2016年 · 第54卷第11期

In recent years, trauma and orthopedic surgeons have made many useful attempts and explorations in the diagnosis and treatment of complex acetabular fractures, and achieved good clinical results. Emergence of Stoppa and its modified approach^[1,2,3]It provides the best exposed visual field for acetabular fractures involving quadrilateral bodies, which is conducive to reduction and internal fixation. From January 2012 to November 2015, we treated 13 cases of unilateral acetabular fractures involving quadrilateral bodies using the rectus abdominis pararectus incision approach with satisfactory results, which are reported below.

A 28-year-old male was admitted to the hospital on 23 December 2015 due to persistent upper abdominal distension and pain for 6 days without obvious trigger. Six days ago, the patient developed upper abdominal pain without obvious trigger, which showed persistent distension and pain, radiating pain in the lower back, accompanied by nausea and vomiting, and the abdominal pain did not alleviate after vomiting. He went to a local hospital, and the blood amylase was 8 504 U/L and the triacylglycerol was 20.7 mmol/L. CT examination of the upper abdomen showed acute necrotizing pancreatitis (massive peripancreatic exudation), severe fatty liver, and gallbladder stones. After treatment measures such as gastrointestinal decompression, acid inhibition, enzyme inhibition, anti-infection, fluid rehydration and improvement of microcirculation, the patient's symptoms did not relieve and he was transferred to our hospital. On admission, the patient complained of dizziness, abdominal distension, poor speech, and irritability. Physical examination: heart rate 133 beats/min, respiratory rate 29 beats/min, blood pressure 143/92 mmHg (1 mmHg =0.133 kPa), body temperature 38.5 ℃, body mass index 33.4 kg/m²There were no abnormalities in cardiopulmonary auscultation, abdominal swelling, tenderness, no rebound pain and muscle tension, and intestinal sounds 0 times/min. Laboratory test: white blood cell count 13.67×10⁹/L, neutrophil percentage 81.7%, hemoglobin 115 g/L, platelet count 204×10¹²/L; ALT 54 U/L, AST 71 U/L, urea 26 mmol/L, serum creatinine 132 μ mol/L, blood glucose concentration 20.7 mmol/L, blood calcium concentration 1.67 mmol/L, lactate dehydrogenase 1 744 U/L, lactic acid 3.86 mmol/L, triacylglycerol 15.27 mmol/L; Urinary routine showed specific gravity 1.040, protein (+), red blood cell count 5.3/high magnification field, tube type count 0.63/low magnification field, pathological tube type 1.35, ketone body (-). Admission diagnosis: (1) Acute pancreatitis (moderately severe, hyperlipidemia) with acute kidney injury and pancreatic encephalopathy; (2) fatty liver; (3) Gallbladder stones.

Please talk about the experience of preoperative radiotherapy for rectal cancer to improve the success rate of anal preservation.

JAMAThe results of two newly published large randomized controlled studies show that minimally invasive laparoscopic surgery for colorectal cancer compared with open surgery does not bring survival benefits to patients.

An article published inPLoS MedThe results of the study on (Douglas I, 2015) show that significant weight loss associated with surgical bariatric surgery can last for at least 4 years. The results of the largest comprehensive study from the UK on the long-term effects of surgical bariatric surgery show that surgical bariatric surgery reduces the risk of developing type 2 diabetes, hypertension, angina pectoris, myocardial infarction and obstructive sleep apnea syndrome.

I'm a ground glass shadow in my lungs

Three minutes is very unremarkable, only enough for you to finish this little essay.