妊娠合并急性脂肪肝（acute fatty liver of pregnancy,AFLP）是一种发生在妊娠末期的严重特发性肝病.AFLP多发生于妊娠28~40周,常见于孕35周以后孕妇,特别是多胎及男胎妊娠孕妇[2G4].研究表明AFLP可导致多器官功能损害,死亡率高娠合并...妊娠合并急性脂肪肝（acute fatty liver of pregnancy,AFLP）是一种发生在妊娠末期的严重特发性肝病.AFLP多发生于妊娠28~40周,常见于孕35周以后孕妇,特别是多胎及男胎妊娠孕妇[2G4].研究表明AFLP可导致多器官功能损害,死亡率高娠合并急性脂肪肝患者进行回顾性分析,探讨妊娠合并急性脂肪肝患者的术后护达80%.展开更多
Surgeons may be severely criticized from the perspective of evidence-based medicine because the majority of surgical publications appear not to be convincing. In the top nine surgical journals in 1996, half of the 175...Surgeons may be severely criticized from the perspective of evidence-based medicine because the majority of surgical publications appear not to be convincing. In the top nine surgical journals in 1996, half of the 175 publications refer to pilot studies lacking a control group, 18% to animal experiments, and only 5% to randomized controlled trials (RCT). There are five levels of clinical evidence:level 1 (randomized controlled trial), level 2 (prospective concurrent cohort study), level 3 (retrospective historical cohort study), level 4 (pre-post study), and level 5 (case report). Recently, a Japanese evidence-based guideline for the surgical treatment of hepatocellular carcinoma (HCC) was made by a committee (Chairman, Professor Makuuchi and five members). We searched the literature using the Medline Dialog System with four Keywords:HCC, surgery, English papers, in the last 20 years. A total of 915 publications were identified systematically reviewed. At the first selection (in which surgery-dominant papers were selected), 478 papers survived. In the second selection (clearly concluded papers), 181 papers survived. In the final selection (clinically significant papers), 100 papers survived. The evidence level of the 100 surviving papers is shown here:level-1 papers (13%), level-2 papers (11%), level-3 papers (52%), and level-4 papers (24%);therefore, there were 24% prospective papers and 76% retrospective papers. Here, we present a part of the guideline on the five main surgical issues:indication to operation, operative procedure, peri-operative care, prognostic factor, and post-operative adjuvant therapy.展开更多
OBJECTIVE The purpose of this study was to evaluate the quality of life （QOL） in Chinese middle-aged male patients with gastric carcinoma after total gastrectomy, to investigate the factors affecting their QOL, and ...OBJECTIVE The purpose of this study was to evaluate the quality of life （QOL） in Chinese middle-aged male patients with gastric carcinoma after total gastrectomy, to investigate the factors affecting their QOL, and to Study the effectiveness of nursing intervention.METHODS Structured questionnaire （EORTC QLQ-C30） was used among 162 middle-aged male patients after total gastrectomy （the patients finished the whole process of chemotherapy, and returned home, and society） for data collection and reevaluate the patients＇ aualitv of life with 2 months nursing intervention.RESULTS The patient＇s quality of life was related to their education level, economic condition, family support, and pathological staging. This study showed that patients got higher scores in Functional scales （except for CF）, and lower scores in Symptom scales and single items （except for FI） after receiving intervention than before it was received before.CONCLUSION The study revealed that the QOL in middleaged male patients after total gastrectomy was worse when there was inadequate attention. After implementing pertinent nursing intervention implementing, patients＇ mental attitude and negative behavior were improved, and their QOL was enhanced after returning home and into society.展开更多
