Objective To investigate the operational timing and manner for the digestive tract reconstruction after Hartmann procedure and the prevention for the postoperative complications in the patients with left colorectal cancer.Methods The data of twenty-four cases with digestive tract reconstruction were analysed retrospectively containing the cause of Hartmann procedure for left colorectal cancer,preoperative evaluation of the digestive tract reconstruction,operation timing,operation manner,postoperative complications and length of hospital stay and so on.Results Three of 24 patients gave up the digestive tract reconstruction due to the results of their distant metastasis detection in the preoperative evaluation.As a commonly manner of digestive tract reconstruction,rectum-sigmoid colon or sigmoid-descending colon end-end anastomosis was used for 17 patients.Meanwhile,ascending colon-sigmoid colon end-side anastomosis was used for 4 patients.The incidence of postoperative complications was 14.29 ％ (3/21),and the mean time of postoperative hospital stay was 10.5 days.Conclusions In patients undergoing Hartmann procedure for left colorectal cancer,adequate assessment of the tumor recurrence and metastasis is necessary.In addition,the optimal timing of surgery should be selected after completion of chemotherapy,and operational manner should be determined by the situation of intraoperative exploration.

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Objective To investigate the clinical application of early postoperative enteral nutrition in patients undergoing colon cancer operation.Methods 90 patients suffering from colon cancer were randomly divided into the enteral nutrition group,indwelling stomach tube group and the control group.The control group was given conventional treatment and the indwelling gastric tube group was received postoperative intermittent clamping of stomach tube and enteral nutrition.Moreover,patients in the enteral nutrition group were pulled out the tube on the first postoperative day while giving enteral nutrition.All patients were observed for exhaust defecation time,length of hospital stay postoperative and nutrition indicators.Results Exhaust defecation time,length of hospital stay postoperative had significant difference among three groups.Indwelling stomach tube group set minimum length of stay and first passage of flatus and defecation in the three groups [the enteral nutrition group:(50.07±11.59) h,(76.75±27.37) h,(10.1 1±1.57) d,the control group:(62.03±12.31) h,(90.67±25.64) h,(11.80±1.83) d,indwelling stomach tube group:(43.53±11.94) h,(61.17± 22.67) h,(8.70±1.53) d (P ＜ 0.05)].The levels of hemoglobin and plasma albumin one week after operation were statistically lower than pre-operation,while that the level of these nutrition indicators were higher in indwelling stomach tube group compare to control group (all P ＜ 0.05).The same result was observed between enteral nutrition group and control group.Whereas,the change of nutrition indicators between the enteral nutrition group and the control group was not statistical significant (P ＞ 0.05).Conclusion Indwelling stomach tube combined with enteral nutrition is a reasonable choice for patients after colonic cancer surgery.

OBJECTIVE: To observe the therapeutic effects of the conventional therapy plus Melitracen and Flupentixol in the treatment of functional dyspepsia(FD).METHODS: 320 FD cases were divided into gastrointestinal dyskinesis type(Type A,n=120 cases),ulceration type(Type B,n=100 cases),and nonspecific type(Type C,n=100 cases) based on their clinical symptoms.Patients of different clinical types were randomly assigned to receive conventional therapy alone or in combination with Melitracen and Flupentixol for 4 weeks.The curative effects were observed using gastrointestinal symptom rating scale(GSRS) and the total effective rate were computed.RESULTS: After treatment,the GSRS score of 3 different clinical types of FD in the combination therapy group versus the conventional therapy alone were 1.53?1.68 vs.3.10?1.78,2.02?1.63 vs.3.48?1.80 and 3.46?2.95 vs.5.18?3.21 respectively(P

