Archive

18 January 2007, Volume 27 Issue 01 Previous Issue    Next Issue
---
论著


For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

论著

Select

Study of gland remnants size on operative primary hyperthyroidism FAN Dong,GUO Hai-feng,YOU Zhen,et al. 2007, 27(01): 1-86.  Abstract ( )   PDF (393KB) ( )   Objective:Investigate the various factors affecting postoperative function of primary hyperthyroidism. Methods:80 patients with moderate and grave primary hyperthyroidism proven postoperatively and pathologically are selected and clinical data is documented.They are follow-up 1-8 years.The obtained data is analyzed by means of SAS software. Results:Age,sex,whether taking hyperthyroidism medicine,the course of disease and preoperative T3、T4、FT3、FT4 all show no obvious effect on postoperative function of thyroid.There is positive linear correlation between total thyroid weight,remnant weight,remnant ratio and postoperative function of thyroid. Conclusion:Total thyroid weight and remnant weight are an important factor affecting postoperative function of thyroid. We advocate that multiple regression equation should be used to determine both preoperatively and postoperatively the thyroid remnant weight of primary hyperthyroidism.

Select

Application of enteral nutritional support by needle catheter jejunostomy feeding tube during postoperative adjuvant chemotherapy of staged gastric cancer RONG Zhen-xiang,FANG Chi-hua,ZHU Da-jian. 2007, 27(01): 1-83.  Abstract ( )   PDF (417KB) ( )   Objective:To study the feasibility and clinical effects of enteral nutrition by needle catheter jejunostomy（NCJ）tube in the postoperative adjuvant chemotherapy for patients of staged gastric cancer. Methods:Seventytwo patients with staged gastric cancer underwent radical gastrectomy and going to receive chemotherapy were randomly divided into group A (n=36) and group B (n=36).All of the patients had been NCJ.Group A received enteral nutrition through the tube during chemotherapy,and group B had been given general diet.A series of parameters were measuredpost-chemotherapy.And the gastrointestinal complications were carefully observed. Results:In postchemotherapy,the level of Hb,Alb,PA,IL2,NK cells activities and Tcell subtypes of A group were significantly higher than those of B group（P＜0.05).The incidences of vomiting in group A was significantly lower than that of in group B（P＜0.05).The average intake in group A was significantly more than that of in group B（P＜0.05).No severe enteral nutrition related complications occurred in group A. Conclusion:It is safe and feasible to enteral nutrition supported by NCJ tube in chemotherapy for patients of staged gastric cancer.It can improve the nutrition status and immune function in the given patients.

Select

Technique and anatomy of laparoscopic totally extraperitoneal inguinal hernia repair：a report of 240 cases DING Rui,YAO Qi-yuan,CHEN Hao,et al. 2007, 27(01): 1-80.  Abstract ( )   PDF (2333KB) ( )   Objective:Need to define accurately preperitoneal groin anatomy and discuss the surgical approach of laparoscopic totally extraperitoneal inguinal hernia repair (TEP). Methods:Preperitoneal groin anatomy was studied with dissections of the groin area in 5 fresh male cadavers. Photographs and videos were taken. During the time of November 2002 through May 2006，240 groin hernias (211 patients) were repaired by TEP approach with unstapled polyethylene mesh (10cm×15cm).Patients with recurrent hernias were excluded. Operative time,hospital time,recurrence and complications were analyzed. Results:a weak area exists in myopectineal office for absence of skeleton muscles.The transversus fascia is bilaminar in groin area.The preperitoneal space used in TEP approach was between the anterior and posterior laminae of the transversus fascia.The mesh was placed in the preperitoneal space and covered myopectineal office.No recurrent case occurred during a mean followup time of 21 months (range:1-42).The average operating time was 57 min (range:30-70).Complication rate was 6.7% (16/240).Mean postoperative hospital time was 2.8 days (range:1-6). Conclusion:From the view of preperitoneal groin anatomy,TEP approach with unstapled polyethylene mesh is rational and minimally invasive.

Select

Clinical use of 64-slice spiral CT negative cholangiopancreatography to diagnose obstruction of bile duct TIAN Yu,WU Shuo-dong,GAO Jian,et al. 2007, 27(01): 1-50.  Abstract ( )   PDF (2192KB) ( )   Objective:To study the value of 64-slice spiral CT negative cholangiopancreatography(NCTCP) to diagnose the level, range and character of obstruction of bile duct. Methods:14 obstructive jaundice patients determined by clinic or lab testing from Oct.2005 to Mar.2006,underwent 64-slice MDCT with routine abdoment intensive scan.Then make SSD,VR,MPR,CPR,MIP,IminIP reconstruction,with PACS system to evaluate the the level,range and character of obstruction of bile duct. Results:N-CTCP has good imaging quality.MinIP is worse than MRCP in displaying thin biliary duct,and SSD+VR reconstitution is similar to MRCP in imaging quality.The veracity rate of the diagnosis to the obstructive character by N-CTCP is 100%(14/14). Conclusion:N-CTCP is a simple and rapid method which costs than MRCP.It can display the anatomy of the bile duct,surrounding tissue and vessels in 3 dimensions.Its imaging quality,capacity of displaying thin bile duct and diagnositic value of obstruction of bile duct are similar to those of MRCP.

