Diagnosis and treatment of primary small bowel tumors / 中国普通外科杂志

Objective　To study the clinical manifestation of small bowel tumors and the prognostic factors. Methods　Retrospective analysis of the clinical data were made on 42 cases of primary small bowel tumors (except periampullary tumors) admitted to our hospital from 1974 to 1999. Results　In this series, there were 6 cases of benign small bowel tumors, 5 of them were leiomyoma and 1 adenoma. Of the 36 cases of malignant 　tumors, there were malignant lyphoma in 17 cases (47.2%), adenocarcinoma in 11 (30.6%),　 leiomyosarcoma in 6(16.7%), carcinoid tumor in 1 (2.8%) and neurofibrosarcoma in 1 (2.8%). There was no characteristic clinical sign in small bowel tumors; endoscopy and barium series were the main diagnostic methods. About 50 per cent of patients with malignancy had metastasis, and only 18 cases (50%) received radical resection. Follow-up were available on 36 cases. The overall 5-year survival rate in the patients with malignant small bowel tumors was 47.3%. Multivariate analysis showed that metastasis and diameter of tumors were the main prognostic factors of the 5-year survival. Conclusions　Early diagnosis and early treatment play the key roles in improving the prognosis of malignant small bowel tumors. Radical resection should be taken if no metastasis is found.

Low calorie parenteral nutrition in the elderly abdominal surgical patients / 中国普通外科杂志

ObjectiveTo determine the appropriate method of parenteral nutritional(PN) treatment in the elderly abdominal surgical patients. Methods48 operative and 33 nonoperative patients who were put in fasting state received parenteral nutrition for 5 days. The calorie supplied by nonprotein nutrition was 20kcal?kg1?d1 and the protein was 0.8～1.25g?kg1?d1. ResultsPN treatment could maintain the normal plasma protein level and had no influence on the liver and renal function. No side effects or metabolism disorders were noted in this series. ConclusionsLow calorie PN can be safely used in the elderly abdominal surgical patients.

Prevention of abdominal adhesion with polyclonal antibody of transforming-growth factor beta : an experimental study / 中国普通外科杂志

Objective To block the bio function of TGF ? by the application of anti TGF ? polyclonal antibody, and observe its efficacy of prevention of abdominal adhesion. Methods The postoperative abdominal adhesion model was established in SD rats. The drugs were administrated by abdominal injection with saline (control group), sodium hyaluronate( HA group), and varied dosage of anti TGF? (anti TGF? groups) respectively. The adhesion was scored 21days later, while 30 of them were executed on the day 3 and day 10 after operation respectively. The expression of TGF ? was checked by immunohistochemistry in the samples obtained from the adhesion sites. Results The score of adhesion in anti TGF ? group (2.4?0.99) was significantly lower than that in control group (6.0?1.25) and HA group (3.4?1.03); in different dosage of anti TGF, the 50?g group showed its economical efficacy; in the control and HA groups the expression of TGF ? had a time dependent manner, which reachs to maximum in the day 3, and could be reduced by antibody. Conclusions The polyclonal antibody of TGF ? shows the power to prevent the postoperative abdominal adhesion in animal model, the mechanism of which is due to inhibition of TGF ? expression.

Clinical application of lower caloric parenteral nutrition with glutamine dipeptide in elder abdominal surgical patients / 肠外与肠内营养

Objectives: To study the value of glutamine dipeptide supplemented lower caloric parenteral nutrition in elder abdominal surgical patients. Methods:Forty patients were randomly allocated into study group and control group, receiving isocaloric (83.6 kJ/kg?d -1 ) and isonitrogenous (0.16 g/kg?d -1 ) PN from post operation day1 to post operation day 6. The study group received 0.3 g of alanyl glutamine/(kg?d)? Plasma albumin, pre albumin, IgG, IgA and IgM level were measured and lymphocyte was counted before surgery and on days 1 and 7 after surgery. Nitrogen balances were calculated postoperatively on day 1, 4 and 7. Results:Compared with preoperation, plasma albumin and pre albumin levels were both decreased in two groups and was markedly decreased in the control group ( P

Application of parenteral nutrition with fructose-1,6-diphosphate in elder abdominal operative patients / 肠外与肠内营养

Objectives:To study the value of fructose-1,6-diphosphate-supplemented parenteral nutrition in elder abdominal surgical patients.Methods:thirty-two patients were randomly allocated into study group and control group,receiving isocaloric(83.6 kJ/kg?d~(-1)) and isonitrogenous(0.2 g/kg?d~(-1)) PN from post-operation day 1 to post-operation day 6.The study group received 10g of FDP every day and did not receive Glycophos.Plasma albumin,pre-albumin and phosphate lever were measured and EKG was examined before surgery and days 1 and 7 after surgery.The level of 3-methylhistidine(3-MH) in urine was measured and nitrogen balances were calculated postoperatively on day 1,3,5 and 7.Results:The blood phosphate levels were normal in two groups before and after surgery.Compared with preoperation,plasma albumin and pre-albumin levels were both decreased in two groups and pre-albumin level was markedly decreased in the control group(P