BACKGROUND Breastfeeding not only meets the nutritional needs of newborn growth and development but also promotes uterine contraction and discharge of lochia,which helps in maternal recovery.However,some mothers exper...BACKGROUND Breastfeeding not only meets the nutritional needs of newborn growth and development but also promotes uterine contraction and discharge of lochia,which helps in maternal recovery.However,some mothers experience abnormal lactation and breast swelling due to a lack of breastfeeding knowledge,painful cesarean incisions,anesthesia,negative emotions,and other factors,resulting in a reduced breastfeeding rate,which adversely affects neonatal and maternal health.AIM To explore the effects of care intervention with a health education form for breastfeeding on breastfeeding-related conditions.METHODS In this study,207 mothers with postpartum breast pain and difficulty lactating were selected and divided into intervention and control groups using a random number table.Both groups of mothers were provided with basic nursing and related treatment measures after delivery.The intervention group additionally received care intervention with a health education form for breastfeeding.The scores of lactation volume,breast distension and pain,breastfeeding rate,breastfeeding self-efficacy,treatment effect,and complication rate of the two groups were compared.RESULTS After treatment,the breast pain score of the intervention group was significantly lower than that of the control group,while the lactation score,score of Breastfeeding Self-Efficacy Scale Short Form scale,parent-child communication score,maternal-infant interaction score,total score of maternal-infant communication,and breastfeeding rate of the intervention group were significantly higher than those of the control group.After intervention,the overall therapeutic effect of the intervention group was better than that of the control group,and the complication rate of the intervention group was lower than that of the control group.CONCLUSION Breastfeeding health education and nursing intervention combined with basic clinical treatment have good clinical effects in managing postpartum breast distension and pain and increasing lactation yield.展开更多
Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Metho...Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Methods:62 patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)admitted to our hospital from February 2023 to February 2024 were selected and divided into the observation group(n=31)and the control group(n=31)by using the random numerical table method.The control group adopted conventional nursing interventions,and the observation group received the nursing program of the control group with the addition of moxibustion nursing interventions.The nursing effectiveness,quality of life scores,and nursing satisfaction were compared between the two groups.Results:The nursing effectiveness of the observation group was significantly higher than the control group(P<0.05);the quality of life score of the observation group was significantly higher than the control group(P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The use of moxibustion nursing intervention in patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)can effectively relieve the symptoms of abdominal distension,improve patients'quality of life,and increase nursing satisfaction,which has promotion and application values.展开更多
AIM:To evaluate the inhibitory effects of carbon dioxide (CO2) insufflation on pneumoperitoneum and bowel distension after percutaneous endoscopic gastrostomy (PEG).METHODS:A total of 73 consecutive patients who were ...AIM:To evaluate the inhibitory effects of carbon dioxide (CO2) insufflation on pneumoperitoneum and bowel distension after percutaneous endoscopic gastrostomy (PEG).METHODS:A total of 73 consecutive patients who were undergoing PEG were enrolled in our study.After eliminating 13 patients who fitted our exclusion criteria,60 patients were randomly assigned to either CO2 (30 patients) or air insufflation (30 patients) groups.PEG was performed by pull-through technique after threepoint fixation of the gastric wall to the abdominal wall using a gastropexy device.Arterial blood gas analysis was performed immediately before and after the procedure.Abdominal X-ray was performed at 10 min and at 24 h after PEG to assess the extent of bowel distension.Abdominal computed tomography was performed at 24 h after the procedure to detect the presence of pneumoperitoneum.The outcomes of PEG for 7 d postprocedure were also investigated.RESULTS:Among 30 patients each for the air and the CO2 groups,PEG could not be conducted in 2 patients of the CO2 group,thus they were excluded.Analyses of the remaining 58 patients showed that the patients' backgrounds were not significantly different between the two groups.The elevation values of arterial partial pressure of CO2 in the air group and the CO2 group were 2.67 mmHg and 3.32 mmHg,respectively (P = 0.408).The evaluation of bowel distension on abdominal X ray revealed a significant decrease of small bowel distension in the CO2 group compared to the air group (P < 0.001) at 10 min and 24 h after PEG,whereas there was no significant difference in large bowel distension between the two groups.Pneumoperitoneum was observed only in the air group but not in the CO2 group (P = 0.003).There were no obvious differences in the laboratory data and clinical outcomes after PEG between the two groups.CONCLUSION:There was no adverse event associated with CO2 insufflation.CO2 insufflation is considered to be safer and more comfortable for PEG patients because of the lower incidence of pneumoperitoneum and less distension of the small bowel.展开更多
AIM： To establish a visceral pain model via colorectal distension （CRD） and to evaluate the efficiency of behavioral responses of CRD by measuring the score of abdominal withdrawal reflex （AWR） in rats. METHODS：...AIM： To establish a visceral pain model via colorectal distension （CRD） and to evaluate the efficiency of behavioral responses of CRD by measuring the score of abdominal withdrawal reflex （AWR） in rats. METHODS： Thirty-eight male SD rats weighing 180-240g were used to establish the visceral pain model. The rat was inserted intra-anally with a 7 cm long flexible latex balloon under ether anesthesia, and colorectal distensions by inflating the balloon with air were made 30 min after recovering from the anesthesia. Five AWR scores （AWR0 to AWR4） were used to assess the intensity of noxious visceral stimuli. It was regarded as the threshold of the minimal pressure （kPa）. For abdominal flatting was induced by colorectal distension. RESULTS： A vigorous AWR to distension of the descending colon and rectum was found in 100% of the awake rats tested. The higher the pressure of distension, the higher the score of AWR. The distension pressures of 0, 2.00, 3.33, 5.33 and 8.00 kPa produced different AWR scores （P〈0.05）. The pain threshold of AWR was constant for up to 80 min after the initial windup （first 1-3 distensions）, the mean threshold was 3.69±0.35 kPa. Systemic administration of morphine sulfate elevated the threshold of visceral pain in a dosedependent and naloxone reversible manner. CONCLUSION： Scoring the AWR during colorectal distensions can assess the intensity of noxious visceral stimulus. Flatting of abdomen （AWR 3） to CRD as the visceral pain threshold is clear, constant and reliable. This pain model and its behavioral assessment are good for research on visceral pain and analgesics.展开更多
