Search

Surgical Indications and Tips of Endoscopic Thyroidectomy

創傷性氣管、食管裂傷一例

結腸癌并急性腸梗阻一期手術治療11例報告

ADVANCEMENT OF ROTATIONAL ALIGNMENT OF FEMORAL PROSTHESIS IN TOTAL KNEE ARTHROPLASTY

Objective?To introduce the concept and clinical applications of rotational alignment of the femoral prosthesis in total knee arthroplasty (TKA) so as to avoide the postoperative complications caused by rotational alignment.?Methods?The clinical and experimental research literature about rotational alignment of the femoral prosthesis in TKA was extensively reviewed and analyzed.?Results?Femoral prosthesis malrotation can lead to flexion gap unbalanced and undesirable patellar track. Rotation alignment of the femoral prosthesis is defined with radiological and computer assisted technique at pre- and post-operation, which can make the rotation alignment of the femoral prosthesis and the function of the knee favorable.?Conclusion?In recent years, many surgical skills and new techniques of defining the rotational alignment are developed, and good clinical results are achieved.

胸部閉合傷后支氣管斷裂八例

Research on the effects of interleukin-6 on proliferation of cervical cancer cell C-33A

ObjectiveTo explore the role of interleukin-6 (IL-6) in cervical cancer cell C-33A.MethodsThe cervical cancer cells C-33A were divided into the IL-6 group and the control group after culture. The IL-6 group were treated with 50 ng/mL of recombinant IL-6 protein, and the control group were without IL-6. Then cell viability and cell migration were detected by MTT assay and wound-healing assay, respectively. The mRNA and protein expressions of epithelial-cadherin (E-Cad), neural-cadherin (N-Cad), vimentin and transcription factors-snail1 (TFs-SNAIL1) were analyzed by real time quantitative polymerase chain reaction and Western blotting, respectively.ResultsCompared with the control group, in the IL-6 group the proliferation of cervical cancer cells C-33A was promoted (12 h: 0.388±0.025 vs. 0.597±0.057; 24 h: 0.547±0.021 vs. 0.798±0.036; 48 h: 0.745±0.056 vs. 1.296±0.122; 72 h: 1.074±0.053 vs. 1.805±0.113; P<0.05), and the relative migration ability of cervical cancer cell was promoted (12 h: 1.057±0.029vs. 1.200±0.045; 24 h: 1.189±0.036 vs. 1.428±0.181; 48 h: 1.273±0.059 vs. 1.569±0.143; 72 h: 1.409±0.047 vs. 1.623±0.170; P<0.05); meanwhile, compared with the control group, in the IL-6 group, the expression of E-Cad mRNA (1.012±0.098vs. 0.483±0.171, P<0.01) and E-Cad protein (1.032±0.015vs. 0.395±0.119; P<0.01) decreased, the expression of N-Cad mRNA (1.054±0.106vs. 1.465±0.230, P<0.01) and N-Cad protein (1.040±0.043vs. 1.605±0.128, P<0.01) increased, the expression of vimentin mRNA (1.050±0.083vs. 1.340±0.099, P<0.05) and vimentin protein (1.043±0.062vs. 1.430±0.077, P<0.05) increased, and the expression of TFs-SNAIL1 mRNA (1.058±0.176vs. 1.510±0.229, P<0.01) and Fs-SNAIL1 protein (1.022±0.015vs. 1.470±0.139, P<0.01) increased.ConclusionIL-6 may promote the proliferation, migration, and epithelial-mesenchymal transition of cervical cancer cell C-33A.

電視胸腔鏡與開胸手術治療復發性自發性氣胸的療效觀察

目的 對比分析電視胸腔鏡手術（VATS）與開胸手術治療復發性自發性氣胸的療效，以提高近、遠期治療效果。 方法 將124例復發性自發性氣胸患者按手術方式不同分為兩組，VATS組（n=73）：采用VATS治療；對照組（n=51）:采用常規開胸手術。比較兩種術式的復發率、手術時間、住院時間、術后胸痛等。 結果 兩組均無手術死亡。VATS組患者手術成功率為97.26%（71/73），其中 1例因胸腔嚴重粘連，1例因術中出血轉為開胸手術。VATS組復發率與對照組比較差異無統計學意義（8.22% vs.5.88%；χ2=0.034，Pgt;0.05）；VATS組手術時間、住院時間均較對照組短（41.13±12.60 min vs. 88.09±41.13 min； 5.96±1.21 d vs. 8.25±1.48 d，u=13.30，9.16；Plt;0.05）；慢性切口疼痛發生率低于對照組（2.74% vs.15.69%;χ2=4.93，Plt;0.05）。所有患者均得到隨訪，隨訪時間12~54個月。VATS組術后5個月內復發6例,行開胸手術治療4例，VATS 2例;對照組術后3個月復發3例,經再次手術治療治愈。 結論 VATS治療復發性自發性氣胸復發率與開胸手術相近，但住院時間短、美觀、微創，近、遠期療效均較好。

心瓣膜置換術圍術期甲狀腺激素的動態觀察

目的 探討心瓣膜置換術圍術期甲狀腺激素的變化及其與病情程度的關系。方法 采用放射免疫分析法連續測定30例低溫體外循環下心瓣膜置換術圍術期甲狀腺激素，并觀察其動態變化。結果 兩組患者三碘甲狀腺原氨酸(T3)、游離T3(FT3)從轉流前至術后72小時呈下降趨勢，各時間點均明顯低于術前；反三碘甲狀腺原氨酸(rT3)均增高，術后72小時仍未恢復至術前水平(P＜0.05)。兩組患者四碘甲狀腺原氨酸(T4)、游離T4(FT4)、促甲狀腺素(TSH)濃度均在生理范圍內變化。結論 心瓣膜置換術圍術期均表現為低T3綜合征，且T3降低與疾病的嚴重程度有關。臨床上通過監測其血清T3和FT3水平可作為了解病情及預后的客觀指標。

Effect of Thalidomide as First-line Therapy on Postrelapse Survival Rate of Multiple Myeloma: A Meta-analysis

ObjectiveTo systematically review the effect of thalidomide as first-line therapy on postrelapse survival rate of patients with multiple myeloma (MM). MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 1, 2007) and Web of Science were searched to collect randomized controlled trials (RCTs) about thalidomide as first-line therapy for MM from 2006 to 2011. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.1 software. ResultsA total of 16 RCTs involving 6097 patients were included. The results of meta-analysis showed that, compared with the chemotherapy alone group, early application of thalidomide could significantly decrease the postrelapse survival rate (HR=1.23, 95%CI 1.05 to 1.45, P=0.002). Subgroup analysis showed that, compared with the chemotherapy alone group, thalidomide maintenance therapy after autologous stem cell transplantation (ASCT) couldn’t decrease the postrelapse survival rate (HR=0.90, 95%CI 0.57 to 1.41, P=0.64), but thalidomide induction therapy before ASCT (HR=1.21, 95%CI 1.01 to 1.45, P=0.04) and thalidomide induction therapy before ASCT combined maintenance therapy after ASCT (HR=1.41, 95%CI 1.13 to1.76, P=0.002) could significantly decrease the postrelapse survival rate. ConclusionCurrent evidence shows that, thalidomide maintenance therapy after ASCT for MM is a better therapy regimen. It couldn’t decrease the survival rate after recurrence, but could increase the disease-free survival (DFS) and overall survival (OS) of patients with MM. Due to the limited quality of included studies, the above conclusion still needs to be verified by more high quality studies.

43例心臟瓣膜疾病的外科治療