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Influence of intraoperative use of saline and balanced salt solution on nerve function recovery in patients with brain trauma

Ziyun GUO ; Xiongxin ZHANG ; Yuxiong LI

Journal of Regional Anatomy and Operative Surgery.2016;25(10):765-768. doi:10.11659/jjssx.01E016104

Objective To study the influence of intraoperative use of saline and balanced salt solution on postoperative nerve function recovery in patients with brain trauma.Methods Totally 120 patients were randomly divided into the saline group and the balanced salt solu-tion group,and the postoperative nerve function recovery of the two groups were observed.Results The level of pH and HCO3 -24 hours af-ter operation in the saline group were lower than those in the balanced salt solution group (P <0.05),while the level of Cl - in the saline group was higer than that in the balanced salt solution group (P <0.05).The intracranial pressure and preoperative Glasgow coma score (GCS)of the two groups had no statistical significance (P =0.94).And the Glasgow coma score at 336 hours and 672 hours after opreation of the two groups were of statistical significance (P =0.00,P =0.03).The mortality of the saline group and the balanced solution group 28days after surgery were 15% and 10% respectively,and there was no significant difference between the two groups (P =0.58).Conclusion Saline resuscitation during surgery would lead to hyperchloremic acidosis as well as worse nerve function.However,the perfusion of balanced salt solution during the operation is more favorable to the recovery of neurological function.

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Minimal invasive surgery combined with ventriculoscope for the treatment of basal ganglia hemorrhage

Yonggang LIU ; Jiangfeng LIU ; Kai BAI ; Zhen CHEN ; Weijun QIAO

Journal of Regional Anatomy and Operative Surgery.2016;25(10):754-757. doi:10.11659/jjssx.03E016052

Objective To investigate the effectiveness and safety of minimal invasive surgery combined with ventriculoscope for the treatment of basal ganglia hemorrhage.Methods From June 2014 to June 2015 there were 57 patients with basal ganglia hemorrhage were selected into this study.These patients were signed into the minimal invasive surgery combined with ventriculoscope group and the craniotomy group according to the methods of surgery they received.And the clinical outcomes of the two groups were compared.Results Compared with the craniotomy group,patients in the minimal invasive surgery combined with ventriculoscope group got a significantly lower Glasgow coma scale at 7 days,14 days and 28 days after the operation (P =0.02,0.04,0.04);the hospital stays were significantly reduced in the minimal invasive surgery combined with ventriculoscope group [(21.45 ±5.67)d vs.(25.67 ±7.45)d,P =0.02];and the operation time were significantly reduced as well [(134.45 ±21.11)min vs.(178.65 ±45.32)min,P =0.000)].There was no significant difference in intra-cranial pressure,rate of hematoma clearance,rate of organ functional failure,rate of re-bleeding and mortality 28 days after operation (P >0.05).Conclusion The minimal invasive surgery combined with ventriculoscope is effective and safe for the treatment of basal ganglia hemorrhage,which is worthy of popularization.

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Effect of comprehensive intervention on the treatment success rate of patients with traumatic shock

Hongye JI

Journal of Regional Anatomy and Operative Surgery.2016;25(10):750-753. doi:10.11659/jjssx.03E016106

Objective To investigate the effect and medical satisfaction of comprehensive intervention on the treatment success rate of patients with traumatic shock.Methods From February 2012 to February 2015,71 patients with traumatic shock were admitted into our hos-pital,and they were randomly divided into the observation group (36 cases)and the control group (35 cases)according to the random num-ber table method.Routine medical measures were adopted in the control group,while comprehensive intervention measures were taken on the basis of routine medical measures in the observation group.And then compared the treatment success rate,complications and medical satisfac-tion rate of the two groups.Results The treatment success rate was 94.44% in the observation group and 74.29% in the control group,the difference was statistically significant (P <0.05).The rate of complications occurred during the treatment was 16.67% (6 /36)in the obser-vation group,while it was 40% (14 /35)in the control group,and the difference was statistically significant(P <0.05).In the observation group,there was 29 cases (80.56%)of satisfied,6 cases (16.67%)of basically satisfied,and 1 cases (2.78%)of dissatisfied.In the con-trol group,there was 19 cases (54.29%)of satisfied,10 cases (28.57%)of basically satisfied,and 6 cases (17.14%of dissatisfied.The difference of satisfaction rate in the two groups was statistically significant(P <0.05).Conclusion Comprehensive inter-vention can efficiently improve the treatment success rate in patients with traumatic shock,reduce the rate of complications occurred during the treatment,help to improve the prognosis of the patients,and improve the medical satisfaction rate of patients.

