China has entered an aging society. Elderly patients with acute abdomen have complex clinical manifestations and often have more complications. For elderly acute abdomen, the results of abdominal physical examination and laboratory testing often can not reflect the patient’s condition. The differential diagnosis of diseases should be emphasized in clinical diagnosis and treatment. The treatment of acute abdomen in the elderly not only needs standardized analgesic treatment, but also pays attention to the evaluation of the disease, and adopts multidisciplinary cooperation to formulate appropriate treatment plans.
ObjectiveTo analyze the predictive factors for central lymph node metastasis in papillary thyroid microcarcinoma (PTMC), and explore the treatment method for the patients with PTMC. MethodThe literatures were reviewed according to the results searched from PubMed in recent years. ResultsCentral lymph node metastases were common in the patients with PTMC. It was important for prophylactic central lymph node dissection so it might reduce the local recurrence and comfirm the clinical staging, further more provide the strategies for the postoperative therapy. ConclusionsLymphadenectomy is necessary for patients with lymph node metastasis. Prophylactic central lymph node dissection should be performed for patients without lymph node metastasis but with one risk factor or more.
ObjectiveTo summarize new progress in diagnosis and treatment of acute biliary pancreatitis at present.MethodThe related literatures on the acute biliary pancreatitis in recent years were searched and reviewed.ResultsThe acute biliary pancreatitis was a common acute abdomen in the surgery. The biliary stone was the main cause of the disease. The disease was acute, rapid, and has a high mortality rate. It was not difficult to make a diagnosis by relying on the imaging and laboratory tests. The active non-surgical treatment and surgical intervention were the key to a clear diagnosis, but the appropriate surgical timing should be chosen.ConclusionsFor acute biliary pancreatitis, active surgical intervention based on non-surgical treatment is focus of treatment. Reasonable choice of surgical methods and timely surgical intervention can effectively prevent progression of disease, reduce mortality rate, and maximize patients’ benefits.
ObjectiveTo summarize the clinical value of procalcitonin (PCT) in the prediction of early stage of acute pancreatitis, the evaluation of therapeutic effect, the evaluation of prognosis, and the use of antibiotics.MethodWe reviewed the related literatures about hematology indexes of severe acute pancreatitis and pancreatic infection and necrosis at home and abroad in recent years.ResultsPCT had high sensitivity and specificity in the diagnosis of severe acute pancreatitis and pancreatic infection and necrosis, and could be used as a tool to guide the early clinical treatment of severe acute pancreatitis. In the course of treatment, with the improvement of the condition, the value of PCT decreased. Monitoring the change of PCT value could evaluate the therapeutic effect of severe acute pancreatitis. Monitoring PCT during treatment could also guide the use of antibiotics.ConclusionPCT can be used as an early indicator for predicting severe acute pancreatitis and necrosis of pancreatic infection, as well as an indicator for guiding antibiotic treatment.