ABSTRACT
The incidence of diffuse gastric cancer is increasing year by year, comprehensive therapy is the main treatment. The main reason of surgical treatment failure is local recurrence, and the long-term curative effect is generally poor. Radiotherapy is an important part of comprehensive treatment for diffuse gastric cancer, which can reduce tumor stage before surgery and prevent recurrence and metastasis after surgery. Effective neoadjuvant radiotherapy is one of the approaches to improve surgical resection rate in patients with diffuse gastric cancer. In this paper, the clinical application of radiotherapy for diffuse gastric cancer will be reviewed, including the selection of reasonable radiotherapy system, precise location, dose setting, application of sensitization technology and mechanism of sensitization, in addition, the prevention and treatment of neoadjuvant radiotherapy and radiotherapy complications will be introduced.
ABSTRACT
Liver cirrhosis in China can be caused by many causes of which the most important one is chronic viral hepatitis. Hemorrhage and ascites were the main manifestations of decompensated liver cirrhosis, and the main cause of hemorrhage is viral hepatitis. The pathological basis of hemorrhage is portal hypertension and its secondary pathophysiological changes. Additionally, the deficiency of coagulation factors and the imbalance of coagulation and fibrinolysis both of which caused by the hypofunction of liver are also important reasons. This article reviews the mechanism of hemorrhage in decompensated liver cirrhosis in order to provide help for further research.
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For patients with poor liver function as a result of the final stage of liver disease,liver transplantation is the best way to prevent them from death.Recently,liver transplantation in China get a rapid development,however,patients who need liver transplantation are much more than livers that can be transplanted,that is a bottleneck problem for liver transplantation,adoption of brain death must be a useful way to deal with this problem.More than a hundred countries have adopted brain death and their liver transplantation developed much better than China.Thus,we should pay more attention to brain death and corresponding legislation to promote the development of liver transplantation.
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Objective To provide the basis for clinical treatment and prevention of Stenotrophomonas maltophilia infection ,ana‐lyze the characteristics of the bacteria infection and drug‐resistant strains of the area children .Methods Statistical analysis of 52 ca‐ses detected Stenotrophomonas maltophilia culture positive patients clinical data from September 2011 to September 2012 ,and the antibiotic susceptibility test results .Results Clinical data analysis showed that patients infected with Stenotrophomonas maltophilia had no difference on age and gender ,in the detection department was given priority to with of NICU and PICU ,82 .7% of infected children with SMA had a history of invasive procedures ,95 .92% of children with SMA had a history of penicillium carbon alkene drug use ,infection SMA patients in hospital for a long time with an average of (22 .3 ± 19 .0) days .Laboratory data analysis showed that Stenotrophomonas maltophilia main detection in sputum specimen type (63 .5% ) ,four kinds of commonly used clinical drug re‐sistance was higher ,sulfa drugs up to 21 .9% .Conclusion Stenotrophomonas maltophilia infection in children is closely related to carbapenem drug use and the invasive operation ,drug resistance in severe cases ,the rational use of antibiotics are crucial to treat‐ment .
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Objective To statistically analyze the bacterial flora change and drug resistance situation in the patients with bacteri‐al infection to provide reference for clinical rational drug use and the management of nosocomial infection .Methods The clinical samples were conventionally isolated and cultured .The bacteria identification and drug sensitivity test were performed by using the bioMerieux company VITEK2 automatic microorganism analyzer .The confirmation test of drug susceptibility adopted the disk dif‐fusion method recommended by the American Clinical and Laboratory Standardization Committee (CLSI) .Results The sample sources in the hospital infection during 2011-2013 were main sputum ,secretions and midstream urine ;the main infectious bacteria showed the increasing trend ,the top 5 of bacteria were :Escherichia coli (ECO) ,Klebsiella pneumoniae (KPN) ,Acinetobacter bau‐manii (ABA) ,Pseudomonas aeruginosa (PAE) ,Staphylococcus aureus (SAU);the top three of common multi‐drug resistant bacte‐ria were ABA ,PAE and ECO ,their constituent ratio during these three years had a small amplitude increase ;the antibiotics for Gram negative bacilli (G -) resistance rate of more than 70% during these 3 years were :ampicillin ,cefuroxime sodium and cefu‐roxime axetil;the antibiotics for Gram positive cocci (G+ ) resistance rate of more than 70% during these 3 years were penicillin and erythromycin ..Except for 4 cases of Enterococcus faecalis ,no other vancomycin‐resistant strains were found .Conclusion The sam‐ple source of bacterial infection is dominated by sputum ,the gram negative bacteria are the main force of hospital infection ,showing a increasing trend every year ,multi- drug resistant strains are also continuously rising ,penicillin is unsuitable to the clinical treat‐ment of bacterial infection ;imipenem has very high sensitivity to ECO and KPN .The hospital should attach great importance to the infection management ,strengthen the application and management of antibiotics ,decrease the outbreak and prevalence of bacterial infection and reduce the increase of drug resistant strains .
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Objective To determine the association of gallstone,cholecystectomy and colorectal cancer.Methods From 2000 through 2007,a historical cohort study was carried out in the check analysis of the cumulative incidence of colorectal cancer of 3809 gallstone patients who had had cholecystectomies (cholecystectomy sub-group),1764 gallstone patients who had not had cholecystectomies(noncholecystectomy sub-group)and 8187 nongallstone patients(control group)were also included in the analysis of the incidence of colorectal cancer.Results(1)The cumulative incidence of colorectal cancer of the gall-stone group was 0.43 ％(24/5573)while that of the control group was 0.13 ％(11/8187)(x2 =11.879,P =0.001).(2)The cumulative incidence of colorectal cancer in cholecystectomy sub-group was 0.45％(17/3890)while that of the non-cholecystectomy sub-group was 0.40％(7/1764)(x2=0.069,P =0.793).(3)The cumulative incidence of colorectal cancer was 0.23％(8/3467)in gallstone patients with a conrse ＜ 15 years,while that was 0.76％(16/2106)when the course ≥ 15 years(x2 =8.550,P =0.003).(4)Serum triglyceride level elevated in 20.83％(5/24)colorectal cancer cases of gallstone group,however serum triglyceride level elevated only in 5.86％(325/5549)of gallstone group with non-colorectal cancer cases(x2 =9.621,P =0.002).(5)The incidence of colorectal cancer in gallstone group was not related to gender,age,overweight,hypertension,diabetes mellitus and dysfunction of liver(x2 =1.444,P =0.229;x2=7.833,P=0.251;x2 =1.151,P=0.283;x2 =0.797,P=0.372;x2 =0.939,P=0.332;x2 =2.103,P =0.147).(6)The ratio of rectal cancer,right colonic cancer,left colonic cancer and multifocal carcinoma were 41％(10/24),38％(9/24),17％(4/24)and4％(1/24),respectively.Conclusions Gallstone is a high risk factor of colorectal cancer irrespective of whether or not a cholecystectomy is carried out.Over fifteen-years course of gallstone and hypertriglyceridemia significantly increases the risk of the colorectal cancer in gallstone patients.The incidence of rectal cancer and right colonic cancer is more frequently seen in gallstone related colorectal cancer.