动静之间——石舒清小说《果院》的文化意蕴

回族作家石舒清书写西海固回族社会生活的作品以其深厚的回族文化底蕴获得了评论界的关注与好评,其中,他的短篇小说《果院》于2005年获《人民文学》短篇小说奖。本文通过对《果院》的分析,认为该作品中蕴含着动与静之间的张力,在终极关怀层面上则表现了一种和谐、顺应的生命状态,暗合回族文化最本质的宗教意蕴。

Effect of Vacuum Sealed Drainage on Recovery of Gastrointestinal Function in Gastric Cancer Patients after Radical Gastrectomy

Objective This study aims to explore the effect of vacuum sealed drainage on the recovery of gastrointestinal function in gastric patients after radical gastrectomy. Methods One hundred and twenty patients who received radical gastrectomy for gastric cancer were randomly divided into two groups.Patients in the control group received continuous gastrointestinal decompression to drain the gastric juices after radical gastrectomy,whereas patients in the treatment group received vacuum sealed drainage.The postoperative variables between the two groups were compared,including time of bowel sound reoccurrence,time of the first flatus,indwelling time of gastric tube,days of hospitalization,and complications,such as anastomotic leakage,intestinal obstruction,wound infection,pulmonary infection,fever, and pharyngitis.SPSS 13.0 was used to analyze the data. Results Significant differences in the following variables were observed in patients between the two groups:time of bowel sound reoccurrence,time of the first flatus,indwelling time of gastric tube,and length of hospitalization of the patients.The value of each of these variables was much smaller in the treatment group than in the control group(P<0.05).No significant difference was found in the incidence of anastomotic leakage,intestinal obstruction,and wound infection among patients between the two groups(P>0.05). However,a significant differences were observed in the incidence of pulmonary infection,fever,and pharyngitis among the patients between the two groups(P<0.05),with much lower incidence of the variables in the treatment group than in the control group. Conclusions Vacuum sealed drainage used in gastric cancer patients after radical gastrectomy can accelerate the recovery of gastrointestinal function and reduce postoperative complications.Moreover,it shortens the indwelling time of the gastric tube, thereby making the patients feel comfortable without the disturbance from the gastric tube.

Impact of a Hospital’s Workload on Clinical Outcome afterResection for Carcinoma of the Esophagus

Surgery for esophageal cancer is a demanding procedure associated with a high rate (30%– 40%) of post-operative complications. Therefore, for esophageal cancer surgery, not only must the surgeon be trained for preoperative preparation, operative therapy, and post-operative management, but also the entire hospital setting including physicians of di?erent specialties and intensive care units. In the past few years publications have been particularly concerned with comparing the outcomes of high-volume centers and other hospitals in cases of various tumor operations. Due to more experience, increased frequency of cases and better training conditions in high-volume centers, esophagectomies have been shown to have better outcomes, especially hospital mortality, when performed there than in centers performing them with less frequency. This review of the current literature for esophageal cancer surgery shows a clear reduction of postoperative mortality with increasing case volume per year. Single papers have analysed the main reasons for this phenomenon and showed that postoperative complication rates are lower in high-volume- hospitals and their management of complications is more succesful. In conclusion, the analysis shows that only with the experience of more than 20 esophagectomies per year a signi?cant reduction of the mortality down to <5% can be achieved.

Clinical Analysis of 13 Cases with Burkitt Lymphoma or Burkittlike Lymphoma

OBJECTIVE To summarize the clinical characteristics and treatment effects of Burkitt lymphoma （BL） and Burkitt-like lymphoma （BLL）, and to explore the best possible optimal regimens and the treatment-related complications.METHODS Clinical data of 13 BL and BLL patients, who were pathologically diagnosed and treated in the Beijing Cancer Hospital from August 1996 to October 2008, were retrospectively analyzed, All patients received the therapeutic regimen with chemotherapy as the first-line treatment. The treatment effect and adverse reactions were evaluated.RESULTS Of the 13 patients, 12 were men and 1 was woman, with a median age of 15 years （range, 11-62）. Three of the patients were in stage Ⅰ, 2 in stage Ⅱ, 2 in stage Ⅲ, and 6 in stage Ⅳ. Advanced cases were 8 （stage Ⅲ and Ⅳ）, accounting for 61.5% of the patients. Bone marrow involvement was found in 2 cases （15.4%） and central nervous system invasion in 4 （30.8%） at the beginning of the treatment. The common involved sites included the superficial lymph nodes （61.5%）, abdominal organs （53.8%）, and abdominal and retro-peritoneal lymph nodes （38.5%）. B symptoms were observed in 7 patients （53.8%）. Serum lactate dehydrogenase （LDH） level was increased in 8 of the 10 patients who underwent the serum LDH determination, while serum uric acid level was increased in 1 of the 10. Pathological diagnosis showed that 11 of the cases were BL and 2 BLL. Of the 13 patients, 11 （84.6%） achieved a complete remission （CR） or CR/unconfirmed （CRu）, and 1 （7.7%） a partial remission （PR）, with a total responsive rate of 92.3%. At a median follow-up of 8 months （range 5-35）, 6 patients were found dead at the end of the follow-up. One of the 13 patients was lost to the follow-up. The 1-year overall survival, progression-free survival and disease-free survival rates were 56.98%, 32.31% and 39.77%, respectively. The grade-Ⅲ or Ⅳ myelosuppression was found in 9 patients during the chemotherapy （69.2%）, and tumor lysis syndrome and grade- Ⅳ total gastrointestinal mucositis were seen in 1.CONCLUSION Intensive short-course chemotherapy is recommended as the optimal first-line treatment for BL and BLL, and actively preventive treatments for chemotherapy-related adverse reactions are essential in the treatment course.

