Objective To review the studies on Oddi′s sphincter motility in recent years. Methods The studies on exploration and evaluation of normal or abnormal Oddi′s sphincter motility by means of electromyography, dynamic hepatobiliary scintigraphy, endoscopic manometry, and laboratory tests were reviewed. Results Endoscopic manometry was the gold standard for distinguishing normal motility from the abnormal. Some surgeries and drugs could lead to the sphincter of Oddi dysfunction. Conclusion The sphincter of Oddi dysfunction can be treated with endoscopic sphincterotomy. Preservation of sphincter function is stressed in surgery.
ObjectiveTo retrospectively analyze the risk factors of recurrent groin hernia. MethodsData came from all hernia repairs recorded in our hospital between 1991 and 2001. A total of 1 082 cases of groin hernia was analyzed through Cox proportional hazard model to determine the relative risks between recurrence and mode of admission, types of groin hernia, repair methods (traditional/tensionfree hernioplasty), and postoperative complications.ResultsFrom 1991 to 2001,1 082 groin hernia operations were performed in our hospital, 88.9% for primary hernia and 11.2% for recurrent hernia. As compared with traditional hernia repair methods, Lichtenstein’s tensionfree hernioplasty technique had less relative risk for recurrent hernia repair than that for primary hernia repair. Postoperative complications and indirect hernia were linked to an increased relative risk for recurrence. ConclusionThere are many factors affecting the recurrence of inguinal hernia, but the use of tensionfree hernia repair may decrease rerecurrence of recurrent hernia.
【Abstract】 Objective To analyze the influencing factors of no-reflow phenomenon after reperfusion in patients with chronic limb ischemia associated with acute thrombosis. Methods Between January 2009 and December 2010, 59 patients (67 limbs) with chronic limb ischemia associated with acute thrombosis were treated. According to whether the no-reflow phenomenon occurred or not, the patients were divided into no-reflow group (19 patients, 21 limbs) and reflow group (40 patients, 46 limbs). Logistic regression was used to analyze the roles of ischemia time, ischemia extent, smoking, hypertension, cardiovascular and cerebrovascular disease, diabetes, surgical procedure, platelet count, fibrinogen (FBG), prostaglandin I2 (PGI2), and thromboxane A2 (TXA2) on no-reflow phenomenon after reperfusion. Results The results of the logistic regression analysis indicated that ischemia time (OR=7.196; 95%CI: 1.679-27.960), ischemia extent (OR=5.116; 95%CI: 1.399-109.338), smoking (OR=6.893; 95%CI: 3.704-2 291.003), diabetes (OR=3.864; 95%CI: 1.009-421.702), PGI2 (OR=7.985; 95%CI: 1.001-1.043), and TXA2 (OR=7.643; 95%CI: 1.011-1.065) were the high risk factors of no-reflow phenomenon. The levels of TXA2 and FBG in no-reflow group were significantly increased and the level of PGI2 was decreased, showing significant differences when compared with the reflow group (P lt; 0.05). However, no significant difference was found in the platelet count between 2 groups (P gt; 0.05). Conclusion Ischemia extent and ischemia time are the main influencing factors of no-reflow phenomenon after reperfusion in patients with chronic limb ischemia associated with acute thrombosis, and the patients combined with smoking or diabetes are high risk population of the no-reflow phenomenon. Postoperative patients with no-reflow phenomenon are at a hypercoagulable state in vivo, in which prostacyclin plays an important role.
OBJECTIVE: To explore the possibility of repair of the extensive bile duct injuries with expanded polytetrafluoroethylene (ePTFE). METHODS: A total of 36 local healthy hybrid dogs were employed to establish bile duct injury models by means of partial removal of bile duct (group A, 14 dogs), excision of a segmental duct (group B, 10 dogs), and ligation of the lower part of common bile duct(group C, 5 dogs; group D, 7 dogs). Group A were patched with ePTFE mesh, group B replaced by ePTFE tube. Interposition of the grafts between gallbladder and duedenum or jejunum was performed on group C and group D. The animals’ postoperative performance status were evaluated. Cholangiography was used to define the patency of bile ducts. Tissues of bile ducts and liver were taken at 3 days, 2, 4, 8, 12 and 52 weeks for microscopic and ultrastructural examination to observe the healing process of bile duct and morphological changes in the liver. RESULTS: Group A with ePTFE patch covered by epithelium had a high patency rate of 75%(9/12) and pathological damages were not found in the liver. The patency rate of group B was merely 40%(4/10), to some extent, accompanying damages in the liver. The grafts of group C and group D were fully expelled, ultimately leading to cystic-duodenal or cystic-jejunal fistulas formation. CONCLUSION: The study suggests that application of ePTFE patch to repair bile duct defects is feasible.
