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Objective:To investigate the therapeutic effects of aromatherapy combined with Yin-Yang massage on insomnia in patients. Methods:A total of 120 patients with insomnia who received treatment in Zhoushan Hospital of Traditional Chinese Medicine between September 2017 and December 2019 were included in this study. They were randomly assigned to undergo either aromatherapy (control group, n = 60) or aromatherapy combined with Yin-Yang massage (observation group, n = 60) for 7 days. After treatment, response rate and anxiety status were recorded in each group. Before and after treatment, the scores of Pittsburgh Sleep Quality Index, frequency of taking sleeping pills, and the incidence of adverse reactions were compared between the two groups. Results:Response rate in the observation group was significantly higher than that in the control group [90.00% vs. 73.34%, χ2 = 5.57, P < 0.05]. After treatment, Pittsburgh Sleep Quality Index in the observation group was significantly lower than that in the control group [(9.47 ± 3.65) points vs. (12.45 ± 2.17) points, t = 5.44, P < 0.05]. The frequency of taking sleeping pills in the observation group was significantly lower than that in the control group [(1.19 ± 0.41) times vs. (2.07 ± 0.98) times, t = 6.42, P < 0.05]. There were 0, 3 and 57 cases of severe, moderate and mild anxiety in the observation group, and 5, 18 and 37 cases of severe, moderate and mild anxiety in the control group. There was significant difference in anxiety status between the two groups ( Z = 19.78, P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Aromatherapy combined with Yin-Yang massage can effectively alleviate anxiety in patients with insomnia, improve sleep quality and is highly safe.
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Objective: To analysis the relationship between glucocorticosteroids (GCS) usage and side effects in the treatment of severe acute respiratory syndrome (SARS). Methods: All clinical records of probable SARS patients in Beijing were collected and input into an Epi6 database, in which 1 291 patients had entire information and met the clinical criteria of SARS. The usage of GCS and GCS associated side effects were analyzed retrospectively. Results: Patients accepted GCS therapy were 83.96% (n= 1 084), whereas 16.04%(n=207) did not take GCS. The average dosage of GCS was 160 mg/d in the first week, and then reduced to 80 mg/d and 40 mg/d in the second and the third weeks, respectively. Initial blood glucose, systolic pressure (SBP), and diastolic pressure (DBP) were no significant difference between GCS group and non-GCS group. The highest blood glucose during the treatment in GCS group was markedly higher than that in non-GCS group [(8.68? 4.80 ) mmol/L vs (6.39?3.71) mmol/L, P05). After GCS administration, SBP and DBP were increased gradually, and reached their peaks in the fourth week [SBP (117.2?14.0) mm Hg and DBP (72.5?9.1) mm Hg vs SBP (120.0?12.5) mm Hg and DBP (74.5?8.7) mm Hg, P
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Objective:To survey the incidence of deep venous thrombosis (DVT) in high risk patients undergoing thoracotomy and observe the changes of hemostatic activity. Methods: Fifty-two consecutive patients (ages that ranged from 35 to 79, 34 men and 18 women) with lung or esophagus cancer were enrolled into this prospective trial. The patients included underwent major thoracic surgery from February 2003 to April 2003. Bilateral lower extremity duplex ultrasonography for DVT screening was performed 3-10 days post surgery in all 52 patients and 57 matched clinic normal controls. Venous blood was collected to determine fibrinogen(FIB), D-dimer(D-D), plasminogen activator inhibitor (PAI), antithrombin (AT), thrombin antithrombin complex (TAT), prothrombin time (PT),international normalized ratio(INR), and activated partial thromboplastin time (APTT) immediately before surgery, the third and tenth days postoperatively. No patient had a prior thromboembotic history. Risk factors for DVT were evaluated. Results: Of the 52 patients, 28 (53.8%) had an acute postoperative DVT detected in the calf. One patient died of suspected pulmonary embolism postoperatively. Plasma levels of FIB and D-D increased significantly up to 7 d after operation. AT level decreased significantly 3 d after operation and returned to normal 7 d latter. TAT increased significantly 3 d post operation and decreased to normal on day 7. PAI level was lowered 3 d after surgery, but increased significantly on day 7 compared with that on day 3. With the addition of risk factors related to thrombosis, the incidence of DVT was increased correspondingly. Conclusion: Of the patients undergoing major thoracic surgery,53.8% of them had a postoperative DVT by postoperative screening duplex ultrasound. In Chinese population, incidence of DVT appears to be high without prophylaxis, which is similar to other reports of westerners. These patients had a number of risk factors for the development of DVT, which include older age, overweight, hypertension, diabetes, and history of thromboembolism, etc. Prophylactic measures should be taken against postoperative venous thromboembolism in major thoracic surgery with high risk, including early mobilization, anticoagulant therapy with heparins, and intermittent pneumatic compression (IPC).
