Analysis of a series of cases of liver metastasis of colorectal carcinoma

The Authors present a six years case-report concerning 135 patients operated on colo-rectal carcinoma (82 of them are still followed up). The incidence of hepatic metastases (synchronous and metachronous) has been 30.37% in all. The preoperative ultrasonography has shown an 11% about margin mistake to visualize secondary lesions of liver. They have acknowledged the intraoperative ultrasonography very useful to visualize occult metastases and to guide an exeresis operation. The resectability of hepatic metastases from colo-rectal cancer has been of 12.19%. Synchronous forms have been rarely operable (5.88%) because they are constituted by multiple and disseminated lesions. They have found an higher incidence of operable forms among the metachronous metastases (42.85%), whose average time of appearance from the primary operation has been about 13 months. The operative mortality and the complications following hepatectomy have been null. The average survival time from operation has been over 22 months. Therefore they recognized the importance of a careful follow-up to find precociously operable lesions.     

58例乳腺肉瘤临床治疗分析

目的探讨乳腺肉瘤的临床最佳治疗方案。方法对1974年3月至2004年12月收治的58例乳腺肉瘤的临床资料进行回顾性分析。结果随访6个月~25年,14例死亡,15例复发;30例存活5年以上,10例存活20年以上。结论本病需病理证实,以手术治疗为主,无论低度或高度恶性,均应采取包括肿瘤周围正常组织的广泛切除;对复发病例不应放弃再次手术机会;对临床未能触及肿大淋巴结者可不予清扫腋下淋巴结。     

老年骨质疏松性腰背痛误诊调查

作者通过对84例老年性骨质疏松性腰背痛误诊病例的调查分析发现：（1）该清首诊误诊率为47.17％（84/176）；（2）县以下医院误诊占91．3％（314/344）；（3）骨科医师误诊占40．1％（138／344）；（4）误诊的主要原因是对本病认识不足。     

Repair of avulsion of insertion of biceps brachii tendon

An end-result study was made of 16 cases of avulsion of the insertion of the biceps brachii tendon. The follow-up period spanned one to 25 years post-treatment (average, eight years). Fourteen of the 16 cases included in the study were acute cases with primary repair and reinsertion of the biceps tendon into the area of the radial tuberosity. One case, with the loss of function of the biceps muscle secondary to temporary paralysis of the musculocutaneous nerve, was explored. The tendon was found intact and did not require repair. The sixteenth case was included for comparison of a patient who chose to forgo surgical treatment. One surgical procedure, a modification of Bunnell's technique, was used in treating all patients from 1954 to 1977. The surgically repaired biceps showed various amounts of residual impairment, ranging from negligible to limited restriction of preinjury activities. The treatment successfully returned 14 patients to their previous occupations and activities. The one case not surgically treated of the ten work-related injuries resulted in continuing disability compensation based on no greater than 20% of the entire extremity. This end-result study substantiates the positive results of this surgical technique, presents modifications of the surgical repair procedures, and allows for a similar long-range study of other treatment techniques. The evaluation of treatment methods is easily attainable by low technological clinical methods.     

牛心包生物瓣远期损坏的原因分析

对１１４例，１１９个植入人体内１年以上损坏的瓣膜作了损坏原因的病理学分析。基本病损：９０．７６％为破损、３４．４５％钙化、５．０４％过度纤维覆盖。结果表明，胶原纤维变性是导致瓣叶破损和钙化的基础。瓣叶的应力集中处可加速胶原纤维变性。早期损坏以破损为主，而后期常是破损和钙化等多种病损因素的复合结果     

The informative value of the criteria of cytological diagnostics of tumors of the thyroid gland

The authors present a comparative analysis of preoperative cytological investigation of 65 bioptates of the thyroid gland obtained by the method of fine-needle aspiration puncture biopsy and smears-prints of the same tumors made during the operation. The analysis was made according to 10 cytological criteria. The degree of correspondence of the cytological and histological investigations was determined in nodular goiter and carcinomas of the thyroid gland. The maximal specificity and sensitivity was noted in capillary carcinoma (95.3% and 100% respectively).     

