Clinical study on diagnosis and treatment of small intestinal hemorrhage / 临床外科杂志

Objective To investigate the diagnostic and therapeutic methods of small intestinal hemorrhage.Method Clinical data of forty-nine cases of small intestinal hemorrhage were analyzed retrospectively.Results Small intestinal tumors were found in 21 cases (42.9%),among wtich,most were benign;infectious diseases in 12(24.5%);diverticula's in 8(16.3%);and vascular malformations in 6(12.2%).Radionuclide scanning was positive in 10 out of 13 cases (76.9%).Angiography was performed in 12,7 of them were abnormal (58.3%).Small bowel series made diagnosis in 25% of 36 cases.Postoperative bleeding was found in 5 cases and short bowel syndrome in 1 case.Conclusions Tumors are the most common cause of small bowel bleeding,and acute hemorrhagic nercotizing enteritis and typhoid often cause small bowel massive bleeding.Radionuclide scanning is one of the most useful diagnostic methods for diverticula's.Angiography is a valuable procedure in diagnosis of vascular lesions and malignants.Small bowel series is also helpful in diagnosis of solid lesions and diverticula's. Exploratory surgery coupled with intraoperative endoscopy can be helpful in diagnosis of small bowel bleeding.

Study of alimentary reconstruction after total gastrectomy / 中国普通外科杂志

Objective To investigate the ideal procedure of digestive tract reconstruction after tota l gastrectomy . MethodsThe clinical data of 86 cases underg oing total gastrectomy were reviewed retrospectively. ResultsTotal gastrectomy was performed in 86 cases, including 76 cases of ga stric carcinoma, 8 cases of malignant lymphoma and 2 of leiomyosarcoma;and 17 cases in stage II, 48 cases in stage III, and 21 cases in stage IV. Radical tot al gastrectomy was performed in 48 cases and palliative total gastrectomy in 38 cases. Gastrectomy combining with resection of tail of pancreas, splenec tomy, transverse colectomy or partial hepatectomy was performed in 28 cases; and with drug delivery system implanted into hepatic artery in 28 cases. The recon struction of digestive tract included esophagoduodenostomy in 12 cases, Braun es ophagojejunostomy in 15 cases, Roux-en-Y esophagojejunostomy in 29 cases, and jejunal pouch interposition in 30 cases. Postoperative complications occurred i n 18 cases, including anastomosis leakage in 3 cases and pancreatic fistula in 1 case. Postoperative heartburn occurred in 21 cases, dumping syndrome in 18 cases, epigastric fullness in 15 cases, diarrhoea in 12 cases, and dysphagia in 9 cases. Conclusions Jejunal pouch interposition is an i deal procedure for reducing the patients′ postoperative symptoms and improving the quality of life after total gastrectomy.

Clinical analysis of hyperthyroidism combined with cerebral infarction / 第三军医大学学报

Objective To investigate the pathogenesis of hyperthyroidism combined with cerebral infarction and the relationship between hyperthyroidism and cerebral infarction. Methods Data from the clinical manifestations, diagnosis, and therapeutic outcomes of 10 patients with hyperthyroidism combined with cerebral infarction were analyzed retrospectively. Results After treatment with drugs for anti hyperthyroidism and active treatment of cerebral infarction, no severe complications were found in all patients. Conclusion Hyperthyroidism combined with cerebral infarction may be one of the important causes of adolescent cerebral infarction. Treatment of hyperthyroidism may play an important role in the treatment of cerebral infarction.