INTRODUCTIONThe principle of surgical treatment for gastric cancer is theradical resectioning although the suitable resetting range fordifferent cases of gastric cancer is still being arguedupon.However,the diagnostic...INTRODUCTIONThe principle of surgical treatment for gastric cancer is theradical resectioning although the suitable resetting range fordifferent cases of gastric cancer is still being arguedupon.However,the diagnostic accuracy of展开更多
A total of 92 patients with benign prostatic hyperplasia (BPH) were subjected to modified Madigan prostatectomy (MPC) for a much satisfactory effect in open prostatectomy surgery. Exposing anterior prostatic urethra n...A total of 92 patients with benign prostatic hyperplasia (BPH) were subjected to modified Madigan prostatectomy (MPC) for a much satisfactory effect in open prostatectomy surgery. Exposing anterior prostatic urethra near the bladder neck and conjunct cystotomy modified the MPC procedure. This modified procedure preserved prostatic urethra intact and could also deal with intracystic lesions at the same time. The intact of prostatic urethra was kept completely or largely in 86 cases. The amount of blood loss during modified procedure was less. The mean operative time was 105 min. Seventy patients had been followed up for 3-24 months. The postoperative average Qmax was 19.2 ml/s. The cystourethrography revealed that the urethra and bladder neck were intact in 10 patients postoperatively. Furthermore, the prostatic urethra was obviously wider after modified MPC. The modified MPC can reduce the occurrence of urethra injury and enlarge the MPC indications. The modified technique is easy to perform with less complications and much satisfactory clinical result.展开更多
BACKGROUND:The use of livers from nonviable fetuses is particularly attractive for its potential to solve the current limitations of organ availability for the pediatric recipient.Therefore,it is essential to study th...BACKGROUND:The use of livers from nonviable fetuses is particularly attractive for its potential to solve the current limitations of organ availability for the pediatric recipient.Therefore,it is essential to study the feasibility of orthotopic fetal liver transplantation.METHOD:We measured the hepatic and extra-hepatic anatomical structures of fetal and neonatal lambs and established an orthotopic liver transplantation model of the fetal lamb.RESULTS:Mean weight of the liver of fetal lambs at 142 to 145 days gestation was 34.75 g and the mean diameter of the portal vein was 3.03 mm,the supra-hepatic vena cava was 5.88 mm,and the infra-hepatic vena cava was 4.00 mm,which matched the corresponding sizes in neonatal lambs aged up to 2 weeks.Using standard surgical procedures we completed the vascular inosculation of fetal liver.However,all the newborn lamb recipients survived less than 24 hours.CONCLUSIONS:Orthotopic transplantation of the fetal liver is anatomically and technically feasible.However,perioperative issues need to be resolved prior to clinical application.展开更多
Background The European System for Cardiac Operative Risk Evaluation （EuroSCORE） is one of the most widely used risk models for the predicting mortality after cardiac surgery. The aim of this study was to validate t...Background The European System for Cardiac Operative Risk Evaluation （EuroSCORE） is one of the most widely used risk models for the predicting mortality after cardiac surgery. The aim of this study was to validate the EuroSCORE model for predicting operative mortality in heart valve surgery on a Chinese multicenter database and comparing the performance of EuroSCORE with our new risk stratification system, the Sino System for Coronary Operative Risk Evaluation （SinoSCORE）. Methods Data from patients undergoing heart valve surgery between January 2007 and December 2008 were retrospectively collected, from 43 hospitals in China. The EuroSCORE and the SinoSCORE were calculated for each patient. Mortality was defined as any in-hospital death. Area under the receiver operating characteristics curve （AUC） was used to study the discriminatory abilities of the models. The Hosmer-Lemeshow （H-L） goodness-of-fit test was used to study the calibration of the predictive models. Results A total of 15 367 patients were analyzed. For the entire cohort, the observed mortality was 2.34%, the predicted mortality was 3.71% （additive）, 3.19% （logistic） and 3.66% （SinoSCORE）. AUC was 0.747 for SinoSCORE, 0.699 additive and 0.696 for logistic EuroSCORE. Calibration of SinoSCORE and additive EuroSCORE was good （H-L： P=-0.250 and P=0.051, respectively）, but the logistic EuroSCORE model had a poor calibration （H-L： P〈0.05）. The discriminatory ability and calibration of the SinoSCORE were good in low- and high-risk patients, However, the discriminatory ability of the EuroSCORE model was poor in all risk deciles. Conclusions The EuroSCORE does not accurately predict mortality in Chinese patients with heart valve surgery, and the SinoSCORE is superior to the EuroSCORE at predicting in-hospital mortality in Chinese heart valve surgery patients.展开更多
