目的 探讨慢传输型便秘Syn、S100、GFAP表达及其意义.方法 回顾性分析该院于2010年1月—2016年2月75例以慢传输便秘行次全结肠或全结肠切除术的病历,采集其病理资料.免疫组化检查Syn、S100、GFAP,与同期外伤致乙状结肠部分切除术者比较,其数据行统计学检验.结果 慢传输便秘组突触素表达(0.3425±0.0586)较对照组(0.4871±0.0732)少表达(P＜0.05).表达仅散在分布于肌层.慢传输便秘组酸性钙结合蛋白S100(0.4629±0.0529)较对照组(0.3213±0.0512)高表达(P＜0.05).慢传输便秘组及对照组胶质纤维酸性蛋白均无表达.结论 慢传输型便秘的形成可能与Syn、S100及GFAP在结肠壁的表达相关,肠神经系统紊乱仍不失为慢传输型便秘的首要病因.

Objective To research endocrine change on pregnancy rabbit's fracture healing .Methods Japan's big ears white female rabbits were randomly divided into control group and pregnancy group ,pregnancy group which mating and becoming pregnant .After making model ,according to 0a ,0b ,1 ,2 ,3week ,extracting blood ,stored in - 80 ℃ .The freeze - stored serum was tested growth hormone ,BGP and prolactin by histological examination and immunohistochemistry examination .All data were statistics tested .Results Serum growth hormone of preg‐nancy group were (1 .33 ± 0 .07) ,(1 .43 ± 0 .02) ,(1 .51 ± 0 .11) ,(1 .83 ± 0 .29)ng/ml respectively ,in 0b ,1 ,2 , 3week ,higher than control group ,that is (1 .21 ± 0 .15) ,(1 .32 ± 0 .10) ,(1 .25 ± 0 .19) ,(1 .34 ± 0 .31)ng/ml(P< 0 .05) .The BGP were (0 .50 ± 0 .05) ,(0 .54 ± 0 .03) ,(0 .59 ± 0 .08) ,(0 .64 ± 0 .05a)ng/ml respectively ,also higher than control group ,that is (0 .41 ± 0 .67) ,(0 .44 ± 0 .08) ,(0 .50 ± 0 .035) ,(0 .55 ± 0 .04)ng/ml(P <0 .05) .Conclusion Rabbits'pregnancy in early metaphase can promote fracture healing .

目的 探讨空肠营养对十二指肠乳头成形术后患者肝功能及胆汁分泌的影响.方法 将48例狭窄性十二指肠乳头炎患者按随机数字表法分为空肠营养组(38例)和静脉营养组(10例),均行十二指肠乳头成形术,术中置T形管入胆总管及经鼻置入空肠营养管,定位胃管于十二指肠降部,定位空肠营养管于Treits韧带下30 cm空肠内,术后观察肝功能及胆汁分泌、缩胆素、胃泌素变化.结果 48例狭窄性十二指肠乳头炎患者均一期出院.无一例切口或腹腔感染、残石、再狭窄、肠瘘发生.静脉营养组胃瘫2例,予胃动力药物、继续静脉营养后逐渐恢复.空肠营养组平均住院12d,静脉营养组为14d.两组术后不同时间T形管引流量、血胃泌素、血缩胆素、丙氨酸氨基转移酶、γ-谷氨酰转移酶、总胆红素比较差异无统计学意义(P＞0.05),两组术后血胃泌素、血缩胆素水平呈增高趋势.结论 空肠营养对十二指肠乳头成形术后患者肝功能及胆汁分泌无影响,空肠营养可提供上消化道疾病患者足够的能量需求,不失为一种安全有效的方法。

