ABSTRACT
Objective To investigate the relationships between the expression levels of tumor necrosis factor receptor associated factor 4 (TRAF4) and ribosomal S6 protein kinase 4 (RSK4) protein in gastric cancer tissues and the recurrence after laparoscopic radical gastrectomy. Methods In total, 176 patients were divided into the recurrence and non-recurrence group, and the expression levels of TRAF4 and RSK4 protein in cancer and adjacent tissues and in gastric cancer tissues in the recurrence and non-recurrence group were compared. The influencing factor of recurrence and the efficacy of TRAF4 and RSK4 protein expression in predicting recurrence were analyzed. Results The positive expression rate of TRAF4 protein in gastric cancer tissues was higher than that in adjacent tissues (P < 0.05) and that in the recurrence group was higher than that in the non-recurrence group (P < 0.05). The positive expression rate of RSK4 protein in gastric cancer tissues was lower than that in adjacent tissues (P < 0.05) and that in the recurrence group was lower than that in non-recurrence group (P < 0.05). The largest tumor diameter 5 cm, poor differentiation, TNM Ⅲ stage, depth of invasion T3-T4, lymph node metastasis, absence of adjuvant chemotherapy after operation, positive expression of TRAF4 and RSK4 protein, and regular diet w influenced the post-operative recurrence (all P < 0.05). The accuracy of TRAF4 and RSK4 protein in gastric cancer tissues in combined predicting the recurrence was 83.52%. Conclusion The expression of TRAF4 protein is high, and the RSK4 protein is low in gastric cancer tissue, which are related to recurrence.
ABSTRACT
Objective:To investigate the relationship between parathyroid hormone（PTH） level and permanent hypoparathyroidism（PHPP） on the first day after radical papillary thyroidectomy, and its predictive value. Methods:A total of 80 patients with papillary thyroid cancer who underwent total thyroid resection and central lymph node dissection were collected and analyzed from January 2021 to January 2022. According to whether PHPP occurred after surgery, the patients were divided into hypoparathyroidism group and normal parathyroid function group, and univariate and binary logistics regression were used to analyze the correlation between PTH and serum calcium levels and PHPP on the first day after surgery in two groups. The dynamic changes of PTH at different time points after operation were analyzed. The area under the receiver operating characteristic was used to evaluate the predictive power of PTH on the development of PHPP after surgery. Results:Among the 80 patients with papillary thyroid cancer, 10 cases developed PHPP, with an incidence rate of 12.5%. Binary logistics regression analysis showed that PTH on the first postoperative day（OR=14.534, 95%CI: 2.377-88.858, P=0.004） was an independent predictive risk factor for postoperative PHPP. Taking PTH=8.75 ng/L on the first postoperative day as the cut-off value, the AUC of the area under the curve was 0.874（95%CI: 0.790-0.958, P<0.001）, the sensitivity was 71.4%, the specificity was 100%, and the Yoden index was 0.714. Conclusion:PTH level on the first day after total thyroid papillary carcinoma surgery is closely related to PHPP, and is an independent predictor of PHPP.
Subject(s)
Humans , Calcium , Hypoparathyroidism/surgery , Parathyroid Glands , Parathyroid Hormone , Postoperative Complications/surgery , Thyroid Cancer, Papillary/surgery , Thyroid Neoplasms/complications , ThyroidectomyABSTRACT
Objective:To explore the application effect of three mode pre-rehabilitation strategy in gastric cancer patients after laparoscopic radical operation and its effect on the recovery of physical function and quality of life after operation.Methods:Totally 96 patients undergoing elective laparoscopic-assisted radical gastric cancer surgery admitted in the Second Affiliated Hospital of Anhui Medical University from January 2019 to September 2020 were divided into control group (48 cases) and observation group (48 cases) by the random number table. Finally two cases in control group were excluded. The control group received gastric cancer regular preoperative health guidance, the observation group received trimodal pre-habilitation strategy for 6-8 days on the basis of the control group. The perioperative indicators and complications were compared between the two groups. The 36-item Health Survey Summary (SF-36) scores were measured before and after intervention.Results:The first postoperative exhaust time, first out of bed time, first oral meal time, hospital stay in the observation group were (61.49 ± 6.71) hours, (19.54 ± 6.13) hours, (71.23 ± 6.79) days, (5.62 ± 1.03) days, which lower than (79.21 ± 8.15) hours, (22.95 ± 7.19) hours, (78.95 ± 7.21) days, (6.64 ± 1.17) days in the control group, and the differences were statistically significant between the two group ( t values were 2.48-11.53, all P<0.05). The incidence of complications was 6.25% (3/48) in the observation group and 21.74% (10/46) in the control group, and the difference was statistically significant between the two groups ( χ2=8.72, P<0.05). At 1 d before operation and 30 d after operation, the average scores of SF-36 were (68.74 ± 8.02), (65.85 ± 7.44) points in the observation group and (60.73 ± 7.43), (61.04 ± 6.85) points in the control group, and the differences were statistically significant ( t=5.02, 3.26, both P<0.05). Conclusions:Preoperative three mode pre-rehabilitation training for gastric cancer patients is beneficial to improving the state of exercise, nutrition and immune function, speeding up postoperative gastrointestinal function and overall rehabilitation, reducing the incidence of postoperative complications and improving the quality of life of patients.
