Table of Content

28 March 2017, Volume 6 Issue 1 Previous Issue    Next Issue

Select

Predictors of non-sentinel lymph node metastasis in breast cancer patients with positive sentinel lymph node 2017, 6 (1):  1-4.  Abstract ( 116 )   PDF (1176KB) ( 298 )   Save Abstract Background: To investigate factors that predict involvement of non-sentinel lymph nodes(nSLNs) in patients with positive SLNs. Methods: We reviewed the records of all patients with invasive breast cancer who underwent SLN biopsy at our institution between May 1999 and September 2015. Multivariate analysis was used to identify clinicopathologic features in SLN-positive patients that predict involvement of nSLNs. Results: A total of 108 patients had a positive SLN and underwent completion axillary lymph node dissection. Multivariate analysis revealed that primary tumor >2cm(P=0.024), SLN metastasis >2mm(P=0.015), and lymphovascular invasion (P=0.001) were independent predictors of positive nSLNs. The more above variable the patient has, the higher the likelihood of positive nSLN is. Conclusions: The likelihood of positive nSLNs correlates with primary tumor size, size of the largest SLN metastasis, and presence of lymphovascular invasion. Detailed pathologic examination of the primary tumor and its SLN metastases may increase precision in the selection of patients for further axillary surgery. Related Articles | Metrics

Select

Investigation of antibacterial susceptibility of bacteria in bile and usage of antibacterials 2017, 6 (1):  5-7.  Abstract ( 129 )   PDF (1124KB) ( 328 )   Save [Abstract] Objective: To investigate the distribution and antibacterial susceptibility of bacterias in bile and antibacterial selection of patients with biliary tract diseases. Methods: The results of bacterial cultivation and drug-sensitivity tests of bile samples from 289 patients in general surgical ward in our hospital and these patients' consumption of antibacterials from January 2011 to September 2016 were collected and analyzed retrospectively. Results: The positive rate of tests was 39.5%. Gram-negative bacterias accounted for 71.9% and gram-positive bacterias accounted for 28.1%. The top 6 pathogens were Escherichia Coli (21.9%), Klebsiella Pneumoniae (13.3%), Pseudomonas Aeruginosa (10.1%), Enterococcus Faecalis (9.4%), Enterobacter Cloacae (7%). Escherichia coli had high rate of resistance to most antibacterials. Enterococcus faecalis had low rate of resistance to vancomycin, linezolid, and penicillin G. The top 5 antibacterials sorted by DDDs were ornidazole, cefuroxime, Cefmetazole, cefepime, latamoxef. Conclusion: The antibacterial seletion wasn't fully justified by the results of bacterial cultivation and drug-sensitivity tests. Doctors should think highly of microbiological examination of bile and select antibacterials according to the results. References | Related Articles | Metrics

Select

Retrospective analysis of the diagnosis and treatment of 110 cases of modalities 2017, 6 (1):  8-11.  Abstract ( 121 )   PDF (1205KB) ( 389 )   Save Summary: Background: The aim of our study was to analyze diagnostic results, different treatment modalities, and the outcome of patients with breast abscesses, to determine whether minimally invasive treatments are successful. Methods: 110 patients with mastitis and suspected breast abscesses at our hospital between January 2013 and end of December 2015 were retrospectively analyzed. Using conservation, US-guided fine needle aspiration (FNA), and surgery treated the breast abscesses. Besides analysis the epidemiological risk factors for all patients. Results: 29% of the patients were treated with antibiotics only, 51% were treated with US-guided FNA or drainage placement. 20% of the patients underwent surgery. Early complications occurred in 7% of patients treated minimally invasive but not in patients treated with surgery alone. Late complications occurred in 5% of patients who underwent minimally invasive treatments and in 30% of patients who underwent surgery. Conclusions: US-guided FNA as a minimally invasive therapy in combination with antibiotics was found to successfully treat most breast abscesses and, in cases where a larger volume of pus was involved, the placement of an additional drainage catheter was effective. References | Related Articles | Metrics