ObjectiveTo assess malignant trophoblastic neoplasia with the standards of the clinical stage and prognostic factor scoring system. MethodsThrough assessing the high-risk factors except clinical stages for 223 patients before treatment according to International Federation of Gynecology and Obstetrics(FIGO) scoring system published in 2000, appropriate treatments were selected for the different patients. ResultsForty-three of 78 cases of choriocarcinomas were with high-risk factors, the other 35 cases were with low-risk factors; 7 of 145 cases of invasive moles were with high-risk factors and the others were with low-risk factors. The primary chemotherapy principle was that one agent was used for those patients with low-risk factors and two or multiple-agents were used for those patients with high-risk factors. Among all patients, the one-year, three-year and five-year survival rates were 98.6%,98.1% and 97.1% respectively. No patient died of drug toxicity or complication. ConclusionSelection of treatment approaches according to the prognostic assessment of malignant trophoblastic neoplasia could lead to promising survival rate with no uncurable complication and toxic effects.

OBJECTIVETo evaluate the results of Gynatron low dose rate (LDR) brachytherapy for cancer of uterine cervix.

METHODSFrom April 1980 to June 1986, 136 patients with uterine cervical carcinoma were given radical radiotherapy through LDR afterloading irradiation and (60)Co external irradiation, compared with those through radium and high dose rate (HDR) intracavitary therapy.

RESULTSAll patients except 5 were followed up for 15 years with a follow-up rate of 96.3% (131/136). The overall 10-year survival rate was 63.5%. The 10-year survival rates of stage II and III patients were 83.9% and 43.2%. The frequency of proctitis and cystitis were 12.5% (17/136) and 9.6% (13/136).

CONCLUSIONGynatron LDR system has achieved good results with tolerable complications including proctitis and cystitis which are more often than those of radium and less so than those of HDR.

Adult ; Aged ; Brachytherapy ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Neoplasm Staging ; Radiation Dosage ; Radiation Injuries ; Survival Rate ; Uterine Cervical Neoplasms ; mortality ; radiotherapy

Objective To observe the effects of glucagon like peptide-1 (GLP-1) analogues liraglutide on expressions of nitric oxide synthase (NOS) and cyclo-oxygen-ase (COX)2 in renal medulla of type 2 diabetes rats, and the mechanism of its lowering blood pressure and promoting excretion of water and salt in kidney. Methods Type 2 diabetes model rats were generated by high-fat and high-sugar feeding for 8 weeks followed by intraperitoneal injection of streptozotocin (STZ). Subse?quently, eighteen type 2 diabetes rats were divided into two groups: liraglutide treatment group (DMT) and diabetes group (DM). Twelve normal rats were divided into two groups: liraglutide treatment wild type group (WTT) and wild type group (WT). DMT and WTT groups were given liraglutide (200μg/kg) by subcutaneous injection, DM and WT groups were given equivalent normal saline by the same way. The levels of blood glucose and blood pressure were detected at 0, 2, 4 and 6 weeks after treatment in groups of rats. Samples of urine were collected for detecting ion concentrations (K+, Na+and Cl-) af?ter treatment for six weeks. Rats were sacrificed and blood samples were collected for detecting ion concentrations (K+, Na+and Cl-). The expression levels of NOS and COX2 mRNA and protein in renal medulla were detected by real-time PCR and Western blot assay. Results After treating with liraglutide, the values of blood glucose (F=5.933, P<0.05) and blood pres?
sure (F=22.070, P<0.05) were gradually decreased in DMT group. After treatment with liraglutide for 6 weeks, the values of blood glucose (mmol/L:12.78 ± 3.82 vs. 18.75 ± 1.68) and blood pressure (mmHg:119.98 ± 4.43 vs. 136.42 ± 4.48) were signifi?cantly decreased (P<0.05) in DMT group than those of DM group (P<0.05). There were no significant differences in the concentrations of K+, Na+and Cl-between the two groups. There were higher levels of K+(mmol/L:46.55 ± 6.43 vs. 33.13 ± 9.71), Na+(mmol/L:56.33±8.83 vs. 41.20±7.25) and Cl-(mmol/L:159.81±25.06 vs. 71.44±12.99) in urine in DMT group than those of DM group (P<0.05). The mRNA levels and protein expressions of NOS and COX2 in renal medulla were significant?ly increased in DMT group than those of DM group (P<0.05). Conclusion GLP-1 analogues liraglutide may enhance the expression of COX2 by increasing the expression of NOS to excrete water and salt, and decrease blood pressure.

