Objective To observe the clinical curative effect of transcatheter arterial chemoembolization (TACE) in combination with 30% percutaneous acetic acid injection (PAI) under B-ultrasonic guidance to cure primary massive hepatocellular carcinoma. Methods Twinty three patients with intermediate or advanced stage of massive hepatocellular carcinomas were undergone transcatheter arterial chemoembolization. After 15-20 days, 30% percutaneous acetic injection was done for 2-3 times under B-ultrasonic guidance. Results After 2-3 periods of treatment, a significant difference (P

Objectiv To investigate the expression and clinical significance of CA125 and CA15-3 in human breast cancer. Methods Radioimmunoassay method was used to determine the serum levels of CA125 and CA15-3 in 80 patients with breast carcinoma, 60 patients with benign breast diseases and 80 normal adults. Results The levels of serum CA125 and CA15-3 in patients with stage Ⅲ-Ⅳ breast carcinomas were significantly higher than those in patients with benign breast diseases,normal adults and stage Ⅰ～Ⅱ breast cancer patients (P0.05). Conclusion CA125 and CA15-3 are helpful to diagnose breast cancer, and can serve as a biological marker for monitoring tumor progression and evaluating prognosis in breast cancer.

OBJECTIVE:To introduce the operation instructions and routine maintenance method of horizontal laminar flow cabinet(HLFC) in PIVAS to provide reference for standardized operation of HLFC.METHODS:The standardized utilization and maintenance of HLFC in respects of compositions,operation principle,operation instructions,etc.RESULTS & CONCLUSIONS:The standardized operation and correct maintenance can ensure the dispensation quality of intravenous drugs and extend service life of HLFC.

ObjectiveTo explore the effect of ultrasonic harmonic scalpel on stress after radical resction of esophageal carcinoma.MethodsAll 115 patients of esophageal carcinoma undergone radical esophagectomy were analyzed retrospectively.60 patients were performed with ultrasonic harmonic scalpel,the other 55 patients were performed with electrotome.The drainage volume of 72h after operation,postoperative complications and hospital days were analyzed.White blood cell count,Neu,CRP and blood glucose level were tested 2 days after operation.ResultsThere was significant difference in the drainage volume of 72h after operation (P ＜ 0.05 ),but the postoperative complications and hospital days had no obvious difference.White blood cell count,Neu,CRP and blood glucose were obviously increased after operation( all P ＜ 0.05 ) ;the barmonic scalpel group was dramatically decreased as compared with the electrotome group except blood glucose ( all P ＜ 0.05 ).ConclusionRadical resection of esophageal carcinoma using ultrasonic harmonic scalpel appears to decrease the drainage volume of 72h after operation and less the stress.

Objective To investigate the significance of preoperative and postoperative enteral nutrition support in gastric cancer patients with nutritional risk.Methods The clinical data of 72 gastric cancer patients with nutritional risk admitted in our department were analyzed.All the patients were randomly allocated into two groups.36 patients in the control group received only intravenous nutrition postoperatively (PN group).36 patients in the treatment group received enteral nutrition support from the fifth day before operation to eighth day after operation (EN group).The body weight,total protein,albumin,transferrin and prealbumin were measured on the fifth day before operation,the operation morning,the first day and the eighth day after operation.Results On the operation morning,the transferrin and prealbumin of the EN group were higher than those in PN group significantly(P ＜0.05).In the eighth day after operation.the treatment group patients showed significant increase in the body weight,total protein,albumin,transferrin and prealbumin compared with those in the control group(P ＜ 0.05).On the operation morning,the transferrin and prealbmnin of EN group were increased significantly than on the fifth day before operation(P ＜ 0.01).Conclusion The preoperative and postoperative enteral nutritional support can improve the nutritlonal condition in the gastric cancer patients with nutritional risk.The preoperative enteral nutritional support can improve the patients' nutritlonal condition and reserves before operation,and reduce adverse reaction of enteral nutrition.

Objective To investigate the curative effect of large dose ambroxol on ventilatorassociated pneumonia(VAP)in the elderly.Methods From January 2009 to January 2011,76patients with VAP treated by ambroxol were randomly divided into general dose group and large dose group(n =38 for each group).General dose group received 60 mg ambroxol in 250 ml normal saline,and large dose group received 500 mg ambroxol in 250 ml normal saline,intravenous drip,twice daily for 14 d.The other therapeutic measures in all patients were accorded to 2005 guidelines for the hospital-acquired pneumonia.Procalcitonin(PCT)and clinical pulmonary infection score(CPIS)were used to detect the degree of pulmonary infection.Treatment effects were described with duration of mechanical ventilation,rates of tracheotomy intubation and second endotracheal intubation.Results PCT concentrations and CPIS in large dose group during treatment of 5 d[(0.79±0.68)mg/L and (5.50±2.08)scores]and 14 d[(0.44 ± 0.36)mg/L and(5.42 ± 2.23)scores]were significantly lower than in general dose group at 5 d[(1.18±0.97)mg/L and(6.61±2.32)scores]and 14 d[(1.11±0.91)mg/L and(6.47±2.17)scores](t =2.065,2.189,4.220 and 2.090,P＜0.05),and the level of PCT in large dose group during treatment of 14 d was decreased as compared with 5 d(P＜0.05).The time of mechanical ventilation,rates of tracheotomy intubation and second endotracheal intubation in large dose group[(6.03± 1.87)d,7.9％ and 10.5％]were declined as compared with general dose group[(7.24±2.72)d,26.3％ and 31.6％](t=2.264,x2 =4.547,5.066,P＜0.05).Conclusions Ambroxol in large dose for the treatment of VAP have better clinical efficacy than in general dose.

