肠梗阻156例临床分析

目的总结13年来肠梗阻的诊治经验及体会，探讨肠梗阻的病因及治疗措施。方法回顾性分析本院外科1994年1月～2006年12月156例肠梗阻病例的诊治经过。结果病因明确128例（占82．05％），原因不明28例（占17．95％）；非手术治疗25例（占16．03％），手术治疗131例（占83．97％），术后并发症11例（占7．05％）；死亡1例（占0．64％）。结论粘连、肿瘤、疝分列为肠梗阻病因的前三位，分别占36．54％、27．56％、10．90％。13年间肠梗阻以粘连性肠梗阻、肿瘤性肠梗阻最常见。粘连性肠梗阻中85％为手术所致，肿瘤性肠梗阻临床表现有一定特点。肠梗阻的手术指征应根据临床表现、辅助检查资料综合判定；而早期诊断、积极合理的综合治疗能够降低病死率。     

肠梗阻98例临床分析

目的探讨肠梗阻的病因、诊断及治疗措施。方法回顾性分析我院外科1998年1月-2008年1月98例肠梗阻病例。结果病因明确89例（91％）,原因不明9例（9％）：非手术治疗68例（61％）,手术治疗30例（30％）,死亡1例。结论粘连、肿瘤、疝分别为病因的前3位,分别占35．93％,27．34％,10．55％。10年期间肠梗阻患者以粘连性肠梗阻、肿瘤性肠梗阻最常见。肠梗阻的手术指征应根据临床表现、辅助检查资料综合判定;而早期诊断、积极合理的综合治疗能够降低病死率。     

肠梗阻385例临床分析

目的 总结10年来肠梗阻的诊治经验。方法 回顾性分析了10年间收治的385例肠梗阻资料。结果 病因明确335例（87%），其中机械性肠梗阻338例（87.8%）。非手术治疗235例（61.0%），手术治疗150例（39%），术后并发症6例（4%），死亡16例（10.7%）。结论 10年间肠梗阻以粘连性肠梗阻、肿瘤性肠梗阻最常见。粘连性肠梗阻中81.4%为手术后所致，青年、无手术史的肠梗阻主要为结核性粘连所致。肿瘤性肠梗阻临床表现有一定特点。对手术早期粘连性肠梗阻应以非手术治疗为主。     

肠梗阻的临床分析

目的 总结5年来肠梗阻的诊治经验及体会,探讨肠梗阻的病因及治疗措施.方法 回顾性分析笔者所在医院外科2003年12月至2008年12月512例肠梗阻病例的诊治经过.结果 病因明确456例(89%),病因不明56例(11%);非手术治疗165例(32.2%),手术治疗347例(67.8%),术后并发症35例(10.1%);死亡26例(5.1%).结论 粘连、肿瘤、疝分列肠梗阻病因的前3位,以粘连性肠梗阻、肿瘤性肠梗阻最常见.粘连性肠梗阻中85%为手术所致,肿瘤性肠梗阻临床表现有一定特点.肠梗阻的手术指征应根据临床表现、辅助检查资料综合判定,而早期诊断、积极合理的综合治疗能够降低病死率.     

老年性肠梗阻的诊治(附212例报告)

目的：总结老年性肠梗阻的临床特点，治疗方法及效果；方法：对1997年到2001年间我科收治的65岁以上212例肠梗阻病人进行分析；结果：病因明确204例(96.2％)中机械性肠梗阻176例(86．3％)，而肿瘤引起肠梗阻86例(42．2％)，原因不明8例(3．77％)。非手术治疗102例(48．1％)，手术治疗110例(51．9％)。术后并发症12例。死亡15例(7．1％)，其中急性肠梗阻及肠梗阻有合并症者6例(2．8％)；结论：204例肠梗阻以粘连性肠梗阻、肿瘤性肠梗阻最常见，粘连性肠梗阻94例(46．1％)，肿瘤性肠梗阻62例(30．4％)，肿瘤性肠梗阻以直肠癌及左半结肠癌多见。老年性急性肠梗阻及合并其它疾病的肠梗阻病情进展快，术后并发症高，死亡率高。强化围手术期治疗，预防肠道感染及时有效手术治疗，合理的术式选择是提高治愈率、降低并发症及死亡率的关键。     

