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1.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-931365

RESUMO

It is still at the initial stage for basic-level military doctors to participate in the standardized residency training. While, their professional backgrounds and training objectives are significantly different from those civilian residents, it is necessary to explore the standardized training methods in line with the military career demands for those basic-level military doctors. Based on the actual needs of grass-roots troops and military medicine, this study makes significant progress in the integration of standardized residency training and field surgery training methods, making the basic-level military doctors achieve the goal of field surgery training in the course of clinical practice of residents. Not only the surgical capability of basic-level military doctors, but also the medical support capability in grass-roots troops has been improved. This article summarizes the application methods and experience of field surgery teaching in the standardized residency training of military medical residents at the grass-roots level.

2.
Med Sci Monit ; 23: 5522-5533, 2017 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-29155699

RESUMO

BACKGROUND Conflict still remains as to the benefit of angioembolization (AE) for non-operative therapy (NOT) of blunt hepatic trauma (BHT). The aim of this study was to determine whether AE could result in lower failure rates in hemodynamically stable BHT patients with high failure risk factors for NOT, and to systematically evaluate the effectiveness of AE for NOT of BHT. MATERIAL AND METHODS Medical records of all BHT patients from January 1, 1998 to December 31, 2015 at a large trauma center were collected and analyzed. Failure of NOT (FNOT) occurred if hepatic surgery was performed after attempted NOT. Logistic regression analysis was used to identify factors associated with FNOT. Hepatobiliary complications related to hepatic trauma during follow-up were reviewed. RESULTS No significant difference in FNOT for the no angiographic embolization (NO-AE) group versus angiographic embolization (AE) group was found in hepatic trauma of grades I, II, and V. However, decrease in FNOT was significant with AE performed for hepatic trauma of grades III to IV. Risk factors for FNOT included grade III to IV injuries and contrast blush on CT. Follow-up data of six months also showed that the incidence of hepatobiliary complications in the NO-AE group was higher than the AE group. CONCLUSIONS Hemodynamically stable BHT patients with grade III to IV injuries, contrast blush on initial CT, and/or decreasing hemoglobin levels can be candidates for selective AE during NOT course.


Assuntos
Embolização Terapêutica/métodos , Ferimentos e Lesões/terapia , Ferimentos não Penetrantes/terapia , Adulto , Angiografia/métodos , China , Feminino , Humanos , Incidência , Fígado/lesões , Masculino , Pessoa de Meia-Idade , Radiografia , Estudos Retrospectivos , Fatores de Risco , Ferimentos não Penetrantes/diagnóstico por imagem
3.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-444210

RESUMO

Objective To compare the clinical effects of surgical treatment and ultrasonic guidance percutaneous radiofrequency ablation(PRFA) therapy in the treatment of liver cancer.Methods 78 patiens with live cancer were randomly divided into the operation group and PRFA group,each group had 39 patients.The operation group was treated with traditional open surgery,the PRFA group was treated with radiofrequency ablation.The clinical effect was compared between the two groups.Results All patients were followed up after therapy,the 1,2,3-year survival rate between operation group and PRFA group had no significant differences (all P > 0.05),but in the patients whose tumor were central type and samller than 3cm,the 1,2,3-year survival rate of PRFA group were significantly higher than operation group(x2 =4.819,4.815,4.919,all P < 0.05).Conclusion Ultrasonic guidance percutaneous radiofrequency ablation therapy in the treatment of liver tumor is effective,and the effect is better than operation group,especially for the patients with central type tumor and the tumor samller than 3cm.

