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??Re-operation for papillary thyroid carcinoma after radiofrequency ablation therapy: A clinical analysis of 5 cases DONG Wen-wu??ZHANG Hao??ZHANG Ping??et al. Department of Thyroid Surgery??the First Affiliated Hospital of China Medical University??Shenyang 110001??China
Corresponding author??ZHANG Hao??E-mail??haozhang@mail.cmu.edu.cn
Abstract Objective To investigate the treatment of papillary thyroid carcinoma (PTC) after radiofrequency ablation (RFA). Methods The clinical data of 5 cases of PTC after RFA from November 2014 to January 2015 in the Department of Thyroid Surgery??the First Affiliated Hospital of China Medical University were studied retrospectively. Results There were 3 cases of single lesion and 2 cases of multiple lesions in bilateral lobes. The mean tumor size was 1.76 cm (range 0.4??3.0 cm). Two cases received unilateral thyroid lobectomy plus isthmusectomy with ipsilateral central lymph node dissection (CLND). One case received total thyroidectomy with unilateral CLND. One case received total thyroidectomy with bilateral CLND and 1 case received total thyroidectomy with bilateral CLND and unilateral modified lateral lymph node dissection. All cases were diagnosed as PTC by routine histopathology. There were 4 cases of central lymph node metastasis in which 1 case of lateral lymph node metastasis. There was no complications??but temporary hypoparathyroidism in 1 case. Conclusion The indications for RFA should be grasped strictly. Early operations for PTC after RFA should be performed by an experienced surgeon??given that local tissue adhesion was obvious.     

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??Learning curve of laparscopic resection in rectal cancer for experienced surgeon ZHU Xiao-ming??LOU Zheng??GONG Hai-feng??et al. Department of Colorectal Surgery??Changhai Hospital??the Second Military Medical University??Shanghai 200433??China
Corresponding author??ZHANG Wei??E-mail: weizhang2000cn@163.com
Abstract Objective To investigate how experienced surgeons in open surgery can quickly learn laparscopic resection for rectal cancer. Methods The clinical data of 120 cases of laparscopic resection for rectal cancer performed by the same team of surgeons from August 2009 to April 2015 in Changhai Hospital of the Second Military Medical University were analyzed retrospectively. The cases were divided into three groups (40 cases in each group) by operative sequence. The time span was 36, 19, 11 months respectively. The operating time??blood loss??the rate of conversion to open operation??number of lymph nodes??the integrityof mesorectum??postoperative aerofluxus time??postoperative hospital stay and the rate of postoperative complications were compared among the 3 groups. Results The operating time in group A was ??162.9±36.7??min??which as much higher than that in group B ??147.0±36.8??min and group C (132.7±31.9)min (P<0.05). However??there was no significant difference between group B and C (P>0.05). Intraoperative blood loss??the rate of conversion to open operation and postoperative hospital stay in group A had no significant difference compared with those in group B and C (P??0.05). Also??there was no significant difference in the integrity of mesorectum??number of lymph nodes??postoperative aerofluxus time and the rate of postoperative complications among 3 gourps ??P>0.05??. Conclusion From the learning curve??surgeons with rich experience in open surgery can learn laparscopic skills for rectal cancer after performing 40 cases.     

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??Risk factors and prevention of surgical site infection LIU Hong-bin. Department of General Surgery, General Hospital of Lanzhou Command of PLA??Lanzhou 730050??China
Abstract Surgical site infection (SSI) is the most common complication after surgical operation. It can cause the increasement of hospitalization expense??extension of hospitalization time and the incidence and mortality of postoperative complications. The increasing of the difficulty and complexity of surgery??transfer technique and prosthesis implantation, immunosuppressant and hormones used widely and misuse of antibiotics may increase the incidence of SSI. With the rapid development of minimally invasive surgery and enhanced recovery after surgery (ERAS), prevent SSI are facing new challenges. So SSI should cause the attention of the society and hospitals. With the improvement of medical treatment level??the standardized treatment measures of SSI should be formulated and implemented. SSI should be prevented from forecast??diagnosis??perioperative managemant. SSI shoule be managed comprehensively in every level of patients, medical staff and environment.     

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??Surgical treatment of Budd-Chiari syndrome SUN Yu-ling, XU Pei-qin. Department of General Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China Corresponding author: SUN Yu-ling, E-mail: ylsun@zzu.edu.cn Abstract Budd-Chiari syndrome (BCS) is a kind of retro-hepatic portal hypertension and surgical procedures are the main methods for its treatment. The choice of surgical procedures according to the clinical pathologic classification is the key for successful management. The new procedure of upper meso-caval shunt possesses higher operative successful rate and takes great advantages in the control of varied complications. The management of BCS complicated with hepatocellular carcinoma (HCC) should focus on HCC which determines the prognosis. Stage treatment will be better choice for subpopulation of BCS with the obstruction of IVC and HVs. Shunt combined with devascularization without splenectomy achieves satisfied results and it should re-evaluate the therapic indication for such BCS patients with complete compensation by intora-and extra-hepatic collateral circulations.     

椎管内神经鞘瘤的MR诊断

目的 探讨椎管内神经鞘瘤的MR特征。经鞘瘤的MR表现及手术病理资料，并复习文献。结果 方法回顾性分析34例经手术病理证实，资料完整的椎管内神16例囊变，全部病例T1加权为均匀或不均匀低信号，T2加权图像为高信号，27例T2加权信号不均匀，全部病例明显强化，边界清楚，27例不均匀强化，其中17例呈外围强化。结论 T1加权图像低信号，T2加权不均匀高信号，明显强化，边界清楚，外围强化，囊变是椎管内神经鞘瘤的特征。     

儿保管理在早产低出生体重儿中的应用效果

目的探讨儿保管理在早产低出生体重儿中的应用效果。方法选取2019年1月~2020年2月我院收治的66例早产低出生体重儿为研究对象,按照收治时间分为对照组和观察组,各33例。对照组给予常规管理,观察组给予儿保管理,观察两组早产低出生体重儿的体重提升效果及转正管理情况。结果观察组早产低出生体重儿的体重提升有效率(93.94%)高于对照组(78.79%)(P<0.05);管理干预后,观察组33例早产低出生体重儿均结案并转为正常儿管理,对照组有32例低体重儿结案转为正常儿管理。结论儿保管理应用于早产低出生体重儿,可有效促进其体重增长,使其尽快达到正常出生体重儿,为后期的健康生长发育奠定扎实的基础,具有较高的临床推广价值。