This ten-year retrospective study was designed to examine the morbidity and mortality of three cases of Cantrell＇s syndrome between 1998 and 2008. The three patients showed different degrees of Cantrell＇s pentalogy ...This ten-year retrospective study was designed to examine the morbidity and mortality of three cases of Cantrell＇s syndrome between 1998 and 2008. The three patients showed different degrees of Cantrell＇s pentalogy including abdominal ectopia cordis, thoracic-abdominal ectopia cordis and left ventricular diverticulum. Of the three, the 5-month-old boy suffering from complicated congenital heart disease with abdominal ectopia cordis received a successful single stage repair and reconstruction of the abdominal wall. The 33-week-old premature girl with thoracic-abdominal ectopia cordis underwent two stage correction of tetraology of Fallot. The 4-year-old girl underwent ectomy of left ventricular diverticulum and thoracoabdominal wall repair. Twenty-four to thirty-five months follow-up were satisfactory. We hold that two-stage repair are technically feasible for Cantrell＇s syndrome, especially for those with complex congenital heart diseases. Post-operative ventilatory support and multiple post-operative care should be prolonged. Malnutrition, infection and arrhytbmia are central problems in medical care and surgery should be considered if there was progressive heart failure or hemodynamic instability.展开更多
AIM： TO examine the diagnostic yield of colorectal neoplasia at computed tomographic colonoscopy （CTC） as well as the feasibility of contrast enhanced CTC in patients with gastric cancer. METHODS： To examine the i...AIM： TO examine the diagnostic yield of colorectal neoplasia at computed tomographic colonoscopy （CTC） as well as the feasibility of contrast enhanced CTC in patients with gastric cancer. METHODS： To examine the incidence of colon polyp we selected postoperative 188 gastric cancer patients, which we refer to as the ‘colon polyp survey group’. To examine the feasibility of CTC for early detection of colon cancer or advanced colon adenoma, we selected 47 gastric cancer patients （M：F 29：18, mean age 53.8 years）, which we call the ‘CT colonoscopy group’. All the 47 patients underwent successive CTC and colonoscopy on the same day. RESULTS： Totally 109 colon polyps were observed from 59 out of 188 gastric cancer patients, the inddence rate of colon polyps in gastric cancer patients being 31.4%. The sensitivity of CTC in detecting individuals with at least 1 lesion of any size was 57.1%, the specificity was 72.7%, the positive predictive value was 47.1%, and the negative predictive value was 71.9%. When the cutoff size was decreased to 6 mm, the sensitivity and specificity were 80.0% and 92.9%, respectively, with positive and negative predictive values of 57.1% and 97.5%, respectively. Only one patient was classified as false negative by virtual colonoscopy. CONCLUSION： The diagnostic yield of colorectal polyp was 31.4% in patients with gastric cancer, and contrast enhanced CTC is an acceptable tool for the detection of synchronous colorectal advanced adenoma and postoperative surveillance of gastric cancer patients.展开更多
The very key element in quality of nursing care is individualized nursing care. Individual differences among patients in terms of their health, illness, social classes and cultural background which lead to different n...The very key element in quality of nursing care is individualized nursing care. Individual differences among patients in terms of their health, illness, social classes and cultural background which lead to different needs emphasize on providing individualized care. And it is strongly related to postoperative care satisfaction. In fact, it tailored nm,ning activities with unique peculiarity of each patient. Actually, it changes all standardized nursing procedures and activities. We aimed to look into the differences between those two types of nursing application in postanesthesia care unit （PACU）, affect postoperative care satisfaction in the research. Methods： We conducted a prospective control study that included 325 patients ,randomly divided into two groups： Individualized nursing care group and ordinary nursing care group, undergoing general anesthesia. The 2 groups of patients were similar in respect to gender distribution, age, and type of surgery and had been admitted into the PACU after elective surgery. Data was collected by interviewing with patients using Satisfaction Questionnaire （North Health Service Hospital Consumer Assessment Works by and service systems （H C A H P S） in patients over Meaning of the questionnaire Chinese Translation Version ） , after assessing its content validity and reliability with Chronbach＇s alpha method. Using SPSS ver. 17 to analysis data .Results： General information on the two groups were no statistically significant differences （P〉 0. 