Archive

23 January 2006, Volume 26 Issue 02 Previous Issue    Next Issue
---
论著


For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

论著

Select

Study on pathogenesis of Crohn’s disease complicated by intestinal fistulaarachidonic acid metabolizing enzyme expression in Crohn’s ulcer. Mao Yao,Ren Jian’an,Li Jieshou. 2006, 26(02): 1-114.  Abstract ( )   PDF (2483KB) ( )   Objective:To investigate the role of arachidonic acid metabolism in Crohn’s disease complicated by intestinal fistula. Methods:By immunohistochemical methods, we examined the expression pattern of major arachidonic acid metabolizing enzymes in 17 samples of Crohn;s disease with associated intestinal fistula. Results:Arachidonic acid metabolizing enzymes were universally present in Crohn’s disease intestines,and the spatial distribution of cyclooxygenase2,5lipoxygenase and 15lipoxygenase1 expression followed sequential arrangement in Crohn’s ulcer. Conclusion:The regulated distribution of these enzymes indicated protective roles for cyclooxygenase 2 and 15lipoxygenase1 and deleterious roles for 5lipoxygenase in Crohn’s disease.

Select

Müller operation for the treatment of lower extremity varicose veins in young female. Cui Jiasen，Jing Zaiping， Zhao Zhiqing，et al. 2006, 26(02): 1-82.  Abstract ( )   PDF (1542KB) ( )   Objective：To evaluate the Müller’s method in treatment of varicose veins of lower extremities in young female Methods：From Oct.1999 to May 2005，225 young female patients with varicose veins that received stripping were respectively analyzed, among them,182 cases were received Müller operation. Results：All 182 patients had good recovery.The average hospitalization after operation was 32 days.After the followup from 3 months to 55 years,no bleeding and haematoma was found，and the pigmentation reduced or disappeared，eczema was remarkably decreased in all cases.No remained varicose veins,and the incision scar vestige became invisible 3 months later,the satisfied cosmetic effects achieved. Conclusion：Utilizing the Müller method to treat the varicose veins of young female has the benefit of miniinvasion,fastrecovery,and good curativeeffect.It can specially fulfill the leg cosmetic request of young female.

Select

Drug resistance and prevalence of bacteria of nosocomial infections in the surgical intensive care unit. Chen Juan，Li Lifen,Guan Xiangdong,et al. 2006, 26(02): 1-114.  Abstract ( )   PDF (2102KB) ( )   Objective:To investigate the drug resistance of bacteria of nosocomial infection (NI) in the SICU at our hospital. Methods:The drug resistance of bacteria of NI in the SICU from Jan.2001 to Dec.2004 was analyzed. Results:The most common pathogens were pseudomonas aeruginosa（11.63%）,coagulase negative staphylococci (11.11%) and candida albicans（9.67%）.ESBLsproducing strains accounted for 66% and 59% of escherichia coli and klebsiella spp.respectively.Methicillinresistant staphylococcus aureus (MRSA) accounted for 94.74% and methicillinresistant coagulase negative staphylococci (MRCNS) accounted for 8824 % in staphylococcus aureus and coagulase negative staphylococci.Carbapenems were the most powerful antibiotics against enterobacteriaceae.The nonfermenters were high resistant to antimicrobial agents.Vancomycin was the most potent antimicrobial against gram positive cocci.Amphotericin B was the most active antibiotic against fungi Conclusion:Most strains of pathogens were antibiotic resistant in SICU. So it is essential to form nosocomial infections surveillance system in order to control, prevent and treat NI effectively.

Select

Immediate management of iatrogenic bile duct injury. Gao Zhiqing,Fu Youchi,Liu Zhengcai. 2006, 26(02): 1-82.  Abstract ( )   PDF (1594KB) ( )   Objective:To explore the management and cautions of the iatrogenic bile duct injury. Methods:A retrospective study was undertaken to investigate the intraoperative procedure and the effect of longterm followup in 13 patients with iatrogenic bile duct injury in Xi’an’s hospitals from October 1992 to January 2005.In these 13 cases,7 men and 6 women,there were 9 cases following laparoscopic cholecystectomy and 4 cases following open cholecystectomy.In the five bile duct transection,4 were underwent endtoend anastomosis.The other one and 3 duct partial resection were performed superior position cholangiojejunostomy.The 5 patients with bile duct resection and left and right hepatic duct partial resection were treated by RouxenY hepaticojejunostomy with fourneedle suture. Results:Following up form 5 moths to 13 years,there were no dead cases and no complication such as jaundice and infection of biliary tract. Conclusion:Once the bile duct was damaged, surgical repair should be performed immediately.The different approach should be chosen according to injury type to obtain satisfactory effect.

