ObjectiveTo evaluate the efficacy of thoracoscopic complex segmentectomy for stageⅠnon-small cell lung cancer (NSCLC).MethodsWe retrospectively reviewed the perioperative clinical data of patients with stageⅠNSCLC who underwent thoracoscopic complex segmentectomy (n=58) or simple segmentectomy (n=33) between January 2017 and March 2020 in our hospital. There were 36 males and 55 females with a median age of 57 years (range: 50-66 years). The clinical data of the two groups were compared.ResultsThere were no significant differences between the two groups in characteristics including age, sex, weight, comorbidities, preoperative pulmonary function, dominant composition of tumor, tumor histology and size, overall complications, estimated blood loss, prolonged air leakage, length of hospital stay, length of drainage, surgical margin distance or number of dissected lymph nodes. Only the operation time and number of staples for making intersegmental plane were significantly different between the two groups (P<0.05). There was no perioperative death in both groups.ConclusionThoracoscopic complex segmentectomy is a feasible and safe technique for stageⅠNSCLC.
Abstract： Objective To investigate videoassisted thoracoscopic surgery (VATS) and percutaneous catheter occlusion (PCO) in interruption of patent ductus arteriosus (PDA), in order to achieve minimally invasive surgical injuries and better clinical results. Methods From November 1995 to September 2009, 312 cases of PDA were treated in Fujian provincial hospital, among whom 252 patients were interrupted with VATS(VATS group) and 60 patients with PCO technique(PCO group). For the VATS group, there were 78 males and 174 females aged from 7 d to 31 years old (9.16±8.91 years), while there were 17 males and 43 females aged from 4 to 57 years old (25.55±14.10 years) in the PCO group. We used titanium clip to interrupt PDA under videoassisted thoracoscope for patients in the VATS group, and adopted Amplatzer method for patients in the PCO group. The clinical results, complications and hospital cost in the two groups were compared in this study. Results In the VATS group, all the PDA were successfully interrupted with no residual shunt. In the PCO group, 5% (3/60) of the patients had minor residual shunt after the procedure. No mortality occurred in both groups. Time of the procedure and hospital stay in the PCO group were shorter than that in the VATS group (70.20±31.20 min vs. 112.50±16.30 min, t=6.344,P=0.002; and 4.70±2.20 d vs. 6.50±2.80 d, t=3.241, P=0.022, respectively). However, the hospital cost for each patient in the PCO group was much higher than that in the VATS group (23 222.00±4 333.40 yuan RMB vs. 8 904.50±2 634.60 yuan RMB,t=25.360, P=0.000). Conclusion Compared with PCO, VATS in interrupting PDA can achieved not only excellent clinical results, especially in the newborn and baby cases, but also very satisfying cost which is just a little more than one third of the PCO cost.
Abstract: Objective To summarize the 17-year clinical experience of coronary artery bypass grafting (CABG). Methods From April 1987 to May 2004, total 253 patients with coronary artery disease underwent CABG. The operation were performed in 217 patients under cardiopulmonary bypass (CPB) with moderate hypothermia, because of calcified ascending aorta, partial replacement of ascending aorta wall with apiece of Gore-Tex graft for the proximal anastomosis were done in 10 patients. Off-pump coronary artery bypass grafting (OPCAB) were performed in 30 patients. The operation under CPB with heart beating were performed in 6 patients. Cardiac valvular operations were performed in 15patients. Left atrium myxoma operation was performed in 1 patient. Left ventricular aneurysm plasty operation were performed in 10 patients. Results Total mortality rate was 7.9% (20/253). There was significant difference between the mortality rate of the first 10 years (16.0%,8/50) and that of the last 7 years (5.9%,12/203; χ2=5.62，Plt;0.05). The causes of death were: 3 patients died on table because of low cardiac output after valvular replacement though emergent CABG were conducted, 2 patients died of multiple organ failure after valvular replacement and emergent CABG had undergone, 3 patients died of ventricular fibrillation during closing the sternum, 6 patients died of multiple organ failure caused of severe lung infection, 2 patients died of ventricular fibrillation after operation, and 4 patients died of acute renal failure. One hundred and fiftyseven patients (67.4%, 157/233) were followed up, follow-up time was 6 months to 15 years. Three of them died of unknown causes, most of them have improved life quality. There were 87 patients in New York Heart Association (NYHA) class Ⅰ, 49 patients in NYHA class Ⅱ, 16 patients in NYHA classⅢ, and 2 patients in NYHA classⅣ. Conclusion When the experience of surgery and postoperative care is matured, CABG is a safe method for treatment of coronary artery disease. Partial replacement of ascending aorta wall with GoreTex graft for proximal anastomosis of the graft is acandidate method for the treatment of patients with calcified ascending aorta.
Objective\ To investigate the surgical technique and clinical results of interruption of patent ductus arteriosus (PDA) with video assisted thoracic operation (VATO).\ Methods\ Fifty PDA cases were divided into two groups, 25 cases treated with VATO(VATO group) as compared to other 25 cases with conventional surgical interruption(conventional surgical interruption group). In the VATO group, the PDA was interrupted by 2 3 hemoclips under VATO technique, and PDA interrupted by suture ligation with the techni...