Select

The clinical effect of radical resection of rectal carcinoma plus chemotherapy for improving the prognosis of patients with colorectal cancer 2017, 6 (1):  12-14.  Abstract ( 96 )   PDF (1130KB) ( 240 )   Save [Abstract] Objective: To explore the clinical effect of radical resection of rectal carcinoma plus chemotherapy for improving the prognosis of patients with colorectal cancer. Methods: The clinical data of 90 patients with colorectal cancer were selected and divided into control group and research group (n=45) in accordance with the random number table. The cases in control group were taken radical resection of rectal carcinoma and the cases in research group were taken chemotherapy on the basis of control group. The adverse reactions, serum CA199 level, CEA level, quality of life and living condition were compared. Results: there was no significant difference of adverse reactions during treatment (P>0.05). Before treatment, there was no significant difference of serum CA199 level and CEA level between the two groups (P>0.05). After treatment, the serum CA199 level and CEA level between the two groups were decreased significantly and the decreased degree in research group was much greater than control group (P<0.05). The life quality score in research was significantly higher than the control group (P<0.05). All the patients were followed up to Jan.2017. The postoperative survival rate and postoperative survive period was significantly better than the control group (P<0.05). Conclusion: Radical resection of rectal carcinoma plus chemotherapy can improve the prognosis, the life quality of patients with colorectal cancer with no obvious adverse effect. It deserves to be spread and studied in the clinic. Related Articles | Metrics

Select

The value of fast track surgery applied in laparoscopic minimally invasive surgery of colorectal carcinoma 2017, 6 (1):  15-17.  Abstract ( 110 )   PDF (1070KB) ( 334 )   Save [Abstract] Objective: To explore the security and validity of fast track surgery applied in laparoscopic minimally invasive surgery of colorectal carcinoma. Methods: 78 cases would undergo laparoscopic minimally invasive surgery of colorectal carcinoma from Jan. 2014 to Dec. 2016 were selected as observation group and another 75 cases would undergo laparoscopic minimally invasive surgery of colorectal carcinoma in the same period were selected as control group. The cases in control group were taken conventional perioperative management and in observation group were taken fast track surgery. The operation time, intraoperatve blood soss, anal aerofluxus time, postoperative feeding time, ambulation time, operation time and complications were compared. Results: In observation group, the anal aerofluxus time, postoperative feeding time, ambulation time and operation time were shorter than control group. The occurrence rate of complications was lower than control group. Differences between the two groups were significant (p<0.05). Conclusion: The application of fast track surgery applied in laparoscopic minimally invasive surgery of colorectal carcinoma can promote the recovery and reduce the postoperative complications. Related Articles | Metrics

Select

The main points of cholecystectomy in liver cirrhosis patients with portal vein branch abnormal expansion of gallbladder bed. 2017, 6 (1):  21-23.  Abstract ( 132 )   PDF (987KB) ( 383 )   Save 【Abstract】This paper analyzes the intraoperative hemorrhage occurs reason of two cases with gallstone and liver cirrhosis, points out that it is important to pay special attention to the abnormal expansive portal vein branch of gallbladder bed . Sometimes they may protrude from the gallbladder bed, which leads to the occurrence of intraoperative bleeding. At the same time corresponding treatment methods are discussed. In addition, for such patients are prone to the other of intraoperative bleeding is also discussed accordingly. References | Related Articles | Metrics

Select

Experience of Laparoscopic Cholecystectomy for acute cholecystitis 2017, 6 (1):  24-26.  Abstract ( 129 )   PDF (1076KB) ( 335 )   Save Objective Review the complications of Laparoscopic cholecystectomy (LC) in the treatment of patients with acute cholecystitis and to discuss the operation and precautions. Methods Analysis and summary of LC for 112 patients with acute cholecystitis from November 2014 to 2016 in Department of Hepatobiliary Surgery，the First Affiliated Hospital of Kunming Medical University. Results LC was performed in 101 cases successfully（90.17%）. 11 cases were converted to laparotomy (9.82%), Reasons of Conversion to Laparotomyis is include 4cases were stone ncarceration on the neck of the gallbladder and uncleared in dissection of calot triangle. 4 cases were gangrene of gallbladder and severe gallbladder adhesion,2 cases were cystic artery bleeding. 1 cases was extrahepatic bile duct injury. ConclusionLC is practical for acute cholecystitis patients , the key to improving the success rate and reduce the complication in LC is separate out Triangle of gallbladder. References | Related Articles | Metrics

