Acupuncture Therapy ; Humans ; Male ; Middle Aged ; Postoperative Complications ; therapy

Molecular targeted therapy is a treatment bed emerging recent years for the treatment of malignant tumors,imatinib mesylate in the treatment of gastrointestinal stromal tumor (GIST) is a successful example ofmolecular targeted therapy.Imatinib mesylate can inhibit tyrosine kinase andinhibition of cell proliferation by treatment of gastrointestinal stromal tumor.With the positive effect of imatinib in the treatment of GIST,the related adverse reactions and the prevention and treatment strategies are worth to be discussed.

Surgical treatment of colon cancer is the first choice in the therapy stages,supplemented with systemicor local radiotherapy and chemotherapy.With the developement of molecular biology,there has been a variety of treatment program,some of these methods have been accepted in clinical testing stage.But the safety of the treatment on colon cancer is still a hot topic.

The treatment of total avulsion of the hand is somewhat difficult and the result usually not satisfactory. Four cases of such patients were treated from 1983 to 1987. After routine debridement, digital nerves and its surrounding adipose tissue were preserved. An "S" shape skin flap was designed an raised in the contralateral upper abdominal quadrant to cover the injured hand like a bag, so that both sides of the hand were covered. The donor area (12cm2) was directly sutured. Nerve endings might grow into the flaps because of the preservation of digital nerves. Three patients were followed-up for 2 to 6 years, the injured hands regained good pain sensation as well as stereognostic and temperatuer sensations. The function of the hand is satisfactory, but the flap looked bulky and multiple plastic operations were necessary to seperate the fingers.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Digestive System Neoplasms ; complications ; surgery ; Female ; Humans ; Intestinal Obstruction ; etiology ; therapy ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Young Adult

Objective To investigate the protective effect of pretreatment with Shenfu injectio(SFI)on myocardium against ischemia-reperfusion(I/R)injury in diabetic rabbits.Methods Forty healthy adult male rabbits weighing 2.4-3.2 kg were used in this study.Type I diabetes mellitus was induced by intravenous alloxan 120 mg?kg~(-1) and confirmed by fasting blood glucose＞11.1 mmol?L~(-1).The animals were randomly divided into 5 groups(n=8 each):groupⅠsham operation;groupⅡI/R and groupⅢ,Ⅳ,ⅤSFI+I/R.I/R was produced by occlusion of the anterior descending branch of left coronary artery(LAD)for 60 min.The occlusion of LAD was then released for reperfusion.In sham operation group(Ⅰ)LAD was exposed but not occluded.In groupⅢ,ⅣandⅤSFI 5,10 and 15 ml?kg~(-1) was givenⅣrespectively 30 min before myocardial ischemia.MAP,HR,left ventricular developed pressure(LVDP),?dp/dt_(max),left ventricular end-diastolic pressure(LVEDP)and Vmax were recorded immediately before ischemia(T_0,baseline),at 5 min of ischemia(T_1),immediately before reperfusion(T_2)and at 5,15,60,90,120 min of reperfusion(T_(3-7)).The animals were killed and hearts removed for determination of infarct size and microscopic examination of the ultrastructure of LAD using transmission electron microscope.Results MAP,HR,LVDP,?dp/dt_(max) and Vmax were significantly decreased while LVEDP was significantly increased during reperfusion as compared to the baseline values at T_0 in I/R group. I/R produced myocardial infarct and damage to the endothelial cells of LAD.The harmful effect of I/R was attenuated by different doses of SFI.SFI 10 ml?kg~(-1) provided best effect.Conclusion Pretreatment with SFI can protect the myocardium against I/R injury in diabetic rabbits.SFI 10 ml?kg~(-1) produces better effect.

Objective To evaluate the diagnostic accuracy of transcranial doppler(TCD)as an additional screening tool for intracranial arterial steno-occlusive disease in patients with acute ischaemic stroke(AIS)by comparing with the computed tomography angiography(CTA). Methods Two hundred and twenty-four consecutive patients who were hospitalized within 7 days of the onset of symptoms and fulfilled the criteria for the clinical di-agnosis of AIS between May 2013 and May 2014 were enrolled for the study. Among the 224 patients,there were 118 males and 106 females with an average age of 61.2±12.6 years. High-resolution brain CTA was performed after completion of TCD. Results There was slight distinction of the diag-nostic accuracy of TCD for different arteries. TCD demonstrated the most accurate diagnosis for carotid artery vascular system,with a sensitivity of 96.19%and specificity of 98.60%. For the vertebrobasilar vascular system,TCD diagnosis showed a sensitivity of 71.11%and specificity of 94.31%. TCD findings were complementary to the CTA results(real-time embolization,collateral flow patterns and steal phenomenon). Conclusion TCD shows a high diagnostic accuracy comparing to CTA in evaluating intracranial and extracranial arterial stenosis in patients with AIS,especially for the carotid artery vascular system analysis within a short time interval. TCD can also provide additional real-time dynamic findings complementary to the information provided by CTA.

