Purpose:To study the surgical treatment of the cases with cancer of esophageal and gastroesophageal conjunction by thoracotomy. Methods:Total of 43 patients were selected. Squamous cell carcinoma of esophagus were found in 26 patients,among them 23 received radical resection and 3 failed due to massive invasion of the tumor.The rest were diagnosed as adeno carcinoma of cardia,13 of them undergoing radical resection and 4 failed.Results:The results of the whole group were surgical resection 93.0 %,complication 41.9% and operative mortality 4.7%.Conclusions:The authors conclude that selecting patients with precise indications as well as treating complication correctly was very important for surgical procedures of elderly patients.The pre-operative preparation,nutrition and approach for resection are also important.

Objective To study the effect and mechanism of intensive insulin therapy on stress hyperglycemia in rabbits with sepsis. Methods Rabbits were subjected to cecal ligation plus puncture (CLP) to reproduce sepsis. Sixty rabbits were randomly divided into three groups, control group (n=12), CLP group, and intensive insulin therapy group (n=24). The following parameters were measured with the method indicated in parentheses: blood glucose (blood sugar meter), glucose transporter 4 (GluT4) mRNA expression (RT-PCR), GluT4 protein level (Western blot). Results Compare with the control group, the level of blood glucose was significantly increased at 2h after CLP and reached its peak 12h after CLP (P

Objective To investigate the effects of tension free herniorrhaphy on endocrine functions of patients with inguinal hernia. Methods One hundred and twenty seven patients were randomly divided into tension free group( n =65) and conventional group ( n =62). The mean ages of tension free group and conventional group were(51.8?14) year and(48.4?12) year respectively. There were 52 indirect hernias and 13 direct hernias in tension free group. There were 51 indirect hernias and 11 direct hernias in conventional group. Bassini repair was used in conventional group. Peripheral blood samples were obtained preoperatively and 3 h, 24 h after operation for measuring the levels of cortisol, T3, TSH, insuline, C peptide and and glucose. The data were analysed through t test. Results The levels of cortisol, C peptide and glucose in conventional group were remarkably higher ( P

Objective To investigate the intra-and postoperative course of patients undergoing laparoscopic liver resections under intermittent total pedicle occlusion (IPO),hemihepatic vascular occlusion (HVO),and selective vascular occlusion(SVO).Methods Retrospective analysis the data of 41 cases of laparoscopic liver resection were conducted in three groups of patients under different occlusion methods,including 15 cases of intermittent total pedicle occlusion (IPO),12 cases of hemihepatic vascular occlusion (HVO) and 14 cases of selective vascular occlusion (SVO).Intraoperation blood loss,operation time,conversion to open operation,changes in postoperative liver function,hospital stays and complications were compared among the three methods.Results There was no operative death in any of the 41 patients.There was no conversion to open surgery.Generally,there was no significant difference among the three groups in blood loss,clamping time or operative time.Ten patients had postoperative complication and all were cured.The effect on liver function for Gro-HVO and Gro-SVO was significantly less severe than that for Gro-IPO (P ＜ 0.05) after operation.Conclusions Both HVO and SVO are feasible and safe in laparoscopic hepatectomy(LH),and have advantage in reducing liver remnant ischemia injury and modality rate over IPO.HVO is easy to do for left lateral lobe or resection of the left half of the liver.SVO is suitable for right lobe resection.

The therapeutic effects of intensive insulin therapy in treatment of traumatic shock combined with multiple organ dysfunction syndrome (MODS) were investigated. A total of 114 patients with traumatic shock combined with MODS were randomly divided into two groups: control group (n=56) treated with conventional therapy, and intensive insulin therapy group (n=58) treated with conventional therapy plus continuous insulin pumping to control the blood glucose level at range of 4.4-6.1 mmol/L. White blood cells (WBC) counts, prothrombin time (PT), serum creatinine (SCr), alanine aminotransferase (ALT), serum albumin and PaO(2) were measured before and at the day 1, 3, 5, 7 and 14 after treatment. The incidence of gastrointestinal dysfunction, the incidence of MODS, hospital stay and the mortality were also observed and compared. After intensive insulin therapy, the WBC counts, SCr, ALT and PT were significantly reduced (P<0.05), but the level of serum albumin was significantly increased (P<0.05) at the day 3, 5, 7 and 14. In the meantime, the PaO2 was significantly elevated at the day 3, 5 and 7 (P<0.01) after intensive insulin therapy. The incidence of gastrointestinal dysfunction, the incidence of MODS, the length of hospital stay and the mortality were markedly decreased (P<0.01). The results suggest early treatment with intensive insulin therapy is effective for traumatic shock combined with MODS and can decrease the length of hospital stay and the mortality.

