1.Progress in perioperative liquid therapy
International Journal of Surgery 2012;39(10):708-712
Liquid therapy is a vital method of perioperative treatment.Choosing correct kinds of transfusion and reasonable therapy strategies can significantly reduce the perioperative complications and shorten days in hospital and improve the critical patients prognosis.The historical development of perioperative liquid therapy is a forward process,which is about crystalloids vs.cilloid,dry vs.wet,and other controversial problems continuing to be summarized,explored and discussed.In this process,there are some specific perioperative treatment strategies with the physician having a deeper cognitive,such as goal-directed therapy,early goal directed therapy and fast track surgery which have significant clinical curative effect.This article summarizes the advance of perioperative liquid therapy.
2.Effect of pecutaneous transhepatic biliary internal external drainage in treatment of malignant biliary obstruction
Guanghua FENG ; Yang CAI ; Deqi YANG
Journal of Clinical Surgery 1999;0(05):-
Objective To evaluate the clinical value of percutaneous transchepatic biliary internal external drainage (PTBIED) in treatment of malignant biliary obstruction.Methods Forty-three patients with malignant biliary obstruction,including 14 cases with hilary metastasis cancer 8 with carcinoma of gallbladder,8 with hilary biliary cancer,13 with pancreatic cancer were treated with PTBIED.Results The technical success rate was 90%.The serum total bilirubin almost fell to normal level in 40 patients.Four cases (9.3%) died within 1 month, twenty (46.5%) cases died within 6 months,thirteen (30.2%) cases are still alive 12 months later.The complications cases mild hemobilia (8 cases,18.6%),bacteriemia(10 cases,23.3%),retrograde infection(6 included,14.0%).Conclusion PTBIED is an effective and safe therapeutic method for palliation of malignant biliary obstruction.
3.Gastrointestinal stromal tumors: A pathomorphologic and immunohistochemical study of 77 cases
Yuanhua CHENG ; Guanghua YANG ; Lixin GUO
Chinese Journal of Clinical and Experimental Pathology 2001;(2):123-127
Purpose To investigate the pathomorphological and immunohistochemical features of gastrointestinal stromal tumors (GIST). Methods Light microscopy was used to study the morphologic characteristics of 77 cases of GIST. The expression of c-kit(CD117), CD34, vimentin, SMA and S-100 protein were detected in all cases with S-P immunohistochemical method. Results GIST tended to have a higher degree of cellularity and lesser degree of cytoplasmic eosinophilia than observed in classic leiomyomas. The neoplastic cells of GIST were spindle, epithelioid or both in different proportion. Focal to prominent cytoplasmic vacuolization was often seen. The histological spectrum included interlacing fascicles, diffuse sheets, storiform and palisading pattern. The formation of cell clusters was rather special. Stromal and vascular hyalinization was common. GIST primary in the mesentery tended to have a higher potentiality of malignancy. The positivity of CD117 and CD34 were 90%, 92%, respectively. Conclusion The characteristic histological features exist in GIST. The detection of CD117 and CD34 is helpful to differential diagnosis.
4.Expression of apoptotic regulators survivin and Ki-67 in rhabdomyosarcoma
Hong ZHENG ; Qiao ZHOU ; Guanghua YANG ;
Journal of Medical Postgraduates 2003;0(03):-
Objectives:To investigate the expression of regulators survivin and Ki 67 in rhabdomyosarcoma(RMS), and to evaluate their relationship with clinicopathological features. Methods: Immunohistochemical technique(S P) and image analysis were used to detect the expression of regulators survivin and Ki 67 in 43 cases of RMS and 10 normal skeletal muscles. Results: Expression of survivin was detected in 86% of the RMS, with higher levels in RMS than in normal skeletal muscles ( P
5.Diagnosis and Treatment of the Severe Complications After Endoscopic Sphincterotomy
Jie NI ; Guanghua FENG ; Yang CAI
Journal of Medical Research 2006;0(04):-
Objective To investigate and analyze the severe complications and their surgical managements after endoscopic sphincterotomy(EST).Method 36 patients with complications after EST such as severe hemorrhage, perforation and severe pancreatitis were analyzed,of them there were 16 cases of hemorrhage, 11 case of perforation, 6 cases of hemorrhage combined with perforation and 3 cases of severe pancreatitis combined with perforation. Results 14 cases of merely hemorrhage patients, 11 cases of merely perforation patients, 1 case of perforation combined with severe pancreatitis patient and 3 case of perforation combined with hemorrhage patient were survived while 2 case of merely hemorrhage patient, 3 cases of perforation combined with hemorrhage patients and 2 case of perforation combined with severe pancreatitis patients died.Conclusions Hemorrhage is the most common complication of EST and most complications can be healed well through expectant treatment. Once severe complications occurred, prompt operations are the keys to lower the mortality.
