Achalasia cardia,type of esophageal dynamic disorder,is a relatively rare primary motor esophageal disease characterized by the functional loss of plexus ganglion cells in the distal esophagus and lower esophageal sph...Achalasia cardia,type of esophageal dynamic disorder,is a relatively rare primary motor esophageal disease characterized by the functional loss of plexus ganglion cells in the distal esophagus and lower esophageal sphincter.Loss of function of the distal and lower esophageal sphincter ganglion cells is the main cause of achalasia cardia,and is more likely to occur in the elderly.Histological changes in the esophageal mucosa are considered pathogenic;however,studies have found that inflammation and genetic changes at the molecular level may also cause achalasia cardia,resulting in dysphagia,reflux,aspiration,retrosternal pain,and weight loss.Currently,the treatment options for achalasia focus on reducing the resting pressure of the lower esophageal sphincter,helping to empty the esophagus and relieve symptoms.Treatment measures include botulinum toxin injection,inflatable dilation,stent insertion,and surgical myotomy(open or laparoscopic).Surgical procedures are often subject to controversy owing to concerns about safety and effectiveness,particularly in older patients.Herein,we review clinical epidemiological and experimental data to determine the prevalence,pathogenesis,clinical presentation,diagnostic criteria,and treatment options for achalasia to support its clinical management.展开更多
Objective: To study the treatment of B-Thalas-semia (ThE) with Chinese herbal medicine for Bushen Yisui (BSYS), its theoretical base and molecular mechanism. Methods: Seventy-eight patients with ThE were treated with ...Objective: To study the treatment of B-Thalas-semia (ThE) with Chinese herbal medicine for Bushen Yisui (BSYS), its theoretical base and molecular mechanism. Methods: Seventy-eight patients with ThE were treated with BSYS recipe (consisted of 11 Chinese herbal drugs as Dogwood fruit, Fleeceflower root, prepared Rehmannia root and turtle shell, etc.) orally taken, 3 times per day, 10 g/time, 3 months as one therapeutic course. Hemoglobin (Hb), red blood cell (RBC), reticulocyte (Ret) and hemoglobin F (HbF) were checked every month. At the same time, PAGE, PVR, PCR-SSCP, RT-PCR, DNA series analysis, mRNA gene expression analysis techniques were used to conduct the systematic gene analysis in patients to study the molecular mechanism of TCM treatment from aspects of gene mutation, gene expression and control-regulation. Results: All the blood criteria in patients after BSYS treatment were improved significantly with clinical symptoms展开更多
肝胆胰外科医师是专业性较强,并对综合素质要求较高的群体在规范化培训阶段采用系统的理论教学和规范的实践操作才能保证教学的质量。以问题为基础的教学法(problem based learning,PBL)是基于学生为主体,以问题为导向,让学生以合作的...肝胆胰外科医师是专业性较强,并对综合素质要求较高的群体在规范化培训阶段采用系统的理论教学和规范的实践操作才能保证教学的质量。以问题为基础的教学法(problem based learning,PBL)是基于学生为主体,以问题为导向,让学生以合作的形式共同解决学习过程中发现的问题,实现将抽象的理论知识贯穿于临床实践中的一种教学方式,已在多个学科领域取得了显著的应用效果。与传统教学方法相比,PBL更适合复杂学科疾病的教学,同时鼓励学生制作PPT参加多学科讨论(multidisciplinary treatment,MDT),有助于调动学生的积极性,锻炼缜密的临床诊疗思维,并提高临床操作实践技能。文章探讨了针对肝胆胰外科医师规范化培训过程中将PBL与MDT相结合的应用效果,以期为后续临床教学提供经验指导。展开更多
文摘Achalasia cardia,type of esophageal dynamic disorder,is a relatively rare primary motor esophageal disease characterized by the functional loss of plexus ganglion cells in the distal esophagus and lower esophageal sphincter.Loss of function of the distal and lower esophageal sphincter ganglion cells is the main cause of achalasia cardia,and is more likely to occur in the elderly.Histological changes in the esophageal mucosa are considered pathogenic;however,studies have found that inflammation and genetic changes at the molecular level may also cause achalasia cardia,resulting in dysphagia,reflux,aspiration,retrosternal pain,and weight loss.Currently,the treatment options for achalasia focus on reducing the resting pressure of the lower esophageal sphincter,helping to empty the esophagus and relieve symptoms.Treatment measures include botulinum toxin injection,inflatable dilation,stent insertion,and surgical myotomy(open or laparoscopic).Surgical procedures are often subject to controversy owing to concerns about safety and effectiveness,particularly in older patients.Herein,we review clinical epidemiological and experimental data to determine the prevalence,pathogenesis,clinical presentation,diagnostic criteria,and treatment options for achalasia to support its clinical management.
文摘Objective: To study the treatment of B-Thalas-semia (ThE) with Chinese herbal medicine for Bushen Yisui (BSYS), its theoretical base and molecular mechanism. Methods: Seventy-eight patients with ThE were treated with BSYS recipe (consisted of 11 Chinese herbal drugs as Dogwood fruit, Fleeceflower root, prepared Rehmannia root and turtle shell, etc.) orally taken, 3 times per day, 10 g/time, 3 months as one therapeutic course. Hemoglobin (Hb), red blood cell (RBC), reticulocyte (Ret) and hemoglobin F (HbF) were checked every month. At the same time, PAGE, PVR, PCR-SSCP, RT-PCR, DNA series analysis, mRNA gene expression analysis techniques were used to conduct the systematic gene analysis in patients to study the molecular mechanism of TCM treatment from aspects of gene mutation, gene expression and control-regulation. Results: All the blood criteria in patients after BSYS treatment were improved significantly with clinical symptoms
文摘肝胆胰外科医师是专业性较强,并对综合素质要求较高的群体在规范化培训阶段采用系统的理论教学和规范的实践操作才能保证教学的质量。以问题为基础的教学法(problem based learning,PBL)是基于学生为主体,以问题为导向,让学生以合作的形式共同解决学习过程中发现的问题,实现将抽象的理论知识贯穿于临床实践中的一种教学方式,已在多个学科领域取得了显著的应用效果。与传统教学方法相比,PBL更适合复杂学科疾病的教学,同时鼓励学生制作PPT参加多学科讨论(multidisciplinary treatment,MDT),有助于调动学生的积极性,锻炼缜密的临床诊疗思维,并提高临床操作实践技能。文章探讨了针对肝胆胰外科医师规范化培训过程中将PBL与MDT相结合的应用效果,以期为后续临床教学提供经验指导。