肠梗阻197例诊治分析

目的总结我院10a来肠梗阻的诊断及治疗经验,探讨肠梗阻的病因、诊断及治疗措施。方法分析我院1999年1月～2009年12月诊治的197例肠梗阻临床资料。结果 130例保守治疗成功、67例手术治疗,治愈180例、好转14例、死亡3例。结论粘连、肿瘤、疝是肠梗阻的主要病因,其中粘连性肠梗阻肿瘤性肠梗阻最常见。肠梗阻的手术指征应根据临床表现、辅助检查综合判定,而早期诊断、积极的综合治疗能降低病死率。     

肠梗阻218例临床分析

目的探讨肠梗阻病因及治疗。方法回顾性分析本院1993~2004年收治的肠梗阻218例资料。结果本组218例中,粘连性肠梗阻133例(占61%),71例行手术治疗;肿瘤性肠梗阻56例(占26%),53例行手术治疗;腹外疝梗阻13例(占6%),13例均行手术治疗。结论近12年来,肠梗阻以粘连性肠梗阻、肿瘤性肠梗阻最常见,粘连性肠梗阻需重视手术时机的把握,肿瘤性肠梗阻需积极的手术治疗。     

粘连性肠梗阻163例临床治疗体会

目的 分析粘连性肠梗阻综合治疗的效果。方法 163例粘连性肠梗阻先采用综合治疗法，其中有39例经综合治疗后，中转手术，中转手术率为23．9％。结果 163例粘连性肠梗阻采用综合治疗，治愈率为66．8％；总有效率为96．1％，死亡率0％，中转手术39例，死亡率为15.3％。结论 粘连性肠梗阻应先采用综合疗法为主。     

经阑尾残端逆行置管减压治疗粘连性肠梗阻

目的：探讨经阑尾残端逆行置管减压治疗粘连性肠梗阻的临床效果。方法：收集我院1999～2007年住院治疗的粘连性肠梗阻78例，对其进行回顾性分析，并根据治疗方式分为置管组和对照组，比较置管减压治疗粘连性肠梗阻的临床效果。结果：置管组术后肛门排气时间为（22．9±9．4）h，明显低于对照组术后肛门排气时间（57．3±15．5）h，P〈0．01；置管组住院时间为（12．0±2．2）d，明显低于对照组住院时间（18．2±4．5）d，P〈0．01；置管组切口感染或裂开率为5．0％，明显低于对照组切口感染或裂开率23．7％，P〈0．05；置管组再次梗阻率为0，明显低于对照组再次梗阻率23．7％．P〈0．05。结论：经阑尾残端逆行置管减压治疗粘连性肠梗阻优于常规手术治疗。     

老年急性肠梗阻66例临床分析

目的：探讨老年急性肠梗阻的诊断和治疗。方法：回顾分析60岁以上老年急性肠梗阻66例患者资料。结果：粘连性肠梗阻31例（46．9％）,肿瘤所致肠梗阻15例（22．7％）,胆石性肠梗阻2例（3．0％）,疝嵌顿引起肠梗阻8例（12．1％）,肠系膜栓塞引起肠梗阻1例（1．5％）,粪石性梗阻9例（13．8％）。非手术治疗39例（59．1％）,急诊手术治疗27例（40．9％）。手术死亡2例（3．0％）,非手术死亡2例（3．0％）。结论：老年急性肠梗阻以粘连性和肿瘤多见,高龄患者合并症多,及时诊断、合理治疗、是保证治疗成功的关键。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.