胃癌全胃切除术后不同消化道重建术式的疗效对比分析

目的 比较分析P型空肠袢食管空肠Roux-en-Y吻合术与改良空肠间置代胃术在胃癌全胃切除术后的疗效.方法 将2008年6月~2012年6月入住我院行P型空肠袢食管空肠Roux-en-Y吻合术的32例胃癌患者设立为对照组,将同期入住我院行改良空肠间Roux-en-Y置代胃术的32例胃癌患者设立为观察组,比较两组胃癌患者消化道重建时间及术后进食、术后6个月体质量下降情况、两组术后并发症情况.结果 观察组消化道重建时间明显短于对照组,观察组患者术后进食情况优于对照组,观察组术后6个月体质量下降幅度明显低于对照组,差异具有统计学意义（P ＜ 0.05）.术后6个月对两组术后并发症情况进行比较观察组术后并发症的发生率明显低于对照组,差异具有统计学意义（P ＜ 0.05）.结论 改良空肠间置代胃术的疗效明显优于P型空肠袢食管空肠Roux-en-Y吻合术,具有进食快、并发症少等优点,值得推广和应用.     

全胃切除术消化道重建方案的临床对比分析

目的对全胃切除术消化道重建方案进行对比分析。方法对P型空肠袢代胃法以及Lahey＋Braun吻合法进行分析。结果两种方案在手术时间上无明显差异,P型空肠袢代胃方案在改善患者消化道状况方面优于Lahey＋Braun吻合方案,但两种方案均存在腹泻等缺点。结论 P型空肠袢代胃法更符合消化道重建方案要求。     

P型空肠袢代胃法和Lahey吻合法在胃癌患者全胃切除对比观察与分析

目的 探讨胃癌全胃切除后P型空肠袢代胃法和Lahey吻合法的效果对比.方法 选择自2007年8月～2010年12月收入的胃癌行全胃切除术患者45例,入选患者根据术后处理方式分为两组.其中术后行P型空肠袢代胃法选为P组(22例),术后行Lahey吻合法的选为L组(23例).对比各组手术患者死亡率,并发症、患者术后进食量、进食后的症状,采用Cuschieri分级法诊断评估.结果 相对于术前,术后1年P组单餐进食约为术前的86%,而L组单餐进食为术前的61%,两组术后进食量对比差异有统计学意义(P<0.05).术后两组患者Cuschieri分级法对比中显示P组预后优于L组,差异有统计学意义(P<0.05),P组患者1例术后6个月因肿瘤扩散而引起全身衰竭死亡,2例并发术后呼吸功能不全.L组1例并发膈下感染,1例并发术后呼吸功能不全.结论 P型空肠袢代胃法是胃癌行全胃切除术后消化道重建的理想术式,能显著改善患者术后生活质量.     

胃癌全胃切除术后二种消化道重建术式对比研究

目的探讨胃癌全胃切除术后理想的消化道重建方式。方法对72例胃癌患者按全胃切除术后消化道重建方式的不同,分为空肠食管端侧吻合术（Ⅰ组）和改良功能性空肠间置代胃术（Ⅱ组）。比较二种术式患者术后并发症发生率及营养指标。结果Ⅱ组术后患者的营养状况均明显优于Ⅰ组,均P〈0.05;Ⅱ组术后并发症也明显少于Ⅰ组,均P〈0.05。结论全胃切除后改良功能性空肠间置代胃重建方式较空肠食管端侧吻合术为胃癌行全胃切除消化道重建较理想的术式,其更有利于患者的营养恢复及减少术后并发症发生率。     

胃癌全胃切除术后不同消化道重建方式的临床效果分析

目的探讨胃癌全胃切除术后有效的消化道重建方式。方法将我院2006年3月-2011年12月间收治的86例行全胃切除术的胃癌患者分为改良＂P＂形空肠间置代胃术治疗组（观察组）和空肠袢食管空肠Roux-en-Y吻合术治疗组（对照组）各43例,观察不同消化道重建术式的临床效果。结果两组手术时间方面的差异无统计学意义（P〉0.05）,观察组术后血清总蛋白、血清白蛋白含量以及预后营养指数均显著优于对照组,组间差异有统计学意义（P〈0.05）。结论采用改良＂P＂形空肠间置代胃术的方式重建消化道对于改善胃癌全胃切除术后患者的营养状况,提高生活质量有重要意义,值得临床推广使用。     

胃癌患者全胃切除方案效果对比观察与分析

目的 观察与分析胃癌患者全胃切除方案效果.方法 选取80例胃癌患者且给予相应手术治疗,同时对其手术情况及术后情况进行观察与数据统计、分析.结果 P型空肠袢代胃法和Lahey+Braun吻合法在手术时间上无显著差异,但在促进患者进食、改善患者消化道症状方面P型空肠袢代胃方案优于Lahey+Braun吻合方案且P型空肠袢代...     

