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factors influencing the results of treatment of bile duct injuries during laparoscopic cholecystectomy

Hepatobiliary & Pancreatic Diseases International 2005年第1期4卷 113-116页

作者： Li-Bo Li, Xiu-Jun Cai, Yi-Ping Mou, Qi Wei and Xian-fa Wang Hangzhou, China Department of General Surgery, sir Run Run Shaw Hospital, Zhejiang University Medical College, Hangzhou 310016, China Department of General Surgery Sir Run Run Shaw Hospital Zhejiang University Medical College Hangzhou 310016 China. lilibo1970@***

BACKGROUND: The short-term results of repair of lapa- roscopic bile duct injuries have been well discussed, but the long-term results have been rarely reported. This study was undertaken to evaluate the factors influencing the outcome of repair of bile duct injuries caused by laparoscopic chole- cystectomy. METHODS: The outcomes of repair of bile duct injuries caused by laparoscopic cholecystectomy in 31 patients were reviewed retrospectively, and the effects of injury recogni- tion, cholangiography, repair modality and techniques on the long-term results were analyzed. RESULTS: Bile duct injuries were repaired successfully in 19 (95%) of 20 patients with injuries who had been recog- nized intraoperatively, and in 10 (90%) of 11 patients with injuries who had been recognized postoperatively. Repair was successful in 29 (93% ) of the 31 patients after complete cholangiography. Closure of partial division, laceration, or small perforation of the bile duct with or without T tube drainage was satisfactory in the 23 patients. End to end re- pair over T tube was successful in 2 transection patients, who were detected intraoperatively. Roux-en-Y hepatico- jejunostomy was used successfully to repair transection, ex- cision or stricture of the bile duct in 4 of 5 patients (80% ). CONCLUSION: Early detection of bile duct injuries caused by laparoscopy, complete evaluation of the biliary duct, and appropriate surgical modality and techniques are help- ful to improve the results of repair for laparoscopic bile duct injuries.

关键词： cholecystectomy laparoscopic injuries bile duct

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Helicobacter pylori infection and esophageal cancer risk:An updated meta-analysis

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World Journal of Gastroenterology 2013年第36期19卷 6098-6107页

作者： fa-Jun Xie Yi-Ping Zhang Qiu-Qing Zheng Hong-Chuan Jin fa-Liang Wang Ming Chen Lan Shao De-Hong Zou Xin-Min Yu Wei-Min Mao Department of Medical Oncology Zhejiang Cancer Hospital Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus) Laboratory of Cancer Biology Sir Runrun Shaw Hospital Medical School of Zhejiang University

AIM:To clarify the association between Helicobacter pylori(***)infection and the risk of esophageal carcinoma through a meta-analysis of published ***:Studies which reported the association between *** infection and esophageal cancer published up to June 2013 were *** odds ratios(ORs)and corresponding 95%CIs of *** on esophageal cancer with respect to health control groups were *** were extracted independently by two investigators and discrepancies were resolved by discussion with a third *** statistical software,STATA(version 12.0),was applied to investigate heterogeneity among individual studies and to summarize the studies.A meta-analysis was performed using a fixed-effect or random-effect method,depending on the absence or presence of significant ***:No significant association between *** infection and esophageal squamous cell carcinoma(ESCC)risk was found in the pooled overall population(OR=0.97,95%CI:0.76-1.24).However,significant associations between *** infection and ESCC risk were found in Eastern subjects(OR=0.66,95%CI:0.43-0.89).Similarly,cytotoxin-associated gene-A(CagA)positive strains of infection may decrease the risk of ESCC in Eastern subjects(OR=0.77,95%CI:0.65-0.92),however,these associations were not statistically significant in Western subjects(OR=1.26,95%CI:0.97-1.63).For esophageal adenocarcinoma(EAC)the summary OR for *** infection and CagA positive strains of infection were 0.59(95%CI:0.51-0.68)and 0.56(95%CI:0.45-0.70),***:*** infection is associated with a decreased risk of ESCC in Eastern populations and a decreased risk of EAC in the overall population.