AIM: To investigate in patients with functional dyspepsia (FD) after an every-day meal whether (1) gastrointestinal (GI) and extra-GI symptoms had any relation with the degree of antral volume, (2) the onset of postpr...AIM: To investigate in patients with functional dyspepsia (FD) after an every-day meal whether (1) gastrointestinal (GI) and extra-GI symptoms had any relation with the degree of antral volume, (2) the onset of postprandial symptoms was associated with, and may predict, delayed gastric emptying. METHODS: In 94 symptomatic FD patients, antral volume variations and gastric emptying were assessed with ultrasonography after a 1050 kcal meal. Symptoms were evaluated with a standardized questionnaire. The association of GI and extra-GI symptoms with antral volumes and gastric emptying were estimated with logistic regression analysis. RESULTS: Forty percent of patients did not report any symptoms after a meal. Compared to the healthy controls, the antrum was more distended in patients throughout the entire observation period and 37 (39.4%) patients had delayed gastric emptying. Only postprandial drowsiness was associated with antral volume variations (AOR = 1.42; P < 0.001) and with delayed gastric emptying (AOR = 3.59; P < 0.03). CONCLUSION: In FD patients, GI symptoms are neither associated with antral distension nor with gastric emptying. Drowsiness is associated with antral distension and delayed gastric emptying. The onset of drowsiness is preceded by an increment of antral distension and the duration of the symptom appears to be related to the persistence of antral distension.展开更多
Objective:To explore the effect of auricular point pressing combined with thunder-fire moxibustion in the treatment of abdominal distension and constipation after thoracic compression fracture.Methods:Totally 100 pati...Objective:To explore the effect of auricular point pressing combined with thunder-fire moxibustion in the treatment of abdominal distension and constipation after thoracic compression fracture.Methods:Totally 100 patients were randomly divided into 4 groups,the observation group 1(n=25)which were treated with conventional nursing combined with auricular piont pressing,observation group 2(n=25)treated with conventional nursing combined with thunder-fire moxibustion,observation group 3(n=25)treated with conventional nursing combined with auricular point pressing and thunder-fire moxibustion,and the control group(n=25)which adopted conventional nursing.First exhaust and defecation time after fracture in 4 groups were observed and compared.Results:The effect of observation group 3 was better than that of observation group 2,observation group 1 and control group(P<0.05).Conclusion:It is obvious that auricular point pressing combined with thunder-fire moxibustion has better result in treating abdominal distension and constipation after thoracic compression fracture.展开更多
Objective:To explore the application value of moxibustion and acupoint application in the treatment of postoperative abdominal distention in patients undergoing gynecological surgery.Methods:Seventy-two patients who u...Objective:To explore the application value of moxibustion and acupoint application in the treatment of postoperative abdominal distention in patients undergoing gynecological surgery.Methods:Seventy-two patients who underwent gynecological surgery in our hospital from May 2020 to May 2021 were randomly divided into two groups.Group A was treated with moxibustion and acupoint application,and group B was treated with routine treatment.The incidence of postoperative abdominal distention,therapeutic effect of abdominal distention,defecation time,exhaust time,recovery time of bowel sounds and the changes of patients’quality of life were analyzed.Results:The incidence of abdominal distension in group A was 22.22%,which was lower than 41.47%in group B(P<0.05).The therapeutic effect of abdominal distension in group A was 87.50%,which was higher than 66.67%in group B(P<0.05).The recovery time of first defecation,first exhaust and bowel sound in group A was shorter than that in group B(P<0.05).All postoperative quality of life scores of group A were higher than that of group B(P<0.05).Conclusion:On the basis of routine postoperative intervention,moxibustion and acupoint application can reduce the risk of postoperative abdominal distention,reduce the degree of abdominal distention,promote the recovery of intestinal function,shorten the first postoperative exhaust and defecation time,and then improve the quality of life of patients.展开更多
Objective To introduce the experience of professor YIN Ke-jing,a national senior and famous doctor of traditional Chinese medicine,in treatment of abdominal distension after abdominal surgery with warming-needle moxib...Objective To introduce the experience of professor YIN Ke-jing,a national senior and famous doctor of traditional Chinese medicine,in treatment of abdominal distension after abdominal surgery with warming-needle moxibustion at Gōngsūn（公孙 SP 4）.Methods Bilateral SP 4 were selected,and warming-needle moxibustion was adopted.The treatment was conducted for twice a day,and treatment for 3 days was considered as 1 course of treatment.The efficacy was evaluated after 2 courses.Results The total effective rate was 96.9% of the 32 patients after treatment and observation for 2 courses.Conclusion This therapeutic method was easy and simple with less acupoints selected and rapid onset of effect.With definite clinical efficacy,this method was worthy of being popularized.展开更多
BACKGROUND Rehabilitation of elderly patients with a high body mass index(BMI)after cholecystectomy carries risks and requires the adoption of effective perioperative management strategies.The enhanced recovery after ...BACKGROUND Rehabilitation of elderly patients with a high body mass index(BMI)after cholecystectomy carries risks and requires the adoption of effective perioperative management strategies.The enhanced recovery after surgery(ERAS)protocol is a comprehensive treatment approach that facilitates early patient recovery and reduces postoperative complications.AIM To compare the effectiveness of traditional perioperative management methods with the ERAS protocol in elderly patients with gallbladder stones and a high BMI.METHODS This retrospective cohort study examined data from 198 elderly patients with a high BMI who underwent cholecystectomy at the Shanghai Fourth People's Hospital from August 2019 to August 2022.Among them,99 patients were managed using the traditional perioperative care approach(non-ERAS protocol),while the remaining 99 patients were managed using the ERAS protocol.Relevant indicator data were collected for patients preoperatively,intraoperatively,and postoperatively,and surgical outcomes were compared between the two groups.RESULTS The comparison results between the two groups of patients in terms of age,sex,BMI,underlying diseases,surgical type,and preoperative hospital stay showed no statistically significant differences.However,the ERAS group had a significantly shorter preoperative fasting time than the non-ERAS group(4.0±0.9 h vs 7.6±0.9 h).Regarding intraoperative indicators,there were no significant differences between the two groups of patients.However,in terms of postoperative recovery,the ERAS protocol group exhibited significant advantages over the non-ERAS group,including a shorter hospital stay,lower postoperative pain scores and postoperative hunger scores,and higher satisfaction levels.The readmission rate was lower in the ERAS protocol group than in the non-ERAS group(3.0%vs 8.1%),although the difference was not significant.Furthermore,there were significant differences between the two groups in terms of postoperative nausea and vomiting severity,postoperative abdominal distention at 24 h,and daily life ability scores.CONCLUSION The findings of this study demonstrate that the ERAS protocol confers significant advantages in postoperative outcomes following cholecystectomy,including reduced readmission rates,decreased postoperative nausea and vomiting,alleviated abdominal distension,and enhanced functional capacity.While the protocol may not exhibit significant improvement in early postoperative symptoms,it does exhibit advantages in long-term postoperative symptoms and recovery.These findings underscore the importance of implementing the ERAS protocol in the postoperative management of cholecystectomy patients,as it contributes to improving patients'recovery and quality of life while reducing health care resource utilization.展开更多
