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Objective:To analyze the clinical efficacy of POEM treating patient with achalasia of cardia and observe the risk factor of effecting curative efficacy.Methods: 66 patients with achalasia of cardia who were treated by using POEM were enrolled in this study, and series of indicators of esophagus dynamics including LESRP, LESP, LESRR and LESL were detected in pre and post operation. Clinical symptom score system(Eckardt score) of achalasia of cardia was adopted to evaluate the effect of surgical treatment for patients at the pre and post operation 7d, and the diameter of widest part of esophagus at pre and post operation 7d were detected. The incidence rate of pneumoderm, substernal ache, pulmonary infection, pleural effusion, tunnel bleeding, postoperative reflux and esophageal perforation and other complications were analyzed and the relative risk factors of effecting curative effect were observed.Results: The LESRP and LESP of patients with achalasia of cardia of post-operative 7d were significantly lower than that of pre-operative 7d(t=12.74,t=17.56,P<0.05), while the LESRR and LESL of post operative 7d were significantly higher than that of pre-operative 7d(t=9.10,t=14.86,P<0.05) , respectively. And the Eckardt score and widest diameter of post-operative 7d were significantly lower than that of pre-operation(t=19.49, t=7.83,P<0.05), respectively. Besides, the incidence rate of complication of patients in post-operation was 48.48％. As the results of Logistic regression, age, Chicago type and Ling type were the risk factors that affect curative effect of POEM for achalasia of chardia. And as the analysis, the prognosis was better when the patient's age was less than 60 years, Chicago II type and Ling type.Conclusion: POEM can significantly improve the indicators of esophagus dynamics, and the complication will be few and the curative effect will be exact in middle and short term of post-operation by using this method. Therefore, it is a safe and effective surgical mode.
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Objective:To discuss the application of water-aided colonoscopy in the enteroscopy, and compare with traditional air insufflations colonoscopy so as to analyze the efficacy and safety of clinical enteroscopy.Methods: 248 patients accepted with non-anesthesia colonoscopy were enrolled in this study and they were divided into two groups (water-aided group,n=124, air insufflations group,n=124) as the random number table. All clinical data of two groups were collected, and the bowel preparation statuses of patients was evaluated when the colonoscopes were taken out. During detection, the success rate of intubation, the entrance time of colonoscope, the withdrawal time of colonoscope and the total time of examinations were recorded. After detection, the pains score of patients were recorded and evaluated, and a series of auxiliary operation in the process, such as the change of body position, abdominal compression and the adjustment for hardness were recorded. Results: The differences of bowel preparation status scores of left colon, transverse colon, right colon and the whole colon between two groups were not statistically significant(t=0.98,t=0.85,t=1.07,t=1.51;P>0.05). The difference of success rate of intubation between two groups was no significant(x2=0.73,P>0.05). The entrance time, the withdrawal time of colonoscope and the total time of intubation of water-aided group were significantly higher than these of air insufflations group, while the VAS of water-aided group was significantly lower than that of air insufflations group(t=5.78,t=3.85,t=5.64, t=10.25;P0.05).Conclusion: The water-aided colonoscopy can relieve pain of patients, and it doesn't affect the success rate of intubation for cecum.
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Objective To study the efficacy of chemotherapy combined with immunotherapy in treatment of middle and advanced stage non-small cell lung cancer and improvement of patients'life quality.Methods 140 patients with middle and advanced stage non-small cell lung cancer treated from Mar .2012 to Mar.2014 were in-cluded and they were randomly divided into two groups:the observation group(70 cases)and the control group(70 cases).The observation group took chemotherapy combined with immunotherapy , while the control group took chemotherapy treatment alone .Patients'life quality , treatment effects and changes in immune indexes were co-mared between the two groups .Results The improvement rate of life quality of the observation group (90.0%) was significantly higher than that of the control group (58.6%), and the difference had satistical significance (P<0.05).The response rate of the observation group (88.6%) was significantly higher than that of the control group(70.0%), and the difference had statistical significance (P<0.05).The increasement rate of CD3 +, CD4 +, CD8 +cells, as well as CD4 +/CD8 +cells was significantly higher in the observation group than in the control group, and the difference had statistical significance (P<0.05).Conclusion Chemotherapy combined with immunotherapy in teatment of patients with middle and advanced non-small cell lung cancer has obvious effect, high safety, and high clinical value .
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To disscus the characteristics of leukorrhea treatment of the four great famous doctors in Jin-Yuan Danasty, including the recognition of etiopathogenisis and pathogenesis, the view of determination of treatment based on differentiation of symptoms and signs, therapeutical principle and medication. LIU Wan-su believed fireheat was the important factor leading to illness. He firstly advocated differentiating symptoms and signs of leukorrhea with heat and treating it by clearing away heat evil and eliminating damp. ZHANG Zi-he considered the leukorrhea due to humid-heat flowing down to small intestine. He advocated lowing heart fire and tonifying kidney yin as the therapeutical method of leukorrhea with emetic and purgation method. LI Dong-yuan considered the injury of qi of the spleen and stomach was the main factor, so he diagnosed and treated leukorrhea on basis of the spleen and stomach. ZHU Dan-xi deemed leukorrhea happened when damp and sputum obstructed the spleen, so he thought that deprived the evil wetness was the fi rst and important method of treating leukorrhea.