目的 探讨消化道吻合器在中、低位直肠癌保肛手术中的应用。方法 回顾分析120例直肠癌患者应用吻合器行保肛手术的临床资料。结果 本组保肛手术成功率为98.3%（118/120），吻合口漏发生率为3.3%（4/120），吻合口狭窄发生率为4.2%（5/120）。结论 在中、低位直肠癌行直肠前切除低位或超低位吻合术中使用吻合器，具有吻合成功率高，并发症少，操作安全简便的优点。
Penicillin is a kind ofβ-lactam drug which has been applied in the clinical treatment firstly in the world, and it has still been widely used at present. The synthesis and regulation mechanism of Penicillium chrysogenum, which is used to produce penicillin, has been studied quite maturely, but its proteomics research started relatively late and fewer reports were published. This paper reviews the synthesis and application of penicillin, transformation of Penicillium chrysogenum, and the research progress of its proteomics. On this basis, the study highlights the advantages of proteomics in the research of protein expression.
Objective To evaluate the effect of ultrasound guided percutaneous drainage on acute perforation of gastroduodenal ulcer in elderly patients. Methods The clinical features, treatments, and the curative effects of 86 elderly cases (≥65 years) of acute perforation of gastroduodenal ulcer in our hospital between January 2004 and October 2009 were retrospectively analyzed. Twenty-one cases were treated by ultrasound guided percutaneous drainage (drainage group), and 65 cases were treated by exploring operation (operation group). Results Drainage group was cured and had no complications. In 15 patients which accepted recheck one month after drainage, gastroscope showed the ulcer healed in 12 cases， and improved in 3 cases. In operation group, 63 cases were cured and 2 cases died. Compared with the drainage group, there was no significant difference in cure rate (Pgt;0.05). However, 11 patients had operative complications in operation group, which was significantly more than that in the drainage group （Plt;0.05）. In 45 patients which accepted recheck one month after operation, gastroscope showed the ulcer healed in 38 cases， and improved in 7 cases. Conclusion For elderly patients with acute perforation of gastroduodenal ulcer， if the patients do not fit for exploring operation， ultrasound guided percutaneous drainage is proved to be a simple, safe, and effective means.
ObjectiveTo evaluate the curative effect of laparoscopic assisted and open D2 radical resection in treatment of advanced gastric cancer. MethodsThe clinical data of 76 cases performed by laparoscopic assisted D2 radical resection (laparoscopic group) and 104 cases performed by open operation (open group) from October 2010 to October 2012 in our center were retrospective analized.Operation related index, postoperative recovery, and extent of radical resection of tumor of 2 groups were compared. ResultsThe operative time of the laparoscopic group[(192.5±14.8) min]was longer than that open group[(171.5±16.5) min, P < 0.05].But the blood loss, postoperative drainage, length of incision, and hospital stay of the laparoscopic group were significantly less or shorter than those of open group (P < 0.05).There were no significant difference in postoperative complications and extent of radical resection of tumor between the 2 groups (P > 0.05).There were no residual tumor in distal margin and operatiive death case in both 2 groups. ConclusionComparing with open operation, the laparoscopic assisted surgery for advanced gastric cancer could achieve the same clinical outcomes, and obvious advantage of minimal invasion.
目的 报告螺纹管在左半结肠梗阻造瘘术中的应用以及术后护理的体会。方法 对近年来收治的36例左半结肠癌性梗阻患者行急诊梗阻近端结肠螺纹管造瘘，并与同期施行的20例结肠造瘘一期外翻成形做比较。结果 结肠螺纹管单腔造瘘术操作简单，术后患者获得满意的减压效果，未发生切口感染。而一期外翻成形者有3例发生切口感染。结论 左半结肠梗阻术中行螺纹管造瘘是一种简单、经济、省时、低污染、减压效果好、护理方便的手术方法。
【摘要】 目的 研究腹腔镜行进展期胃癌根治术较传统开腹手术在围手术期临床和生化指标的变化，进一步探讨其临床应用的优越性。 方法 采用统一入组标准、同期临床对比研究方法，对2010年1-12月腹腔镜手术组和开腹手术组完成的112例进展期胃癌根治术患者在围手术期临床指标和生化指标的比较分析，其中腹腔镜手术组59例，开腹手术组53例。 结果 腹腔镜组手术切口长度为（5.77±0.74） cm，开腹手术组为（12.05±1.30） cm，组间差异有统计学意义（t=-30.921，P=0.000）；腹腔镜组术中失血量为（107.20±27.23） mL，开腹手术组为（168.87±96.76） mL，组间差异有统计学意义（t=-4.483，P=0.000）；腹腔镜组术后住院时间为（7.19±0.97） d，开腹手术组为（8.32±1.16） d，组间差异有统计学意义（t=-5.634，P=0.000）；腹腔镜组手术时间为（202.12±15.71） min，开腹手术组为（196.32±16.73） min，组间差异无统计学意义（t=1.891，P=0.061）；腹腔镜组清扫淋巴结枚数（14.15±4.51）枚，开腹手术组（15.25±5.17）枚，组间差异无统计学意义（t=0.736，P=0.471）；腹腔镜组肠功能恢复时间为（57.88±9.70） h，开腹手术组为（59.16±10.82） h，组间差异无统计学意义（t=-0.655，P=0.514）。两组前白蛋白和血红蛋白水平差异无统计学意义（Pgt;0.05）。 结论 进展期胃癌行腹腔镜手术与传统开腹手术比较，并不加重患者创伤反应，也不增加手术并发症，具有手术切口小、术中出血少、术后恢复快等优点。【Abstract】 Objective To evaluate the differences between laparoscopy and open surgery for treating advanced gastric cancer in peri-operative clinical and biochemical indexes, in order to investigate the superiority of laparoscopy in treating the disease. Methods The same including standards and double-blind randomized control study were carried out to compare the peri-operative clinical and biochemical indexes of 112 patients who underwent radical treatment for advanced gastric cancer from January to December 2010. Among them, 59 patients were included in the laparoscopic group, and 53 in the traditional open operation group. Results Compared with the open surgery group, the incision length [(5.77±0.74) cm vs. (12.05±1.30) cm; t=-30.921, P=0.000], intraoperational blood loss [(107.20±27.23) mL vs. (168.87±96.76) mL; t=-4.483, P=0.000] and hospital stay time [(7.19±0.97) days vs. (8.32±1.16) days; t=-5.634, P=0.000] were significantly shorter or lower in the laparoscopic group. However, the operation time [(202.12±15.71) minutes vs. (196.32±16.73) minutes; t=1.891, P=0.061], number of lymph nodes removed (14.15±4.51 vs. 15.25±5.17; t=0.736, P=0.471), and intestinal functioning time [(57.88±9.70) hours vs. (59.16±10.82) hours; t=-0.655, P=0.514] were not significantly different between the two groups. There was no significant difference between the two groups in the level of prealbumin and hemoglobin. Conclusion Compared with the traditional open operation, laparoscopic surgery for gastric cancer has obvious advantages including smaller incision, lower blood loss during the operation, and fast recovery, without aggravating patients′ traumatic response or increasing the incidence of operational complications.