Table of Content

28 June 2016, Volume 5 Issue 2 Previous Issue    Next Issue

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Safe management of Bile duct injury in the laparoscopic cholecystectomy 2016, 5 (2):  73-75.  Abstract ( 145 )   PDF (1080KB) ( 338 )   Save Objective: Prevation the incidence of Bile duct injury in the laparoscopic cholecystectomy.Methods: During September 1991 to today， 11000 LCs were preformed and 15 cases were diagnosed in bile duct injure during the operation and received corresponding treatment.Result: The mean follow-up period after surgery was 5-10 years，all bile duct injury patients were fine.Conclusions:We should correctly handle the relationship of various duct and avoid burn or cut duct for reducing incidence of the extrahepatic bile duct damage. Correctly treatment can reduce or avoid the incidence of postoperative complications. References | Related Articles | Metrics

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Clinicopathological characteristics and treatment of phyllodes tumor of the breast 2016, 5 (2):  79-81.  Abstract ( 135 )   PDF (1123KB) ( 341 )   Save [Abstract]Objective:To investigate the clinicopathological characteristics and treatment of phyllodes tumor.Methods:A retrospective analysis of 38 cases of breast phyllodes tumors, analyze the clinical pathological features, clinical effect and recurrence rate.Results:Among the 38 cases, the main phyllodes tumor of the breast were unilateral and solitary painless mass. No capsule, tumor diameter less than 5cm, the pathological types are mostly benign (P < 0.05) of.38 patients with a total of 8 cases of recurrence, the total recurrence rate was 21.1%. for breast local resection of the recurrence rate of patients was significantly higher than that of extended local excision of hysterectomy, the difference was statistically significant (P < 0.05).Conclusion:The clinical features of phyllodes tumor of the breast is unilateral and solitary painless mass, no capsule, surgical treatment is the main treatment, operation effect and operation methods are closely related. [Key words] phyllodes tumor; Pathology; treatment References | Related Articles | Metrics

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Clinical value of endoscopic metal stenting for colorectal cancer obstruction under x-ray 2016, 5 (2):  82-84,107.  Abstract ( 111 )   PDF (1056KB) ( 288 )   Save Objective: To observe the efficacy of endoscopic stenting for proximal colonal obstruction casused by malignant lesion. Methods: A total of 27patients,17 men and 10 women, a mean of 65.8 years old, who received X-ray-guided endoscopic stenting from September 2012 to July 2015 ,were enrolled into these retrospective analysis. The obstructive siter were: sigmoid colon(n=17), descending colon (n=6), rectum (n=3), transverse colon(n=1) . Results: Of the 27 patients ,25 were successfully inserted with metal stents(25/27,92.6%) ,and showed relif or disappear of symptoms within 1 day without major complications. 22 underwent metal stent elective surgical resection after 5～12 days and 1 case after 38 days. There were not important complications in surgical operation cases. Among the metal stent was performed in 2 cases for palliative treatment. Conclusions: Endo scopic placement of metal state can relive the obstructive symptoms caused by colorectal cancer with high successful rate.It is safe,effective, and furthermore for promotion of stage I coeloretal cancer resction ang anastomosis. References | Related Articles | Metrics

