Animals ; Disease Models, Animal ; Endothelin-1 ; metabolism ; Male ; Nitric Oxide ; metabolism ; Paraquat ; poisoning ; Rats ; Rats, Sprague-Dawley

The status of anesthesia and psychotropic substances use for cancer pain control was analyzed in 355 cancer patients in Huanggu District of Shenyang City.The results revealed that patients aged 60 and above accounted for 62.8％ of the total; the 5 leading diseases were lung cancer ( 132 cases,37.2％ ),colorectal cancer (34 cases,9.6％ ),liver cancer (33 cases,9.3％ ),stomach cancer ( 31cases,8.7％ ) and pancreatic cancer (20 cases,5.6％ ).There was no significant difference in constituent ratio of disease categories in the last 4 years ( x2 =18.75,P ＞ 0.05 ).The daily oral dose of morphine sulphate was 60 - 200 mg with an effective rate of 91.5％ (325/355). The side effects including constipation,nausea,vomiting and itching can be effectively reduced by prophylactic medication.

Objective To compare the effect of scapula lateral margin approach and standard Judet approach in the operative treatment of scapular fracture. Methods Medical data of 48 patients with scapular fractures from January 2006 to February 2013 were retrospectively analyzed. They were divided into the observation group and the control group according to the surgical approach. 27 patients in the observation group were treated with operative treatment through scapula lateral margin approach and 21 patients in the control group were treated with sur-gical treatment through standard Judet approach. Compared the clinical effects and complications of the patients in two groups. Results To operation time and intraoperative hemorrhage in the observation group were less than that of the control group (P<0. 05),fracture healing time was shorter than that of the control group after operation (P<0. 05). Six months after operation,the excellent rate of the observation group was higher than that of the control group. Scores of daily activities and myodynamia in the observation group were higher than that of the control group,the differences were statistically significant(P<0. 05),and there was no significant difference in the scores of pain and joint motion between the groups(P>0. 05). Conclusion Scapula lateral margin approach in treatment of scapular fracture has the advanta-ges of easy operation,small trauma,definite effect,little complication and it can be used as the preferred scheme of scapular fracture operative treatment.

Objective To study the effects of ? carotene on rat liver fibrosis induced by carbon tetrachloride (CCl 4). Methods ① After being treated with CCl 4 for 3 weeks to induce the experimental rat liver fibrosis, rats were treated with ? carotene 250 000 U/kg body weight by oral feeding twice a week. The normal and the CCl 4 control group were also set. ② The liver pathological and ultrastructual change were studied. The content of rat liver hydrooxylproline, the expression of ? 2 (Ⅰ) collagen RNA and transforming growth facter ? 1 (TGF ? 1) were studied at the same time. Results In the treatment group, the liver fibrosis scores were fewer significantly than those in the CCl 4 group ( P

Objective To analyze the factors influencing the prognosis of patients with bile duct carcinoma after resection. Methods The clinical data of 120 patients with bile duct carcinoma receiving resection in our hospital from 1980 to 2004 were collected retrospectively and clinicopathologic factors that might influence survival were analysed. A multiple factor analysis was performed through Cox proportional hazard model. Results The overall 1-year, 3-year and 5-year survival rates were 71.7%, 32.5% and 19.2% respectively. The single factor analysis showed that the major significant factors influencing survival of these patients were histological type of the lesions, lymph node metastasis, pancreatic infiltration, duodenal infiltration, resected surgical margin, perineural infiltration, peripheral vascular infiltration and depth of tumor infiltration (P

ObjectiveTo improve the diagnosis and treatment of primary duodenal carcinoma.MethodThe clinical data of 45 patients with primary carcinoma of the duodenum from 1987 to 2000 were analyzed retrospectively.ResultAccording to the site of cancer, tumors around, below and above the duodenal papilla accounted for 64%, 22% and 13% of all cases. The diagnosis rate of duodenoscopy was 71%(15/21). Pancreatoduodenectomy was performed in 22 cases, segmental duodenectomy in 2 cases, simple tumor resection in 3 cases, gastroenterostomy or choledochojejunostomy in 12 cases and simple laparotomy in 4 cases. In patients of curative resection, the postoperative 3 and 5 years′ survival rate was 41 4% and 23 6%. In those with gastroenterostomy or choledochojejunostomy, the average survival time was 6～15 months. All cases undergoing biopsy only died within six months.ConclusionPrimary duodenal carcinoma mainly occurs around duodenal papilla. The long time survival of Whipple′s procedure is favourable.

