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Objective To investigate the postoperative complications of ex vivo liver resection combined with autologous liver transplantation in the treatment of end-stage hepatic alveolar echinococcosis at high altitude and related prevention and treatment strategies. Methods Surgical data and follow-up data were collected from 11 patients with end-stage hepatic alveolar echinococcosis who underwent autologous liver transplantation in Qinghai People's Hospital from January 2013 to March 2019, and intraoperative and postoperative conditions were analyzed. Results All 11 patients underwent autologous liver transplantation successfully, without intraoperative death, among whom 2(18.18%) underwent hemi-extracorporeal hepatectomy and 9 (81.82%) underwent total extracorporeal hepatectomy. For the reconstruction of the retrohepatic inferior vena cava, 2 patients (18.18%) underwent reconstruction with the autologous great saphenous vein, 4 patients (36.36%) underwent reconstruction with artificial vessels, and the autologous retrohepatic inferior vena cava was preserved in 5 patients (45.45%). For biliary reconstruction, 8 patients (72.73%) underwent choledochoenterostomy and 3 (27.27%) underwent choledochocholedochostomy. The main postoperative complications of the 11 patients included bleeding in 2 patients (18.18%), bile leakage and abdominal infection in 4 patients (36.36%), bilioenteric anastomotic stenosis in 1 patient (9.09%), thrombus in 2 patients (18.18%), pulmonary infection and pleural effusion in 2 patients (18.18%), and echinococcosis recurrence in 1 patient (9.09%). Of all 11 patients, 2 (18.18%) died during the perioperative period, and the other 9 patients (81.82%) were improved and discharged. Conclusion Bleeding, biliary complications, and infection are the main causes of death in patients undergoing autologous liver transplantation at high altitude. An accurate understanding of surgical indication, careful multidisciplinary evaluation before surgery, superb operation during surgery, standardized surgical procedures, and fine perioperative management are the key to reducing perioperative mortality, avoiding and reducing postoperative complications, and achieving good long-term survival in patients undergoing autologous liver transplantation.
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Objective To analyze the main distribution of multi-drugresistant bacteria(MDROS)from 2012 to 2016.Methods Methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Acinetobacter baumanni(CRABA),carbapenem-resistant Pseudomonas aeruginosa(CRPAE),vancomycin resistant entero-coccus(VRE),carbapenem-resistant Enterobacteriaceae bacteria(CRE)were retrospectively analyzed. Results There were 529 strains of MRSA,718 strains of CRABA,96 strains of CRPAE,4 strains of VRE,48 strains of CRE detected in five years,and most were from department of ICU,neurosurgery,respiratory,burns and paediatrics.The most MDROS were detected from sputum and excretion samples.There were 13 strains producing KPC-2,and 3 strains producing NDM-5 among 16 strains resistant to carbon penicillium strain.Con-clusion CRABA and MRSA are the main MDROS in the hospital.CRPAE,CRE and VRE are significantly lower than those in similar reports.The future work should focus on strengthening the management of various MDROS,while the timeliness and correctness of clinical specimen delivery are the prerequisite for reliable mo-nitoring data.
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Objective To study the clinical curative effect of Chinese traditional medicine Prunella vulgaris Decoction for elderly hypertensive patients ,and its influence on endothelin －1( ET －1).Methods From January 2016 to January 2018,76 senile patients with hypertension in Wenling Hospital of Traditional Chinese Medicine were selected.According to different therapeutic methods ,the patients were divided into two groups ,with 38 cases in each group.The control group was given calcium antagonists benzene sulfonic acid amlodipine therapy , the observation group was given the combined therapy of Chinese and western medicine ( Prunella vulgaris Decoction combined with benzene sulfonic acid amlodipine ).All the patients were treated for 2 months,the therapeutic effect was evaluated . The 24－hour average diastolic blood pressure (24hDBP),24－hour average systolic blood pressure (24hSBP),and diastolic pressure (dDBP),the day systolic blood pressure (dSBP),diastolic blood pressure at night (nDBP) and nocturnal systolic blood pressure (nSBP) were used to evaluate the clinical curative effect .Before and after treatment, the plasma ET－1 level was used to evaluate the influence on endothelial function .The clinical curative effect and its influence on ET－1 were compared between the two groups .Results After treatment,the 24hDBP,24hSBP,dDBP, dSBP,nDBP and nSBP in the observation group were significantly lower than those in the control group [24hDBP (72.26 ±4.62)mmHg vs.(86.63 ±5.18) mmHg,24hSBP (133.26 ±6.71) mmHg vs.(143.29 ±7.22) mmHg, dDBP (76.08 ±5.26)mmHg vs.(87.32 ±5.73)mmHg,dSBP (136.51 ±8.63)mmHg vs.(153.67 ±9.51)mmHg,nDBP (72.34 ±3.96)mmHg vs.(80.75 ±4.27)mmHg,nSBP (133.64 ±5.21)mmHg vs.(148.27 ±6.32)mmHg,t＝12.637,11.268,11.762,12.406,10.625,11.738,all P＜0.05].The plasma ET－1 level of the observation group was (59.37 ±7.82)μg/L,which was significantly lower than (67.58 ±7.72)μg/L of the control group (t ＝10.653,P＜0.05).Conclusion Prunella vulgaris Decoction in the treatment of elderly hypertensive patients can effectively improve therapeutic effect , lower the blood pressure levels , and can improve endothelial function , it is worthy of popularization and application .
