Effect of laparoscopic complete mesocolic excision ( CME) for right colon cancer / 中国基层医药

Objective To evaluate the experience of laparoscopic complete mesocolic excision (CME) for right colon cancer.Methods 45 patients with right colon cancer underwent laparoscopic CME were selected as research subjects(laparoscopy group),and 40 patients with right colon cancer underwent open CME were selected as control group(open group).The clinical effects of the two groups were observed .Results All the 45 cases were successfully performed with laparoscopic CME and 40 specimens were evaluated pathologically as mesocolic plane surgery. The average time for passage of flatus in the laparoscopy group [(3.43 ±0.72)d] was less than that in the open group [(4.10 ±0.99)d,P =0.039,P <0.05].The average time of leaving bed [(3.39 ±0.66)d] in the laparoscopy group was significantly less than that in the open group [(4.20 ±0.79)d,P =0.005,P <0.05].The mean operative time of the laparoscopy group [(160.93 ±20.91)min] was longer than that of the open group [(103.00 ±24.29)min,P =0.000,P <0.05].The average number of total lymph nodes removed of the laparoscopy group [(23.16 ±8.21)] was higher than that of the open group [(19.06 ±7.48)],but the difference was not statistically significant between the two groups (P =0.102,P >0.05).The overall postoperative complication rate of the laparoscopy group was 13.33%,which was lower than 22.50% of the open group,but the difference was not statistically significant between the two groups(P =0.268,P >0.05).Conclusion Laparoscope complete mesocolic excision for right colon cancer is safe and feasible.

The short-term effect of tegafur in the treatment of colorectal cancer and the impact on long-term prognosis / 中国基层医药

Objective To evaluate the short -term effect of tegafur combined with oxaliplatin in the treatment of advanced colorectal cancer and its impact on long -term prognosis .Methods 70 patients with advanced colorectal cancer were selected .The patients were randomly divided into tegafur group ( oxaliplatin plus tegafur ) and capecitabine group ( oxaliplatin combined with capecitabine ) according to the digital table ,35 cases in each group , The short-term efficacy,side effects,2-year survival rate and median survival time were compared between the two groups.Results The total effective rate of the tegafur group was 85.71％, which of the capecitabine group was 77.14％,but the difference was not statistically significant between the two groups (χ2 =0.850,P=0.356).After treatment,the levels of VEGF in the two groups were significantly lower than those before treatment ( t =21.694, 20.558,P=0.305,0.249).There was no statistically significant difference between the two groups (t =0.998, 1.242,P=0.281,0.307).The 1-year survival rate was 51.43％and the 2-year survival rate was 25.71％of the tegafur group,compared with 45.71％ and 17.14％ in the capecitabine group ,the differences were not statistically significant (χ2 =0.229,0.764,P=0.632,0.382).The median survival time of the tegafur group was 13.5 months, which of the capecitabine group was 13.0 months,there was no statistically significant difference ( Z=1.304,P=0.752).The incidence rate of hand -foot syndrome of the tegafur group was 5.71％,which was lower than 22.86％of the capecitabine group (χ2 =4.163,P=0.027).Conclusion The efficacy of tegafur combined with oxaliplatin in the treatment of advanced colorectal cancer is similar to capecitabine plus oxaliplatin , with a slightly lower complication rate.

Analysis of health-seeking delay and relevant factors of tuberculosis diagnosis among ethnic minority areas / 重庆医学

Objective To analyze the treatment-delay situation of tuberculosis(TB) patients and its influencing factors in ethnic minority areas to provide reference basis for formulating the effective prevention and control measures.Methods The medical records data in 1166 cases of pulmonary TB in Jinping county during 2010-2014 were collected from national TB information management system,their treatment-delay related situation was analyzed and its influencing factors were also analyzed by adopting the Logistic regression model.Results Among 1 166 cases of pulmonary TB reported by Jinping County during 2010-2014,568 cases were treatment-delay,the treatment-delay rate was 48.71％ (568/1 066),the treatment-delay time ≥30 d accounted for 67.25 (382/568),which ≥183 d(half a year) accounted for 6.51％ (37/568),which ≥365 d accounted for 2.64％ (15/568),and the maximal treatment-delay time reached 7 years(2 549 d);the multivariate Logistic regression analysis results showed that compared with non-peasants,sputum smear negative,non-critical patients,peasants(OR=1.867,95％ CI:1.300-2.700),sputum positive(OR=1.631,95 ％ CI:1.200-2.100),critical patients(OR =0.684,95 ％ CI:0.500-0.900) were the risk factors for the treatment-delay in the pulmonary TB patients in ethnic minority areas.Conclusion The treatment-delay of pulmonary TB patients in ethnic minority areas has no relation with the nationality difference,patient's peasant occupation,sputum smear positive and whether severe case are the influencing factors of treatment-delay in pulmonary TB patients.

