ABSTRACT
<p><b>OBJECTIVE</b>To observe the influence on prognosis and possible side-effects of arginine in</p><p><b>METHODS</b>Multi-center clinical trial, randomized double blinded patients with severe trauma and burns. and placebo control methods were employed in the study. Eighty-six patients with severe trauma and burns were randomly divided into control (C, n = 45) and arginine treatment (Arg, n = 41) groups. The patients in Arg group received arginine in dose of 0. 4 g x kg(-1) x d(-1) orally, while those in C group received same dose of placebo (tyrosine) for 7 days. All the patients in both groups were given diet with equal calories and equal nitrogen content. The changes in the wound healing time, hospital stay, and the incidence of side-effects of the medication in both groups of patients were observed and compared before and after the supplementation of arginine.</p><p><b>RESULTS</b>The wound healing time and hospital stay days of severe trauma patient in Arg group (n = 29) were 11. 1+/-2. 8 d and 19+/-6 d, which were all obviously shorter than those in C group (13. 2+/-5. 5 d, 22 +/-6 d, n =33, P <0.05). On the other hand, in severe burn patients there were no significant difference of the wound healing time (20+/-5 d vs 22+/-8 d, n = 12, P > 0. 05) and hospital stay days (28+/-6 d vs 29+/-8 d, n = 12, P >0. 05) between the Arg and C groups. In addition, in C and Arg groups, the occurrence of the side-effects were seldom (2. 44% vs 2. 22% , P = 1. 000) and it disappeared when the supplementation of drugs was stopped.</p><p><b>CONCLUSION</b>Oral feeding of arginine is beneficial in enhancing wound healing, reduction of hospital stay days in severe trauma patients and with little side-effects, but it is not beneficial to improve the prognosis of severe burn patients. Maybe this is due to inadequate number of case involved in the study.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Administration, Oral , Arginine , Therapeutic Uses , Burns , Diagnosis , Drug Therapy , Double-Blind Method , Length of Stay , Prognosis , Wound HealingABSTRACT
<p><b>OBJECTIVE</b>To discuss the principle of diagnosis and surgical treatment of middle lobe diseases of right lung.</p><p><b>METHODS</b>We analysed the clinical data and prognosis of 163 patients who suffered from middle lobe diseases of right lung and received surgical treatment.</p><p><b>RESULTS</b>There were 97 men and 66 women in the group with the ratio 1.5:1, whose age arranged from 13 to 74 years. The shortest course was one week, and the longest 25 years. The average course was 30.3 months. 78 of 163 patients with tumors were malignant (47.9%) and 85 benign (52.1%). The number of the patients below 50 years old was 91 and 81.3% of them were benign, which was very markedly higher than that of the patients with malignant tumors (P < 0.01). The number of the patients above 50 years old was 72 and 84.7% were malignant, which was very markedly higher than that of the patients with benign tumors (P < 0.01); 8 of 11 patients (72.7%, 8/11) who suffered from tuberculosis combined with bronchoactesis. One of this group died from respiratory failure after operation, packed accumulation of fluid between lobes happened in seven cases (4.3%). The survival rate of 1, 3, 5 years of malignant patients at stages I, II were 88.4%, 62.8%, 51.2%, for that at stages III, IV were 76.5%, 41.2%, 14.7%. All of the four patients who received vage-resection, their malignant tumors recurred in one year after operation. No benign lesion recurred in 10 years.</p><p><b>CONCLUSION</b>(1) It should be noticed that nearly half of middle lobe disease were malignant, especially to those whose ages were above 50 years old. (2) When the diagnosis is hard to be confirmed, open-thoracic exploration should be performed in order not to delay the treatment or enlarge the range of lung resection. (3) Most of middle lobe tuberculosis may be combined with bronchoactesis. (4) Setting drainage tube may be useful to decrease the risk of interlobe accumulation of fluid. (5) Vage resection is not suitable for carcinoma of middle lobe of lung.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Diagnosis, Differential , Lung Diseases , Diagnosis , General Surgery , Postoperative Complications , Thoracic Surgical ProceduresABSTRACT
Objective To study the expression of p73 in human non-small cell lung cancer (NSCLC) and the relationship between p73 expression and clinico-pathological parameters. Methods Expression of p7 3 gene was detected by RT-PCR in 32 human NSCLC tissues, tissues adjacent to ca ncer and non-cancer lung tissues. Results p73 gene expression up-regulated substantially and detected in 87.5%(28/32) of human NSCLC tissues while expressed at low level in tissues adjacent to cancer and non-cancer lung tissues. Conclusion Marked up-regulation of p73 gene expres sion is found in human NSCLC.