Select

Under local anesthesia peritoneal clearance senile inguinal hernia repair straight before 48 cases treatment experience 2017, 6 (1):  27-29.  Abstract ( 122 )   PDF (1097KB) ( 377 )   Save [Abstract] Objective Discussed before peritoneal clearance hernia repair under local anesthesia in senile application value in the treatment of inguinal hernia straight. Methods Retrospective analysis of 48 cases of senile inguinal hernia straight before peritoneal clearance hernia repair under local anesthesia clinical data and follow-up results. Results After operation were successful, 2 ~ 5 d discharged from hospital. Complications: 1 case of seroma, puncture pumping by ultrasonic positioning to heal. June 一5 years follow-up, the average (38. 25 and 28. 52) months. No case of recurrence. Conclusions Hernia repair under local anesthesia before peritoneal clearance treatment of inguinal hernia straight in the safe, reliable, economic, and the recurrence rate is low . References | Related Articles | Metrics

Select

The Clinical Study of the Treatment of Senile Osteoporotic Vertebral Compression Fractures with Percutaneous Kyphoplasty 2017, 6 (1):  30-32.  Abstract ( 128 )   PDF (1070KB) ( 388 )   Save 82 cases patients with osteoporotic vertebral compression fractures were admitted to our hospital from April 2014 to April 2015 with percutaneous kyphoplasty treatment to observe VAS score, SF-36 score, and vertebral height changes before and after the operation. Result After the operation, the lumbago and backache of patients had significantly improved or disappeared with significant dropping of VAS score (P<0.05), and significant increasing of SF-36 score. There was significant difference (P<0.05) compared with that before operation; The height of the anterior and middle height of patients’ fracture vertebral body was decreased significantly compared with pre-operation（P<0.05）and the postoperative Cobb angle was significantly reduced as well (P<0.05). Conclusion the treatment of senile osteoporotic vertebral compression fracture with percutaneous kyphoplasty can significantly improve the clinical symptoms of patients, restore the spine sequence, and improve the function so that it has the value of popularization. References | Related Articles | Metrics

Select

Application of Dexmedetomidine in Postoperative Hypoxemia after off-pump CABG 2017, 6 (1):  33-36.  Abstract ( 105 )   PDF (1166KB) ( 310 )   Save Methods: Forty-three patients, who had off-pump coronary artery bypass graft (CABG) surgery, were randomly divided into two groups, control group(n=22) and experimental group(n=21). patients in both group accepted routine treatment. The experimental group was given the treatment of dexmedetomidine additionally. SaO2,HR,BP,RR,PaCO2、PaO2 were observed pre-treatment and 30min,6 hours after treatment. Duration of ICU stay and endotracheal re-intubation were also observed. Results: The differences between two groups were not significantly initially. Compared with control group，SaO2, PaCO2、PaO2 improved, while the Hr and RR decreased after the therapy of dexmedetomidine 30min and 6 hours later. There were no changes of PaCO2. The incidence of endotracheal re-intubation was lower than the control group(P＜0.05). And the duration of ICU stay of experimental group was much shorter than the control group. The difference between the two groups was statistically significant(p＜0.05) . Conclusion：Dexmedetomidine combined with routine treatment in postoperative hypoxemia after off-pump CABG could correct hypoxemia，And it could decrease incidence of endotracheal re-intubation and shorten duration of ICU stay. References | Related Articles | Metrics

Select

Thoracoscopic resection of teratoma in the upper lobe of the left lung : a case report 2017, 6 (1):  37-38.  Abstract ( 161 )   PDF (1036KB) ( 621 )   Save Lung teratomas derived from germ cells, have the potential to different to body cells. This tumor occurs in the male testes and female ovaries, extragonadal teratomas occur in residual primordial germ cells of abnormal embryonic development. Primary intrapulmonary teratoma is a rare benign tumor of the lung. In the past only to find case reports, lung teratomas is easy to misdiagnose in clinical work. This paper reports one case of teratoma in the upper lobe of the left lung in our hospital recently. References | Related Articles | Metrics

Select

System evaluation for risk factors of surgical site infection 2017, 6 (1):  39-43.  Abstract ( 118 )   PDF (2085KB) ( 301 )   Save Related Articles | Metrics

Select

Clinical application of procalcitonin in SIRS after cardiac surgery 2017, 6 (1):  44-47.  Abstract ( 118 )   PDF (1107KB) ( 441 )   Save Procalcitonin(PCT) is a new infection-associated biomarker. It plays an important role in the early diagnosis of severe infection after cardiac surgery, identification of infectious and non-infectious SIRS, assessing the severity of infection and prognosis. PCT has been widely used as a clinical index. References | Related Articles | Metrics

