Objective To investigate the clinical effect of splanchnicectomy for pain palliation with advanced pancreatic carcinoma.Methods Altogether 27 cases were treated from January 2005 to February 2008,retrospective study was used to analyze the clinical data of them.All the patients had diverse extent pain,among these 16 cases who had underwent splanchnicectomy (therapy group),others were in control group.Results Pain extent was scored according to visual analogue scale (VAS),preoperative score of therapy group (6.06±1.93) scores,postoperative score 3 months(2.67±1.68) scores,6 months(2.69±1.75) scores,the discrepancy had statistical significance (P<0.01),preoperative score of control group (5.91±1.87) scores,postoperative score 3 months(5.11±2.03) scores,6 months(5.33±2.25) scores,the discrepancy had no statistical significance.Intergroups contrast,showing significant difference (P<0.05).Conclusion For the patients who request to deal with primary disease,splanchnicectomy is manipulated easy,short of complication,significantly relief of pain,and deserve to be spreaded.

Objective To investigate the diagnosis and treatment of secondary sclerosing cholangitis after billary tract operation.Methods The clinical clata of 7 cases with secondary sclerosing cholangitis after billary tract operation treated in our hospital from January 2000 to June 2008 were retrospectively analyzed.Results Recurrent episodes of bacterial cholangitis were present in all patients,and they all had history of biliary tract operation.After definite diagnosis,2 cases underwent operation and 5 cases underwent conservative treatment.Among the latter,1 case underwent endoscopic sphincterotomy and 1 case had liver transplantation.Of all the patients,2 cases recovered(2/7),2 cases died(2/7) and 3 cases are still undergoing treatment.Conclusions The prognosis of secondary sclerosing cholangitis after billary tract operation is relatively poor.The key measure is prevention,and early diagnosis together with rational treatment can have certain therapeutic effect.

Objective To explore the efficacy of craniotomy and aneurysm clipping in elderly patients with ruptured intracranial aneurysms.Methods Totally 75 elderly patients with ruptured intracranial aneurysms in our hospital who underwent craniotomy and intracranial aneurysm clipping:approaching into head by wing point based on CT image,selecting the appropriate position and angle for clipping the aneurysm.Surgical efficacy and postoperative complications were observed.Prognosis was assessed by Glasgow Outcome Scale (GOS).Results 77 aneurysms presented in 75 patients and 76 aneurysms were clipped.The main postoperative complications were intracranial hematoma (5 cases),pulmonary infection (4 cases),electrolyte imbalance (10 cases),intracranial infection (2 cases),arrhythmia (3 cases),gastrointestinal bleeding (5 cases),cerebral infarction (3 cases).GOS assessment demonstrated that prognosis in 48 cases was good (64.0％),16 cases was moderate disability (21.3％),6 cases was severe disability (8.0％),2 cases was vegetative survival (2.7％),3cases was in death (4.0％).The cure rate was 64.0％ and the overall good-prognosis rate was 85.3％.Conclusions Craniotomy and aneurysm clipping has a better surgical efficacy and a high cure rate in elderly patients with ruptured intracranial aneurysm.

AIM To investigate the effects of trifluoperazine on naloxone precipitated withdrawal symptoms in morphine dependent rats and mice, and its pharmacological mechanisms. METHODS\ Naloxone precipitated tests in morphine dependent rats and mice were used. RESULTS\ Trifluoperazine(2～20 mg?kg -1 ) dose dependently inhibited naloxone precipitated withdrawal jumping, wet dog shakes, paw tremor and weight loss in morphine dependent mice. With ip trifluoperazine (5～20 mg?kg -1 ), most of positive withdrawal symptoms, including jumping, wet dog shakes, defeacation, weight loss, teeth chattering, salivation, diarrhea, ptosis and irritating, induced by naloxone in morphine dependent rats were significantly reduced. Apomorphine (2～8 mg?kg -1 ), a mixed DA 1/DA 2 receptor agonist, did not affect inhibition of trifluoperazine on naloxone precipitated withdrawal symptoms in morphine dependent mice. However, nifedipine(5～20 mg?kg -1 ), a L type voltage sensitive calcium channel blocker, enhanced a pharmacological action of trifluoperazine against naloxone precipitated symptoms in morphine dependent mice. CONCLUSION\ Trifluoperazine attenuates naloxone precipitated withdrawal symptoms in morphine dependent rats and mice by inhibiting the activity of post receptor calmodulin, but it does not antagonizes DA 2 receptor, in central nervous system.

