Objective To compare the effects between laparoscopic and conventional open abdominal approaches on perineal wound healing for patients with rectal cancer. Methods The clinical data of 54 patients undergoing laparoscopic abdominal perineal resection (laparoscopy group) and 48 patients undergoing open abdominal perineal resection (open group) between January 2008 and December 2009 in this hospital were collected. Parameters including class A healing rate of perineal wound, duration of surgery, duration of perineal resection, blood loss during operation, anterosacral drainage, and serum albumin level on day 3 after surgery were compared between two groups. Results There was no significant difference of gender, age, tumor Dukes stage, preoperative albumin, or preoperative complications between two groups (Pgt;0.05). The class A healing rate of perineal wound (χ2=5.54, Plt;0.05) and serum albumin level on the third day after surgery （t＝3.92, Plt;0.01） in the laparoscopy group was significantly higher than those in the open group. In the laparoscopy group, duration of perineal resection （t＝6.64, Plt;0.01）, blood loss during operation （t＝6.05, Plt;0.01）, and anterosacral drainage （t＝12.86, Plt;0.01） were less than those in the open group. Conclusion The higher class A healing rate of laparoscopic approach for the patients with rectal cancer might be associated with the minimal invasiveness, less blood loss, and shorter duration.
Bl factor is a key system parameter of the resonant blood viscoelastic sensor. In this paper, a dynamic measurement system for the spatial distribution of Bl factor based on velocity amplitude and motional impedance was designed. The system extracted the velocity amplitude and motional impedance of the coil under the dynamic condition of driving the sensor to generate simple harmonic oscillations using laser displacement and impedance analysis combined with in-phase/quadrature demodulation algorithm, and controlled the equilibrium position of the coil by adjusting the direct current component of the excitation current to realize the position scanning. In the position interval of [−240, 240] μm, the maximum coefficient of variation of the measurement results was 0.077 3%, and the maximum relative error to the simulation results was 2.937 9%, with a linear fitting correlation coefficient R2 = 0.996 8. The system can be used to accurately measure the spatial distribution of Bl factor of the resonant blood viscoelastic sensor, which provides a technical support for the verification of the design of the sensor magnetic circuit.
Objective To investigate the effectiveness of split nail in the emergency treatment of nail bed partial defect. Methods Between February 2008 and August 2011, 27 cases (30 fingers) of nail bed partial defect were treated. There were 19 males (22 fingers) and 8 females (8 fingers) with an average age of 27.4 years (range, 16-64 years). The causes of injury included machine injury in 25 cases and cutting injury in 2 cases. The injured fingers included 5 thumbs, 7 index fingers, 11 middle fingers, and 9 ring fingers. The disease duration ranged from 30 minutes to 7 hours with an average of 4.3 hours. The size of nail bed defect ranged from 4 mm × 3 mm to 9 mm × 5 mm. All defects were repaired with residual split nail (4 mm × 3 mm-10 mm × 6 mm in size). Results The split nail survived in 25 cases (28 fingers), and primary healing of wound was obtained. Exudation occurred in 2 cases (2 fingers) and was cured after symptomatic treatment. Twenty-three patients (25 fingers) were followed up 5-17 months (mean, 11.1 months). At 3-5 months after operation, the fingernail regeneration was observed in all fingers. Except 2 cases (2 fingers) of delayed healing having poor nail growth, the other patients had smooth nail and normal finger tip function without pain. According effectiveness standard for fingernail regeneration, the results were excellent in 15 fingers, good in 6 fingers, fair in 3 fingers, and poor in 1 finger, with an excellent and good rate of 84%. Conclusion It is a simple and effective method to use residual split nail for emergency treatment of nail bed partial defect.
Objective To investigate the effectiveness of dorsal metacarpal island flap for treating scar contracture of the finger web. Methods Between June 2009 and December 2010, 10 patients with scar contracture of the finger web were treated. There were 6 males and 4 females with an average age of 30 years (range, 14-57 years). Scar contracture was caused byinjury in 8 cases, by burn in 1 case, and by operation in 1 case. The locations were the 1st web space in 1 case, the 2nd web space in 3 cases, the 3rd web space in 5 cases, and the 4th web space in 1 case. The disease duration was 3 to 9 months with an average of 5 months. The maximum abduction was 10-20°. After web space scar release, the dorsal metacarpal island flap (3.5 cm × 1.2 cm-4.0 cm × 2.0 cm in size) was used to reconstruct web space (2.0 cm × 1.0 cm-3.0 cm × 1.8 cm in size). The donor site was directly sutured or repaired with local flaps. Results At 2 days after operation, necrosis occurred in 1 flap, which healed by extractive treatment. The other flaps survived and wound healed by first intention; all the flaps at donor sites survived and incision healed by first intention. Ten patients were followed up 6 to 15 months (mean, 9 months). The reconstructed web space had good appearance, the maximum abduction was 80 ° in 1 case of the 1st web space scars contracture, and the maximum abduction was 35-45° (mean, 40°) in the other 9 cases. In 8 scar patients causing by injury, no scar contracture recurred during follow-up. Conclusion It can achieve good results in appearance and function to use dorsal metacarpal island flap for treating scar contracture of the finger web.