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Objective To summarize the experience in prevention and treatment of bile duct injury during laparoscopic cholecysteclomy(LC). Methods Retrospective analysis on the clinical data of 31 cases of LC was carried out. Of them, 27 underwent one stage operative repair and 4 underwent palliative external drainage of the bile duct first. Results 16 cases succeeded and 11 failed in the one stage operative repairing.There were 15 cases underwent 2～4 operations in this series,and the re-operation rate was 48.4%. 29 patients was cured while 2 died. Conclusions During LC, the operative rule should always be strictly observed, and the key to preventing bile duct injury is to avoid clipping, cutting and coagulation blindly.
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The pneumoperitoneum may reduce the renal blood flow which was demonstrated both in experimental and clinical research. Greater change could be seen as the pressure of pneumoperitoneum increased,which may induce lower GFR, decrease urine output ,increase the level of plasma Scr?BUN and so on.All these changes were related to the variety of hemodynamics?nerval-endocrine factors releasing?body position and sorts of insufflated gas.Ischemia-reperfusion injury also is an ignorable factor. Pneumoperitoneum may influence the kidney function , which is reversible under certain pressure and operating time,and were concerned with multiple mechanism. More obvious damage to the dysfunctional kidney could occur under high pressure of pneumoperitoneum.
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Objective To study the experience in prevention and treatment of iatrogenic bile duct trauma(IBDT). Methods A retrospective study was made on the clinical data of 118 patients with iatrogenic bile duct trauma admitted to the Hunan Provincial People's Hospital from March 1990 to September 2000. Results 50.8% (60/118) of patients with IBDT resulted from the wrong identification of the anatomy of the Calot' Triangle during cholecystectomy. The clinical diagnosis of IBDT depended on the clinical findings, diagnostic abdominocentesis and image examination. The diagnostic rate of ultrasonography for IBDT was 93.2%(110/118). According to the injury site of bile duct, IBDT could be divided into 6 types, the most common type of IBDT was resection of partical hepatic duct and part common bile duct(type Ⅲ) which occurred in 83.9% (99/118) of the patients. The cure rate of IBCT was 100%(118/118) in this series due to the choice of operation according to the trauma type. Conclusions The key of prevention to IBDT lies in abiding by the princible of “identifying-cut-recognazing” during cholecystectomy. The choice for surgical operative procedure should agree with the trauma type.
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Objective To study the effect of glutamine and arginine in rats with hepatic fibrosis.Methods Thirty male Wistar rats with hepatic fibrosis induced by CCl4 for 6 weeks were randomly divided into control group(n=10)、glutamine treatment group(n=10) and arginine treatment group(n=10).At 8 weeks after treatment,the liver appearance、collagen protein level and the degree of hepatic fibrosis were observed.Results At the end of 8 weeks,there was no death of any group of the rats.The glutamine group showed the most severe hepatic fibrosis,the control group showed less,and the arginine group showed the least fibrosis.Conclusions The degree of hepatic fibrosis is aggravated by glutamine,while arginine obviously relieves rat hepatic fibrosis.