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A biomechanical study of new developed external fixation system on tibia fracture

Mei WANG ; Wen ZHAO ; Qingmin SHEN ; Zihao LIU

Journal of Regional Anatomy and Operative Surgery.2016;25(10):742-745. doi:10.11659/jjssx.04E016004

Objective To test the biomechanical properties and evaluate the feasibility of the new developed external fixator system,so as to provide reliable theoretical basis for further clinical research.Methods The tibia of 10 fresh male cadaver were made into fracture model.In order to fix the fracture of tibia,experimental group were treated with the new developed external fixator system and the control group were treated with the Hoffman 2 external fixator which was used in clinic commonly.Then axial compression and horizontal torsion test were made on tibia fracture model.The test results were recorded and statistically analyzed.Results There was no statistical difference on the aspect of the ability to resist axial compression and horizontal torsion between the experimental group and the control group(P >0.05). The new developed external fixator system could meet the criterion in clinical application.Conclusion The new developed external fixation system can meet the requirement of biomechanics on fixing the fracture of bone,and it can greatly simplify and diversify the clinical applica-tion of external fixation device.

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Clinical efficacy of membrane induced technique for reconstruction of large tibia bone defects

Jun GUO ; Xinwei LIU ; Bing XIE ; Hongwei WANG ; Dapeng ZHOU ; Yu CHEN

Journal of Regional Anatomy and Operative Surgery.2016;25(10):738-741. doi:10.11659/jjssx.04E016014

Objective To investigate the clinical efficacy of induced membrane technique for reconstruction of large tibia bone defects in adults.Methods From February 2010 to February 2014,28 cases with tibia bone defect (16 cases caused by traumatic,9 cases caused by chronic osteomyrlitis,and 3 cases caused by tumor resrction)were treated in our deparment.There were 21 males and 7 females,with a mean age of 36.7 years old.The mean bone loss after final debridement and tumor resrction was (6.2 ±2.6)cm,and the maximum length of bone loss was 16 cm in this series.All the patients were treated by induced membrane technique,and the healing rate,occurrence of complications and limb function were recorded.The bone union was assessed by Paley scores.Results The average duration of follow-up ranged from 12 to 37 months,averagely (23.4 ±4.7)months.The healing rate was 85.7% at a mean time of 5.2 months.According to the Paley scores,there were 20 cases of excellent,6 cases of good,2 cases of moderate.There were 2 patients with pin site infection,2 patients with deep infection re-quiring operative debridement,1 patient with superficial iliac incision infection,1 patient with nonunions of one ends of the bone gap,and 1 patient suffered the implant failure due to fullweight-bearing early.Conclusion The induced membrane technique is a valid option for the management of large tibia bone defects in adults caused by traumatic,tumor resection and removal of chronic osteomyelitis lesions,which sig-nificantly shorten treatment cycle,provide satisfactory results with minimal complications,and promote good recovery of limb function.

