腹腔镜辅助与开腹远端胃癌根治术的临床对比研究

目的比较腹腔镜辅助与开腹远端胃癌根治术的手术效果。方法选取2009年1月～2011年1月我院行腹腔镜辅助远端胃癌根治术患者28例为研究对象,设立为腹腔镜组,另选择同期开腹手术病例28例作为对照组,比较两组的手术时间、术中出血量、平均术中清扫淋巴结数、住院时间、术后并发症发生率。结果腹腔镜组手术时间明显长于对照组（P〈0．05）,腹腔镜组平均术中出血量、平均住院时间、平均术中清扫淋巴结数、术后并发症发生率明显少于对照组（P〈0．05）。结论腹腔镜辅助远端胃癌根治术具有术中出血少、术后恢复快、并发症少等优点,值得推广和应用。     

腹腔镜辅助与开腹手术治疗进展期胃癌患者的围手术期疗效对比

目的 通过对比研究腹腔镜辅助与开腹手术治疗进展期胃癌患者的围手术期临床疗效,探讨腹腔镜辅助胃癌根治术临床应用的优势与不足,为临床广泛开展腹腔镜辅助胃癌根治术提供依据.方法 回顾性分析安徽医科大学第一附属医院胃肠外科2014年1~12月实施的进展期胃癌手术483例临床资料,其中腹腔镜手术230例,开腹手术253例,比较腹腔镜与开腹手术的手术时间、术中出血量、淋巴结清扫数目、切口长度、术后通气时间、术后排便时间、术后住院时间及术后并发症等指标.结果 腹腔镜组手术时间[(256.76±52.62)min]比开腹组[(165.55±51.55)min]长,差异有统计学意义(P<0.05),但腹腔镜组术中出血量、切口长度、术后拔管时间、术后通气时间、术后排便时间及术后住院时间均少于或短于开腹组,差异均有统计学意义(P<0.05),两组淋巴结清扫数目及术后并发症发生率差异无统计学意义(P>0.05).结论 腹腔镜辅助胃癌根治术能达到开腹手术的疗效,并具有术中出血少,术后恢复快等优点.     

经脐单孔腹腔镜胃癌D2根治术与传统开腹胃癌切除术临床疗效比较

目的:对比分析经脐单孔腹腔镜胃癌D2根治术与传统开腹胃癌切除术的临床疗效.方法:67例患者,其中30例行经脐单孔腹腔镜胃癌D2根治术为观察组,37例行传统开腹胃癌切除术为对照组,比较两组患者术中出血量、术后排气及进食时间、平均清扫淋巴结数、住院时间及术后并发症.结果:与对照组相比,术中出血量及术后并发症显著减少(P<0.05),术后排气时间、进食时间及住院时间均明显缩短(P<0.05);两组平均清扫淋巴结数无显著差异(P>0.05).结论:经脐单孔腹腔镜胃癌D2根治术可达到与开腹手术相当的根治效果,但其创伤小,术后并发症少,更利于患者术后恢复.     

腹腔镜进展期胃癌全胃切除D2根治术疗效评价

目的:探讨腹腔镜进展期胃癌全胃切除D2根治术的可行性及其疗效。方法:选择400例进展期胃癌患者施行胃癌全胃切除D2根治术,其中腹腔镜手术组200例,开腹手术组200例。两组患者的术中及术后恢复情况、淋巴结清扫数目、术后并发症进行比较分析。结果:腹腔镜手术组手术时间长于开腹手术组,出血量少于开腹组。比较两组患者术后胃肠功能恢复时间、术后住院时间,腹腔镜组均优于开腹组,差异有统计学意义(P<0.05)。两组术后并发症发生率差异无统计学意义(P>0.05)。两组患者平均淋巴结清扫数差异无统计学意义(P>0.05)。结论:腹腔镜进展期胃癌全胃切除D2根治术具有安全、术后恢复快和并发症少等优点,同时在淋巴结清扫方面与开腹手术效果相同。     

腹腔镜与开腹手术治疗胃癌的临床疗效比较

目的比较腹腔镜与开腹手术治疗胃癌的临床疗效,探讨腹腔镜胃癌根治术的临床价值。方法回顾性分析2007年1月至2010年12月收治的103例胃癌患者,其中采用腹腔镜胃癌根治术(LAP组)治疗49例,采用传统开腹胃癌根治术(OPEN组)54例,比较两组的手术时间、手术切口程度、术中出血量、术后胃肠道恢复时间、清扫淋巴结数、术后住院天数、术后并发症等指标。结果 LA组的术中出血量、胃肠道恢复时间和住院天数都明显少于OPEN组,无瘤生存率也均优于OPEN组,但其手术时间较长(P<0.05),两组在局部复发、远处转移和并发症发生率方面差异有统计学意义(P>0.05)。术后1周,LAP组外周血T淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+及NK细胞活性均高于OPEN组,差异有统计学意义(P<0.05)。结论腹腔镜胃癌根治术安全可靠,具有创伤小、出血少、术后恢复快等优点,值得临床使用。     

