Objective To investigate the clinical characteristics, diagnosis and treatment of acute intestinal perforation in the patients with colorectal carcinoma. Methods The clinical data of 38 colorectal carcinomas complicated with acute intestinal perforation treated in our hospital during 19 years were analyzed retrospectively. Results Acute intestinal perforation was common in old patients with colorectal carcinoma (mean age 62 years).The primary lesions were mostly located in left-side colon and superior rectum(27/38,71.1%). The perforation in the proximal colon of tumor and cecum accounted for 81.6%(31/38), and in tumor site accounted for 18.4%(7/38). The correct rate of preoperative diagnosis was only 15.8%(6/38). The postoperative complications were common and severe. The perioperative mortality was 42.1%(16/38). All the causes of death were multiple organ function deficiency. There were close relations between perioperative mortality and operation time. The postoperative recurrent rate was 41.2%(7/17). Five-year survival rate was 23.5%(4/17). Conclusion Early diagnosis, early operation and active prevention and treatment of multiple organ function deficiency were key to decrease the mortality of the colorectal carcinoma patients with acute intestinal perforation.

Objective To study the epidemiological features of patients for emergency transport so as to enhance the control level of pre hospital emergency treatment. Methods Investigations were made of 956 cases of patients for emergency transport in the authors hospital in 2000～2001 and their epidemiological features analyzed. Results Among the 956 cases, males outnumbered females, patients within the age group of 20 to 39 numbered 391, accounting for 40.9%, and patients within the age group of 50 to 69 numbered 400, accounting for 41.8%. Of all the cases, ordinary ones numbered 671(70.2%),critical ones numbered 241(25.2%), and cases that died numbered 44(4.6%). The first three diseases demanding emergency transport were successively craniocerebral wound(17.4%), cerebrovascular disease(16.0%), and cardiovascular disease(13.5%). The periods for emergency transport ranged mainly from 9:00 to 12:00 and from 15:00 to 18:00. The sources of emergency cases were successively township hospitals(53.8%), hospitals at the county level(26.0%), and hospitals at the city level(20.2%). Conclusion Control of pre hospital emergency treatment needs to be strengthened according to the epidemiological features of patients for emergency transport.

Objective:To evaluate the effects of perioperatively administrated enteral immunonutrition in gastrointestinal cancer patients on immune and inflammatory responses,nutrition states and postoperative morbidity.Methods:Sixty patients with gastrointestinal cancer were divided randomly into two groups.Two groups perioperatively(from preoperative day 5 to postoperative day 7) received an supplemented diet with arginine,RNA,and ?-3fatty acids(immunonutrition group;n=30) or an isoenergetic and isonitrogenous standard diet (standard-nutrition group;n=30).All variables of immune and inflammatory responses,nutrition states and postoperative morbidity were measured on preoperative day 5 and postoperative day 1,4 and 8.Results:On postoperative day 4 and 8,most immune variables and prealbumin in the immuno-group were significantly higher than those in the standard-group(P0.05),and inflammatory variables as CRP in the immunonutrition group were significantly lower than those in the standard group.In the immunonutrition group,there were significantly fewer patients who experienced postoperative complications and shorter days of hospital stay compared with standard group(P0.05).Conclusion:The perioperative administration of enteral immunonutrition in gastrointestinal cancer patients can significantly modulate the postoperative immunosuppressive and inflammatory responses at the early postoperative day,can significantly decrease the occurrence of infectious and overall postoperative complications as well as the length of hospital stay.

Objective To study the application value of high frequency ultrasound to the diagnosis of early rheumatoid arthri‐tis .Methods 40 cases were selected ,who were diagnosed with early rheumatoid arthritis ,as the RA group ,another 40 healthy per‐sons were selected as the normal control group .Objects in the 2 groups were examined with high frequency ultrasound and X‐ray . Comparison of the examination results was made ,at the same time ,the results of suprapatellar bursa effusion ,synovial hyperplasia and bone erosion of the positive detection rate in group RA from the analysis of high‐frequency ultrasound and X‐ray examination were also compared .In addition ,the relativity between the related index and ESR index and CRP index in group RA was also ana‐lysed .Results The suprapatellar bursa effusion ,synovial hyperplasia ,bone erosion of color flow rate and bone erosion of the posi‐tive detection rate were higher than those in normal control group(P<0 .05);Compared with the control group ,the artery resist‐ance index was less ,the femoral condyle and lateral condylar cartilage thickness of RA group increased more(P<0 .05) .High fre‐quency ultrasound positive detection rate suprapatellar bursa effusion ,synovial hyperplasia ,bone erosion in patients of group RA were higher than those of X‐ray(P<0 .05) .The knee joint suprapatellar bursa effusion ,synovial hyperplasia of synovial membrane thickenss ,the thickness of the color blood flow grade and CRP ,ESR of patients in RA group were correlated(P<0 .01) .Conclusion High frequency ultrasound can respond to the situation of early rheumatoid arthritis patients ,and the lesion detection rates are higher ,there is a certain correlation between ultrasonographic indexes and CRP ,ESR .