Objective To investigate the effect of Shanzha Xiaozhi Capslue on stability of atherosclerosis plaques in patient with metabolic syndrome (MS) and carotid atherosclerosis (CAS). Methods Totally 106 patients with MS and CAS were randomly divided into 2 groups with 55 cases in the treatment group and 51 cases in the control group. The control group improved the way of life and control of relevant risk factors, while the treatment group was treated with Shanzha Xiaozhi Capslue additionally for 6 months. The occurrence of major adverse cardiovascular and cerebrovascular events of the two groups was compared. The intima-media thickness, plaques grade of carotid artery and the changes of Hs-CRP, Hcy, insulin resistance were measured before and after the treatment. Results After treatment, the occurrence of major adverse cardiovascular and cerebrovascular events in the treatment group reduced significantly compared with the control group (P=0.047). The intima-media thickness and plaques grade of carotid artery in the treatment group decreased significantly compared with the control group (P<0.05), and the serum levels of Hs-CRP, Hcy, insulin resistance were decreased significantly compared with the control group (P<0.01). Conclusion Shanzha Xiaozhi Capslue can decrease the intima-media thickness and plaques score of carotid artery, stabilize atherosclerotic plaque, thus reduce the occurrence of major adverse cardiovascular and cerebrovascular events of patients with MS and CAS.

Objective:Comparing the different effects between using electrotome and ultrasonic scalpel in segmentectomy for separating intersegmental plane.Methods:The ex vivo porcine lungs were chosen for experiments, the a segment of the cranial lobe of the right lung(RS1a) was removed by using electrotome(coagulation mode) or ultrasonic scalpel, the values of minimum air leak pressure among them were compared, and also the hematoxylin and eosin staining for evaluating the injury degree of incision edge.Results:The mean values of minimum air leak pressures for the intersegmental plane after segmentectomy were(17.3±1.0)cmH 2O by electrotome, (16.4±2.9) cmH 2O by ultrasonic scalpel, the differences did not reach significance between electrotome and ultrasonic scalpel( P=0.17). When focused on heat injury degree of incision edge, electrotome caused a heavier damage than ultrasonic scalpel[(819.70±158.00)μm vs.(354.35±98.81)μm, respectively, P<0.01]. Conclusion:Electrotome and ultrasonic scalpel presented different merits and defects, and we should opt energy devices rationally for separating inter-segmental plane.

OBJECTIVETo investigate the clinicopathological features and prognosis of patients with gastrointestinal stromal tumor(GIST) after surgery in Shandong Province.

METHODSClinicopathological data of GIST patients undergoing surgery from January 2001 to June 2013 in four university teaching hospitals in Shandong Province were reviewed. Pathology results were rechecked. Patients were followed up. The prognostic factors were evaluated by univariate and multivariate analyses with Log-rank test and Cox proportional hazard model.

RESULTSA total of 1039 GIST cases were enrolled, including 509 males and 530 females, with age from 18 to 87 years(median, 58). Ninety-three patients died of GIST during follow-up. The 1-, 3-, 5-year survival rates were 94.6%, 91.7% and 87.8%, respectively. Patients undergoing R0 resection had a higher 5-year overall survival rate than those undergoing R1 resection(88.8% vs 69.0%, P<0.05). For patients with intermediate risk of recurrence after surgery, the 5-year overall survival rate was 94.4% and 89.2% respectively in imatinib and non-imatinib intervention groups(P>0.05). For patients with high risk of recurrence after surgery, the 5-year overall survival rate was 76.8% and 67.7% respectively(P<0.05). Multivariate analysis revealed that tumor size(P<0.01, RR=1.988, 95%CI:1.497-2.641), mitotic count(P<0.01, RR=2.326, 95%CI:1.686-3.208) and tumor rupture(P<0.01, RR=3.032, 95%CI:1.732-5.308) were independent prognostic factors.

CONCLUSIONSTumor size, mitotic count and tumor rupture affect the prognosis of patients after resection of primary GIST independently. The standard treatment of localized GIST is R0 resection. Adjuvant imatinib therapy can improve overall survival of patients with high risk of recurrence after surgery. The efficacy of imatinib for patients with intermediate risk of recurrence remains to be verified.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Benzamides ; Cohort Studies ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Gastrointestinal Neoplasms ; diagnosis ; therapy ; Gastrointestinal Stromal Tumors ; diagnosis ; therapy ; Humans ; Imatinib Mesylate ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Piperazines ; Prognosis ; Proportional Hazards Models ; Pyrimidines ; Retrospective Studies ; Survival Rate ; Young Adult

