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28 September 2014, Volume 3 Issue 3 Previous Issue    Next Issue

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research progresses of transcatheter therapies for mitral regurgitation 2014, 3 (3):  157-160.  Abstract ( 117 )   PDF (515KB) ( 284 )   Save Due to the complex structure of mitral valve and its surrounding tissues, technique of minimally invasive treatment of mitral valve diseases was started late. At present, only Mitraclip technique is selectively used in some developed countries to treat mitral regurgitation. However, new technologies have leaped forward. Nowadays, various prototypes of minimally invasive treatment of mitral valve diseases are in different stages of experimental or preclinical study. In this review, these technologies of minimally invasive treatment are summarized. Related Articles | Metrics

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Insight into diagnosis and treatment of gallbladder cancer from vasculogenic mimicry, a new blood supply for gallbladder cancer Yue-Zu FAN 2014, 3 (3):  161-168.  Abstract ( 124 )   PDF (4623KB) ( 293 )   Save Objective：from the discovery of a new blood supply of gallbladder carcinoma--- vasculogenic mimicry (VM), insight into diagnosis and treatment of gallbladder cancer. Methods：74 cases of primary gallbladder carcinoma diagnosed at Tongji Hospital from 1994.1 to 2000.12 and their clinical pathological and demographic data were used; VM of gallbladder carcinoma was detected by HE staining and CD31-PAS double staining (Envision method), single- or multiple- factor clinical parameters, Cox model, Kaplan-Meier survival analysis and log-rank test for gallbladder carcinoma with VM (+)/(-) were done. Two or three-dimensional cultures of GBC-SD and SGC-996 cells, invasion, migration, VM formation assay and hemodynamic of gallbladder cancer in vitro and in vivo were carried out. VM-related signal pathways were studied by immunohistochemistry, immunofluorescence, Western blotting and QRT-PCR. Results: VM in 13.5% (10/74) of gallbladder cancers was found, namely VM of gallbladder cancer is the pipeline structures surrounded by gallbladder cancer cells and non vascular endothelial cells, with the PAS positive, red blood cells inside under the microscope; VM (+) gallbladder cancers being mainly adenocarcinoma with highly blood metastasis; VM is an independent prognostic factor for gallbladder cancer patients with VM, and prognosis of gallbladder cancer patients with VM is poor. VM was found in GBC-SD cell 3-D matrices and xenografts, and the formation of VM through the activation of the PI3K/MMPs/Ln-5γ2 signaling pathway. Conclusions: there is a special biological characteristic of VM in highly aggressive gallbladder carcinoma; because VM cannot be detected by conventional pathology, CD31-PAS double staining for specimens were routinely done in the gallbladder cancer patient with highly malignant, easy to hematogenous metastasis and poor prognosis; the presence of VM should be considered for post-operational recurrence after gallbladder cancer radical resection, poor results of adjuvant chemotherapy and anti-angiogenic targeted therapy, "anti vasculogenic mimicry" adjuvant therapy was adopted. Related Articles | Metrics

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The Cardiac Protection Effects of A Single High Loading Dose of Statins Therapy before Coronary Artery Bypass Grafting on Cardiac Specific miRNAs Regulation 2014, 3 (3):  169-173,179.  Abstract ( 122 )   PDF (1006KB) ( 245 )   Save OBJECTIVE: To explore the cardiac protection effects of a single high loading dose of statins therapy before coronary artery bypass grafting (CABG) on cardiac specific miRNAs (miRNA-1, miRNA-133 miRNA-208 and miRNA-499). METHODS: Patients undergoing CABG were divided into two groups randomly 12 hours before cardiac operation: Group A, receiving standard-dose of 20mg atorvastatin; Group B, receiving single-dose of 80mg atorvastatin. 5 right atriums from group A and 3 from group B were achieved during the operation. Accompanied with 4 right atriums in healthy population as group C, the gene expression on cardiac specific miRNAs (miRNA-1, miRNA-133, miRNA-208 and miRNA-499) of the three groups were examined by a stem-loop quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). RESULTS: The expressions of cardiac specific miRNAs including miRNA-1, miRNA-133a, miRNA-133b, miRNA-208a, miRNA-208b, miRNA-499a-3p, miRNA-499a-5p and miRNA-499b-3p in group A, B and C were not significant changed. Strikingly, miRNA-499b-5p was significantly increased in group B comparing to both healthy group A(p=0.005) and group C (p=0.010). CONCLUSINS: The cardiac protection effect of a single high loading dose of statins therapy before CABG maybe related to elevated miRNA-499b-5p. Related Articles | Metrics