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Objective To explore the prophylaxis and treatment strategies for psychic syndrome in patients after piggyback liver transplantation.Methods The data on the etiology,treatment outcome and prognosis of psychic syndrome occurring in 45 of 235 patients who had piggyback liver transplantation were retrospectively analyzed.Results The incidence of psychic syndrome complication was 19.1%(45/235),22 cases presented as mania(48.9%),5 cases as tristimania(11.1%),3 cases as hallucinosis(6.7%),1 case as suicidal tendency(2.2%),1 case as metamorphopsia(2.2%),8 cases as angst insomnia(17.8%),2 cases as maladjusted disturbance(4.4%),3 cases as affective disturbance(6.7%),and the majority presented as delirious alienation.All the cases were cured,except 1 case of coma,who was confirmed by CT to have intracranial hemorrage,died after failure of resuscitation.Conclusions The incidence of psychic syndrome in patients after piggyback liver transplantation is relatively high.However,most cases have mild symptoms and the prognosis is fine.When the patients have psychogenic symptoms,the prognosis of patients can be improved by some symptomatic treatment strategies directed to their different clinical manifestations.
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Objective To study the microinvasive treatment of post-gastrectomy acute cholecystisis. Methods Teweenty-eight cases of post-gastrectomy acute cholecystitis were treated by routine non-operative method first, if cases with no apparent relief after 24h of treatment were further treated with percutanous transhepatic gallbladder puncture and drainage(PTGD) guided by ultrasonography. Results Five cases were treated by non-operative method with complete relief within 24 hours. PTGD was done successfully in all the other 23 cases.In cases with ideal bile drainage at the time of intubation, the patients had immediate marked relief of their symptoms and signs, and they fully recovered within 3~7 days.Conclusions Ultrasound guided PTGD is an effective treatment for post-gastrectomy acute cholecystitis with the advantages of microinvasion and quick patient recovery.
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ObjectiveTo investigate the methods of hepatic arterial reconstruction in orthotopic liver (transplantation)(OLT), and the prevention and management of associated complications, so as to improve the therapeatic results and donor survival rate of OLT.MethodsThe clinical data of 85 cases of orthotopic liver transplantation performed in our institute from May 1995 to May 2004 were retrospectively analysed. Hepatic artery reconstruction was made by use of Carrels patch of donor celiac artery or bifurcation of donor common hepatic artery and splenic artery anastoniosed to left and right hepatic artery of recipient in 16 cases((18.82)%), to bifurcation of gastroduodenal and proper hepatic arteries of recipient in 61 cases((71.76)%), or use of donor iliac artery interposition graft to abdominal aorta in 8 cases(9.42%). Regular heparin or low-molecular-weight heparin as a prophylactic anticoagulation therapy was maintained during and after (operation) as indicated by prothrombin time. Intra-and postoperative Doppler ultrasonography was used to (monitor) hepatic arterial blood supply.ResultsHepatic artery thrombosis(HAT) was observed in 1 case (intraoperatively)(overall incidence 1.2%).Thrombectomy and reconstruction of the arterial anastomosis were performed immediately.This patient currently has a survival time of 13 months without HAT. HAT was not observed in any of the other 84 cases during the follow up of 2 to 52 months.Conclusions Hepatic artery thrombosis may be minimized by proper selection of anastomotic site of hepatic artery reconstruction and (effective) use of postoperative anticoagulation.Close follow-up by Doppler ultrasonography may make a prompt diagnosis of HAT, salvage grafts and avoid re-transplantation.