05）. Individualized nursing care group （98.2%） compared with the ordinary nursing care group satisfaction （92%） significantly increased （P 〈0. 01）. Conclusions： Deployment of individualized nursing care in PACU can significantly improve postoperative satisfaction compared to ordinary nursing care.展开更多
Mixed hemorrhoids,especially ring-shaped mixed hemorrhoid,is still a headache for anorectal surgeons due to its post-operative complications.In recent years,clinicians have been studying and exploring to avoid and all...Mixed hemorrhoids,especially ring-shaped mixed hemorrhoid,is still a headache for anorectal surgeons due to its post-operative complications.In recent years,clinicians have been studying and exploring to avoid and alleviate these complications.In the Chinese medicine industry,the application of traditional Chinese medicine nursing technology has good and unique effect in prevent local pain,perianal edema,promote wound healing,relieve urinary retention,improve constipation,relieve anxiety,and so on.This article summarized the evidences of investigated the role of traditional Chinese medicine nursing technique in preventing and treating mixed hemorrhoid so that practitioners can make decision based on the best available evidences.展开更多
Objective: To observe the clinical effect of traditional Chinese medicine nursing on the recovery of gastrointestinal function after abdominal operation. Methods: A total of 148 patients undergoing abdominal surgery f...Objective: To observe the clinical effect of traditional Chinese medicine nursing on the recovery of gastrointestinal function after abdominal operation. Methods: A total of 148 patients undergoing abdominal surgery from June 2013 to June 2014 in our hospital were randomly divided into observation group and control group, 74 cases in each group. The control group received routine nursing and the observation group was treated with the pointer, acupuncture and external application of abdominal treatment on the basis of routine nursing, which is 2 times a day,7 days for a course of treatment. Results: The recovery time of bowel sound, the first anal exhaust defecation time the in the observation group and the hospital day was less than the control group. With the comparison of two groups, the difference between the two groups was statistically significant (P < 0.05). The incidence of abdominal pain, abdominal distension, nausea, vomiting and constipation in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion: On the basis of routine nursing, the implementation of traditional Chinese medicine characteristic nursing can effectively promote the recovery of gastrointestinal function, reduce the occurrence of complications, shorten the length of stay and improve the clinical effect.展开更多
Penile amputation and successful replantation is very uncommon, and there is no routine standardized procedures for dealing with this medical condition. Here we report two cases of penile amputation and replantation i...Penile amputation and successful replantation is very uncommon, and there is no routine standardized procedures for dealing with this medical condition. Here we report two cases of penile amputation and replantation involving different degrees of vascular insult leading to different pathogenesis, clinical presentation, surgical approach and prognosis. This report described the microsurgical procedure and postoperative care using bipedicled scrotal flap to achieve successful engraftment and function. A review of the published data and future methods to increase success of such surgical procedures is provided.展开更多
文摘妊娠合并急性脂肪肝（acute fatty liver of pregnancy,AFLP）是一种发生在妊娠末期的严重特发性肝病.AFLP多发生于妊娠28~40周,常见于孕35周以后孕妇,特别是多胎及男胎妊娠孕妇[2G4].研究表明AFLP可导致多器官功能损害,死亡率高娠合并急性脂肪肝患者进行回顾性分析,探讨妊娠合并急性脂肪肝患者的术后护达80%.
