Table of Content

28 June 2013, Volume 2 Issue 2 Previous Issue    Next Issue

Orignal Article

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MMP-2 and MT1-MMP contribute to vasculogenic mimicry and poor prognosis in human primary gallbladder carcinomas SUN Wei,FAN Yue-Zu,ZHANG Wen-Zhong,GE Chun-Yan 2013, 2 (2):  73-86.  Abstract ( 143 )   PDF (3560KB) ( 337 )   Save Objective To investigate MMP-1,-2,-9,-14 expressions and their correlation with prognosis of the gallbladder carcinoma patients with/without vasculogenic mimicry.Methods Immunohistochemistry (IHC) computer-assisted quantitative image analysis and receiver operating characteristic curve were used to analyze expression of MMPs (MMP-1,-2,-9,and -14) in 89 gallbladder carcinoma (GBC) samples,IHC quantitative analysis and selection of the cut-off score for high or low IHC reactivity.Correlation of MMPs expression with vasculogenic mimicry (VM),clinicopathologic features and prognosis of GBC patients with VM and non-VM was evaluated simultaneously.Reaults Over-expression of MMP-2 and MMP-14 was significantly associated with VM in GBC (both P<0.01).Moreover,the expression of MMP-2 and MMP-14 was correlated with Nevin stage,degree of differentiation and liver metastasis in non-VM group (both P<0.05).In addition,MMP-2 expression was also associated with serosal invasion and liver metastasis in VM group (both P<0.05).Over-expression of MMP-2 in GBC patients was associated with VM in the same subset of clinicopathologic parameters,including moderate degree of differentiation,Nevin stage (S3-S5),positive liver metastasis,serosal invasion and lymph node metastasis (both P<0.05).Moreover,over-expression of MMP-14 in GBC patients was correlated with VM in the same subset of clinicopathologic parameters,including degree of differentiation (G2 and G3),Nevin stage,positive lymph node metastasis and serosal invasion,negative liver metastasis and serosal invasion(both P<0.05).Multivariate analysis showed that MMP-2 and MMP-14 were independent factors for the overall survival (OS) rate and associated with poor prognosis either in VM negative or positive group (both P<0.05).Conclusion MMP-2 and MMP-14 were independent factors,associated with prognosis of the GBC patients with/without VM,might play significant role in VM formation and progression of GBC. References | Related Articles | Metrics

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Risk factors and surgical skill on difficult laparoscopic cholecystectomy TU Zhi-yuan, ZHU Qin 2013, 2 (2):  87-89.  Abstract ( 130 )   PDF (704KB) ( 559 )   Save Based on our 15 years experience of laparoscopic cholecystectomy,we discussed the risk factors about case history,ultrasound and MRCP.Risk factors during operation in difficult laparoscopic cholecystectomy was well conserned.Surgical skill was also mentioned to decrease morbidity and mortality. Related Articles | Metrics

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Development of noncontacting mechanical measurement system for instruments in laparo-endoscopic single-site surgery with digital image correlation technology XU An-an, ZHU Jiang-fan, SU Jin, ZHANG Dong-sheng, WANG Qiang 2013, 2 (2):  90-93.  Abstract ( 133 )   PDF (1583KB) ( 253 )   Save Objective Analysis of mechanical measurements in laparo-endoscopic single-site surgery (LESS) is an important instrument design and surgical simulator.Aims of this study was to set up and evaluate the reliability and stability of noncontacting mechanical measurement system for instrument of LESS in company with digital image correlation technology.Methods The noncontacting mechanical measurement system was connected to a digital image correlation devices and a LESS manipulation platform (set up with a SILS Port and an inanimate laparoscopic trainer box).The correlation between the changes of deformation measurements (displacement and strain calculated by digital image correlation technology) and the change of workload (workout by the universal material testing machine)were evaluated.The experiment was repeated 8 times.Results A strong correlation was noticed between the changes of deformation measurements and the change of workload.The correlation coefficient was statistical significant (P<0.001).A high stability was well shown in all repetitions.Conclusions A noncontacting mechanical measurement system has been developed for LESS.Comprehensive mechanical parameters of SILS port can be obtained precisely by the digital image correlation technology.It is reliable and stable for the evaluation of instruments and manipulations in laparo-endoscopic single-site surgery by this system. References | Related Articles | Metrics

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Gallbladder-preserving cholelithotomy by a combination surgery of laparoscopy and choledochoscopy for cholecystolithiasis ZENG He-ping, LI Zhen, LIU Hai-long, YE Zheng-xiong, WANG Yun-feng 2013, 2 (2):  94-96.  Abstract ( 164 )   PDF (687KB) ( 554 )   Save Objective To discuss and analyze the application of gallbladder-preserving cholelithotomy by a combination of laparoscopy and choledochoscopy for cholecystolithiasis.Methods 62 patients with cholecystolithiasis were recruited for Gallbladder-preserving cholelithotomy.Clinical data of these patients were retrospectively analyzed.Results All patients underwent cholelithotomy successfully with this approach.There was no complication of hemorrhage and bile leakage.2 patients with gallbladder hematocele was observed.2 patients with recurrence of gallstone were identified during a follow-up of 3 to 26 months.Conclusions Gallbladder-preserving cholelithotomy by a combination of laparoscopy and choledochoscopy is a safe,feasible and effective approach for cholecystolithiasis. References | Related Articles | Metrics