Objective To find out technological evidence for the rapid propagation of Aloe vera L.var.chinensis (Haw.)Berber. Methods The technique of plant tissue culture was used to study the rapid propagation of Aloe vera L.Var.Chinesis(Haw.)Berger.The shoot growing from the underground stem of Aloe vera L.Var.chinensis(Haw.)Berger was taken as the explant to induce fascicular bud. Results The optimal culture medium was MT.MT culture medium added with 6-benzylaminopurine(BA) was effective to induce the shoot formation and increase the direct shooting rate.The optimal BA concentration for the induction and formation of shoot was 2 mg?L -1 ,the shooting rate being 100%.As for the induction of rooting,MT culture medium adding with 0.5 mg?L -1 naphthalene acid was optimal,the rooting rate being 100%. Conclusion The culture of Aloe shoot growing from the underground stem,proper culture medium and BA concentration are important for the rapid propagation of Aloe.

OBJECTIVE To discuss the operative plan for nasal cavity abnormality and evaluate the effect of revision FESS. METHODS A retrospective study of 36 revision FESS performed during 2002.3-2005.5 (age from 17 to 55 years old) is presented. Patients were evaluated with endoscopic examination of the nasal cavities and computed tomography of the sinuses and nasal cavities. Information was also collected during the revision surgery. The plan was designed according to nasal cavity abnormality. RESULTS The reasons of revision FESS: Among 36 cases there are 24 ethmoid sinusitis, 16 cases with recurrence of polyps,13 middle meatal stenosis, 11 middle turbinate adhesion, 10 septal deviation, 5 frontal recess stenosis, 5 sphenoid sisusitis, 3 maxillary ostium obstruction,3 inferior turbinate hypertrophy. Follow up for 6 month～43 month after revision FESS, 22 cases were successful, 10 satisfied and 4 inefficacy. CONCLUSION The primary FESS failure was associated with nasal cavity structure diseases. Meticulous attention in these areas and correcting it during surgery may reduce recurrence and ensure operative effect after revision FESS.

Objective To study the diagnosis and treatment of blunt pancreatic injury (BPI). Methods A retrospective analysis was made on the clinical data of 58 cases of BPI admitted and treated in our hospital during 23 years. Results The positive diagnosis rate was 51.1%(23/45) for single BUS examination ,but 70.0%(21/30) for two and more BUS examimations. The positive diagnosis rate was 65.0%(26/40) for single CT scanning, but 91.3%(21/23) for two and more CT scannings. Twenty-five cases(25/37,67.6%) with BPI were determined preoperatively, and 12 cases(12/37,32.4%)during (operation).Thirty-seven cases underwent operatiom, included grade I in 10cases、grade II 13cases、grade III 9cases、 grade IV 4cases and gradeV 1case. Twenty-one cases received nonoperative treatment, included 11 grade in I,7 grade II and 3 grade III. In the entire group, 6 cases died(10.4%).The mortality in the operation group was 16.2%(6/37).There were no deaths in the nonoperative group. The main cause of death was multiorgan failure(5/6,83.3%). There were 11(19.0%)cases of pancreatic pseudocyst after treatment in the entire group, included 3(3/37,8.1%) in operation group and 8(8/21,38.1%) in nonoperation group. Conclusions The diagnosis of BPI should combine the clinical findings with repeated BUS and CT scanning. Nonoperative treatment is a good choice for BPI without main pancreatic duct injury. Operative treatment is suitable for serious BPI and those with other intra-abdominal organ jnjury.