基金a Grant-in-Aid for Scientific Research from the Ministry of Education Science and Culture, No. 13307037, No. 16209038
文摘Surgeons may be severely criticized from the perspective of evidence-based medicine because the majority of surgical publications appear not to be convincing. In the top nine surgical journals in 1996, half of the 175 publications refer to pilot studies lacking a control group, 18% to animal experiments, and only 5% to randomized controlled trials (RCT). There are five levels of clinical evidence:level 1 (randomized controlled trial), level 2 (prospective concurrent cohort study), level 3 (retrospective historical cohort study), level 4 (pre-post study), and level 5 (case report). Recently, a Japanese evidence-based guideline for the surgical treatment of hepatocellular carcinoma (HCC) was made by a committee (Chairman, Professor Makuuchi and five members). We searched the literature using the Medline Dialog System with four Keywords:HCC, surgery, English papers, in the last 20 years. A total of 915 publications were identified systematically reviewed. At the first selection (in which surgery-dominant papers were selected), 478 papers survived. In the second selection (clearly concluded papers), 181 papers survived. In the final selection (clinically significant papers), 100 papers survived. The evidence level of the 100 surviving papers is shown here:level-1 papers (13%), level-2 papers (11%), level-3 papers (52%), and level-4 papers (24%);therefore, there were 24% prospective papers and 76% retrospective papers. Here, we present a part of the guideline on the five main surgical issues:indication to operation, operative procedure, peri-operative care, prognostic factor, and post-operative adjuvant therapy.
文摘OBJECTIVE The purpose of this study was to evaluate the quality of life （QOL） in Chinese middle-aged male patients with gastric carcinoma after total gastrectomy, to investigate the factors affecting their QOL, and to Study the effectiveness of nursing intervention.METHODS Structured questionnaire （EORTC QLQ-C30） was used among 162 middle-aged male patients after total gastrectomy （the patients finished the whole process of chemotherapy, and returned home, and society） for data collection and reevaluate the patients＇ aualitv of life with 2 months nursing intervention.RESULTS The patient＇s quality of life was related to their education level, economic condition, family support, and pathological staging. This study showed that patients got higher scores in Functional scales （except for CF）, and lower scores in Symptom scales and single items （except for FI） after receiving intervention than before it was received before.CONCLUSION The study revealed that the QOL in middleaged male patients after total gastrectomy was worse when there was inadequate attention. After implementing pertinent nursing intervention implementing, patients＇ mental attitude and negative behavior were improved, and their QOL was enhanced after returning home and into society.
文摘This ten-year retrospective study was designed to examine the morbidity and mortality of three cases of Cantrell＇s syndrome between 1998 and 2008. The three patients showed different degrees of Cantrell＇s pentalogy including abdominal ectopia cordis, thoracic-abdominal ectopia cordis and left ventricular diverticulum. Of the three, the 5-month-old boy suffering from complicated congenital heart disease with abdominal ectopia cordis received a successful single stage repair and reconstruction of the abdominal wall. The 33-week-old premature girl with thoracic-abdominal ectopia cordis underwent two stage correction of tetraology of Fallot. The 4-year-old girl underwent ectomy of left ventricular diverticulum and thoracoabdominal wall repair. Twenty-four to thirty-five months follow-up were satisfactory. We hold that two-stage repair are technically feasible for Cantrell＇s syndrome, especially for those with complex congenital heart diseases. Post-operative ventilatory support and multiple post-operative care should be prolonged. Malnutrition, infection and arrhytbmia are central problems in medical care and surgery should be considered if there was progressive heart failure or hemodynamic instability.
文摘AIM： TO examine the diagnostic yield of colorectal neoplasia at computed tomographic colonoscopy （CTC） as well as the feasibility of contrast enhanced CTC in patients with gastric cancer. METHODS： To examine the incidence of colon polyp we selected postoperative 188 gastric cancer patients, which we refer to as the ‘colon polyp survey group’. To examine the feasibility of CTC for early detection of colon cancer or advanced colon adenoma, we selected 47 gastric cancer patients （M：F 29：18, mean age 53.8 years）, which we call the ‘CT colonoscopy group’. All the 47 patients underwent successive CTC and colonoscopy on the same day. RESULTS： Totally 109 colon polyps were observed from 59 out of 188 gastric cancer patients, the inddence rate of colon polyps in gastric cancer patients being 31.4%. The sensitivity of CTC in detecting individuals with at least 1 lesion of any size was 57.1%, the specificity was 72.7%, the positive predictive value was 47.1%, and the negative predictive value was 71.9%. When the cutoff size was decreased to 6 mm, the sensitivity and specificity were 80.0% and 92.9%, respectively, with positive and negative predictive values of 57.1% and 97.5%, respectively. Only one patient was classified as false negative by virtual colonoscopy. CONCLUSION： The diagnostic yield of colorectal polyp was 31.4% in patients with gastric cancer, and contrast enhanced CTC is an acceptable tool for the detection of synchronous colorectal advanced adenoma and postoperative surveillance of gastric cancer patients.
