Objective To study the change of immunologic function of the patient with obstructive jaundice. Methods The level of the sIL-2R, TNF-α, IL-6 and IL-8 in 36 cases of obstructive jaundice before and after operation were measured. Results The level of the sIL-2R, TNF-α, IL-6 and IL-8 in 36 cases of obstructive jaundice before operation was higher than normal control group (Ｐ＜0.01). It decreased after the obstruction was removed, and it was close to normal control on 14th day after operation. Conclusion The result suggest that relief of jaundice could improve the immunologic function of the patient.
Objective To investigate diagnosis and treatment of farlateral lumbar disc herniations. Methods The clinical data from 16 patients with far-lateral lumbar disc herniations from January 1999 to January 2004 were retrospectively analyzed. The CT scanning showed that the shadow density of the CT scanning values in the corresponding intra-foramen, extraforamen and all-foramen was as the same as that of the intervertebral disc. Of the 16 patients, 10 were operated on by the interlaminar approach, 3 were operatedon by the laterolaminar approach, 3 were operated on by the combined interlaminal and laterolaminal approach.Results According to the follow-up for 6 monthsto 5 years, excellent results were obtained in 8 patients, good results in 5, and fair results in 3. The postoperative CT examination showed that the space occupying in the foramen or extraforamen of the corresponding segment vanished and the nerve root compression of the identical segment also vanished. Conclusion The lamellar highresolution CT is a better way to diagnose lumbar disc herniation. The operative approach should be chosen according to the position of the intervertebral disc protrusion, pathologic type, and presence or absence of the lesions in the vertebral canal.
Objective To investigate the clinical curative effect of distal phalanx of great toe and soft tissue orthopaedics for treatment of obstinateingrown nail. Methods From October 1997 to May 2006,31 patients(38 nails) suffering from obstinate ingrown nail were treated by the distal phalanx of great toe and soft tissue orthopaedics. There were 23 males(27 nails) and 8 females(11 nails) with an average age of 17.5 years(12-28 years). The disease course was 2years and 1 month to 14 years(average, 31-6 months). At the same time, thirty-eight patients with diseases of feet were selected randomly as controls. The depth of the nail groove was measured.The X-ray films were taken to calculate the rate of upward projection of tuberosity (r). Results Thedepth of the nail and r value of 31 patients were 2.87±0.31 mm and 0.149±0.013，respectively. There were statistically significant differences when compared with control group（1.06±0.10 mm and 0.060±0.019）（Plt;0.01）. Thirty patients(37 nails) had a primary healing; 1 patient(1 nail) had a delayed healing. Twenty-nine patients(36 nails) were followed up for 8 to 29 months(average, 21 months). The appearance of the nail was satisfactory. No relapse occurred in all patients. Conclusion The upward projection of tuberosity of distal phalanx of great toe and deepened nail groove are the most important anatomical causes for ingrown nail. The distal phalanx of great toe and soft tissue orthopaedics is aneffective treatment for obstinate ingrown nail.
Objective To enhance survival rate and treatment effect for advanced gallbladder cancer (GBC). MethodsEighty cases of advanced GBC were treated surgically from January 1990 to June 2001.Seventyone cases had obstructive jaundice, 15 had palpable abdominal mass. Extended radical cholecystectomy was performed in 39 cases of advanced GBC in which the tumor invaded the surrounding organs or tissues but without distant metastasis. ResultsFollowup showed that the survival period was between 8 and 37 months (average 18.1 months), 1， 2 and 3year survival rates were 43.6%， 20.5% and 5.1% respectively. Palliative operations were performed in other 41 advanced GBC cases with distant metastasis. All of the patients died within one year. Conclusion This result suggests that extended radical cholecystectomy is effective for advanced GBC.
OBJECTIVE To investigate the therapeutic effect of percutaneous lumbar discectomy (PLD) combined with sodium hyaluronate (SH) injection in the treatment of lumbar intervertebral disc herniation. METHODS Forty-eight patients suffered from lumbar disc herniation were divided into two groups and treated by PLD combined with SH injection into epidural cavity (treatment group) or single PLD (control group) respectively. All patients were followed up for 24 months. The therapeutic effects in both groups were assessed and compared according to Macnab’s criterion. RESULTS The patients in the treatment group got much more significant improvement than those in the control group, with shorter therapeutic course and more safety. CONCLUSION PLD combined with SH injection into epidural cavity is more effective and safety in the treatment of lumbar disc herniation than of pure PLD.
