Objective To investigate the efficacy of enteral nutrition containing glutamine on improving blood lipids and immune parameters in elderly patients with gastrointestinal cancer.Methods 98 cases of elderly patients with gastrointestinal cancer were randomly divided into observation group(n=5 1)and control group (n=47).The control group was additionally given conventional enteral nutrition,and the observation group was additionally given enteral nutrition containing glutamine.The levels of albumin (ALB),tumor necrosis factor (TNF),indicators of cellular immunity,indicators of humoral immune function and blood lipid,before and after operation,were observed in the two groups.Results 9 days after operation,the levels of ALB and total cholesterol,per-centage of CD8 + cells were lower than those in the control group,and levels of TFN,IgA,triacylglycerol,low density lipoprotein cholesterin,percentage of CD4 + cells and CD4/CD8 ratio were higher than those in the control group,and have significant differ-ences (P <0.05).While,there was no statistically significant difference of the percentage of CD3 cells between the groups(P >0.05).Conclusion Enteral nutrition containing glutamine can significantly improve blood lipids and immune function in elderly pa-tients with gastrointestinal cancer,which may have important clinical research value and be worthy of further application.

OBJECTIVETo investigate the etiology and treatment of sympathetic cervical spondylosis (SCS).

METHODSTwenty patients who with SCS had undergone operations for sympathetic cervical spondylosis were reviewed retrospectively from 1988 to 2000. Lateral views in flexion and extension of pre- and postoperative cervical X-ray were analyzed to quantify cervical instability.

RESULTSCervical instability was detected at one level in seven patients, two levels in ten patients, three levels in three. Cervical instability mainly occurred at C(3)-C(4) and C(4)-C(5). Cervical epidural block had a short time effect in the greater part of patients. Cervical discectomy and fusion at unstable segment was carried out in all 20 cases. The effective rate was 90%.

CONCLUSIONSCervical instability at C(3)-C(4) or C(4)-C(5) maybe an important factor in the etiology of sympathetic cervical spondylosis. Cervical epidural block may provide diagnostic information. Anterior cervical fusion were effective to treat sympathetic cervical spondylosis.

Adult ; Cervical Vertebrae ; surgery ; Female ; Follow-Up Studies ; Humans ; Joint Instability ; complications ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; methods ; Spondylolysis ; etiology ; surgery

Objective To research the combined prognostic utility of NT-proBNP and hs-CTNI in NSTE-ACS risk stratification and early intervention therapy .Methods A total of 245 NSTE-ACS patients were divided to 4 groups(Aa ,Ab ,Ba ,Bb groups) ac-cording to immediate admission NT-proBNP and hs-CTNI .Patients were accepted percutaneous coronary intervention (PCI) ,coro-nary artery bypass grafting and conservative treatment were taken 6 months follow-up .Results The heart failure incidence of Aa group was significantly higher than Ba group(P<0 .05) .6 patients happened left main lesion or multivessel lesion in Aa group were obviously higher than other groups .The incidence of Bb group accepted PCI was obviously higher than Aa group (P<0 .05) .Bb group patients were accepted PCI earlier than other groups ,there was no significance(P>0 .05) .In 6 months follow-up ,5 patients died and 10 patients accepted revascularization again because of severe angina and AMI .Conclusion In NSTE-ACS patient ,NT-proBNP and hs-CTNI elevation was closely related with severe coronary lesions and worse prediction ,which could undergo early in-tervention therapy .

Objective To estimate the safety,feasibility and generalization of three point single-incision laparoscopic cholecystectomy (SILC).Methods The clinical data of 1 126 patients who underwent three-point SILC at the second department of Hepatobiliary Surgery of Zhu Jiang Hospital,Southern Medical University From January 1,2011 to December 30,2015 was analyzed retrospectively.The patient who were indicated for conventional laparoscopic cholecystectomy were included,but those suspected malignant diseases of gallbladder were excluded.Results Of the 1126 patients,the surgery was performed successfully in 923 patients,and 192 patients need extra ports due to the adhesion and difficulty of exposing the Calots triangle,and 11 were converted to open surgery due to severe adhesion,with the success rate being 81.9％.The operating time was (29.5 ± 12.2) min (from the entrance of laparoscope to the removing of gallbladder),the blood loss was (8.7 ± 7) ml,and the hospital stay time was (1.4 ± 0.7) d (after surgery).There were three cases of bile duct injury:two of them were bile leak of aberrant duct,one of them was bile leak of cystic duct damaged by heat.And there was one case of injury of duodenum,22 cases of umbilicus hematoma,13 cases of hematoma of thorax,and 2 cases of thoracic hemorrhage who required surgery.There were no hernia,aerothorax and so on.Conclusion Three point SILC is a technology that is safe,maneuverable and suitable for being carried out in clinical practice.