Yolk sac tumors of the ovary are rare entities that account for 2% - 5% of all ovarian tumors. They represent the second most common histological variant of malignant germ cell tumors of the ovary after dysgerminomas....Yolk sac tumors of the ovary are rare entities that account for 2% - 5% of all ovarian tumors. They represent the second most common histological variant of malignant germ cell tumors of the ovary after dysgerminomas. Yolk sac tumors are most commonly encountered in women in the second and third decades. Microscopically, they are highly polymorphic and can present in a pure form or associated with another contingent of germ cell tumor. We report the case of a 26-year-old woman, who underwent surgery for a large right ovarian tumor rupturing into the peritoneal cavity. The ovarian tumor was revealed by ascites of great abundance and abdomino-pelvic pain. On histological examination, the diagnosis of yolk sac tumor in its pure and polyvesicular vitelline pattern was made. Through this observation, we propose to discuss the anatomoclinical particularities of these tumors by emphasizing the importance of histology for the diagnosis as well as the need of an early and appropriate management.展开更多
Frozen shoulder is a common disease which causes significant morbidity. Despite over a hundred years of treating this condition the definition, diagnosis, pathology and most efficacious treatments are still largely un...Frozen shoulder is a common disease which causes significant morbidity. Despite over a hundred years of treating this condition the definition, diagnosis, pathology and most efficacious treatments are still largely unclear. This systematic review of current treatments for frozen shoulder reviews the evidence base behind physiotherapy, both oral and intra articular steroid, hydrodilatation, manipulation under anaesthesia and arthroscopic capsular release. Key areas in which future research could be directed are identified, in particular with regard to the increasing role of arthroscopic capsular release as a treatment.展开更多
Both sensorimotor and autonomic dysfunctions often occur after spinal cord injury（SCI）. Particularly, a high thoracic or cervical SCI interrupts supraspinal vasomotor pathways and results in disordered hemodynamics ...Both sensorimotor and autonomic dysfunctions often occur after spinal cord injury（SCI）. Particularly, a high thoracic or cervical SCI interrupts supraspinal vasomotor pathways and results in disordered hemodynamics due to deregulated sympathetic outflow. As a result of the reduced sympathetic activity, patients with SCI may experience hypotension, cardiac dysrhythmias, and hypothermia post-injury. In the chronic phase, changes within the CNS and blood vessels lead to orthostatic hypotension and life-threatening autonomic dysreflexia（AD）. AD is characterized by an episodic, massive sympathetic discharge that causes severe hypertension associated with bradycardia. The syndrome is often triggered by unpleasant visceral or sensory stimuli below the injury level. Currently the only treatments are palliative - once a stimulus elicits AD, pharmacological vasodilators are administered to help reduce the spike in arterial blood pressure. However, a more effective means would be to mitigate AD development by attenuating contributing mechanisms, such as the reorganization of intraspinal circuits below the level of injury. A better understanding of the neuropathophysiology underlying cardiovascular dysfunction after SCI is essential to better develop novel therapeutic approaches to restore hemodynamic performance.展开更多
Cystic lymphangiomas are rare benign tumors.Most frequently occurring in children and involving the neck or axilla,these tumors are much less common in adults and very rarely involve the abdomen.The known congenital a...Cystic lymphangiomas are rare benign tumors.Most frequently occurring in children and involving the neck or axilla,these tumors are much less common in adults and very rarely involve the abdomen.The known congenital and acquired(traumatic)etiologies result in failure of the lymphatic channels and consequent proliferation of lymphatic spaces.This case report describes a very rare case of a giant mesenteric cystic lymphangioma in an adult male with no clear etiology and successful resolution by standard radical resection.A previously healthy 44-year-old male presented with a 6-wk history of progressive upper abdominal pain,vomiting,anorexia and unintentional weight loss accompanied by rapid abdominal distension.A palpable mass was detected upon physical examination of the distended abdomen and abdominal computed tomography scan showed a giant multilobulated cystic process,measuring 40 cm in diameter.Exploratory laparotomy revealed an enormous cystic mass containing 6 L of serous fluid.The process appeared to originate from the lesser omentum and the lesser curvature of the stomach.Radical resection of the tumor was performed along with a partial gastrectomy to address potential invasion into the adjacent tissues.Histological analysis confirmed the diagnosis of a multicystic lymphangioma.The postoperative recovery was uneventful and the patient was discharged after 6 d.At 3-mo follow-up,the patient was in good health with no signs of recurrence.展开更多
This study tested the effects of the gastrointestinal pulse train electrical stimulation with different parameters and at different locations on the neuronal activities of the lateral hypothalamus area（LHA） in obese...This study tested the effects of the gastrointestinal pulse train electrical stimulation with different parameters and at different locations on the neuronal activities of the lateral hypothalamus area（LHA） in obese rats in order to find the optimal stimulation parameter and location. Eight gastric electrical stimulations（GES） with different parameters were performed and the neuronal activities of gastric-distension responsive（GD-R） neurons in LHA were observed. The effects of stimulations with 8 parameters were compared to find the optimal parameter. Then the optimal parameter was used to perform electrical stimulation at duodenum and ileum, and the effects of the duodenal and ileac stimulation on the GD-R neurons in LHA were compared with the gastric stimulation of optimal parameter. The results showed that GES with the lowest energy parameter（0.3 ms, 3 mA, 20 Hz, 2 s on, 3 s off） activated the least neurons. The effects of GES with other parameters whose pulse width was 0.3 ms were not significantly different from those of the lowest energy parameter. Most gastric stimulations whose pulse width was 3 ms activated more LHA neurons than the smallest energy parameter stimulation, and the effects of those 3 ms gastric stimulations were similar. Accordingly, the lowest energy parameter was recognized as the optimal parameter. The effects of stimulations with the optimal parameter at stomach, duodenum and ileum on the LHA neuronal activities were not different. Collectively, gastrointestinal electrical stimulation（GIES） with relatively large pulse width might have stronger effects to the neuronal activities of GD-R neurons in LHA of obese rats. The effects of the GIES at different locations（stomach, duodenum and ileum） on those neurons are similar, and GES is preferential because of its easy clinical performance and safety.展开更多