Objective:To discuss the influence of bifid triple viable enteric-coated capsules on liver function and inflammatory fac-tor in the patients with non-alcoholic steatohepatitis ( NASH) . Methods:Totally 70 cases of patients with NASH were selected and di-vided into the control group and the observation group at random. The patients in the two groups were all given routine hepatoprotective therapy. The patients in the observation group were additionally given 420mg bifid triple viable enteric-coated capsules, three times a day for 4 weeks. Except for bifid triple viable enteric-coated capsules, the patients in the control group were given the same medical treatment as that in the observation group. The changes of liver function index, serum high sensitivity C reaction protein ( hs-CRP) , IL-6 and IL-8 levels in the two groups before and after the medical treatment were observed and the security was compared. Results:After the 4-week medical treatment, ALT, GGT, serum hs-CRP, IL-6 and IL-8 levels in the two groups were obviously declined than those before the treatment (P<0. 05 or P<0. 01), and the declining rate in the observation group was much higher than that in the control group (P<0. 05). Totally 6 and 4 cases of adverse drug reaction (ADR) respectively appeared in the observation group and the control group during the medical treatment with mild symptom, and the difference was without statistical significance (P>0. 05). Conclusion:Bifid triple viable enteric-coated capsules in the treatment of NASH can obviously reduce the serum hs-CRP, IL-6 and IL-8 levels, inhibit the intrahepatic inflammation and immunologic injury, and improve the liver function index with high security.

OBJECTIVETo evaluate the feasibility of surgical management for patients with locally advanced carcinomas of uterine cervix after radical radiation therapy who were prone to develop central recurrence.

METHODSThese 40 patients were treated by combined pre-operative radiotherapy with dose at point A of > 70 Gy in 30 patients, 60 approximately 70 Gy in 7, 50 approximately 59 Gy in 2 and 44 Gy in 1. The interval between radiation and surgery was 1 - 6 weeks. Extrafascial hysterectomy was performed in 15 patients, subradical hysterectomy in 23 and radical hysterectomy with pelvic lymphadenectomy in 2 cases.

RESULTSThese patients have been followed up for 1 - 8 years with 2 died of other diseases and 12 died of cancer. Eighteen of the 26 survivors have been followed up for more than 5 years. The 3- and 5-year survival rates were 74.9% and 66.8%. Half of the death occurred within the first year after treatment. The 2-year death rate was 9/12 (75.0%). Three patients suffered from long term complications after the treatment, but all were cured by conservative management.

CONCLUSIONThe combination of hysterectomy performed shortly after radical radiotherapy, ie, for patients with locally poor prognostic cervical carcinoma is reasonable and feasible.

Adult ; Cervix Uteri ; Combined Modality Therapy ; Female ; Humans ; Hysterectomy ; Middle Aged ; Neoplasm Staging ; Survival Rate ; Uterine Cervical Neoplasms ; mortality ; radiotherapy ; surgery

In order to clarify the chemical constituents in Qiliqiangxin capsule, a rapid ultra-performance liquid chromatography/orthogonal acceleration time-of-flight mass spectrometry (UPLC-Q-TOF/MS(E)) method was established. Forty peaks were identified on line using this method. The herbal sources of these peaks were assigned. The results implied that triterpenoid saponins, flavonoid glycosides, C21-steroids and phenolic acids were included in the main components of Qiliqiangxin capsule. The method is simple and rapid for elucidation of the constituents of Qiliqiangxin capsule and the results are useful for the quality control of Qiliqiangxin capsule.