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Clinical curative effect of early activity on preventing deep vein thrombosis after joint replacement

Yuanyuan WU ; Rongrong XI ; Yong ZHOU

Journal of Regional Anatomy and Operative Surgery.2016;25(10):732-734. doi:10.11659/jjssx.04E016002

Objective To observe the clinical efficacy of the early activity on preventing deep vein thrombosis after joint replacement. Methods A total of 90 patients who undergone skeleton and knee joint replacement from January 2014 to January 2015 were randomly divid-ed into the observation group and the control group (with 45 cases in each group)according to the random number table method.The control group were given routine nursing care to prevent thrombosis,while the observation group were given intervention nursing,namely implementa-tion of early activities.The related symptoms of deep venous thrombosis and D-dimer level of high blood coagulation state of plasma of the two groups were observed and compared before and after treatment.Results The symptoms of deep vein thrombosis of the observation group in the early postoperative period were less than that of the control group,and the difference was significant(P <0.05).The D-dimer level of the observation group was lower than that of the control group 7 days after the operation with a significant difference (P <0.05).Conclusion Systematic nursing intervention of early activities can significantly reduce the related symptoms of forming deep vein thrombosis after joint re-placement.In addition,it has an apparent effect on lowing the high blood coagulation state and preventing deep vein thrombosis.

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Correlation research and clinical significance between youth cervical hook and transverse foramen

Xing WANG ; Jun SHI ; Shaojie ZHANG ; Xiaohe LI ; Ying LIU ; Zhijun LI ; Erfei HOU ; Jie CHEN ; Wei WANG

Journal of Regional Anatomy and Operative Surgery.2016;25(10):728-731. doi:10.11659/jjssx.04E016089

Objective The correlation analysis was proceeded between youth cervical hook and transverse foramen by using imaging scanning and three-dimensional reconstruction method,which can provide theoretical basis for early diagnosis,treatment and prevention of ju-venile cervical spondylosis.Methods A total of 66 teenagers who had no trauma,neurological symptoms or signs were selected with aged from 6 to 20 years old,who were scanned by multi slice spiral CT,ranged from C1 to T1 .The original data in DICOMformat to import 3D re-construction software was related index measurement and subsequent statistical analysis.Results There was a correlation between hook height,base width,base length of luschca joint and transverse diameter,longitudinal diameter.Conclusion Hook vertebral meridian of lus-chca joint and transverse foramen has a close contact.Factors such as fracture and hyperplasia of luschca joint,vertebral artery of transverseforamen can be oppressed that cause corresponding vertebral artery type of cervical spondylosis.

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Bioinformatics screening of up-regulated protein kinases and their inhibitors in nasopharyngeal cancer

Shu ZHANG ; Xiaobo CUI ; Juan SUN

Journal of Regional Anatomy and Operative Surgery.2016;25(10):720-723. doi:10.11659/jjssx.04E016024

Objective To screening up-regulated protein kinases and their inhibitors in order to provide new targets for molecular thera-py of nasopharyngeal cancer.Methods GEO database and SAM software were employed to screen the up-regulated protein kinase gene in nasopharyngeal cancer.Based on DAVID database,the regulating functions of kinases were identified.The inhibitors of up-regulated kinase genes were identified by Selleckchem database.Literature mining was used to screen the potential anti-cancer drugs.Results Totally 2360 differentially expressed genes including 21 up-regulated protein kinases (CHEK1,CHEK2,PRKDC,AURKA,VRK2,STK17A,MELK,NU-AK1,TRPM7,MASTL,AXL,BUB1,BUB1B,CDK4,TTK,CDC7,CASK,AKT3,TBK1 and PBK)were identified in the whole genome profi-ling (Fold Change≥2,P <0.05).The results of function analysis showed the up-regulated genes were enriched in 10 function terms such as‘protein amino acid phosphorylation’‘phosphorylation’‘phosphate metabolic process’‘mitotic cell cycle’‘cell cycle phase’‘regulation of cell cycle’,and so on.The Selleckchem database analysis showed there were 9 up-regulated protein kinases equipped with 51 inhibitors which were proved already.The results of literature mining showed that 18 inhibitors of them had a few studies (less than 10 literatures)in cancer terms,and there was a potential to become new drugs to treat nasopharyngeal cancer.Conclusion A total of 21 up-regulated protein kinases were identified,and they might promote the nasopharyngeal carcinoma by regulating functions such as the cell-cycle control pathway.Their ki-nase inhibitors may have a potential role in anti-cancer treatment,which provided a new target point for molecular therapy of nasopharyngeal cancer.