ObjectiveTo review the recent progress in research on the role of estrogen and estrogen receptor on the onset and progression of adolescent idiopathic scoliosis (AIS). MethodsThe recently published clinical and experimental 1iterature at home and abroad on abnormality of estrogen and its receptor in AIS was reviewed and summarized. ResultsThere are many abnormal changes of estrogen and estrogen receptor in most AIS patients, including higher serum estrogen concentration, unusual cellular response to estrogen, late age at menarche, and gene polymorphisms of estrogen receptor, which are closely associated with AIS predisposition, curve severity, and scoliosis progression. ConclusionEstrogen and its receptor participate in the onset and progression of AIS by certain mechanisms, but exact mechanism remains indefinite, which needs further research to better define the role of estrogen and its receptor in AIS.
ObjectiveTo evaluate the safety, functional protection, and clinical efficacy of three-dimensional (3D) complete laparoscopic radical rectal cancer resection using natural orifice specimen extraction surgery (NOSES). MethodsAccording to the inclusion and exclusion criteria, the patients who received laparoscopic radical rectal cancer surgery in the Second Affiliated Hospital of Chongqing Medical University from January 2019 to December 2020 were retrospectively collected. The patients underwent 3D complete laparoscopic radical rectal cancer resection using NOSES were allocated to the observation group, while traditional laparoscopic assisted radical rectal cancer resection were allocated to the control group. The indexes of safety, functional protection, and clinical efficacy were compared between the two groups. ResultsA total of 80 patients were included in this study, including 40 patients in the observation group and 40 patients in the control group. There were no statistical differences in the baseline data between the two groups (P>0.05). There were no statistical differences between the two groups in the total operative time, intraoperative bleeding, number of lymph node dissection, positive rates of intraperitoneal tumor cells and bacterial culture, and tumor recurrence and metastasis rate (P>0.05). Compared with the control group, the first getting out of bed time, exhausting and defecating time after operation were earlier, meanwhile the postoperative pain score, use of analgesics, and the occurrence of severe low anterior resection syndrome were better in the observation group (P<0.05). The incidence of postoperative overall complications in the observation group was lower than that in the control group (P<0.01). The postoperative hospital stay was shorter and the hospitalization costs were less in the observation group as compared with the control group (P<0.05). ConclusionFrom results of this study, 3D complete laparoscopic radical rectal cancer resection using NOSES is safe and feasible, its functional protection and clinical efficacy are better than those of traditional laparoscopic assisted radical rectal cancer resection.
OBJECTIVE: To investigate the effect of soft tissue repairing at different times on the union of type III b tibial fracture. METHODS: From January 1987 to January 1999, seventy-six type III b tibial fractures were divided into 3 groups: early group(0 to 7 days), subacute group(8 to 30 days), late group(more than 30 days) according to the time of soft tissue repairing. The morbidity rates of complications such as infection, nonunion as well as the time to union were compared respectively. RESULTS: Followed up for 10 to 36 months (averaged 24 months), the infection and nonunion rates of early group were lower than that of subacute and late groups(P lt; 0.01), the average time of fracture union of early group was less than that of subacute and late groups. CONCLUSION: Early soft tissue repairing can decrease the complications and the time to union of Type III b tibial fracture obviously. The time of "early" should be limited in one week and as soon as possible.
Objective To investigate the effect of extract of ginkgo biloba leaves (EGb50) on the prol iferation of SCs cultured in vitro. Methods The SCs were isolated from 3-day-old SD rats’ sciatic nerves by the method of enzyme gradationdigestion (n=20) and the purified 2nd passage of SCs were divided into 2 groups: the experimental group, in which SCs were cultured in FBS-DMEM medium with EGb50 (terminal concentration: 50 μg/mL); the control group, in which SCs were cultured in the FBS-DMEM medium without EGb50. The absorbance (A) value was detected by the 2, 3-bis- (2-methoxy-4-nitro-5- sulfophenyl)-2H-tetrazol ium-5-carboxanil ide (XTT) method 1, 3, 5, 7 and 9 days after culture, then the growth curves was drawn. Cell cycle was detected by flow cytometry (FCM). Disintegration per minute (DPM) of SCs was detected by the method of 3H-thymine nucleoside (3H-TdR) 2 and 3 days after culture and nerve growth factor (NGF) synthesis in SCs culture media was detected by ELISA method. Results Most SCs were spindle-shaped with a purity above 90%. XTT detection showed that A value of SCs in the control group was gradually increased 3 days after culture, reached the peak 5 days after culture and gradually decreased from then; the A value in the experimental group experienced the similar changes, but it was higher than that in the control group at each time point (P lt; 0.01). 3H-TdR showed that the DPM of the experimental group was 1 961.78 ± 231.13 and 4 601.51 ± 605.08 at 2 and 3 days after culture, while for the control group, the A value was 1 347.15 ± 121.57 and 3 740.42 ± 158.73 at the same time point, indicating a significant difference between two groups (P lt; 0.01). FCM observation indicated that the SCs prol iferation index of the experimental group and the control group was 18.6% ± 3.2% and 9.7% ± 2.9%, indicating a significant difference between two groups (P lt; 0.01). ELISA observation showed that the NGF concentration in the experimental and the control group was (0.065 6 ± 0.003 9) ng/mL and (0.038 6 ± 0.003 6) ng/mL, indicating a significant difference (P lt; 0.01). Conclusion EGb50 is capable of enhancing the prol iferation of SCs cultured in vitro, which may be one of the important mechanisms to promote peripheral nerve regeneration.