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Clinical analysis of laparoscopic radical operation of rectal cancer on 44 patients with rectum or colorectal cancer 2014, 3 (3):  174-176.  Abstract ( 136 )   PDF (1020KB) ( 440 )   Save ObjectiveTo investigate the clinical effect of laparoscopic rectum, sigmoid colon cancer radical operation on rectum or colorectal cancer, and to provide reference for clinical treatment of colorectal cancer. Methods 90 patients with colorectal carcinoma in our hospital were selected. They were randomly divided into the observation group 44 cases and control group with 46 cases. The observation group was treated by laparoscopic rectum, sigmoid colon cancer radical resection for treatment. The control group received laparotomy operation treatment, The operation time, intraoperative bleeding volume, postoperative anal exhaust time, postoperative hospital stay and postoperative complications; survival through follow-up of both groups were compared. Results The amount of bleeding, the intraoperative and postoperative anal exhaust time and postoperative hospitalization of the control group were significantly more than those in the laparoscopic group, the difference was statistically significant (P < 0.05). The complication rate was 9.09% in observation group, while it was 10.87% in the control group, the difference was not statistically significant (P > 0.05). The progression free survival of control group was 9 months (95% confidence interval, 5.6~11.8 months), the median survival was 22.7 months (95% confidence interval, 17.2~29.4 months); while it was 12.5 months (95% confidence interval, 8.4~17.6 months) in the observation group, the median survival period for 34.3 months (95% confidence interval, 25.6~33.4 months), it was significantly longer than that in the control group (P < 0.05). Conclusion Laparoscopic rectum, sigmoid colon cancer radical resection is helpful to improve the clinical efficacy of colorectal cancer, can improve the prognosis of patients, prolong the survival of patients with and without increasing the risk, operation, good safety. Related Articles | Metrics

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Curative effect analysis in preservation of left colic artery and superior rectal artery for the treatment of upper rectum carcinoma 2014, 3 (3):  177-179.  Abstract ( 137 )   PDF (999KB) ( 508 )   Save 【Abstract】 Objective Discussed the feasibility and benefits of left colic artery and superior rectal artery for the treatment of upper rectum carcinoma,and compared with conventional surgery. Methods From January 2011-June 2013,59 patiens with upper rectum carcinoma in general surgery were divided into experimental group(n=30) and control group(n=29).Experimental group keep left colic artery and superior rectal artery, control group conventional surgery,compared of operation time,number of lymph node cleaning, blood loss, anastomotic healing between two groups. Results Experimental group operating time is longer than the control group,patients with blood loss is greater than the control group,the difference was statistically significant（P＜0.05）;Number of lymph node cleaning had no statistical significance（P＞0.05）; Experimental group patients without anastomotic fistula patients,2 case of control group occurred. Conclusion Preservation of left colic artery and superior rectal artery for the treatment of upper rectum carcinoma is good for patients,and could reduce the risk of anastomotic fistula. Related Articles | Metrics

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Analysis of 27 cases of stromal tumor laparoscopy combined with electronic gastroscope treatment of stomach 2014, 3 (3):  180-181,184.  Abstract ( 120 )   PDF (974KB) ( 568 )   Save [Abstract] Objective To summarize the gastroscope guided the feasibility of laparoscopic surgery in the treatment of gastric stromal tumor. Methods Retrospective analysis of our hospital from 2010 March to 2014 March, clinical data of 27 cases of gastric therapy guided laparoscopic surgery stromal tumor patients in gastroscopy. Results 27 cases of gastric stromal tumor patients in the endoscopic laparoscopic successful resection, tumor resection, no residue. Surgical incision of about 3～6cm, 40～110min, operation time, postoperative recovery was smooth, without any complications. The postoperative hospital stay was 4～7d, average 5.5d. Patients were followed up for 3～36 months, no recurrence or metastasis. Conclusion Laparoscopic difficult positioning of gastric stromal tumor, surgery can be guided in electronic gastroscopy, and can make more accurate and complete resection range, avoid excessive resection of normal gastric tissue and residual tumor. Related Articles | Metrics