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Effects of different operation plans on stress and immune function in patients with thyroid tumor during perioperative period 2016, 5 (2):  85-87.  Abstract ( 119 )   PDF (1104KB) ( 316 )   Save [Abstract] Objective To explore effects of different operation plans on stress and immune function in patients with thyroid tumor during perioperative period. Methods 77 cases of patients with thyroid tumor in our hospital from March 2013 to March 2015 were selected, according to the operation plans, 41 cases were divided into study group and 36 cases in control group. The study group was given endoscope-assisted neck micro-incision treatment while the control group was given traditional open surgery. The basic situation of operation in the two groups, including operation time, intraoperative blood loss, hospitalization time were observed, and differences of perioperative stress and immune function related indexes between the two groups were compared , including CD3+, CD4+, body temperature and C reactive protein (CRP) level. Results The operation time (42.43±11.02)min and hospitalization time (34.20±8.32)ml in the observation group were significantly shorter than that in the control group, intraoperative blood loss (4.16±0.65)d was significantly lower than that in the control group ( P < 0.05); there was no significant difference in preoperative 24h body temperature, CRP, CD3+ and CD4+ ( P > 0.05), the highest postoperative temperature in the observation group was (36.46±0.21)degree, which was significantly lower than that in the control group, 48 and 72 hours after operation, CRP in the the observation group were (20.29±1.39)mg/L, (12.46±1.70)mg/L, which were significantly lower than the control group ( P < 0.05); 48h after operation, CD3+ in the observation group was significantly higher than that of the control group ( P < 0.05), but there were no significant differences in CD3+ (48h after operation) and CD4+ (48h and 72h after operation) between the two groups ( P > 0.05). Conclusion Compared with traditional open surgery, endoscope-assisted neck micro-incision treatment for patients with thyroid tumor can make operation time and hospitalization time shorter, intraoperative blood loss fewer, influence on the stress reaction of patients less, there was no significant difference in the influence on the immune function of the patients between two types of operation plans, so endoscope-assisted neck micro-incision treatment can be a priority selection for patients with thyroid tumor in clinic. References | Related Articles | Metrics

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Correlation Analysis between Procalcitonin levels and Infectious Agents 2016, 5 (2):  88-90.  Abstract ( 138 )   PDF (1113KB) ( 416 )   Save Objective To investigate the correlation between procalcitonin (PCT) levels and the infection site/pathogenic microorganisms. Method 120 patients aged 20 to 85 years who were admitted to the surgery intensive care unit (SICU) from August 2012 to August 2014, who had a procalcitonin drawn were evaluated. PCT blood specimens were collected at morning in SICU; blood cultures data, sputum culture data, urine culture data were studied to determine the causative organism. Result 120 patient records were reviewed. Patients without a known infection/source of sepsis had a mean procalcitonin of 3.79. Those with pneumonia had a procalcitonin of 24.87 (p=0.038). Those with a UTI had a mean procalcitonin of 52.19（P=0.0009）. Patients with a bloodstream infection had a mean procalcitonin of 27.73(p=0.0052). Those with Gram-positive sepsis had a procalcitonin of 25.87 (p=0.0161) and those with Gram-negative sepsis at 45.13 (p= 0.0203). Those with fungal in-fections had a procalcitonin of 45.13 (p=0.0017). Conclusion PCT levels were significantly different in different types of infections and pathogenic microorganisms so that procalcitoninmay play a role in guiding treatment for Pyemiaby indicating causative organism and infection type. References | Related Articles | Metrics

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Distribution and Drug-resistance analysis of pathogenic bacteria isolated from clinical sample in 2015 2016, 5 (2):  91-95.  Abstract ( 119 )   PDF (1175KB) ( 314 )   Save 【Abstact】 Objective To explore the clinical characteristics and the drug resistance in our hospital and to provide the scientific evidence for clinically reasonable use of antibiotics. Methods VITEK-2 Compact was used to identify the clinical strains. WHONET 5.6 software was used to analyze the clinical isolates of pathogens (Jan 2015- Dec 2015 ). Results A total of 2924 non-repetitive messages of bacteria were collected in 2015. Among them, the prevalence of gram-negative bacteria was 69.6%（2036/2924）and gram-positive bacteria was 30.4%.（888/2924）. Most of the bacteria were isolated from sputum，urine，blood and secretion specimens. Departments of ICU was the main endemic area of bacteria，followed by clinic service，general surgery，urology surgery and respiratory .For Escherichia coli and klebsiella pneumoniae，the drug resistance of ESBLs positive Escherichia coli and klebsiella pneumoniae is more serious than the ESBLs negative Escherichia coli and klebsiella pneumoniae. For gram-negative bacteria, the Carbapenem-resistace of Acinetobacter baumannii and klebsiella pneumonia was still serious. For gram-positive bacteria, the resistance rate of methicillin-resistant staphylococcus(MRS) is higher than that of methicillin sensitive staphylococcus(MSS). Conclusion The bacterial drug-resistance was still serious issue in the clinical setting in the year of 2015. Monitoring antimicrobial resistance have important significance to control infection and guide clinical rational drug use. References | Related Articles | Metrics