关键词： Helicobacter pylori Esophageal carcinoma Cancer risk Meta-analysis

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Gastrointestinal stromal tumors of the duodenum:Surgical management and survival results

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World Journal of Gastroenterology 2013年第36期19卷 6000-6010页

作者： Xiao Liang Hong Yu Lin-Hua Zhu Xian-fa Wang Xiu-Jun Cai Department of General Surgery Sir Run Run Shaw Hospital School of Medicine Zhejiang University

AIM:To provide long-term survival results of operable duodenal gastrointestinal stromal tumors(DGISTs)in a tertiary center in ***:In this retrospective study,the pathological data of 28 patients with DGISTs who had been treated surgically at the Second Department of General Surgery,sir Run Run Shaw Hospital(SRRSH)from June1998 to December 2006 were *** pathological slides were examined by a single pathologist to confirm the *** patients whose diagnosis was not confirmed by immunohistochemistry at the time of resection,representative paraffin blocks were reassembled,and sections were studied using antibodies against CD117(c-kit),CD34,smooth muscle actin(SMA),vimentin,S-100,actin(HHF35),and *** procedures were classified as wedge resection(WR,local resection with pure closure,without duodenal transection or anastomosis),segmental resection[SR,duodenal transection with Roux-Y or BillrothⅡgastrojejunostomy(G-J),end-to-end duodenoduodenostomy(D-D),end-to-end or end-to-side duodenojejunostomy(D-J)],and pancreaticoduodenectomy(PD,Whipple operation with pancreatojejunostomy).R0 resection was pursued in all cases,and at least R1 resection was *** lymphadenectomy was not *** manifestations,surgery,medical treatment and follow-up data were retrospectively *** studies in the literature were ***:There were 12 males and 16 females patients,with a median age of 53 years(20-76 years).Their major complaints were"gastrointestinal bleeding"(57.2%)and"nonspecific discomfort"(32.1%).About14.3%,60.7%,17.9%,and 7.1%of the tumors originated in the first to fourth portion,respectively,with a median size of 5.8 cm(1.6-20 cm).Treatment was by WR in 5 cases(17.9%),SR in 13 cases(46.4%),and by PD in 10 cases(35.7%).The morbidity and mortality rates were 35.7%and 3.6%,*** median post-operative stay was 14.5 d(5-47 d).During a follow-up of 61(23-164)mo,the 2-year and 5-year relapse-free su

关键词： Gastrointestinal stromal tumors Duodenum Limited resection Pancreaticoduodenectomy Survival

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Polypropylene mesh-reinforced pancreaticojejunostomy for periampullar neoplasm

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World Journal of Gastroenterology 2007年第45期13卷 6072-6075页

作者： Di-Yu Huang Xian-fa Wang Wei Zhou Ying Xin Yi-Ping Mou Xiu-Jun Cai Depatment of Surgery Sir Run Run Shaw Hospital School of Medicine of Zhejiang University Institute of Microinvasive Surgery of Zhejiang University Hangzhou 310016 Zheiiang Province China

AIM： To evaluate the effect of polypropylene mesh- reinforced pancreatojejunostomy on pancreatic leakage. METHODS： Seventeen consecutive patients with paraampullar malignancy received polyprolene meshreinforced pancreatodudeonectomy and the Child＇s method was used to rebuild the alimentary tract. RESULTS： The mean time of polyprolene mesh-reinforced pancreatojejunostomy was 22 rain. Anastomosis could endure 30-500 cm H20 pressure during operation. All patients recovered without pancreatic leakage. CONCLUSION： Polyprolene mesh-reinforced pancreatojejunostomy is a feasible and reliable procedure to prevent pancreatic leakage.

关键词： Pancreatic leakage Pancreatojejunostomy Anastomosis Pancreatodudenectomy

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Pancreatic solid cystic desmoid tumor:Case report and literature review

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World Journal of Gastroenterology 2013年第46期19卷 8793-8798页

作者： Bin Xu Ling-Hua Zhu Jia-Guo Wu Xian-fa Wang Erik Matro Jun-Jun Ni Department of General Surgery Sir Run Run Shaw HospitalZhejiang University School of Medicine Department of Gastroenterology Sir Run Run Shaw HospitalZhejiang University School of Medicine

Desmoid tumors(DTs)are nonmetastatic,locally aggressive neoplasms with a high rate of postoperative *** DTs are especially rare;only a few cases have been reported to *** paper describes a case of a sporadic cystic DT of the pancreas managed successfully with central pancreatectomy,with no signs of recurrence 40 mo after *** to the literature,this is the first reported case in China of a pancreatic DT presenting as a solid cystic lesion,as well as the first pancreatic DT managed with central pancreatectomy and *** report the case for its rarity and emphasize disease management by concerted application of clinical,pathological,radiological and immunohistochemical analyses.