BACKGROUND Malignant peritoneal mesothelioma(MPM)originates from the mesothelial and subcutaneous cells of the abdominal cavity.Its diagnose is difficult due to its nonspecific and vague symptoms,and it should be diff...BACKGROUND Malignant peritoneal mesothelioma(MPM)originates from the mesothelial and subcutaneous cells of the abdominal cavity.Its diagnose is difficult due to its nonspecific and vague symptoms,and it should be differentiated from alcoholic cirrhosis and liver and pancreatic cancers.Misdiagnosis and missed diagnosis can easily occur when MPM presents with other diseases.To the best of our knowledge,no case of MPM concurrent with alcoholic cirrhosis has been reported.CASE SUMMARY A 63-year-old man presented to our hospital with abdominal distension for 20days.He had a history of alcohol consumption for nearly 30 years and no history of special drug use or toxic exposure.After treatment for alcoholic cirrhosis in a community hospital,his symptoms did not improve significantly.The patient underwent exploratory laparotomy and surgical resection.Pathologic examination showed an epithelioid MPM.He was treated with chemotherapy and intraperitoneal hyperthermic perfusion after surgery.Currently,he is in a stable condition and tumor recurrence has not occurred.CONCLUSION Misdiagnosis and missed diagnosis of MPM can easily occur because of its insidious onset.Therefore,there is a need to understand.MPM in clinical practice,make the correct diagnosis,and provide timely and effective treatment.展开更多
AIM: To investigate anti-hypersensitive effects of α2δ-1 ligands in non-inflammatory and inflammationassociated colonic hypersensitivity(CHS) mouse models.METHODS: To induce an inflammation-associated CHS, 1% dextra...AIM: To investigate anti-hypersensitive effects of α2δ-1 ligands in non-inflammatory and inflammationassociated colonic hypersensitivity(CHS) mouse models.METHODS: To induce an inflammation-associated CHS, 1% dextran sulfate sodium(DSS) was administered to C57Bl/6J male mice, in drinking water, for 14 d. Regarding the non-inflammatory neonatal maternal separation(NMS)-induced CHS model, wild-type C57BI/6J pups were isolated from their mother from day 2 to day 14(P2 to P14), three hours per day(from 9:00 a.m. to 12:00 p.m.). Colorectal distension was performed by inflating distension probe from 20 μL to 100 μL by 20 μL increment step every 10 s. After a first colorectal distension(CRD), drugs were administered subcutaneously, in a cumulative manner,(Gabapentin at 30 mg/kg and 100 mg/kg; Pregabalin at 10 mg/kg and 30 mg/kg; Carbamazepine at 10 mg/kg and 30 mg/kg) and a second CRD was performed one hour after each injection.RESULTS: The visceromotor response(VMR) to CRD was increased by our NMS paradigm protocol in comparison to non-handled(NH) mice, considering the highest distension volumes(80 μL: 0.783 ± 0.056 mV /s vs 0.531 ± 0.034 m V/s, P < 0.05 and 100 μL: 1.087 ± 0.056 m V/s vs 0.634 ± 0.038 m V/s, P < 0.05 for NMS and NH mice, respectively). In the inflammationassociated CHS, DSS-treated mice showed a dramatic and significant increase in VMR at 60 and 80 μL distension volumes when compared to control mice(60 μL: 0.920 ± 0.079 m V/s vs 0.426 ± 0.100 m V/s P < 0.05 and 80 μL: 1.193 ± 0.097 mV /s vs 0.681 ± 0.094 mV /s P < 0.05 for DSS- and Water-treated mice, respectively). Carbamazepine failed to significantly reduce CHS in both models. Gabapentin significantly reduced CHS in the DSS-induced model for both subcutaneous injections at 30 or 100 mg/kg. Pregabalin s i g n i f i c a n t l y r e d u c e d V M R t o C R D i n t h e n o n-inflammatory NMS-induced CHS model for the acute subcutaneous administration of the highest cumulative dose(30 mg/kg) and significantly reduced CHS in lowdose DSS-treated mice in a dose-dependent manner. Finally, the percent decrease of AUC induced by acute GBP or Pregabalin treatment were higher in the inflammatory DSS-induced CHS model in comparison to the non-inflammatory NMS-induced CHS model.CONCLUSION: This preclinical study demonstrates α2δ-1 ligands efficacy on inflammation-associated CHS, highlighting their potential clinical interest in patients with chronic abdominal pain and moderate intestinal inflammation.展开更多
AIM： To investigate the hypothesis that duodeno-jejunal dyssynergia existed at the duodeno-jejunal junction.METHODS： Of 112 patients who complained of epigastric distension and discomfort after meals, we encountered...AIM： To investigate the hypothesis that duodeno-jejunal dyssynergia existed at the duodeno-jejunal junction.METHODS： Of 112 patients who complained of epigastric distension and discomfort after meals, we encountered nine patients in whom the duodeno-jejunal junction did not open on duodenal contraction. Seven healthy volunteers were included in the study. A condom which was inserted into the ist duodenum was filled up to 10 mL with saline in increments of 2 mL and pressure response to duodenal distension was recorded from the duodenum, duodeno-jejunal junction and the jejunum.RESULTS： In healthy volunteers, duodenal distension with 2 and 4 mL did not produce pressure changes, while 6 and up to 10 mL distension effected significant duodenal pressure increase, duodeno-jejunal junction pressure decrease but no jejunal pressure change. In patients, resting pressure and duodeno-jejunal junction and jejunal pressure response to 2 and 4 mL duodenal distension were similar to those of healthy volunteers. Six and up to 10 mL 1^st duodenal distension produced significant duodenal and duodeno-jejunal junction pressure increase and no jejunal pressure change.CONCLUSION： Duodeno-jejunal junction failed to open on duodenal contraction, a condition we call ＇duodenojejunal junction dyssynergia syndrome＇ which probably leads to stagnation of chyme in the duodenum and explains patients＇ manifestations.展开更多
he incidence and mortality of colorectal cancer(CRC)are on the rise in China and rank the fifth in all malignant cancers,which may result from the increasingly aging population and unhealthy lifestyles.At present,the ...he incidence and mortality of colorectal cancer(CRC)are on the rise in China and rank the fifth in all malignant cancers,which may result from the increasingly aging population and unhealthy lifestyles.At present,the major treatment methods for CRC include laparoscopic surgery,radiotherapy and neoadjuvant and palliative chemotherapies,but they all have the limited impact on cure rates and long-term survival.Traditional Chinese medicine(TCM)plays important roles in preventing recurrence and metastasis,improving the quality of life and prolonging the survival of patients with advanced CRC after radical operations.Thereby,this article mainly explored the key points of common syndromes,TCM nursing methods and health guidance of CRC in order to further develop the advantages of TCM,improve its efficacy and standardized its nursing behavior.展开更多
Ultrasound technology is widely used to make assessments of arterial function. The delicate nature of these measurements requires that sources of errors are limited. Therefore, the aim of this study was to assess vari...Ultrasound technology is widely used to make assessments of arterial function. The delicate nature of these measurements requires that sources of errors are limited. Therefore, the aim of this study was to assess variability due to probe selection and optimization settings. Methods: Ten healthy 20 - 26 year old male and female subjects were tested. Brachial artery size (diameter) was measured thirty times a second using a B-mode Ultrasound unit equipped with a high-resolution video capture device. Distension was calculated using systolic and diastolic diameters. To assess intersession variability, we made recordings over twelve minutes;with the probe being removed and re-positioned every four minutes. To assess variability due to probe selection and optimization, we manipulated four parameters: 1) Probe selection (7 - 13 MHz, 5 - 10 MHz, 6 - 9 MHz). 2) Probe frequency (11 MHZ, 9.6 MHZ, 8 MHz). 3) Measurement location (near, center or middle field). And, 4) Image mode (B-mode, duplex-mode). To assess inter-session variability, three sets of recordings were made for each probe selection and optimization setting. Results: Mean diameter ICC’s for inter-session variability, probe frequency, measurement location, image display size, and probe selection were 0.99, 0.98, 0.97, 0.99, and 0.90 respectively. Distension ICC’s for intersession variability, probe frequency, measurement location, image display size, and probe selection were 0.66, 0.26, 0.62, 0.60, and 0.51 respectively. Conclusions: Altering probe selection increases measurement variability to the greatest extent. However, as long as probe selection and optimization settings are kept constant, our inter-session variability shows that reliable measurements can be made.展开更多
