Objective:To observe the feasibility and safety of awake anesthesia for tumor excisions in pa- tients with brain tumors involving cerebral functional areas.Methods:Fifty patients with brain tumors in- volving cerebral...Objective:To observe the feasibility and safety of awake anesthesia for tumor excisions in pa- tients with brain tumors involving cerebral functional areas.Methods:Fifty patients with brain tumors in- volving cerebral functional areas,ASAⅠ-Ⅱgrade,were enrolled in this study.Propofol and remifentanil were used for total intravenous anesthesia,and a laryngeal mask airway(LMA)was inserted for the air- way opening and synchronized intermittent mandatory ventilation(SIMV).At the surgeon's request for an intraoperative wake-up test,the propofol infusion was stopped advance of 10-15 min,the remifentanil in- fusion rate was decreased to 0.050-0.075μg/kg from 0.10-0.20μg/kg per min for easing surgical pain. The LMA was removed until the patient awakened.The anesthesiologist then kept up an on-going neuro- logical examination.After that,anesthesia was re-deepened and LMA was re-inserted until the whole surgery was accomplished.Results:Forty-six of 50 patients(92%)were successfully awakened and 4 (8%)failed to complete the intraoperative wake-up test because of dyspnea,over-sedation,or severe hy pertension.No severe complications occurred during the whole process.Conclusions:During the awake anesthetic period,the intraoperative wake-up test combined with navigation,evoked potential and ultra- sound techniques can help surgeons excise maximumly and precisely the brain tumors near to or in the functional areas.展开更多
AIM: To explore the relationship between metastasis and vagina vasorum in the progress of gastric carcinoma and to find some facts and references for gastric surgeons. METHODS: One hundred and seven specimens of left ...AIM: To explore the relationship between metastasis and vagina vasorum in the progress of gastric carcinoma and to find some facts and references for gastric surgeons. METHODS: One hundred and seven specimens of left or right gastric arteries (55 left and 52 right) were gathered from 59 patients undergoing radical gastrectomy for gastric carcinoma. All the frozen specimens were cut into 3 μm-thick sections and stained with hematoxylin-eosin (HE) and immunohistochemical method separately. Cytokeratin (CK) and mesothelial cells (MC) were stained with immunohistochemical method. Cancer cells inside vagina vasorum were detected and the structure of artery wall was observed under microscope. RESULTS: Metastatic cancer cells or tubercles were found inside vagina vasorum in some stage Ⅲ or Ⅳ specimens, but not in stageⅠor Ⅱ specimens. Tumor cells in vagina vasorum were CK positive in 26 specimens of 14 tumors. Among them, stage Ⅲ was found in 4 specimens of 2 tumors, and stage Ⅳ in 22 specimens of 12 tumors. None of these specimens was positive for MC. The positive rate of CK increased with TNM staging. Compared with the lower part, tumors in the upper and middle parts of stomach were more likely to metastasize into vagina vasorum. CONCLUSION: Vagina vasorum dissection should be performed during D2 lymphadenectomy for TNM stage Ⅲ or Ⅳ gastric carcinoma.展开更多
The half-dry cutting employs cryogenic compressed air cooled down to (10 to 40) and a micro-dosage of lubricating oil, called cryogenic cold air jet cutting was studied. On the basis of a comparative experiment on dr...The half-dry cutting employs cryogenic compressed air cooled down to (10 to 40) and a micro-dosage of lubricating oil, called cryogenic cold air jet cutting was studied. On the basis of a comparative experiment on dry and cryogenic cold air jet cuttings carried out for grade 45 steel, the effects of cryogenic cold air jet on the breaking of chips were discussed. The experimental results reveal that in the valid ranges of pressure and temperature, the cryogenic cold air jet widens the chip breaking areas effectively. When the cutting depth is not greater than 1 mm, the influence of chip breaking is much more significant. But different injecting angle of cold air has different influence on the chip-break. From the experiment, the optimized jet injecting angle, temperature effecting range and pressure working range of cold air are obtained. These results can offer a foundation for industrial manufacturing.展开更多
Objective To investigate the theoretical basis and clinical significance of thymectomy in the treatment of myasthenia gravis (MG). Methods Analyze the changes in the contents of serum AchRab and sIL-2R, lymphocyte sub...Objective To investigate the theoretical basis and clinical significance of thymectomy in the treatment of myasthenia gravis (MG). Methods Analyze the changes in the contents of serum AchRab and sIL-2R, lymphocyte subtypes in peripheral blood lymphocytes before and after thymectomy in 69 patients.Results In the study group significant changes were found in serum contents of AchRab and sIL-2R before and after operation and there was also remarkable change in the number and constitution of peripheral blood lymphocyte subtypes. Conclusion Thymectomy is an effective therapy for MG.展开更多