Select

Research for the correlative indicators of diagnosing lymph nodes metastases by helical CT in gastric cardiac carcinoma ZHANG Xiao-peng,CUI Yan-hai，TANG Lei，et al. 2007, 27(01): 1-27.  Abstract ( )   PDF (754KB) ( )   Objective:To discuss the relationship between metastases and size or number of lymph nodes (LNs) detected by CT through comparing with pathological results. Methods:Helical CT was performed in 65 patients.Various groups were classified according to histopathologic results on N staging.Sensitivity and specificity were evaluated by means of receiver operator characteristic curve (ROC) to determine the diagnostic values of size and number. Results:(1)The numbers of LNs detected by CT in each patients with and without LNs metastases were 14.20±7.72 and 6.86±3.37,respectively, with a significant difference.(2)Differences of LNs’ number among No1,3,7 stations between metastasis group and nonmetastasis one were significant.(3)The sensitivity and specificity were 82.4% and 71.4%,82.4% and 71.4%,80.4% and 78.6% respectively,according to ROC analysis,when criterions of 8 LNs detected in each patients,5 total nodes detected in No.1,3,7 stations in each patients,12mm of the largest LN detected in each patients was used to determine metastasis.(4)The sensitivity and specificity were 72.5% and 92.9% respectively,by combining the number and size indicators. Conclusion:(1)There is a tightly correlation between number of LNs detected by CT and metastasis.(2)LNs metastases is strongly indicated when most nodes are presented in No1、3、7 stations.When 5 total nodes criterion was used,the sensitivity and specificity were 82.4% and 71.4% respectively.(3)Combining the number and size indicators can increase specificity of diagnosing metastases.

Select

Liver transplantation for acute hepatic failure:a report of 21 cases SHEN Zhong-yang,ZHU Zhi-jun,ZHENG Hong,et al. 2007, 27(01): 1-50.  Abstract ( )   PDF (2277KB) ( )   Objective:To investigate the effect of orthotropic liver transplantation（OLT）in treatment for acute hepatic failure (AHF) patients. Methods:A retrospective review was undertaken on the clinical data of 21case undergoing liver transplantation for AHF. Results:In 21case，the followup time was 3 to 60 months with the median followup time as 25 months. The survival time was 1 to 1 530 days with the median as 517dyas.The one month survival rate was 66.7%,and the 1year and 2year survival rate were 66.7% the same.The causes of death cases were included:infection,multiple organ failure,acute respirator distress syndrome,intracalvarium hemorrhage,upper digestive tract hemorrhage and primary nonfunction.One of the 13 HBV relative was HBV recurrence in one year after OLT. Conclusion:Liver transplantation was effective in the treatment of AHF.The key points to elevate the effect were strict indication and good operation opportunity.

Select

New strategy of prevention and treatment for fungal infection after liver transplantation CAI Chang-jie,LI Min-ru,LU Min-qiang,et al. 2007, 27(01): 1-83.  Abstract ( )   PDF (2424KB) ( )   Objective:To investigate the distribution of fungal infection and the corresponding prevention and treatment after liver transplantation. Methods:Epidemiology data and susceptibility test of 485 cases of orthotropic liver transplantation were retrospective analyzed between 2004 and 2005. Results:88 fungi strains were isolated in 79 patients and the infection rate was 16.3%.Among them 71 strains were albicans in which 35 strains Candida albicans and 36 strains other Candida albicans,17 strains were aspergillus.There was significant difference in the distribution of fungi between 2004 and 2005（P<0.05）.The resistence of albicans to fluconazole in 2005 (60%) was significantly higher than that in 2004 (33.3%)（P<0.05）. Conclusion:The percentage of other Candida albicans and aspergillys is increasing.We should select appropriate antifungal drug according to the cultivation.

Select

Clinical analysis 308 radical pancreatectomies for pancreatic cancer JIN Da-yong，LOU Wen-hui，KUANG Tian-tao,et al. 2007, 27(01): 1-80.  Abstract ( )   PDF (2374KB) ( )   Objective:Retrospectively analyzed 308 cases radical pancreatectomies for pancreatic cancer. Methods:A total of 308 cases with pancreatic cancer received radical pancreatectomies in our union from Jan 2001 to Dec 2005，including 222 radical pancreaticoduodenectomies,69 distal pancreatectomies and 17 total pancreatectomies. Results:the overall postoperative morbidity and mortality were 25% and 2.3%,respectively;the major complication include bile leak（7.5%）、gastric paralysis（5.5%）、pancreatic fistula（2.6%）and intra-abdominal bleeding(1.3%). Conclusion:Specialized pancreatic group is critical for improving resection rate and reducing the morbidity.Skillful manipulation,adhere to “tender treat” principle,and pancreatic duct stent could lower the incidence of pancreatic fistula.