Objective To investigate associate chief physician the clinical effects of Jiawei Jinhuang powder with fumigation -washing on hand -foot skin reaction(HFSR)caused by sorafenib.Methods 48 patients who received sorafenib were randomly divided into two groups.24 patients in the treatment group were administered Jiawei Jinhuang powder with fumigation -washing,and another 24 patients in the control group were given VitB6 orally.After 8 weeks,the incidence and grade of HFSR were statistically studied between the two groups.Results There was significant differences of hand -foot reaction between the treatment group and the control group (incidence rate:29.17% vs 70.83%,χ2 =8.375,P <0.05;The incidence rate of Ⅱ -Ⅲ:12.50% vs 33.33%,P <0.05 ). Conclusion Jiawei Jinhuang powder with fumigation -washing could remarkably reduce the incidence rate of HFSR caused by sorafenib.

Objective To evaluate ipsilateral hepatic blood flow exclusion in combination with liver hanging manoeuvre for hepatectomy. Methods From Jul 2007 to Feb 2008, 14 cases underwent hemihepatectomy under ipsilateral hepatic blood inflow and draining hepatic vein exclusion in combination with liver hanging manoeuvre for liver malignancier or ligating ligating vessels, portal vein branch and major hepatic vein to set up a tunnel at the interior vena cava. Results Small laceration on fight hepatic vein was encountered in 2 cases during the operation and managed by suturing. There was no intraoperative injury on inferior vena cava or short hepatic veins. Blood loss ranged from 100 ml to 600 ml with a mean of 280 ml. Postoperative pleural effusion was cured conservatively in 3 cases and paracentes was needed in one case. There was no severe postoperative hepatorenal dysfunction, biliary fistula, infection or other major complications. The operative mortality was nil. Conclusion For regular major hepatectomy, ipsilateral hepatic blood flow exclusion plus liver hanging manoeuvre has the advantage of less blood loss and protecting contralateral hemiliver from reporfusion injuries.

Objective To explore the application of hepatic artery ligation,portal vein and hepatic vein ligation for hemihepatectomy of the patients with liver neoplasms.Methods Hepatic artery,portal vein and hepatic vein were ligated.We isolated a gap between foreside of interior vena cava and the back of hepatic parenchymal to build tunnel,and then preseted blocker to block.Results A Total of 10 performed were completed and they recovered well after operation without any complications.Conclusion Selective hepatic blood inflow occlusion through ligating or preseting blocker for hemihepatectomies has many advantages such as reducing bleeding,avoiding damages to main vessels,keeping from injury of remnant liver reperfusion and preventing latrogenic tumbr disseminating.

Objective To investigate the effect of local application of triamcinolone acetonide in promoting wound healing and recurrence after granulomatous lobular mastitis (GLM) operation. Methods The clinical data of 55 GLM patients with the diameter > 5 cm were retrospectively analyzed, and all patients treated with incision drainage to breast abscess and removal of inflammatory lesions. Thirty - one patients were treated with routine dressing change after operation (control group), and 24 patients were treated with routine dressing change and triamcinolone acetonide injection after operation (experiment group). The wound dressing time, recovery rate and recurrence rate were compared between 2 groups, and hormone related adverse reaction of experiment group was observed. Results The wound dressing time in experiment group was significantly shorter than that in control group:(58 ± 19) d vs. (71 ±25) d, and there was statistical difference (P<0.05). There were no statistical differences in the recovery rate and recurrence rate between experiment group and control group:91.7%(22/24) vs. 83.9%(26/31) and 9.1%(2/22) vs. 15.4% (4/26), P>0.05. The patients of experiment group did not have the hormone related adverse reaction. Conclusions The local application of triamcinolone acetonide after GLM operation can accelerate the wound healing, and it may also contribute to higher recovery rate and lower recurrence rate.

Objective To explore the relationship between cognitive fusion and the state of anxiety and depression of perinatal women and to provide empirical evidences for acceptance and commitment therapy in mental treatment of anxiety and depression in perinatal women.Methods 309 perinatal women collected by cluster random sampling were assessed with self-made general information questionnaire,Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale (SDS) and Cognitive Fusion Questionnaire (CFQ) in predelivcry period and 3-7 days after childbirth respectively.Results (1) CFQ scores in the predelivery or postpartum anxiety group ((32.18±10.78),(31.54±10.30))were higher than that in the normal group((21.49±9.56),(20.84±9.82)),and the difference was statistically significant (t=-8.26,-8.22;all P=0.000);CFQ scores in the predelivery or postpartum depression group ((26.74 ±11.76),(26.84 ± 12.11)) were higher than that in the normal group((23.06± 10.33),(21.79±9.90)),and the difference was statistically significant(t=-2.76,-3.71;P=0.006,0.000).(2)It was found that the predelivery or postpartum CFQ scores were positively associated with the SAS scores of predelivery periods and postpartum periods respectively(r=0.51,0.45,0.50,0.55;P=0.000);the predelivery or postpartum CFQ scores were positively associated with the SDS scores of predelive1y periods and postpartum periods respectively (r =0.26,0.31,0.21,0.38;P =0.000).(3) Hierarchical multiple regression analyses were then conducted.The predelivery CFQ had a significant effect on postpartum SAS(△R 2=0.02,P=0.006)and postpartum SDS respectively(△R 2=0.02,P=0.006),and the regression equations were statistically significant.Conclusion A function to predict the occurrence of matemal postpartum anxiety and depression is obtained from the cognitive fusion which is attributed to the risk of maternal postpartum anxiety and depression.