文摘BACKGROUND Breastfeeding not only meets the nutritional needs of newborn growth and development but also promotes uterine contraction and discharge of lochia,which helps in maternal recovery.However,some mothers experience abnormal lactation and breast swelling due to a lack of breastfeeding knowledge,painful cesarean incisions,anesthesia,negative emotions,and other factors,resulting in a reduced breastfeeding rate,which adversely affects neonatal and maternal health.AIM To explore the effects of care intervention with a health education form for breastfeeding on breastfeeding-related conditions.METHODS In this study,207 mothers with postpartum breast pain and difficulty lactating were selected and divided into intervention and control groups using a random number table.Both groups of mothers were provided with basic nursing and related treatment measures after delivery.The intervention group additionally received care intervention with a health education form for breastfeeding.The scores of lactation volume,breast distension and pain,breastfeeding rate,breastfeeding self-efficacy,treatment effect,and complication rate of the two groups were compared.RESULTS After treatment,the breast pain score of the intervention group was significantly lower than that of the control group,while the lactation score,score of Breastfeeding Self-Efficacy Scale Short Form scale,parent-child communication score,maternal-infant interaction score,total score of maternal-infant communication,and breastfeeding rate of the intervention group were significantly higher than those of the control group.After intervention,the overall therapeutic effect of the intervention group was better than that of the control group,and the complication rate of the intervention group was lower than that of the control group.CONCLUSION Breastfeeding health education and nursing intervention combined with basic clinical treatment have good clinical effects in managing postpartum breast distension and pain and increasing lactation yield.
文摘Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Methods:62 patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)admitted to our hospital from February 2023 to February 2024 were selected and divided into the observation group(n=31)and the control group(n=31)by using the random numerical table method.The control group adopted conventional nursing interventions,and the observation group received the nursing program of the control group with the addition of moxibustion nursing interventions.The nursing effectiveness,quality of life scores,and nursing satisfaction were compared between the two groups.Results:The nursing effectiveness of the observation group was significantly higher than the control group(P<0.05);the quality of life score of the observation group was significantly higher than the control group(P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The use of moxibustion nursing intervention in patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)can effectively relieve the symptoms of abdominal distension,improve patients'quality of life,and increase nursing satisfaction,which has promotion and application values.
文摘AIM:To evaluate the inhibitory effects of carbon dioxide (CO2) insufflation on pneumoperitoneum and bowel distension after percutaneous endoscopic gastrostomy (PEG).METHODS:A total of 73 consecutive patients who were undergoing PEG were enrolled in our study.After eliminating 13 patients who fitted our exclusion criteria,60 patients were randomly assigned to either CO2 (30 patients) or air insufflation (30 patients) groups.PEG was performed by pull-through technique after threepoint fixation of the gastric wall to the abdominal wall using a gastropexy device.Arterial blood gas analysis was performed immediately before and after the procedure.Abdominal X-ray was performed at 10 min and at 24 h after PEG to assess the extent of bowel distension.Abdominal computed tomography was performed at 24 h after the procedure to detect the presence of pneumoperitoneum.The outcomes of PEG for 7 d postprocedure were also investigated.RESULTS:Among 30 patients each for the air and the CO2 groups,PEG could not be conducted in 2 patients of the CO2 group,thus they were excluded.Analyses of the remaining 58 patients showed that the patients' backgrounds were not significantly different between the two groups.The elevation values of arterial partial pressure of CO2 in the air group and the CO2 group were 2.67 mmHg and 3.32 mmHg,respectively (P = 0.408).The evaluation of bowel distension on abdominal X ray revealed a significant decrease of small bowel distension in the CO2 group compared to the air group (P < 0.001) at 10 min and 24 h after PEG,whereas there was no significant difference in large bowel distension between the two groups.Pneumoperitoneum was observed only in the air group but not in the CO2 group (P = 0.003).There were no obvious differences in the laboratory data and clinical outcomes after PEG between the two groups.CONCLUSION:There was no adverse event associated with CO2 insufflation.CO2 insufflation is considered to be safer and more comfortable for PEG patients because of the lower incidence of pneumoperitoneum and less distension of the small bowel.
基金Supported by Natural Science Foundation of Jiangsu Province,NO.BK2005033Medical Foundation of Department of Health,Jiangsu Province, No. H200325+1 种基金Natural Science Foundation of Department of Education, Jiangsu Province, No. 04kJB320127Medical Foundation of Department of Health, Zhejiang Province, No. 2004A084
文摘AIM： To establish a visceral pain model via colorectal distension （CRD） and to evaluate the efficiency of behavioral responses of CRD by measuring the score of abdominal withdrawal reflex （AWR） in rats. METHODS： Thirty-eight male SD rats weighing 180-240g were used to establish the visceral pain model. The rat was inserted intra-anally with a 7 cm long flexible latex balloon under ether anesthesia, and colorectal distensions by inflating the balloon with air were made 30 min after recovering from the anesthesia. Five AWR scores （AWR0 to AWR4） were used to assess the intensity of noxious visceral stimuli. It was regarded as the threshold of the minimal pressure （kPa）. For abdominal flatting was induced by colorectal distension. RESULTS： A vigorous AWR to distension of the descending colon and rectum was found in 100% of the awake rats tested. The higher the pressure of distension, the higher the score of AWR. The distension pressures of 0, 2.00, 3.33, 5.33 and 8.00 kPa produced different AWR scores （P〈0.05）. The pain threshold of AWR was constant for up to 80 min after the initial windup （first 1-3 distensions）, the mean threshold was 3.69±0.35 kPa. Systemic administration of morphine sulfate elevated the threshold of visceral pain in a dosedependent and naloxone reversible manner. CONCLUSION： Scoring the AWR during colorectal distensions can assess the intensity of noxious visceral stimulus. Flatting of abdomen （AWR 3） to CRD as the visceral pain threshold is clear, constant and reliable. This pain model and its behavioral assessment are good for research on visceral pain and analgesics.