ABSTRACT
Hilar cholangiocarcinoma (HCCA) is a highly malignant tumor adjacent to liver tissue and the anatomical site of the hepatic portal, which easily invades the hepatic arteries and portal veins. Consequently, vascular resection and reconstruction are significant for the surgical treatment of HCCA, which are the key to improving the R 0 resection rate and long-term efficacy. The resection and reconstruction of hepatic hilar vessels, especially the hepatic arteries, have always been a challenge for surgeons. The purpose of this article is to discuss the surgical points of HCCA radical treatment combined with resection and reconstruction of portal vein and hepatic artery to help clinicians improve the R 0 resection rate of HCCA, thus improving the outcomes and prognosis of patients.
ABSTRACT
The standard lymphadenectomy (D2) is the most important quality control index for the surgical treatment of locally advanced gastric cancer (LAGC). It is debatable whether there is a survival benefit of extended lymphadenectomy beyond D2 dissection. Para-aortic lymph nodes are not included in the range of D2 lymph node dissection. However, the patients with para-aortic node metastasis can get better survival after neoadjuvant chemotherapy and D2+ surgery. Lymph nodes along the superior mesenteric vein (No.14v) are considered as regional nodes, and the prognosis of patients with No.14v metastasis treated with D2+ lymph node dissection is significantly better than that of stage Ⅳ patients undergoing only D2 dissection. No.14v was not included in the D2 lymph node dissection paradigm. In case with nodal metastases in No.6 group, D2+ dissection is recommended. Lymph nodes at the splenic hilum (No.10) are not included in the range of D2 dissection, when the tumor infiltrates the greater curvature of the stomach, D2+ splenectomy or No.10 nodal dissection should be performed. Lymph nodes on the posterior surface of pancreatic head (No.13) do not belong to the D2 range, but the rate of metastasis is significantly higher when distal gastric cancer invades the duodenum, D2+ lymphadenectomy is recommended. Lymph node dissection in the posterior group of the common hepatic artery (No.8p) can improve the patient's long-term survival, but there is no support from of evidence-based medicine. In the era of perioperative treatment and minimally invasive surgery in China, open or laparoscopic D2 lymphadenectomy is recommended for cT3-4N1M0 patients and SOX neoadjuvant chemotherapy plus D2 surgery plus SOX adjuvant chemotherapy should be carried out for patients with cT3-4N2-4M0. Depending on the patient's condition and the experience of the surgical team, open or laparoscopic surgery can be performed.