Select

Surgical choice and prognostic analysis of Acute Cholangitis Combined with Diabetes. Li Jiyu,Liu Pu,Wang Xuefeng,et al. 2006, 26(02): 1-114.  Abstract ( )   PDF (444KB) ( )   Objective:To investigate the effect on prognosis of acute cholangitis combined with diabetes using different surgical treatments. Methods:A retrospective analysis of prognosis,including release of symptoms,infectious complications,duration of hospital stay,of 319 cases from Jan.2003 to Oct. 2005 using different treatment was studied. Results:Compared with serum glucosenormal group,patients with diabetes manifested more complicated,longer duration of hospital stay,and more incidence of infectious complications (P<0.05).The firstdiagnosis of diabetes in these cases made prognosis worse.Recovery time in endoscopic therapy group was significant shorten than that in surgical group (P<0.05). Conclusion:Stable serum glucose level maintains was the key factor resulted in better prognosis of acute cholangitis combined with diabetes.While firstdetection of diabetes in this kind of cases was the high risk factor.Endoscopic drainage could be the optimal therapeutic approach to earn better prognosis with fewer complications.

Select

The change of the fasting blood sugar and clinic significance in the patients underwent pancreatectomy. Long Jin,Ge Chunlin,Guo Renxuan. 2006, 26(02): 1-82.  Abstract ( )   PDF (2265KB) ( )   Objective:To value the effect of pancreatectomy on the fasting blood sugar（FBS）. Methods:The patients who underwent pancreatectomy from June 1994 to June 2004 in our hospital were observed retrospectively.We compared the level of the FBS before and after the operation. Results:Patients underwent pancreatectomy lead to hyperglycemia in the early stage of postoperation.Intensive insulin therapy could correct the level of FBS.Along with the past of time after the operation,the level of the FBS would come to normal level. Conclusion:The pancreatectomy led to the hyperglycemia in the early stage of postoperation,where as using intensive insulin therapy could correct the hyperglycemia after the operation.The pancreatectomy does not destroy the pancreas endocrine function and leads to diabetes.

Select

The effect of somatostatin on the levels of plasma vascular endothelial growth factor and transforming growth factor beta1 after hepatectomy in hepatocellular carcinoma patients. Liang Weiwen,Gong Shiwen,Fu Yuru,et al. 2006, 26(02): 1-114.  Abstract ( )   PDF (283KB) ( )   Objective:To investigate the effect of somatostatin (SST) on the levels of plasma vascular endothelial growth factor (VEGF) and transforming growth factor beta1 (TGF-β1) after hepatectomy in hepatocellular carcinoma patients. Methods:From March 2002 to April 2003,20 patients after hepatectomy were randomly divided into two groups,SST treatment group (10 cases) and control group (10 cases).The plasma levels of VEGF and TGFβ1 were measured by Elisa method. Results:The plasma levels of VEGF and TGF-β1 after hepatectomy in control group were significantly increased than that before operation,P<0.05.The plasma levels of VEGF and TGF-β1 after hepatectomy in SST treatment group was significantly decreased than that in control group，P<0.05. Conclusion:The administration of SST after hepatectomy could significantly decreased the plasma levels of VEGF and TGFβ1.The effect of enhancing growth of residual tumor tissue by VEGF and TGFβ1 might be suppressed.The result showed that the administration of SST might be beneficial to prevent the recurrence of residual tumor after surgery.

Select

Clinical Application and Efficacy of UTubes for Late Stage Hilar Cholangiocarcinoma. Lü Bin,Zeng Qingdong,Wang Lei,et al. 2006, 26(02): 1-127.  Abstract ( )   PDF (1594KB) ( )   Objective：The recent experience with Utubes was reviewed in order to assess their clinical value for late stage hilar cholangiocarcinoma. Methods：The hospital charts of all patients with unresectable hilar cholangiocarcinoma who had Utubes placed between 1995 and 2003 were reviewed retrospectively. Results：All operations were performed successfully.The mean TBIL levels dropped from （307.9±164.8）mmol/L to（180.1±83.8）mmol/L and the mean ALT levels dropped from （132.2±41.9）U/L to（51.9±15.3）U/L.The mean survival time of 22 patients who were followed up was 15.3 months and 2 patients had survived 4 years. Conclusion：The use of Utubes could relieve biliary obstruction and improve hepatic function,so it was advocated in the patients with unresectable hilar cholangiocarcinoma.

