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.
目的 探讨大隐静脉高位结扎及剥脱术后腹股沟切口淋巴瘘发生的原因和防治方法。方法 回顾性分析我院收治的120例(186条患肢)行大隐静脉高位结扎及剥脱术者中术后发生腹股沟切口淋巴瘘患者的临床资料，并对相关文献进行复习。结果 大隐静脉高位结扎及剥脱术后腹股沟切口淋巴瘘发生率为4.3%（8/186）。2例单侧腹股沟切口淋巴瘘患者扩创后予以碘伏纱布填塞创面，于第20天及第23天后淋巴瘘闭合，再行切口二期缝合，7 d后拆线； 3例双侧腹股沟切口淋巴瘘患者切口创面予以医用胶喷洒后碘伏纱布填塞，3 d后淋巴瘘全部闭合，切口二期缝合、加压包扎后7 d拆线。切口均愈合良好。结论 对腹股沟区股根部不恰当的广泛解剖及淋巴结切除的不规范与大隐静脉高位结扎及剥脱术后腹股沟切口淋巴瘘的发生密切相关。术前对大隐静脉准确定位，术中仔细操作、避免广泛剥离、避免切除肿大淋巴结是预防腹股沟切口淋巴瘘的有效措施。淋巴瘘发生后予以医用胶封堵是有效的补救措施。
Objective To investigate the early diagnosis and effective treatment of Fournier syndrome. Methods The clinical data of 385 patients with perianal abscess in this hospital between 2006 and 2009 were retrospectively analyzed for screening the patients with complication of Fournier syndrome. Results Fournier syndrome was detected in 6 patients （1.56%）， who were all cured by treating with early incision and drainage, complete debridement, effective antibiotics, and supporting therapy. Conclusions Perianal abscess can induce Fournier syndrome of perineal, genital, and abdominal wall regions, which spreads rapidly and progressively, so early diagnosis and extensive surgical debridement play a decisive role on the prognosis.