Objective To evaluate the clinical application of gastric tube in radical operation for patients with esophageal or cardial carcinoma. Methods From January 2007 to June 2010,50 patients with esophageal or cardial carcinoma were enrolled. Based on surgical methods, they were divided into the gastric tube group (26 cases) and the traditional way group (24 cases). Among the gastric tube group, 21 patients had esophageal carcinoma,and the other 5 patients had cardial carcinoma,and 1 patient was treated with anastomosis in the left neck, 11 patients with anastomosis in upper aortic arch,9 patients with anastomosis in lower aortic arch and 5 cardial carcinoma patients underwent radical resection. Among the traditional way group, 20 patients had esophageal carcinoma,and the other 4 patients had cstdial carcinoma, 1 patient wastreated with anastomosis in the left neck, 11 patients with anastomosis in upper aortic arch, 8 patients with anastomosis in lower aortic arch and 4 cardial carcinoma patients underwent radical resection. The rate of anastomotic leakage, operation time, and length of stay in hospital of the two groups were observed. Results All surgeries were successfully performed. There was no anastomotic leakage case in the two groups, while there were 3 cases pulmonary infection and 1 case death in the traditional way group. There was no statistical difference in operation time [(175 ± 11) min vs. (182±6) min, t = 1.556, P = 0.072] and length of stay in hospital [(16.8 ±9.8) d vs.(17.0 ± 11.3) d,t = 1.495,P= 0.068] between the gastric tube group and the traditional way group. Conclusion Gastric tube has good value in clinical application with fewer complications and without prolonging operation and hospitalization time, which can surely ameliorate quality of life.

Objective To investigate the effects of diagnosis,surgical treatment of giant esophageal leiomyoma. Method The clinical data of 13 patients with giant esophageal leiomyoma treated by surgical operation from April 2001 to March 2009 were retrospectively analyzed. Results Twelve cases were preoperatively diagnosed by esophagogram and esophagoscopy, 1 case was misdiagnosed. Surgical resection was performed successfully in all 13 patients and no complications such as esophageal fistula and esophageal stenosis were found. Followed up 6 months to 3 years, no recurrence was found among 12 patients with giant esophageal leiomyoma, 1 case with esophageal leiomyosarcoma died of tumor recurrence 10 months after operation. Conclusions Surgical resection is the only effective treatment of giant esophageal leiomyoma.Enucleation of tumor extra-mucosa can be used in most cases. Esophagectomy is available for large tumor or malignant tumor. Treatment by endoscopic and thoracoscopic surgery has some limitations and the indications should be considered strictly.

Objective:To evaluate the efficacy of paroxetine on functional low fever. Methods:Using a randomized and placebo controlled trail, a total of 54 with functional low fever were randomized into paroxetine group and placebo group. In paroxetine group, 28 patients received oral paroxetine 1 tablet (20mg/tablet), one times a day for 8 weeks. There were 26 patients in the placebo. The criteria of assessing the therapeutic efficacy on functional low fever and Hamilton Depression Scale (HAMD; 17 items) were used to assess the therapeutic efficacy at the 4th and 8th weekend respectively.Results:After 8 weeks of treatment, the efficacy rate on functional low fever and antidepression were 78.6%, 82.1% in paroxetine group and 26.9%, 23.1% in the placebo group respectively. There was a significant difference between the two groups (P

Objective:To investigate the effect ofGuilong Kechuanning tablets combine with antibiotic drugs on pulmonary infection after chemotherapy in patients with lung cancer,so as to reduce the incidence of pulmonary infection in hospital.Methods:A total of 120 patients with lung cancer complicated with pulmonary infection,who underwent chemotherapy in Baoji Hospital of Traditional Chinese Medicine from August 2013 to August 2015,were selected and randomly divided into control group (n=60) and experiment group (n=60).The control group was treated with Ceftizoxime,based on which,the experiment group was added oral Guilong Kechuanning tablets.The course oftreatment of the two groups was 2 weeks.Inflammation indicators of the two groups were compared before and after treatment,and the clinical effect,hospitalized time,antifebrile time,time significantly reduced of cough and expectoration,disappearance time of lung rales and the pulmonary bacterial clearance rate were observed between the two groups.Results:The total effective rate (91.67％) of experiment group was significantly higher than that(73.33％) of control group (x2=13.121,P=0.004).Before treatment,there were no significant differences in WBC,CRP and NEUT levels between the two groups (P＞0.05);while after treatment,the levels of WBC,CRP and NEUT were all lower than those before treatment in both groups (all P＜0.05),and the levels of WBC,CRP and NEUT in the experiment group were lower than those in the control group(P＜0.05).After treatment,the bacterial clearance rate (99.09％) of the experiment group was significantly higher than that (86.94％) of the control group (x2=54.876,P=0.000).Conclusion:Guilong Kechuanning tablets combined with antibiotic drugs can effectively control the pulmonary infection after chemotherapy in the patients with lung cancer,and can improve the clinical symptoms and inflammatory reaction,which is worthy of clinical application.