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Construction and identification of Fn14-shRNA lentiviral vector 2016, 5 (2):  96-101.  Abstract ( 142 )   PDF (1498KB) ( 464 )   Save Objective To construct a Fn14-shRNA lentiviral vector to further study the expression and biological significance of Fn14 in osteosarcoma with animal experiment. Methods Constructing Fn14-shRNA vector by RNA interference technique, viral packaging, co-transfecting cells and indentification. Results Single enzyme detection was positive, sequencing result was consistent with design, Fn14 was downregulated in stably transfected cell lines. Conclusion The Fn14-sh RNA lentivirus recombinant vectors were successfully constructed which laid the foundation for further study of the biological significance of Fn14 in osteosarcoma. References | Related Articles | Metrics

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Treatment of proximal phalangeal fractures of lesser toes with close reduction and percutaneous K wire fixation 2016, 5 (2):  102-104.  Abstract ( 192 )   PDF (1221KB) ( 1016 )   Save Objective To investigate the clinical effect of using K wire to treat the proximal phalangeal fractures of lesser toes. Methods Between June 2012 and June 2014, 18 patients with proximal phalangeal fractures of lesser toes were treated with K wire, to evaluate the fracture healing, loss of fracture reduction, complications and the occurrence of the corpus callosum. Results Patients in this group were followed up for 6-40 months with an average of 22 months. All fractures were healed without loss of fracture reduction. There were no infection, no K wire breakage, 2 patients with K wire pull out and no formation of the corpus callosum. Conclusion Closed reduction and percutaneous K wire fixation to treat proximal phalangeal fractures of lesser toes were reliable and effective. References | Related Articles | Metrics

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Safety observation of closed reduction external fixator with a fixed treatment in curing phalanx Pilon fracture 2016, 5 (2):  105-107.  Abstract ( 135 )   PDF (1089KB) ( 357 )   Save Abstract Objective: To investigate the safety of losed reduction external fixator with a fixed treatment in curing phalanx Pilon fracture. Methods: 32 cases of phalanx Pilon fracture in our hospital from October 2012 to October 2014 were selected as study objects. Retrospectively observed the surgical results of patients’ operation data. Results: After operation, fracture situation were improved, some patients removed the external fixator 4 weeks after fracture. The fracture started to heal, no infection appeared at fixation period. Evaluated the finger function according to total angle of motion, 18 cases excellent, 10 cases good, 2 case normal, 2 cases poor, the good rate was 87.5%. Conclusion: For patients with phalanx Pilon fracture, closed reduction external fixator with a fixed treatment can repair injured joints and gradually recover original function. It is worthy of wide application. Related Articles | Metrics

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Related factors of vascular tumor embolus in esophageal carcinoma 2016, 5 (2):  108-110.  Abstract ( 166 )   PDF (1129KB) ( 486 )   Save Objective: To investigate the clinical pathological characteristics of esophageal carcinoma complicated with vascular tumor embolus (VTE). Methods: The pathological data and clinical features of 535 patients with esophageal carcinoma were analyzed retrospectively. Results: There were 125 cases with VTE among 535 cases of esophageal carcinoma. The VTE is more likely to occur in poorly differentiated tumors than in high differentiated tumors, the difference is statistically significant（P?0.01）. The occurrence of VTE was closely related to the depth of tumor invasion and the number of lymph node metastasis, the statistics have significant（P?0.01）.The univariate regression analysis showed that VTE, the degree of tumor differentiation, the depth of invasion and lymph node staging were prognostic factors of patients with esophageal cancer. Conclusions: There is obvious relationship among the degree of tumor differentiation, the depth of invasion and the number of lymph node metastasis for VTE in esophageal cancer. VTE is a risk factor for prognosis of esophageal carcinoma. References | Related Articles | Metrics