Objective: To investigate the opportune time of sec-ondary definitive surgery for patients with multiple injuries from earthquakes based on the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and t...Objective: To investigate the opportune time of sec-ondary definitive surgery for patients with multiple injuries from earthquakes based on the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and the principles of damage control.Methods: Twenty-one patients with critical earthq-ake injuries were treated with damage control strategies, fol-lowed by medical support and surgical intervention to re-store their physical potential in the intensive care unit (ICU). Successive APACHE Ⅱ scoring was adopted to evaluate the patients' physiological status, and then, internal fixa-tion of fractures and other definitive operations were performed.Results: All the patients were effectively treated with few complications, low deformity rate and no death.Conclusions: Appropriate evaluation of patients' physi-ological potential, right decision on surgical time and proper operative method can reduce the rates of complications, disability and death for patients with critical earthquake injuries.展开更多
Objective: To study the influence of operative timing on the prognosis of patients with acute subdural hematoma (ASDH) in order to provide theoretical basis for clinical treatment.Methods: The clinical data of 202 pat...Objective: To study the influence of operative timing on the prognosis of patients with acute subdural hematoma (ASDH) in order to provide theoretical basis for clinical treatment.Methods: The clinical data of 202 patients with ASDH undergoing operations were collected, and the mortalities and functional survival rates were analyzed 2, 4, 6, and 8 hours after injury.Results: No significant difference was found in mortalities and functional survival rates at different operative timings. However, there was a clear trend that the shorter the operative timing was, the lower the mortality and the higher functional survival rate were. In addition, the mean time from injury to operation of non-survivors was significantly longer than that of survivors.Conclusions: Operative timing has potential influences on the prognosis of patients with ASDH. Surgical evacuation of ASDH should be performed as soon as possible once the operation indication emerges.展开更多
基金Scientific Research Foundation for Returned Overseas Chinese Scholars,Slate Education Commission(1997-832)
文摘INTRODUCTIONThe principle of surgical treatment for gastric cancer is theradical resectioning although the suitable resetting range fordifferent cases of gastric cancer is still being arguedupon.However,the diagnostic accuracy of
文摘A total of 92 patients with benign prostatic hyperplasia (BPH) were subjected to modified Madigan prostatectomy (MPC) for a much satisfactory effect in open prostatectomy surgery. Exposing anterior prostatic urethra near the bladder neck and conjunct cystotomy modified the MPC procedure. This modified procedure preserved prostatic urethra intact and could also deal with intracystic lesions at the same time. The intact of prostatic urethra was kept completely or largely in 86 cases. The amount of blood loss during modified procedure was less. The mean operative time was 105 min. Seventy patients had been followed up for 3-24 months. The postoperative average Qmax was 19.2 ml/s. The cystourethrography revealed that the urethra and bladder neck were intact in 10 patients postoperatively. Furthermore, the prostatic urethra was obviously wider after modified MPC. The modified MPC can reduce the occurrence of urethra injury and enlarge the MPC indications. The modified technique is easy to perform with less complications and much satisfactory clinical result.