文摘The very key element in quality of nursing care is individualized nursing care. Individual differences among patients in terms of their health, illness, social classes and cultural background which lead to different needs emphasize on providing individualized care. And it is strongly related to postoperative care satisfaction. In fact, it tailored nm,ning activities with unique peculiarity of each patient. Actually, it changes all standardized nursing procedures and activities. We aimed to look into the differences between those two types of nursing application in postanesthesia care unit （PACU）, affect postoperative care satisfaction in the research. Methods： We conducted a prospective control study that included 325 patients ,randomly divided into two groups： Individualized nursing care group and ordinary nursing care group, undergoing general anesthesia. The 2 groups of patients were similar in respect to gender distribution, age, and type of surgery and had been admitted into the PACU after elective surgery. Data was collected by interviewing with patients using Satisfaction Questionnaire （North Health Service Hospital Consumer Assessment Works by and service systems （H C A H P S） in patients over Meaning of the questionnaire Chinese Translation Version ） , after assessing its content validity and reliability with Chronbach＇s alpha method. Using SPSS ver. 17 to analysis data .Results： General information on the two groups were no statistically significant differences （P〉 0. 05）. Individualized nursing care group （98.2%） compared with the ordinary nursing care group satisfaction （92%） significantly increased （P 〈0. 01）. Conclusions： Deployment of individualized nursing care in PACU can significantly improve postoperative satisfaction compared to ordinary nursing care.
文摘Mixed hemorrhoids,especially ring-shaped mixed hemorrhoid,is still a headache for anorectal surgeons due to its post-operative complications.In recent years,clinicians have been studying and exploring to avoid and alleviate these complications.In the Chinese medicine industry,the application of traditional Chinese medicine nursing technology has good and unique effect in prevent local pain,perianal edema,promote wound healing,relieve urinary retention,improve constipation,relieve anxiety,and so on.This article summarized the evidences of investigated the role of traditional Chinese medicine nursing technique in preventing and treating mixed hemorrhoid so that practitioners can make decision based on the best available evidences.
文摘Objective: To observe the clinical effect of traditional Chinese medicine nursing on the recovery of gastrointestinal function after abdominal operation. Methods: A total of 148 patients undergoing abdominal surgery from June 2013 to June 2014 in our hospital were randomly divided into observation group and control group, 74 cases in each group. The control group received routine nursing and the observation group was treated with the pointer, acupuncture and external application of abdominal treatment on the basis of routine nursing, which is 2 times a day,7 days for a course of treatment. Results: The recovery time of bowel sound, the first anal exhaust defecation time the in the observation group and the hospital day was less than the control group. With the comparison of two groups, the difference between the two groups was statistically significant (P < 0.05). The incidence of abdominal pain, abdominal distension, nausea, vomiting and constipation in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion: On the basis of routine nursing, the implementation of traditional Chinese medicine characteristic nursing can effectively promote the recovery of gastrointestinal function, reduce the occurrence of complications, shorten the length of stay and improve the clinical effect.
文摘Penile amputation and successful replantation is very uncommon, and there is no routine standardized procedures for dealing with this medical condition. Here we report two cases of penile amputation and replantation involving different degrees of vascular insult leading to different pathogenesis, clinical presentation, surgical approach and prognosis. This report described the microsurgical procedure and postoperative care using bipedicled scrotal flap to achieve successful engraftment and function. A review of the published data and future methods to increase success of such surgical procedures is provided.
