Objective To investigate the difference between different surgical methods for thoracic ossification of ligamentum flavum(OLF) combined with cervical spondylotic myelopathy(CSM) . Methods From January 1991 to January ...Objective To investigate the difference between different surgical methods for thoracic ossification of ligamentum flavum(OLF) combined with cervical spondylotic myelopathy(CSM) . Methods From January 1991 to January 2003,56 cases展开更多
Objective: To investigate the effect of surgical nursing on grade III Hand-Foot Syndrome (HFS) induced by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery. Method: From January 2019 to Decem...Objective: To investigate the effect of surgical nursing on grade III Hand-Foot Syndrome (HFS) induced by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery. Method: From January 2019 to December 2019, 10 patients with HFS grade III caused by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery in the Breast Department of Cancer Prevention and Treatment Center of Sun Yat-sen University were selected, and surgical nursing methods were used to intervene and observe the therapeutic effects of the patients. Results: One patient was cured within 7 days, the cure rate was 10% in 7 days, 8 patients were cured within 10 days, the cure rate was 80% in 10 days, 10 patients were cured within 15 days, the cure rate was 100% in 15 days. Conclusion: The surgical nursing method is effective for patients with grade III HFS caused by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery, shortening the treatment time of HFS, and is worthy of clinical promotion.展开更多
Background:The nasal alar defect in Asians remains a challenging issue,as do clear classification and algorithm guidance,despite numerous previously described surgical techniques.The aim of this study is to propose a ...Background:The nasal alar defect in Asians remains a challenging issue,as do clear classification and algorithm guidance,despite numerous previously described surgical techniques.The aim of this study is to propose a surgical algorithm that addresses the appropriate surgical procedures for different types of nasal alar defects in Asian patients.Methods:A retrospective case note review was conducted on 32 patients with nasal alar defect who underwent reconstruction between 2008 and 2022.Based on careful analysis and our clinical experience,we proposed a classification system for nasal alar defects and presented a reconstructive algorithm.Patient data,including age,sex,diagnosis,surgical options,and complications,were assessed.The extent of surgical scar formation was evaluated using standard photography based on a 4-grade scar scale.Results:Among the 32 patients,there were 20 males and 12 females with nasal alar defects.The predominant cause of trauma in China was industrial factors.The majority of alar defects were classified as type Ⅰ C(n=8,25%),comprising 18 cases(56.2%);there were 5 cases(15.6%)of type Ⅱ defect,7(21.9%)of type Ⅲ defect,and 2(6.3%)of type Ⅳ defect.The most common surgical option was auricular composite graft(n=8,25%),followed by bilobed flap(n=6,18.8%),free auricular composite flap(n=4,12.5%),and primary closure(n=3,9.4%).Satisfactory improvements were observed postoperatively.Conclusion:Factors contributing to classifications were analyzed and defined,providing a framework for the proposed classification system.The reconstructive algorithm offers surgeons appropriate procedures for treating nasal alar defect in Asians.展开更多
Tethered cord syndrome is a progressive disease with a typically insidious onset in infants and children, and which can lead to persistent progress of neurological deficits and a high rate of disability without timely...Tethered cord syndrome is a progressive disease with a typically insidious onset in infants and children, and which can lead to persistent progress of neurological deficits and a high rate of disability without timely intervention. The purpose of this study was to investigate the curative effect of microsurgery in children with different types of tethered cord syndrome. In this study, we analyzed 326 patients with tethered cord syndrome, aged from 2 months to 14 years old, who were followed for 3-36 months after microscopic surgery. Based on clinical manifestations and imaging findings, these patients were classified into five types： tight ilium terminale （53 cases）, lipomyelome- ningocele （55 cases）, lipomatous malformation （124 cases）, postoperative adhesions （56 cases）, and split cord malformation （38 cases）. All patients underwent microsurgery. Curative effects were measured before and 3 months after surgery by Spina Bifida Neurological Scale based on sensory and motor functions, reflexes, and bladder and bowel function. The results showed that Spina Bifida Neurological Scale scores improved in all five types after surgery. Overall effective rates in these patients were 75%. Effective rates were 91% in tight ilium terminale, 84% in lipomyelomeningocele, 65% in lipomatous malformation, 75% in postoperative adhesion, and 79% in split cord mal- formation. Binary logistic regression analysis revealed that types of tethered cord syndrome （lipoma-type or not） and symptom duration before surgery were independent influencing factors of surgical outcome. These results show that therapeutic effect is markedly different in patients with different types of tethered cord syndrome. Suitable clinical classification for tethered cord syndrome will be helpful in predicting prognosis and guiding treatment. This trial has been registered in the Chinese Clinical Trial Registry （registration number： ChiCTR1800016464）.展开更多
