【Abstract】ObjectiveTo study the application of ultrasonically activated scalpel in laparoscopic intestinal adhesion release.MethodsIntestinal adhesion release with ultrasonically activated scalpel under laparoscope was performed in 29 patients suffered from intestinal adhesive obstruction after gynecological operation. ResultsAll operations were successfully performed, and none of them converted into open surgery. Intestinal disruption occurred durring operation in 2 patients with extensive intestinal denseadhesion which were mended successfully under laparoscope. The operative duration was 30-150 min (mean 45 min). Postoperative complications such as bowel leakage, bleeding, abdominal infection were not experienced. Postoperative hospital stay was 3-7 days (mean 4 days). No case had relapse symptom such as abdominal distention or pain after 1-24 months of followup. ConclusionCompared with electric scalpel, ultrasonically activated scalpel can improve the operative safety, lessen tissue damage, shorten operative time, and reduce the chance of relapse in laparoscopic operation in gynecology.
Objective To investigate the significance of three dimensional (3D) visualization and virtual surgery system in liver transplantation surgery. Methods Two patients suffered from cholangiolithiasis were scanned by 64 slice helical-CT on livers and the data were collected. Man-made segmentation and true up on the image from the data were carried out. 3D moulds of the liver and the intrahepatic vessels were reconstructed by VTK software respectively. And then, the moulds were imported to the FreeForm Modeling System for modifying. At last, auxiliary partial orthotopic liver transplantation was simulated with the force-feedback equipment (PHANTOM). Results ①It had greatly verisimilar image for the reconstructed 3D liver moulds with artery, vein, portal vein and bile duct; By liver seeing through, it had high fidelity and b 3D effect for the intrahepatic artery, vein, portal vein and bile duct, and their spatial disposition and course and correlationship were shown clearly. ②In the virtual surgery system, the virtual scalpel could be manipulated on 3D liver mould with PHANTOM. The simulating effect was the same as the clinic operation for auxiliary partial orthotopic liver transplantation. Plane visualization of hepatic resection and intrahepatic vessel cutting was achieved by adjusting the transparency of the resection part. Life-like could be felt and power feeling could be touched during virtul operation. Conclusion ①The visualized liver mould reconstructed is 3D and verisimilar, and it is helpful to design reasonable scheme for liver transplantation. ②It not only can improve the surgical effect and decrease the surgical risk, but also can reduce the complications and enhance the communication between doctor and patient through designing surgical plan and demonstrating visualized operation before surgery. ③Visualized liver transplantation surgery is helpful for medical workers to train and study.
目的 腫瘤壞死因子相關凋亡誘導配體（TRAIL）能夠誘導乙型肝炎病毒（HBV）感染細胞發生凋亡，但抑制病毒復制的具體機制不清楚，研究通過非凋亡濃度TRAIL對4種HBV啟動子調控作用的研究，探討HBV復制的可能調控機制。 方法 采用噻唑藍法和末端脫氧核苷酸轉移酶介導的dUTP缺口末端標記熒光法，檢測不同濃度TRAIL作用后人肝癌細胞株HepG2的存活率。使用HBV的4種啟動子重組質粒，4種啟動子分別控制乙肝表面抗原、X抗原、核心抗原、PS1抗原基因的轉錄與表達。將受HBV上述4種啟動子調控的熒光素酶報道基因表達質粒（SpLUC、XpLUC、CpLUC、PS1pLUC）轉染HepG2細胞，6 h后按300 、30 、3 ng/mL濃度梯度加入可溶性TRAIL，采用雙熒光報道基因分析系統檢測細胞化學發光值，計算相對熒光素酶活性。 結果 300 ng/mL是可溶性TRAIL誘導HepG2細胞凋亡的濃度閾值。采用遠低于凋亡閾值濃度（30 ng/mL）的TRAIL可明顯上調對HBV的 Sp啟動子活性（P＜0.001），另3種質粒的相對熒光素酶活性在加入TRAIL后改變不大。 結論 TRAIL僅對HBV的 Sp啟動子活性具有上調作用，其生物學意義值得進一步研究。
Objective To study the safety and feasibility of modified laparoscopic Dixon surgery for rectal cancer. Methods In the procedure of modified laparoscopic Dixon surgery, the rectum with tumor was pulled out and cut and colon-rectum anastomosis was performed through anus. The clinical data of patients with rectal cancer between modified laparoscopic Dixon surgery (laparoscopy group) and open Dixon surgery (open group) were compared and analysed prospectively. The clinical data included operative time, volume of bleeding, number of lymph node dissection, volume of abdominal drainage, time to bowel gas passage, hospital stay and relative complications, such as anastomotic leakage, ureteral injury, dysuria and fecal incontinence. Results Fifty-eight cases were selected in this study between September 2007 and July 2008, including 25 laparoscopic surgery in laparoscopy group and 33 open surgery in open group. Patient’s data on gender, age, distance between tumor and anus edge, tumor diameter, tumor pathologic type and Dukes stage were similar between two groups by statistic analysis (Pgt;0.05). All the operations were performed successfully. Two cases experienced anastomotic leakage in laparoscopy group, while 1 case experienced anastomotic leakage in open group. All these patients got recovered by conservative treatment at last. No other complications were experienced, such as ureteral injury, dysuria, fecal incontinence, and so on. There were no significant differences in term of operative time, volume of bleeding and number of lymph node dissection between two groups (Pgt;0.05). The volume of abdominal drainage was less while the time to bowel gas passage and hospital stay were shorter in laparoscopy group than those in open group (P＜0.05). Conclusion This study reveals that it is safe and feasible to perform modified laparoscopic Dixon surgery for rectal cancer, and it presents the character of minimal invasion.
Coronavirus disease 2019 (COVID-19) is highly contagious, and the route of transmission is dominated by respiratory droplets and contact transmission. At present, the disease prevention and control are difficult. In order to prevent and control COVID-19 and prevent its spread in the hospital, West China Hospital of Sichuan University has set up isolation wards in the center of infectious diseases. The work norms for isolation ward were formulated. This may help to strengthen the prevention and treatment of COVID-19, effectively control the epidemic situation, as well as protect the health and safety of the public and medical staff. This article introduces the specific settings, diagnosis and treatment specifications, and hospital infection prevention and control strategies of the isolation ward of West China Hospital of Sichuan University, shares the work experience of isolation wards, aims to provide a reference for other hospitals to effectively prevent the spread of COVID-19 in hospitals and curb the spread of COVID-19.