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Objective To study the mental experience of nurses from outpatient department in dealing with patient's complaints.Method Using convenient sampling method,15 nurses from 5 sections of the outpatient department were chosen as interviewees,with the interviews on their mental experience in handling the complaints from outpatients.Result The issues from the interviews included:part of the patients were unable to complain accurately,part of the nurses were ineffective and therefore inactive in handling the complaints;some of the nurses were poor at employing communication skills and some others were incapable of specifying the complaints or asking for assistance.Conclusions Complaint handling is part of the nurses' job in the outpatient service.The nurses should take the initiative to improve their ability in complaint handling,so as to handle the complaints in a positive and effective way and improve patient's satisfaction.
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BACKGROUND: Overexpression of cancer suppressor gene ING1 may cause apoptosis of many kinds of cancer cells and results in cell cycle arrest in G1 stage. ING1 is involved in p53 signaling pathway and regulates the activity of p53 as a transcription-activating factor.OBJECTIVE: To explore the association of ING1 gene expression and mutation with the clinicpathological features of colorectal cancer.DESIGN: A controlled observation of the pathological samples.SETTING: Department of General Surgery, Southwest Hospital, Third Military Medical University of Chinese PLA.PARTICIPANTS: Totally 52 fresh colorectal cancer samples were obtained from patients hospitalized in the Southwest Hospital, Third Military Medical University of Chinese PLA from October 1998 to October 1999. Normal mucosal tissues were also collected 10 cm from the margin of the tumor during the operation. The patients included 29 male and 23 female patients with an average age of 50.28 years.METHODS: ING1mRNA and protein expressions were detected in the 52 colorectal cancer tissue samples. The ING1 gene mutation was detected by analyzing single-stranded DNA polymorphism. The expression of p53 protein in the colorectal cancer tissue was detected immunohistochemically.tion-single-strand conformation polymorphism.was obviously decreased in comparison with that in the normal mucosa(0. 626 ±0. 382 vs 1. 166 ±0. 245, P ＜ 0. 001) . The expression of ING1 in the tumor tissue of patients with lymphatic metastasis was significantly lower than that in the tumor tissues from patients without lymphatic metastasis (0. 393 ±0. 243 vs 0. 960 ±0. 299, P ＜0.01). The expression of p53 protein was positively correlated with ING1 mRNA expression( P ＜ 0.01). Only one of the 52 samples was positive for ING1 gene mutation.CONCLUSION: ING1 gene may participate in the occurrence and progression of colorectal cancer and its decreased expression inhibits the action of tumor suppressor genes. The decrement in ING1 mRNA and protein expression without gene mutation indicates that ING1 participates in the pathogenesis of colorectal cancer in a manner quite different from that of the classic tumor suppressor genes.
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Objective To summarize the clinical experiences in partial splenectomy for the treatment of splenic injuries Methods The indications, surgical procedures and surgical outcomes of a total of 105 cases undergoing partial splenectomy for splenic injuries in Southwest Hospital in the past 16 years were analyzed retrospectively Results Sixty seven cases(63 8%) suffered from isolated splenic injury According to splenic injury scale, grade Ⅰ (13, 11 4%), grade Ⅱ (56, 53 3%), gradeⅢ (28, 26 7%) and grade Ⅳ(8, 7 6%) were found in 105 cases of splenic injuries Surgical procedures included segmental splenectomy in 41 cases, hemi splenectomy in 35 cases, subtotal splenectomy in 29 cases and autotransplantation of splenic tissue in 21 cases of splenic injury in children There was no in hospital death in all cases Severe complications of subdiaphragmatic fluid collection and infection occurred in 3 cases, but the patients were cured by conservative treatment Conclusion Partial splenectomy is a safe and reasonable choice for selected patients with splenic injury
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Objective To provide the theoretic basis for the clearance of the metastatic lymph nodes in radical operation of colorectal carcinoma(CRC) by means of exploring the relationship between mass size of both tumor and lymph nodes and the rate of lymph node metastasis. Methods A total of 702 lymph nodes from 57 cases of CRC radical operations were divided into 5 groups and each of the lymph nodes was examined. The size of lymph nodes, Dukes' phases, the pathological types of CRC and their metastasis rate were analyzed. Results ① High metastasis rate was found at Dukes' C and D phases of CRC, being 29.93% and 48.12%, respectively. ② The metastasis rates of mucous adenocarcinoma and signet ring cell carcinoma were the highest of all pathological types, being 59 52% and 59.26%, respectively. ③ Metastasis rate of lymph nodes was not correlated with the mass size of tumor, but correlated with Dukes' phase. Conclusion ① Metastasis rate of lymph nodes increases with the growth and infiltration of tumor. ② Metastasis rates of mucous adenocarcinoma and signet ring cell carcinoma are higher than those of well and mid differentiated carcinomas. ③ Metastasis may be suggested for lymph node of CRC more than 5 mm in diameter during operation. However, clearance of lymph node of CRC less than 5 mm in diameter needs further study.
