Objective To study the preoperative nursing care in excision of adrenal tumor by using laparoscope. Methods 72 patients with adrenal tumor have undergone the excision of adrenal tumor by using laparoscope in our hospital. Preoperative nursing included mental care, cardiac and pulmonary function assessement, pharmacotherapy, gastrointestinal and skin preparation. Postoperative monitoring the condition of all the patients, and given oxygen uptake to prevent hypercarbonemia. All the patients were encouraged to do functional recovery early and were guided to diet properly. Results All patients were successful obtained the excision of adrenal tumor by using laparoscope except two were reversed to open surgery. The patients could take food and leave bed in the first post-operative day. The mean post-operative stay was 6 days. Hydrothorax occurred in 2 cases and fat liquidation and wound infection occurred in 2 cases. There were no major complications such as hemorrhage and hypercarbonemia occurred. Conclusion The excision of adrenal tumor by using laparoscope is safe and reliable. Sufficient preoperative preparation, careful post-operative monitoring and timely using counter-measure are the key points in nursing care.

Objective To evaluate the clinical usefulness of manometry of esophgeal varices with endoscopic balloon technique. Methods The variceal pressure was measured by endoscopic balloon technique in 26 patients with portal hypertension, at the same time , laboratory parameters of liver function were determined. ResultsDetermination of variceal pressure was successful in 23/26 patients, while no side effects was observed. The intraobserver coefficient of variation was 7.18% ?2.64%,and there was a significant(P

Pharmacogenomics refers to all the genes encoding drug-metabolizing enzymes,drug transporters,and other drug targets. Studying the relations betweeen gene polymorphisms and drug effects as well as the prediction of adverse reactions at the gene level will be a new method for the clinical therapy of digestive system diseases. Therefore,pharmacogenomics will be a complement of traditional methods for forming and administering drugs regimens.

Drug Resistance, Neoplasm ; Humans ; Stomach Neoplasms ; drug therapy

Objective To evaluate the diagnostic accuracy of drug-induced liver injury over a 10-year period . Methods The 112 cases of drug-induced liver injury were retrospectively studied. Inter-national consensus criteria were applied to assess the causality of suspected drug hepatotoxicity,in which the chronological criteria and elimination of other causes were analysed. Results Among 1127 adult inpatients with acute hepatitis over 10-year period, 112 patients(10%) were recorded as drug-induced liver injury. Based on the causality assessment of 112 cases, either incompatible time to apparent onset of the reaction or incompatible course of the reaction was found in 60 cases(53.6%) and 20 cases(17.9%), respectively. The presence of other possible causes for the reaction was found in 34 patients (37.5%). Therefore, 26 cases(23.2%) of liver injury were related to the incriminated drug, 25 cases(22.3%) unrelated,61(54.5%) were considered to indeterminate cause. Conclusions The international consensus criteria were helpful to identify drug-related or unrelated liver injury, but more than half of reported hepatic adverse drug reactions are still in suspected condition. The current diagnostic methods for drug-induced liver injury are needed to be revised in clinical practice.

Acupuncture Therapy ; history ; Books ; history ; China ; History, Ancient ; Humans ; Medicine in Literature

