�����Ի�����ǰ����������Ч����

??Therapeutic effect analysis of preoperative biliary drainage for obstructive jaundice CAO Feng, LI Fei. Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
Corresponding author : LI Fei??E-mail??xw_lifei@yahoo.com.cn
Abstract Objective To determine the benefits and harms of preoperative biliary drainage (PBD) for obstructive jaundice. Methods Cochrane systematic evaluation was used to search data between 1966 and 2010 through Cochrane libraries of clinical comparative trials, PubMed, Embase, Cancer Lit and the Chinese BioMedical Literature on disc. The quality of literatures was independently evaluated and cross-checked by two evaluators. The indicators for assessment included overall mortality, overall morbidity and postoperative morbidity. The results were analyzed with RevMan 4.2 software. Results Eight articles were involved in the Meta analysis with total 728 patients. No statistical differences were found in the overall mortality??OR 1.08??95%CI 0.68-1.73, P=0.74??, overall morbidity??OR 1.72??95%CI 0.86-3.45, P=0.13?? and postoperative morbidity??OR 0.6??95%CI 0.35-1.03, P=0.06?? between the groups. Conclusion The potential benefits of PBD in terms of postoperative rates of death and complications do not outweigh the disadvantage of the drainage procedure and should be performed cautiously now.     

��ͬ�������ؽ���ʽ��θ�г����������������ϵ

??Analysis on the relationship between methods of reconstruction after gastrectomy and digestive tract obstruction LIU Tong??QI Feng??ZHAO Zhong-zhi. Department of Gastraintestinal Surgery, Tianjin Medical University General Hospital??Tianjin General Surgery Institute??Tianjin 300052??China
Corresponding author??LIU Tong??E-mail??liutonga@126.com
Abstract The progress of surgical techniques and surgical instruments has brought a variety of innovation for gastric surgery. The causes of postoperative digestive tract obstruction also become diversified??involving primary disease??choice of procedure??anastomosis method and other factors. Anastomotic stenosis or obstruction after gastrectomy mainly occurs in stomach-duodenum??stomach-jejunum??esophagus-jejunum, esophagus-residual stomach and other anastomosis??closely related to the selection of anastomosis, procedures and instruments??scar or tumor relapse. The afferent loop and efferent loop obstruction are still one of the important complications. It is more afferent loop obstruction in clinic. The Roux limb of Roux-en-Y anastomosis may also have some unique obstructions, such as intussusception??internal hernia??Roux stasis syndrome. In addition??gastric paralysis or adhesive intestinal obstruction may also occur. Therefore??with the changes in disease spectrum and the development of gastrointestinal surgery??the causes and characteristics of digestive tract obstruction after gastrectomy have undergone great changes. Surgeons need to carry forward the artisan spirit??strive for excellence??and constantly sum up clinical experience.     

��״��΢С����������̽��

??Ultrasound characteristics of thyroid microcarcinoma PAN Fu-shun*??XIE Xiao-yan??LI Xiao-xi??et al. *Department of Ultrasound, the First Affiliated Hospital of Sun Yat-sun University, Guangzhou 510080,China
Corresponding author??XIE Xiao-yan??E-mail??xxy1992@live.cn
Abstract Objective To investigate the ultrasound characteristics of thyroid microcarcinoma. Methods The ultrasound imaging of thirty-four cases of thyroid microcarcinoma confirmed by surgery and pathology between January 2003 and January 2009 at the First Affiliated Hospital of Sun Yat-sun University was analyzed retrospectively. Results Thirty-two (94.1%) cases were detected as hypo-echo nodules. Twenty-eight (85.3%) cases were with irregular shape. Twenty-six (76.5%) cases were with irregular edges calcification. Blood flow was detected in 7 cases with CDFI and lymph node metastasis was found in 4 cases. Conclusion Hypo-echo nodules, regular shape, irregular edges and calcification are the ultrasound characteristic. Comprehending the characteristics may improve the pre-operation diagnosis efficacy.