Objective:To compare the efficacy of anal adenectomy with virtual hanging wire and anal fistulotomy in the treatment of low anal fistula in infants and children.Methods:60 children with low anal fistula who were admit...Objective:To compare the efficacy of anal adenectomy with virtual hanging wire and anal fistulotomy in the treatment of low anal fistula in infants and children.Methods:60 children with low anal fistula who were admitted to our hospital from October 2021 to March 2022 and met the inclusion criteria were randomly divided into two groups of 30 cases each;the treatment group was treated with anal adenectomy and virtual hanging wire surgery,and the control group was treated with anal fistula resection.The clinical efficacy after treatment was compared.Results:The total effective rate of both groups was 96.67%and the difference between the two groups was not statistically significant(P>0.05).The postoperative pain score of the treatment group was lower than that of the control group(P<0.05).The length of hospitalization and healing time of the treatment group was lower than that of the control group(P<0.05).The anal function of the patients in both groups was normal,and there was no adverse reaction.Conclusion:Anal gland excision and virtual hanging surgery for the treatment of low anal fistula in infants and children have the advantages of mild pain,reduced length of hospitalization,short healing time,and better patient experience as compared to anal fistula excision.展开更多
BACKGROUND Supra-and infratentorial acute epidural hematoma(SIEDH)is a common posterior cranial fossa epidural hematoma located at the inner surface of the squamous part of the occipital bone(SOB).Traditionally,surgic...BACKGROUND Supra-and infratentorial acute epidural hematoma(SIEDH)is a common posterior cranial fossa epidural hematoma located at the inner surface of the squamous part of the occipital bone(SOB).Traditionally,surgical treatment of the SIEDH requires a combined supra-infratentorial craniotomy.AIM To analyze the morphological characteristics of the SOB and introduce a single supratentorial craniotomy for SIEDH.METHODS Skull computed tomography(CT)scan data from 32 adult patients were collected from January 1,2019 to January 31,2020.On the median sagittal plane of the CT scan,the angle of the SOB(ASOB)was defined by two lines:Line A was defined from the lambdoid suture(LambS)to the external occipital protuberance(EOP),while line B was defined from the EOP to the posterior edge of the foramen magnum(poFM).The operative angle for the SIEDH(OAS)from the supra-to infratentorial epidural space was determined by two lines:The first line passes from the midpoint between the EOP and the LambS to the poFM,while the second line passes from the EOP to the poFM.The ASOB and OAS were measured and analyzed.RESULTS Based on the anatomical study,a single supratentorial craniotomy was performed in 8 patients with SIEDH.The procedure and the results of the modified surgical method were demonstrated in detail.For males,the ASOB was 118.4±4.7 and the OAS was 15.1±1.8;for females,the ASOB was 130.4±5.1 and the OAS was 12.8±2.0.There were significant differences between males and females both in ASOB and OAS.The smaller the ASOB was,the larger the OAS was.The bone flaps in 8 patients were designed above the transverse sinus intraoperatively,and the SIEDH was completely removed without suboccipital craniotomy.The SOB does not present as a single straight plane but bends at an angle around the EOP and the superior nuchal lines.The OAS was negatively correlated with the ASOB.CONCLUSION The single supratentorial craniotomy for SIEDH is reliable and effective.展开更多
[ Objective] The paper was to test the feasibility of embryo transfer technique in pig production. [ Method ] Twenty-four estrus muhiparity Landraee sows provided by Longjing Agricultural Science and Technology Instit...[ Objective] The paper was to test the feasibility of embryo transfer technique in pig production. [ Method ] Twenty-four estrus muhiparity Landraee sows provided by Longjing Agricultural Science and Technology Institute were performed embryo transfer surgery, and postoperative effects were observed. [ Result] Totally 11 out of 24 receptor sows were pregnant ; pregnant sows delivered 67 cloned piglets, and the average farrowing rate of sows was approximately 6 piglets/sow. There were 22 mortalities of newborn piglets because of various reasons. [ Conclusion] Embryo transfer technique is an indispensable link in pig production, and an important means of pig breeding and improvement.展开更多
<strong>Background</strong><strong>:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Hysterectomy is one of the most ...<strong>Background</strong><strong>:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Hysterectomy is one of the most performed surgeries </span><span style="font-family:Verdana;">through</span><span style="font-family:Verdana;"> the world, even in Sub Saharan </span><span style="font-family:Verdana;">setting</span><span style="font-family:Verdana;"> where indications are not rare. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To study the frequency, indications, surgical methods, and complications of hysterectomies at the Douala General Hospital. </span><b><span style="font-family:Verdana;">Patients and methods:</span></b><span style="font-family:Verdana;"> We carried out a </span><span style="font-family:Verdana;">cross-sectional</span><span style="font-family:Verdana;"> study over </span><span style="font-family:Verdana;">a 20-year period</span><span style="font-family:Verdana;">, from the 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> January 2000 to 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> December 2019, in the </span><span style="font-family:Verdana;">department</span><span style="font-family:Verdana;"> of Gynaecology and Obstetrics of the Douala General Hospital, a tertiary health facility in Cameroon, central Africa. All patients who underwent hysterectomies for </span><span style="font-family:Verdana;">gynaecological</span><span style="font-family:Verdana;"> or obstetrical indications and whose files were complete were retained. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of a total of 7126 </span><span style="font-family:Verdana;">gynaecological</span><span style="font-family:Verdana;"> and obstetrical surgical cases 1007 were hysterectomies, giving a frequency of 14.21%. Meanwhile, 968 files fulfilled the inclusion criteria. The average age of the patients was 45.75 ± 7.71 years (range 19 to 75 years). The indications included symptomatic fibroids 64.15% (621 cases), </span><span style="font-family:Verdana;">gynaecological</span><span style="font-family:Verdana;"> cancers 13.94% (135 cases), severe cervical dysplasia 11.15% (108 cases), and endometrial hyperplasia with atypia 7.02% (68 cases), </span><span style="font-family:Verdana;">haemostatic</span><span style="font-family:Verdana;"> hysterectomies 2.68% (26 cases), uterine prolapse 0.82% (8 cases), a case of </span><span style="font-family:Verdana;">post abortion</span><span style="font-family:Verdana;"> uterine necrosis (0.10%) and a case of uterine endometriosis (0.10%). Laparotomy was the main surgical approach 86.05% (833 cases), followed by the vaginal route, 10.20% (97 cases) </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> then laparoscopy 3.92% (38 cases). The average length of hospital stay was 6.07 ± 1.92 days following laparotomy, 3 ± 1.09 days following the vaginal route, and 3.6 ± 1.04 days following laparoscopy. The main intra-operative complications included </span><span style="font-family:Verdana;">haemorrhage</span><span style="font-family:Verdana;">, 1.75% (17 cases), bladder injuries 0.82% (8 cases) </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> ureteral injuries 0.72% (7 patients). </span><span style="font-family:Verdana;">Post-operative</span><span style="font-family:Verdana;"> complications mainly included: fever 3.61% (35 cases), anaemia 2.5% (24 cases) and abdominal wall sepsis 0.92% (9 cases). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The frequency of hysterectomy was 14.21%. Uterine fibroid, </span><span style="font-family:Verdana;">gynaecological</span><span style="font-family:Verdana;"> cancer </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> cervical dysplasia were the main indications. Intra-operative </span><span style="font-family:Verdana;">haemorrhage</span><span style="font-family:Verdana;">, bladder </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> ureteral injuries were the major complications. </span><span style="font-family:Verdana;">Increase</span><span style="font-family:Verdana;"> in the practice of vaginal and laparoscopic hysterectomies could contribute to the reduction of peri and </span><span style="font-family:Verdana;">post-operative</span><span style="font-family:Verdana;"> complications and hospital stay. Thus reinforcement of abilities is required.</span></span>展开更多
BACKGROUND The standard treatment of transitional cell carcinoma of the upper urinary tract consists of radical nephroureterectomy with bladder cuff removal,which can be performed either in open or laparoscopy or robo...BACKGROUND The standard treatment of transitional cell carcinoma of the upper urinary tract consists of radical nephroureterectomy with bladder cuff removal,which can be performed either in open or laparoscopy or robot-assisted laparoscopy.Treatment of chronic renal insufficiency patients with upper urothelial tumor is in a dilemma.Urologists weigh and consider the balance between tumor control and effective renal function preservation.European Association of Urology guidelines recommend that select patients may benefit from endoscopic treatment,but laparoscopic treatment is rarely reported.CASE SUMMARY In this case report,we describe a case of 79-year-old female diagnosed with urothelial carcinoma of the renal pelvis and adrenal adenoma with chronic renal insufficiency.The patient was treated with retroperitoneal laparoscopic partial resection of the renal pelvis and adrenal adenoma resection simultaneously.CONCLUSION Retroperitoneal laparoscopic partial resection of the renal pelvis is an effective surgical procedure for the treatment of urothelial carcinoma of the renal pelvis.展开更多
BACKGROUND Hutch diverticulum arises from the compromised muscular development at the ureteral orifice.It is a congenital disease and extremely rare in adult,only accounting for about 3%occurrence worldwide.It can be ...BACKGROUND Hutch diverticulum arises from the compromised muscular development at the ureteral orifice.It is a congenital disease and extremely rare in adult,only accounting for about 3%occurrence worldwide.It can be either symptomatic or asymptomatic,and relies on image tools for diagnosis and preoperative planning.Indications for surgery are dependent on the complications from the diverticulum.Metaplasia is about 10%among those with hutch diverticulum,and it still has chances turning into malignancy,especially urothelial cell carcinoma.CASE SUMMARY A 27-year-old man was presented with frequently recurrent urinary tract infection for one year,and had suffered from intermittent right flank pain for 3 mo.No past medical histories were recorded before.No obvious abnormalities on laboratory data and urine examination were found.Under ultrasound,right hydronephrosis was seen and an anatomical abnormality was observed on intravenous pyelography.Further computed tomography urogram showed one diverticulum seated at superolateral side of right ureteral orifice.Cystoscopy was done and biopsy results showed focal metaplasia.After discussing with him,roboticassisted diverticulectomy with reconstruction was performed.Right hydronephrosis was greatly improved after surgery.He has completed his 1.5-year follow-ups,and no malignancies were seen from urine cytology and image of intravenous pyelography.CONCLUSION Robotic-assisted diverticulectomy and reconstruction to hutch diverticulum is a safe and efficient operation,providing several advantages over open and laparoscopic ones.展开更多