Subject(s)
Humans , Gastrectomy , Laparoscopy , Lymph Node Excision , Retrospective Studies , Stomach Neoplasms/pathologyABSTRACT
Objective To investigate the factors influencing the disease-free survival (DFS) and prognosis of patients with non small cell lung cancer after Ⅲa stage resection, and to evaluate the effect of traditional Chinese medicine intervention.Methods A total of 148 cases met the inclusion criteria were enrolled in the study. The DFS, 1-, 2- and 3-year disease-free survival rates were analyzed. Univariate and multivariate survival analysis were used to investigate the prognostic factors.Results In the analysis of 148 cases, the DFS was 17.49 months, 1 years, 2 years, 3 years disease-free survival rates were 62％, 40％, 29％. Single factor analysis showed that the duration of DFS was 21.03 months, and the difference was statistically significant (P<0.001) for 8.26 months without the intervention of Chinese medicine (TCM). Open chest surgery, syndrome differentiation, oral medicine, oral medicine dialectical decoction continuous time, vein used traditional Chinese medicine preparation course, traditional Chinese medicine to the route of administration, multidisciplinary intervention methods for prognosis related factors(P<0.05). Multivariate analysis showed that vein used traditional Chinese medicine preparation course (≥4 courses) and traditional Chinese medicine intervention (≥six months time), syndrome differentiation, oral administration of traditional Chinese medicine combined with intravenous preparations continued administration were the non-independent protective factors for disease-free survival and prognosis (P<0.05). Postoperative application of intravenous formulation more than or equal to four courses showed 57.1％ risks of recurrence and metastasis than the those fewer than 4 courses. After operation is Postoperative continued intervention of traditional Chinese medicine more than or equal to 6 months showed 50.4％ risks of recurrence and metastasis than the those fewer than 6 months. Postoperative adminstration of intravenous and oral traditional Chinese medicine showed 27.7％ risks of recurrence and metastasis than the those fewer than only TCM syndromes differentiation of traditional Chinese medicine.Conclusions The combination of syndrome differentiation with oral and intravenous application of traditional Chinese medicine helps to delay the recurrence and metastasis of postoperative stage Ⅲa NSCLC.
ABSTRACT
Objective To explore the prognostic factors for the recurrence of vaginal stump of earlystage cervical cancer after radical hysterectomy and evaluate the effect on clinical prognosis.Methods Clinical data of stage Ⅰ-ⅡA cervical cancer patients undergoing radical hysterectomy in Guizhou Cancer Hospital from January,2007 to December,2016 were retrospectively analyzed.Results A total of 493 patients were enrolled and followed up until May 30,2018.Among them,96.6％(474/493) completed the follow-up.The median age was 45 years.Patients aged 40-50 years had a high incidence rate.In total,451 cases (91.48％) had no recurrence of vaginal stump.The average time without stump recurrence was 51.2 months and the median time without stump recurrence was 44.8 months.Multivariate Cox regression analysis demonstrated that pelvic external irradiation and brachytherapy were the independent prognostic factors for the recurrence of vaginal stump (P=0.000,0.000).Tumor size,lymph node metastasis and pelvic external irradiation were the independent prognostic factors for overall survival (P=0.045,0.022,0.000).Conclusions Pelvic external irradiation and brachytherapy play an extremely pivotal role in reducing the risk of vaginal stump recurrence after radical hysterectomy for patients with stage Ⅰ-Ⅱ A cervical cancer.Tumor size,lymph node metastasis and pelvic external irradiation are the independent prognostic factors for overall survival of patients with stage Ⅰ-Ⅱ A cervical cancer following radical hysterectomy.
ABSTRACT
Objective:To evaluate the safety and feasibility of enhanced recovery after surgery (ERAS) in total laparoscopic Uncut Roux-en-Y gastrojejunostomy after distal gastrectomy.Methods:The clinical data of 42 patients who were divided into ERAS group (n=20) and control group (n=22) were collected.Observation indicators included operation condition,postoperative clinical indexes and postoperative serum stress indexes.Measurement data with normal distribution were presented as-x±s and analyzed by T test.Count data were analyzed by the chi-square test.Results:The operative time,volume of intraoperative blood loss and number of patients with conversion to open surgery shown no statistically significant difference between the 2 groups(P＞0.05).Postoperative clinical indexes:time for initial anus exhaust,time for initial liquid diet intake,time for out-of-bed activity,duration of hoSpital stay of patients without complications in the ERAS group were lower than in the control group,with statistically significant differences between the 2 groups (P＜0.05).But the time to initial defecation,time of abdominal drainage-tube removal and the early postoperative complications between the 2 group had no statistically difference(P＞0.05). Postoperative complications:at the first days and the third days after operation,WBC,CRP and I L-6 in ERAS group were lower than in the control group,the differences were statistically significant (P＜0.05).Conclusion:The perioperative ERAS program in total laparoscopic Uncut Roux-en-Y gastrojejunostomy after distal gastrectomy is safe and effective and should be popularized,meanwhile,it can also reduce duration of hospital stay and improve the comfortable degree and satisfaction of patients.