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Objective To explore the effect and the mechanism of glycynhizin in the prevention of colonic cancer (after) cholecystectomy. Methods Sixty mice were randomly divided into 3 groups: Sham group(S group),group of model of colonic cancer after cholecystectomy(C group) and glycynhizin treatment group(GL group). The incidence of colonic cancer, expressions of p53 mRNA,p21 mRNA and bcl-2mRNA and the activity of NF-?B were tested. Results The incidence of colonic cancer in C group was significantly higher than that in GL group (P
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Objective To investigate the relationship of postoperative complications of thyroid surgery with primary thyroid disease, operation procedures and operative manipulation. Methods The clinical data of 1805 cases of thyroid diseases treated by surgery in our department between 1990～2001 were analyzed retrospectively . Results There were 67 complications occurred in 1805 cases (3.7%). The postoperative complications rate in Hashimoto′s disease and thyroid carcinoma were 6 (16.2%) and 27 (12.2%) respectively ,which were obviously higher than that in other primary thyroid disease( P
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ObjectiveTo determine the possible causes for functional delayed gastric emptying (FDGE) and its diagnosis and treatment. MethodsThe clinical data of 53 FDGE patients after subtotal gastrectomy from 1987 to 2001 were retrospectively analysed. ResultsAll the 53 patients were recovered and discharged. Among them, 11 were misdiagnosised as mechanical ileus and were reoperated on. ConclusionsThe main cause of FDGE may be the disturbance of gastrointestinal motility which may be caused by vegetative nerve injury during the operation. The main therapy is non-surgical treatment and reoperation should be avoided at the early stage.
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Objective To explore the effect of exposure of the recurrent laryngcal nerve(RLN) in prevention of RLN injury during thyorid surgery.Methods The clinical data of 810 cases of thyroid operation in which the RLN was exposed in 252 cases(group A) and was unexposed in 558 cases(group B) were analyzed.Results Although the extent of thyroid resection was greater in group A than in group B,the rate of RLN injury in group A(1.19 %) was significantly lower than that of group B(3.05 %,P
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Objective To study the etiology,diagnosis and treatment of functional delayed gastric emptying(FDGE) resulting from pancreatoduodenectomy.Methods From June,1990~June,2003,136 patients received pancreatoduodenectomy,whose clinical data were retrospectively analyzed.Upper gastrointestinal(radiography) and endoscopy were the main methods of examination.Results Twenty-eight cases were(complicated) with FDGE in the 136 patients(20.6%) after operation.The occurrence of FDGE was(correlated) with hyperbilirubinemia,diabetes,duodenal obstruction,pancreatic fistula and abdominal infection.All patients were cured with conservative treatment.The recovery time of gastric motility was 14-42 days,average time was 28 days.Conclusions Hyperbilirubinemia,diabetes,duodenal obstruction,pancreatic(fistula) and abdominal infection were the main causes of FDGE.
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Objective To improve the technique of pancreatoduodenectomy in order to facilitate the(management) of complications and direct observation on follow up.Methods Pancreatoduodenectomy and Child′s method of digestive tract reconstruction was performed in 42 paltents.A blind loop of jejunum 5 to 6 cm in length was constructed beyond the pancreatojejular anastomosis and it was fixed to the subcutaneous(tissue) of the adjacent abdominal wall.Results Thirty-two cases recovered uneventfully,and 10 cases had complications induding pancreatic and biliary leakage and hemorrhage.These complications were successfully treated under direct vision by choledochoscope passed into the blind jejunal loop.This method of observation was used for long-time follow up in 22 cases,and revealed ercurrent tumor(n=5),bile duct stricture(n=4) and bile duct ascariasis(n=1).Conclusions This operative method did not cause new(complications) and it can be combined with the traditional operation.Postoperatively,direct observation and management of leakage of pancreatojejular anastomosis and biliointestinal anastomosis and hemorrhage can be accomplished,and the anastomoses and pancreatic stump can be directly observed at followup.