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Experience of implementing clinical pathway in hepatic cystic echinococcosis 2014, 3 (3):  182-184.  Abstract ( 96 )   PDF (1008KB) ( 273 )   Save objective To report our experiences of implementing clinical pathway in hepatic cystic echinococcosis (HCE). Methods In our district echinococcosis fixed-point hospital, 120 operated patients with HCR were divided into a clinical pathway group (n=60) and a control group (n=60, non-implementation of clinical pathway. Days of hospital stay including days of preoperative preparation and postoperative recovery, and hospital costs including nation echinococcosis treatment project (NETP) actual expenses, reimbursement charges, number of zero pay and patients' satisfaction index of each group were followed-up and compared. Conclusion The implementation of HCE clinical pathway in our region can regulate patterns of diagnostic and treatment for HCE, reduce postoperative complications, shorten hospitalization time, reduce hospital cost, so is worthy of promotion. Related Articles | Metrics

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Relationship between Helicobactor Pylori infection and upper gastrointestinal hemorrhage caused by anti platelet therapy 2014, 3 (3):  185-186,190.  Abstract ( 144 )   PDF (999KB) ( 303 )   Save Objective This study was to investigate the Relationship between Helicobactor Pylori infection and upper gastrointestinal hemorrhage caused by anti platelet therapy. Methods 565 patients taking enteric-coated aspilin and 531 patients taking clopidogrel in our hospital from January 2012 to Junuary 2014 were studyed. All patients were given Hp testing and divided into Hp-positive group and Hp-negative group. Rusults We found that the Hp-positive groups have the more possibility of bleeding than the Hp-negative groups（P＜0.05）. Conclusion Eradication of Helicobacter pylori is helpful to reduce the risk of the gastrointestinal tract bleeding. Related Articles | Metrics

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Protection experience of parathyroid glands in 42 cases of total thyroidectomy 2014, 3 (3):  187-190.  Abstract ( 131 )   PDF (1181KB) ( 535 )   Save Abstract Objective：To summarize the protection method of parathyroid glands in total thyroidectomy. Methods：Clinical data of 42 patients who were treated by total thyroidectomy in our hospital from 2009.10 to 2014.6 were retrospectively analyzed. The level of serum PTH and blood calcium before and after surgery were compared. Result：19 cases (45.2%)had decreased PTH and 9 cases (21.4%)had complicated symptomatic hypocalcemia, and the level of serum PTH and blood calcium return to normal at 30 days after surgery. Perpetual hypoparathyroidism was not found. Compared with before treatment, the level of serum PTH was significantly decreased(P<0.05), while there was no difference at 30 days after surgery(P>0.05). There was no difference on the level of blood calcium compared with that before surgery expect that at 1st and 3rd day after surgery. Conclusions: To strengthen the identify of parathyroid anatomical location and protection of blood supply in total thyroidectomy, which can effectively reduce postoperative parathyroid damage, avoid severe complications. Related Articles | Metrics

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The influence of dexmedetomidine on postoperative cognitive dysfunction in elderly patients undergoing Transurethral Resection of Prostate 2014, 3 (3):  191-193.  Abstract ( 95 )   PDF (983KB) ( 260 )   Save Objective To evaluate the effects of dexmedetomidine on postoperative cognitive dysfunction in elderly patients undergoing Transurethral Resection of Prostate.Methods eighty ASA I～II elderly patients scheduled for selective Transurethral Resection of Prostate under general anesthesia,aged 65～85 years,were randomized equally into 2 groups(n=40 each): dexmedetomidine group and control group.In the dexmedetomidine group，a loading dexmedetomidine dose of 0.5μg?kg－1 was infused about 30 min after endotracheal intubation of anesthesia，respectively，followed by infusion a maintenance dose of 0.5μg?kg－1?h-1, respectively,until 40 min before the end of surgery，while the equal volume of normal saline was given in the control group．All patients were tested with mini-mental state examination(MMSE),preoperatively and postoperatively on day 4 and day 7.Results There was no significant difference in the score of MMSE and WMS between dexmedetomidine group and control group preoperatively(P＞0.05).Compared with control group, the score of MMSE in dexmedetomidine group was obviously higher on day 4 and day 7 postoperatively,which was significantly different(P＜0.05). Conclusion dexmedetomidine can reduce the incidence of postoperative cognitive dysfunction in elderly patients undergoing Transurethral Resection of Prostate. Related Articles | Metrics