Select

Surgical technique of rapid procurement and backtable procedures of liver graft. Ma Yi,He Xiaoshun,Zhu Xiaofeng,et al. 2006, 26(02): 1-103.  Abstract ( )   PDF (2365KB) ( )   Objective:To explore the method of rapid harvesting and backtable procedure of liver graft. Methods:One hundred and eightysix cases of liver grafts' harvesting and backtable procedure in 2004 were analyzed retrospectively.The shortterm outcome after the operation was evaluated.Orthotopic abdominal aorta and superior mesentery vein perfusion with inferior vena cava drainage were applied in the method.Liver grafts were preserved and trimmed in 4℃ UW fluid. Results:The warm ischemia time of liver graft was from 3 to 10 minutes and mean was 45 minutes.The cold ischemia time was from 3 to 16 hours and mean was 7 hours.The time of back-table procedures was from 26 to 90 minutes and mean is 46 minutes.Twenty cases of liver artery abnormality were found in the study. Conclusion:Harvesting and trimming of liver graft is the first and chief step of liver transplantation.The method of rapid procurement of liver graft can insure the quality of liver graft and the perfect donor operation.

Select

Microinvasive surgery by laparoscopy for treating gastric stromal tumors (a report of 17 cases). Tian Zhong,Gou Jian,Zhao Haiying,et al. 2006, 26(02): 1-107.  Abstract ( )   PDF (1657KB) ( )   Objective:To evaluate the clinical value of micro-invasive surgery by laparoscopy for treating gastric stromal tumors. Methods:The records of 17 patients who underwent laparoscopic wedge resection were reviewed. Results:Laparoscopic wedge resection was completed successfully in all 17 patients with a mean operating time of 65±12 min,and no complications occurred,and the mean hospital stay was 43 days.Pathologic analysis of 17 resected specimens showed: Very low risk 3 cases,low risk 8 cases,Intermediate risk 4 cases,High risk 3 cases.During a followup period from 1 to 6 months,No case of recurrence and/or metastasis was found. Conclusion:Laparoscopic wedge resection is a safe and feasible procedure for treating gastric stromal tumors.

Select

Causes of the Recurrence of Varicose Veins after Varicotomy in Lower Extremity. Li Honghao,Cao Hailing,Chen Jianyu,et al. 2006, 26(02): 1-103.  Abstract ( )   PDF (2503KB) ( )   Objective：To analyze the causes of the recurrence of varicose veins after varicotomy in lower extremity Methods：Total 46 patients (52 lower extremities) with the recurrence of varicose veins after varicotomy were retrospectively analyzed.20 patients (24 lower extremities) of them were accompanied by venous ulceration.All of the patients were accepted ascending phlebography and color Doppler ultrasonography of deep for superficial and perforating veins. Results：The causes of the recurrence were:remnant of the main trunk and partial branches of great saphenous vein (11 limbs),accompanying by the insufficiency of perforating veins (35 limbs),accompanying by the insufficiency of deep venous valves (20 limbs),varicosis of small saphenous vein (10 limbs),the sequelae after deep venous thrombosis (5 limbs),simultaneous insufficiency of three venous systems (15 limbs). Conclusion：The causes of the recurrence of varicose veins after varicotomy in lower extremities are very complicated,usually involving three venous systems.The insufficiency of perforating veins is the main cause resulting in the recurrence of varicose veins after varicotomy in lower extremities.The preoperative overall image examination and the choice of correct operation are the key for avoidance of the postoperative recurrence of varicose veins.

Select

Sclerosing foam for treatment of great saphenous vein (a report of 34 cases). Liu Xiaoping,Wen Chaoyang,Guo Wei,et al. 2006, 26(02): 1-107.  Abstract ( )   PDF (1635KB) ( )   Objective:A preliminary experience of sclerosing foam made of purified sodium tetradecylsulfate is used to treat great saphenous vein.We evaluated the safety and efficacy of the doses and concentrations of the drug Methods:Over a 6 months period,we performed Duplexguided sclerotherapy using SFT to treat 34 patients with great saphenous vein.SFT was formed using a threeway stopcock and 2 syringes,mixing air with liquid sodium tetradecylsulfate to create foam.The working concentrations and doses of SFT were 15% and 6-8 mL. Results:At 3month followup,the majority of treated larger veins were either obliterated or showed a normal state of cephalad blood flow.Four patients experienced transient scotomas and developed segmental phlebitis of a collateral vein.The best foam was obtained by mixing one part liquid sodium tetradecylsulfate and four to five parts air,but the duration of the foam product was also related to several other factors. Conclusion:This preliminary pilot study demonstrates that the technique of producing sclerosing foam according to Tessari’s method (threeway stopcock device) is very promising,especially for larger veins.No serious complications were reported, and further standardization of the method may improve the results and feasibility of this technique.Further studies are needed to validate this new technique.