基金supported by a grant from the Science and Technology Commission of Shanghai Municipality(07-JC14045)
文摘BACKGROUND:The use of livers from nonviable fetuses is particularly attractive for its potential to solve the current limitations of organ availability for the pediatric recipient.Therefore,it is essential to study the feasibility of orthotopic fetal liver transplantation.METHOD:We measured the hepatic and extra-hepatic anatomical structures of fetal and neonatal lambs and established an orthotopic liver transplantation model of the fetal lamb.RESULTS:Mean weight of the liver of fetal lambs at 142 to 145 days gestation was 34.75 g and the mean diameter of the portal vein was 3.03 mm,the supra-hepatic vena cava was 5.88 mm,and the infra-hepatic vena cava was 4.00 mm,which matched the corresponding sizes in neonatal lambs aged up to 2 weeks.Using standard surgical procedures we completed the vascular inosculation of fetal liver.However,all the newborn lamb recipients survived less than 24 hours.CONCLUSIONS:Orthotopic transplantation of the fetal liver is anatomically and technically feasible.However,perioperative issues need to be resolved prior to clinical application.
文摘Background The European System for Cardiac Operative Risk Evaluation （EuroSCORE） is one of the most widely used risk models for the predicting mortality after cardiac surgery. The aim of this study was to validate the EuroSCORE model for predicting operative mortality in heart valve surgery on a Chinese multicenter database and comparing the performance of EuroSCORE with our new risk stratification system, the Sino System for Coronary Operative Risk Evaluation （SinoSCORE）. Methods Data from patients undergoing heart valve surgery between January 2007 and December 2008 were retrospectively collected, from 43 hospitals in China. The EuroSCORE and the SinoSCORE were calculated for each patient. Mortality was defined as any in-hospital death. Area under the receiver operating characteristics curve （AUC） was used to study the discriminatory abilities of the models. The Hosmer-Lemeshow （H-L） goodness-of-fit test was used to study the calibration of the predictive models. Results A total of 15 367 patients were analyzed. For the entire cohort, the observed mortality was 2.34%, the predicted mortality was 3.71% （additive）, 3.19% （logistic） and 3.66% （SinoSCORE）. AUC was 0.747 for SinoSCORE, 0.699 additive and 0.696 for logistic EuroSCORE. Calibration of SinoSCORE and additive EuroSCORE was good （H-L： P=-0.250 and P=0.051, respectively）, but the logistic EuroSCORE model had a poor calibration （H-L： P〈0.05）. The discriminatory ability and calibration of the SinoSCORE were good in low- and high-risk patients, However, the discriminatory ability of the EuroSCORE model was poor in all risk deciles. Conclusions The EuroSCORE does not accurately predict mortality in Chinese patients with heart valve surgery, and the SinoSCORE is superior to the EuroSCORE at predicting in-hospital mortality in Chinese heart valve surgery patients.
文摘Objective: To investigate the opportune time of sec-ondary definitive surgery for patients with multiple injuries from earthquakes based on the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and the principles of damage control.Methods: Twenty-one patients with critical earthq-ake injuries were treated with damage control strategies, fol-lowed by medical support and surgical intervention to re-store their physical potential in the intensive care unit (ICU). Successive APACHE Ⅱ scoring was adopted to evaluate the patients' physiological status, and then, internal fixa-tion of fractures and other definitive operations were performed.Results: All the patients were effectively treated with few complications, low deformity rate and no death.Conclusions: Appropriate evaluation of patients' physi-ological potential, right decision on surgical time and proper operative method can reduce the rates of complications, disability and death for patients with critical earthquake injuries.
文摘Objective: To study the influence of operative timing on the prognosis of patients with acute subdural hematoma (ASDH) in order to provide theoretical basis for clinical treatment.Methods: The clinical data of 202 patients with ASDH undergoing operations were collected, and the mortalities and functional survival rates were analyzed 2, 4, 6, and 8 hours after injury.Results: No significant difference was found in mortalities and functional survival rates at different operative timings. However, there was a clear trend that the shorter the operative timing was, the lower the mortality and the higher functional survival rate were. In addition, the mean time from injury to operation of non-survivors was significantly longer than that of survivors.Conclusions: Operative timing has potential influences on the prognosis of patients with ASDH. Surgical evacuation of ASDH should be performed as soon as possible once the operation indication emerges.
