Integrating visualization toolkit and the capability of interaction, bidirectional communication and graphics rendering which provided by HTML5, we explored and experimented on the feasibility of remote medical image reconstruction and interaction in pure Web. We prompted server-centric method which did not need to download the big medical data to local connections and avoided considering network transmission pressure and the three-dimensional (3D) rendering capability of client hardware. The method integrated remote medical image reconstruction and interaction into Web seamlessly, which was applicable to lower-end computers and mobile devices. Finally, we tested this method in the Internet and achieved real-time effects. This Web-based 3D reconstruction and interaction method, which crosses over internet terminals and performance limited devices, may be useful for remote medical assistant.
ObjectiveTo explore the reliability and safety of diagnosis and treatment for cholecystocolonic fistula during laparoscopic cholecystectomy. MethodsData of patients with cholecystocolonic fistula in department of general surgery, Gansu provincial hospital from Jan 2002 to Dec 2015 were analyzed retrospectively. There were 112 cases diagnosed by routine intraoperative cholangiography from 11 472 laparoscopic cholecystectomy patients, including 33 males and 79 females, age from 58 to 84 years〔(67.4±12.6) years〕. ResultsOne hundred and twelve cases of cholecystocolonic fistula were diagnosed by routine intraoperative cholangiography in laparoscopic cholecystectomy. There were 105 cases of cholecystocolonic fistula performed laparoscopic cholecystectomy and colon repair, and 7 cases performed colostomy, no surgical complications occurred. Seventy cases were followed-up for 6-27 months〔(16.4±5.3)months〕after operation, no long-term complications occurred. ConclusionsThere is a lack of specific symptoms and special diagnosis for cholecystocolonic fistula before operation. Intraoperative cholangiography is a only objective method for diagnosis, and treatment of cholecystocolonic fistula by laparoscopic cholecystectomy and colon repair or colostomy is safe and reliable based on experienced laparoscopic skill.
ObjectiveTo systematically review the expression and clinical significance of CD133 in gastric cancer. MethodsSearches in the databases such as PubMed, EMbase, Web of Knowledge, The Cochrane Library (Issue 10, 2013), CBM, VIP, CNKI and WanFang Data were performed to collect case-control studies about the association between the CD133 expression and gastric cancer up to October 2013. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality of the included studies, and then RevMan 5.2 software was used for meta-analysis. ResultsNine case-control studies involving 623 patients were included. The results of the meta-analyses showed that, there were significant differences of CD133 expression in the following comparisons:gastric cancer tissues vs. normal esophageal tissues (OR=3.89, 95%CI 1.87 to 8.11, P=0.000 3), lymph node metastasis vs. non-lymph node metastasis (OR=2.75, 95%CI 1.99 to 3.81, P < 0.000 01), clinical stages Ⅲ-Ⅳ vs. clinical stages Ⅰ-Ⅱ (OR=2.83, 95%CI 2.13 to 3.76, P < 0.000 01), as well as distant metastasis vs. non-distant metastasis (OR=2.38, 95%CI 1.47 to 3.85, P=0.000 4). While no significant difference was found between the cell differentiation G1-G2 vs. cell differentiation G3 (OR=1.70, 95%CI 0.90 to 3.21, P=0.10). ConclusionOver-expression of CD133 is associated with lymph node metastasis, distant metastasis and poor TNM stage, which suggests that CD133 may participate in the carcinogenesis of gastric cancer. However, due to the limitations of the included studies, more large-sample high-quality case-control studies are still needed to verify these results.
ObjectiveTo compare the effects of medical glue and stapling in the prevention of postoperative seroma for patients undergoing laparoscopic direct hernia repair. MethodsNinty-four patients were randomly by computer generated randomization number divided into two groups: medical glue group (medical glue was used to fix pseudo-direct hernia sac) and stapling group (staple was used to fix pseudo-direct hernia sac).The time of follow-up was two years.The operative time, length of hospital stay, the pain level on first day and 7th day after operation, postoperative complications (seroma, wound infection, wound bleeding), hospital costs, and hernia recurrence rate within 2 years were observed. ResultsThe medical glue group compared with the stapling group, the operative time was shorter〔(35±5.1) min vs.(41±7.5) min〕, hospitalization time was shorter〔(4±0.51) d vs.(5±0.83) d〕, lower postoperative pain score〔the first day: (5±0.52) scores vs.(6±0.33)scores; the 7th day: (3±0.67) scores vs.(4±0.53) scores〕, and lower cost in hospital〔(5 731±560.50) yuan vs.(8 715±534.33) yuan〕, there were significant difference (P < 0.05).The incidence of seroma and other complications after operation and postoperative 1-year and 2-year hernia recurrence rate showed no significant differences (P > 0.05). ConclusionsThe medical glue has good prevention effects on postoperative seroma for patients undergoing laparoscopic direct hernia surgery, with shorter operative time and lower cost.This method is suitable for all levels of hospitals
ObjectiveTo evaluate short and medium term results of nitinol self-expending stent (LifeStent) implantation for iliac arteriosclerosis obliteran. MethodsThe clinical data of 75 limbs iliac artery occlusions in 64 patients from June 2011 to June 2014 in this hospital were analyzed retrospectively. The postoperative ankle brachial index (ABI), limb salvage rate, primary and secondary patency rate, and postoperative complications were evaluated. ResultsThere were 75 limbs iliac artery occlusions in 64 patients (54 males and 10 females), 11 lesions were type A of TASCⅡ, 26 lesions were type B of TASCⅡ, 29 lesions were type C of TASCⅡ, 9 lesions were type D of TASCⅡ. The postoperative ABI was significantly higher than that preoperative ABI (0.94±0.16 versus 0.29±0.20, t=-24.7, P < 0.01). The following-up time was (22±10) months, 5 patients were lost to follow-up. In 12 and 24 months after surgery, the cumulative primary patency rates were 79% and 60%, respectively, the cumulative second patency rates were 91% and 84%, respectively, the limb salvage rates were 96% and 94%, respectively. Complications occurred in 5 patients (7.8%). There was no severe complications and inhospital mortality. ConclusionClinical efficacy of short and medium term is satisfactory by nitinol self-expending stents implantation (LifeStent) for iliac arteriosclerosis obliteran, but long term efficacy remains to be further studied.