6.Alteration of CD69 and HLA-DR-positive T Cells in Patients with Gastric Cancer after Operations and its Clinical Significances.
Yang CAI ; Wei ZHU ; Guanghua FENG
Journal of Medical Research 2006;0(02):-
Objective To evaluate the T cell subsets in peripheral blood of patients with gastric cancers after operation. Methods The T cell subsets of peripheral blood were determined by flow cytometry in 82 cases of gastric cancer before and after operation, and the data were compared with those of benign disease. Results Before operation CD69-positive T cell were significantly lower in cancer patients than those in control (P
7.Diagnosis and Treatment of Gastroparasis Syndrome After Abdominal Operation
Bei LU ; Yang CAI ; Guanghua FENG
Journal of Medical Research 2006;0(09):-
Objective To explore the diagnosis and treatment of gastroparasis syndrome after abdominal operation. Methods Clinical data of 25 cases with gastroparasis syndrome after abdominal operation from Jan 1995 to June 2006 were analysed retrospectively. Results Gastrectomy and nongastrectomy amounted to 16 and 9 cases( portal-azygous vein disconnection in 4 cases, panceaticoduodenectomy in 1 case, partial small intestinectomy and adhesions lysis in 1 case, radical excision of colon carcinoma in 2 cases, choledocholithotomy in 1 case). Gastroparasis syndrome characterized by upper abdominal distension, nausea, vomiting after clipping the pipe or large quantity of gastric drainage after operations. Gastrointestinal series and gastroscopy confirmed functional delayed gastric emptying. All cases recoverd through non-operative therapy including fasting, continuous gastrointestinal decompression, total parenteral nutrition or enteral nutrition, adn administration of gastro-intestinal dynamic medicine. Conclusions Gastroparasis syndrome is the common complication after abdomianl operation, gastrointestinal series, gastroscopy are main diagnostic methods, conservative medication obtains good effect.
8.Research of Early Using Glutamine-enriched Enteral Nutrition in Short Period on Patients with Gastric Neoplasms After Total Gastrictomy
Bei LU ; Yang CAI ; Guanghua FENG
Journal of Medical Research 2006;0(10):-
Objective To explore the effect on nutrient and immune function of glutamine-enriched enteral nutrition on patients after total gastrectomy. Methods 36 patients after total gastriecomy were randomly divided into EN(n=18) and GLN(n=18) group. Compared the index after total gastrectomy including nutrient status, immune function and lassitude degree in the 1st, 3rd, 7th day. Results GLN group showed more effective process than EN group in improving postoperative nutrient status, immune function, nitrogen balance and lassitude degree. All the indexes in GLN group changed significantly on the 7th day than that in EN group(P
9.Protective Effects of Salvia Miltiorrhiza on Small Intestinal Ischemia Reperfusion Injury During Intestinal Transplantation Induced by Cytokines in Rats
Bei LU ; Yang CAI ; Guanghua FENG
Journal of Medical Research 2006;0(02):-
Objective To explore the protective effect of Salvia miltiorrhiza on small intestinal ischemia reperfusion injury during intestinal transplantation induced by cytokines in rats.Methods Sixty Sprague Dawley rats were randomly divided into sham operation group,model group and low,mid,high doze treatment group,the superior mesenteric artery was occluded and then released to simulate the model of small intestinal ischemia reperfusion during intestinal transplantation.Tumor necrosis factor-?,interleukin-1?,interleukin-8 both in the plasm and small intestinal tissue were evaluated by ELISA 2 hours after reperfusion,changes of pathology in intestinal mucosa were observed.Results TNF-?,IL-1?,IL-8 were significantly higer(P