ABSTRACT
Objective To explore the effect of general anesthesia combined with epidural block for patients with gastric cancer undergoing laparoscopic radical operation.Methods Totally 62 patients with gastric cancer who received laparoscopic radical operation were randomly and equally divided into combined group(n =31) and control group (n =31).Combined group and control group was given pure general anesthesia and general anesthesia combined with epidural block,respectively.The perioperative related indicators,hemodynamics and occurrence of POCD in both groups were compared.Results The dosage of propofol in combined group was significantly lower than that in control group (P ＜ 0.05).From T2 moment,the HR was significantly increased,and MAP was reduced in control group compared with T0 moment (P ＜ 0.05).The level of MAP in combined group was significantly higher than that in control group at T2-T4 moment(P ＜ 0.05).At 1 day after operation,MMSE score in control group was significantly reduced compared with before operation,and lower than combined group (P ＜ 0.05).The incidence of POCD in combined group was significantly lower than that in control group (P ＜ 0.05).Conclusion General anesthesia combined with epidural block for patients with gastric cancer undergoing laparoscopic radical operation can reduce the dosage of anesthetic drug,maintain hemodynamic stability,and improve postoperative cognitive ability.
ABSTRACT
Objective • To evaluate the clinical efficacy of laparoscopic-assisted Soave radical operation in the treatment of children with congenital megacolon. Methods • The clinical datum of 148 pediatric patients with congenital megacolon who had underwent laparoscopic-assisted Soave radical operation in Hainan General Hospital from Mar. 2012 to Sept. 2015 were collected. Operation time, blood volume lost during the operation, complication incidence during the hospitalization and follow-up period were analyzed, retrospectively. Results • All 148 patients were finished the surgery successfully. Operation time was (121.66±22.98) min, blood volume lost during the operation was (4.86±0.66) mL. During the hospitalization, the incidence of complications was 8.10%. There were no short-term complications observed on abdominal bleeding and anastomotic leakage. The patients were followed up for 24 months, there was one patient with anastomotic stoma stenosis at the 6 months after the operation, who recovered after the treatment of anal dilation. All the pediatric patients’ stool were mushy within 3 months after the operation, and they recovered to normal at the 6-12 months. The excellent rate of defecation function was 97.97%. There were no symptoms of bloated abdomen and astriction for all the patients during the follow-up period. Conclusion • Laparoscopic-assisted Soave radical operation is effective and safe for the treatment of children with congenital megacolon, with few complications, quick recovery, good short-term and long-term clinical effect.
ABSTRACT
@#Objective To compare the clinical effect of three operations for one-stage radical correction of small left ventricle in children with tetralogy of Fallot (TOF). Methods We retrospectively analyzed the clinical data of 120 patients with left ventricular dysplasia and TOF undergoing one-stage radical surgery in the First Hospital of Hebei Medical University from December 2004 to May 2017. According to the different types of operation used, they were divided into 3 groups, including a routine group (30 patients, 16 males and 14 females, aged 11.58±2.05 months ranging from 3-24 months), a large patch group (40 patients, 22 males, 18 females, aged 11.22±2.24 months ranging from 3-25 months) who were treated with a large patch, and an enlarged ventricular septal defect group (50 patients, 26 males, 24 females, aged 10.17±2.15 months ranging from 3-22 months) using new left ventricular enlargement technique to enlarge ventricular septal defect. The clinical effect of the three operations were compared. Results The incidence of postoperative low cardiac output syndrome (6.0% vs. 40.0% vs. 50.0%, P<0.05), renal failure (4.0% vs. 37.5% vs. 46.7%, P<0.05), infection rate (10.0% vs. 50.0% vs. 66.7%, P<0.05), mortality (2.0% vs. 12.5% vs. 20.0%, P<0.05), ventilator-assisted time (8.34±5.24 h vs. 36.14±10.91 h vs. 38.58±10.12 h, P<0.05), ICU stay (4.13±1.01 d vs. 7.64±2.11 d vs. 8.03±3.03 d, P<0.05), hospital stay (10.48±4.26 d vs. 21.02±3.23 d vs. 22.52±2.93 d, P<0.05) and hospitalization costs (51 300±9 400 yuan vs. 103 200±39 300 yuan vs. 115 500±35 200 yuan, P<0.05) were less in the enlarged ventricular septal defect group compared with the other two groups. Conclusion The clinical effect of enlarged ventricular septal defect is better than that of the routine and large patch methods, and long-term efficacy should be further followed up.