OBJECTIVE To prove the value of subject global assessment’s effects on nutrition assessment and prognostic value of Chinese gastrointestinal cancer patients. METHODS 486 gastrointestinal cancer patients of primary diagnosis and surgical treatment from 2008 to 2010 were elected. 262 cases (53.9%) were males and 224 cases (46.1%) were females. Every patient was evaluated with Subject Global Assessment (SGA) for his / her nutritional status, at the same time, related parameters measurement and laboratory tests, including Prealbumin (PA) , Albumin (ALB) level on preoperation were detected. Hospital stays, incidence of postoperative complications, hospital costs on post-operation were collected. RESULTS According to the evaluation results all patients were divided into three groups: normal nutrition group (group A) with 256 cases ( 52.7% ) , light-moderate malnutrition group ( group B) with 202 cases ( 41.6% ) and severe malnutrition group (group C)with 28 cases (5.7%). Single factor analysis of variance results showed that it had a statistical difference on Body Mass Index (BMI), Triceps Skin Fold (TSF), PA, ALB, Hospital stays, Hospital costs (P < 0.05). There was no statistical difference on incidence of complications between groups (χ2 = 4.16, P﹥0.05). CONCLUSION SGA is a safe, non-invasive, reliable, simple and convenient evaluative method for nutrition states of chinese gastrointestinal cancer patient. Its index could predict prognosis for certain disease, such as hospital stays and hospital costs.

目的观察空肠营养对十二指肠乳头成型术患者胰腺功能的影响。方法 38例接受十二指肠乳头成型术的患者,术中置T形管入胆总管,置胰腺硅胶管于主胰管(途经20 cm空肠后穿出固定于腹腔外并接无菌袋);经鼻置入胃管、空肠营养管,定位胃管于十二指肠降部,定位空肠营养管于Treits韧带下30 cm空肠内。术后观察血淀粉酶、胰液分泌及胰腺管引流液中淀粉酶、胃泌素、胆囊收缩素—促胰酶素(CCK)水平变化。与10例同期非空肠营养患者作对照。结果术后各时间点空肠营养与非空肠营养患者血清淀粉酶、胰液分泌及胰管引流液淀粉酶、胃泌素、CCK水平相比,P均>0.05。结论空肠营养对十二指肠乳头成形术患者胰腺功能无不良影响,是一种安全的营养供给方法。

<正>恶性血液系疾病均具有岀血、感染及贫血等特点,而化疗是其主要治疗手段,重复静脉穿刺所导致的血肿和感染,以及化疗药物的毒副作用引起的静脉炎及渗漏性损伤,甚至皮肤坏死,血管的破坏,往往严重影响患者的生活质量和下一周期的治疗。因此,建立一条好的静脉通道,可以大大减少患者重复

<正>目前,经外周静脉置入中心静脉导管(PICC)临床应用越来越广。但其存在一系列静脉导管相关并发症。PICC穿刺置管位置多样,不同穿刺置管部位PICC的并发症发生情况是否有差异尚不明确。2008年11月~2010年5月,我们比较了不同穿刺部位PICC的并发症发生情况。现将结果报告如下。

<正>动脉穿刺难度较大,常用于危急重患者抢救及各种监测。2009年3～9月我们对118例患者进行了动脉穿刺,结果报告如下。1临床资料本组118例,男82例,女36例,年龄60～82岁,平均73.5岁。体质量38～82kg。其中股动脉穿刺30例,桡动脉穿刺88例。

恶性肿瘤患者常处于痛苦、不安的心理状态,表现为焦虑、抑郁、绝望、麻木不仁,甚至自我放弃,可伴有植物神经系统症状和行为异常.2000年1月～2007年12月,我们对256例恶性肿瘤患者行进行心理护理,显著改善了患者的心理状态.现将其心理护理方法介绍如下.