Objective To study the influence of clinicopathologic characteristics and surgical treatment of gastric cancer on patients' survival rate.Methods From Apr.1994 to Aug.2005, the data of 759 gastric cancer patients concerning surgical treatment, pathological diagnosis and outcome were collected. Retrospective analysis of the results was made, 3-year and 5-year survival rates were calculated by Kaplan-Meier curve method, univariate analysis was done through Log-rank and multiple factors comparison through Cox regression analysis, and follow-up duration was 4-131 months.Results Single factor analysis indicated that age,tumor location,diameter of tumor, Borrmann type, type of histology, TNM stage, depth of infiltration, lymph node metastasis, liver metastasis, peritoneal dissemination, blood of transfusion during operation, extent of the radical cure of the tumor and excision techniques were significantly influential factors for the prognosis of patients. Cox regression analysis showed that tumor location, diameter of tumor,depth of infiltration, lymph node metastasis,liver metastasis, TNM stage, peritoneal dissemination, blood transfusion during operation, extend of the radical cure of the tumor and excision techniques were independent factors influencing the postoperative survival rate.Conclusion Independent factors influencing the postoperative survival rate include tumor location, diameter of tumor, lymph node metastasis, infiltration depth of the tumor, pathological classification, liver metastasis, peritoneal dissemination, and TNM stage, extent of the radical cure of the tumor, lymphanodectomy techniques and blood transfusion during operation are also important factors.

Objective To investigate the change in quality of life (QoL) following laparoscopic Roux-en-Y gastric bypass (LRYGB) for T2DM with obesity.Methods A total of 46 overweight T2DM cases (mean baseline BMI (32.7 ± 3.9) kg/m2) undergoing LRYGB were followed by QoL questionnaires (SF-36) before and after 6 and 12 months.Results The preoperative physical QoL scales (physical component summary,PCS) was significantly different from the general population(GP) scales (P ＜ 0.01),and the improvement in QoL was significant at 6 months postoperative and continued to consistently increase up to 12 months (P ＜ 0.01).For mental component summary (MCS),the preoperative scales was not significantly different from the GP scales,however,the 6 and 12 postoperative scales improved significantly (P ＜0.01).As for physical function,role physical,role emotion,the 6 (78 ± 8,76 ± 17,70 ± 23) and 12 months' (85 ± 7,82 ± 18,77 ± 18) postoperative scales were markedly higher than those in the preoperative controls (P ＜ 0.01),and there were no differences between the 12 month's postoperative scales and GP scales.The preoperative bodily pain,general health and social function (66 ± 14,55 ± 12,63 ±15) was different when compared with (76 ± 12,75 ±6,75 ± 13) at 6 months and (82 ±9,79 ±6,94 ±9) at 12 months (P ＜0.01).The preopertive mental health (71 ± 12) was not significantly different from GP scales,nor there were significant difference when compared with (71 ± 10) at 6 months and (73 ±8) at 12 months.Conclusions There were improvements in physical and mental QoL in T2DM patients with obesity after LRYGB.

Objective To use a simple bedside technique to verify the pathophysiological mechanism of pulmonary hypertension (PH) in different races. Method The Valsalva maneuver (VM) was performed in patients referred to a specialty PH clinic. The blood pressure response of patients to VM was in different fashions. The blood pressure (BP) was measured by using cuff and stethoscope. When the cuff was inflated to 15 mmHg above the systolic pressure, sound could be heard by auscultation during VM and when the cuff was deflated the sound disappeared over 3 heart beats which was considered as abnormal BP response, and less than 3 heart beats defined as normal BP response. The right heart catheterization in patients with PH as a part of the standard evaluation. Results This study included 84 patients with a mean age of (63 ± 16) years. Those with abnormal BP response to VM had higher pulmonary artery wedge pressure (PAWP) [(22.5±6.6) vs. (11.9±4.3) mmHg, P ＜0.0001] and lower pulmonary vascular resistance [(5.8 ± 4.0) vs. (8.1 ± 4.6 ) WU, P = 0.01]. Blood pressure response to VM did not correlate with mean pulmonary artery (PA) pressure [(46.2 ± 9.9) vs. (43.4 ±10.4) mmHg, P =0.20] or cardiac index (both 2.4 ± 0.6 L/min/m2). The abnormal BP response to VM had high sensitivity (89.4%), specificity (86.1%) and accuracy (86.9%) for determining PAWP＞ 15 mmHg.Conclusions BP response to Valsalva maneuver provides important information about left heart filling pressures in patients with PH.