Objective To investigate the related risk factors of contrast-induced acute kidney injury (CI-AKI)after cerebrovascular intervention. Methods The clinical data of 5423 patients performed cerebrovascular angiography and intervention at the Departments of Neurology and Neurosurgery,Guangdong People′s Hospital from January 2005 to December 2013 were analyzed retrospectively. The patients who underwent cerebrovascular angiography and intervention were evaluated and screened. A clinical history database was established. All the selected patients used iodixanol,an isotonic contrast agent. The occurrence of CI-AKI was used as an endpoint. The patients were divided into either a CI-AKI group or a non CI-AKI group. A multivariate Logistic regression model was used to analyze the risk factors associated with the occurrence of CI-AKI. Results A total of 4164 patients were finally enrolled,including 137 had CI-AKI. The incidence of CI-AKI was 3. 3%. The results of multivariate Logistic regression showed that age >60 years (OR,1. 965,95%CI 1. 244-3. 136),baseline estimated glomerular filtration rate (eGFR)<60mL/(min·1. 73 m2)(OR,4. 163,95%CI 2. 422-5. 873),diabetes (OR,3. 140,95%CI 1. 983-3. 902),and anemia (OR,1. 524,95%CI 1. 226 -3. 253)were the influencing factors for occurring CI-AKI after cerebrovascular angiography and intervention. Conclusion Chronic kidney disease (eGFR<60 mL/[min·1. 73 m2 ]),diabetes,anemia,and old age (age >60 years)are the independent risk factors for occurring CI-AKI after cerebrovascular angiography and intervention.

Objective:To investigate the clinical effects of combined tissue flap transplantation in repairing giant chest wall defects.Methods:This study was a retrospective observational study. From August 2013 to December 2020, 31 patients with chest wall tumor or radiation ulcer after radical resection of chest wall tumor and conformed to the inclusion criteria were admitted to the Department of Breast Oncoplastic Surgery of Hunan Cancer Hospital, including 12 males and 19 females, aged 25-71 years. After resection of tumor or ulcer and wound debridement, the area of secondary chest wall defect was 300-600 cm 2 with length of 16-35 cm and width of 16-32 cm. According to the actual situation of the patients and the preoperative design, the chest wall defects were repaired with the flexible combination of perforator flaps and myocutaneous flaps from different donor sites, and the area of the combined tissue flap was 260-540 cm 2 with length of 20-30 cm and width of 13-20 cm. Free posteromedial thigh perforator flap+free anterolateral thigh myocutaneous flap were used in 2 patients, free deep inferior epigastric artery perforator flap+free anterolateral thigh myocutaneous flap were used in 5 patients, free deep inferior epigastric artery perforator flap+pedicled rectus abdominis myocutaneous flap+free anterolateral thigh myocutaneous flap were used in 7 patients, free deep inferior epigastric artery perforator flap+pedicled rectus abdominis myocutaneous flap+pedicled latissimus dorsi myocutaneous flap were used in 2 patients, and bilateral free anterolateral thigh myocutaneous flaps were used in 15 patients. For the remaining small area of superficial tissue defect after being repaired by combined tissue flaps, skin graft was used to repair or delayed local flap transfering was performed after the tissue flaps survived and edema subsided. The appropriate blood vessels in the donor and recipient sites were selected for anastomosis to reconstruct the blood supply of tissue flaps. The wounds in the donor sites of tissue flaps that can be directly sutured were sutured directly; for those that cannot be sutured directly, the skin grafting or delayed suture was performed. The anastomosis of blood vessels in the recipient sites, operation length, and postoperative hospital stay were recorded. The survivals of tissue flaps and skin grafts, the shape and texture of reconstructed chest wall, the wound healing, scar formation, and function of donor sites of tissue flaps, and the scar formation of the donor sites of skin grafts were observed after operation. Tumor recurrence and death of recurrent patients were followed up after operation. Results:The blood vessels in the recipient sites were anastomosed as follows: proximal internal thoracic vessels for 24 times, distal internal thoracic vessels for 12 times, trunk of thoracodorsal vessels for 4 times, anterior serratus branches of thoracodorsal vessels for 8 times, and thoracoacromial vessels for 12 times. The operation length was 6.0 to 8.5 hours, and the postoperative hospital stay was 9 to 21 days. Necrosis at the edge of partial tissue flaps occurred in 4 patients after operation, which healed after dressing change, and the tissue flaps and skin grafts of the other patients survived completely. The shape and texture of the reconstructed chest wall were good. Four patients had poor wound healing in the donor sites of abdominal tissue flaps, which healed after dressing change and local drainage. Only linear scar was left in the donor sites of all tissue flaps, and there was no obvious dysfunction in the donor sites of tissue flaps. Mild hypertrophic scar was left in the donor sites of skin grafts. During follow-up of 9 to 36 months after operation, 6 patients had tumor recurrence, and the recurrence time was 5 to 20 months after operation. After comprehensive treatment for patients with tumor recurrence, 3 patients died.Conclusions:Transplantation of combined tissue flaps in repairing the giant chest wall defects can shorten the time of total operation and hospital stay, and avoid multiple operations. After operation, patients had good chest wall appearance, with reduced tumor recurrence in patients with chest wall tumor.