Regulatory Effect of Modified Liu Junzitang on Immune Function, Nutritional Status and Intestinal Microecology in Advanced Gastric Cancer Patients with Syndrome of Deficiency of Qi and Blood / 中国实验方剂学杂志

Objective:To explore the regulatory effect of modified Liu Junzitang on the immune function， nutritional status and intestinal microecology in advanced gastric cancer patients with syndrome of deficiency of Qi and blood. Method:The 86 advanced gastric cancer patients with syndrome of deficiency of Qi and blood were randomly divided into control group and observation group according to their admission numbers， with 43 cases in each group. The control group was given Yiqi Yangxue oral liquid on the basis of basic treatment while the observation group was given modified Liu Junzitang. After 4 weeks， compare the clinical efficacy of two groups of patients， traditional Chinese medicine （TCM） syndrome score， gastrointestinal function recovery， adverse reaction and quality of life， immune function， T cell subsets CD3⁺， CD4⁺， CD8⁺， C₃ and C₄ levels， immunoglobulin A （IgA）， immunoglobulin G （IgG）， immunoglobulin M （IgM）， nutritional status： albumin （propagated）， prealbumin （PA）， serum total protein （TP） and hemoglobin （Hb） content changes， the intestinal micro ecology： <italic>Bifidobacterium</italic>， <italic>Lactobacillus</italic>， <italic>Enterococcus aureus</italic>， <italic>Escherichia coli</italic> content changes. Result:The total effective rate of the observation group was 95.35% （41/43）， which was significantly higher than 79.07% （34/43） of the control group （<italic>χ²</italic>=5.108，<italic>P</italic><0.05）， after treatment， the TCM syndromes such as dizziness， pale complexion， palpitation， shortness of breath and fatigue in the observation group were significantly lower than those in the control group （<italic>P</italic><0.05）， the bowel sound recovery， exhaust and defecation time of the observation group were significantly lower than those of the control group （<italic>P</italic><0.05）， the quality of life scores in the observation group， such as the nature-to-human correspondence， form and spirit integration， specific modules， functional areas， and overall health score， were significantly higher than those in control group （<italic>P</italic><0.05）， the CD3⁺， CD4⁺， CD4⁺/CD8⁺， C₃， C₄， IgA， immune function indexes such as IgG and IgM were significantly higher than those of the control group， and the CD8⁺ level was lower than which of control group （<italic>P</italic><0.05）， the nutritional status levels such as Alb， PA， TP and Hb in the observation group were significantly higher than those of the control group （<italic>P</italic><0.05）， <italic>Bifidobacterium</italic>， <italic>Lactobacillus</italic>， and <italic>E. faecalis </italic>in the observation group were higher than those in the control group， and <italic>E. coli</italic> was lower than the control group （<italic>P</italic><0.05）， the adverse reaction rate of the observation group was 11.63% （5/43） and the control group was 16.28% （7/43） ， and there was no statistical difference between two groups. Conclusion:Modified Liu Junzitang has a good clinical effect on advanced gastric cancer patients with syndrome of deficiency of Qi and blood. It can improve TCM syndromes and gastrointestinal function， improve quality of life， and its mechanism is related to improving immune function， enhancing nutritional status， and improving intestinal microecology， and it has good safety.

Diagnosis and treatment of esophageal fistula in anterior cervical spine surgery / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the causes, diagnosis, treatment and prevention of esophagocutaneous fistula in anterior cervical spine surgery.</p><p><b>METHODS</b>Thirteen cases with esophagocutaneous fistula in anterior cervical spine surgery were studied.</p><p><b>RESULTS</b>The causes includes: (1) During the operation, esophagus was oppressed by a clasp for so long time that made a pressure necrosis of the esophagus; (2) Esophagus was injured by loose plates and screws; (3) Loose bone grafts oppressed esophagus; (4) Esophagus was injured by operative appliance in the operation; (5) Esophagus was oppressed by the plate.</p><p><b>DIAGNOSIS</b>After anterior cervical spine surgery if patients had a high fever, sore throat, swelling incision, and food sediment was found in the incision, esophagocutaneous fistula should be considered. The final diagnosis could be done by esophageal radiography.</p><p><b>TREATMENT</b>Fasting cure, nasogastric tube and wound drainage should be used; When the inflammation ended, patients should undergo operation of closure of the esophageal fistula.</p><p><b>CONCLUSIONS</b>The esophagocutaneous fistula in anterior cervical spine surgery has several causes mentioned above. We should take precautionary measures to avoid the complication, and use appropriate treatment to cure when it happens.</p>