Objective To investigate the clinicopathological features and prognosis of patients with gastrointestinal stromal tumor (GIST) after surgery in Shandong Province. Methods Clinicopathological data of GIST patients undergoing surgery from January 2001 to June 2013 in four university teaching hospitals in Shandong Province were reviewed. Pathology results were rechecked. Patients were followed up. The prognostic factors were evaluated by univariate and multivariate analys es with Log-rank test and Cox proportional hazard model. Results A total of 1039 GIST cases were enrolled, including 509 males and 530 females, with age from 18 to 87 years (median, 58). Ninety-three patients died of GIST during follow-up. The 1-, 3-, 5-year survival rates were 94.6%, 91.7% and 87.8%, respectively. Patients undergoing R0 resection had a higher 5-year overall survival rate than those undergoing R1 resection (88.8% vs 69.0%, P<0.05). For patients with intermediate risk of recurrence after surgery, the 5-year overall survival rate was 94.4% and 89.2% respectively in imatinib and non-imatinib intervention groups (P>0.05). For patients with high risk of recurrence after surgery, the 5-year overall survival rate was 76.8% and 67.7% respectively (P<0.05). Multivariate analysis revealed that tumor size (P<0.01, RR=1.988, 95%CI:1.497-2.641), mitotic count (P<0.01,RR=2.326, 95%CI:1.686-3.208) and tumor rupture (P<0.01, RR=3.032, 95%CI:1.732-5.308) were independent prognostic factors. Conclusions Tumor size, mitotic count and tumor rupture affect the prognosis of patients after resection of primary GIST independently. The standard treatment of localized GIST is R0 resection. Adjuvant imatinib therapy can improve overall survival of patients with high risk of recurrence after surgery. The efficacy of imatinib for patients with intermediate risk of recurrence remains to be verified.

Objective To investigate the clinicopathological features and prognosis of patients with gastrointestinal stromal tumor (GIST) after surgery in Shandong Province. Methods Clinicopathological data of GIST patients undergoing surgery from January 2001 to June 2013 in four university teaching hospitals in Shandong Province were reviewed. Pathology results were rechecked. Patients were followed up. The prognostic factors were evaluated by univariate and multivariate analys es with Log-rank test and Cox proportional hazard model. Results A total of 1039 GIST cases were enrolled, including 509 males and 530 females, with age from 18 to 87 years (median, 58). Ninety-three patients died of GIST during follow-up. The 1-, 3-, 5-year survival rates were 94.6%, 91.7% and 87.8%, respectively. Patients undergoing R0 resection had a higher 5-year overall survival rate than those undergoing R1 resection (88.8% vs 69.0%, P<0.05). For patients with intermediate risk of recurrence after surgery, the 5-year overall survival rate was 94.4% and 89.2% respectively in imatinib and non-imatinib intervention groups (P>0.05). For patients with high risk of recurrence after surgery, the 5-year overall survival rate was 76.8% and 67.7% respectively (P<0.05). Multivariate analysis revealed that tumor size (P<0.01, RR=1.988, 95%CI:1.497-2.641), mitotic count (P<0.01,RR=2.326, 95%CI:1.686-3.208) and tumor rupture (P<0.01, RR=3.032, 95%CI:1.732-5.308) were independent prognostic factors. Conclusions Tumor size, mitotic count and tumor rupture affect the prognosis of patients after resection of primary GIST independently. The standard treatment of localized GIST is R0 resection. Adjuvant imatinib therapy can improve overall survival of patients with high risk of recurrence after surgery. The efficacy of imatinib for patients with intermediate risk of recurrence remains to be verified.

Objective:To develop the Self-management Behavior Questionnaire for Middle-aged and Young Patients with Myocardial Infarction and test its reliability and validity.Methods:Using social cognitive theory, self-efficacy theory, and self-management theory as theoretical frameworks, a preliminary questionnaire was formed through literature review, semi-structured interviews, and Delphi expert consultation. Convenience sampling was used to select middle-aged and young patients with myocardial infarction from the First Affiliated Hospital of Henan University of Chinese Medicine, Henan Provincial Chest Hospital, and the Second Affiliated Hospital of Zhengzhou University from June to July 2022 for investigation, and item analysis and exploratory factor analysis of the questionnaire were conducted. From August to November 2022, middle-aged and young patients with myocardial infarction from the Heart Center of the First Affiliated Hospital of Henan University of Chinese Medicine were selected for investigation, and confirmatory factor analysis and reliability testing of the questionnaire were conducted.Results:A total of 300 and 480 questionnaires were distributed, respectively, and 280 and 468 valid questionnaires were collected, with effective response rates of 93.33% (280/300) and 97.50% (468/480), respectively. The Self-management Behavior Questionnaire for Middle-aged and Young Patients with Myocardial Infarction included 31 items. The total Cronbach 's α coefficient of the questionnaire was 0.918, the half reliability coefficient was 0.853, and the retest reliability coefficient was 0.975. The content validity index of the questionnaire level was 0.965, and the content validity index of the item level was 0.830 to 1.000. Exploratory factor analysis extracted 6 common factors with a cumulative variance contribution rate of 69.795%. Confirmatory factor analysis showed that the model fitted well and the questionnaire factor structure was stable. Conclusions:The Self-management Behavior Questionnaire for Middle-aged and Young Patients with Myocardial Infarction developed in this study has good reliability and validity, which can provide references for medical and nursing staff to evaluate the self-management behavior of middle-aged and young patients with myocardial infarction.