Select

Interaction of opioid analgesics with regional intravertebral anesthesia - A progress review 2017, 6 (1):  48-52,59.  Abstract ( 155 )   PDF (1001KB) ( 624 )   Save Though intravertebral anesthesia has numerous potential advantages in some surgeries, unfortunately it has numerous potential disadvantages, such as potential hypotension due to sympathetic block, and potential toxicity, nausea and vomiting and so on. Recent experiments showed that the combined application of intrathecal opioids and regional anesthetics can produce obvious synergistic effect- extremely low concentrations of regional anesthetics combined with opioids greatly enhance the analgesic effect. There are reports of opioid analgesics administered combined with intravertebral can be added for nerve block and in regional anesthetic which can prolong the duration of sensory and motor nerve block, enhance the regional anesthetic analgesic effect during operation, prolong the time of postoperative analgesia, and decrease the dose of regional anesthetic. Thus, in an attempt to avoid unpleasant side-effects associated with intravertebral anesthesia, opioid analgesics administered intravertebrally has been offered to patients as an additive to intravertebral anesthesia. Binding to its receptor，opioids can stimulate the release of endogenous opioid peptides, it can also inhibit the sympathetic nerve to reduce the release of norepinephrine，so it can enhance the threshold of body pain． References | Related Articles | Metrics

Select

Analysis of the ABC classification of non-implantable medical devices in our hospital 2017, 6 (1):  53-55.  Abstract ( 126 )   PDF (1068KB) ( 258 )   Save Objective To explore the value and strategies of the application of ABC classification in the management of non-implantable medical devices in operating theatre and provide meaningful information for decision making in hospital management of medical device. Methods The consumption of non-implantable medical devices in our hospital this year were analyzed by ABC classification. Results From 1st August, 2015 to 1st August, 2016, 316 non-implantable medical devices were consumed in our hospital’s operating theatre. Of which, non-implantable medical devices of class A were comprised of the top 8 annual purchases, class B of the intermediate 26 devices and class C of the rest 282 devices. Conclusions We should put emphasis on the purchase, stock and usage of medical devices of class A and strengthen the management and control of devices of class B, while the devices of class C can be managed routinely. References | Related Articles | Metrics

Select

The study of the cost and management riskabout Ultrasonic knife system 2017, 6 (1):  56-59.  Abstract ( 161 )   PDF (1152KB) ( 979 )   Save When the ultrasonic knife is used widely in the hospital clinical as surgical instruments,the safety and the charging standard of ultrasonic knife are delayed.The balance of the safety and reasonable charge become the hot issue. References | Related Articles | Metrics

Select

Progress of the wrist nursing in patients undergoing coronary intervention from the transradial approach 2017, 6 (1):  65-69.  Abstract ( 139 )   PDF (1145KB) ( 966 )   Save Radial artery access for coronary angiography and interventions has the advantages of minor invasion, less hemostasis time, improved patient comfort and shorter recovery time, which has been widely adopted in clinical practice. But due to the interventional puncture damage caused by the small size and the various anatomic variants of the radial artery, artery associated complication incidence rate is very high. The purpose of this article is to review the current status and progress of wrist nursing in patients undergoing coronary intervention from the transradial approach. References | Related Articles | Metrics

Select

Continuation of care on the quality of life of patients with lung cancer chemotherapy after surgery 2017, 6 (1):  70-72.  Abstract ( 103 )   PDF (1134KB) ( 334 )   Save Objective To evaluate Continuation care on the quality of life of patients with lung cancer chemotherapy after surgery. Methods Choose in January 2013 - August 2015 in Shanghai tongji hospital thoracic surgeons line operation - discharge of 120 patients with lung cancer after chemotherapy treatment. In digital randomized divided into observation group and control group (n = 60). Control group routine nursing methods, observation group on the basis of the implementation of the continuation of care, was applied to evaluate life quality evaluation scale for Chinese lung cancer respectively when two groups of patients discharged from hospital, 3 months and 6 months after hospital discharge, the quality of life. Results The control group, the observation group quality of life in all dimensions and total discharge at low levels, but there is no statistically significant differences between the two groups (p > 0.05); 3 months, 6 months after discharge in the two groups in various dimensions and the total score rise speed difference, with statistical significance (p < 0.05, p < 0.01). Conclusion Continuation of nursing can effectively improve the quality of life of postoperative chemotherapy in patients with lung cancer. References | Related Articles | Metrics