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Objective To explore the risk factors and causes affecting the operative mortality in esophagectomy patients with esophageal can cer. Methods 1400 cases with a curative esophagectomy for neopl asm of esophagus hospitalized from Mar,1973 to June, 2000 were reviewed. There w ere 31 died within 30 d or during hospitalization after esophagectomy as a group , and 1 369 survival cases, after operation, as another group. Sixteen factors t hat may influence the operational mortality were selected. A multi-variate anal ysis of these individual variables was performed by the computer′s logistic reg ression model. Results The operative mortality was 2.2%(31/1400 ). The causes of death included respiratory complication 17 cases (including res piratory failure caused by pneumonia or atelectasis), 15 cases, and adult respir atory distress syndrome (ARDS) 2 cases, the mortality was 54.8% in the death gro up), anastomotic leak 11 cases (34.5%), Chylothorax 2 cases (6.5%) and postopera tive digestive tract hemorrhage 1 case (3.2%). The results showed that the major risk factors that affected operative mortality in cases with esophageal cancer were history of long-herm heavy smoking, duration of operation and the year of operational (P<0.05). Conclusion To minimize operative mort ality of esophagectomy, some means must be noticed, including the reinforcemen t of the perioperative care, the improvement of anastomotic methods and surgical skill, reduing operative time as p ossible, disposing pulmonary complications in time and using respirator if neces sary.
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Objective To estimate the value of applying left heart bypass technique in esophageal carcinoma resection and gastroesophageal reconstruction. Methods The operation was performed under lef t he art bypass. Results Applying left heart bypass during esophagea l carcinoma resection and gastroesophageal reconstruction increased the probabil ity of the resection. The patient lived better and without operative complicatio n. Conclusion In case of esophageal carcinoma with invasion of descending aorta by carcinoma, left heart bypass may increase the probability of the resection and enhance the safety of surgical treatment.
ABSTRACT
Objective To study the expression of p73 in human non-small cell lung cancer (NSCLC) and the relationship between p73 expression and clinico-pathological parameters. Methods Expression of p7 3 gene was detected by RT-PCR in 32 human NSCLC tissues, tissues adjacent to ca ncer and non-cancer lung tissues. Results p73 gene expression up-regulated substantially and detected in 87.5%(28/32) of human NSCLC tissues while expressed at low level in tissues adjacent to cancer and non-cancer lung tissues. Conclusion Marked up-regulation of p73 gene expres sion is found in human NSCLC.
ABSTRACT
Objective To explore the risk factors and causes affecting the operative mortality in esophagectomy patients with esophageal can cer. Methods 1400 cases with a curative esophagectomy for neopl asm of esophagus hospitalized from Mar,1973 to June, 2000 were reviewed. There w ere 31 died within 30 d or during hospitalization after esophagectomy as a group , and 1 369 survival cases, after operation, as another group. Sixteen factors t hat may influence the operational mortality were selected. A multi-variate anal ysis of these individual variables was performed by the computer′s logistic reg ression model. Results The operative mortality was 2.2%(31/1400 ). The causes of death included respiratory complication 17 cases (including res piratory failure caused by pneumonia or atelectasis), 15 cases, and adult respir atory distress syndrome (ARDS) 2 cases, the mortality was 54.8% in the death gro up), anastomotic leak 11 cases (34.5%), Chylothorax 2 cases (6.5%) and postopera tive digestive tract hemorrhage 1 case (3.2%). The results showed that the major risk factors that affected operative mortality in cases with esophageal cancer were history of long-herm heavy smoking, duration of operation and the year of operational (P<0.05). Conclusion To minimize operative mort ality of esophagectomy, some means must be noticed, including the reinforcemen t of the perioperative care, the improvement of anastomotic methods and surgical skill, reduing operative time as p ossible, disposing pulmonary complications in time and using respirator if neces sary.
ABSTRACT
Objective To estimate the value of applying left heart bypass technique in esophageal carcinoma resection and gastroesophageal reconstruction. Methods The operation was performed under lef t he art bypass. Results Applying left heart bypass during esophagea l carcinoma resection and gastroesophageal reconstruction increased the probabil ity of the resection. The patient lived better and without operative complicatio n. Conclusion In case of esophageal carcinoma with invasion of descending aorta by carcinoma, left heart bypass may increase the probability of the resection and enhance the safety of surgical treatment.