cases of pregnant women scheduled for delivery by cesarean section were randomly assigned to 59 cases in modification group with modified Misgav Ladach technique, 57 cases in Misgav Ladach group with Misgav Ladach tec...cases of pregnant women scheduled for delivery by cesarean section were randomly assigned to 59 cases in modification group with modified Misgav Ladach technique, 57 cases in Misgav Ladach group with Misgav Ladach technique and 56 cases in Pfannenstiel group with Pfannenstiel technique from May to Dec. 1999. The modified points included: transversely incising the fascia 2 to 3 cm, then dividing it bluntly; without opening and dissociating the visceral peritoneum; two layers suturing of low transverse uterine incision; closing the skin by continuous suturing. Results showed the average delivery time in the modification group was (3.6±2.6) min and (5.7±2.9) min in the Misgav Ladach group ( P <0.05). Median operating time was (28.3±5.4) min in modification group compared with (27.5±6.5) min in the Misgav Ladach group ( P >0.05). Average blood loss was (128±35) ml in modification group compared with (212±147) ml in the Pfannenstiel group ( P <0.05). It was concluded that the modified Misgav Ladach technique not only preserved all advantages of Misgav Ladach method, but also had additional advantages, such as faster in delivering the fetus, less damage, easier mastering for obstetricians.展开更多
Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children...Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.Methods From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified method.Totally,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn score.Results The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side pin.All children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.展开更多
From August 2016 to June 2018, a total of 7 patients underwent lateral ventriculo-superior sagittal shunt surgeries in our hospital. All cases were followed up for 3 months to 2 years after the surgeries. The results ...From August 2016 to June 2018, a total of 7 patients underwent lateral ventriculo-superior sagittal shunt surgeries in our hospital. All cases were followed up for 3 months to 2 years after the surgeries. The results of their head CT scans or MRI scans indicated that the conition of hydrocephalus generally improved, and the symptoms of intracranial hypertension significantly improved or disappeared. The superior sagittal sinus shunt surgery for hydrocephalus is simple to operate and also safe and effective, and it's an important method of treatment for hydrocephalus. This article described the specific surgical procedure for lateral ventriculo-superior sagittal shunt surgery in detail so that this surgical procedure can be better promoted.展开更多
Orthodontic procedures can be inconvenient in nature.To overcome this problem,accelerated orthodontics play a very important role to reduce existing trouble and discomfort.The most common inconvenience caused during o...Orthodontic procedures can be inconvenient in nature.To overcome this problem,accelerated orthodontics play a very important role to reduce existing trouble and discomfort.The most common inconvenience caused during orthodontic treatment procedures is that they are very time consuming which can result in several drawbacks,including an increased risk of tooth decay,gingival recession,and root resorption.Various methods can be employed to expedite orthodontic treatment by accelerating tooth movement,including surgical-assisted procedures,biological interventions,and the utilization of devices.These approaches effectively reduce the overall period of treatment.The purpose of this review is to study the effective techniques for orthodontic tooth movement as well as highlight various orthodontic accelerating methods in the respective approaches.Some nonsurgical studies indicated that drug-induced methods can have a therapeutic effect on tooth movement.One of the approaches involves the local administration of Vitamin 1.25D,which has been found to expedite tooth movement.Vibrational orthodontic devices are a painless and cost-effective option that is considered the least invasive approach for accelerating tooth movement.Meanwhile,surgical approach is also a successful method,wherein great results and strong PDL tissue response were observed,but they cause a lot of pain and discomfort to the patient.Therefore,due to the strengths and limitations of each procedure covered in the study,more research should be done to identify the fastest way to speed up tooth mobility。展开更多
Objective： Conventional open spinal surgery of adult scoliosis can be performed from anterior, posterior, or combined approach. Minimally invasive spine surgery （MISS） was developed for the purpose of reducing the ...Objective： Conventional open spinal surgery of adult scoliosis can be performed from anterior, posterior, or combined approach. Minimally invasive spine surgery （MISS） was developed for the purpose of reducing the undesirable effects and complications. This review aimed to make a brief summary of recent studies of the approach and clinical outcomes of MISS in adult scoliosis. Data Sources： We conducted a systematic search from PubMed, Medline, EMBASE, and other literature databases to collect reports of surgical methods and clinical outcomes of MISS in treatment of adult scoliosis. Those reports were published up to March 2017 with the following key terms： ＆quot;minimally invasive,＆quot; ＆quot;spine,＆quot; ＆quot;surgery,＆quot; and ＆quot;scoliosis.