AIM: To compare the results of the anoscope of the PPH kit and a modified anoscope during stapled haemorrhoidopexy. METHODS: The hospital records of 37 patients who underwent stapled haemorrhoidopexy between 2001 an...AIM: To compare the results of the anoscope of the PPH kit and a modified anoscope during stapled haemorrhoidopexy. METHODS: The hospital records of 37 patients who underwent stapled haemorrhoidopexy between 2001 and 2006 were reviewed. The purse-string suture anoscope in the PPH kit was used on 15 patients (Group 1), and the modified anoscope was used on 22 patients (Group 2). Demographic characteristics of the patients, operation time, surgeon's performance, analgesic requirement, and complications were compared. RESULTS: Operation time was significantly longer in Group 1 (42.0 4- 8.4 min vs 27.7 4- 8.0 min, P = 0.039). The surgeons reported their operative performance as significantly better in Group 2 (the results of the assessments were poor in ten, medium in four and good in one in Group 1, while good in all patients in Group 2, P 〈 0.001). The need for haemostatic sutures was significantly higher in Group 1 (six cases) and was needed in two cases in Group 2 (P = 0.034). CONCLUSION: Operation time decreased and the surgeon's satisfaction increased with use of the modified anoscope, and fewer haemostatic sutures were required if the surgeon waited longer before and after firing the stapler.展开更多
Pericardial barrier destruction,inflammatory cell infiltration,and fibrous tissue hyperplasia,trigger adhesions after cardiac surgery.There are few anti-adhesion materials that are both functional and sutureable for p...Pericardial barrier destruction,inflammatory cell infiltration,and fibrous tissue hyperplasia,trigger adhesions after cardiac surgery.There are few anti-adhesion materials that are both functional and sutureable for pericardial reconstruction.Besides,a few studies have reported on the mechanism of preventing pericardial adhesion.Herein,a functional barrier membrane with sutureability was developed via a modified electrospinning method.It was composed of poly(L-lactide-co-caprolactone)(PLCL)nanofibers,poly(vinyl alcohol)(PVA)aerogel,and melatonin,named PPMT.The PPMT had a special microstructure manifested as a staggered arrangement of nanofibers on the surface and a layered macroporous aerogel structure in a cross-section.Besides providing the porosity and hydrophilicity obtained from PVA,the structure also had suitable mechanical properties for stitching due to the addition of PLCL nanofibers.Furthermore,it inhibited the proliferation of fibroblasts by suppressing the activation of Fas and P53,and achieved anti-inflammatory effects by affecting the activity of inflammatory cells and reducing the release of pro-inflammatory factors,such as interleukin 8(IL-8)and tumor necrosis factorα(TNF-α).Finally,in vivo transplantation showed that it up-regulated the expression of matrix metalloproteinase-1(MMP1)and tissue inhibitor of metalloproteinase-1(TIMP1),and down-regulated the expression of Vinculin and transforming growth factorβ(TGF-β)in the myocardium,thereby reducing the formation of adhesions.Collectively,these results demonstrate a great potential of PPMT membrane for practical application to anti-adhesion.展开更多
文摘AIM: To compare the results of the anoscope of the PPH kit and a modified anoscope during stapled haemorrhoidopexy. METHODS: The hospital records of 37 patients who underwent stapled haemorrhoidopexy between 2001 and 2006 were reviewed. The purse-string suture anoscope in the PPH kit was used on 15 patients (Group 1), and the modified anoscope was used on 22 patients (Group 2). Demographic characteristics of the patients, operation time, surgeon's performance, analgesic requirement, and complications were compared. RESULTS: Operation time was significantly longer in Group 1 (42.0 4- 8.4 min vs 27.7 4- 8.0 min, P = 0.039). The surgeons reported their operative performance as significantly better in Group 2 (the results of the assessments were poor in ten, medium in four and good in one in Group 1, while good in all patients in Group 2, P 〈 0.001). The need for haemostatic sutures was significantly higher in Group 1 (six cases) and was needed in two cases in Group 2 (P = 0.034). CONCLUSION: Operation time decreased and the surgeon's satisfaction increased with use of the modified anoscope, and fewer haemostatic sutures were required if the surgeon waited longer before and after firing the stapler.
基金The National Natural Science Fund of China(81873923)Shanghai Science and Technology Development Fund(20Y11910600,18441901900)supported this study.
文摘Pericardial barrier destruction,inflammatory cell infiltration,and fibrous tissue hyperplasia,trigger adhesions after cardiac surgery.There are few anti-adhesion materials that are both functional and sutureable for pericardial reconstruction.Besides,a few studies have reported on the mechanism of preventing pericardial adhesion.Herein,a functional barrier membrane with sutureability was developed via a modified electrospinning method.It was composed of poly(L-lactide-co-caprolactone)(PLCL)nanofibers,poly(vinyl alcohol)(PVA)aerogel,and melatonin,named PPMT.The PPMT had a special microstructure manifested as a staggered arrangement of nanofibers on the surface and a layered macroporous aerogel structure in a cross-section.Besides providing the porosity and hydrophilicity obtained from PVA,the structure also had suitable mechanical properties for stitching due to the addition of PLCL nanofibers.Furthermore,it inhibited the proliferation of fibroblasts by suppressing the activation of Fas and P53,and achieved anti-inflammatory effects by affecting the activity of inflammatory cells and reducing the release of pro-inflammatory factors,such as interleukin 8(IL-8)and tumor necrosis factorα(TNF-α).Finally,in vivo transplantation showed that it up-regulated the expression of matrix metalloproteinase-1(MMP1)and tissue inhibitor of metalloproteinase-1(TIMP1),and down-regulated the expression of Vinculin and transforming growth factorβ(TGF-β)in the myocardium,thereby reducing the formation of adhesions.Collectively,these results demonstrate a great potential of PPMT membrane for practical application to anti-adhesion.