Antineoplastic Agents ; therapeutic use ; Clinical Trials as Topic ; Humans

Objective To analyze the correlation between the bleeding control time,treatment and prognosis in acute gastroesophageal variceal hemorrhage and to explore the predictive factors in treatment failure.Methods The clinical data of 309 patients with acute gsstroesophageal variceal hemorrhage was collected.The bleeding control was retrospectively analyzed within and at two hours after treatment,over two hours but less than six hours,over six hours but less than five days,at and after five days.The correlation between bleeding control time and mortality rate was analyzed.The differences in success rate of bleeding control and mortality rate between medication treatment alone and medication combined with endoscopic treatment were compared.Logistic regression mode was used to analyze the predictive factors of treatment failure.Results Of the 309 acute gastroesophageal variceal hemorrhage hospitalized patients,the failure of bleeding control within and at two hours,over two hours but less than six hours and over six hours but less than five days were 79 cases,25 cases and 26 cases respectively and there were one,four and 16 cases who died respectively.The success rate of bleeding control by medication treatment alone was 57.93％ (179/309) and the mortality was 10.36％ (32/309). The success rate of bleeding control by medication combined with treatment under endoscope was 82.35％ (28/34) and the mortality rate was 0.The results of Logistic regression mode analysis indicated that the admission systolic blood pressure (≤90 mm Hg,1 mm Hg=0.133 kPa),increase of total bilirubin,increase of Child-Pugh grade and ascites were the predictive factors of treatment failure.Conclusions The time of bleeding control failure mostly was within two hours.With time extended,the mortality increased. The success rate of bleeding control by medication combined with endoscopic treatment was higher and the mortality was lower.The admission systolic blood pressure lower than 90 mm Hg,increase of total bilirubin,increase of Child-Pugh grade and ascites may be the predictive factors of treatment failure.

Objective It has been shown that ketamine attenuates cytokine production and release induced by endotoxin. The purpose of this study was to investigate the effects of diazepam and ketamine on inflammatory responses during early stage of burn. Methods BALB/C male mice weighing 20-25 g were randomly divided into 5 groups : (1) normal control group (n = 10); (2) burn control group received Ⅲ degree bums covering 15%-20% of the body surface (n = 10); (3) D-K group received intramuscular diazepam 0.4mg?kg-1 and ketamine 10 mg?kg-1 ( n = 10); (4) D + K pretreatment group received D + K 15 min before burn ( n = 10) and (5) D + K post-treatment group received D + K 15 min after burn ( n = 10) . Four hours after burn or anesthesia (D + K) the animals were sacrificed and blood was collected for determination of serum TNF-?, IL-1? and IL-10 concentrations (ELISA) and peritoneal macrophages were isolated for detection of glucocorticoid receptor (GR) by Western blotting. In addition peritoneal macrophages isolated from normal animals (group 1) and bum animals (group 2) were cultured with diazepam-ketamine for 1 h befor detection of GR.Results Serum TNF-?, IL-1? and IL-10 levels in group 2 were significantly higher than those in group 1. In group 4 and 5 serum TNF-?, IL-l? and IL-10 levels were significantly lower than those in group 2. In group 4 only serum IL-10 level whereas both serum IL-1? and IL-10 levels in group 5 were significantly higher than those in group 1. GR of peritoneal macrophage was significantly down regulated 4 h after bum (group 2) as compared with group 1. The level of GR in group 4 was significantly higher than that in group 2 but not significantly different from that in group 1; whereas the GR level in group 5 was significantly higher than that in group 2 but lower than that in group 1 and 4. There was no significant difference in GR expression after macrophages were cultured in vitro with diazepam and ketamine between normal or bum groups. Conclusion Diazepam-ketamine pretreatment can suppress cytokine release induced by severe bum. The expression of GR in peritoneal macrophages is significantly reduced by bum. Diazepam-ketamine given before or after bum can suppress the inflammatory response but have no direct effect on peritoneal macrophages.

Treatment of patients with advanced hepatocellular carcinoma (HCC) remains a huge challenge since a widely accepted therapeutic strategy has not been identified. There are some special features in patients with HCC in China, such as are mainly related to hepatitis B virus infection, often diagnosed as advanced or end-stage disease, and usually have a poorer prognosis compared with patients in western countries. Hence, appropriate treatments are urgently needed for these patients. Notably, immune-oncology therapy has been received increased attention in recent years. Based on promising results observed in clinical trials, immune-oncology therapy has been approved for treatment of various malignant diseases and brings a new hope to the treatment of advanced HCC. The review summarizes the current situation of advanced HCC treatment in China and discusses the prospects of immuno-oncology therapy.