目的 探讨特发性结肠穿孔的治疗方法及成因。方法 结合文献分析2001～2009年期间我院收治的特发性结肠穿孔患者的诊治经过。结果 共收治特发性结肠穿孔9例，占同期结肠穿孔患者的28.1%（9/32），其中5例穿孔（5/9）发生在乙状结肠。修剪破口后直接缝合者2例，行结肠双腔造瘘者7例。术后死亡3例。结论 特发性结肠穿孔好发于乙状结肠，与其解剖和生理上的特点有关。不明原因结肠穿孔的患者要想到本病的可能。及时、合理的手术治疗，仔细周到的术后管理是治疗成功的关键。
Objective To review study of various imaging examination methods for evaluating of gastric cancer. Method The recent and relevant literatures about the imaging examination methods for evaluating of gastric cancer were scrutinized and analyzed retrospectively. Results The imaging examination methods such as the barium meal, endoscopic ultrasonography, computed tomography (CT), magnetic resonance imaging, positron emission tomography-CT, were used to evaluate the gastric cancer, but with certain limitations. The new methods such as the dual-energy CT, radiomics, and so on, had become the focus of the clinical research. The imaging methods are of great significances in the evaluation of the gastric cancer before the surgery, peritoneal metastasis, chemoradiotherapy and neoadjuvant chemotherapy later. Conclusions Various imaging examination methods, used in evaluating of gastric cancer, play some important roles in clinical application. New methods such as dual-energy CT, radiomics, and so on, are with bright potentiality for clinical application.
Lung cancer ranks first in the incidence of malignant tumors in China, which is seriously harmful to people’s life and health. Chemotherapy is an effective treatment for lung cancer, and it is also an important cause of cognitive dysfunction. Cognitive impairment is usually evaluated by subjective assessment, neuropsychological testing and neuroimaging research. The mechanism of cognitive impairment in patients with lung cancer caused by chemotherapy may include the accumulation of a large amount of endogenous tau protein in hippocampus, the induction of hippocampal neuroinflammation, and the direct killing effect of drugs on nerve cells. There is no effective treatment for chemotherapy-related cognitive impairment (CRCI), but current studies have found that cognitive education in the form of mind map, diet regulation, physical exercise and caring therapy may contribute to the improvement of cognitive function of lung cancer patients after chemotherapy. Based on the current research results, this article provides new ideas for the research and treatment of lung cancer patients with CRCI in terms of clinical characteristics, evaluation methods, influencing factors, mechanism and prevention strategies.
Objective To analyze the outcome of fast track surgery after intercostal nerve block (INB) during thoracoscopic resection of lung bullae. Methods We recuited 76 patients who accepted thoracoscopic resection of lung bullae from February 2013 to March 2015. They were randomly divided into two groups: an intercostal nerve block and intravenous patient-controlled analgesia (INB+IPCA) group, in which 38 patients (30 males, 8 females, with a mean age of 23.63±4.10 years) received INB intraoperatively and IPCA postoperatively, and a postoperative intravenous patient-controlled analgesia (IPCA) group, in which 38 patients (33 males, 5 females, with a mean age of 24.93±6.34 years) only received IPCA postoperatively. Their general clinical data and the postoperative pain visual analogue scale (VAS) were recorded. Analgesia-associated side effects, rate of the pulmonary infection were observed. Expenses associated with analgesia during hospital were calculated. Results The score of VAS, the incidence of nausea and vomiting, fatigue and other side effects, pulmonary atelectasis and the infection rate in the INB+IPCA group were significantly lower than those in the IPCA group. Postoperative use of analgesic drugs was significantly less than that in the IPCA group. Medical expenses did not significantly increase. Conclusion INB+IPCA is beneficial for fast track surgery after thoracoscopic resection of lung bullae.