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Objective To analyse the causes of postoperative complications of pancreatoduodenectomy(PD) and study measures for prevention and treatment of the complications.Methods A retrospective study was carried out on the data of 139 cases of pancreatoduodenectomy performed during recent 3 years in our(hospital).They included 91 cases of radical resection operation and 43 cases of pancreatoduodenectomy(combined) with vascular resection.Results There were 38 cases(27.4%) occurred complications after PD,including 10 cases(7.2%) of upper gastrointestinal hemorrhage,4 cases(2.9%) of hemorrhage in the abdominal cavity,and 6(4.3%) cases of pancreatic leakage,4cases(2.9%) of bile duct leakage,3((2.2%)) cases of intra-abdominal infection,5 cases(3.6%) of pulmonary infection,and 6 cases((4.3%)) of functional delayed gastric emptying.Four cases died during the peri-operative period.The overall mortality rate were 2.9%.Conclusions The main complications after PD were hemorrhage,pancreatic leakage,bile duct leakage and intra-abdominal cavity infection.Meticulons operative technique,the selection of appropriate anastomoses technique,careful observation and timely aggressive management in the postoperative period are the key points to reduce postoperative morbidity and motality rate after PD.
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Objective To summarize the causes of abdominal pain in the early postoperative period after laparoscopic cholecystectomy(LC), so as to employ preventative measures. Methods The clinical data of 35 patients with early postoperative abdomial pain after LC were analyzed retrospectively and the literature was reviewed . Nine cases underwent reoperation, and conservative treatment was successfully performed in the other 26 cases. Results Traumatic factors were involved in 8 cases, including 6 cases of postoperative biliary fistula , and 2 cases with calculus retained in the trocar hole of the abdominal wall. 27 cases had no traumatic factor and included 2 cases of ascariasis of common bile duct, 5 cases with calculus of common bile duct, 1 case of acute pancreatitis, 17 cases of bile duct dysfunction, 1 case of duodenal ulcer and 1 case of stomach cancer. All were cured. Conclusions The key to decrease complications after LC is a complete examination before LC and pay attention to each aspect of perioperative management.
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Objective To assess the effect of intravenous infusion of octreotide in prevention of pancreatic fistula after pancreaticoduodenectomy. Methods The clinical data of 74 cases of pancreaticoduodenectomy performed from January 1996 to July 2003 were retrospectively reviewed. These included 36 cases in control group in which octreotide was not adminstered,and 38 cases in octreotide group in which octreotide was administered by intravenous infusion of 0.5?g/( kg?h) for 12 hours per day from the operative day to postoperative day 7. The study parameters included clinical manifestation,drainage from peritioned cavity and the amount of drainage of pancreatic fluid. Results The drainage of pancreatic fluid at postoperative day 1,3,5 the in octreotide group was significantly less than those in the control group,the average hospital stay and the incidence of pancreatic fistula were significantly lower than those in the control group,and the drainage of pancreatic fluid was significantly increased after the withdrawal of octreotide in the octreotide group. Conclusions Intravenous infusion of octreotide can significantly lower the incidence of pancreatic fistula after pancreaticoduodenectomy.
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Objective To explore the etiology,mechanism and treatment of diarrhea after(pancreatoduodenectomy).Methods Based on the clinical data of 159 cases of pancreatoduodenectomy(performed) in the recent one and half years,the pathogenesis of post-pancreatoduodenectomy diarrhea was(analyzed) and the effect of different treatments was observed.Results Seventy-one cases had diarrhea,with an incidence of 44.7%.Tweenty-two cases had bacterial infection of the intestinal tract and 4 cases had fungus infection.The incidence of infection was 36.6%.In 64 cases diarrhea was relieved with effective treatment,accounting for 90.1% of all cases.Seven cases with chronic diarrhea had additional treatment with oral pancreatic enzyme and symptoms were relieved 2 weeks after treatment.Conclusions Diarrhea is frequently observed in patients after pancreatoduodenectomy,and the majority of them can be cured with(treatment) selected according to the pathogenesis.