＆quot;Study Selection： The inclusion criteria of the articles were as followings： diagnosed with adult degenerative scoliosis （DS） or adult idiopathic scoliosis; underwent MISS or open surgery; with follow-up data. The articles involving patients with congenital scoliosis or unknown type were excluded and those without any follow-up data were also excluded from the study. The initial search yielded 233 articles. After title and abstract extraction, 29 English articles were selected for full-text review. Of those, 20 studies with 831 patients diagnosed with adult DS or adult idiopathic scoliosis were reviewed. Seventeen were retrospective studies, and three were prospective studies. Results： The surgical technique reported in these articles was direct or extreme lateral interbody fusion, axial lumbar interbody fusion, and transforaminal lumbar interbody fusion. Among the clinical outcomes of these studies, the operated levels was 3–7, operative time was 2.3–8.5 h. Both the Cobb angle of coronal major curve and evaluation of Oswestry Disability Index and Visual Analog Scale decreased after surgery. There were 323 complications reported in the 831 （38.9%） patients, including 150 （18.1%） motor or sensory deficits, and 111 （13.4%） implant-related complications. Conclusions： MISS can provide good radiological and self-evaluation improvement in treatment of adult scoliosis. More prospective studies will be needed before it is widely used.展开更多
文摘Objective To investigate the difference between different surgical methods for thoracic ossification of ligamentum flavum(OLF) combined with cervical spondylotic myelopathy(CSM) . Methods From January 1991 to January 2003,56 cases
文摘Objective: To investigate the effect of surgical nursing on grade III Hand-Foot Syndrome (HFS) induced by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery. Method: From January 2019 to December 2019, 10 patients with HFS grade III caused by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery in the Breast Department of Cancer Prevention and Treatment Center of Sun Yat-sen University were selected, and surgical nursing methods were used to intervene and observe the therapeutic effects of the patients. Results: One patient was cured within 7 days, the cure rate was 10% in 7 days, 8 patients were cured within 10 days, the cure rate was 80% in 10 days, 10 patients were cured within 15 days, the cure rate was 100% in 15 days. Conclusion: The surgical nursing method is effective for patients with grade III HFS caused by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery, shortening the treatment time of HFS, and is worthy of clinical promotion.
文摘Background:The nasal alar defect in Asians remains a challenging issue,as do clear classification and algorithm guidance,despite numerous previously described surgical techniques.The aim of this study is to propose a surgical algorithm that addresses the appropriate surgical procedures for different types of nasal alar defects in Asian patients.Methods:A retrospective case note review was conducted on 32 patients with nasal alar defect who underwent reconstruction between 2008 and 2022.Based on careful analysis and our clinical experience,we proposed a classification system for nasal alar defects and presented a reconstructive algorithm.Patient data,including age,sex,diagnosis,surgical options,and complications,were assessed.The extent of surgical scar formation was evaluated using standard photography based on a 4-grade scar scale.Results:Among the 32 patients,there were 20 males and 12 females with nasal alar defects.The predominant cause of trauma in China was industrial factors.The majority of alar defects were classified as type Ⅰ C(n=8,25%),comprising 18 cases(56.2%);there were 5 cases(15.6%)of type Ⅱ defect,7(21.9%)of type Ⅲ defect,and 2(6.3%)of type Ⅳ defect.The most common surgical option was auricular composite graft(n=8,25%),followed by bilobed flap(n=6,18.8%),free auricular composite flap(n=4,12.5%),and primary closure(n=3,9.4%).Satisfactory improvements were observed postoperatively.Conclusion:Factors contributing to classifications were analyzed and defined,providing a framework for the proposed classification system.The reconstructive algorithm offers surgeons appropriate procedures for treating nasal alar defect in Asians.
基金supported by the Science Foundation of Military Medical Research and Clinical Research Foundation of PLA General Hospital in China,No.2016FC-CXYY-1006(to AJS)a grant from the Application of Clinical Features of Capital City of Science and Technology Commission in China,No.Z171100001017140(to AJS)
文摘Tethered cord syndrome is a progressive disease with a typically insidious onset in infants and children, and which can lead to persistent progress of neurological deficits and a high rate of disability without timely intervention. The purpose of this study was to investigate the curative effect of microsurgery in children with different types of tethered cord syndrome. In this study, we analyzed 326 patients with tethered cord syndrome, aged from 2 months to 14 years old, who were followed for 3-36 months after microscopic surgery. Based on clinical manifestations and imaging findings, these patients were classified into five types： tight ilium terminale （53 cases）, lipomyelome- ningocele （55 cases）, lipomatous malformation （124 cases）, postoperative adhesions （56 cases）, and split cord malformation （38 cases）. All patients underwent microsurgery. Curative effects were measured before and 3 months after surgery by Spina Bifida Neurological Scale based on sensory and motor functions, reflexes, and bladder and bowel function. The results showed that Spina Bifida Neurological Scale scores improved in all five types after surgery. Overall effective rates in these patients were 75%. Effective rates were 91% in tight ilium terminale, 84% in lipomyelomeningocele, 65% in lipomatous malformation, 75% in postoperative adhesion, and 79% in split cord mal- formation. Binary logistic regression analysis revealed that types of tethered cord syndrome （lipoma-type or not） and symptom duration before surgery were independent influencing factors of surgical outcome. These results show that therapeutic effect is markedly different in patients with different types of tethered cord syndrome. Suitable clinical classification for tethered cord syndrome will be helpful in predicting prognosis and guiding treatment. This trial has been registered in the Chinese Clinical Trial Registry （registration number： ChiCTR1800016464）.