Difficulties and complications of the Ender method of treatment of trochanteric fractures of the femur

The advantages of the Ender technique over the other methods of treatment of trochanteric fractures of the femur have been emphasized by several authors but the difficulties and complications of the method have perhaps not been sufficiently highlighted. With this imbalance in mind, 60 patients treated by the Ender method have been reviewed with particular emphasis on the problems encountered during treatment. The follow-up period ranges from 6 to 28 months.The main technical difficulties were experienced during the reduction and nailing of the comminuted and displaced fracture. The main postoperative complications were the cutting out of the nails from the head and neck fragment with weight bearing, backing down of the nails at the knee, and external rotation deformity. The early mortality, infection, delayed union and non-union rates were low.     

Results of replantation of limbs

Authors describe 7 cases of limb replantation in their material. The field of indication is reviewed, the early postoperative complications and the possibilities of their treatment are discussed. The means of reaching the possible best results are examined. The ways of performing the possible optimal limb replantation are scheduled on the basis of their own experiences.     

Correlation of compensatory alignment of the subtalar joint to the progression of primary osteoarthritis of the ankle

BACKGROUND: The etiology of primary osteoarthritis of the ankle is not well understood. The varus deformity of the ankle and the compensatory function of the subtalar joint are expected to be important factors in the progression of osteoarthritis. The purpose of this study was to document joint inclination at the various stages and to try to deduce the mechanism of primary, varus osteoarthritis of the ankle. MATERIALS AND METHODS: Weightbearing ankle anteroposterior (AP) views, lateral views and subtalar views were taken for 133 ankles in 80 patients (OA group) and 62 ankles in 50 subjects (control group). The OA group was divided into 5 radiographic stages. The inclination of the articular surface of the tibial plafond, the talar dome and the posterior facet of the calcaneus were measured from the radiographs. The inclination of the subtalar joint against the ankle was also calculated. At each stage, each value of the OA group was compared with the control group. RESULTS: The varus inclination of the articular surface of the tibial plafond progressed by stages; however, anterior opening was not significant at all stages. The valgus inclination of the subtalar joint progressed until the intermediate stage and converted to varus position at the later stage. CONCLUSION The compensatory function of the subtalar joint was most pronounced at the intermediate ankle arthritis stage.     

The influence of strategy of treatment of obturation colonic tumor obstruction on short-term results and quality of life of patients

The results of treatment of 120 patients with colonic tumor obstruction, included in the main group, with the formation at the first stage of decompressive double-barrel colostomy were analyzed as well as resection of the colon with ablation of the tumor and simultaneous liquidation of the stoma on the second stage. The overall postoperative lethality was 1.6%. Operations of the second stage were made in 96.7% of the patients. The interval between operations was 18.3 days. The control group consisted of 182 patients with Hartmann operations fulfilled at the first stage and liquidation of the double-barrel colostomy at the second stage. Postoperative lethality was 9.9%. Restorative operation was made in 83.5% of patients. The average term of colostomy was 196.3 days. A comparative assessment of quality of life of the patients fulfilled with the MOS SF-36 questionnaire demonstrated better results in the main group of the patients.     

Method of plasty of defects of a hairy part of the head skin after tumor excision

Results of operative treatment of 8 patients with cellular basal cancer of the hairy part of the head are presented. The patients were operated by an original worked out method of plastic reconstruction of skin defects of the head hairy part after tumor excision. The mathematical substantiation of the surgical method was stated. The technique of operative intervention is described. The clinical course and illustration of the long-term results are given.     

Technique of scleral fixation of extraocular muscles

In this paper the subject of scleral fixation is thoroughly outlined and reviewed.The strength of the scleral fiber is stressed. The technique of scleral suturing in the region of the equator is outlined and intimately described. The three regions in which scleral suturing can be practiced, i.e.: (a) behind the equator; (b) between the equator and muscle insertion; and (c) the region anterior to the muscle insertion, are discussed in detail. The instrumentation, especially the needle to be used is described. The advantages of catgut are cited. The ligated suture used in cases of tension is stressed.     

Prevention of complications of endoscopic electric excision of benign tumors of the stomach]

The authors suggest a method for endoscopic infiltration of glue under the base of a benign gastric tumor before its removal through an endoscope, for the prevention of bleeding from its seat and perforation of the organ. The method was used in removal of 116 benign tumors measuring from 0.5 to 5.0 cm in size. The results provide evidence of reliable prevention of these complications with the use of the suggested method.     