ABSTRACT
Objective To investigate the effectiveness and safety of laparoscopic and open radi cal resection of right colon cancer.Methods The clinical data of 81 cases of colon cancer were analyized retrospectively.According to the different surgical methods,all patients were divided into laparoscopic surgery group (n =39) and open surgery group (n =42).Perioperative conditions,postoperative complications and short-term prognosis were compared between these two groups.Results There was significant difference in the length of incision (5.2 ± 1.1) cm,bleeding volume (89.4 ± 30.6) ml as well as the time of exsufflation(4.2 ± 1.5) d and hospitalization after operation(11.8 ± 1.5) d(P ＜ 0.05).There was no remarkable difference in the time of extubation,total number of lymph node dissection,operative time,cost of hospitalization,incidence of postoperative complications,the rate of survival and recurrence in 1 year(P ＞ 0.05).Conclusion There was no significant difference in short-term prognosis between these two groups.laparoscopic radical resection of right colon cancer deserve to be popularized by means of enhance recovery after surgery.
ABSTRACT
Objective To investigate the effectiveness and safety of laparoscopic and open radi cal resection of right colon cancer.Methods The clinical data of 81 cases of colon cancer were analyized retrospectively.According to the different surgical methods,all patients were divided into laparoscopic surgery group (n =39) and open surgery group (n =42).Perioperative conditions,postoperative complications and short-term prognosis were compared between these two groups.Results There was significant difference in the length of incision (5.2 ± 1.1) cm,bleeding volume (89.4 ± 30.6) ml as well as the time of exsufflation(4.2 ± 1.5) d and hospitalization after operation(11.8 ± 1.5) d(P ＜ 0.05).There was no remarkable difference in the time of extubation,total number of lymph node dissection,operative time,cost of hospitalization,incidence of postoperative complications,the rate of survival and recurrence in 1 year(P ＞ 0.05).Conclusion There was no significant difference in short-term prognosis between these two groups.laparoscopic radical resection of right colon cancer deserve to be popularized by means of enhance recovery after surgery.
ABSTRACT
Objective To investigate the protective effect of gonadotropin releasing hormone agonist on ovarian function in patients with early stage cervical cancer.Methods80 cases ofadmitted patients with early stage cervical cancerfrom January 2015 to January 2016 in Yinzhou Second Hospital were selected, were randomly divided to observation group and control group.Patients in the observation group were retained ovarian resection, while giving the gonadotropin releasing hormone (GnRH) agonist treatment, the control group patients only with reservation of ovary resection and compared between the two groups before and after chemotherapy in patients with basal follicle stimulation hormone (bFSH) levels, serum anti Mullerian tube hormone (AMH) level, basic estrogen (bE2) levels, and the basal antral follicle number (bafc).ResultsThere were no significant differences in two groups of chemotherapy in patients with anterior bFSH and bE2 level, after chemotherapy, the observation group patients bFSH and bE2 level was significantly lower than that in control group (P<0.05) and chemotherapy after bFSH level of two groups of patients were higher than that in the chemotherapy before.bE2 levels were lower than those before chemotherapy (P<0.05);chemotherapy the number of patients in the two groups of AMH level and bafc without significant difference, after chemotherapy, the observation group AMH levels and bafc number were significantly higher than those of the control group (P<0.05) and chemotherapy after two groups of patients with AMH levels and bafc number lower than the chemotherapy before (P<0.05).ConclusionGnRH agonists can effectively protect the early cervical cancer patients with radical resection of ovarian reserve and ovarian reserve function, clinical application is worthy of further promotion.
