cases.B ultrasonic locating (53 cases),the mean age was(46.36 ± 14.29) years; the mean Stone diameter (1.34 ±0.62) cm; Stone is located in the upper calyx in 2 cases,the middle of calyx in 24 cases,under the calyx in 8 cases,the upper ureter in 16 cases.Compared with preoperative general data of two groups,there was no statistically significant difference (P ＞ 0.05).X-ray group,the mean operation time (130.43 ± 31.63) min ; Intraoperative blood loss(80.42 ± 43.75) mL; Postoperative hospital stay (6.20 ± 2.08) d; Infected with 8 cases (17％) of postoperative,hemorrhage in 2 cases (4％) ; and calculi exhausted rate was 90％ (43/47).B Ultrasound group,the mean operation time(102.45 ± 36.32) min.Intraoperative blood loss(160.07 ± 52.33) mL;Postoperative hospital stay(5.62 ±2.37) d; Infected with 16 cases (30％) of postoperative,bleeding in 9 cases (17％) ; and calculi exhausted rate was 83％ (46/53).By comparison,X-ray and B ultrasound group in operation time,intraoperative blood loss,postoperative infection,a stone exhausted rate was statistically significant (P ＜0.05),and postoperative hospital stay,no statistical significance (P ＞ 0.05).Conclusion X-ray positioning compared with B ultrasound,X-ray is longer than B ultrasonic of operation time,but,blood much less,calculi exhausted rate is higher,and infected rate is lower.

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Diagnosis and treatment of pseudomyxoma peritonei in accidental discovery: a report of 8 cases

Jianglin LI ; Fei SHEN ; Zhe FENG ; Jiwei CHEN ; Wensong CAI ; Guanghui ZHU ; Bo XU

International Journal of Surgery.2015;42(1):20-23. doi:10.3760/cma.j.issn.1673-4203.2015.01.007

Objective To investigate the diagnosis and treatment of pseudomyxoma peritonei (PMP) and provide a reference for diagnosis and treatment of PMP.Methods The clinical features,laboratory examinations,treatment and outcomes of 8 PMP misdiagnosed cases were analyzed with recent relevant reference.Results Ultrasonography,CT,peritoneal cytological examination,tumor markers results are helpful for diagnosis of PMP.PMP will be confirmed and classified by pathological examination after operation.Complete cytoreductive surgery (CRS)or major debulking surgery (MDS) of the tumor combined intraperitoneal chemotherapy and systemic chemotherapy,eight patients in seven cases survived 4-71 month range,one patient died of respiratory failure of pulmonary infection after the third operation.Conclusions Ultrasonography,CT,peritoneal cytological examination,tumor markers tests help avoid misdiagnosis of PMP before operations.Intraoperative findings follow after PMP,CRS or MDS should be executed in the operation or the next time.Intraperitoneal chemotherapy and conventional chemotherapy can improve survival in patients with PMP and prolong their survival time.

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