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Primary resection of obstructive left-sided colorectal cancer TU Zhi-yuan, ZHU Qin 2013, 2 (2):  97-98.  Abstract ( 131 )   PDF (638KB) ( 315 )   Save Objective The aim of this retrospective study is to evaluate surgical outcomes of primary resection as emergent curative surgery for obstructive left-sided colorectal cancer.Methods 22 patients with obstructive left-sided colon cancer received emergent curative resection.Complication,mortality and hospital stay were analyzed.Results No death and leakage were found in these patients.Conclusion For obstructive left-sided colorectal cancers,primary resection may be a safer surgical option. References | Related Articles | Metrics

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The efficiency of uterine artery embolization in treating cesarean scar pregnancy ZHANG Yi, LEI Hui, OUYANG Yi-qin, LI Huai-fang 2013, 2 (2):  99-102.  Abstract ( 136 )   PDF (668KB) ( 402 )   Save Objective To provided evidence for guided uterine artery embolization as a secured therapy for cesarean scar pregnancy (CSP).Methods We retrospectively studied 40 CSP patients’ therapeutic methods and outcomes from January 2010 to June 2013.Results Of these 40 patients, 30 were diagnosed CSP immediately, 10 were miss-diagnosed as normal pregnancy and turned out CSP later-on.Of those 30 patients, 17 received uterine artery embolization with methotrexate plus D&C; 13 received conservative medical therapy plus D&C.When compared these 30 patients therapeutic outcomes, guided uterine artery embolization has shown an apparent advance in operation duration, blood loss (p<0.05).Conclusion There were multiple therapies for CSP including conservative therapy, embolization therapy, operation therapy, and early diagnose, early therapy could get a satisfactory effect.Our therapy:uterine artery embolization with methotrexate plus D&C is a therapy which had merits of less blood loss, mini-invasive and shorter inpatient duration. References | Related Articles | Metrics

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A comparison between titanium plate internal fixation and wire ligation preliminary resilts in treatment of mandibular fractures SGAO Jing-Jing, ZHU Xiao-hong, YU Ming-yan, MAO Ai-dong 2013, 2 (2):  103-105.  Abstract ( 185 )   PDF (714KB) ( 662 )   Save Objective To investigate clinical efficacy of titanium plate internal fixation and intermaxillary wire ligation fixation in treatment of mandibular fractures.Methods From June 2009 to July 2012,42 retrospective analysis cases of mandibular fracture were collected.21 patients were treated with intermaxillary wire ligation fication,the remaining 21 patients accepted fitanium plate fixation.Two groups were compared in fracture healing,occlusion,biting force and infratemporal joint.Results 42 cases were followed up for 6-32 months.Titanium plate group was better than the wire group in clinical results including fracture healing,occlusion ,biting force and infratemporal joint (P<0.05).Conclusion Titanium plate internal fixation has excellent reduction,rigid fixation and fewer complications in treatment of mandibular fracture.It is an ideal menthod for treating mandibular fractures. References | Related Articles | Metrics

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Proximal humeral fractures treated by lockinganatomical plate with minimally invasive incision:Management and results XIE Qing-xiang, LI Wei, HUANTG Hua, QUAN Di 2013, 2 (2):  106-109.  Abstract ( 140 )   PDF (5406KB) ( 377 )   Save Objective To investigate and analyze the application of minimal invasive incision combined with locking anatomical plate for treatment of proximal humeral fractures.Methods From May 2006 to October 2009,15 patients with proximal humeral fractures (Neer type Ⅱ-Ⅳ) were treated with T-shaped minimal invasive incision and locking anatomical plate including 8 males and 7 females at average age of 45.1 years old (range 19-82 years);13 fresh fractures cases,2 old injuries cases;8 fall on flat cases,3 traffic accidents cases,4 other injuries cases;6 Neer two-part fractures cases,8 Neer three-part fractures cases,1 Neer four-part fractures case.Results 15 patients were followed up for 18 months on average (12-24 months).The mean ASES score was 89.1±13.0 (55-100),mean VAS score was 0.9±1.1 (0-5) and mean Constant-Murley score was 88.5+10.1 (62-100).All fractures healed well in 15 patients and there was no avascular necrosis.Screw piercing occurred in 1 case and there was traumatic arthritis in 1 case.Conclusion Minimal invasive incision combined with locking anatomical plate is an effective method to treat proximal humeral fractures that can reduce injuries of muscle and ligament attachment points,promote functional recovery earlier,protect the blood supply of the proximal humerus and ensure the fracture healing effectively. References | Related Articles | Metrics