文摘AIM: To investigate in patients with functional dyspepsia (FD) after an every-day meal whether (1) gastrointestinal (GI) and extra-GI symptoms had any relation with the degree of antral volume, (2) the onset of postprandial symptoms was associated with, and may predict, delayed gastric emptying. METHODS: In 94 symptomatic FD patients, antral volume variations and gastric emptying were assessed with ultrasonography after a 1050 kcal meal. Symptoms were evaluated with a standardized questionnaire. The association of GI and extra-GI symptoms with antral volumes and gastric emptying were estimated with logistic regression analysis. RESULTS: Forty percent of patients did not report any symptoms after a meal. Compared to the healthy controls, the antrum was more distended in patients throughout the entire observation period and 37 (39.4%) patients had delayed gastric emptying. Only postprandial drowsiness was associated with antral volume variations (AOR = 1.42; P < 0.001) and with delayed gastric emptying (AOR = 3.59; P < 0.03). CONCLUSION: In FD patients, GI symptoms are neither associated with antral distension nor with gastric emptying. Drowsiness is associated with antral distension and delayed gastric emptying. The onset of drowsiness is preceded by an increment of antral distension and the duration of the symptom appears to be related to the persistence of antral distension.
文摘Objective:To explore the effect of auricular point pressing combined with thunder-fire moxibustion in the treatment of abdominal distension and constipation after thoracic compression fracture.Methods:Totally 100 patients were randomly divided into 4 groups,the observation group 1(n=25)which were treated with conventional nursing combined with auricular piont pressing,observation group 2(n=25)treated with conventional nursing combined with thunder-fire moxibustion,observation group 3(n=25)treated with conventional nursing combined with auricular point pressing and thunder-fire moxibustion,and the control group(n=25)which adopted conventional nursing.First exhaust and defecation time after fracture in 4 groups were observed and compared.Results:The effect of observation group 3 was better than that of observation group 2,observation group 1 and control group(P<0.05).Conclusion:It is obvious that auricular point pressing combined with thunder-fire moxibustion has better result in treating abdominal distension and constipation after thoracic compression fracture.
文摘Objective:To explore the application value of moxibustion and acupoint application in the treatment of postoperative abdominal distention in patients undergoing gynecological surgery.Methods:Seventy-two patients who underwent gynecological surgery in our hospital from May 2020 to May 2021 were randomly divided into two groups.Group A was treated with moxibustion and acupoint application,and group B was treated with routine treatment.The incidence of postoperative abdominal distention,therapeutic effect of abdominal distention,defecation time,exhaust time,recovery time of bowel sounds and the changes of patients’quality of life were analyzed.Results:The incidence of abdominal distension in group A was 22.22%,which was lower than 41.47%in group B(P<0.05).The therapeutic effect of abdominal distension in group A was 87.50%,which was higher than 66.67%in group B(P<0.05).The recovery time of first defecation,first exhaust and bowel sound in group A was shorter than that in group B(P<0.05).All postoperative quality of life scores of group A were higher than that of group B(P<0.05).Conclusion:On the basis of routine postoperative intervention,moxibustion and acupoint application can reduce the risk of postoperative abdominal distention,reduce the degree of abdominal distention,promote the recovery of intestinal function,shorten the first postoperative exhaust and defecation time,and then improve the quality of life of patients.
文摘Objective To introduce the experience of professor YIN Ke-jing,a national senior and famous doctor of traditional Chinese medicine,in treatment of abdominal distension after abdominal surgery with warming-needle moxibustion at Gōngsūn（公孙 SP 4）.Methods Bilateral SP 4 were selected,and warming-needle moxibustion was adopted.The treatment was conducted for twice a day,and treatment for 3 days was considered as 1 course of treatment.The efficacy was evaluated after 2 courses.Results The total effective rate was 96.9% of the 32 patients after treatment and observation for 2 courses.Conclusion This therapeutic method was easy and simple with less acupoints selected and rapid onset of effect.With definite clinical efficacy,this method was worthy of being popularized.
基金the Hongkou District Health Committee,No.Hong Wei 2002-08and Discipline Promotion Program of Shanghai Fourth People's Hospital,No.SY-XKZT-2020-1021.
文摘BACKGROUND Rehabilitation of elderly patients with a high body mass index(BMI)after cholecystectomy carries risks and requires the adoption of effective perioperative management strategies.The enhanced recovery after surgery(ERAS)protocol is a comprehensive treatment approach that facilitates early patient recovery and reduces postoperative complications.AIM To compare the effectiveness of traditional perioperative management methods with the ERAS protocol in elderly patients with gallbladder stones and a high BMI.METHODS This retrospective cohort study examined data from 198 elderly patients with a high BMI who underwent cholecystectomy at the Shanghai Fourth People's Hospital from August 2019 to August 2022.Among them,99 patients were managed using the traditional perioperative care approach(non-ERAS protocol),while the remaining 99 patients were managed using the ERAS protocol.Relevant indicator data were collected for patients preoperatively,intraoperatively,and postoperatively,and surgical outcomes were compared between the two groups.RESULTS The comparison results between the two groups of patients in terms of age,sex,BMI,underlying diseases,surgical type,and preoperative hospital stay showed no statistically significant differences.However,the ERAS group had a significantly shorter preoperative fasting time than the non-ERAS group(4.0±0.9 h vs 7.6±0.9 h).Regarding intraoperative indicators,there were no significant differences between the two groups of patients.However,in terms of postoperative recovery,the ERAS protocol group exhibited significant advantages over the non-ERAS group,including a shorter hospital stay,lower postoperative pain scores and postoperative hunger scores,and higher satisfaction levels.The readmission rate was lower in the ERAS protocol group than in the non-ERAS group(3.0%vs 8.1%),although the difference was not significant.Furthermore,there were significant differences between the two groups in terms of postoperative nausea and vomiting severity,postoperative abdominal distention at 24 h,and daily life ability scores.CONCLUSION The findings of this study demonstrate that the ERAS protocol confers significant advantages in postoperative outcomes following cholecystectomy,including reduced readmission rates,decreased postoperative nausea and vomiting,alleviated abdominal distension,and enhanced functional capacity.While the protocol may not exhibit significant improvement in early postoperative symptoms,it does exhibit advantages in long-term postoperative symptoms and recovery.These findings underscore the importance of implementing the ERAS protocol in the postoperative management of cholecystectomy patients,as it contributes to improving patients'recovery and quality of life while reducing health care resource utilization.