Introductory course in accounting-Factors affecting the choice of students＇ consideration

This study attempts to investigate if and how students＇ perceptions regarding the first accounting course related with the selection of accounting as a major. Moreover, it examines students＇ initial perceptions and course performance regarding the introductory accounting course. Participants in this study were 120 students from Technological Educational Institute of Kavala, School of Business and Economics （3 departments）, who were asked to complete a survey instrument. The instrument used eleven statements regarding students＇ perceptions （such as difficulty and motivation of the course） of the first accounting course. The main factors affect students＇ decisions to follow accounting and seem to be similar with other researchers＇ findings （Geiger ＆ Ogilby, 2000）. Future research could be used larger sample from different countries and the survey could also be used for a longer time period.

Extracolonic findings of computed tomographic colonography in Koreans

AIM:To determine the frequency and characteristics of extracolonic lesions detected using computed tomographic(CT)colonography.METHODS:The significance of extracolonic lesions was classified as high,intermediate,or low.Medical records were reviewed to establish whether further investigations were carried out pertaining to the extracolonic lesions that were detected by CT colonography.RESULTS:A total of 920 cases from 7 university hospitals were included,and 692 extracolonic findings were found in 532(57.8%)patients.Of 692 extracolonic findings,60 lesions(8.7%)were highly significant,250(36.1%)were of intermediate significance,and 382(55.2%)were of low significance.CT colonography revealed fewer extracolonic findings in subjects who were without symptoms(P<0.001),younger(P<0.001),or who underwent CT colonography with no contrast enhancement(P=0.005).CT colonography with contrast enhancement showed higher cost-effectiveness in detecting highly significant extracolonic lesions in older subjects and in subjects with symptoms.CONCLUSION:Most of the extracolonic findings detected using CT colonography were of less significant lesions.The role of CT colonography would be optimized if this procedure was performed with contrast enhancement in symptomatic older subjects.

Discussion on the Classroom Teaching Management of the Art and Design Major in Higher Vocational Colleges

As a teaching aid, the classroom management model of art and design major courses undoubtedly should follow the rules of art education. Compared with colleges and universities, the teachers in higher vocational colleges often need to educate many students of poor foundation and bad habits, so the management model should be explored more deeply and specifically. Through the depth analysis of the teaching environment, objects, and objectives, a relatively solid, perfect management system including discipline management and system control, mental management and standard attitudes, process management, incentive and interaction, evaluation management, and ability goal is proposed, for the purpose of providing a powerful guarantee for the classroom teaching effect of the an and design major in higher vocational colleges by using reasonable classroom management methods and means. As a result, a solid foundation is laid for the an and design students to become the professionals of the sustainable development.

Diagnostic accuracy of CT scan in abdominal blunt trauma

Objective： To evaluate the sensitivity and specificity of CT scan findings in patients with blunt abdominal trauma admitted to the university hospital. Methods： All the patients with blunt abdominal trauma admitted at a tertiary teaching trauma center in Iran between 2005 and 2007 were enrolled in this study. In the absence of any clinical manifestations, the patients underwent a diagnostic CT scan. Laparatomy was performed in those with positive CT results. Others were observed for 48 hours and discharged in case no problem was reported; otherwise they underwent laparatomy. Information on patients＇ demographic data, mechanism of trauma, indication for CT scan, CT scan findings, results of laparotomy were gathered. The sensitivity, specificity and accuracy of the CT-scan images in regard with the organ injured were calculated. The sensitivity, specificity and accuracy of the CT scan were calculated in each case. Results： CT scan had the highest sensitivity for detecting the injuries to liver （100%） and spleen （86.6%）. The specificity of the method for detecting retroperitoneal hematoma （100%） and injuries to kidney （93.5%） was higher than other organs. The accuracy of CT images to detect the injuries to spleen, liver, kidney and retroperitoneal hematoma was reported to be 96.1%, 94.4%, 91.6% and 91.6% respectively. Conclusion： The findings of the present study reveal that CT scan could be considered as a good choice, especially for patients with blunt abdominal trauma in teaching hospitals where the radiologic academic staff is not present in the hospital in the night shifts.