The therapeutic effects of intensive insulin therapy in treatment of traumatic shock combined with multiple organ dysfunction syndrome (MODS) were investigated.A total of 114 patients with traumatic shock combined with MODS were randomly divided into two groups:control group (n=56) treated with conventional therapy,and intensive insulin therapy group (n=58) treated with conventional therapy plus continuous insulin pumping to control the blood glucose level at range of 4.4-6.1 mmol/L.White blood cells (WBC) counts,prothrombin time (PT),serum creatinine (SCr),alanine aminotransferase (ALT),serum albumin and PaO2 were measured before and at the day 1,3,5,7 and 14 after treatment.The incidence of gastrointestinal dysfunction,the incidence of MODS,hospital stay and the mortality were also observed and compared.After intensive insulin therapy,the WBC counts,SCr,ALT and PT were significantly reduced (P＜0.05),but the level of serum albumin was significantly increased (P＜0.05) at the day 3,5,7 and 14.In the meantime,the PaO2 was significantly elevated at the day 3,5 and 7 (P＜0.01) after intensive insulin therapy.The incidence of gastrointestinal dysfunction,the incidence of MODS,the length of hospital stay and the mortality were markedly decreased (P＜0.01).The results suggest early treatment with intensive insulin therapy is effective for traumatic shock combined with MODS and can decrease the length of hospital stay and the mortality.

Objective To investigate the relationship between the levels of serum CXC chemokine ligand 1(CXCL1)and phosphatase and tensin homology deleted on chromosome ten(PTEN)mRNA in patients with acute cerebral infarction and the severity and prognosis of the disease.Methods A total of 102 patients with acute cerebral infarction admitted to the hospital from March 2022 to March 2023 were enrolled in the study as the experimental group,and 85 healthy people who underwent physical examination in the hospital during the same period were enrolled as the control group.Serum samples of fasting venous blood were collected from people enrolled in the study.The serum CXCL1 level was detected by using enzyme-linked immunosorbent as-say.Real-time fluorescence quantitative PCR(qPCR)was used to detect the relative expression level of serum PTEN mRNA(hereinafter referred to as the level).According to the National Institutes of Health Stroke Scale(NIHSS)score,the patients in the experimental group were divided into three groups with different de-grees of neurological impairment(severe group,moderate group and mild group),and the serum CXCL1 and PTEN mRNA levels of the three groups were compared.According to the cerebral infarction volume evaluated by computed tomography(CT)or magnetic resonance imaging(MRI),the patients in the experimental group were divided into small infarction group,medium infarction group and large infarction group,and the serum CXCL1 and PTEN mRNA levels of the three groups were compared.According to the modified Rankin scale(mRS),the patients in the experimental group were divided into the good prognosis group and the poor prog-nosis group,and the serum CXCL1 and PTEN mRNA levels were compared between the two groups.Pearson correlation was used to analyze the correlation between serum CXCL1 and PTEN mRNA levels in patients with acute cerebral infarction.Multivariate Logistic regression analysis was used to analyze the factors affect-ing the prognosis of patients with acute cerebral infarction.Results The proportion of patients with a history of diabetes and hypertension and serum CXCL1 and PTEN mRNA levels in the experimental group were high-er than those in the control group,and the differences were statistically significant(P＜0.05).With the in-crease of the degree of neurological impairment,the serum CXCL1 level and PTEN mRNA level increased,and there were significant differences among the severe group,moderate group,and mild group(P＜0.05).With the increase of infarction size,the serum levels of CXCL1 and PTEN mRNA increased,and there were signifi-cant differences among small infarction group,medium infarction group,and large infarction group(P＜0.05).Compared with the good prognosis group,the poor prognosis group had significantly higher proportions of patients with a history of diabetes,a history of hypertension,and serum CXCL1 and PTEN mRNA levels(P＜0.05).There was a positive correlation between serum CXCL1 level and PTEN mRNA level in patients with acute cerebral infarction(r=0.479,P＜0.001).The levels of serum CXCL1 and PTEN mRNA,history of diabetes and hypertension were all influencing factors for the prognosis of patients with acute cerebral in-farction(P＜0.05).Conclusion The levels of serum CXCL1 and PTEN mRNA in patients with acute cere-bral infarction increase,which can be used to evaluate the disease severity and prognosis of patients.