Research progress of the open abdomen in the treatment of gastrointestinal fistula with complicated intra-abdominal infection / 中华胃肠外科杂志

Gastrointestinal fistula patients may suffer from complicated intra-abdominal infection and sepsis with improper treatment, which is characterized by high mortality ranging from 20% to 60%, as well as high medical costs. Gastrointestinal fistula patients with complicated intra-abdominal infections are not often diagnosed early, and proper treatment remains an unsolved problem. Therefore it is a great challenge for surgeons to repair broken intestines under complicated intra-abdominal infection conditions and to repair ruptured intestines under conditions of severe abdominal adhesions and swelling of the intestinal wall and mesentery. After the open abdominal approach was first adopted to treat complicated intra-abdominal infection patients by Duff and Moffat in 1981, it gradually began to be used more widely. However, some investigators have reported that the open abdomen approach has not been effective in controlling controlled mortality, instead, it may even increase mortality. For this reason, the approach has only been used in large medical centers rather than having been widely popularized. In this review, the effect, timing, indications of open abdomen approach and the principles for the open abdominal wound management are summarized, and the reason for the various efficacy among different centers is also analyzed. We provide a new perspective for clinicians to manage the gastrointestinal fistula patients with complicated intra-abdominal infection.

Experience of the three-stage strategy for intestinal fistula complicated with complex abdominal infection / 中华胃肠外科杂志

Intestinal fistula, as a serious complication after abdominal surgery, not only leads to a series of pathophysiological changes such as fluid loss, malnutrition and organ dysfunction, but also causes the severe abdominal infection, which often threatens the life of patients. How to make the diagnosis and give the treatment of intestinal fistula is the key to save the lives of high-risk patients. In our hospital, during the past course of diagnosis and treatment for intestinal fistula complicated with severe abdominal infection, based on the combination of literatures at home and abroad with our clinical experiences for many years, an effective three-stage prevention and treatment strategy was formed gradually, which included early diagnosis, effective treatment of infection source, open drainage of abdominal infection and early enteral nutrition support. This strategy subverts the traditional concept of surgery alone, and becomes an effective means to save patients with severe abdominal infection.

"New Direction in Chinese Materia Medica Toxicity Study: Discovery of Potential Toxicity in ""Non-toxic"" Drug" / 世界科学技术-中医药现代化

In recent years, with the rapid development of Chinese materia medica (CMM) industry, its clinical applications have become more and more widespread. While, adverse reactions of CMM have also become increasingly prominent. However, for adverse reactions of some CMM, the applications of conventional toxicology studies cannot draw definitive conclusions. These CMM, which were not defined as toxic drugs in traditional Chinese medicine (TCM) theories, have unknown potential toxicities and affect the safety in their clinical use. This paper reviewed recent advances in studies on potential toxicity of non-toxic CMM. It analyzed and summarized potential toxic compounds among them, and introduced application for metabolomics researches on potential toxicities in non-toxic CMM.