Objective To evaluate the effects of modified early goal directed therapy (EGDT )on the prognosis of patients with septic shock .Methods Clinical data of 116 patients with septic shock admitted to ICU during January 2011 to March 2013 were retrospectively analyzed .Patients were divided into modified early goal‐directed therapy group (n=57) and traditional early goal‐di‐rected therapy group (n=59) according to different methods of treatment ,the patients′28‐day survival rates of these 2 groups were compared .Modified early goal‐directed therapy are divided into survival group (n=46) and non‐survival group (n=11) according to 28‐day prognosis .Acute physiology and chronic health evaluation Ⅱ (APACHEⅡ ) score ,sequential organ failure assessment (SOFA) ,multiple organ dysfunction syndrome (MODS) score and other relevant indicators of survival group and non‐survival group were compared .Results The 28‐day survival rate in modified early goal‐directed therapy group had increased approximately 18 .9% higher than that of the traditional early goal‐directed therapy group(P< 0 .05) .The APACH Ⅱ score ,SOFA score and MODS score in non‐survivors were significantly higher than those of survivors in modified EGDT group ,which were[(29 .36 ± 1 .57)d vs .(24 .30 ± 3 .27)d] ,[(13 .45 ± 0 .52)d vs .(12 .78 ± 1 .33)d] ,[(9 .00 ± 0 .00)d vs .(4 .04 ± 1 .94)d]separately .And vaso‐pressors time and mechanical ventilation time was significantly longer in non‐survivors than survivors(P<0 .05) .Conclusion Mod‐ified early goal directed therapy could improve 28‐day survival rate ,and it show s beneficial effects on outcome of critical patients w ith septic shock .

Objective To evaluate the advantage of video-assisted mini thoracotomy for patients with esophageal cancer compared with routine open thomcotomy.Methods Perioperative clinical results were compared between 24 csses received VAMT(test group)and 26 cases underwent routine open thoracotomy(control group)during the same period.All the cancer stages were T2-3N0-1M0.Results This study showed that VAMT Was a minimally invasive swgew with shorter operation time(40.0±3.3)min vs.(70.3±3.2)min,P＜0.05)and had less bleeding volume both during and after operation compared to the control group(108.1±15.2)ml V8.(200.1±11.3)ml,(380.8±45.4)ml vs.(780.1±52.2)ml,P＜0.05).No significant differences were observed in the two groups with respect to complication occurrence rate(4.2%vs.19.2%,P＞0.05).Conclusion It is suggested that VAMT is safe,reliable and less invasive in the treatmem of esophagus carcinoma.

Total parathyroidectomy (PTX) can be used to treat secondary hyperparathyroidism (SHPT)in uremic patients,relieving the patient's osteolytic destruction.Complete resection of bilateral parathyroid glands is key to successful operation.Recently,2 patients successfully received surgical treatment,in which carbon nanoparticles suspension injection were used.With the help of carbon nanoparticles suspension injection,all of the 4 hyperplastic parathyroid glands were found successfully.The parathyroid hormone(PTH) was significantly decreased after operations and the clinical symptoms were relieved simultaneously.We conclude that the use of carbon nanoparticles suspension injection is helpful for total parathyroidectomy operation in uremic patients with SHPT,which can protect the normal thyroid and recurrent laryngeal nerve.

Objective To explore the feasibility and value of laparoscopic-assisted surgery(LAS) for colorectal cancer.Methods The clinical data of 51 cases of LAS for colorectal cancer were reviewed retrospectively.Of them,3 cases were converted to open operation,and in 48 cases LAS for colorectal cancer was completed.Among them,9 cases underwent right hemicolectomy,8 cases left hemicolectomy,14 cases sigmoid resection,9 cases rectal anterior resection,and 6 cases Miles operation.Results No intra-operative deaths occurred. The average operation time was 195(150-320)min with 120(40-300)mL average blood loss.The average number of lymph nodes excised was 8(2-26).The time of bowel function recovery was 20-72h after operation.The average hospital stay after operation was 8(7-10)d.No major intra-operative blood loss nor postoperative complications were observed.The follow-up time was from 3-54months for 45(88.2%) patients.Two cases with Ducke′s C rectal cancer died,one died of liver metastasis 17 months after operation,and the another died of diffuse peritoneal metastasis 19 months after operation.There was no trocar port tumor metastasis and no local tumor recurrence at the small abdominal incision.Conclusions LAS of colorectal cancer is technically feasible and has advantages such as less surgical trauma,less bleeding and quick recovery.It is a mini-invasive,safe and efficient treatment for colorectal cancer.