文摘Yolk sac tumors of the ovary are rare entities that account for 2% - 5% of all ovarian tumors. They represent the second most common histological variant of malignant germ cell tumors of the ovary after dysgerminomas. Yolk sac tumors are most commonly encountered in women in the second and third decades. Microscopically, they are highly polymorphic and can present in a pure form or associated with another contingent of germ cell tumor. We report the case of a 26-year-old woman, who underwent surgery for a large right ovarian tumor rupturing into the peritoneal cavity. The ovarian tumor was revealed by ascites of great abundance and abdomino-pelvic pain. On histological examination, the diagnosis of yolk sac tumor in its pure and polyvesicular vitelline pattern was made. Through this observation, we propose to discuss the anatomoclinical particularities of these tumors by emphasizing the importance of histology for the diagnosis as well as the need of an early and appropriate management.
文摘Frozen shoulder is a common disease which causes significant morbidity. Despite over a hundred years of treating this condition the definition, diagnosis, pathology and most efficacious treatments are still largely unclear. This systematic review of current treatments for frozen shoulder reviews the evidence base behind physiotherapy, both oral and intra articular steroid, hydrodilatation, manipulation under anaesthesia and arthroscopic capsular release. Key areas in which future research could be directed are identified, in particular with regard to the increasing role of arthroscopic capsular release as a treatment.
基金supported by research grants to VJT from the National Institutes of Health(R01 NS085426)the Department of Defense(W81XWH-14-1-060)
文摘Both sensorimotor and autonomic dysfunctions often occur after spinal cord injury（SCI）. Particularly, a high thoracic or cervical SCI interrupts supraspinal vasomotor pathways and results in disordered hemodynamics due to deregulated sympathetic outflow. As a result of the reduced sympathetic activity, patients with SCI may experience hypotension, cardiac dysrhythmias, and hypothermia post-injury. In the chronic phase, changes within the CNS and blood vessels lead to orthostatic hypotension and life-threatening autonomic dysreflexia（AD）. AD is characterized by an episodic, massive sympathetic discharge that causes severe hypertension associated with bradycardia. The syndrome is often triggered by unpleasant visceral or sensory stimuli below the injury level. Currently the only treatments are palliative - once a stimulus elicits AD, pharmacological vasodilators are administered to help reduce the spike in arterial blood pressure. However, a more effective means would be to mitigate AD development by attenuating contributing mechanisms, such as the reorganization of intraspinal circuits below the level of injury. A better understanding of the neuropathophysiology underlying cardiovascular dysfunction after SCI is essential to better develop novel therapeutic approaches to restore hemodynamic performance.
文摘Cystic lymphangiomas are rare benign tumors.Most frequently occurring in children and involving the neck or axilla,these tumors are much less common in adults and very rarely involve the abdomen.The known congenital and acquired(traumatic)etiologies result in failure of the lymphatic channels and consequent proliferation of lymphatic spaces.This case report describes a very rare case of a giant mesenteric cystic lymphangioma in an adult male with no clear etiology and successful resolution by standard radical resection.A previously healthy 44-year-old male presented with a 6-wk history of progressive upper abdominal pain,vomiting,anorexia and unintentional weight loss accompanied by rapid abdominal distension.A palpable mass was detected upon physical examination of the distended abdomen and abdominal computed tomography scan showed a giant multilobulated cystic process,measuring 40 cm in diameter.Exploratory laparotomy revealed an enormous cystic mass containing 6 L of serous fluid.The process appeared to originate from the lesser omentum and the lesser curvature of the stomach.Radical resection of the tumor was performed along with a partial gastrectomy to address potential invasion into the adjacent tissues.Histological analysis confirmed the diagnosis of a multicystic lymphangioma.The postoperative recovery was uneventful and the patient was discharged after 6 d.At 3-mo follow-up,the patient was in good health with no signs of recurrence.
基金financially supported by National Natural Science Foundation of China(No.30870927)
文摘This study tested the effects of the gastrointestinal pulse train electrical stimulation with different parameters and at different locations on the neuronal activities of the lateral hypothalamus area（LHA） in obese rats in order to find the optimal stimulation parameter and location. Eight gastric electrical stimulations（GES） with different parameters were performed and the neuronal activities of gastric-distension responsive（GD-R） neurons in LHA were observed. The effects of stimulations with 8 parameters were compared to find the optimal parameter. Then the optimal parameter was used to perform electrical stimulation at duodenum and ileum, and the effects of the duodenal and ileac stimulation on the GD-R neurons in LHA were compared with the gastric stimulation of optimal parameter. The results showed that GES with the lowest energy parameter（0.3 ms, 3 mA, 20 Hz, 2 s on, 3 s off） activated the least neurons. The effects of GES with other parameters whose pulse width was 0.3 ms were not significantly different from those of the lowest energy parameter. Most gastric stimulations whose pulse width was 3 ms activated more LHA neurons than the smallest energy parameter stimulation, and the effects of those 3 ms gastric stimulations were similar. Accordingly, the lowest energy parameter was recognized as the optimal parameter. The effects of stimulations with the optimal parameter at stomach, duodenum and ileum on the LHA neuronal activities were not different. Collectively, gastrointestinal electrical stimulation（GIES） with relatively large pulse width might have stronger effects to the neuronal activities of GD-R neurons in LHA of obese rats. The effects of the GIES at different locations（stomach, duodenum and ileum） on those neurons are similar, and GES is preferential because of its easy clinical performance and safety.
基金Shandong Province Medical and Health Science and Technology Development Plan,No.202003030878.
文摘BACKGROUND Malignant peritoneal mesothelioma(MPM)originates from the mesothelial and subcutaneous cells of the abdominal cavity.Its diagnose is difficult due to its nonspecific and vague symptoms,and it should be differentiated from alcoholic cirrhosis and liver and pancreatic cancers.Misdiagnosis and missed diagnosis can easily occur when MPM presents with other diseases.To the best of our knowledge,no case of MPM concurrent with alcoholic cirrhosis has been reported.CASE SUMMARY A 63-year-old man presented to our hospital with abdominal distension for 20days.He had a history of alcohol consumption for nearly 30 years and no history of special drug use or toxic exposure.After treatment for alcoholic cirrhosis in a community hospital,his symptoms did not improve significantly.The patient underwent exploratory laparotomy and surgical resection.Pathologic examination showed an epithelioid MPM.He was treated with chemotherapy and intraperitoneal hyperthermic perfusion after surgery.Currently,he is in a stable condition and tumor recurrence has not occurred.CONCLUSION Misdiagnosis and missed diagnosis of MPM can easily occur because of its insidious onset.Therefore,there is a need to understand.MPM in clinical practice,make the correct diagnosis,and provide timely and effective treatment.