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Correlation between preoperative CT characteristics and visceral pleural invasion in lung adenocarcinoma presented as ground glass opacity 2016, 5 (2):  111-114.  Abstract ( 139 )   PDF (1163KB) ( 892 )   Save Abstract Objective To analyze the correlation between CT characteristics and visceral pleural invasion (VPI) in lung adenocarcinoma presented with ground glass opacity (GGO). Methods 740 GGOs diagnosed with adenocarcinoma were selected, including 84 lesions with VPI. Results Age, GGO types (pure or part solid), the largest whole diameter, the largest diameter of consolidation, the proportion of consolidation, the distance from lesions to pleura, pleural retraction, margins (smooth or nonsmooth) and shape (round/oval or irregular) were significantly associated with VPI. Multivariate logistic regression analysis showed the largest whole diameter >12mm, the largest diameter of consolidation >5mm, the distance from lesions to pleura <6mm, pleural retraction, nonsmooth margin were risk factors of VPI (OR=3.23, 4.41, 3.58, 2.21, 2.65). The area under the receiver operating curve of multivariate analysis model was 0.861. Conclusion Preoperative CT was useful in evaluating VPI for pulmonary GGO diagnosed with adenocarcinoma. Related Articles | Metrics

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Idiopathic pulmonary fibrosis: a case report 2016, 5 (2):  115-117.  Abstract ( 171 )   PDF (1325KB) ( 817 )   Save Objective To investigate the clinical features of idiopathic pulmonary fibrosis (IPF). Methods One patient with idiopathic pulmonary fibrosis was diagnosed by integrating clinical, radiologic and pathologic information and clinical data of this case was analyzed. Results The patient described in the present case was a 70-year-old male who presented with 2 years history of progressive dyspnea. Pulmonary function testing revealed severe restrictive ventilator impairment and the diffusing capacity for carbon monoxide was reduced. The histological examination showed a pattern of usual interstitial pneumonia (UIP). Conclusions The pathological diagnosis of IPF should be identified combing clinical features and findings on lung HRCT. Related Articles | Metrics

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Application and current status of fast track surgery in gastrointestinal surgery 2016, 5 (2):  118-121.  Abstract ( 210 )   PDF (1145KB) ( 270 )   Save Fast track surgery is a burgeoning concept based on evidence and structured pathway to perfectly integrate a multidisciplinary team in modern medicine. This paper aims to present uptodate literatures about FTS in gastrointestinal surgery inland and abroad. It appears to be safe and effective for the patients. However more researches and effective protocols are required to standardize the clinical pathway. References | Related Articles | Metrics

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The treatment of the femoral neck fractures with posterior comminution in young adults. 2016, 5 (2):  122-125.  Abstract ( 162 )   PDF (1143KB) ( 341 )   Save Femoral neck fracture in young adults are the result of high-energy injury, the oblique fracture line or the short spiral often accompanied by the comminution of the posterior cortex. Posterior comminution is an important cause of unstable fixation. The comminution defects are easy to cause fracture delayed union, nonunion and avascular necrosis of femoral head. The femoral neck fractures with posterior comminution in young adults is still a clinical problem. Fracture reduction techniques and internal fixation devices have made a lot of progress in recent years. Related Articles | Metrics

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Post dural puncture headache 2016, 5 (2):  126-131.  Abstract ( 157 )   PDF (1224KB) ( 658 )   Save Spinal anesthesia was first developed in the late 1800s by Wynter, Quincke and Corning. However, a German surgeon, Karl August Bier, in 1898 gave the first spinal anesthesia. Bier, himself experience the severe headache due to dural puncture. He suspected that the headache was due to excessive loss of cerebrospinal fluid (CSF). Recently, there have been lots of modification in the size and tip of spinal needles which lead to decrease the incidence of Post dural puncture headache (PDPH). There are various major of management for PDPH such as conservative, pharmacological and interventional management. Epidural blood patch has the highest cure rate. There are other various majors such as epidural saline, epidural dextran, opiods, fibrin glues had been used to reduce the incidence of PDPH. The surgical closure of the dura mater is the last resort in the management of PDPH. References | Related Articles | Metrics

