Objective To summarize the experience of seven-step nursing method used in the care to patients with spontaneous esophageal rupture.Method Twenty patients with spontaneous esophageal rupture were treated with the seven-step nursing method. Results All patients were discharged after cure.The follow-ups found no complications of esophageal stenosis,reflux esophagitis and chronic empyema.Conclusion The seven-step nursing method used for caring the patients with spontaneous esophageal rupture can promote the recovery of patients and reduce their suffering.

Objective To observe the relationship between carotid stiffness and coronary angiography in elderly patients of coronary heart disease (CHD) complicated with hypertension.Methods The patients were divided into three groups.Coronary angiography was performed in 40 elderly patients of CHD complicated with hypertension.The carotid stiffness was measured by ultrasound.Results There were significant differences on hypertension in arterial stain,arterial distensibility and arterial stiffness.There was significant correlation between coronary angiography score and carotid stiffness among three groups(r=-0.353,-0.125,0.376,P<0.01).Conclusion There is close relationship between carotid atherosclerosis and coronary atherosclerosis in elderly patients of CHD complicated with hypertension.

Objective To investigate the relationship between carotid stiffness and coronary angiography in elderly patients with coronary heart disease(CHD). Methods Thirty-five elderly patients with CHD who underwent coronary angiography were enrolled in the study. The carotid stiffness was measured by ultrasound, the results were compared with those in hypertension group,hyperlipemia group and healthy elderly group. Results There were significant differences in carotid tensity (8.15 ± 1.54), arteriectasis ( 0.34 ± 0.07 ) and carotid stiffness ( 640.51 ± 150.98 ) of elderly patients with CHD compared to other groups (all P＜0.05 or P ＜ 0. 01 ). There was significant correlation between coronary angiography score and carotid stiffness in elderly patients of CHD(P＜0.05 or P＜0.01). Conclusions There is close relationship between carotid atherosclerosis and coronary atherosclerosis in elderly patients with CHD.

Ht-toxin was extracted by singular or mixed organic solvents after solid and liquid culturing Helminthosporium turcicum in vitro, and pathogenic activity and toxicity of these extracts were assayed using root growth inhibition, isolated root cap cell death and isolated leaf soaking bioassays. Several best singular and mixed organic solvents have been screened for extracting Ht-toxin in vitro and this may lay foundation for its purification and structure analysis.

Objective To evaluate the effects of clinical nursing path on respiratory function exercise of patients with esophageal carcinoma.Methods A total of 60 postoperative patients with esophageal cancer were divided into the observation group and the control group according to the time period with 30 cases in each group.The observation group was given the clinical nursing pathway care in their respiratory exercise,and the control group routine nursing before and after the operation. The two groups were compared in terms of blood gas analysis implement on 5th day,pulmonary function on 10 th day and pulmonary complications after operation.Results PaO2,VC,MVV,FEV1 and FEV1/FVC in the observation group were much better than those of the control group.The incidence of complications was obviously lower than that of the control group(P<0.05). Conclusion Clinical nursing path used in respiratory function training of perioperative patients is effective for the improvement of pulmonary function and reduction of postoperative complications.

Crohn's disease(CD)is a chronic non-specific intestinal inflammatory disease,and the incidence of perianal fistulizing CD(PFCD)is 17%-43%. Non-cutting setons is the first choice for surgical treatment of PFCD. Some new surgical methods are effective for specific types of PFCD,however,the efficacy of most new methods remains to be confirmed by further studies. The multidisciplinary team(MDT)mode has become a new direction of PFCD surgery. This article reviewed the advances in surgical treatment of PFCD.

Objective:To investigate the application value of barbed suture in reinforcing anastomosis during laparoscopic radical resection of rectal cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 215 patients with rectal cancer who underwent laparoscopic radical resection in the Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine from March 2016 to December 2018 were collected. There were 122 males and 93 females, aged (62.3±0.7)years, with a range from 20 to 75 years. Of 215 patients, 86 patients undergoing laparoscopic radical resection of rectal cancer with barbed suture for anastomosis were allocated into barbed suture group, and 129 patients undergoing laparoscopic radical resection of rectal cancer without reinforced anastomosis were allocated into traditional group, respectively. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) follow-up. Follow-up using outpatient examination and telephone interview was performed to detect postoperative complications, anastomotic healing and patency of patients up to May 2019. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were described as M (range). Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Ordinal data were analyzed using the Friedman non-parametric test. Results:(1) Intraoperative situations: patients in the two groups underwent laparoscopic radical resection of rectal cancer successfully, without conversion to open laparotomy. The volume of intraoperative blood loss, operation time, distance between the anastomosis and dentate line, length of auxiliary incision of the barbed suture group were (127±9)mL, (160.2±3.8)minutes, (3.56±0.15)cm, (4.12±0.11)cm, respectively, versus (114±6)mL, (128.9±2.4)minutes, (3.67±0.12)cm, (4.25±0.09)cm of the traditional group. There was a significant difference in the operation time between the two groups ( t=7.33, P<0.05), but no significant difference in the other indicators between the two groups ( t=1.32, 0.61, 0.94, P>0.05). (2) Postoperative situations: the time to first flatus after surgery and duration of postoperative hospital stay of the barbed suture group were (72.5±2.2)hours and (8.1±0.5)days, respectively, versus (76.2±1.7)hours and (8.0±0.5)days of the traditional group, showing no significant difference between the two groups ( t=1.33, 0.87, P>0.05). (3) Follow-up: 215 patients were followed up for 6-12 months, with a median follow-up time of 8 months. In the barbed suture group, 2 patients had postoperative anastomotic leakage, 5 had urinary retention, 6 had incision infection, 4 had intestinal obstruction, 3 had bowel dysfunction in 6 months after operation. In the traditional group, 13 patients had postoperative anastomotic leakage, 15 had urinary retention, 11 had incision infection, 8 had intestinal obstruction, 9 had bowel dysfunction in 6 months after operation. There was a significant difference in the anastomotic leakage between the two groups ( t=4.77, P<0.05), but no significant difference in the urinary retention, incision infection, intestinal obstruction, bowel dysfunction in 6 months after operation between the two groups ( t=2.07, 0.17, 0.22, 1.26, P>0.05). Patients in the two groups showed unobstructed intestinal tract on enteroscopy. Conclusion:The barbed suture for reinforcing anastomosis in radical resection of rectal cancer is safe and feasible, which can reduce the incidence of anastomotic leakage.