关键词： Pancreatic tumor Desmoid tumor Cystic tumor Central pancreatectomy Pancreaticogastros-tomy

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Effects of collapsing gully erosion on soil qualities of farm fields in the hilly granitic region of South China

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Journal of Integrative Agriculture 2016年第12期15卷 2873-2885页

作者： XIA Dong DING Shu-wen LONG Li DENG Yu-song WANG Qiu-xia WANG Shu-ling CAI Chong-fa College of Resources and Environment Huazhong Agricultural University Wuhan 430070 P.R. China Key Laboratory of Arable Land Conservation (Middle and Lower Reaches of Yangtze River) Ministry of Agriculture/Huazhong Agricultural University Wuhan 430070 P.R. China Sichuan Research Institute of Water Conservancy Science Chengdu 610072 P.R.China

Collapsing gully erosion is a specific form of soil erosion types in the hilly granitic region of tropical and subtropical South China, and can result in extremely rapid water and soil loss. Knowledge of the soil physical and chemical properties of farmland influenced by collapsing gully erosion is important in understanding the development of soil quality. This study was conducted at the Wuli Watershed of the Tongcheng County, south of Hubei Province, China. The aim is to investigate soil physical and chemical properties of three soil layers （0-20, 20-40 and 40-60 cm） for two farmland types （paddy field and upland field） in three regions influenced by collapsing gully erosion. The three regions are described as follows： strongly influenced region （sir）, weakly influenced region （WIR） and non-influenced region （NIR）. The results show that collapsing gully erosion significantly increased the soil gravel and sand content in paddy and upland fields, especially the surface soil in the sir and WIR. In the 0-20 cm layer of the paddy field, the highest gravel content （250.94 g kg-1） was in the sir and the lowest （78.67 g kg-1） was in the NIR, but in the upland filed, the surface soil （0-20 cm） of the sir and the 40-60 cm soil layer for the NIR had the highest （177.13 g kg-1） and the lowest （59.96 g kg-1） values of gravel content, respectively. The distribution of gravel and sand decreased with depth in the three influenced regions, but silt and clay showed the inverse change. In the paddy field, the average of sand content decreased from 58.6 （in the sir） to 49.0% （in the NIR）, but the silt content was in a reverse order, increasing from 27.9 to 36.9%, and the average of the clay content of three regions showed no significant variation （P〈0.05）. But in the upland filed, the sand, silt and clay fluctuated in the NIR and the WIR. Soils in the paddy and upland field were highly acidic （pH〈5.2） in the sir and WIR; moreover lower nutrient contents （soil organic matter （SOM）, to

关键词： collapsing gully erosion farmland hilly granitic region soil nutrient soil properties South China

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Unexpected difficult airway due to severe upper tracheal distortion:A case report

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World Journal of Clinical Cases 2022年第26期10卷 9348-9353页

作者： Jian-Wei Zhou Chuan-Guang Wang Gang Chen You-fa Zhou Jia-Feng Ding Jia-Wei Zhang Department of Anesthesia The Fifth Affiliated Hospital of Wenzhou Medical UniversityLishui Municipal Central HospitalLishui 323000Zhejiang ProvinceChina Department of Anesthesia Sir Run Run Shaw HospitalHangzhou 310016Zhejiang ProvinceChina Department of Urology The Fifth Affiliated Hospital of Wenzhou Medical UniversityLishui Municipal Central HospitalLishui 323000Zhejiang ProvinceChina

BACKGROUND Difficult airway is a significant cause of anesthesia-associated death and ***,physical examinations of thyromental distance,mouth opening,Mafampaii classification,*** with X-ray,computed tomography(CT),and other imaging technologies are mainly used to evaluate difficult ***,in many special cases,i.e.,emergency surgery,imaging examinations cannot be completed *** patients’airway can only be evaluated through general physical examination,which inevitably increases the likelihood of an unexpected difficult airway during *** SUMMARY We report a rare case of difficult intubation because of severe upper trachea distortion after *** holmium laser lithotripsy was performed under transurethral ureteroscopy because the patient had anuria for 4 d and a creatinine level of 890μmol/*** to the urgency of the condition,chest radiography or chest CT was not examined before surgery and the anesthesiologist did not evaluate the airway adequately,resulting in an unexpected difficult *** The incidence of tracheal malformation and tracheal stenosis is extremely low,but the risk of hypoxia and even death due to difficult airways is extremely high for such *** is recommended to complete preoperative imaging examinations of the *** life-threatening emergency patients,a pre-anesthesia reassessment should be performed and surgeons should be prepared to prevent and manage the difficult airway.

