Objective To evaluate the CT manifestation of pancreatic carcinoma proved by patholoical results. Methods The patients were supine. Both plain and three-phase dynamic contrast-enhanced CT scan were performed. 100 ml of Ominipaque was injected at a rate of 2～4ml/s, with 5~10 mm slice thickness and interval. Results CT scanning clearly showed the direct signs or indirect signs of pancreatic carcinomal, which include: pancreatic mass, obstructive dilatation of the bile duct and pancreatic duct, the visualization of the abnormal large peripancreatic vessels, lymph node metastasis, etc. Conclusion Plain CT scanning shows clearly manifestation of pancreatic carcinomal and the surrounding tissue, and three-phase dynamic contrast-enhanced CT scan can clearly display the tiny changes of pancreatic parenchyma. Therefore it is valuable for diagnosis of pancreatic carcinomal.

Senior citizens have many diseases related to blood stasis, which was often overlooked by clinicians, and thus affected the treatment of the disease. Through analyzing and summarizing of related literature in recent five years of senile constipation treated from blood stasis, we found that the blood stasis is closely linked to senile constipation. Blood stasis in the gut forms constipation, and constipation with the passing of time forms blood stasis in returen. Blood stasis and constipation often influence each other.

Objective To study the effects of modified Sanxiang Decoction on gastrointestinal transmission function of patients with functional bloating (FB). Methods Sixty cases of FB patients were randomly divided into treatment group (40 cases) and control group (20 cases). Treatment group was given modified Sanxiang Decoction, while control group was given placebo granules, one bag each time. Twice a day, taking it after mixing it with water. Gastrointestinal symptoms, 48 h GITT, and adverse reactions were recorded. Results There was statistical significance in TCM symptom scores between before and after treatment in the two groups (P<0.05). After treatment, the total score of abdominal distension, belching, anorexia and TCM symptoms of the treatment group were lower than the control group, with statistical significance (P=0.000, 0.000, 0.010, 0.003). The total effective rate was 82%(33/40) in the treatment group, 30%(6/20) in thecontrol group;the treatment group was better than the control group (P<0.05). A total of 30 patients completed gastrointestinal transit test, of which delayed 48 h GITT pass rate accounted for 54% (16/30). Compared with the control group, the 48 h GITT of the treatment group was more obviously improved than that of the control group with statistical significance (P=0.002). There were no significant adverse reactions in both groups. Conclusion Most of FB patients have the problem of abnormal intestinal motility. Modified Sanxiang Decoction can improve the symptoms of patients with FB, promote gastrointestinal motility, and improve intestinal transmission function.

Medicine, Chinese Traditional ; methods ; trends

Coronary Disease ; diagnosis ; Humans ; Medicine, Chinese Traditional ; methods

Objective To observe the effect and the influence on carotid atherosclerotic plaques,C-reactive protein,lipids,coagulation of atorvastatin and xuesaitong injection in the treatment of elderly patients with acute cere-bral infarction.Methods 100 elderly patients with acute cerebral infarction met inclusion criteria were randomly divided into 50 cases of the observation group and 50 cases of the control group,the control group were given conven-tional therapy,the observation group were given atorvastatin and xuesaitong injection on the basis of the control group, atorvastatin calcium 20mg/d,qd,Xuesetong 400mg/times,qd,both groups had been treated for 3 weeks for a course of treatment,the serum C-reactive protein,serum lipids and coagulation parameters were detected before and after treat-ment,the IMT and carotid plaque area were determined by color Doppler ultrasonography,NIHSS score were calculat-ed.Results The PT,APTT,CRP,IMT,carotid plaque area,NIHSS score of the observation group were (18.07 ± 2.24)s,(36.59 ±3.52)s,(11.2 ±3.6)mg/L,(0.57 ±0.16)mm,(1.36 ±0.32)cm2,(9.31 ±2.06)point,the observation group were (15.24 ±1.88) s,(31.84 ±2.55) s,(26.4 ±6.7) mg/L,(0.68 ±0.13) mm,(1.55 ± 0.37)cm2,(15.86 ±2.25)point,both groups were significantly improved after treatment than before treatment (all P<0.05),The total efficiency of observation group and control group were 96%and 72%,the observation group was significantly higher than those of the control group, the difference was statistically significant (χ2 =10.867, P <0.01).Conclusion The method containing atorvastatin and Xuesaitong injection can effectively regulate blood lipid levels and blood coagulation,inhibit vascular inflammation,Stabilizing or reversing carotid artery plaque,reduce carot-id intima-media thickness,can inhibit thrombosis and progress,improve cerebral hypoxia and ischemia parts neurologi-cal defects,improve clinical outcomes,significantly improved clinical outcomes.

