Health-related quality of life of patients with Crohn′s disease: A meta synthesis of qualitative studies / 医学研究生学报

Objective The article aimed to identify health-related quality of life(HRQOL) themes of patients with Crohn's disease(CD) and establish a HRQOL model by a meta synthesis of qualitative studies on CD patients′ HRQOL. Methods A retrieval of HRQOL-related qualitative studies on CD patients was conducted in databases including DirectPsycINFO, VIP, etc and the results were integrated by integrating method. Results A total of 8 researches were included to refine 44 results which were integrated into 15 themes. The themes were further grouped into 6 HRQOL domains: physical function, psychological function, social function, study and work skills, sexual function, perception of health and well-being. Conclusion HRQOL themes of CD have been identified and a preliminary HRQOL concept model has been established, which will provide a reference for the development of HRQOL evaluation tools in CD patients.

Short-term clinical outcomes in extremely/very low birth weight infants with individual nutritional support / 肠外与肠内营养

Objective: To explore the application value of bedside nasojejunal feeding tube placement using four steps of ultrasonic-assisted method in critical ill patients. Method: Thirty-three critical ill patients receiving enteral nutrition were enrolled. We adopt four steps of ultrasonic guidance to conduct nasojejunal feeding tube placement. The details were as followed: nasojejunal feeding tube placement within the esophagus, within Gastric body, within After the pylorus, at last the location of nasojejunal feeding tube. Results: The placement of nasojejunal feeding tube was successful in 28 patients, failed in 2 patients. The failure reason include that the false appearance of pylorus through and the lost gastrointestinal motility led to the sticking of nasojejunal feeding tube on arcus major ventriculi and it couldn't enter into gastric antrum and pylorus. Conclusion: The application of nasojejunal feeding tube placement by four steps of ultrasonic-assisted is a novel feeding technique, and it's simple, effective, noninvasive and repeatability procedure with a high success rate and low complications.

The clinical effectiveness of percutaneous drainage and laparotomy for patients with infective pancreatic necrosis / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the clinical effectiveness of percutaneous US- or CT-guided drainage and laparotomy for patients with infective pancreatic necrosis.</p><p><b>METHODS</b>Data of 90 infective pancreatic necrosis patients admitted from January 2008 to December 2009 were included. They were divided into two groups by the different treatment choices. Twenty-seven patients in the percutaneous group received percutaneous US- or CT-guided drainage as first choice. After that a sump suction apparatus was applied for controlled drainage. If no improvement was achieved after 3 days, they would received operation soon. While patients in the laparotomy group received surgical drainage at the time when the diagnosis of infected pancreatic necrosis was confirmed. Continuous drainage was also applied for these ones.</p><p><b>RESULTS</b>The percutaneous group had a significant low rate of reoperation (7.1% vs. 14.3%, P < 0.05) and postoperative residual abscesses (7.1% vs. 28.6%, P < 0.05). Furthermore, 48.1% of patients in percutaneous group successfully avoid laparotomy. In the regard of complications, the percutaneous group presented lower incidence of both single organ dysfunction (7.4% vs. 28.6%, P < 0.05), intestinal fistula (7.4% vs. 27.0%, P < 0.05) and long-term complications (3.7% vs. 22.2%, P < 0.05). In addition, the percutaneous group costed less medical resources as evidenced by shorter ICU duration (21.2 ± 9.7 vs. 28.7 ± 12.1, P < 0.01), shorter hospital duration (48.2 ± 12.5 vs. 59.6 ± 17.5, P < 0.05) and less expenditure (191 762 ± 5892 vs. 341 689 ± 10 854, P < 0.05).</p><p><b>CONCLUSIONS</b>Percutaneous drainage can effectively lower the surgical rates and the rates of complications and reoperations in patients with infective pancreatic necrosis. Besides that, it could also reduce the cost of medical resources.</p>

Treatment experience of severe acute pancreatitis on 1033 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To summary the treatment experience of severe acute pancreatitis (SAP).</p><p><b>METHODS</b>From January 1997 to March 2009, a total of 1033 patients suffered SAP were admitted with a mean APACHE II score 12.0 +/- 4.3. There were 622 males and 411 females, aged from 13 to 98 years old. All patients were cared by the multidisciplinary team with intensivist, endoscopists, gastroenterologists, radiologist, nephrologist and surgeons.Patients treated in SICU in the early phase of the disease. In these 1033 patients, 365 cases received mechanical ventilation, 218 with tracheotomy, 159 cases received high-volume continuous venovenous hemofiltration (CVVH), 179 received nasobiliary drainage, 513 were treated with early enteral nutrition. CT-guided percutaneous catheter drainge for peripancreatic fluid collection was pefromed for 477 times and 438 patients received surgical debridement for infected pancreatic necrosis.</p><p><b>RESULTS</b>In all these 1033 cases, 975 patients (94.4%) survived, and 38 patients died (3.7%). The mortality of patients who received surgical debridement for infected pancreatic necrosis was 7.1% (31/438).</p><p><b>CONCLUSION</b>The muti-discipline management of severe acute pancreatitis can remarkably improve the prognosis of patients.</p>