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.

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.

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

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

In early stage of the severe acute pancreatitis, mediators of inflammation make the permeability of the microcirculation blood vessel increasing and more fluidify aggregates in tissue space. Pancreatic tissue is dropsical and necrotic ; a great quantity of body fluid accumulates in abdominal cavity, which induce utility circulation volume and returned blood volume decreasing rapidly. As more and more utility circulation volume decreases, the blood current of the coronary arterY is insufficient and the cardiac muscle cell is ischemic, the cardiac muscle is suffering injury to different extent. The cardiac load is overweight relatively. The cardiac muscle fiber is prolonged and interchanged idand cardiac muscle cellular membrane is damaged. The chain reaction and magnification of the mediators of inflammation let body delivery generous cell factors such as TNF-α,interleukin, oxygen free radical and so on, which make cardiac muscle cell's integrality damage,apoptosis,cardiac functional disturbance even exhaustion. In addition, abdominal compartment syndrome,pancreatitis associated ascetic fluid and electrolyte disturbances etc are also the important factors that affect the development of the disease.

Objective To explore the influence of parenterai nutrition(PN) on nutritional status and immune function in breast cancer patients undergoing postoperative chemotherapy.Methods 94 patients with breast cancer postoperative patients were randomly divided into the treatment group(47 cases) and the control group(47 cases).All the patients were given chemotherapy with VBP.The treatment group was given glutamine fortified PN,and the control group was given normal nutrition support,respectively.The nutritional status and immune function before and after chemotherapy,and main toxicities were observed.Results Compared with those before chemotherapy,there were no significant decrease on the level of ALB,PA and HB in treatment group(all P ＞ 0.05),while those indicators in control group was significantly decreased (all P ＜ 0.05).After chemotherapy,CD4,CD8,CD4/CD8 and IgA,IgG,IgM levels of the two groups were lower than those before chemotherapy (all P ＜ 0.05),and the levels of immune indicators of the treatment group were significantly higher than those of the control group(all P ＜ 0.05).The main toxicities in two groups were nausea and vomiting,diarrhea and mild bone marrow suppression,and the body weight in control group decreased (0.91 ± 0.53)kg,while it increased (0.45 ± 0.21)kg in treatment group (t =5.53,P ＜0.05).Conclusion PN treatment for breast cancer patients during chemotherapy can improve nutrition status and immune function,enhance the tolerance of chemotherapy,so as to improve curative effect and prognosis.