Objective To compare the effectiveness, complications, and follow-up results between endovascular recanalization (EVR) and open surgical revascularization (OSR) in the treatment of peripheral pseudoaneurysm, so as to provide a reference for choosing a appropriate surgical procedure. Methods Clinical data of 62 cases of peripheral pseudoaneurysm between January 2001 and January 2012 were analyzed retrospectively. EVR was performed in 28 patients (EVR group) and OSR in 34 patients (OSR group). There was no significant difference in gender, age, cause of injury, tumor location, and diameter of tumor between 2 groups (P gt; 0.05). Results The operation time, blood loss, ICU monitoring time, and hospitalization time in EVR group were significantly shorter than those in OSR group (P lt; 0.05). In OSR group, 12 cases (35.29%) had early postoperative complications, including 2 deaths due to acute respiratory distress syndrome, 5 cases of pulmonary infection, 3 cases of wound infection, and 2 cases of deep vein thrombosis; in EVR group, 2 cases (7.14%) had early postoperative complications, including 1 case of hematoma at puncture site and 1 case of thrombosis in stent. There was significant difference in early postoperative complication incidence between 2 groups (χ2=6.691, P=0.008). The patients were followed up 12-39 months (mean, 26 months). In OSR and EVR groups after operation, the patency rates of the reconstructed vessels were 96.88% (31/32) and 92.86% (26/28) respectively at 12 months, showing no significant difference (χ2=0.014, P=0.905); the patency rates were 89.29% (25/28) and 84.00% (21/25) respectively at 24 months, showing no significant difference (χ2=0.322, P=0.570). Conclusion Compared with OSR, EVR is a minimally invasive, safe, and effective therapy for peripheral pseudoaneurysm with the advantages of less bleeding, shorter hospitalization time, and less complications. Long-term effectiveness still needs further observation, and patients have to take antiplatelet drugs for long time after EVR.
Objective To systematically review the efficacy of poly-L-lactide (PLLA) material treatment versus titanium plates treatment for mandibular fractures. Methods We searched the Cochrane Library, PubMed, Embase, Chinese Journal Full-text Database, VIP Database, and Wanfang Database to collect literatures about randomized or non-randomized controlled trials using PLLA treatment (the trial group) versus titanium plates treatment (the control group) for mandibular fractures in the last ten years (from January 2007 to March 2017). The quality evaluation and data extraction were carried out by 2 reviewers independently and analyzed by Review Manager 5.3 software. Results A total of 8 literatures including 453 patients with mandibular fractures were included in this Meta-analysis. There was no significant difference in total complications between the two groups [odds ratio (OR)=0.98, 95% confidence interval (CI) (0.55, 1.75), P=0.95], including dislocation healing [OR= 0.96, 95%CI (0.46, 2.01), P=0.90], occlusal disturbance [OR=1.53, 95%CI (0.61, 3.87), P=0.37], infection [OR=0.63, 95%CI (0.23, 1.74), P=0.37], and secondary operation [OR=0.46, 95%CI (0.17, 1.27), P=0.14]. Conclusion There is no significant difference between PLLA and titanium plate in the treatment of mandibular fractures.
Objective To explore the clinical characteristics and management of ovarian tumor complicated by pregnancy and its influence on the pregnancy outcome, so as to provide diagnostic and therapeutic experiences. Methods A total of 248 cases were surgically and pathologically diagnosed as ovarian tumor complicated by pregnancy in The 202 Military Hospital from January, 2003 to December, 2009, and their clinical data were analyzed retrospectively. Results The incidence rate of ovarian tumor complicated by pregnancy was 0.49%. Among total 248 cases, 131 (52.82%) were benign tumors, of which 22.18% were ovarian mature teratomas; 113 (45.57%) were tumourlike lesions, of which most were ovarian chocolatecyst and lutealcyst, and 4 (1.61%) were malignant tumors. There were 212 cases treated by tumorectomy or salpingo-oophorectomy, and 3 of 4 cases with malignant tumors took postoperative chemotherapy. A total of 192 cases were diagnosed by regular antenatal care and ultrasound examination, accounting for 77.42% of the total sample size found during pregnancy. Among 14 cases receiving emergency operations, 9 were complicated by torsion, and the other 5 were by rupture. There were 67 cases receiving operation from the 14th to 18th gestational week, and 57 cases had full-time pregnancy. Conclusion Ultrasonography and pelvioscopy are of principal importance in the diagnosis and detection of ovarian tumor complicated by pregnancy which should be treated by tumorectomy, and suitable surgery intervention during second trimester is safe.
The existing one-time identity authentication technology cannot continuously guarantee the legitimacy of user identity during the whole human-computer interaction session, and often requires active cooperation of users, which seriously limits the availability. This study proposes a new non-contact identity recognition technology based on cardiac micro-motion detection using ultra wideband (UWB) bio-radar. After the multi-point micro-motion echoes in the range dimension of the human heart surface area were continuously detected by ultra wideband bio-radar, the two-dimensional principal component analysis (2D-PCA) was exploited to extract the compressed features of the two-dimensional image matrix, namely the distance channel-heart beat sampling point (DC-HBP) matrix, in each accurate segmented heart beat cycle for identity recognition. In the practical measurement experiment, based on the proposed multi-range-bin & 2D-PCA feature scheme along with two conventional reference feature schemes, three typical classifiers were selected as representatives to conduct the heart beat identification under two states of normal breathing and breath holding. The results showed that the multi-range-bin & 2D-PCA feature scheme proposed in this paper showed the best recognition effect. Compared with the optimal range-bin & overall heart beat feature scheme, our proposed scheme held an overall average recognition accuracy of 6.16% higher (normal respiration: 6.84%; breath holding: 5.48%). Compared with the multi-distance unit & whole heart beat feature scheme, the overall average accuracy increase was 27.42% (normal respiration: 28.63%; breath holding: 26.21%) for our proposed scheme. This study is expected to provide a new method of undisturbed, all-weather, non-contact and continuous identification for authentication.