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A further Discussion about the Classification and Surgical Management of Concealed Penis (122 cases report) SUN Xu, LI Rong-bing, ZHOU Lan, WANG Xue-lei, WEN Ji-ling, WEN Xiao-fei 2013, 2 (2):  110-112.  Abstract ( 523 )   PDF (648KB) ( 947 )   Save Objective To select an appropriate surgical procedure according to the different classification of concealed penis.Methods 122 patients with concealed penis underwent surgical treatment in our hospital from Mar.1998 to Jun.2012 were reviewed and analyzed.According to different pathological change of concealed penis,122 patients were classified into four types,phimosis type,fascia bands type,micropenile skin sleeve type and obesity type.Different surgical methods were reviewed respectively for their different classification.The phimosis type patients were mainly treated by relaxing the narrow prepuce ring,and penile dorsal Y-V plasty for inadequate penile skin.The fascia bands type patients by removing the dysgenic dartos fascia bands,the micropenile skin sleeve type patients by penile dorsal and ventral Y-V plasty and the serious obesity type patients by fixing the penile skin onto the lateral Buck’s fascia at the base of the penis.Results All patients with concealed penis were improved in appearance and accessibility after corresponding surgery.Conclusion The classification of the concealed penis patients is helpful to clinical diagnosis and surgical treatment selection. References | Related Articles | Metrics

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Research progress on the morphology of corneal endothelial cells DU Fei, BI Yan-long 2013, 2 (2):  113-117.  Abstract ( 355 )   PDF (692KB) ( 1620 )   Save The adult corneal endothelial cells (CEC) could not take self-renewal.The circumjacent cells enlarge and migrate to fill the vacancy after trauma.A normal endothelial cellular density and morphology are pivotal to maintain a normal corneal structure,transparency and refractive index.Traumas,surgeries and some metabolic problems may lead to irreversible results.In this review,the CEC morphological parameters,CEC function and redistribution in a variety of the situation were comprehensively reviewed.Hope it would provide a reference for the treatment of ocular diseases and the judgment of surgical prognosis. References | Related Articles | Metrics

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Progress of Surgical Robot in Minimal Invasive Surgery WU Yang-chun, CHENG Li-ming 2013, 2 (2):  119-122.  Abstract ( 172 )   PDF (659KB) ( 296 )   Save It is a hot topic about the development of surgery robot in minimal invasive surgery.Known as the second cohort of robots,ZEUS and Da Vinci have been designed for variant purposes; however,its high cost and huge body obstructs its clinical application.Recent rising small robots that could be adapt to different needs with a lower cost.It is no doubt that robotic surgery has become a main technology in minimal invasive surgery. References | Related Articles | Metrics

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Research progress of the treatment of dislocation of peroneal tendons YU Yao-ping, YU Guang-rong 2013, 2 (2):  123-127.  Abstract ( 396 )   PDF (754KB) ( 1868 )   Save Peroneal tendons dislocation refers to slip the external ankle peroneal tendons in the rear of the fibula groove,inducing a series of symptoms such as instability and pain in the external ankle.There are variously different surgical methods of treating the dislocation of peroneal tendons,each with distinct characteristics.Operation styles mostly consist of soft tissue repair,fibular groove deepening,fibular osteotomy,tissue graft,peroneal tendons rerouting and using of endoscopy in treatment of dislocation.The method of treating peroneal tendons dislocation depend on injury mechanism and patients individual condition for achieving high healing rate,less complications and rapid recovery. References | Related Articles | Metrics

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Current situation and prospects of public hospitals corporate governance structure and its reform in China under deepening reform WANG Fei, QIU Hai-ou, WANG Le-min 2013, 2 (2):  128-132.  Abstract ( 126 )   PDF (667KB) ( 279 )   Save Public hospital management reform based on establishing modern hospital management system is under the way.Building corporate governance structure centered modern hospital management system is coming.The corporate governance structure reform in public hospital is one of the critical missions for innovating public hospital system and mechanism,and is an important institutional guarantee for safeguarding the commonweal of public hospital.This article elaborated the conception of corporate governance structure of public hospital,analyzed the current situation and prospects of public hospital corporate governance structure,and proposed some concrete measures of the reform.At present,an consensus which is to establish hospital management committee or council as the core of corporate governance of China’s public hospitals has been reached. References | Related Articles | Metrics

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Report for a case of primaru lung meningioma ZHOU Wen-bo, WANG Jiong, CHEN Ling-jie 2013, 2 (2):  133-126.  Abstract ( 145 )   PDF (2346KB) ( 316 )   Save References | Related Articles | Metrics