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Large diameter esophagogastric internal fistula combined with fundoplication for treatment of achalasia

Xu ZHAO ; Xiaoping LIANG ; Heping BAI ; Zhen ZHANG ; Jun YU ; Baojun CAO ; Jiang HE ; Rui WANG

Journal of Regional Anatomy and Operative Surgery.2016;25(10):758-761. doi:10.11659/jjssx.01E016018

Objective To explore the clinical the efficacy of large diameter esophagogastric internal fistula combined with fundoplication and modified Heller surgery for treatment of achalasia.Methods From June 2008 to March 2014,18 patients diagnosed as achalasia were se-lected into this suty,and they were divided into the observation group (8 cases)and the control group (10 cases).Patients of the observation group were received large diameter esophagogastric internal fistula combined with fundoplication while patients of the control group received modified Heller surgery.Compared the surgical curative effect and complications between the two groups.Results All the 18 patients suc-cessfully completed the arranged surgical treatment.The imaging examination 3 months after the operation showed that the contrast agent suc-cessfully passed through the esophagus,cardia and the anastomosis,and then went into the gastric lumen.The total effective rate was 100% in the observation group 12 months after operation,while it was 60% in the control group,and the difference between the two groups was statisti-cally significant (P =0.014).The incidence of complications in the observation group was lower than that of the control group,the difference was statistically significant (P =0.026).Conclusion Large diameter esophagogastric internal fistula combined with fundoplication for treat-ment of achalasia is safer,and there is a possibiltiy to cure the achalasia.

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Clinical anatomic type observation of the first metatarsal dorsal artery

Yisheng ZHANG ; Bin MENG ; Fengliang SONG ; Boshu CHU ; Yingjian CUI ; Heng MENG ; Jiangfa XU ; Xiaohuan LU ; Yuxian SUN ; Bin YU

Journal of Regional Anatomy and Operative Surgery.2016;25(10):715-719. doi:10.11659/jjssx.05E016019

Objective To study the anatomic data of the first metatarsal dorsal artery and to provide anatomical basis for clinical tissue transplantation based on the first metatarsal dorsal artery.Methods The 16 adult cadaver specimens with 32 feet were dissected and meas-ured by vernier caliper.Then the anatomic data of the first metatarsal dorsal artery were analyzed.Results Through the examinations of 32 feet sample,the first metatarsal dorsal artery were classified into 5 types.Type Ⅰ:the first metatarsal dorsal artery runs at the surface of the first dorsal interosseous muscle (13 sides,40.6%).Type Ⅱ:the first metatarsal dorsal artery runs in the interior of the first dorsal interosse-ous muscle (11sides,34.4%).Type Ⅲ:the first metatarsal dorsal artery runs underneath the first dorsal interosseous muscle (6 sides, 18.8%).Type Ⅳ:the first metatarsal dorsal artery is slender (1 side,3.1%).TypeⅤ:the first metatarsal dorsal artery is absent (1 side, 3.1%).Distance relationship was measured between the first metatarsal bone and the first metatarsal dorsal artery:the vertical distance be-tween the origin of the posterior branch of the first metatarsal dorsal artery and base of the first metatarsal bone was (2.4 ±0.3)mm,the ver-tical distance between the origin of the posterior branch of the first metatarsal dorsal artery and head of the first metatarsal bone was (10.1 ±1.0)mm;the vertical distance between the origin of the anterior branch of the first metatarsal dorsal artery and the first metatarso-phalangeal joint was (7.6 ±2.7)mm.Conclusion The first metatarsal dorsal artery has clinical reference significance for the hands and feet’s trauma and skin flap transplantation such as thumb reconstruction.

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