基金Xi’an Municipal Bureau of Science and Technology,No.21YXYJ0060。
文摘Objective:To compare the efficacy of anal adenectomy with virtual hanging wire and anal fistulotomy in the treatment of low anal fistula in infants and children.Methods:60 children with low anal fistula who were admitted to our hospital from October 2021 to March 2022 and met the inclusion criteria were randomly divided into two groups of 30 cases each;the treatment group was treated with anal adenectomy and virtual hanging wire surgery,and the control group was treated with anal fistula resection.The clinical efficacy after treatment was compared.Results:The total effective rate of both groups was 96.67%and the difference between the two groups was not statistically significant(P>0.05).The postoperative pain score of the treatment group was lower than that of the control group(P<0.05).The length of hospitalization and healing time of the treatment group was lower than that of the control group(P<0.05).The anal function of the patients in both groups was normal,and there was no adverse reaction.Conclusion:Anal gland excision and virtual hanging surgery for the treatment of low anal fistula in infants and children have the advantages of mild pain,reduced length of hospitalization,short healing time,and better patient experience as compared to anal fistula excision.
基金Supported by Key Research and Development Plan of Shaanxi Province,China,No.2021SF-298,and No.2018SF-137.
文摘BACKGROUND Supra-and infratentorial acute epidural hematoma(SIEDH)is a common posterior cranial fossa epidural hematoma located at the inner surface of the squamous part of the occipital bone(SOB).Traditionally,surgical treatment of the SIEDH requires a combined supra-infratentorial craniotomy.AIM To analyze the morphological characteristics of the SOB and introduce a single supratentorial craniotomy for SIEDH.METHODS Skull computed tomography(CT)scan data from 32 adult patients were collected from January 1,2019 to January 31,2020.On the median sagittal plane of the CT scan,the angle of the SOB(ASOB)was defined by two lines:Line A was defined from the lambdoid suture(LambS)to the external occipital protuberance(EOP),while line B was defined from the EOP to the posterior edge of the foramen magnum(poFM).The operative angle for the SIEDH(OAS)from the supra-to infratentorial epidural space was determined by two lines:The first line passes from the midpoint between the EOP and the LambS to the poFM,while the second line passes from the EOP to the poFM.The ASOB and OAS were measured and analyzed.RESULTS Based on the anatomical study,a single supratentorial craniotomy was performed in 8 patients with SIEDH.The procedure and the results of the modified surgical method were demonstrated in detail.For males,the ASOB was 118.4±4.7 and the OAS was 15.1±1.8;for females,the ASOB was 130.4±5.1 and the OAS was 12.8±2.0.There were significant differences between males and females both in ASOB and OAS.The smaller the ASOB was,the larger the OAS was.The bone flaps in 8 patients were designed above the transverse sinus intraoperatively,and the SIEDH was completely removed without suboccipital craniotomy.The SOB does not present as a single straight plane but bends at an angle around the EOP and the superior nuchal lines.The OAS was negatively correlated with the ASOB.CONCLUSION The single supratentorial craniotomy for SIEDH is reliable and effective.
基金Supported by National Transgenic Major Project Fund(2009ZX08006-002B)
文摘[ Objective] The paper was to test the feasibility of embryo transfer technique in pig production. [ Method ] Twenty-four estrus muhiparity Landraee sows provided by Longjing Agricultural Science and Technology Institute were performed embryo transfer surgery, and postoperative effects were observed. [ Result] Totally 11 out of 24 receptor sows were pregnant ; pregnant sows delivered 67 cloned piglets, and the average farrowing rate of sows was approximately 6 piglets/sow. There were 22 mortalities of newborn piglets because of various reasons. [ Conclusion] Embryo transfer technique is an indispensable link in pig production, and an important means of pig breeding and improvement.