Choice of the method of treatment of unilateral fractures of the femur and bones of the shin

The authors present their experience in the treatment of 74 patients with unilateral fractures of the femur and the bones of the crus. The peculiarities of these injuries which unfavourably affect the results of the treatment are discussed. Four versions of treatment are distinguished, with surgical treatment of fractures of the femur and the bones of the crus being the preferable one. The best results, concerning both the duration of the period of in-patient treatment and the final outcome, were obtained in cases of combined intraosseous osteosynthesis of the femur and perosseous osteosynthesis of the fragments of the tibia with Ilizarov's apparatus.     

Introduction of regulations of administration of blood components into clinical practice

The authors describe "The regulations of administration of blood components" taking into account the purposeful parameters of homeostasis, which must be obtained during transfusion of blood components. The volume of erythrocytes and plasma transfused in the Center during the first and second quarters of 2006 and 2007 years were compared with the main indicators of the medical activities. The introduction of the limiting strategy of hemotransfusions based on the advantages of the world conclusive medicine was not followed by worse results of treatment, but promoted economy of facilities and blood components for the country.     

PKCγ基因RNAi慢病毒载体的构建

目的 构建蛋白激酶Cγ(PKCγ)基因RNA干扰(RNAi)慢病毒载体.方法 针对已经筛选确定的PKCT基因RNAi有效靶序列,合成靶序列的短发夹RNA(shRNA)寡核苷酸序列(Oligo)DNA,退火形成双链DNA,与经Age Ⅰ和EcoR Ⅰ酶切后的pGCSIL-GFP载体[含U_6启动子和绿色荧光蛋白(GFP)]连接,转化DH5a大肠杆菌,挑选重组阳性克隆行PCR鉴定和DNA测序.用pGCSIL-GFP、pHelper 1.0和pHelper 2.0三质粒共转染293T细胞,包装产生慢病毒,逐孔稀释滴度法测定病毒滴度.结果 PCR鉴定结果显示,以经双酶切后未插入片断的pGCSIL-GFP空载体(PCR产物为306 bp)为对照,重组细菌克隆的PCR产物为343 bp(插入片段为37 bp),鉴定结果与预期相符.测序结果显示,合成的PKCT基因shRNA寡核苷酸链序列插入正确.包装慢病毒,浓缩慢病毒悬液的滴度为1×10~9 TU/ml.结论 成功构建了PKCT基因shRNA慢病毒载体.     

两种术式治疗直肠脱垂疗效分析

目的探讨Delorme手术和经腹直肠悬吊固定术治疗直肠脱垂的临床效果。方法对天津市人民医院肛肠外科2008～2012年期间收治的采用上述两种术式治疗35例直肠脱垂的患者的临床资料进行回顾性分析。结果Delorme术较经腹直肠悬吊固定术住院天数明显缩短（13．76±4．55比23．61±6．39d,P=0．00）,且住院费用明显降低（14511．00±5034．71比21812．00±5199．97元,P=0．00）,术后便秘的患者也明显较少发生（2／17比5／13,P=0．042）,两种术式其他术后并发症发生率差异无统计学意义,Delorme术组有3例患者手术治疗无效,总的手术疗效较经腹直肠悬吊固定术组较差（P=0．047）,两组术式中最大静息压、最大压榨压术后较术前明显增大（P〈0．05）,最大耐受容积术后较术前明显下降（P〈0．05）,两种术式初始容积术后和术前无明显差异（P〉0．05）。结论两种术式术后直肠肛门功能均明显改善,Delorrae手术组住院天数少,手术费用低,术后便秘并发症发生率较低,但其复发率较高,临床医生术前应对患者仔细评估病情,选择恰当的手术术式。     

On the question of the development of medical-economic standard of diagnostics of oncologic diseases of the upper gastrointestinal tract in outpatient clinics of Saint Petersburg

The authors investigated general principles and specific development of medico-economic standard-based data-processing system, "Expert-MES", for early diagnosis of tumors of the upper gastrointestinal tract. The method of calculating the actual cost of diagnostic measures is demonstrated with regard to necessary volumes. The possibilities of monitoring the implementation of MES in request of patients for examination in outpatient clinics are evaluated.     

Possibilities of treatment of arthrogryposis]

The results of the treatment of 90 patients with arthrogryposis are resumed. The possibilities of the conservative treatment are discussed and on the basis of their experiences and the data of the literature the details of the surgical technique are given for each articulation. Besides conservative therapy 86 different surgical interventions have been performed on 21 patients. The treatment necessitates utmost care and good collaboration is necessary between the doctor and the patient, or the patients relatives, resp. The therapeutical program yields often after several years satisfactory result.