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09 January 2006, Volume 26 Issue 01 Previous Issue    Next Issue
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Percutaneous endoscopic gastrostomy in the treatment of advanced malignancy intestinal obstruction:a report of 65 cases. Jiang Zhiwei，Wang Zhiming，Ding Kai，et al. 2006, 26(01): 1-62.  Abstract ( )   PDF (280KB) ( )   Objective:The purpose of this study was to report percutaneous endoscopic gastrostomy (PEG) applied in the treatment of advanced malignancy intestinal obstruction for gastrointestional drainage. Methods:65 patients with inoperative advanced malignancy obstruction were performed PEG for gastrointestinal decompression. Results:The success rate of PEG was 970%,and the procedure had no serious complication and only 4 minor complications.PEG could drain gastrointestinal fluid about 200～1 500ml/d,replaced nasogastric tube,and improve quality of life significantly. Conclusion:PEG seems to be an effective method for palliating malignancy intestinal obstruction and suitable to replace nasogastric tube for gastrointestional drainage.

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Clinical analysis of patients’ operative patterns and complications with curative resection and hepatectomy. Xiao mei,Zhou Ningxin，Huang Zhiqiang，et al. 2006, 26(01): 1-35.  Abstract ( )   PDF (459KB) ( )   Objective:To summarize experience in curative resection with hepatectomy of hilar cholangiocarinoma. Methods:A retrospective analysis was performed in 74 cases of hilar cholangiocarcinoma. Results:50 with left hepatectomy,14 with right hepatectomy,2 with extended right hepatectomy,2 with left medial segmentectomy,4 with left medial segmentectomy,2 with caudate lobectomy.The 1,3,5-year survival rate was 75.4%、24.4%、12.2%. Conclusion:The treatment of curative resection with hepatectomy plays an important role for curative effect and long term survival rate in patients with H-CC.Appropriately perioperative care can reduce the operative morbidity and mortality.

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Clinical research on vacuum pack system for temporary abdominal closure. Jiang Jinbo,Dai Yong，Zhu Min,et al. 2006, 26(01): 1-62.  Abstract ( )   PDF (427KB) ( )   Objective:To discuss the clinical application of vacuum close system for temporary abdominal closure. Methods:Vacuum pack system is applied for incapability to achieve tension-free abdominal fascial closure or planned reexploration.Conventional pack system is compared with vacuum pack system for temporary abdominal closure. Results:Temporary abdominal closure were performed in 35 patients,vaccum pack for 15 patients and conventional pack for 20 patients.In vacuum pack group，8 patients (53.3%) went on to primary closure and 6 patients (40.0%) couldn’t close the defect followed by granulation and eventual skin grafting; one patient (7.7%) died before abdominal closure was attempted;two patients (13.3%) developed intra-abdominal abscesses. In conventional group，4 patients(20.0%) went on to primary closure and 14 patients (70.0%) underwent skin grafting;two patients(10.0%) died before skin grafting;four patients(20.0%) developed intra-abdominal abscesses;two patients (10.0%) developed enterocutaneous fistula.There were no evisceration in two groups. Conclusion:The vacuum pack is a better temporary abdominal wound closure device for patients undergoing open abdomen management.High rate of primary closure is achieved with a low rate of complication compared with conventional pack.

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The treatment of 81 cases of Advanced malignant tumor with Extracorporeal Whole Body Hyperthermia. Ye Xiaoming，Huang Wenqi，Chen quanyong，et al. 2006, 26(01): 1-62.  Abstract ( )   PDF (563KB) ( )   Objective:This article is mainly to evaluate the primary treatment effect and the impairment of the vital organs and tissues in vivo of the Extracorporeal Whole Body Hyperthermia(EWBH). Methods:From 2001 to 2003,81 cases of advanced malignant tumor were treated with EWBH.It was assayed that the primary treatment effect of the EWBH by following the patients condition.The impair of vital organs and tissues,such as brain,liver,kidney and lung were evaluated by examinating index of blood elements,and by the result of the animal experiment. Results:(1)The effective rate (CR plus PR)of the EWBH was 72.8% on treating advanced malignant tumor.The descent rate of index concerning tumor(as AFP,CEA etc.) was 74.4%,and the rate of pain relieve was 100%.And 65.4% cases alive were over one year and 84% over half one year.(2)There are some impairment on function and tissues in the vital organs but the damage is venial and reversible. Conclusion:In treating malignant tumour,EWBH can improve the patients live quality and prolonging their life.EWBH can make some reversible impair to the vital organs and tissues.

