穴位贴敷联合耳穴压豆在小儿腹腔镜疝气术后疼痛的应用

目的观察穴位贴敷联合耳穴压豆在小儿腹腔镜疝气术后疼痛治疗中的临床效果。方法选择临沂市人民医院小儿外科二病区收治的80例疝气患儿作为研究对象,根据患儿的入院时间分为对照组(40例)和观察组(40例),对照组采用常规护理方式,观察组在对照组的基础上应用穴位贴敷联合耳穴压豆治疗。结果干预6 h、24 h、48 h后,观察组患儿疼痛评分显著低于对照组(P<0.05),观察组患儿家长满意度调查问卷评分高于对照组(P<0.05)。结论穴位贴敷联合耳穴压豆能有效缓解小儿腹腔镜疝气术后疼痛,对改善患儿生活质量、促进患儿早日康复、提高患儿家属满意度具有重要意义。

花椒果皮中化学成分的研究

自芸香科(Rutaceae)花椒属植物花椒(Zanthoxylum bungeanum Maxim.)的果皮中分得了五种结晶和一个白色固体。结晶Ⅰ为香草木宁(kokusaginine),结晶Ⅱ为茵芋碱(skimmianine),结晶Ⅱ为合帕洛平(Haplopine),结晶Ⅳ为2′-羟基-N-异丁基[反式2,6,8,10]-十二烷四烯酰胺(2′-hydroxyl-N-isobytyl-[2E,6E,8E,10E]-dodecatetraenamide),结晶Ⅴ为脱肠草素(herniarin),白色固体为廿九烷(n-nonacosane)。

Presence of columnar-lined esophagus is negatively associated with the presence of esophageal varices in Japanese alcoholic men

AIM To determine whether the presence of columnar-lined esophagus(CLE) is associated with the presence of esophageal varices(EVs) in male Japanese alcoholics. METHODS The subjects were 1614 Japanese alcohol-dependent men(≥ 40 years of age) who had undergone upper gastrointestinal endoscopic screening. Digitalized records of high-quality endoscopic images that included the squamocolumnar junction and esophagogastric junction were retrospectively jointly reviewed by four expert endoscopists for the purpose of diagnosing CLE. The authors investigated whether and to what extent there were associations between the presence of CLE and the presence of EVs, especially in the group with liver cirrhosis(LC).RESULTS CLE ≥ 5 mm in length was found in 355 subjects(≥ 30 mm in 6 of them), LC without EVs in 152 subjects, LC with EVs in 174 subjects, and EVs without LC in 6 subjects. Advanced EVs, i.e., nodular, large or coiled forms, red color sign, or post-treatment, were found in 88 subjects. The incidence of CLE ≥ 5 mm decreased in the following order(P < 0.0001): 23.3% in the group without EVs, 17.4% in the group with small and straight EVs, and 5.7% in the group with advanced EVs. The multivariate ORs(95%CI) for EVs and advanced EVs in the group with LC were lower when CLE ≥ 5 mm was present [0.46(0.23-0.93) and 0.24(0.08-0.74), respectively, vs 0-4 mm CLE]. CONCLUSION The presence of CLE in male Japanese alcoholics was negatively associated with the presence of EVs.

Trajectories of endoscopic Barrett esophagus: Chronological changes in a community-based cohort

AIM To elucidate longitudinal changes of an endoscopic Barrett esophagus(BE), especially of short segment endoscopic BE(SSBE). METHODS This study comprised 779 patients who underwent two or more endoscopies between January 2009 and December 2015. The intervals between the first and the last endoscopy were at least 6 mo. The diagnosis of endoscopic BE was based on the criteria proposed by the Japan Esophageal Society and was classified as long segment(LSBE) and SSBE, the latter being further divided into partial and circumferential types. The potential background factors that were deemed to affect BE change included age, gender, antacid therapy use, gastroesophageal reflux disease-suggested symptoms, esophagitis, and hiatus hernia. Time trends of a new appearance and complete regression were investigated by Kaplan-Meier curves. The factors that may affect appearance and complete regression were investigated by χ~2 and Student-t tests, and multivariable Cox regression analysis. RESULTS Incidences of SSBE and LSBE were respectively 21.7% and 0%, with a mean age of 68 years. Complete regression of SSBE was observed in 61.5% of initial SSBE patients, while 12.1% of initially disease free patients experienced an appearance of SSBE. Complete regressions and appearances of BE occurred constantly over time, accounting for 80% and 17% of 5-year cumulative rates. No LSBE development from SSBE was observed. A hiatus hernia was the only significant factor that facilitated BE development(P = 0.03) or hampered(P = 0.007) BE regression. CONCLUSION Both appearances and complete regressions of SSBE occurred over time. A hiatus hernia was the only significant factor affecting the BE story.

Application of Bu Zhong Yi Qi Tang According to TCM Differentiation of Syndromes

Bu Zhong Yi Qi Tang (补中益气汤Decoction for Reinforcing the Middle-jiao and Replenishing Qi) is an effective formulated recipe commonly used for treating a variety of diseases with the manifestations of kidney-qi deficiency. In my opinion, however, it is also very effective for the conditions of which the symptoms of kidney-qi deficiency is not noticeable, but its mechanism lies in dysfunction of the spleen. The following are some examples.……

食管癌术后并发膈疝合并肠梗阻伴肠穿孔1例(英文)

We reported a case of diaphragmatic hernia complicated with intestinal obstruction with colon perforation after surgery for esophageal cancer. In this case, the conservative treatment took too long, which delayed the diagnosis and treatment and resulted in colon perforation. After computed tomography confirmed the diagnosis, an emergency operation was performed. During the operation, we found colon perforation. Because pollution of thoracic cavity was serious, we performed proximal end colon neostomy. The patient recovered and discharged with active treatment 35 days after operation. We consider surgical repair of the diaphragmatic hernia is recommended to avoid the potentially disastrous complications, such as strangulation or perforation of the herniated contents, which can threaten the life of the patient if diagnosis is delayed.

黄苞大戟的化学成分研究

目的研究黄苞大戟Euphorbia sikkimensis地上部分的化学成分。方法采用多种色谱技术对黄苞大戟地上部分的醇提物进行分离纯化,并根据理化性质和谱学数据对化合物结构进行鉴定。结果从黄苞大戟95%乙醇提取物的醋酸乙酯萃取部分分离得到16个化合物,分别鉴定为9-epi-blumenol C(1)、blumenol A(2)、4-hydroxy-2,3-dimethyl-2-nonen-4-olide(3)、耳壳藻内脂(4)、硬骨霉素(5)、脱肠草素(6)、巨大戟醇(7)、樱花亭(8)、柚皮素(9)、木犀草素(10)、蒲公英萜酮(11)、黏霉酮(12)、叶绿醇(13)、9,12,15-亚麻油酸(14)、9,12-亚麻油酸(15)、α-棕榈精(16)。结论以上化合物除了9、14外均为首次从该植物中分离得到。