Liu S.,Tianjin 4th Center Hospital
Pakistan Journal of Medical Sciences | Year: 2014
Objective: To evaluate the clinical outcome of emergency and elective operation of splenectomy with periesophagogastric devascularization in treating upper gastrointestinal hemorrhage resulted from portal hypertension. Methods: We retrospectively reviewed 219 patients of upper gastrointestinal hemorrhage resulted from portal hypertension treated using emergency or elective operation between Jul 2002 and Aug 2010. The clinical data were collected and analyzed. Results: In the group of elective operation, four patients with grade B and three with grade C died, and in the group of emergency operation, two patients with Grade B and four with Grade C died. The Grade C patients treated using emergency operation presented with a higher mortality than those treated using elective operation, but no significant difference was found (p > 0.05). In the two groups, no patients with Grade A died. 17 cases (11.1%) suffered from complications in the group of elective operation and 11 cases (16.7%) in emergency operation (p > 0.05). The complication rate in patients with Grade C is significantly higher than that in patients with Grade A or B in each group (p < 0.05). The hospital stay and cost in group of elective operation are significantly higher than those in group of emergency operation (p < 0.05). Conclusion: The patients with Grade A or B treated using emergency operation have similar clinical outcomes as those treated using elective operation, but emergency operation may result in higher rate of death and complication in patients with Grade C.
Shi L.,Tianjin 4th Center Hospital
Pakistan Journal of Medical Sciences | Year: 2013
Objective: To analyse the early outcome of main arterial injuries with delayed treatment in extremity trauma and help vascular surgeons in determining proper treatment strategy for such injuries. Methodology: Forty-three patients with delayed treatment of main arterial injuries during May 2003 and January 2008 were reviewed retrospectively. Results: In 43 patients, injuries were caused by blunt trauma in 26 cases and penetrating trauma in 17 cases. The maximum ischaemia time was 38 hours and the minimum was 13 hours. Eight patients underwent primary amputations and four patients underwent secondary amputation. There was no perioperative mortality, while wound infection occurred in five patients, followed by graft occlusion in four patients, arteriovenous fistulae in two patients and pseudoaneurysm in one patient. Conclusion: The delayed intervention in main arterial injuries is associated with higher risk of amputation, while the suitable surgical techniques may decrease the risk of limb loss. Viable limbs should be revascularized in otherwise stable patients even with long periods of ischaemia.
Liu Y.,Tianjin 4th Center Hospital
Pakistan Journal of Medical Sciences | Year: 2012
Objective: To investigate the incidence of vascular injury in lumbar spine surgery and determine the strategy for its diagnosis and treatment. Methodology: We retrospectively reviewed 1159 patients in our institution treated with lumbar spine surgery from September 2003 to November 2009. Primary outcomes measured included intraoperative vascular complications, operative blood loss and operative mortality. Results: The incidence of vascular injury is significantly higher in anterior exposure (9.1%) than posterior exposure (0.29%) (p < 0.05) and 84.4% of vascular injury involved in L4-5 segment. Nineteen patients experienced vascular injury in two-level or multi-level exposure and 26 in one-level exposure, no significant difference between two groups was found (p > 0.05). One patient died and others got favourable results. Conclusion: L4-5 segment has high incidence of vascular injury especially when anterior exposure is performed, and spine surgeons should pay more attention to the fatal complication.
Wang Y.-R.,Tianjin 4th Center Hospital
Journal of Cancer Research and Therapeutics | Year: 2014
Objective: The aim of this study is to investigate whether or not serum carcino-embryonic antigen (CEA), alpha fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9) can be used as potential biomarkers for colorectal cancer (CRC) diagnosis. Materials and Methods: Forty-six patients with pathology or cytology confirmed CRC and 36 cases with non-malignant colorectal disease (NMCD) were included in this retrospective study. The serum level of CEA, AFP and CA19-9 were arrayed and recorded for the two groups. The diagnosis sensitivity, specificity and area under the receiver-operating characteristic (ROC) curve for serum CEA, AFP and CA19-9 were calculated by the STATA-10.0 software. Results: We found that serum CEA, AFP and CA19-9 level in CRC patients were significantly higher than in NMCDs cases (all P < 0.05). The diagnosis sensitivity of CRC for CEA, AFP and CA19-9 were 80.43%, 73.91% and 69.57%; the diagnosis specificity of CRC for CEA, AFP and CA19-9 were 75.00%, 69.44% and 61.11%. The areas under the ROC curves for CEA, AFP and CA19-9, were 0.88, 0.78 and 0.77 respectively. Conclusion: These findings suggest that serum CEA, AFP and CA19-9 may be a useful biomarker for diagnosis of colorectal carcinoma against NMCD. © 2014, Medical Knowledge. All rights reserved.
Wang L.,Tianjin 4th Center Hospital
Pakistan Journal of Medical Sciences | Year: 2014
Objective: To evaluate the characterization of normal prevertebral soft tissue width of cervicothoracic region using magnetic resonance images. Methods: Prevertebral soft tissue width in the cervicothoracic region of 165 patients was measured using magnetic resonance images (MRI). The mean and standard deviation of these measurements were calculated and Spearman's correlation analysis was conducted to study the influences of age, sex and vertebral level on prevertebral soft tissue width. Results: The prevertebral soft tissue width in 165 subjects were measured and documented, and the value at each level is significantly different from those at adjacent level (p < 0.05). In addition, the width of prevertebral soft tissue in female and younger is significantly smaller than those in male and elders (p > 0.05). Conclusion: Vertebral level, sex and age have significant influence on prevertebral soft tissue width.