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The Progress of One Lung Ventilation Method with Video-Assisted Thoracic Surgery 2014, 3 (3):  194-197,201.  Abstract ( 114 )   PDF (906KB) ( 583 )   Save In early 1990s, thoracoscope developed into a modern thoracoscopic technology —Video-Assisted Thoracic Surgery (VATS), and was applied to the diagnosis and treatment of chest diseases. The completion of VATS needs the assistance of One Lung Ventilation (OLV). OLV leads to the atelectasis of operated lung side, which on one hand clarifies the location and scope of lesion, shows a clearer vision field for more space for surgeon’s observation and surgical operation, on other hand reduces potential injury on non-operated side. The OLV with VATS method includes double-lumen endobronchial tube (DLT) intubation, bronchial blocker (BB) intubation and nonintubated autonomous one lung ventilation etc. Now people don’t adopt single-lumen endobronchial tube intubation any more except for special cases, such as for accident or emergency intubation. This article discussed the characteristics and progresses in these methods. Related Articles | Metrics

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The Progress of Thoracic Sympathetic Procedure 2014, 3 (3):  198-201.  Abstract ( 113 )   PDF (923KB) ( 277 )   Save Thoracic sympathetic procedure is an effective method to treat many sympathetic nerve-related diseases. Currently the procedure is usually used to treat hyperhidrosis (palmar and plantar hyperhidrosis, craniofacial hyperhidrosis, axillary hyperhidrosis etc.) and facial blushing. In 1920, Kotzareff became the first one who applied thoracic sympathectomy to treat palmar and plantar hyperhidrosis and succeed. Nowadays, the conventional Endoscopic Thoracic Sympathetic procedures (ETS) are adopted by most thoracic surgeons. In recent years, this surgery has been further improved; some scholars proposed own procedures. Regarding this, the article made summary and discussion on various ways of thoracic sympathetic procedures. Related Articles | Metrics

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Progress of approaches for Transcatheter aortic valve implantation 2014, 3 (3):  207-211.  Abstract ( 130 )   PDF (961KB) ( 473 )   Save 【Summary】 Transcatheter aortic valve implantation (TAVI) is a new technology, which is the interventional treatment for symptomatic aortic stenosis. After more than ten years of development, results and interim survival of TAVI are equivalent to surgical treatment. With the improvement of delivery devices and valves, TAVI indications has expanded, safety and efficacy have been improved. This article will introduce the different approaches for TAVI. Related Articles | Metrics

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Progress in Resarch on the Protective Role of ECS in Nervous System 2014, 3 (3):  212-214.  Abstract ( 212 )   PDF (982KB) ( 1119 )   Save The endogenous cannabinoid system (endocannabinoidsystem,ECS) consists primarily of Gprotein-coupled receptor CB1, CB2, endogenous ligands for AEA, 2-AG and inactivation system AEA hydrolysis enzymes system(FAAH). Numerous studies have shown that the endogenous cannabinoid system can play a neuroprotective role via complex mechanisms,such as the anti-inflammatory, antioxidant, regulation of neurotransmitter release, inhibition of calcium ion concentration and so on. This article is to review the protective function of ECS in nervous system. Related Articles | Metrics

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Nodular goiter surgery status and progress 2014, 3 (3):  215-216.  Abstract ( 119 )   PDF (975KB) ( 633 )   Save Operation excision is one of the effective methods for treatment of nodular goiter, the operation mode is still controversial, to further explore perfect. Accuracy of endoscopic thyroid operation is the future direction of development, choose appropriate operation indications, endoscopic nodular goiter operation is safe. Related Articles | Metrics

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Ultrasound technology application in the identification of benign and malignant breast tumor analysis 2014, 3 (3):  217-218.  Abstract ( 133 )   PDF (1006KB) ( 341 )   Save Abstract] Objective To explore the application value of ultrasound technology in the identification of benign and malignant breast neoplasms. Methods color Doppler ultrasonography w. Methods color Doppler ultrasonography was performed on 79 patients with breast masses, combined with ultrasonic technology elastography score, retrospective analysis. Results 79 cases of breast masses were confirmed by operation and pathology, 30 cases are malignant, 49 cases of benign, tumor diameter of 2.3mm ~ 8.5mm, ultrasound in the diagnosis of breast masses in 79 cases in 2 cases, including 1 cases misdiagnosed as benign from malignant, 1 cases misdiagnosed as malignant from benign. Conclusion the ultrasonic diagnosis results were compared with operation and pathology, the accuracy of ultrasound in the diagnosis of breast cancer was 90%. Related Articles | Metrics