4.
Hepatogastroenterology ; 60(126): 1497-503, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23591733

RESUMO

BACKGROUND/AIMS: Pancreatic injury after blunt abdominal trauma is always associated with a high morbidity and mortality. The purpose of this study was to evaluate the effect of a grading-therapeutic strategy and to highlight various challenges in the management of blunt pancreatic injury. METHODOLOGY: All cases of pancreatic injury after blunt abdominal trauma from January 1, 2008, to December 30, 2012, were retrospectively reviewed, and the clinical data were collected. RESULTS: Ninety-five patients formed the group, out of which 76 (80.0%) undertook operative management, 19 (20.0%) undertook non-operative management; 18 underwent ERCP for pancreatic duct evaluation, with 7 (38.9%) undergoing nasopancreatic drain placement and 4 (22.2%) transpapillary pancreatic duct stent placement. Operation was performed for patients according to pancreatic injury grading and results of intra-operative selective pancreatography. Twenty-three (30.3%) developed various pancreatic-related complications. CONCLUSIONS: Grading-therapeutic strategy for blunt pancreatic injury based on condition of the pancreatic duct could be performed safely and effectively. It not only expanded the scope of non-operative management, but also preserved the normal pancreatic tissue.


Assuntos
Traumatismos Abdominais/cirurgia , Pâncreas/lesões , Ductos Pancreáticos/cirurgia , Ferimentos não Penetrantes/cirurgia , Adolescente , Adulto , Colangiopancreatografia Retrógrada Endoscópica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas/cirurgia , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
5.
Hepatogastroenterology ; 60(124): 890-5, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23298872

RESUMO

BACKGROUND/AIMS: Features of LSPH secondary to pancreatic cancer is ambiguous, and controversy remains in the treatment. METHODS: 48 cases from our department were retrospectively analyzed to evaluate the clinical features, as well as the feasibility and effect of surgical treatment. RESULTS: 16 patients had gastrointestinal hemorrhage history. Laboratory findings showed normocytic and normochromic anemia, thrombocytopenia, lymphocyte reduction, and elevated liver enzyme. Tumor markers were normal in 12 patients. Ultrasonography showed splenic venous obstruction in 40 patients and splenomegaly in 35. Esophagogastric varices could be detected by endoscopy in 40 patients and by CT in 37. Radical resection was performed in 43 patients and splenectomy or additional devascularization in 29. 15 patients had gastrointestinal bleeding during follow-up, and the median survival time was 11.0 months. CONCLUSION: Associated LSPH brought special features to pancreatic cancer. Radical resection, as well as splenectomy or additional devascularization for varices above Grade II, was worth performing.


Assuntos
Hipertensão Portal/etiologia , Hipertensão Portal/cirurgia , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/cirurgia , Adulto , Biomarcadores Tumorais/análise , Diagnóstico por Imagem , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/diagnóstico , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
6.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-441439

RESUMO

Objective To discuss the relationship between TCM syndromes and peritoneal fluid cytokine IL-6, IL-8 and TNF-α of endometriosis infertility patients, and provide thoughts for clinical treatment. Methods Totally 105 patients of endometriosis infertility were differentiated to six syndrome groups, including kidney deficiency and blood stasis, qi stagnation and blood stasis, heat stagnation and blood stasis, cold congelation and blood stasis, qi deficiency and blood stasis, phlegm-dampness stagnation. Thirty patients of non-endometriosis infertility were selected as control group. Enzyme-linked immunosorbent assay was used to detect cytokine levels of IL-6, IL-8 and TNF-α. Results In 105 cases of EM infertility, 35 cases (33.33%) were syndrome of kidney deficiency and blood stasis, 22 cases (20.95%) were syndrome of cold congelation and blood stasis, 18 cases (17.14%) were syndrome of qi stagnation and blood stasis, 10 cases (9.52%) were syndrome of heat stagnation and blood stasis, 11 cases (10.48%) were syndrome of qi deficiency and blood stasis, 9 cases (8.57%) were phlegm-dampness stagnation syndrome. The levels of IL-6, IL-8 and TNF-αin each syndrome group of EM infertility were higher than control group (P<0.01). IL-6 level in kidney deficiency and blood stasis group were higher than other syndrome groups (P<0.05). The levels of IL-8 and TNF-α in kidney deficiency and blood stasis group, and heat stagnation and blood stasis group were higher than other syndrome groups (P<0.05). IL-8 in kidney deficiency and blood stasis group was higher than that in heat stagnation and blood stasis group (P<0.05). Conclusion TCM syndromes in patients with endometriosis infertility have some relevance with peritoneal fluid cytokine levels of IL-6, IL-8, TNF-α, which may guide clinical understanding and treatment of endometriosis infertility.