Objective To observe the effect of parecoxib sodium on relieving acute postoperative pain and inflammatory fac‐tors in laparoscopic cholecystectomy .Methods Totally 96 cases of laparoscopic cholecystectomy were randomly divided into 3 groups :experimental group (group A ,group B) and control group(group C) ,32 cases in each group .Group A received intravenous infusion of parecoxib sodium 40 mg (diluted to 5 mL ) intravenously at the induction of general anesthesia and intravenous injection of 5 mL normal saline 15 min before surgery .In group B ,anesthesia induction ,15 minutes before surgery were given 5 mL of normal saline ,parecoxib sodium 40 mg (diluted to 5 mL) intravenously .In group C ,5 mL of normal saline was given intravenously at the time of general anesthesia induction and 15 min before operation .The total number of PCA and the number of effective compres‐sions and VAS scores at 12 h postoperatively ,the levels of serum TNF‐α,IL‐6 and IL‐12 before operation ,immediately after opera‐tion ,at 2 ,12 ,24 h after operationwere compared .Results The PCA press times and effective press times of patients in group A within 12 hours after the operation were much less than those in group B ,C(all P<0 .05) .The VAS scores of group A at 1 ,2 ,4 ,6 , 8 and 12 h were lower than those in group B and C (P<0 .05) ,but there was no significant difference between group A and group B after 24 h(P>0 .05) .The changes of serum IL‐6 ,TNF‐αlevel in three groups of patients at the end of the operation ,2 ,12 ,24 h after operationwere :group A < group B < group C .While the changes of serum IL‐12 were:group A > group B > group C . Conclusion Parecoxib sodium has a good analgesic effect of laparoscopic cholecystectomy in the induction of general anesthesia than before the end of the operation and application effect is better ,and its analgesic effect can reduce the production of inflammato‐ry factors IL‐6 and TNF‐α,and increase the level of IL‐12 ,which is beneficial to postoperative recovery .

Data were analyzed from self-filled questionnaires for the students who took the elective course of general practice in China Medical University. 95.5% of students thought it was necessary to study general practice in the college. 0-10 was used to score the degree of how they want to choose general practice as a career, the median was 0 before they had the class and the median was 5 after the class (Wilcoxon rank test, P<0.01). But there were still some places need to be improved in terms of curriculum design, teaching methods and community practice. The General Practice teaching need to be innovated and the teaching mode should be different from the traditional one.

Objective To inquire the nutritional and immune status in patients with gallbladder carcinoma before and after radical cholecystectomy.Methods The nutritional and immune status in patients with gallbladder carcinoma were assessed in 1 week before surgery, and on 3rd day, 7th day, 14th day and 21st day after operation, respectively.Results All of the nutritional parameters but the serum level of iron, TIBC and transferrin recovered within 3 week after operation. Remarkable decrease of serum IgG, IgA, IgM and C3, C4 complement, IL-2, CD4, CD4/CD8 ratio, and the remarkable increase of serum SIL-2R and CD8(P＜0.01) on 3rd day after operation.Conclusion Adequate iron should be supplemented after the radical cholecystectomy for gallbladder carcinoma in the third postoperative week. Radical cholecystectomy with complete resection of the tumor and removal of lymph nodes played the important roles in the recovery of immune function.

OBJECTIVETo investigate the mid-term outcome of operation for thoracolumbar tuberculosis. METHODS : Twenty-eight patiens with thoracolumbar tuberculosis underwent one stage anterior debridement,interbody fusion with bone graft and posterior pedicle screw internal fixation treatment from July 2006 to July 2011. There were 17 males and 11 females. Total 17 patients had nerve injuries ,including 6 cases of grade B, 5 cases of grade C, 6 cases of grade D according to Frankel classification. The poisoning symptoms of tuberculosis and recovery of spinal function were observed. The bone fusion and recovery of [umbar function were evaluated.

RESULTSAll the patients were followed up ,and the duration ranged from 39 to 85 months (mean 57 months). The clinical symptoms were controlled gradually, and the thoracolumbar back pain was alleviated after operation. Among the 17 patients with complications of nerve injuries, 3 patients were improved from preoperative grade B to postoperative grade D, 3 patients were improved from preoperative grade B to postopertive E, 5 patients with preoperative grade C and 6 patients with preoperative D were almostly recovered to normal after operation. According to JOA scoring system for curative effect evaluation, the excellent and good rate at the 3rd month, the 1st year, the 3rd year and the 5th year after operation were 67.86% ,82.14% ,85.71% ,89.29% and 91.30% respectively. The results at the 6th month and the 1st year had no statistical differences compared to the results at the 3rd month (P > 0.05); but the results at the 3rd year and the 5th year were better than that at 3 months after operation (P < 0.05); and the results between 3 yesrs and 5 years after operation had no statistical differences (P < O.05). The degeneration of adjacent segments were evaluated according to the California University (Universith of California at Los Angeles , UCLA) score. The degeneration rate was 53.57% (15/28) at the 3rd year after surgery, which was better than that before surgery. Twenty-three patients were followed up for 5 years ,and the degeneration rate was 86.96% (20/23) ,which was better than those of before surgery and 3 years after surgery.

CONCLUSIONThe surgical treatment for thoracolumbar spinal tuberculosis can achieve the thorough debridement, reconstruction of spinal stability, recovery of lumbar function and promote the functional recovery of the spinal cord, which is an effective method of treatment. However, the mid term follow-up showed that more severe degenerative changes were found in the postoperative adjacent segment.

Adult ; Aged ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Spinal Fusion ; methods ; Thoracic Vertebrae ; surgery ; Tuberculosis, Spinal ; physiopathology ; surgery