【Abstract】ObjectiveTo study the distal intramural spread of rectal carcinoma, and provide evidence for modification of rectal carcinoma surgery. MethodsSixty patients with rectal carcinoma admitted to the first affiliated hospital of Chongqing university of medical science from November 2001 to October 2002 were included. The specimens were extended to its original size and shape by the fat clearing method. Mesenteric lymph nodes were dissected by using transillumination to examine metastases histologically, then a lymph nodes map was produced which including the site of the primary lesion, the vascular distribution, and the sites of dissected nodes. The specimen below the distal margin of the tumor was cut continuously with 0.5 cm interval then sectioned for histopathological examination. ResultsTumor spread to the distal intramural was observed in 11 of 60 patients (18.3%) with the range within 1.5 cm, of which less than 0.5 cm in 5 case, 5 cm to 1.0 cm in 2 cases, 1.0 cm to 1.5 cm in 4 cases. The tumor invasion was correlated with gross type, histological type and infiltrative depth, but not with sex, age, location of the tumor, size of the tumor, lymph nodes metastases and Dukes stage. Conclusion The range of distal mural excision should exceed 1.5 cm to tumor margin in radical surgery for rectal carcinoma. This rule should be emphasized for patients with poor cell differentiation and deep infiltration.
One thousand four hundred and fifty-four cases of operations for gastric carcinoma in this hospital from 1983 to 1994 are reviewed. 121 out of 1454 patients sustained 168 occurrences of early postoperative complications. The patiets involvement rate was 8.32% and the occurrence rate of complications was 11.55%. Complications could be divided into two groups, the general complication after surery (8.25%) and complication relavent to gastrointestinal reconstruction (3.30%). Most common complications were wound infection, pulmonary infection, anastomotic obstruction or leakage. The authors stress the prevention of surgical complications that would furhter improve the therapeutic result of gastric cancer.
【Abstract】ObjectiveTo explore selective criteria of sphincter preservation operation (SPO) for middle to low third rectal cancer, and analyze clinicopathologic parameters resulting in the selective criteria. MethodsTwo hundred and seventynine cases of middle to low third rectal cancer who accepted operative treatment from 1996 to 2004 were analyzed retrospectively. One hundred and eightyseven rectal tumours were located in 5-10 cm from anus, 92 rectal tumours in below 5 cm from anus. Among them 127 cases were treated by abdominalperineal resection (APR), and 152 cases were treated by SPO in which there were 130 Dixon operations, 12 Bacon operations, and 10 Parks operations. Clinicopathologic parameters and survival rate in APR and SPO groups were compared statistically. ResultsGender, age, size, tumor types, site of tumor, degree of differentiation, infiltrated circumference of intestine, and lymph node metastasis, depth of invasion and Dukes stages were not significantly different between APR and SPO groups. SPO performed rate was 54.48% in all. SPO was performed in 48 lower third rectal cancer cases (52.17%, 48/92). Regional recurrence rate was 6.81% （19/279）.Middle survival time was （65.00±6.87）months and 5year survival rate was 63.51% in SPO group. Middle survival time was （52.23±5.63） months and 5year survival rate was 52.50% in APR group. ChiSuqare was 18.14 by Logrank test (P=0.054 1). ConclusionThere is no statistically difference in survival rate between APR and SPO groups.
Objective To analyze the significance of operation date in clinical path designing of cleft lip-palate. Methods The case records of cleft lip-palate patients from 8 hospitals in Gansu province were collected from 2005 to 2008. By means of comprehensive analysis of case records and frequencies of hospitalization duration, analyzed the influence of operation date selection on hospitalization duration in clinical path designing. Result In Gansu province, the average hospitalization duration of cleft lip-palate was 11 days, and the operation was usually done at the sixth day. The main preparations for operation were kinds of examinations. Within five days after operation, most treatments were postoperative care, diet and antibiotic therapy. Conclusion The strategy of operation date selection is much important to ascertain the real hospitalization duration in clinical path designing.
In order to study the immune function of patients with obstructive jaundice, the rate of RBC-C3b receptor rosette (RCR), tumour-RBC rosettes (TRR), RBC-immune complex rosette (RICR) and CD３+,CD4+,CD8+ cells were investigated. In these patients, the pre-operative erythrocyte and T lymphocyte subsets immune functions were lower than those of the control (Ｐ＜0.001). At the 5th day after operation, there was no significant change and 14th day after operation the erythrocyte and T lymphocyte substes immune functions were significantly elevated(Ｐ＜0.05), while, compared with the normals, which was still depressed in some degree. Operation is useful to the recovery of the immune function in all patients.