文摘AIM: To investigate anti-hypersensitive effects of α2δ-1 ligands in non-inflammatory and inflammationassociated colonic hypersensitivity(CHS) mouse models.METHODS: To induce an inflammation-associated CHS, 1% dextran sulfate sodium(DSS) was administered to C57Bl/6J male mice, in drinking water, for 14 d. Regarding the non-inflammatory neonatal maternal separation(NMS)-induced CHS model, wild-type C57BI/6J pups were isolated from their mother from day 2 to day 14(P2 to P14), three hours per day(from 9:00 a.m. to 12:00 p.m.). Colorectal distension was performed by inflating distension probe from 20 μL to 100 μL by 20 μL increment step every 10 s. After a first colorectal distension(CRD), drugs were administered subcutaneously, in a cumulative manner,(Gabapentin at 30 mg/kg and 100 mg/kg; Pregabalin at 10 mg/kg and 30 mg/kg; Carbamazepine at 10 mg/kg and 30 mg/kg) and a second CRD was performed one hour after each injection.RESULTS: The visceromotor response(VMR) to CRD was increased by our NMS paradigm protocol in comparison to non-handled(NH) mice, considering the highest distension volumes(80 μL: 0.783 ± 0.056 mV /s vs 0.531 ± 0.034 m V/s, P < 0.05 and 100 μL: 1.087 ± 0.056 m V/s vs 0.634 ± 0.038 m V/s, P < 0.05 for NMS and NH mice, respectively). In the inflammationassociated CHS, DSS-treated mice showed a dramatic and significant increase in VMR at 60 and 80 μL distension volumes when compared to control mice(60 μL: 0.920 ± 0.079 m V/s vs 0.426 ± 0.100 m V/s P < 0.05 and 80 μL: 1.193 ± 0.097 mV /s vs 0.681 ± 0.094 mV /s P < 0.05 for DSS- and Water-treated mice, respectively). Carbamazepine failed to significantly reduce CHS in both models. Gabapentin significantly reduced CHS in the DSS-induced model for both subcutaneous injections at 30 or 100 mg/kg. Pregabalin s i g n i f i c a n t l y r e d u c e d V M R t o C R D i n t h e n o n-inflammatory NMS-induced CHS model for the acute subcutaneous administration of the highest cumulative dose(30 mg/kg) and significantly reduced CHS in lowdose DSS-treated mice in a dose-dependent manner. Finally, the percent decrease of AUC induced by acute GBP or Pregabalin treatment were higher in the inflammatory DSS-induced CHS model in comparison to the non-inflammatory NMS-induced CHS model.CONCLUSION: This preclinical study demonstrates α2δ-1 ligands efficacy on inflammation-associated CHS, highlighting their potential clinical interest in patients with chronic abdominal pain and moderate intestinal inflammation.
文摘AIM： To investigate the hypothesis that duodeno-jejunal dyssynergia existed at the duodeno-jejunal junction.METHODS： Of 112 patients who complained of epigastric distension and discomfort after meals, we encountered nine patients in whom the duodeno-jejunal junction did not open on duodenal contraction. Seven healthy volunteers were included in the study. A condom which was inserted into the ist duodenum was filled up to 10 mL with saline in increments of 2 mL and pressure response to duodenal distension was recorded from the duodenum, duodeno-jejunal junction and the jejunum.RESULTS： In healthy volunteers, duodenal distension with 2 and 4 mL did not produce pressure changes, while 6 and up to 10 mL distension effected significant duodenal pressure increase, duodeno-jejunal junction pressure decrease but no jejunal pressure change. In patients, resting pressure and duodeno-jejunal junction and jejunal pressure response to 2 and 4 mL duodenal distension were similar to those of healthy volunteers. Six and up to 10 mL 1^st duodenal distension produced significant duodenal and duodeno-jejunal junction pressure increase and no jejunal pressure change.CONCLUSION： Duodeno-jejunal junction failed to open on duodenal contraction, a condition we call ＇duodenojejunal junction dyssynergia syndrome＇ which probably leads to stagnation of chyme in the duodenum and explains patients＇ manifestations.
文摘he incidence and mortality of colorectal cancer(CRC)are on the rise in China and rank the fifth in all malignant cancers,which may result from the increasingly aging population and unhealthy lifestyles.At present,the major treatment methods for CRC include laparoscopic surgery,radiotherapy and neoadjuvant and palliative chemotherapies,but they all have the limited impact on cure rates and long-term survival.Traditional Chinese medicine(TCM)plays important roles in preventing recurrence and metastasis,improving the quality of life and prolonging the survival of patients with advanced CRC after radical operations.Thereby,this article mainly explored the key points of common syndromes,TCM nursing methods and health guidance of CRC in order to further develop the advantages of TCM,improve its efficacy and standardized its nursing behavior.
文摘Ultrasound technology is widely used to make assessments of arterial function. The delicate nature of these measurements requires that sources of errors are limited. Therefore, the aim of this study was to assess variability due to probe selection and optimization settings. Methods: Ten healthy 20 - 26 year old male and female subjects were tested. Brachial artery size (diameter) was measured thirty times a second using a B-mode Ultrasound unit equipped with a high-resolution video capture device. Distension was calculated using systolic and diastolic diameters. To assess intersession variability, we made recordings over twelve minutes;with the probe being removed and re-positioned every four minutes. To assess variability due to probe selection and optimization, we manipulated four parameters: 1) Probe selection (7 - 13 MHz, 5 - 10 MHz, 6 - 9 MHz). 2) Probe frequency (11 MHZ, 9.6 MHZ, 8 MHz). 3) Measurement location (near, center or middle field). And, 4) Image mode (B-mode, duplex-mode). To assess inter-session variability, three sets of recordings were made for each probe selection and optimization setting. Results: Mean diameter ICC’s for inter-session variability, probe frequency, measurement location, image display size, and probe selection were 0.99, 0.98, 0.97, 0.99, and 0.90 respectively. Distension ICC’s for intersession variability, probe frequency, measurement location, image display size, and probe selection were 0.66, 0.26, 0.62, 0.60, and 0.51 respectively. Conclusions: Altering probe selection increases measurement variability to the greatest extent. However, as long as probe selection and optimization settings are kept constant, our inter-session variability shows that reliable measurements can be made.