Angioplasty, Balloon, Coronary ; Heart Injuries ; drug therapy ; etiology ; Humans ; Thrombin ; administration & dosage

OBJECTIVETo explore the feasibility of single-incision laparoscopic cholecystectomy using a three-dimensional (3D) laparoscopic system.

METHODSTwo patients with benign gallbladder disease with a history of recurrent abdominal pain were selected to undergo the surgery. Gallstones were diagnosed by B ultrasound examination. All the operations were performed through the umbilical incision with the 3D laparoscopic system.

RESULTSThe 2 operations were completed successfully with a operative time of 35 min and 50 min. Both of the patients were ambulatory 8 h after the surgery, began to have a normal diet 1 day after operation, and were discharged 2 days postoperatively without any clinical symptoms.

CONCLUSIONS3D single-incision laparoscopic operation can well reveal the tissue anatomy in the operative field especially for some important structures such as the Calot's triangle with an improved safety compared to conventional laparoscopic operations.

Cholecystectomy, Laparoscopic ; Cholelithiasis ; surgery ; Gallbladder Diseases ; surgery ; Gallstones ; Humans

Objective To evaluate the value of fast track surgery (FTS) in laparoscopic hepatectomy.Methods The clinical data of 142 patients undergoing laparoscopic liver resection from January 2014 to January 2016 were analyzed retrospectively.74 patients received fast track surgery treatment (FTS group) and 68 patients received traditional treatment methods (control group).Results Compared with control group,FTS group had a shorter operative time and less blood lose (t =2.279,t =2.432,P ＜0.05),quicker postoperative intestinal function recovery (t =3.548,P ＜ 0.05),a shorter postoperative hospitalization time (t =2.821,P ＜ 0.05),a lower hospitalization cost (t =2.507,P ＜ 0.05),a lower postoperative VAS scores (t =3.394,t =3.176,t =7.079,P ＜ 0.05) in 3 post-op successive days.There were 3 patients with major post-op complications in FTS group (4.05％,3/74) compared with 4 cases in control group (5.88％,4/68) (x2 =0.253,P ＞ 0.05).Conclusion The application of fast track surgery in laparoscopic liver resection is safe and effective,and helpful in reducing patients' inhospital cost.

Objective To explore the feasibility of single-incision laparoscopic cholecystectomy using a three-dimensional (3D) laparoscopic system. Methods Two patients with benign gallbladder disease with a history of recurrent abdominal pain were selected to undergo the surgery. Gallstones were diagnosed by B ultrasound examination. All the operations were performed through the umbilical incision with the 3D laparoscopic system. Results The 2 operations were completed successfully with a operative time of 35 min and 50 min. Both of the patients were ambulatory 8 h after the surgery, began to have a normal diet 1 day after operation, and were discharged 2 days postoperatively without any clinical symptoms. Conclusions 3D single-incision laparoscopic operation can well reveal the tissue anatomy in the operative field especially for some important structures such as the Calot's triangle with an improved safety compared to conventional laparoscopic operations.

Objective To investigate the effects of different dosages of atorvastatin,rosuvastatin,and simvastatin in elderly patients with ST-segment elevation acute myocardial infarction(STEMI)undergoing percutaneous coronary intervention(PCI).Methods A total of 180 patients with STEMI undergoing PCI were prospectively selected as study subjects and divided into group A,group B,group C,group D,group E,and group F using a random number table method,with 30 patients in each group.The group A received low-dose simvastatin orally,the group B received high-dose simv-astatin orally,the group C received low-dose atorvastatin orally,the group D received high-dose atorv-astatin orally,the group E received low-dose rosuvastatin orally,and the group F received high-dose rosuvastatin orally.The levels of serum inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)],myocardial injury markers[crea-tine kinase isoenzyme(CK-MB),cardiac troponin T(cTnT),N-terminal pro-brain natriuretic pep-tide(NT-proBNP)],cardiac function indicators[left ventricular ejection fraction(LVEF),cardiac index(CI),cardiac output(CO)],as well as the ST-segment resolution,occurrence of adverse cardiovascular events,and adverse reactions were compared among the groups.Results At 1 day and 1 month postoperatively,the levels of IL-6,hs-CRP,and TNF-α decreased successively in groups A,B,C,D,E,and F(P＜0.05).At 1 day and 1 month postoperatively,the levels of cTnT,CK-MB,and NT-proBNP also decreased successively in the groups A,B,C,D,E,and F(P＜0.05).At1 month postoperatively,the LVEF,CO,and CI increased successively in the groups A,B,C,D,E,and F(P＜0.05).The proportions of patients with ST-segment resolution successively increased in the groups A,B,C,D,E,and F(P＜0.05).There were no statistically significant differences in the total incidence of adverse cardiovascular events and adverse reactions among the groups(P＞0.05).Conclusion Both low-dose and high-dose atorvastatin,rosuvastatin,and simvastatin can effectively relieve inflammation reactions,improve myocardial function,and promote ST-segment resolution in elderly patients with STEMI undergoing PCI,with high-dose rosuvastatin showing the best effect.