目的比较外剥内扎（注射）加开窗治疗环状混合痔和传统外剥内扎法治疗环状混合痔的临床疗效。方法80例环状混合痔患者分别接受外剥内扎（注射）加开窗治疗和传统外剥内扎法治疗，对两种术式的疗效进行比较。结果2组患者术后均未发生肛门失禁症状，肛门功能的差异无统计学意义（Pgt;0.05），而治疗组患者肛门狭窄、肛门水肿和疼痛明显轻于对照组（Plt;0.05），尿潴留、切口愈合时间以及复发也明显少于对照组（Plt;0.05）。结论外剥内扎（注射）加开窗术是环状混合痔的较好治疗方案。
ObjectiveTo investigate the feasibility of laparoscopy in the diagnosis and treatment of acute abdomen. MethodsThe clinical data of 81 patients with acute abdomen treated in our hospital from January 2012 to December 2013 were retrospectively analyzed. ResultsOf the 81 patients with acute abdomen, there were 38 cases of acute appendicitis, 15 cases of gastric perforation, 10 cases of duodenal ulcer perforation, 10 cases of acute cholecystitis, 1 case of mesenteric artery embolism, 2 cases of internal hernias, 2 cases of ileocecal tumor, 2 cases of sigmoid colon rupture, 1 case of intestinal adhesion. The 81 cases were treated by laparoscopy, including 79 cases (97.5%) were clearly diagnosed; 73 cases were succeeded by laparoscopy, and 8 cases converted to laparotomy. The operation time were 35-191 minutes, with an average of 76 minutes; the intraoperative blood loss were 20-130 mL, with an average of 43 mL; the postoperative hospital stay were 3-13 days, with an average of 5.6 days. Seventy-six patients received followed-up for 2-24 months, and the median time were 14 months, no special complications occurred during follow-up period, but 1 case of ileocecal tumor suffered from lung metastases in 12 months after operation. ConclusionsLaparoscopy can be used in the preferred way of diagnosis and treatment of acute abdomen.
Objective To investigate expressions of silence signal regulating factor-1 (SIRT-1) and epithelial cadherin (E-cadherin) in gastric cancer and their clinical significances. Methods The immunohistochemistry SP technique was used to detect the expressions of SIRT-1 and E-cadherin in the gastric cancer tissues and their corresponding paracancerous gastric tissues. The relationship between the SIRT-1 expression and E-cadherin expression was analyzed using Spearman. Results The positive rate of the SIRT-1 protein expression in the gastric cancer tissues was significantly higher than that of the corresponding paracancerous gastric tissues (χ2=5.791, P=0.016). The SIRT-1 protein positive expression was related to the Lauren histological type of gastric cancer (χ2=4.941, P=0.026), in other words, in the intestinal type was significantly higher than that of the diffuse type, but which was not related to the age, gender, tumor size, tumor site, differentiation degree, TNM stage, or lymph node metastasis (P>0.05). While the positive rate of the E-cadherin protein expression in the gastric cancer tissues was significantly lower than that of the corresponding paracancerous gastric tissues (χ2=10.868, P=0.001), which in the intestinal type of gastric cancer was significantly lower than that in the diffuse type of gastric cancer (χ2=5.203, P=0.023), also not related to the age, gender, tumor size, tumor site, differentiation degree, TNM stage, or lymph node metastasis (P>0.05). There was a negative correlation between the SIRT-1 protein and the E-cadherin protein (rs=–0.381, P=0.013). Conclusions Gastric cancer with higher SIRT-1 expression might be way to achieve tumor development through E-cadherin as a facilitator. Upregulation of SIRT-1 and declining of E-cadherin might play a possible role in intestinal type gastric cancer.