文摘<strong>Background</strong><strong>:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Hysterectomy is one of the most performed surgeries </span><span style="font-family:Verdana;">through</span><span style="font-family:Verdana;"> the world, even in Sub Saharan </span><span style="font-family:Verdana;">setting</span><span style="font-family:Verdana;"> where indications are not rare. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To study the frequency, indications, surgical methods, and complications of hysterectomies at the Douala General Hospital. </span><b><span style="font-family:Verdana;">Patients and methods:</span></b><span style="font-family:Verdana;"> We carried out a </span><span style="font-family:Verdana;">cross-sectional</span><span style="font-family:Verdana;"> study over </span><span style="font-family:Verdana;">a 20-year period</span><span style="font-family:Verdana;">, from the 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> January 2000 to 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> December 2019, in the </span><span style="font-family:Verdana;">department</span><span style="font-family:Verdana;"> of Gynaecology and Obstetrics of the Douala General Hospital, a tertiary health facility in Cameroon, central Africa. All patients who underwent hysterectomies for </span><span style="font-family:Verdana;">gynaecological</span><span style="font-family:Verdana;"> or obstetrical indications and whose files were complete were retained. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of a total of 7126 </span><span style="font-family:Verdana;">gynaecological</span><span style="font-family:Verdana;"> and obstetrical surgical cases 1007 were hysterectomies, giving a frequency of 14.21%. Meanwhile, 968 files fulfilled the inclusion criteria. The average age of the patients was 45.75 ± 7.71 years (range 19 to 75 years). The indications included symptomatic fibroids 64.15% (621 cases), </span><span style="font-family:Verdana;">gynaecological</span><span style="font-family:Verdana;"> cancers 13.94% (135 cases), severe cervical dysplasia 11.15% (108 cases), and endometrial hyperplasia with atypia 7.02% (68 cases), </span><span style="font-family:Verdana;">haemostatic</span><span style="font-family:Verdana;"> hysterectomies 2.68% (26 cases), uterine prolapse 0.82% (8 cases), a case of </span><span style="font-family:Verdana;">post abortion</span><span style="font-family:Verdana;"> uterine necrosis (0.10%) and a case of uterine endometriosis (0.10%). Laparotomy was the main surgical approach 86.05% (833 cases), followed by the vaginal route, 10.20% (97 cases) </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> then laparoscopy 3.92% (38 cases). The average length of hospital stay was 6.07 ± 1.92 days following laparotomy, 3 ± 1.09 days following the vaginal route, and 3.6 ± 1.04 days following laparoscopy. The main intra-operative complications included </span><span style="font-family:Verdana;">haemorrhage</span><span style="font-family:Verdana;">, 1.75% (17 cases), bladder injuries 0.82% (8 cases) </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> ureteral injuries 0.72% (7 patients). </span><span style="font-family:Verdana;">Post-operative</span><span style="font-family:Verdana;"> complications mainly included: fever 3.61% (35 cases), anaemia 2.5% (24 cases) and abdominal wall sepsis 0.92% (9 cases). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The frequency of hysterectomy was 14.21%. Uterine fibroid, </span><span style="font-family:Verdana;">gynaecological</span><span style="font-family:Verdana;"> cancer </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> cervical dysplasia were the main indications. Intra-operative </span><span style="font-family:Verdana;">haemorrhage</span><span style="font-family:Verdana;">, bladder </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> ureteral injuries were the major complications. </span><span style="font-family:Verdana;">Increase</span><span style="font-family:Verdana;"> in the practice of vaginal and laparoscopic hysterectomies could contribute to the reduction of peri and </span><span style="font-family:Verdana;">post-operative</span><span style="font-family:Verdana;"> complications and hospital stay. Thus reinforcement of abilities is required.</span></span>
文摘BACKGROUND The standard treatment of transitional cell carcinoma of the upper urinary tract consists of radical nephroureterectomy with bladder cuff removal,which can be performed either in open or laparoscopy or robot-assisted laparoscopy.Treatment of chronic renal insufficiency patients with upper urothelial tumor is in a dilemma.Urologists weigh and consider the balance between tumor control and effective renal function preservation.European Association of Urology guidelines recommend that select patients may benefit from endoscopic treatment,but laparoscopic treatment is rarely reported.CASE SUMMARY In this case report,we describe a case of 79-year-old female diagnosed with urothelial carcinoma of the renal pelvis and adrenal adenoma with chronic renal insufficiency.The patient was treated with retroperitoneal laparoscopic partial resection of the renal pelvis and adrenal adenoma resection simultaneously.CONCLUSION Retroperitoneal laparoscopic partial resection of the renal pelvis is an effective surgical procedure for the treatment of urothelial carcinoma of the renal pelvis.
文摘BACKGROUND Hutch diverticulum arises from the compromised muscular development at the ureteral orifice.It is a congenital disease and extremely rare in adult,only accounting for about 3%occurrence worldwide.It can be either symptomatic or asymptomatic,and relies on image tools for diagnosis and preoperative planning.Indications for surgery are dependent on the complications from the diverticulum.Metaplasia is about 10%among those with hutch diverticulum,and it still has chances turning into malignancy,especially urothelial cell carcinoma.CASE SUMMARY A 27-year-old man was presented with frequently recurrent urinary tract infection for one year,and had suffered from intermittent right flank pain for 3 mo.No past medical histories were recorded before.No obvious abnormalities on laboratory data and urine examination were found.Under ultrasound,right hydronephrosis was seen and an anatomical abnormality was observed on intravenous pyelography.Further computed tomography urogram showed one diverticulum seated at superolateral side of right ureteral orifice.Cystoscopy was done and biopsy results showed focal metaplasia.After discussing with him,roboticassisted diverticulectomy with reconstruction was performed.Right hydronephrosis was greatly improved after surgery.He has completed his 1.5-year follow-ups,and no malignancies were seen from urine cytology and image of intravenous pyelography.CONCLUSION Robotic-assisted diverticulectomy and reconstruction to hutch diverticulum is a safe and efficient operation,providing several advantages over open and laparoscopic ones.