Objective:To investigate and summarize the procedures of direct-covedng pancreaticojejunostomy with remaining jejunal mucosa in pancreaticoduodenectomy and to analyze the incidence of pancreatic fistula and other postoperative complications.Methods:A total of 21 patients were treated with pancreaticoduodenectomy between May 2005 and June 2009.During the surgery,we dissected 3cm long remnant of the pancreas out of ambient tissues.Near the 2.0-3.0cm of the pancreatic remnant.we fixed partial posterior wall with the full-thickness jejunum without mucosa destroyed by interrupted suture,and then pushed the remnant into the jejunum and fixed the anterior wall.Finally,at the 1.0cm of the panceratic remnant,we binded the iejunum to surround the pancreas through 7-silk sutures.Results:One case was treated with secondary surgery due to bleeding of the pancreatic remnant.The other patients recovered smoothly without pancreatic fistula or other complications.Conclusion:Postoperative pancreatic fistula is related to the texture of pancreas,method of pancreaticojejunostomy,surgical skills and perioperative treatment.Compared with other types of pancreaticojejunostomy,direct-covering pancreaticojejunostomy with remaining jejunal mucosa is simpler.

Objective To compare the short-term quality of life after total gastrectomy in patients with gastric cancer with three recontructive methods of stamoch storage function. Methods Totally 62 cases underwent jejunal interposition afar total gastrectomy from March 2000 to December 2007. Patients were divided into three groups according to the procedures: functional jejunal interposition (FJI-type) group ( n = 23 ), modified jejunal interposition ( Ⅲ -type) group ( n = 20), and P-type jejunal interposition (P-type) group (n = 19). In each group,the patients' general conditions, the nutritional status at month 3 and 12, and gastrointestinal symptoms were evaluated. Results The durations of procedures were significantly different among three groups (P ＜0. 01 ). The intraoperative bleeding volume, postoperative complications, and food intake of each meal at month 3 were not significantly different ( P ＞ 0. 05 ). Compared with the data at month 3, the levels of hemoglobin and serum calcium at month 12 were significantly higher in all three groups (P ＜ 0. 01 ). Compared to the level at month 3, the level of serum albumin at month 12 significantly increased in FJI-type group (P ＜ 0. 05 ) but showed not significant difference in Ⅲ-type group and P-type group ( P ＞ 0. 05 ). The incidence of reflux esophagitis in three groups and the comparative parameters among the three groups at month 12 were not significantly different ( P ＞ 0. 05 ). Conclusions The jejunal interpositions after total gastrectomy will not increase the complexity and risk of the surgical procedure. In fact, they can reduce the reflux esophagitis and improve quality of life by keeping the storage function and restoring food passage through the duodenum. FJI-type is simpler than the other two types, and P-type is preferred for operations that need to open the pectoral cavity.

Objective To assess the efficacy and significance of hepatic protection by observing the incidence of liver injury in patients with chemotherapy who were treated and untreated with traditional Chinese medicine (TCM).Methods A retrospective analysis was applied to compare the changes in liver function tests and incidence rate of drug -induced liver injury between the observation group (treated with TCM)and the control group (untreated with TCM)after chemotherapy.Results The incidence rates of liver injury in the observation group and control group was 4.7%(2 /43)and 23.9%(11 /46)respectively.The difference between the two groups was statisti-cally significant(χ2 =6.611,P =0.01).The ALT,AST,TBIL,ALP between the two groups had statistically signifi-cant differences after treatment (all P <0.05).Conclusion Using TCMin hepatic protection can improve liver tests and reduce the incidence of drug -induced liver injury from chemotherapy.

Objective To compare the incidence of recurrent laryngeal nerve (RLN) injury in thyroidectomy with or without exposing RLN. Methods Records of 704 patients in our hospital undergoing thyroidectomy were retrospectively studied, among whom 472 patients underwent thyroidectomy with RLN being exposed and 232 underwent thyroidectomy without RLN being exposed. Results The incidence of RLN temporary damage and permanent damage in RLN exposed group was 1.49% (7/472) and 0, while it was 6. 03% (14/232)and 2. 16%(5/232) in the non-exposed group. There was statistic difference between the two groups in terms of permanent injury incidence and operation duration (P ＜ 0. 01). Conclusions Although the operation duration was prolonged in RLN exposure group, RLN exposure during operation is very helpful to prevent recurrent laryngeal nerve injury. Therefore, it's necessary to expose RLN during operation in sub-total thyroidectomy and total thyroidectomy.

Objective To investigate the pancreaticoenterostomy technique using end to end anastomosis of remianing pancreas and jejunum with jejunum mucus preserved. Methods 28 cases underwent pancreatectomy were observed and analyzed from May 2005 to August 2009. There were 26 cases underwent duodenopancreatectomy and 2 cases underwent the pancreatectomy of pancreas body and tail. All cases used the end to end pancreaticoenterostomy, remnant pancreas was directly anastomosed with jejunum without destroy of jejunal mucosa. During the operation, 2.0 cm～2.5 cm long remnant of pancreas was pulled into jejunum without mucosa destroyed. Then, the cut end of the jejunum was fixed on the pancreatic remnant correspondingly by interrupted suture. Finally, a 7-silk suture was used to bind the jejunum and the pancreatic remnant together 1 cm away from the cut surface of the pancreatic remnant. Results 1 case underwent operated again due to bleeding of the pancreatic remnant. 28 patients recovered and discharged from hospital without having the complication of pancreatic fistula. Conclusions Because of the complicated suturation methods, the conventional pancreaticoenterostomy consumes more time. But it still has rather high incidence of pancreatic fistula.The new pancreaticoenterostomy which we used can shorten the operating time and integrity and binding stomas. It is effective to lower the incidence of pancreatic fistula.