[Objective]To investigate Effects of Jejunum nutrition in the function of stomach after duodenum papilla shape operations.[Methods]38 patients receiving duodenum papilla shape operations underwent EN,and compared with 10 patients with parenteral nutrition(PN).In the operation for the 12 patients,we put T-tube into common bile duct and put into jejunum nutrition tube through nose,gastric tube was located in descending part of duodenum,jejunum nutrition tube was located in jejunum about 30cm beyond Treits ligament.Then we observed the effect of Jejunum nutrition in patients with secreting gastric juice,the PH of drainage liquid,and stomach electrical chart change after operations as well as clectrogastrogram.[Results]There was no significant difference in secreting gastric juice,the PH of drainage liquid,and stomach electrical chart change after operations as well as clectrogastrogram between patients ecreting gastric juice after Duodenum papilla shape operation and patients with PN(P﹥0.05).[Conclusion]It was extremely tiny about influence of Jejunum nutrition in patients with secreting gastric juice after Duodenum papilla shape operations.Jejunum nutrition could offer enough energy to patients with upper alimentary tract,and it was a safe and effective method.

阑尾炎是外科常见症.也是最多见的急腹症.虽然,过多的误诊已使临床医生重视阑尾炎的症状及辅助检查在其早期诊断中的价值,然而,异位阑尾炎[1]仍不时地给我们以教训.尤其是左位阑尾炎没有引起我们的充分注意,因而,我们仍不可忽视每一个具体患者.鉴于此,现将我院1986--2007年收治的4例左位阑尾炎报告如下.

急性胰腺炎是常见的急腹症之一,它不仅仅是胰腺的炎性病变,而且是涉及多个脏器的全身性疾病.收集我院自97年以来经彩超及CT确诊的急性胰腺炎病历36例,作一临床分析,以说明应用空肠营养在治疗急性胰腺炎中的营养支持作用.

目的:探讨回盲部肿瘤的首发病症及其误诊原因.方法:回顾性分析我院于2000年6月～2007年12月对18例以阑尾炎为首发病征的回盲部肿瘤的资料.结果:本组18例患者均以初诊急性或慢性阑尾炎急性发作而急诊手术,一期右半结肠癌根治术2例,姑息治疗2例,仅行阑尾切除术1例,二期手术右半结肠癌根治术13例.结论:回盲部肿瘤可能以阑尾炎为首发病症,鉴别诊断应引起注意.

目的:探讨PICC在恶性血液系统疾病患者中的应用及护理。方法:回顾性分析我院于2003年6月～2007年12月对158例恶性血液系疾病患者实施PICC技术,进行化疗的资料。结果:本组158例患者PICC导管留置时间36～325天,平均108.5天,发生静脉炎13例,导管堵塞2例,导管折断2例,其余141例病人PICC治疗过程均满意。结论:PICC在恶性血液系统疾病患者中的应用具有优越性,值得推广,在临床上,应注意治疗中的护理。

急性胰腺炎是常见的急腹症之一,它不仅仅是胰腺的炎性病变,而且是涉及多个脏器的全身性疾病.1997年以来, 我们应用奥美拉唑与乌司他丁联合治疗急性胰腺炎36例,疗效满意,报告如下.

目的探讨大隐静脉曲张的理想术式.方法应用Diomed激光联合缝扎术治疗下肢静脉曲张30例,与同期经典术式治疗的25例进行比较.结果联合术式治疗效果满意,无并发症发生,随访3个月无复发.与经典术式比较,无统计学差异,但住院时间短、费用低、患者满意度高.结论用激光加缝扎术治疗下肢静脉曲张是全微创化手术,术式简单、安全、美腿,且近期疗效可靠,值得推广应用.

阑尾炎是外科常见急腹症.目前,绝大多数阑尾炎患者均能早期就医,早期诊断,早期手术.然而,临床医师仍时常在其诊断或手术的处理中遇到麻烦.1997年以来,我们收治以肠梗阻为首发的阑尾炎26例,分析报告如下.

急性心肌梗死患者具有发病急骤、易复发、危险性大等特点.对患者进行健康教育不但要有计划性,还要注重它的艺术性.现将我们实施过程中的具体方法报告如下. 1急性期心理指导是健康教育的基础 心肌梗死患者发病急骤,常伴有濒死感,易发生猝死.患者常见的情绪反应为恐惧、悲观.研究证明,心理因素在决定心肌梗死患者的转归上起着很重要的作用.做好急性期心理疏导,是实施有效健康教育的前提.