ABSTRACT
Objective To analyze the clinical data of patients with hilar cholangiocarcinoma (HCCA),and to compare the therapeutic effects of different methods on treating these patients.Methods The clinical data of 101 patients with HCCA in China-Japan Union Hospital of Jilin University were analyzed.Results The overall 1-year and 2-year survival rates in the radical operation group were 95.5％ and 40.9％,respectively.There was a significant difference between the radical operation group and the palliative resection group (P ＜ 0.05).The overall 1-year and 2-year survival rates in the palliative resection group were 75.0％ and 16.7％,respectively,which were much better than those in patients treated with PTCD,biliary stent on open abdominal biliary drainage (P ＜ 0.05).There were no significant differences among the PTCD,biliary stent and open abdominal biliary drainage groups (P ＞ 0.05).Conclusions Radical HCCA resection is still the best and the first choice treatment for patients with HCCA.The therapeutic effects of radical operation were much better than those of palliative resection,biliary stent,PTCD and open abdominal biliary drainage.
ABSTRACT
Objective To analyze the influence of thoracoscopy combined with laparoscopy for radical operation of esophageal carcinoma and open ones on the perioperative effects and postoperative quality of life.Methods The data in 74 esophagus cancer patients in the thoracic surgery department of our hospital from October 2012 to June 2015 were collected and divided into the endo-scopic group and open group according to different operative ways.The perioperative effects and complications in the two operation ways were analyzed.The EORTC QLQ-C30 and QLQ-OES18 were used to conduct the questionnaire investigation and comparative analysis.Results The mean intraoperative blood loss,postoperative catheter drainage,hospitalization time,occurrence rates of post-operative complications such as pneumonia,hydrothorax and gastric emptying disorder in the endoscopic group were lower than those in the open group,while the operative time was longer than that in the open group,the differences were statistically significant (P <0.05).The total healthy status and function scores at postoperative 1,12 weeks in the two groups were decreased and symp-tom scores were increased,which at postoperative 24 weeks were back to close to preoperative level.The scores in the aspects of to-tal healthy status,physical functioning,role functioning,social functioning,fatigue,pain,dyspnea and difficultly coughing at postop-erative 1,12 weeks in the endoscopic group were superior to those in the open group,in which the scores of total healthy status, physical functioning and fatigue symptom at postoperative 24 week were still superior to those in the open group,the differences were statistically significant(P <0.05).Conclusion Thoracoscopy combined with laparoscopy for radical operation of esophageal carcinoma has the advantages in the aspects of intraoperative blood loss,catheter drainage,hospitalization time,some postoperative complications and QOL scores,but the operative time is longer.
ABSTRACT
Objective To investigate the influence of synangio-excision-restruction in pancreatic cancer radical operation on the complications,living quality and survival status in the patients with pancreatic cancer.Methods A total of 255 patients with pancreatic cancer in our hospitals from January 2010 to October 2015 were selected and divided into 3 groups according to different operation modes:41 cases in the Synangio-excision-restruction group(A),113 cases in the non-synangio-excision-restruction group (B) and 101 cases in the palliative by-pass operation group(C).The clinical data in 3 groups were analyzed.The influence of Synangio-excision-restruction on operative complications,living quality and survival status was investigated.Results The incidence rate of complications in the group A was 56.10％,which was obviously higer than 34.51％ in the group 1β and 20.79％ in the group C,and the difference was statistically significant(P＜0.05).In the group A,the incidence rates of belly ache and body weight gain were 36.59％ and 51.22％ respectively,which comparing with 91.09％ and 9.09％ in the group C showed statistically significant difference(P＜0.05).The median survival time(MST) in the group A was 11.83 months,which in the group B and C were 15.43 months and 7.50 months,the difference between the group A and C was statistically significant(x2 =4.27,P＜0.05);while the difference between the group A and B was not statistically significant(x2=3.67,P＞0.05).Conclusion For the pancreatic cancer patients with affected portal vein and inferior mesenteric vein,the synangio-excision-restruction radical operation can obviously prolong the patients' survival time and improves their living quality.