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Effects of recombinant factor Ⅶ (rFⅦa) and aprotinin in orthotopic liver transplantation. Cai Changjie,lumingqiang,Yang Yang,et al. 2006, 26(01): 1-18.  Abstract ( )   PDF (436KB) ( )   Objective:To evaluate the efficacy and safety of recombinant activated human coagulation factor VII (rFVIIa, NovoSeven) in orthotopic liver transplantation. Methods:Prospectively,sixty patients were randomized to rFVIIa treatment group aprotinin group and control group.Coagulation variables and thromboelastography (TEG) parameters [reaction time (r),Clot lysis at 30 minutes (LY30%),and maximal amplitude (MA)] were recorded at described time points.Blood loss,transfusion requirements,hospital time,hospital cost and vascular complication were compared to controls. Results:Administration of rFVIIa significantly shortened the prolonged prothrombin time (PT) and reaction time (r),increase maximal amplitude (MA) significantly (P<005),whereas didn t influenced the activated partial thromboplastin time (APTT),fibrinogen (FIB),platelet count (PLT) and Clot lysis at 30 minutes (LY30%) (P>005).Aprotinin group only increase maximal amplitude (MA) and decrease Clot lysis at 30 minutes (LY30%).In contrast with the control group,Both the perioperative blood loss and transfusion requirements were significantly reduced in rFVIIa group and aprotinin group (P<005). Conclusion:This study demonstrated that rFVIIa rapidly improved the exogenous coagulation function,aprotinin slowly inhibits hyperfibrinolysis,Both of them obviously reduced operation bleeding,but never increased the postoperative vascular complications.Application of rFVIIa and aprotinin are effective and safe during orthotopic liver transplantation.

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Multivariate regression analysis of factors influencingsurvival after resection for ductal adenocarcinoma of the head of the pancreas. Xi Pengcheng,Shi Kaiwang,Wu Wenlan. 2006, 26(01): 1-62.  Abstract ( )   PDF (424KB) ( )   Objective:To analysize the factors influecingsurvival after resection for ductal adenocarcinoma of the head of the pancreas. Methods:The factors of clinical and pathological were nanlysized by Time-Constant cox Regression and Kaplan-Meier. Results:There are four factors,the size of tumor,metastasis of lymphnode,MVD and the expression of uPA,influencing the survival after resection of the head of the pancreatic carcinoma.Multivariate regression analysis showed that uPA is an independent prognostic factor. Conclusion:There are many factors influencing the survival after resection of the head of the pancreatic carcinoma and which biological character play a role in survival.

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Clinical research of oxidative stress in septic patients. Chen Minying,Liang Lijian,Guan Xiangdong,et al. 2006, 26(01): 1-41.  Abstract ( )   PDF (429KB) ( )   Objective:To investigate the oxidative status in septic patients and explore a new strategy for sepsis. Methods:31 critical patients which divided into sepsis group and non-sepsis group in surgical intensive care unit (SICU) were involved.Serum malondialdehyde (MDA) data of were measured at the first and the third day after they admitted to SICU.MDA level were compared between different groups.At the same time,organ function was observed and the numbers of dysfunctional organ were recorded.The relationship between MDA level and organ injury was analyzed. Results:MDA was significantly higher in septic patients than non-septic patients［(11.97±2.02)μmol/L vs (6.58±1.69)μmol/L，P<0.01］.MDA level was significantly related with the numbers of dysfunctional organ (r=0.850,P<0.01). Conclusion:Septic patients exist severe oxidative stress that result in organ dysfunction.Antioxidant may become a new strategy for sepsis.

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Application of suegical treatment for severe acute pancreatitis with staged minimally invasive operation. Ou Jinrui,Hou Baohua. 2006, 26(01): 1-41.  Abstract ( )   PDF (297KB) ( )   Objective:To investigate the timing and method of surgery for severe acute pancreatitis (SAP). Methods:Sixtytwo patinas with SAP in our hospital from Jan,2000 to Dec,2004 were analyzed retrospectively. Results:The overall mortality and morbidity in the early operation group both was 57.1%,compared with 18.5% and 25.9% of those receiving surgery on the late stage（P=0.039,P=0.000）.In the early operation group,the mortality in celiotomy group and CT guided percutaneous drainage group was 75% and 33.3%（P=0.274）,respectively;the morbidity was 100% and 0%（P=0.000）,respectively.In the late surgery group,the mortality in celiotomy group and staged miniinvasive operation group was 71.4% and 0%（P=00000）,respectively,and the morbidity was 100% and 0（P=0.000）,respectively. Conclusion:The surgical treatment with miniinvasive operation by stages for SAP was one of the effective way.