The treatment of gastric carcinoma consists of neoadjuvant chemoradiation,partial gastrectomy,subtotal gastrectomy,total gastrectomy,extended resection,and postoperative chemotherapy.Currently,gastrectomy and extended...The treatment of gastric carcinoma consists of neoadjuvant chemoradiation,partial gastrectomy,subtotal gastrectomy,total gastrectomy,extended resection,and postoperative chemotherapy.Currently,gastrectomy and extended lymphadenectomy is the optimal choice for late gastric carcinoma.Postoperative complications are common after total gastrectomy including hemorrhage,anastomotic leakage,f istula,and obstruction.However,deep venous thrombosis(DVT) is an uncommon complication after gastrectomy for gastric carcinoma.We describe a case of a 68-year-old female patient with DVT after gastrectomy for gastric carcinoma.The patient was treated with anticoagulants and thrombolytics and subjected to necessary laboratory monitoring.The patient recovered well after treatment and was symptom-free during a 3-mo follow-up.We conclude that correct diagnosis and treatment of DVT are crucial.展开更多
The aim of the study was to evaluate the influence of surgical trauma on systemic inflammation and immune response correlating preoperative and postoperative cytokine levels in patients undergoing laparotomy versus la...The aim of the study was to evaluate the influence of surgical trauma on systemic inflammation and immune response correlating preoperative and postoperative cytokine levels in patients undergoing laparotomy versus laparoscopic cholecystectomy. Seventy patients with chronic, symptomatic cholelithiasis confirmed by ultrasonography, without presence of cancer or signs of acute cholecystitis were assigned to laparoscopic cholecystectomy-LC （n = 35） and open cholecystectomy-OC （n = 35）. Blood samples were obtained preoperatively, 24 and 72 hours after surgery. Blood concentration of cytokines TNF-ct （tumor necrosis factor-a）, IL-11~ （interleukin-l）, IFN-y （interferon gamma） and IL-6 （interleukin-6）, anti-inflammatory cytokine IL-10 were measured in both groups. Although levels of TNFa were decreased on postoperative day one in LC group, the secretion in patients who underwent open laparatomy was significantly higher （/9 = 0.000）. After 72h the values raised in the OC and also in LC group compared to postoperative day one. Analyzing the values of IFN y and IL-I in our study we noticed that the values declined in the LC group after 72 hours, but significantly raised in the OC group （p = 0.000）. We observed significantly higher values of IL-6 in OC group, with the serum peak level 72 hours after procedure. In contrast, serum levels of IL-6 in patients who underwent laparascopic cholecystectomy had a decrease of values postoperativly. A similar event occurred with IL-10 in the laparoscopic group at the same times.The levels of interleukins are increased and significantly higher in patients undergoing open procedures demonstrating that laparoscopic method displays less inflammatory response compared to open technique.展开更多
OBJECTIVE To evaluate the feasibility of intra-operativedetection of sentinel lymph nodes (SLN) in the patient withendometrial cancer (EC).METHODS Thirty-one patients with Stage Ⅰ and Ⅱ endometrialcancer, who underw...OBJECTIVE To evaluate the feasibility of intra-operativedetection of sentinel lymph nodes (SLN) in the patient withendometrial cancer (EC).METHODS Thirty-one patients with Stage Ⅰ and Ⅱ endometrialcancer, who underwent a hysterectomy and a lymphadenectomy,were enrolled in the study. At laparotomy, methylene blue dyetracer was injected into the subserosal myometrium of corpusuteri at multiple sites, and dye uptake into the lymphatic channelswas observed. The blue nodes which were identified as SLNs weretraced and excised. The other nodes were then removed. All of theexcised nodes were submitted for pathological hematoxylin andeosin (H&E) staining examination.RESULTS Failure of dye uptake occurred in 4 of the 31 cases(12.9%) because of spillage, and no lymphatic coloration wasobserved there. Lymphatic staining was clearly observable as bluedye diffused to the lymphatic channels of the uterine surface andthe infundibulopelvic ligaments in 27 (87.1%) cases. Concurrentcoloration in the pelvic lymphatic vessels was also observed in 22of the 27 patients. The SLNs were identified in 23 of the 27 (85.2%)cases with a lymphatic staining, with a total number of 90 SLNs,and a mean of 3.9 in each case (range, 1-10). Besides one SLN (1.1%)in the para-aortic area, the other 89 (98.9%) were in the nodes ofthe pelvis. The most dense locations of SLNs included obturator in38 (42.2%) and interiliac in 19 (21.1%) cases. In our group, pelviclymphadenectomy was conducted in 27 (87.1%) patients andpelvic nodal sampling in 4 (12.9%). Of the 31 cases, a concurrentabdominal para-aortic lymph node sampling was conducted in7. A total of 926 nodes were harvested, with an average of 39.8 ineach case (range, 14-55). Nodal metastases occurred in 3 patients(9.7%), 2 of them with SLN involvement and the other withoutSLN involvement. Adverse reactions or injury related to the studywas not found.CONCLUSION Application of methylene blue dye is feasible inan intra-operative SLN identification of endometrial cancer. Thetechnology is convenient, safe, and worth further investigation.展开更多