ABSTRACT
OBJECTIVE:To investigate the effects of preemptive analgesia of parecoxib-sodium for radical mastectomy of breast cancer. METHODS:A total of 60 female patients underwent selective radical mastectomy of breast cancer under general anes-thesia were randomly divided into observation group(40 cases)and control group(20 cases). 15 min before anesthesia induction, observation group was given intravenous injection of Parecoxib-sodium for injection 40 mg. Control group was given intravenous in-jection of 0.9% Sodium chloride injection 5 mL. The pain visual analogue scale(VAS),the frequency of patient controlled intrave-nous analgesia(PCA)and ADR were observed between 2 groups at different time points after surgery. RESULTS:VAS scores of observation group were significantly lower than those of control group 2,4,6,8 h after operation,and the frequency of PCA 0-4, 4-12,12-24,24-36 h after operation was significantly lower than control group,with statistical significance(P0.05). CONCLUSIONS:The preemptive analgesia of parecoxib-sodium can effectively reduce pain degree of patients with breast cancer after radical mastectomy,the frequency of PCA, and do not increase the occurrence of ADR.
ABSTRACT
Objective To evaluate the effect of Dachengqi decoction,omeprazole and cisapride in the treatment of gastric cancer radical operation in serum gastrin and motilin.Methods 88 cases of gastric cancer after radical gastrectomy from May 2013 to July 2015 in our hospital were selected and divided into control group and treatment group with each 44 cases.Patients in both groups were given routine treatment and symptomatic treatment.Control group received omeprazole Enteric-coated capsules 20mg,qd,cisapride tablets 10mg,tid,treatment group received more Dachengqi decoction 200mL,bid,respectively by intragastric injection and retention enema,two times a day,a total of 21 days of treatment.The clinical efficacy,serumgastrin,plasma gastric motility,gastric juice volume and adverse reactions were compared between the two groups.Results The total effective rate in the treatment group was significantly higher than that in control group(P<0.05); After treatment,gastric juice volume of two groups was significantly lower than before treatment,the gastric juice volume in the treatment group were significantly lower than control group(P<0.05);Compare with pre-treatment,after treatment,the serum gastrin,plasma gastric motility levels of two groups were significantly higher,and the treatment group were significantly higher than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Omeprazole,cisapride combined with Dachengqi decoction in the treatment of gastric cancer radical operation was obvious and high safety.
ABSTRACT
@#Objective To compare the subaxillary small incision thoracotomy (SSIT) with video-assisted thoracic surgery (VATS) for patients with lung cancer. Methods Retrospective analysis of 142 patients with lung cancer in Department of Thoracic Surgery, The First People's Hospital of Neijiang from January 2014 to April 2016 was conducted. There were 86 males and 56 females, aged 40-77 years. Patients were divided into a VATS group (n=72) and a SSIT group (n=70). The following postoperative data were evaluated: operation time, number of dissected lymph nodes, intraoperative bleeding, postoperative chest drainage volume, drainage duration, postoperative ambulation time, average hospital stay, postoperative complications, hospitalization cost, early postoperative incision pain (visual analogue scale, VAS) and other indicators. Results There were no statistically significant differences between the two groups in the operation time (120.8±20.4 min vs. 126.2±21.6 min, P=0.124), the dissected lymph node (11.1±2.0 vs. 11.4±1.9, P=0.333) and the postoperative complications rate (13.9% vs. 15.7%, P=0.759). Laparoscopic intraoperative bleeding and postoperative drainage volume were significantly less in the VATS group than those in the SSIT group (123.2±26.9 ml vs. 156.4±24.0 ml, P<0.001; 227.0±75.5 ml vs. 334.3±89.1 ml, P<0.001). Postoperative drainage duration, postoperative ambulation time and hospital stay were shorter in the VATS group than those in the SSIT group (2.5±0.5 d vs. 3.1±0.6 d, 1.5±0.5 d vs. 2.2±0.6 d, 6.5±0.5 d vs. 7.4±0.6 d, all P<0.001). The average hospitalization cost of the VATS group was significantly higher than that of the SSIT group (42 338.9±8 855.7 yuan vs. 32 043.7±7 178.1 yuan, P<0.001). There was no significant difference in the operation cost and anesthesia cost between the two groups (P>0.05). The early postoperative pain of laparoscopic group was less, but the difference was not statistically significant (P>0.05). Conclusion The hospitalization cost of the SSIT is lower than that of thoracic surgery, which may be beneficial to the appilication in primary hospitals.