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.

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.

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

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.

Purpose:To investigate the relationship between expression of COX-2,VEGF in gastric carcinoma and its prognostic significance.Methods:281 patients with early and middle stage of gastric carcinoma were followed up. Expression of COX-2 and VEGF was examined by immunohistochemistry in 232 archival paraffinembedded tissue specimens.Results:The MVD value was much higher in COX-2(+) group and VEGF(+) group than that in COX-2(-) group and VEGF(-) group ( P

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

Objective To evaluate argon-helium cryoablation combined with transcatheter arterial chemoembolization (TACE) in treating primary hepatocellular carcinoma by comparing the changes of AFP level and T cell immunity after the therapy with that obtained after the treatment of argon-helium cryoablation alone and with that obtained after the treatment of TACE alone. Methods (1) Ninety-nine patients with primary hepatocellular carcinoma were randomly divided into three groups: group A (n=30), treated with argon-helium cryoablation; group B (n=34), treated with TACE; and group C (n=35), treated with argon-helium cryoablation together with TACE. The patients' gender, age and pathology of three groups were comparable with each other. (2) The peripheral blood T cell immunity and AFP level both before and after the treatment were determined and the results were statistically compared. Results After the treatment the AFP level in all 3 groups was significantly reduced when compared to that determined before the treatment (P < 0.05). And the difference in the decrease of AFP level between group C and A, also between group C and B, was statistically significant (P < 0.05). After the treatment the T cell immunity, including Th, TS and Th / TS, in all 3 groups was significantly different from that determined before the treatment (P < 0.01), and significant difference also existed between group C and A and between group C and B (P < 0.01). Conclusion The statistic analysis of AFP and T cell immunity, which are regarded as the index of therapeutic efficacy, indicates that argon-helium cryoablation combined with TACE is superior to simple argon-helium cryoablation and also to simple TACE in the treatment of primary hepatocellular carcinoma.