老年右半结肠癌行腹腔镜根治术与开腹术的疗效比较

目的对比老年右半结肠癌腹腔镜根治术和开腹根治术的手术效果。方法行右半结肠癌根治性切除术的老年患者72例。开腹组36例采用传统开腹根治术,腹腔镜组36例采用腹腔镜根治术。对比两组患者的手术时间、术中出血量、淋巴结清扫数目、术后肛门首次排气时间、术后住院天数和术后并发症的情况。结果两组患者的手术时间、淋巴结清扫数量对比,差异无统计学意义(P0.05);腹腔镜组的术中出血量为(48.03±34.87)mL,术后肛门首次排气时间为(42.45±6.58)h,术后住院天数为(10.32±1.13)d,均显著少于对照组(P0.05);腹腔镜组术后并发症的发生率为16.67%,开腹组术后并发症的发生率为11.11%,两组对比差异无统计学意义(P0.05)。结论腹腔镜根治术对老年右半结肠癌肿瘤的清除效果和开腹手术相当,但腹腔镜根治术的创伤小,安全性良好,术后康复快。     

腹腔镜胃癌D2根治术与开腹手术临床疗效对比分析

目的比较腹腔镜胃癌D2根治术与开腹手术治疗进展期胃癌的安全性及近期疗效。方法对2013年1月—2014年6月在该院普通外科行腹腔镜胃癌根治术(腹腔镜组,56例)和同期行开腹手术(开腹组,60例)患者的临床资料进行回顾性分析,比较两组的手术相关指标、术后恢复情况和肿瘤根治程度。结果腹腔镜组术中所需时间显著高于开腹组,但其术中出血量、切口长度显著少于开腹组(P<0.05),两组淋巴结清扫情况对比结果差异无统计学意义(P>0.05);腹腔镜组术后情况均优于开腹组(P<0.05);开腹组术后并发症发生率(13.33%)显著高于腹腔镜组(3.57%)(P<0.05)。结论进展期胃癌患者经腹腔镜D2根治术治疗后可达到与开腹手术同样的临床近期疗效,且微创优势明显,术后恢复快。     

腹腔镜与开腹结肠癌根治术临床疗效比较

目的：比较腹腔镜结肠癌根治术与开腹结肠癌根治术临床疗效。方法：采用前瞻性非随机对照方法纳入40例腹腔镜手术患者和40例开腹手术患者,比较腹腔镜结肠癌根治术与开腹结肠癌根治术在手术时间、术中出血量、切缘阳性数、清扫淋巴结数目、转移复发率方面的差异。结果：两组患者围手术期临床病理资料无显著差异;两组在手术时间、切缘阳性数、清扫淋巴结数目、转移复发率差异无统计学意义;两组术中出血量差异有统计学意义,腹腔镜组术中出血量少于开腹组。结论：腹腔镜结肠癌手术患者可达到与开放手术相当临床疗效,可安全地用于结肠癌根治术。     

腹腔镜胃癌根治术治疗胃癌的疗效和安全性研究

目的探讨腹腔镜胃癌根治术治疗胃癌的疗效和安全性。方法选取该院2010年12月—2013年5月期间收治的96例胃癌患者,随机均分为对照组和实验组,对照组患者行传统开腹胃癌根治术,实验组患者行腹腔镜胃癌根治术。比较两组患者手术时间、术中出血量、切口长度、淋巴结清扫枚数、术后住院时间和并发症发生率的差异。结果实验组手术时间、术中出血量、切口长度、术后住院时间以及并发症发生率均显著低于对照组,两组比较差异有统计学意义（P〈0.05）。实验组与对照组淋巴结清扫数目差异不大,组间比较差异无统计学意义（P〉0.05）。结论腹腔镜胃癌根治术具有出血少、切口小、恢复快等优点,临床疗效优于传统开腹手术,值得临床推广。     

腹腔镜与开腹结肠癌根治术临床疗效比较

目的:比较腹腔镜结肠癌根治术与开腹结肠癌根治术临床疗效。方法:采用前瞻性非随机对照方法纳入40例腹腔镜手术患者和40例开腹手术患者,比较腹腔镜结肠癌根治术与开腹结肠癌根治术在手术时间、术中出血量、切缘阳性数、清扫淋巴结数目、转移复发率方面的差异。结果:两组患者围手术期临床病理资料无显著差异;两组在手术时间、切缘阳性数、清扫淋巴结数目、转移复发率差异无统计学意义;两组术中出血量差异有统计学意义,腹腔镜组术中出血量少于开腹组。结论:腹腔镜结肠癌手术患者可达到与开放手术相当临床疗效,可安全地用于结肠癌根治术。     

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…     

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.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…