文摘cases of pregnant women scheduled for delivery by cesarean section were randomly assigned to 59 cases in modification group with modified Misgav Ladach technique, 57 cases in Misgav Ladach group with Misgav Ladach technique and 56 cases in Pfannenstiel group with Pfannenstiel technique from May to Dec. 1999. The modified points included: transversely incising the fascia 2 to 3 cm, then dividing it bluntly; without opening and dissociating the visceral peritoneum; two layers suturing of low transverse uterine incision; closing the skin by continuous suturing. Results showed the average delivery time in the modification group was (3.6±2.6) min and (5.7±2.9) min in the Misgav Ladach group ( P <0.05). Median operating time was (28.3±5.4) min in modification group compared with (27.5±6.5) min in the Misgav Ladach group ( P >0.05). Average blood loss was (128±35) ml in modification group compared with (212±147) ml in the Pfannenstiel group ( P <0.05). It was concluded that the modified Misgav Ladach technique not only preserved all advantages of Misgav Ladach method, but also had additional advantages, such as faster in delivering the fetus, less damage, easier mastering for obstetricians.
基金supported by Program of the National Natural Science Foundation of China(No.82074233)Scientific Research Foundation for Advanced Talents,Xiang’an Hospital of Xiamen University(No.PM201809170009).
文摘Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.Methods From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified method.Totally,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn score.Results The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side pin.All children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.
文摘From August 2016 to June 2018, a total of 7 patients underwent lateral ventriculo-superior sagittal shunt surgeries in our hospital. All cases were followed up for 3 months to 2 years after the surgeries. The results of their head CT scans or MRI scans indicated that the conition of hydrocephalus generally improved, and the symptoms of intracranial hypertension significantly improved or disappeared. The superior sagittal sinus shunt surgery for hydrocephalus is simple to operate and also safe and effective, and it's an important method of treatment for hydrocephalus. This article described the specific surgical procedure for lateral ventriculo-superior sagittal shunt surgery in detail so that this surgical procedure can be better promoted.
基金Dr.Vishwanath Karad MIT-World Peace University,Pune,411038 India and Dr.D.Y.Patil Dental College,and Hospital,Pimpri,Pune-411018 India.
文摘Orthodontic procedures can be inconvenient in nature.To overcome this problem,accelerated orthodontics play a very important role to reduce existing trouble and discomfort.The most common inconvenience caused during orthodontic treatment procedures is that they are very time consuming which can result in several drawbacks,including an increased risk of tooth decay,gingival recession,and root resorption.Various methods can be employed to expedite orthodontic treatment by accelerating tooth movement,including surgical-assisted procedures,biological interventions,and the utilization of devices.These approaches effectively reduce the overall period of treatment.The purpose of this review is to study the effective techniques for orthodontic tooth movement as well as highlight various orthodontic accelerating methods in the respective approaches.Some nonsurgical studies indicated that drug-induced methods can have a therapeutic effect on tooth movement.One of the approaches involves the local administration of Vitamin 1.25D,which has been found to expedite tooth movement.Vibrational orthodontic devices are a painless and cost-effective option that is considered the least invasive approach for accelerating tooth movement.Meanwhile,surgical approach is also a successful method,wherein great results and strong PDL tissue response were observed,but they cause a lot of pain and discomfort to the patient.Therefore,due to the strengths and limitations of each procedure covered in the study,more research should be done to identify the fastest way to speed up tooth mobility。
文摘Objective： Conventional open spinal surgery of adult scoliosis can be performed from anterior, posterior, or combined approach. Minimally invasive spine surgery （MISS） was developed for the purpose of reducing the undesirable effects and complications. This review aimed to make a brief summary of recent studies of the approach and clinical outcomes of MISS in adult scoliosis. Data Sources： We conducted a systematic search from PubMed, Medline, EMBASE, and other literature databases to collect reports of surgical methods and clinical outcomes of MISS in treatment of adult scoliosis. Those reports were published up to March 2017 with the following key terms： ＆quot;minimally invasive,＆quot; ＆quot;spine,＆quot; ＆quot;surgery,＆quot; and ＆quot;scoliosis.＆quot;Study Selection： The inclusion criteria of the articles were as followings： diagnosed with adult degenerative scoliosis （DS） or adult idiopathic scoliosis; underwent MISS or open surgery; with follow-up data. The articles involving patients with congenital scoliosis or unknown type were excluded and those without any follow-up data were also excluded from the study. The initial search yielded 233 articles. After title and abstract extraction, 29 English articles were selected for full-text review. Of those, 20 studies with 831 patients diagnosed with adult DS or adult idiopathic scoliosis were reviewed. Seventeen were retrospective studies, and three were prospective studies. Results： The surgical technique reported in these articles was direct or extreme lateral interbody fusion, axial lumbar interbody fusion, and transforaminal lumbar interbody fusion. Among the clinical outcomes of these studies, the operated levels was 3–7, operative time was 2.3–8.5 h. Both the Cobb angle of coronal major curve and evaluation of Oswestry Disability Index and Visual Analog Scale decreased after surgery. There were 323 complications reported in the 831 （38.9%） patients, including 150 （18.1%） motor or sensory deficits, and 111 （13.4%） implant-related complications. Conclusions： MISS can provide good radiological and self-evaluation improvement in treatment of adult scoliosis. More prospective studies will be needed before it is widely used.