文摘Objective:To observe the feasibility and safety of awake anesthesia for tumor excisions in pa- tients with brain tumors involving cerebral functional areas.Methods:Fifty patients with brain tumors in- volving cerebral functional areas,ASAⅠ-Ⅱgrade,were enrolled in this study.Propofol and remifentanil were used for total intravenous anesthesia,and a laryngeal mask airway(LMA)was inserted for the air- way opening and synchronized intermittent mandatory ventilation(SIMV).At the surgeon's request for an intraoperative wake-up test,the propofol infusion was stopped advance of 10-15 min,the remifentanil in- fusion rate was decreased to 0.050-0.075μg/kg from 0.10-0.20μg/kg per min for easing surgical pain. The LMA was removed until the patient awakened.The anesthesiologist then kept up an on-going neuro- logical examination.After that,anesthesia was re-deepened and LMA was re-inserted until the whole surgery was accomplished.Results:Forty-six of 50 patients(92%)were successfully awakened and 4 (8%)failed to complete the intraoperative wake-up test because of dyspnea,over-sedation,or severe hy pertension.No severe complications occurred during the whole process.Conclusions:During the awake anesthetic period,the intraoperative wake-up test combined with navigation,evoked potential and ultra- sound techniques can help surgeons excise maximumly and precisely the brain tumors near to or in the functional areas.
文摘AIM: To explore the relationship between metastasis and vagina vasorum in the progress of gastric carcinoma and to find some facts and references for gastric surgeons. METHODS: One hundred and seven specimens of left or right gastric arteries (55 left and 52 right) were gathered from 59 patients undergoing radical gastrectomy for gastric carcinoma. All the frozen specimens were cut into 3 μm-thick sections and stained with hematoxylin-eosin (HE) and immunohistochemical method separately. Cytokeratin (CK) and mesothelial cells (MC) were stained with immunohistochemical method. Cancer cells inside vagina vasorum were detected and the structure of artery wall was observed under microscope. RESULTS: Metastatic cancer cells or tubercles were found inside vagina vasorum in some stage Ⅲ or Ⅳ specimens, but not in stageⅠor Ⅱ specimens. Tumor cells in vagina vasorum were CK positive in 26 specimens of 14 tumors. Among them, stage Ⅲ was found in 4 specimens of 2 tumors, and stage Ⅳ in 22 specimens of 12 tumors. None of these specimens was positive for MC. The positive rate of CK increased with TNM staging. Compared with the lower part, tumors in the upper and middle parts of stomach were more likely to metastasize into vagina vasorum. CONCLUSION: Vagina vasorum dissection should be performed during D2 lymphadenectomy for TNM stage Ⅲ or Ⅳ gastric carcinoma.
文摘The half-dry cutting employs cryogenic compressed air cooled down to (10 to 40) and a micro-dosage of lubricating oil, called cryogenic cold air jet cutting was studied. On the basis of a comparative experiment on dry and cryogenic cold air jet cuttings carried out for grade 45 steel, the effects of cryogenic cold air jet on the breaking of chips were discussed. The experimental results reveal that in the valid ranges of pressure and temperature, the cryogenic cold air jet widens the chip breaking areas effectively. When the cutting depth is not greater than 1 mm, the influence of chip breaking is much more significant. But different injecting angle of cold air has different influence on the chip-break. From the experiment, the optimized jet injecting angle, temperature effecting range and pressure working range of cold air are obtained. These results can offer a foundation for industrial manufacturing.
文摘Objective To investigate the theoretical basis and clinical significance of thymectomy in the treatment of myasthenia gravis (MG). Methods Analyze the changes in the contents of serum AchRab and sIL-2R, lymphocyte subtypes in peripheral blood lymphocytes before and after thymectomy in 69 patients.Results In the study group significant changes were found in serum contents of AchRab and sIL-2R before and after operation and there was also remarkable change in the number and constitution of peripheral blood lymphocyte subtypes. Conclusion Thymectomy is an effective therapy for MG.