7.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-440218

RESUMO

This study was aimed to analyze the medication rules of AIDS fever by Professor Li Fazhi, in order to pro-vide the corresponding medication reference basis for Chinese medicine treatment of AIDS fever. The complex net-work analysis method was used. This study was conducted among AIDS fever patients treated by Professor Li Fazhi from September 2007 to June 2012 in Weishi County, Henan Province. The analysis was made on the etiology and pathogenesis of AIDS fever, syndrome differentiation and treatment as well as medication of senior famous Chinese medicine doctors. The results showed that through a multidimensional query analysis, the core medication in the treatment of AIDS fever included harmonization and heat-clearing herbs such as Bupleurum, Licorice, Scutellaria, as well as qi-supplementing and healthy qi reinforcing herbs such as Codonopsis and Astragalus. The core prescriptions were modified Xiaochaihu Decoction and Buzhong Y iqi Decoction. It was concluded that the treatment rules of AIDS fever by Professor Li Fazhi was to clear heat in combination with supplementing the center and boost qi.

8.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-546981

RESUMO

Objective: To explore the parameters used for the clinical evaluation of post-trau- matic hepatic function crashing down to the ground. Methods: By establishing the animal model of liver impact injury in simulation of parachuter,blood were sampled before injuries and 15 min, 30 min,45 min,1 h, 3 h, 6 h ,9 h after injuries. Cytokines including TNF?、IL-2 and liver function parameters including ALT,AST,LD-L,GGT,ALP were measured and analyzed statistically. Results: TNF? increased after 15 min- utes, and IL-2 increased after 30 minutes(P0.05). These two pa- rameters were significantly increased all the time after injuries(P

9.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-547274

RESUMO

Objective:To investigate the surgical indication and effect of surgical treatment for giant cavernous hemangioma of the liver(LHG).Methods:The clinical data,including selection of operations,management for severe operative bleeding and postoperative supplementary treatment,of 15 patients with giant LHG treated by surgical measures from 2003 in our hospital were summarized and assessed.Results:Nine cases accepted decollement of LHG,and the recovery courses were all right,6 cases accepted embolization of hepatic artery,in which 2 cases accepted operation afterward.Conclusions:Decollement or embolization of hepatic artery were effective in the treatment of giant cavernous hemangioma.

10.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-547077

RESUMO

Objective: To investigate the cinlical features and therapeutic methods of unex-pected gallbladder carcinoma. Methods: A retrospective analysis was performed in 19 cases of unexpected gallbladder carcinoma treated in our hospital from April 2002 to April 2008. Results: Ten cases in early stage were perfomed gallbaldder resection and local lymph node removal, and the average survival time was 18.7 months; 4 cases were perfomed extend radical resection, and the average survival time was 12.3 months; 5 cases were performed palliative resection, and the survival time was less than 6 months. Conclusions: Frozen section examination during opera-tion is key to diagnose unexpected gallbladder carcinoma. Radical resection is the first option once the diagnosis is confirmed, and the method can be decided according to Nevin classification and B ultrosound scaning during opreation.

11.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-673840

RESUMO

Objective To study the effects of 4 1BBL on antitumor immunity induced in vivo by murine 4 1BBL gene transfected hepatocellular carcinoma cell line Hepa1 6. Methods Eukaryotic expression vector pcDNA3 1(+) m4 1BBL was transfered into murine hepatocellular carcinoma cell line Hepa1 6 via lipofectamine method. The transfected cells were selected in RPMI1640 containing G418(400~800 ?g/ml) and termed as Hepa1 6 m4 1BBL.The TCV m4 1BBL was obtained by treating with mitomycin (MMC). Three models (immunological model, early model, and later model) were established for the study of anticancer effects of TCV m4 1BBL. Results The syngeneic mice were completely protected and could survive free from tumor for a long period by inoculation with TCV 4 1BBL. In early models, TCV 4 1BBL showed strong immunotherapy effects( P 0 05). Conclusion The antitumor effect against syngeneic murine hepatocellular carcinoma cell line in vivo is significantly enhanced by the treatment with TCV 4-1BBL.

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