关键词： Tracheal distortion Difficult airway Management Imaging examination Emergency

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Massive gastrointestinal bleeding from Meckel diverticulum with ectopic pancreatic tissue

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Chinese Medical Journal 2011年第4期124卷 631-633页

作者： YANG Jian-feng SUN Lei-min WANG Xian-fa DAI Ning Department of Gastroenterology Sir Run Run Shaw Hospital College of Medicine Zhejiang University HangzhouZhejiang 310016 China Department of General Surgery Sir Run Run Shaw Hospital College of Medicine Zhejiang University HangzhouZhejiang 310016 China

Meckel diverticulum （MD）, a congenital gastrointestinal anomaly, is often involved in pediatrics, but less in the adult population. The patient in this report was a 69-year-old female presented with massive gastrointestinal bleeding causing hemorrhagic shock due to MD containing ectopic pancreatic tissue. A review of the literature revealed that gastrointestinal bleeding from MD containing ectopic pancreatic tissue is rare in adults and difficult to be identified preoperation. MD should be considered as one of the differential diagnosis for lower gastrointestinal bleeding, although scarce in adults, especially when the patient has massive painless bleeding.

关键词： Meckel diverticulum hemorrhage ectopic tissue

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传染病传播模型综述

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系统工程理论与实践 2011年第9期31卷 1736-1744页

作者：张发李璐宣慧玉空军工程大学工程学院西安710038 西安交通大学管理学院西安710049

建立传染病传播模型是理解传染病流行机理,预测流行趋势,进行防控决策的基础.将传染病传播模型分为单一群体模型,复合群体模型和微观个体模型三类.单一群体模型从宏观角度刻画了集计量的变化,以经典的sir为基础,在仓室设置、年龄结构、... 详细信息

建立传染病传播模型是理解传染病流行机理,预测流行趋势,进行防控决策的基础.将传染病传播模型分为单一群体模型,复合群体模型和微观个体模型三类.单一群体模型从宏观角度刻画了集计量的变化,以经典的sir为基础,在仓室设置、年龄结构、随机性、异质性等方面进行了扩展.复合群体模型将人群划分为多个子群体,子群体之间因人口流动而耦合,适合研究具有空间异质性的跨地区传播问题.微观个体模型的出发点是个体状态和行为,所有个体形成接触网络.这类模型有理想网络和现实网络两个研究方向,理想网络关注接触网络特性对传染病传播动力学的影响,现实网络致力于揭示社会接触的实际特征,构建足够真实的模拟网络,研究传染病的传播.这三类模型各有特点,分别具有各自的适用领域,应根据研究目的和问题特点选择合适的建模方法.

关键词：传染病模型仓室复合群体接触网络综述

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Multivariable analysis of factors associated with hospital readmission following pancreaticoduodenectomy for malignant diseases

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Chinese Medical Journal 2011年第7期124卷 1022-1025页

作者： ZHU Zi-yi HE Ji-kai WANG Yi-fan LIANG Xiao YU Hong WANG Xian-fa CAI Xiu-jun Institute of Micro-Invasive Surgery of Zhejiang University Department of General Surgery Sir Run Run Shaw HospitalCollege of Medicine Zhejiang University Hangzhou Zhejiang310016 China

Background Readmission rates after pancreaticoduodenectomy （PD） for malignant diseases have a significant impact on survival rate. Identification of risk factors for readmission may improve discharge plans and postoperative care. Data exist on the morbidity and mortality of patients undergoing PD, but there are few reports about hospital readmissions after this procedure. Our aims were to evaluate the proportion and reasons for readmissions after PD for malignant diseases, the factors influencina readmissions, and to analyze the. r~.latinn^hin hAtwAAn r^dmi^inn r^fa ~nrl ~lln/i~,~l r^t~

关键词： pancreaticoduodenectomy readmission complications survival rate

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