Objective To investigate the clinical applicationand curative effect of isoionic microtrauma arthroscope on treatment of knee arthropathy. Methods From May 2003 to November 2004, 52 cases of knee joint injury were cured by using isoionic microtrauma arthroscope, including 30 cases ofknee osteoarthritis, 10 cases of meniscus injury, 5 cases of kneecap dislocation, 5 cases of laxity of anterior cruciate ligation and 2 cases of rheumatoid arthritis. In accordance with Lysholm criterion for knee joint function, the scores were 35.5±4.9 before operation. Results All of these patients were followed up for 2-17 months. The scores of knee joint function was 86.4±5.3 after operation, and there was significant difference (Plt;0.001). Conclusion Isoionic microtrauma arthroscope is characterized by low-temperature hemoagglutination, crimpling,boiling, cutting and hemostasia, which makes kneejoint arthroscope operation easier-to-do, miner histological scathe and lighter side effect; so it is favourable for functional recovery and its curative effect is satisfactory.
ObjectivesTo systematically review the risk factors for intestinal injury induced by non-steroidal anti-inflammatory drugs(NSAIDs).MethodsWe comprehensively searched WanFang Data, CNKI, Web of Science, EBSCO, PubMed and The Cochrane Library databases to collect studies on risk factors of NSAIDs-induced intestinal injury. Two reviewers independently screened literature, extracted data and assessed risk of bias, and then, meta-analysis was performed by using RevMan 5.2 and STATA 12.0 software.ResultsA total of 6 case-control studies were included, in which 265 patients were in the case group and 301 patients in the control group. The results of meta-analysis showed that PPI was an independent risk factor for NSAIDs-induced intestinal injury (OR=1.59, 95%CI 1.07 to 2.35, P=0.02). In addition, patients with osteoarthritis (OR=2.44, 95% CI 1.11 to 5.36, P=0.03) or rheumatoid arthritis (OR=3.04, 95% CI 1.31 to 7.03, P=0.01) was associated with intestinal mucosal injury induced by NSAIDs. Gender, age, smoking history, drinking history, H2RA and rebamipide medication history, cardiovascular disease and cerebrovascular disease were not associated with intestinal injury.ConclusionsPPI is an independent risk factor for NSAIDs-induced intestinal injury. However, studies with high-quality, larger sample size are required to further verify that PPI increases the prevalence of intestinal injury.
Objective To investigate the application of air leak test combined with methylene blue solution leak test in the detection of anastomotic leakage after total mesorectal excision (TME) in rectal cancer. Methods In total of132 patients with rectal cancer underwent Dixon according to TME in our hospital from Mar. 2010 to Mar. 2013 were enrolled. All patients were randomly divided into air leak test group (n=65) and air leak+methylene blue solution leak test group (n=67). The intestinal anastomosis of patients in air leak test group were clamped at 2 cm from the upper endof bowel, then injecting 500 mL distilled water to pelvic, and placing 24# Foley catheter through the anus. The catheter balloon was injected with water to close anus, and then injected with 50 mL gas to find the anastomotic leakage where bubbles happened, and then repaired it. Patients of air leak+methylene blue solution leak test group were treated with methylene blue solution test in addition. After sucking out of the distilled water in pelvic and gas in the rectum, 1 bottle of methylene blue solution (20 mg) and 50 mL saline were injected, observing the location where the methylene blue solutionleaking out and repaired it. Results Three cases (4.62%) of anastomotic leakage were found during operation in air leak test group, and 9 cases (13.85%) were found after operation. Of the 9 cases, 5 cases were cured with placement of adeq-uate drainage and symptomatic treatment, 3 cases were cured with anal patch, and 1 case was cured with transverse colon fistula and drainage. In total of 15 cases (22.39%) were found anastomotic leakage, 2 cases of them were found by air leak test and another 13 cases were found by methylene blue solution leak test during operation in air leak+methylene bluesolution leak test group, but no one suffered anastomotic leakage after operation. Compared with air test group, detectionrate of anastomotic leakage during operation was higher (P<0.05), and incidence rate of anastomotic leakage after opera-tion was lower in air leak+methylene blue solution leak test group (P<0.05). Conclusions Large anastomotic leakage can be found by using air leak test, and small and hidden leakage can be found by using methylene blue solution leak test, combination method of the two experiments is better. Repair can be performed effectively under direct vision.