Objective To investigate the method and cl inical outcomes of repairing the skin and tissue defect of the finger pulp with transverse digital palmar island flap. Methods From August 2007 to September 2008, 9 patients with skin and tissue defects of the finger pulp were treated, including 6 males and 3 females aged 18-48 years old. The defect was caused bycrush injury by machine in 6 cases, pressure injury by heavy objects in 2 cases, and abrasion injury by grinding wheel in 1 case. The defect was located in the index finger in 4 cases, the middle finger in 2 cases, the ring finger in 3 cases, the proximal phalanx in 1 case, the middle phalanx in 7 cases, and the distal phalanx in 1 case. The defect size ranged from 1.3 cm × 1.0 cm to 2.5 cm × 1.5 cm. The defect was compl icated with unilateral blood vessel and nerve defect in 8 cases, bone fracture in 2 cases, and tendon exposure in 5 cases. The time between injury and hospital admission was 20 minutes-14 hours. Transverse digital palmar island flaps (2.0 cm × 1.2 cm-4.0 cm × 1.7 cm) were used to repair the soft tissue defect during operation. The donor site was repaired with full-thickness skin graft. Results All the flaps and skin graft at the donor site survived uneventfully. All the wounds healed by first intention. Nine patients were followed up for 6-17 months. The appearance of the flaps was similar to that of the uninjured side, there was no occurrence of obvious pigmentation and scar contracture, and the two-point discrimination value was 8-11 mm. According to the function evaluation standard for the replantation of severed finger by Chinese Medical Association Hand Surgery Academy, 8 cases were graded as excellent, 1 as good. Conclusion Repairing the skin and tissue defects in the finger pulp of middle and distal phalanx with transverse digital palmar island flap can simpl ify the operation procedure, reduce the suffering of the patient, and provide satisfying therapeutic effect.
Objective To observe the life quality and the immune function of colorectal cancer patients treated by huaier granule combined with FOLFOX4 chemotherapy. Methods A total of 76 cases of colorectal cancer with chemotherapy indications were divided into two groups at random. Huaier granule and FOLFOX4 chemotherapy was applied in trial group， meanwhile， placebo and FOLFOX4 chemotherapy in control group. The changes of life quality， common condition， and immune state in two groups before and after treatment were abserved. Results The effective rate in the trial group was 92.1％ （35/38）， and in the control group was 65.8％ （25/38）， χ2=7.91， P＜0.005. The life quality improving rate in the trial group was 78.9％ （30/38）， and in the control group was 31.6％ （12/38）， χ2=6.33， P＜0.05. The CD3 increase rate in the trial group was 65.8％（25/38）， and in the control group was 23.7 ％ （9/38）， χ2=7.96， P＜0.005， the CD4/CD8 increase rate in the trial group was 68.4 ％（26/38） , and in the control group was 28.9％ （11/38）， χ2=10.53， P＜0.005. Conclusions Huaier granule can significantly improv the clinical symptoms, life quality, and immune state. Huaier granule combined with FOLFOX4 chemotherapy is a new effective scheme to cure colorectal cancer， is worth further generalization．
ObjectiveTo summarize the experience of comprehensive treatment of parathyroid carcinoma (PTC).MethodThe clinicopathologic data of patient with PTC admitted to the First Affiliated Hospital of Kunming Medical University were retrospectively analyzed.ResultsThe patient was a 42-year-old male, who was diagnosed with the primary hyperparathyroidism after suffering from systemic joint pain for more than 2 years. The patient accepted the first operation in a primary hospital, including the resection of the PTC and ipsilateral thyroid lobectomy, and the PTC was confirmed pathologically. The second operation was performed due to the tumor relapse within thyroid bed. The third operation was performed with the palliative resection of the recurrent tumor in the right neck and the three-dimensional conformal radiation therapy was performed. The fourth operation was performed in the left neck with lateral lymph node dissection of level Ⅲ and level Ⅳ. The lower left lung cuneiform resection was performed in the fifth operation. For the last operation, the mediastinal metastatic tumor was removed with thoracoscopy. The multiple imaging evaluation showed no evidence of recurrence in the neck, but the extensive pulmonary metastasis occurred.ConclusionsSurgery is the only effective treatment for PTC. En bloc excision consists of resection of primary tumor, ipsilateral thyroid lobectomy, other surrounding structures involved by the tumor and central neck dissection. During operation, tumor rupture should be avoided. Accessible metastatic tumor should be resected when possible. Radiotherapy should be performed in patient with local infiltration or unresectable tumor. Effect of chemotherapy for PTC is poor. Supportive medical care should be given for fatal hypercalcemia in patient when treatment failed to control tumor.