The association between body mass index and postoperative complications in patients with colorectal cancer / 中国基层医药

Objective To investigate the association between body mass index and postoperative complications in patients with colorectal cancer.Methods 120 patients with colorectal cancer were prospectively studied.According to the body mass index,all patients were assigned to study group (BMI ＜ 18.5kg/m2) or control group (BMI ≥ 18.5kg/m2),60 cases in each group.All patients received elective colorectal cancer resection.The operation situation,postoperative complications,postoperative recovery and postoperative stress reaction of the two groups were observed.Results There were no significant differences in the operation time,the number of lymph node dissection and the amount of bleeding between the two groups during the operation (all P ＞ 0.05).Compared with the control group,the total infection rate of the study group was significantly higher(11.67％ vs.1.67％,x2 =4.324,P =0.038);the incidence of postoperative complications was significantly increased (25.00％ vs.5.00％,x2 =7.908,P =0.005).There were no significant differences in other complications such as wound infection,anastomotic leakage,anastomotic obstruction,adverse cardiovascular events and stress ulcer (all P ＞ 0.05).Compared with the control group,the postoperative anal exhaust time of the study group was significantly prolonged [(51.48 ± 9.47) h vs.(43.73 ± 8.63) h,t =5.382,P =0.000];and the length of hospital duration was significantly prolonged [(20.35 ± 3.21) d vs.(16.28 ± 3.48) d,t =6.462,P =0.000].There were no significant differences in recurrence rate,mortality rate and progression free survival between the two groups after 1 year (all P ＞ 0.05).There were no significant differences in preoperative IL-6 and CRP levels between the two groups (all P ＞ 0.05).Compared with the control group,the IL-6 level of the study group at 7-day after operation was significantly higher[(165.56 ±45.39) ng/L vs.(122.58 ± 29.58) ng/L,t =6.459,P =0.000];CRP level was significantly higher [(23.49 ± 8.48) mg/L vs.(15.37 ±6.53)mg/L,t =4.285,P=0.002].Conclusion Body mass index less than 18.5 kg/m2 is a risk factor for postoperative infection and complications in patients with colorectal cancer,and is associated with increased stress response and prolonged hospital stay.

Clinical application of hydroxyethyl starch in radical resection of gastric cancer in the old / 中国生化药物杂志

Objective To investigate the clinical value of elderly gastric cancer patients undergoing preoperative use of hydroxyethyl amylase. Methods From June 2012 to February 2016 underwent gastrointestinal surgery in our hospital 54 cases of radical resection of gastric cancer patients with clinical research, according to the patients divided into experimental group, control group 27 cases, preoperative intravenous hydroxyethyl starch or Ringer lactate solution, monitoring the hemodynamic changes, inflammatory factors and coagulation indexes in patients in two groups.Results T0 moment, MAP, CVP and HR of experimental group and control group were no significant difference; in T1, T2, T3, MAP and HR of experimental group were higher than that of control group (P<0.05), the CVP value was lower than the control group (P<0.05);T1 T2, T3, PT and APTT in two groups compared with T0 times were significantly increased (P<0.05); pre-treament, there was no significant difference in serum TNF-α, IL-10, IL-6 and CRP between the observation group and the control group; post-treament, The levels of TNF-α, IL-10, IL-6 and CRP in the observation group were lower than those in the control group ( P <0.05 ) .Conclusion The elderly gastric cancer patients undergoing preoperative use of hydroxyethyl amylase is important for inflammation and maintain stable hemodynamics in patients with postoperative .