Objective To investigate the efficacy of sunitinib in the treatment of patients with imatinibresistant advanced gastrointestinal stromal tumor (GIST).Methods The clinical data of 45 patients with imatinib-resistant advanced GIST who received the treatment of sunitinib (37.5 mg/d) at the First Affiliated Hospital of Sun Yat-Sen University from March 2008 to June 2012 were retrospectively analyzed.The mutation of c-kit and platelet-derived growth factor receptor α (PDGFRα) was detected,and the efficacy of imatinib was assessed after the treatment for 3 months,and factors influencing the survival were analysed.The survival rate was calculated using the Kaplan-Meier method,survival analysis was done using the one-way analysis of variance,and multivariate analysis was done using the COX regression model.Results The median time of treatment with sunitinib for the 45 patients was 11.0 months (range,4-37 months).The complete remission rate,partial response rate,rate of stabilized condition and disease progression rate were 15.6％ (7/45),8.9％ (4/45),46.7％ (21/45) and 28.9％ (13/45) after the treatment with sunitinib for 3 months.All the patients with clinical (imaging) complete remission received surgery for metastatic lesions or B-ultrasound guided ablation for single liver metastasis before the treatment with sunitinib.The most common grade 3 or 4 adverse reactions of sunitinib were hand-foot syndrome and anemia.C-kit and PDGFRα mutational analysis were carried out.C-kit exon 9 mutation was detected in 9 patients,c-kit exon 11 mutation in 21 patients,and no mutation was detected in 12 patients.The median progression-free survival time was 8.0 months (range,4.1-11.9 months),and the median overall survival time was 25.0 months (range,13.4-36.6 months).The results of univariate analysis showed that the primary lesion sites and mutational status of primary lesions were factors influencing the progression-free survival and overall survival (x2=5.967,6.622 ; 7.965,8.765,P ＜ 0.05).The results of multivariate analysis showed that only the mutational status of c-kit of primary lesions was the independent factor influencing the progression-free survival and overall survival (Wald =6.540,7.205,P ＜ 0.05).The progression-free survival and overall survival of patients with c-kit exon 9 mutation and patients with no gene mutation were significantly longer than patients with c-kit exon 11 mutation (x2 =7.965,8.765,P ＜ 0.05).Conclusion Sunitinib with a dosage of 37.5 mg/d could effectively treat patients with imatinib-resistant advanced GIST.A better survival is observed in patients with c-kit exon 9 mutation or with no gene mutation when compared with patients with c-kit exon 11 mutation.

Objective To observe the impact of laparoscopic Roux-en-Y gastric bypass on bowel habits in patients with type 2 diabetes mellitus(T2DM).Methods 70 cases of T2DM undergoing laparoscopic Roux-en-Y gastric bypass were studied.Changes in bowel habits, frequency and odor of flatulence, and social life were estimated at least 6 months after surgery using a self-administered questionnaire.Results 67.1%of the patients had normal bowel habit, 68.6%of patients maintained normal flatus before undergoing surgery, and visual ana-logue scale reveals bowel and flatus habit would cause little trouble on daily life.47.1% of patients maintained their normal bowel habit, and 45.7%of patients had loose stools and diarrhea after surgery.The number of pa-tients with loose stools significantly increased(28/70, 40% after surgery vs 5/70, 7.1% before surgery), with statistical difference( P<0.001) .42.9%patients believed that eating high-fat diet was related with loose stools (P<0.001).Patients with constipation decreased significantly after surgery(5/70, 7.1% vs the preoperative 16/70, 22.9%), with statistical difference(P=0.016).Visual analogue scale showed that 57.1% of patients thought their daily life and social activities were not affected(P=0.05).50%of patients considered an increase flatus, and 55.7%had malodorous flatus, which had statistical significance compared with those before surgery ( P<0.001) .A visual analogue scale showed that 60%of patients thought that this change would not affect their daily life and social activities( P=0.212) .Conclusions After laparoscopic Roux-en-Y gastric bypass surgery, some patients had loose stod, diarrhea, increased flatus and and offensive odor, but after proper treatment these changes do not affect their daily life and social activities.

0.99). DC: reproducibility was good for neutrophils, lymphocytes monocytes, eosinophils and basophils. Comparison of the results by instrument with manual for normal samples in morphology, the correlation was better for neutrophils, lymphocytes and eosinophils (r:0.968～0.983) ,good for monocytes(r=0.917), not good for basophils(r=0.659);The WBC scattergram would change and alarm flags would display when there are neutrophilic stab granulocytes, abnormal or atypical lymphocytes and immature cells in higher proportion.Conclusions The analyzer can be used to test blood cell parameters accurately and reliably. Its main performance indices accorded with the experimental requirements; The results were credible. It is necessary to check with microscopy for DC before reported when it were doubtted.