Clinical analysis of ultrasound guided microwave ablation and traditional surgical treatment for nodular goiter / 中国综合临床

Objective To explore the advantages and disadvantages of ultrasound guided puncture microwave ablation and traditional surgical treatment of nodular goiter.Methods From January 2014 to June 2015,102 cases of nodular goiter who were treated in the Traditional Chinese Medicine Hospital of Gaozhou Affiliated to Guangzhou University of Traditional Chinese Medicine were randomly divided into two groups,51 cases in each group.Respectively by ultrasound guided puncture nodules of thyroid swollen microwave ablation (microwave ablation group) and traditional operation type removed most of the thyroid nodules (traditional surgery group) in the treatment of containing.The amount of bleeding,operation time,hospital stay,medical cost,clinical efficacy,postoperative complications and the degree of pain,and thyroid function were compared between the two groups.Results The amount of bleeding,operation time and length of hospital stay in the microwave ablation group were better than those in the traditional operation group((2.02±0.79) ml vs.(28.24±18.49) ml,(34.20 ±9.60) min vs.(75.59±25.41) min,(3.55± 1.05) d vs.(10.27±2.68) d),the medical cost of the microwave ablation group was higher than that of the traditional operation group((14 341±593) yuan vs.(5 812±970) yuan),the differences were statistically significant (t =-10.12,-10.88,-16.68,53.54;P ＜0.01).There were significant difference in terms of the postoperative pain and complications between the groups (x2=50.86,13.22;P＜0.01).The total absorption rate was 100％ in 18 months after the ablation of the nodule.There was no significant difference about postoperative residual small nodules between the two groups(P ＞0.05).Conclusion Compared with the traditional treatment,the microwave ablation treatment of nodular goiter with less complications,is a new technique of minimally invasive,beauty,safe and feasible,the exact clinical effect,and worthy of popularization and application.

Comparative analysis between subtotal colectomy combined with modified Duhamel procedure and simple subtotal colectomy for severe functional constipation / 中国医师进修杂志

Objective To compare postoperative outcomes and complications between subtotal colectomy combined with modified Duhamel procedure and simple subtotal colectomy for severe functional constipation (SFC). Methods Between January 2006 and June 2010,40 SFC patients after strict but inefficient nonoperative treatments were randomized by number table method to control group (20 cases, receiving simple subtotal colectomy) and combined group (20 cases,receiving subtotal colectomy and modified Duhamel procedure). The selection criteria were normal colonoscopy,and abnormal dynamic proctography (DPG). The functional outcomes after surgery were assessed from 6 months to 2 years period. Results The preoperative clinical manifestations of the two groups were similar. No statistically significant difference was observed between the two groups for time for recovery of the bowel function,length of postoperative hospitalization.and the early postoperative complications (P > 0.05). Functional outcomes of combined group with CIQOL score [(110.5 ±5.0) scores],relieving of costive gastrointestinal symptoms [(79.0 ±6.5)%], recurrent constipation rate [10.0% (2/20)], satisfaction rate of defecation frequency [85.0%(17/20)], satisfaction rate of quality of life[90.0%(18/20)] were significantly better than those of control group[(90.5 ± 3.5) scores, (60.5 ± 2.8)% ,35.0%(7/20), 15.0%(3/20),20.0%(4/20)](P< 0.05). Conclusion Combined application of subtotal colectomy and modified Duhamel procedure for SFC has better outcomes.

The research of early utilization of nutrient of home-made formula in post-operation of gastric fundic cardia cancer patients / 中国医师进修杂志

Objective To investigate the efficiency, safety and application value of early utilization of nutrient of home-made formula in post-operation of gastric fundic cardia cancer patients. Methods One hundred and forty-five cases of gastric fundic cardia cancer patients were randomly divided into two groups,early enteral-intestinal nutrient formula of home-made (enteral-intestinal group,73 cases) and intra-venous nutrition (intra-venous group,72 cases). Patients in enteral-intestinal group were given home-mada nutrition-liquid plus nutrison fibre for 6-8 days from the first post-operation day, intravenous group were given venousnutrition injection for 6-8 days from the first post-operation day. The average residential day, spends,complications and recovery situation were recorded and compared between the two groups. Results The average residential day in enteral-intestinal group was less than that in intra-venous group, average spends /drugs cost were (9433.1±1024.6)/(3271.8±420.9) yuan vs (12 953.4±2919.7 )/(4832.9±872.6) yuan respectively (P < 0.01 ),the complication in enteml-intestinal group was less than that in intra-venous group (P < 0.01 ). Time of revive testinal function in enteral-intestinal group was earlier than that in intra-venous group,ALB in enteral-intestinal group was higher than that in intra-venous group (P < 0.01 ). Conclusion Early enteral-intestinal nutrient utilization of home-made formula in post-operation of gastric fundic cardia cancer patients is safe and applicable, it can improve patients' post-operation nutrition situation and intestinal function.

The application value of side way lymph node cleaned up in the low order rectal cancer operation / 中国基层医药

Objective To analyze the application value of side way lymph node cleaned up in the low order rectal cancer operation. Methods 45 cases were randomly divided into two groups:first group was 30 cases, they were used the side way lymph node cleaned up of the rectal cancer broadens the curing once and for all skill;second group was 15 cases,they were used traditional rectal cancer curing once and for all skill. Results 7 cases of 1 group happen the side way lymph nodes transfer,the rate of transform was 23. 33% ,that low disintegration gland cancer and mucus gland cancer happen the rate of the side way lymph nodes transfer was beyond one-fold much than hight and middle disintegration gland cancer( P＜0. 05 ) ,the divergence is obvious. The operation time and amount losing blood of two group is not obvious, but first group's 3 years living rate was more higher than second group. Conclusion To the low order rectal cancer case sufferer that the side way lymph node cleaned up, may cut down the pelvic cavity recurs,obviously improve the living quality,lift the living rate,it has clinical practice value.

Clinical effects of partial hepatectomy In treating intrahepatolithiasis / 中国基层医药

Objective To evaluate the clinical efficacy of partial hepatectomy in treating intrahepatolithiasis. Methods The data of 63 cases with partial hepatectomy were retrospectively evaluated. Results All operations were successful. Mean hospital stay was 30.5d. Complications were found in 9 cases (14.3%), including 2 cases of sub-phrenic abacess,2 cases of biliary fistula,4 cases of wound infectiun,1 case of pleural effusion. Residual stones were found in 7 cases (11.1%) ,4 were in left hepatic lobe,3 were in right. 62 cases (98.4%) were followed for 6 months to 8 years. Stones recurred in 2 cases. Conclusion Partial hepatectomy is effective for the treatment of intrahepatoli-thiasis with low residual stone rate.