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Recent research of cell-free DNA methylation in ovarian cancer 2016, 5 (2):  132-135,138.  Abstract ( 142 )   PDF (1302KB) ( 448 )   Save Ovarian cancer is one of the most common malignant tumors in gynecology. In early stage, patients usually don’t have any symptoms. So when it was diagnosised, the cancer often had transferred to other tissues. And it always made bad influence to the treatment. Therefore, it is important to find new biomarkers which contribute to the diagnosis of ovarian cancer in the early stage. Based on other researches, the aberrant DNA methylation has been associated to the ovarian cancer, including the diagnosis in early stage, treatment and prognosis. The methylation of cell-free DNA which come from the tumor cells maybe a kind of important biomarkers of ovarian cancer. This review is telling about the newest researches and the use in ovarian cancer. Related Articles | Metrics

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Improvement of inserting gastric tube in a coma in patients with tracheotomy nursing experience 2016, 5 (2):  136-138.  Abstract ( 139 )   PDF (1154KB) ( 316 )   Save Objective:To study the clinical nursing for coma patients of receiving the tracheotomy upon the improvement of inserting gastric tube. Method:80 coma patients of receiving the tracheotomy from June 2015 to December 2015 in our hospital were selected. The gastric tube was inserted. The patients were divided into two groups according to different operation methods, 40 cases each group. The control group adopted the conventional methods of inserting gastric tube; the observation group adopted the improved methods of inserting gastric tube. The incidence of two groups of patients with a successful rate of intubation, 24 hours after aspiration and oxygen saturation were observed. Result:After operation, the one-time success rate for observation group (95.0%) was higher than that of control group (62.5%); within 24h, the incidence rate of aspiration for observation group (2.5%) was lower than that of control group (25.0%); the descent rate of oxygen saturation for observation group (12.5%) was lower than that of control group (80.0%)(P＜0.05).Conclusion: For coma patients of receiving the tracheotomy, the improvement of inserting gastric tube and clinical nursing can efficiently reduce the adverse event rate of repeated inserting of gastric tube, improve the one-time success rate 、to reduce the incidence of adverse reactions after intubation and reduce the patient’s pain. It is worthy of clinical application and promotion. References | Related Articles | Metrics

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Quality control circles in the application of portable pump infusion chemotherapy delay rate 2016, 5 (2):  139-141,144.  Abstract ( 120 )   PDF (1114KB) ( 364 )   Save [abstract] objective to discuss the quality control circle (QCC) activities in reducing the rate of a portable chemotherapy pump infusion time delay effect. Methods set up quality management circle activity chosen subject, activity plan, analyzing the status quo of the department of chemotherapy pump infusion rate of delay and its influence factors, and then on to formulate measures and implement planned by circle, finally compared before and after infusion of a portable chemotherapy pump activity delay rate, confirm the effect of the quality management circle activity. Results through quality management circle activity, portable pump infusion chemotherapy delay rate fell from 30.10% to 30.10%, the circle part quality control means, analysis and problem solving ability, long circle management ability, fellowship centripetal force, the quality consciousness, enthusiasm, communication ability, harmony degree are improved. Conclusion to carry out quality control circle activities can effectively reduce the portable pump infusion chemotherapy delay rate, improve the work efficiency, worthy of clinical popularization and application. References | Related Articles | Metrics

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Influence of comfortable nursing on psychological states and comfort level of patients with non-general anesthesia 2016, 5 (2):  142-144.  Abstract ( 136 )   PDF (1211KB) ( 274 )   Save Objective: To investigate the clinical effect of comfortable nursing on psychological states and comfort level of patients with general anesthesia. Aimed at providing effective proof of operating room nursing work. Methods: 100 cases with non-general anesthesia in our hospital from December 2013 to December 2015 were selected and divided into two groups, 50 cases in control group and was given routine nursing intervention, 50 cases in observation group and was given comfortable nursing based on control group. Observed the nursing effect of the two groups. Results: Compared with before treatment, SAS、SDS of the two groups obviously lowered after treatment, the difference was statistically significant (P＜0.05). Comfort level score and total points of observation group were obviously higher than control group (P＜0.05). Conclusion: The application of comfortable nursing on psychological states and comfort level of patients with non-general anesthesia can improve comfortable level of patients and psychological states of patients. It is worthy of wide application. References | Related Articles | Metrics