Objective To study the diagnosis and treatment of acute gangrenous cholecystitis in senile (patients), so as to decrease complications and lower the mortality rate. Methods The clinical data of 112 senile patients with acute gangrenous cholecystitis were retrospectived analysed.Results 19 cases(17.0%) of the 112 patients had hyperpyrexia, 8(7.1%) had icterus,11(17.0%) had a mass in the right upper abdomen, 26(23.2%) had symptoms of peritonitis; 11(9.8%) were complicated with acute edematous pancreatitis, 5(4.5%) had acute obstructive suppurative cholangitis, 6(5.4%) had septic shock. All of the 112 patients underwent surgery. At operation, 79 of 95 cases of acute calculous cholecystitis had (gangrene) of gallbladder,16(16.8%) had gangrene with perforation; in 17 cases with acute non-calculous cholecystitis had gangrene of gallbladder, 9(52.9%) had gangrene with perforation. Of the 112 patients, 86 underwent cholecystectomy, 18 underwent partial cholecystectomy, 5 underwent cholecystectomy with bile duct exploration and T tube drainage, and 3 underwent cholecystostomy 104 patients(92.9%) were cured, 8 patients(7.1%) died, and 9(8.7%) of the 104 cured patients had postoperative complications. (Conclusions) Acute gangrenous cholecystitis in senile patients should be definitely diagnosed as soon as (possible), co-existent diseases should be correctly treated, emergency operation should be performed with in 24 hours of onset of symptoms(or in the shortest time after admission), and a suitable operation should be (selected).

Objective To investigate the differences in expression of hypoxia-inducible factor-1? (HIF-1?) in placental trophoblasts between normal pregnancy and pregnancy-induced hypertension (PIH) and the relationship of HIF-1? expression with magnesium sulfate treatment of PIH. Methods Immunohistochemical streptavidin biotin-peroxidase complex technique (SABC) was used to examine the expression of HIF-1? in 20 cases of PIH and 20 cases of normal placenta. Three groups of PIH were divided according to the degrees of severity. The results were analyzed by computer-assisted imaging and compared by t-test. Results There was significant difference in the expression of HIF-1? between the PIH group and the control group (P

Colorectal cancer is one of the most common malignancies with a high risk of liver metastasis in China. Compared with systemic chemotherapy, hepatic arterial infusion (HAI) transports cytotoxic agents directly into the hepatic artery, leading to the persistent level of medicine in tumor cells and the relative lower systemic concentration. With advances in HAI, this technique has been successfully used not only as the pre-and post-operative chemotherapy for the resection of colorectal liver metastases, but also as an ad-juvant chemotherapy after the colorectal radical surgery to prevent the liver metastasis. This review discusses the application and per-spective of HAI in the treatment of colorectal cancer liver metastasis.

Raf kinase inhibiting protein (RKIP)plays a vital role in various physiological processes and participates in multiple signaling pathways,with a close releationgship with tumor.The mechanism of RKIP down-regulation in neoplasms includes transcriptional regulation,methylation,acetylation,histone modifica-tion,microRNA regulation and NF-κB/Snail/RKIP loop regulation.

Objective:To study the clinical curative effect and nursing interventions of CBP used in critically ill patients. Methods:critically ill patients were enrolled and given CBP treatment, then randomly divided into given nursing intervention and control group were given usual care. Cardiac function, renal function and treatment related complications were observed. Results:after the treatment, E/A, LVEF, LVEDD, Ccr were higher than that before treatment;Scr, BUN levels were lower than that before treatment;cases of arrhythmia, angina pectoris, hypotension, cardiac packing, hypoxemia and puncture point infection, hematoma of observation group were less than control group. Conclusion:CBP therapy can improve heart function and renal function in critically ill patients and the nursing intervention measures can reduce the occurrence of complications in treatment.

