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The prognosis of malignant tumors of the digestive system is still a matter of close attention in the medical and health field. At present, evaluating the prognosis of patients with digestive system malignant tumors is mainly based on the TNM staging of the tumor after surgery. As one of the ten characteristics of cancer, inflammatory indicators have certain guiding significance for the prognosis and treatment of patients with malignant tumors of the digestive system. As a new type of inflammation index, the systemic inflammatory response index is significantly better than other traditional inflammatory indexes in evaluating the prognosis of patients with digestive system malignant tumors. This article reviews the related studies on the systemic inflammatory response index in evaluating the prognosis of digestive system malignant tumors.
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Objective To evaluate the efficacy of phloroglucinol combined with dyclonine hydrochloride mucilage in preventing catheter-related bladder discomfort (CRBD)during recovery from anesthesia in patients under general anesthesia.Methods A total of 120 male patients scheduled for laparoscopic cholecystectomy under general anesthesia,aged 18-60 years,weighing 46-80 kg, ASA physical status I or II,were randomly divided into 3 groups (n=40 in each group):group of combination of phloroglucinol and dyclonine hydrochloride mucilage (group P),sufentanil group (group S)and control group (group C).After induction of general anesthesia,the patients in group P were tracheally incubated and then inj ected with 5 ml dyclonine hydrochloride mucilage per urethra.In the meantime,for patients of groups S and C,equal volume of normal saline was inj ected and paraffin oil was used to lubricate for urethral catheterization.The catheter was clamped and then reopened 30 min later.At 15 min before the end of surgery,80 mg Phloroglucinol,0.10 μg/kg sufentanil and an equal volume of normal saline were injected intravenously in group P,group S and group C,respec-tively.The catheter was removed when the patients were fully awake.The awakening time and extu-bation time were recorded.In addition,Riker sedation-agiation scale (SAS)score was documented at 5 min (T1),15 min (T2),30 min (T3),1 h (T4)and 2 h (T5)after extubation.The occurrence and severity of CRBD within 2 h after surgery,as well as occurrence of nausea and vomiting and respira- tory depression were recorded.Results Compared with group C,the SAS score at T1-T4and inci-dence and severity CRBD were decreased,whereas the emergence time and extubation time were pro-longed in group S.The SAS score at T1-T5,incidence and severity of CRBD were decreased (P<0.05),and no significant change was found in emergence time and extubation time in group P.Com-pared with group S,the SAS score at T1-T4was increased,whereas the SAS score at T5,incidence and severity of CRBD were decreased,and the emergence time and extubation time were shortened in group P (P<0.05).There was no significant difference in the incidence of nausea and vomiting,re-spiratory depression and extubation time among the three groups. Conclusion Dyclonine hydrochloride mucilage injected per urethra combined with phloroglucinolol injected intravenously at 1 5 min before the end of surgery can reduce the incidence and severity of CRBD during the recovery from anesthesia in the patients under general anesthesia.
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Objective To study the epidemic characteristics,distribution of pathogen and clinical characteristics of hand,foot and mouth disease in Shenyang area,2014.Methods Swab specimens was collected from 5 070 cases of hand,foot and mouth disease caces,the F-PCR method was adopted for entero-virus 71 (EV71 ),coxsackievirus A 16(CA16)and universal enteroviruses(EU)detection,and combining the relevant clinical data for comparative analysis .Results June to August was the peak epidemic period.5 070 nasopharyngeal swab specimens were detected positive 3 715 intestinal virus nucleic acid,and the detection rate was 73.27%,including CA16 positive 1 481 (39.87%),EU positive 1 148 (30.90%),EV71 positive 1 086(29.23%).The proportion of EU positive was highest in June(29.71 %).The proportion of EV71 pos-itive(24.78%)and CA16 positive(33.27%)were highest in July,respectively .The proportion of nervous system symptoms in EV71 infection group(88 /1 12,78.57%)was higher than those in EU infection group (97 /147,65.99%)and CA16 infection group (44 /78,56.41 %).The proportion of abnormal myocardial enyzme in CA16 infection group (37 /78,47.44%)was higher than those in EU infection group (48 /147, 32.65%)and EV71 infection group(34 /1 12,30.36%).Conclusion CA16 is the major pathogen causing hand,foot and mouth disease in Shenyang area,2014.Severe hand,foot and mouth is still dominated by EV71 .
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Objective To compare the bronchial blocker and double-lumen tube for one-lung ventilation in the elderly patients undergoing minimally invasive direct coronary artery bypass (MIDCAB).Methods Thirty six patients of both sexes,aged 65-78 yr,with the left ventricular ejection fraction ≥ 45％,with body mass index ＜ 30 kg/m2,of ASA physical status Ⅱ or Ⅲ (NYHA Ⅰ-Ⅲ),scheduled for elective MIDCAB in the left thorax,were randomly divided into 2 groups (n =18 each):double-lumen endotracheal tube group (group D) and bronchial blocker group (group B).Anesthesia was induced with midazolam 0.05 mg/kg,etomidate 0.3 mg/kg,fentanyl 10μg/kg and cisatracurium 0.15-0.20 mg/kg.The patients were intubated with a left-sided double-lumen endotracheal tube 5 min later in group D.The patients were intubated with a single-lumen endotracheal tube 5 min later,and then Coopdech bronchial blocker was inserted into the primary bronchus in group B.The patients were mechanically ventilated.Before induction of anesthesia,at 2 min before intubation,immediately before and after intubation,and at 1 and 2 min after intubation,mean arterial pressure (MAP),heart rate (HR),and mean pulmonary arterial pressure (mPAP) were recorded and rate-pressure product (RPP) was calculated.The requirement for vasoactive drugs was recorded during induction of anesthesia.Lung collapse developed after the pleura was opened was also recorded.Surgical exposure was scored at the end of operation.Results Compared with group D,MAP,HR RPP and mPAP were significantly decreased after intubation,the requirement for nicardipine and esmolol was decreased,and no significant change was found in the requirement for atropine and metaraminol,rate of lung collapse and score of surgical exposure in group B.Conclusion Compared with doublelumen tube,bronchial blocker can provide sufficient exposure of the surgical filed,and intubation-induced fluctuation of hemodynamics is small in the elderly patients undergoing MIDCAB.
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Teaching is an art,which requires teachers to have high profession level and better ability of language expression.To stress teaching techniques is the request of higher medical science education.It is worth summarizing and thinking seriously.This article summarized several aspects of teaching techniques,essence.In addition,it explained the significance of teaching techniques.