BACKGROUND:Traditional total knee arthroplasty adopts medial parapatel ar approach, which induces severe trauma, requires long-term rehabilitation, and interferes the end point of quadriceps femoral tendon on superior patel ar pole. Total knee arthroplasty by subvastus approach has no impact on the knee-extension equipment, but it cannot provide sufficient exposure of surgical field and can induce damage to femoral muscle, so its application and safety need further exploration.
OBJECTIVE:To explore clinical effect of total knee arthroplasty by subvastus approach and medial parapatel ar approach.
METHODS:A total of 78 patients with 82 knees who were candidates for total knee arthroplasty were randomly divided into two groups. Treatment group (39 cases;41 knees) was given subvastus approach and control group (39 cases;41 knees) was given median parapatel ar approach. The knee function, range-of-motion of knee joint and complications after total knee arthroplasty were observed and compared.
RESULTS AND CONCLUSION:Compared with control group, the operation time in treatment group was significantly increased, while the postoperative wound drainage, straight leg raising time and walking time were obviously reduced (P<0.05). The scores of HSS before surgery and 12 weeks after surgery were not significantly different between the two groups (P>0.05), while at 1 and 6 weeks after surgery the scores in treatment group were significantly higher than those in control group (P<0.05). The range-of-motion of knee joint and MMT rank for quadriceps muscle were significantly improved in two groups after treatment (P<0.05), and those indicators in treatment group were more significant than the control group (P<0.05). The incidences of complications in treatment group and control group were 2.6%and 15.4%, respectively, with statistical y significant difference (P<0.05). The total knee arthroplasty by subvastus approach has less impact on the extensor mechanism, improves the recovery of knee function and range-of-motion of knee joint, and reduces the incidence of complications.

Objective:To explore the combined application effect of failure mode and effect analysis (FMEA) and root cause analysis (RCA) in IV infusion risk management of pediatric outpatient so as to enhance the quality of care and ensure the safety of outpatients.Methods: For this exploration, a special analysis team was established and the flowchart was drawn up, and the potential failure modes were listed by using FMEA. And the RCA was used to analyze and evaluate the key mode in these potential failure modes so as to find the root cause might affect the safety of IV infusion, and then the improved measures were implemented and the effects of new measurement were evaluated. Results:After implemented the improved measures, the risk of top 4 risk priority number (RPN) in intravenous infusion flow decreased obviously. For the transfusion management, patients' satisfaction increased from 78.09% to 95.03% (P<0.05), and nurses' satisfaction increased from 83.79% to 97.80%(P<0.05).Conclusion: The combined application of FMEA and RCA in the IV infusion risk management of pediatric outpatient can effectively reduce the occurrence of risk events, reduce nursing complaints and disputes, and enhance the quality of nursing care.

Objective To improve the level of diagnosis and treatment of acute appendicitis in leukemia.Method 17 cases of acute appendicitis in leukemia that were treated from 1980 to 2002 were reviewed.Result All 17 cases underwent appendectomy,16 survived the immediate postoperative period,only one died.Conclusions Leukemia were predisposed to acute appendicitis than normal during chemotherapy period and our experience supports the surgical management of acute appendicitis in leukemia.Because immunosuppression and thrombocytopenia were the main causes of additional surgical dangers,relative methods should be applied in perioperation period.The complications of incision were common,so the observation of incision should be emphasized.

0.05).Anastomotic inflammatory reaction occurred in 2 patients(3.2%) in BAR group and 13 patients(20.0%) in manual group.The difference was statistically significant(P