Clinical usefulness of ^(18) F-FDG PET/CT in the restaging of esophageal cancer after surgical resection and radiotherapy

AIM： To evaluate the clinical usefulness of lSF-fluorodeoxyglucose positron emission and computed tomography QSF-FDG PET/CT） in restaging of esophageal cancer after surgical resection and radiotherapy. METHODS： Between January 2007 and Aug 2008, twenty histopathologically diagnosed esophageal cancer patients underwent 25 PET/CT scans （three patients had two scans and one patient had three scans） for restaging after surgical resection and radiotherapy. The standard reference for tumor recurrence was histopathologic confirmation or clinical follow-up for at least ten months after ^18F-FDG PET/CT examinations. RESULTS： Tumor recurrence was confirmed histopathologically in seven of the 20 patients （35%） and by clinical and radiological follow-up in 13 （65%）. ^18F-FDG PET/CT was positive in 14 patients （68.4%） and negative in six （31.6%）. ^18F-FDG PET/CT was true positive in 11 patients, false positive in three and true negative in six. Overall, the accuracy of ^18F-FDG PET/CT was 85%, negative predictive value （NPV） was 100%, and positive predictive value （PPV） was 78.6%.The three false positive PET/CT findings comprised chronic inflammation of mediastinal lymph nodes （n = 2） and anastomosis inflammation （n = 1）. PET/ CT demonstrated distant metastasis in 10 patients. ^18F-FDG PET/CT imaging-guided salvage treatment in nine patients was performed. Treatment regimens were changed in 12 （60%） patients after introducing ^18F-FDG PET/CT into their conventional post-treatment follow-up program. CONCLUSION： Whole body ^18F-FDG PET/CT is effective in detecting relapse of esophageal cancer after surgical resection and radiotherapy. It could also have important clinical impact on the management of esophageal cancer, influencing both clinical restaging and salvage treatment of patients.

Clinical research of superior mesenteric vascular intrathecal approach in right hemicolectomy

Objective: The aim of the study was to investigate the clinical value of superior mesenteric vascular intrathecal approach in right hemicolectomy. Methods: We retrospectively studied the clinical data of 132 patients who had right hemicolectomy from June 2007 to June 2010, including 68 cases with superior mesenteric vascular intrathecal approach to resect specimen, and compared the operation time, blood loss, hospital stay and the number of dissected lymph nodes with patients treated with conventional surgery. Results: Compared the vascular intrathecal approach with conventional approach, the operation time and blood loss were decreased significantly, the number of Dukes C No. 3 lymph node dissection was increased, while the incidence of postoperative complications and hospital stay were equivalent to traditional surgery group. Conclusion: The use of vascular intrathecal approach in right hemicolectomy can significantly shorten the operation time and reduce bleeding and improve surgical radical outcomes.

APPLICATION OF ACUPUNCTURE ANESTHESIA TO APPENDECTOMY AND COMMENTS ON THE OPERATION AND ITS POSSIBLE MECHANISMS

Objectives: To observe the analgesic effect and to analyze the related mechanisms of acupuncture anesthesia (AA) for appendectomy. Methods: A total of 41 cases of appendicitis patients (24 males and 17 females) were subjected into this observation. Electroacupuncture (AA, 60-100 Hz, a bearable stimulus strength) of Pishu (BL 20), Weishu (BL 21), Zhangmen (LR 13) and Wushu (GB 27) was performed beginning 30 minutes before operation. Adjuvants used were luminal (100 mg, intra muscular injection), dolantin (1 mg/kg), 0.5% procaine (1-2 mL). Results: Of the 41 cases, the successful rate was 87.80% and the excellent plus good rate was 75.61% respectively. Conclusion: Acupuncture anesthesia is applicable for appendectomy in clinic but is still to be improved further in operation.

Clinical application of thoracic small incision in radical operation for lung and esophageal cancer

Objective: The aim of this study was to explore clinical value of thoracic small incision in radical operation for lung and esophageal cancer in assuring same treatment effects with conventional incision. Methods: Collected data of patients was given radical operation for lung and esophageal cancer in our department from January 1, 2006 to January 1, 2007, and performed retrospective analysis, among them, small incision group (improved group) was 143 cases, and conventional group was 167 cases including 6 cases which was changed from small incision to conventional incision in operation. Compared operation time, incision length, intraoperative blood loss, postoperative drainage flow, number of lymph node dissected, recovery time of postoperative upper limb function, postoperative pain, postoperative complications etc. between both groups. Results: Compared with conventional group, intraoperative blood loss, postoperative drainage flow, postoperative pain, recovery time of postoperative upper limb function in improved group was improved significantly, and there was no obvious difference in operation time and number of lymph node dissected between both groups. Conclusion: Small incision in radical operation for lung and esophageal cancer is small trauma, and quick recovery after operation, treatment effects of it is basically similar to that of conventional operation method, however, its application is limited in few cases.

《神农本草经百种录》文献概述

<神农本草经百种录>为清代名医徐大椿氏所作.是历代<本经>注疏中偏重阐发古本草药性机理与用药规律的临床指导著作.该书篇幅极短,但蕴奥甚深.<四库全书总目提要·子部·医家>称赞该书:"凡所笺释,多有精意,较李时珍<本草纲目>所载,发明诸条颇为简要."又<清史稿·列传·艺术一>亦为推崇:"大椿学博而通,注<神农本草经>百种,以旧注但言其当然,不言其所以然.采掇常用之品,备列经文,推阐主治之义,于诸家中最有启发之功."下面就徐大椿与其著作<神农本草经百种录>作一浅要概述.