Objective To investigate the effect of small intestine exclusion surgery on blood glucose and oral glucose tolerance test (OGTT) in Goto-Kakizaki (GK) rat with type Ⅱ diabetes mellitus.Methods 40 GK rats were randomly divided into 5 groups:duodenal bypass (Group A,n = 8),duodenaljejunal bypass (Group B,n = 8),duodenum and total jejunum exclusion (Group C,n = 8),sub-total small intestine exclusion (Group D,n = 8),and sham-operation (Group SO,n=8).All rats were observed for 24 weeks after surgery.Fasting blood glucose was tested at 0,1,3,6,12,and 24 wk.OGTT was performed at 0,1,and 24 wk.After the administration of 3 g/kg glucose by oral gavage,blood glucose was measured in conscious rats before (baseline) and after 30,60,120,and 180 minutes.Areas under curves (AUC) were calculated by trapezoidal integration.Results Rats in group A,B,C and D had lower fasting blood glucose levels and better oral glucose tolerance as shown by lower peak and area-under-thecurve (AUC) glucose values through the entire follow-up period[group B (fasting blood glucose:(9.0±2.4) mmol/L vs.(4.4±1.0) mmol/L;OGTT peak:(20.8±3.1) mmol/L vs.(10.3±2.0) mmol/L;AUC:(2658±417) mmol·min/L vs.(1324±317) mmo·min/L,P ＜0.05 or P ＜0.01].Fasting blood glucose had no differences before 12 wk and significantly increased at 12 (9.1±2.4) mmol/L and 24 wk (10.0±2.3) mmol/L in group SO (preoperative values were (8.1±1.9) mmol/L,P ＜ 0.01.There was no differences in oral glucose tolerance as shown by lower peak and area-under-the-curve (AUC) glucose values between 0 and 1 wk (P＞0.05),while the oral glucose tolerance become worse as shown by the delay of peak,higher peak (25.6±2.0) mmoL/L vs.(21.4±2.7) mmoL/l,and AUC (3422±360) mmol·min/L vs.(2667±377) mmol·min/L.Glucose values in group SO at 24 wk compared to preoperatively (P＜0.01).Rats in group A,B,C,and D had lower fasting blood-glucose and better oral glucose tolerance compared with sham-operated group through the entire follow-up period (P＜0.05 or P＜0.01).Rats in group B had lower fasting blood-glucose and better oral glucose tolerance compared to those in group A while the effect on diabetes control in group B,C and D were similar to one another (P＞0.05).Conclusion Small intestinal exclusion containing proximal gut was effective for glucose control and improving gucose tolerance,duodeno-jejunal bypass may be applicable for diabetes control in clinical setting.

Objective To study the burden of main earegivers of patients with stroke and its influ-encing factors, besides, the corresponding nursing countermeasures were disucssed. Methods 56 main caregivers of stroke families were selected to complete caregiver burden inventory (CBI). Results The general level of burden of main caregivers was in the moderate level with score value (1.55±0.35),factors influencing the burden of caregivers included ADL index, number of caregivers who involved in nursing and hospitalization times. Conclusions Nurses should educate the stroke patients about their rehabilitation systematically to decrease the severity of stroke sequela and readmission times, besides, they should strengthen their family support to reduce the burden of caregivers and increase their health status both physically and psychologically.

Objective To summerize our experience in the diagnosis and treatment of pancreatic cystic neoplasms.Methods A retrospective analysis was conducted on the clinical data of 126 patients with pancreatic cystic neoplasms seen between January 2003 and December 2012 in the Fuzhou General Hospital.Results There was no special clinical manifestation in this series of 126 patients with pancreatic cystic neoplasms.The diagnostic accuracies of ultrasound,CT and MRI were 90.8％ (109/120),93.4％ (114/122) and 96.3％ (103/107) respectively.Eighteen and ten patients were observed to have elevated serum CA19 9 and CEA respectively.One hundred and five patients received conventional open surgery,while 21 patients underwent laparoscopic operations.The operations in cluded enucleation of tumor (n=11),pancreatic segment resection (n=5),spleen preserving distal pancreatectomy (n=30),distal pancreatectomy (n=26),duodenum-preserving pancreatic head resection (n=4),pylorus-preserving Whipple resection (n=5),Whipple procedure (n=38),total pancre atectomy (n=2) and exploratory laparotomy and biopsy (n=5).The perioperative mortality rate was 0.8％ (1/126).Pancreatic fistula (B and C) occurred in 16 patients (12.7％,16/126),and postoperative hemorrhage (B and C) occurred in 9 patients (7.1％,9/126).One hundred and fourteen patients were followed up from 6 to 72 months (median 52.4 months).The five-year survival rates for all the pancreatic cystic neoplasms,non-invasive and invasive neoplasms were 80.5％,96.4％ and 40.7％ respectively.Conclusions Pancreatic cystic neoplasms are a rare subset of pancreatic tumor,being increasingly detected due to the widespread use of abdominal imaging and improved imaging techniques.Most of them are benign,but some are malignant or they have malignant transformation and metastatic potential.Patients with asymptomatic benign pancreatic cystic neoplasms,especially small size,are candidates for observation.Patients with clinical symptoms or having a high suspicion of malignancy should be offered surgical resection.Non-invasive neoplasms should receive pancreatic preserving operations.Pancreatectomy plus regional lymph nodes dissection with or without combined resection of adjacent multi organs should be adopted for invasive neoplasms.