Objective Summarize 8 cases of non-small cell lung cancer (NSCLC) that has accepted completely video-as-sisted thoracoscopic sleeve lobectomy in People's Hospital of Peking University in china,to explore the safety,effectiveness indications and experience of this procedure.Methods Between September 2011 and December 2011,Medical records of 8 cases of non-small cell lung cancer that has accepted complete thoracoscopic sleeve lobectomy were reviewed (7 male,1 female).Median patient age was 62.4 years.And median maximal diameter of solid tumors was 2.3 cm.This group consisted of 5 cases of right upper lobe sleeve lobectomy,2 case of left lower lobe sleeve lobectomy and 1 case of left upper lobe sleeve lobectomy.The operation procedure was completely VATS anatomic sleeve lobectomy combined with systematic lymph node resection (at least 3 groups of lymph nodes in the mediastinum area).All procedure were underwent under general anesthesia with double-lumen endotracheal intubation.The patient was placed lateral decubitus position.Three incision were made at the seventh intercostal space on the median axillary line,the fourth intercostal space anterior axillary line and the seventh intercostal space subscapularis line.Bronchial were anastomosed combine with simple continuous suture anastomosis of membranous part of bronchus and simple interrupted suture anastomosis of cartilaginous part of bronchus,and then covered by? Surrounding tissue with blood supply? Results All procedures were carried out smoothly without serious complication.The median operative time was 240min median,the median bronchial anastomosis time was 45 min,the median blood loss was 200 ml,and median number of resected lymph nodes was 19.8.There were no conversion to open thoracotomy.Post operative show pathology squamous cell carcinoma in 7 cases and adenocarcinoma in 1 case.pTNM staging show 1 case of T1a N0 M0,4 cases of T1b N0 M0,2 case of T1b N1 M0 and 1 case of T1b N2 M0.There was 1 case of slight post operative complication.The median postoperative chest tube drainage duration was 7 days,and median postoperative hospital stay was 9 days.All patients were well during the followed up for 3-8 months.Conclusion Completely thoracoscopic sleeve lobectomy was a safe and effective surgical procedure for patients with non-small cell lung cancer; the operative incision placed at the fourth intercostal space anterior on the axillary line was convenient for anastomosis; anastomosis combine with simple continuous suture anastomosis of membranous part of bronchus and simple interrupted suture anastomosis of cartilaginous part of bronchus was a fast and secure mode; keeping azygos vein does not affect the anastomosis.

Objective To access the analgesia effect and side effect of flurbiprofen axetilcombined with sufentanil.Methods Thirty-eight patients underwent cardiac surgery were randomlydivided into two groups with nineteen cases each.Group S was given sufentanil 250μg diluted to 125ml via PCIA after surgery.Group F was given sufentanil 125 gg plus flurbiprofen axetil 150 mgdiluted to 125 ml via PCIA after surgery.The PCIA pump was set at a rate of 0.2 ml/h,bellus dosewas 0.8 ml.lockout time interval was 10 min. Analgesia grade was accessed,vital sign and sideeffects were recorded.Results 'Fhere was no significant difference in analgesia grade between tWOgroups.The side effects were lower in group F than those in group S.Conclusion Flurbiprofen axetilcombined with sufentanil can obtain similar analgesia effects to sufentanil alone,but can reduce sideeffects and fever temperature.

Objective To discuss the technical strategies for thoracoscopic lobectomy.Methods Between September 2006 and May 2008,a total of 91 patients underwent thoracoscopic lobectomy in our hospital.The lobectomy and lymph node resection were completed via three mini incisions with the same procedures as those in an open surgery.Among the cases,75 had primary or metastatic malignancies,and 16 showed benign tumor.By thoracoscopy,upper right lobectomy was carried out in 21 patients,right middle lobectomy in 12,lower right in 20,upper left in 18,and lower left in 20.Results Only two cases were converted to open thoracotomy.In the other 89 patients,the mean operation time for the thoracoscopy was(185.8?52.9)minutes(ragne,60-300 minutes),and the mean blood loss was 213.2 ml(range,50-650 ml).In this series,the chest drainage lasted(6.9?2.9)days;the patients were discharged from the hospital in(9.4?3.2)days after the surgery.No severe complications or perioperative death occurred in the cases except in one patient,who developed chylothorax after the treatment.Two patients,who had primary lung cancer,showed distant metastasis at 15 and 3 months respectively after the surgery.No recurrence or metastasis was found in the other cases.Conclusions Thoracoscopic lobectomy is safe and effective for patients with indications for the surgical procedure.Surgical skills for dissection of vessels and lymph nodes are the key to the operation.

Objective To review the primary experience of video-assisted rigid laser bronchoscopy in the treatment of tracheobronchial tumors. Methods From Sep.2002 to Nov.2004, 13 patients (15 procedures) with tracheobronchial tumors were treated with video-assisted rigid bronchoscope. Benign tumors with small pedicles were removed directly. For benign tumors with wide pedicles or tumors extending beyond the wall of air-way, total enucleating through thoracotomy were employed. In cases with malignant tumors, stenosis or obstructions were relieved by implantation of stents or cautering with electric argoulaser knife. For malignant but resectable primary tumors of trachea and main bronchi, rigid bronchoscopy might serue as a preparation of radical resection. Results Of the 5 patients with benign tumors, 4 received endoscopic total resection and 1 were conversed into thoracotomy. For the 8 malignant cases, 3 received stent implantation, 2 had palliative ablation and 3 got curative resections through thoracotomy. No peri-operative complications or death occurred in this group. Conclusion Total resection of benign tracheobronchial tumors or palliative therapy for tracheobronchial malignant stenosis or preparation of radical resection can be performed safely and efficiently by video-assisted rigid bronchoscopy.