胃癌行全胃切除术后消化道重建术式对营养代谢影响的临床研究

目的　从胃癌行全胃切除术后 5种消化道重建术式对营养代谢的影响 ,来探讨最佳的消化道重建的最佳术式。方法　将 14 9例拟行全胃切除的胃癌患者 ,随机抽签法分为 5组 ,每组 30例 (最后一组 2 9例 ) ,消化道重建采用 5种术式。术后 3、6个月检测生活质量指数、预后营养指数PNI ,体重 ,血浆营养学指标 ,作为判断各种术式优劣的依据。结果　 5种消化道重建术式对患者的体重 ,生活质量评分、PNI指数及血液营养学指标均有不同程度的影响。Roux en Y组术后体重下降明显 ,且ALB、TP、TF明显低于其他组 ,P <0 0 5 ,差异有显著意义。术后 6个月 ,空肠原位间置代胃术组 ,Hunt Lawrence经十二指肠组 ,HB、SI、TS明显高于Roux en Y组 ,P袢 +Roux en Y组和Hunt Lawrence组 ,P <0 0 5 ,差异有显著意义。结论　全胃切除术后消化道重建术式对患者术后营养有较大影响。有代胃者术后体重恢复较快。空肠原位间置代胃术既有代胃又恢复了十二指肠通道是一种较理想的消化道重建术式。     

胃癌患者胃切除后消化道重建手术效果观察

目的探讨胃癌患者胃切除后消化道重建手术的效果。方法 2011年2—12月本院收治的98例胃癌患者按照消化道重建手术方案分为两组：P型空肠袢代胃手术组和Lahey＋Braun吻合术组（每组49例）,同时对两种手术方案、患者术后机体恢复情况、生存质量进行比较。结果 P型空肠袢代胃手术组机体功能恢复好于Lahey＋Braun吻合手术组,术后并发症发生率也低于Lahey＋Braun吻合手术组,半年后对两组患者随访结果显示P型空肠袢代胃手术组生存质量明显优于Lahey＋Braun吻合手术组（P〈0.05）。结论加强对消化道重建手术的探讨对选取更为合理的方案具有十分重要的临床价值。     

胃癌全胃切除后消化道重建术式的比较

目的:探讨胃癌全胃切除术后消化道重建术式的合理性.方法:36例经腹全胃切除后胃癌患者分为3组,A组12例行间置双腔空肠代胃术,B组8例行Roux-en-Y型食管空肠吻合术,C组16例行Lahey+Braun食管空肠吻合术,术后加强营养支持治疗.观察术后6个月消化道症状指标(进食次数＜5次/d,进食量＞300 g/d,胃...     

胃癌全胃切除术几种消化道重建方式的比较

目的探讨胃癌患者全胃切除术后较理想的消化道重建方式。方法对115例胃癌行全胃切除术患者的临床资料进行回顾性分析。结果行食管-十二指肠端端吻合术15例（13．04％）。行食管-空肠端侧吻合、空肠-空肠侧侧吻合术40例（34．79％）。行P型空肠袢代胃术、空肠-空肠行Roux-en-Y吻合术式45例（39．13％）。行间置P型空肠袢代胃术15例（13．04％）。P型空肠袢代胃术和间置P型空肠袢代胃术式出现返流性食管炎及恶心、呕吐、腹胀者明显少于十二指肠-食管端端吻合术式及食管-空肠端侧吻合、空肠-空肠侧侧吻合术式。食管-空肠端侧吻合、空肠-空肠侧侧吻合术式有1例术后出现肠漏。采用P型空肠袢代胃术、空肠-空肠行Roux-en-Y吻合术式联合脾切除有1例术后出现脾窝感染。结论P型空肠袢代胃术手术操作简便，符合生理要求，术后并发症少，是全胃切除术后一种较为合理的消化道重建方式。     

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.     

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…     

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     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.