文摘The treatment of gastric carcinoma consists of neoadjuvant chemoradiation,partial gastrectomy,subtotal gastrectomy,total gastrectomy,extended resection,and postoperative chemotherapy.Currently,gastrectomy and extended lymphadenectomy is the optimal choice for late gastric carcinoma.Postoperative complications are common after total gastrectomy including hemorrhage,anastomotic leakage,f istula,and obstruction.However,deep venous thrombosis(DVT) is an uncommon complication after gastrectomy for gastric carcinoma.We describe a case of a 68-year-old female patient with DVT after gastrectomy for gastric carcinoma.The patient was treated with anticoagulants and thrombolytics and subjected to necessary laboratory monitoring.The patient recovered well after treatment and was symptom-free during a 3-mo follow-up.We conclude that correct diagnosis and treatment of DVT are crucial.
文摘The aim of the study was to evaluate the influence of surgical trauma on systemic inflammation and immune response correlating preoperative and postoperative cytokine levels in patients undergoing laparotomy versus laparoscopic cholecystectomy. Seventy patients with chronic, symptomatic cholelithiasis confirmed by ultrasonography, without presence of cancer or signs of acute cholecystitis were assigned to laparoscopic cholecystectomy-LC （n = 35） and open cholecystectomy-OC （n = 35）. Blood samples were obtained preoperatively, 24 and 72 hours after surgery. Blood concentration of cytokines TNF-ct （tumor necrosis factor-a）, IL-11~ （interleukin-l）, IFN-y （interferon gamma） and IL-6 （interleukin-6）, anti-inflammatory cytokine IL-10 were measured in both groups. Although levels of TNFa were decreased on postoperative day one in LC group, the secretion in patients who underwent open laparatomy was significantly higher （/9 = 0.000）. After 72h the values raised in the OC and also in LC group compared to postoperative day one. Analyzing the values of IFN y and IL-I in our study we noticed that the values declined in the LC group after 72 hours, but significantly raised in the OC group （p = 0.000）. We observed significantly higher values of IL-6 in OC group, with the serum peak level 72 hours after procedure. In contrast, serum levels of IL-6 in patients who underwent laparascopic cholecystectomy had a decrease of values postoperativly. A similar event occurred with IL-10 in the laparoscopic group at the same times.The levels of interleukins are increased and significantly higher in patients undergoing open procedures demonstrating that laparoscopic method displays less inflammatory response compared to open technique.
文摘OBJECTIVE To evaluate the feasibility of intra-operativedetection of sentinel lymph nodes (SLN) in the patient withendometrial cancer (EC).METHODS Thirty-one patients with Stage Ⅰ and Ⅱ endometrialcancer, who underwent a hysterectomy and a lymphadenectomy,were enrolled in the study. At laparotomy, methylene blue dyetracer was injected into the subserosal myometrium of corpusuteri at multiple sites, and dye uptake into the lymphatic channelswas observed. The blue nodes which were identified as SLNs weretraced and excised. The other nodes were then removed. All of theexcised nodes were submitted for pathological hematoxylin andeosin (H&E) staining examination.RESULTS Failure of dye uptake occurred in 4 of the 31 cases(12.9%) because of spillage, and no lymphatic coloration wasobserved there. Lymphatic staining was clearly observable as bluedye diffused to the lymphatic channels of the uterine surface andthe infundibulopelvic ligaments in 27 (87.1%) cases. Concurrentcoloration in the pelvic lymphatic vessels was also observed in 22of the 27 patients. The SLNs were identified in 23 of the 27 (85.2%)cases with a lymphatic staining, with a total number of 90 SLNs,and a mean of 3.9 in each case (range, 1-10). Besides one SLN (1.1%)in the para-aortic area, the other 89 (98.9%) were in the nodes ofthe pelvis. The most dense locations of SLNs included obturator in38 (42.2%) and interiliac in 19 (21.1%) cases. In our group, pelviclymphadenectomy was conducted in 27 (87.1%) patients andpelvic nodal sampling in 4 (12.9%). Of the 31 cases, a concurrentabdominal para-aortic lymph node sampling was conducted in7. A total of 926 nodes were harvested, with an average of 39.8 ineach case (range, 14-55). Nodal metastases occurred in 3 patients(9.7%), 2 of them with SLN involvement and the other withoutSLN involvement. Adverse reactions or injury related to the studywas not found.CONCLUSION Application of methylene blue dye is feasible inan intra-operative SLN identification of endometrial cancer. Thetechnology is convenient, safe, and worth further investigation.