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Objective To explore the effect of Zhibitai capsule in the treatment of elderly coronary artery disease patients with normal lipid,and to investigate its influence on prognosis.Methods 90 elderly coronary artery disease patients with normal lipid were randomly divided into the control group (n =30),the treatment group 1 (n =30) and the treatment group 2 (n =30).The control group received routine treatment,once a day for 2 months.The treatment group 1 received the Xuezhikang capsule,once a day for 2 months.The treatment group 2 received the Zhibitai capsule,once a day for 2 months.The expression of inflammatory factors,the level of blood fat,the maintenance rate of sinus rhythm and the incidence rate of embolism before and after treatment were compared among the three groups.Results After treatment,the levels of hs-CRP,IL-6,TNF-α,TC,TG,LDL-C of the three groups were significantly lower than those before treatment(P ＜ 0.05),and the level of HDL-C was significantly higher than before treatment (P ＜ 0.05).The levels of hs-CRP,IL-6,TNF-α,TC,TG,LDL-C in the treatment group 2 were significantly lower and the level of HDL-C was significantly higher than the other two goups (P ＜ 0.05).Moreover,the differences between the control group and the treatment group 1 were not statistically significant.The maintenance rate of sinus rhythm of the treatment group 2 was significantly higher and the incidence rate of embolism was significantly lower than the treatment group 1.Conclusion For elderly coronary artery disease patients with normal lipid,the Zhibitai capsule has ideal effect in controlling inflammation,which can delay the progress of atherosclerosis,decrease the major cardiovascular events and better than the Xuezhikang capsule.
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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.
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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.
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Objective To examine the practicability and security of the LigaSureTM vessel-sealing system in radical gastrcctomy.Methods Seventy patients of stage Ⅰ～Ⅲ gastric cancer undergone radical gastrectomy were analyzed retrospectively.Thirty-five radical gastrectomy were performed with LigaSureTM vessel-sealing system,the other 35 eases were performed without LigaSureTM.The operative duration,volume of intraoperative hemorrhage,and postoperative complications were analyzed.Results There were significant difference in both operative duration[(159.9±24.7)min vs(172.6±23.7)min,P＜0.05]and volume of intraoperative hemorrhage[(335.7±40.3)ml vs(371.7±43.2)ml,P＜0.01].There was no significant difference in the postoperative complications between LigaSureTM group and conventional method group.All patients recovered without severe postoperative complications.Conclusion Radical resection of gastric cancer using LigaSureTM instead of conventional hand tie method appears to he shorten operative duration,decreased volume of intraoperative hemorrhage.And the technique is convenient and safe.
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Objective The purpose of this study was to develop a database program based on Microsoft Access 2003 for patients with breast cancer to save and manage clinical data.This makes it easier to analyze data of the database.Methods A total of 1177 cases with breast cancer who were performed surgical treatment from December 1998 to June 2007,the clinical data collection which included regular fouow-up data of these patients after therapy,the database was designed by using Microsoft Access 2003 included the creation of tables,forms and queries according to the therapy guidelines for breast cancer.Results The clinical data for patients with breast cancer can be stored in an Access database that is both user-friendly with reliable data administration and that can be shared in network,and it is capable of recording regular updated data.Conclusion This program will not only convenient for researchers to statistic and analyze their outcome data,but also for minimizing data entry errors and reducing the time spent on data query.
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<p><b>OBJECTIVE</b>To study the short tandem repeat (STR) polymorphism in Chinese Drungs (Tulungs).</p><p><b>METHODS</b>The genetic distributions of fifteen STR loci were investigated with the use of coamplification, genescan and genotype from 67 Drungs.</p><p><b>RESULTS</b>There were 144 STR alleles in Drung nationality, with their frequencies ranging from 0.0077 to 0.7846, heterozygosity(H) 0.3723-0.8639, discrimination power(DP) 0.5567-0.9548, probability of paternity exclusion(EPP) 0.2738-0.8358, polymorphism information content (PIC) 0.3461-0.8456 the accumulative DP 0.99999998 and EPP 0.99999894.</p><p><b>CONCLUSION</b>The results of this study on the STR polymorphism in Chinese Drungs could be used as a basis for the genetic structure of Chinese ethnic groups and also be of significant application in anthropology and forensic science.</p>