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Objective To explore the relationship between the stromal angiogenesis and growth of the large intestinal carcinoma. Methods The vascular quantitative parameters(, , Sv, TA/BA) of the distal and proximal ends of the carcinoma, the center of the carcinoma, and the intestinal mucosa of distal and proximal ends of carcinoma were analyzed with computerized image. Differentiation degree of tumor cell was observed microscopically. Results Of the 48 cases studied, significant differences( P
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<p><b>OBJECTIVE</b>To study the long-term clinical results of 34 chronic duodenal ulcer patients treated with high selective vagotomy plus pylorus-preserved mucosal antrectomy (HSV + PPMA).</p><p><b>METHODS</b>Clinical follow-up results of the patients from 8 approximately 14 years were analyzed.</p><p><b>RESULTS</b>Thirty-tow patients (94.1%) followed-up for 8 approximately 14 years after operation achieved Visick grades I-II. No patient died. Gastric acid secretion and infection rate of Helicobacter pylori in the antral mucosa were significantly reduced after operation. No significant difference was found in bile acids, total bacterial counts in gastric juice, and the level of serum gastrin after operation. Gastric emptying was normal. No ulcer recurrence was found by barium meal and endoscopy.</p><p><b>CONCLUSIONS</b>HSV + PPMA is a better operative treatment for duodenal ulcer, which not only can decrease acid secretion and ulcer recurrence rate but also can preserve the function of antrum and pylorus and prevent post-operation bile reflux and intragastric bacterial overgrowth.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Duodenal Ulcer , Blood , Microbiology , General Surgery , Follow-Up Studies , Gastric Acid , Bodily Secretions , Gastrins , Blood , Pyloric Antrum , General Surgery , Recurrence , Stomach , Microbiology , Vagotomy , MethodsABSTRACT
Objective To explore the correlation between the expression of p33/ING1 and the clinicopathological features in patients with colorectal cancer, and to understand the possible mechanism of p33/ING1 in the oncogenesis of colorectal neoplasms. Methods All samples of normal mucosa and cancer tissues from 52 patients with colorectal cancer were detected for their expression levels of p33/ING1 by RT-PCR. Results A significant decrease in p33/ING1 mRNA expression was found in 30 out of 52(57.7%) colorectal cancer tissues. The results also showed that repression of p33/ING1 expression markedly related to both the Duke's stage and metastasis. Conclusion Down-regulation of p33/ING1 may play an important role in the oncogenesis and development of colorectal carcinoma.
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Objective To investigate effects of dendritic cells (DC) vaccine on immune function in postoperative gastric cancer patients Methods DCs were extracted and pulsed with self tumor antigens in vitro Fifty patients with gastric cancer were divided into 2 groups randomly Four times of DC vaccinations were administered at 7 days intervals to the postoperative patients in treatment group after they underwent chemotherapy The control group were treated with chemotherapy only The level of IL 12 、 IFN ? and IL 4 in peripheral blood were analysed Results In DCs group, the levels of IL 12 were 37?4、 68?6、 96?12 and 59?9 pg/ml, the levels of IFN ? were 61?12、 134?19、 145?20 and 111?15 pg/ml, and levels of IL 4 were 55?7、 49?6、 46?5 and 50?8 pg/ml before and 2, 4 and 8 weeks after vaccination, respectively In control group, the levels of IL 12 were 39?7、 45?9、 44?10 and 44?6 pg/ml, the levels of IFN ? were 63?10、 61?13、 62?11、 61?7 pg/ml, and levels of IL 4 were 52?11、 55?9、 53?10、 55?8 pg/ml before and 2, 4 and 8 weeks after vaccination, respectively The levels of IL 12 and IFN ? increased significantly in DCs group No severe side effects were found during treatment Conclusion DC vaccine improves immune function of posroprative patients with gastric cancer
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Objective To investigate the clinicopathological characteristics, diagnosis and treatment of primary duodenal malignant tumors (PDMTs). Methods The clinical data of 47 PDMTs confirmed by pathology were retrospectively analyzed. Results Pathological types were adenocarcinoma in 42 cases, leiomyosarcoma in 4, and carcinoid in 1.The most common location of the tumor was the descending portion (35), especially the peri-papillary region (28) of the duodenum. The most common symptoms and signs were abdominal pain, jaundice, upper gastrointestinal hemorrhage, obstruction ,and weight loss. The main diagnostic modalities were gastroduodenoscopy, GI barium meal, ERCP, ultrasound (US) and CT. US together with ERCP was the most useful in improving the diagnosis of peripapilla tumors in the duodenum. Panceraticoduodenectomy and some palliative procedures were performed for 25 and 20 cases, respectively.Surgical mortality and postoperative morbidity were 2.2% (1/45) and 20% (9/45),retrospectively. The 3-year and 5-year survival for those adenocarcinoma without distant metastasis undergoing pancreaticoduodenectomy were 50% and 32%. No long survival was found after the palliative operation. Conclusions Adenocarcinoma is the most common pathological type of PDMTs.No specific symptoms were shown in the early stage of PDMTs, US, CT and ERCP are the main diagnostic procedures. Radical pancraticoduodenectomy can prolong survival time and should be attempted for those without systemic dissemination.Palliative operations should be considered for tumors in advanced stage.
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Objective To investigate the possible contributing risk factors, diagnosis and treatment of gastroparesis after abdominal surgery. Methods Potential risk factors, clinical manifestations and therapeutic approaches of 22 cases of gastroparesis after abdominal operation were analyzed retrospectively. Results In this series, gastroparesis more frequently occured in those patients having a long-term preoperative gastric outlet obstruction, malignant tumor, O type blood group pancreaticoduodenectomy or simple gastrojejunostomy without gastric resection. Endoscopy, upper gastrointestinal radiography and radioisotope scintigraphy were effective methods in the diagnosis of gastroparesis, and normal gastrointestinal movement was achieved mostly in 5 weeks postoperatively by conservative treatments.Conclusions Postoperative gastroparesis can recover spontaneously after a longer period of supportive treatment combined with prokinetic drugs, and reoperation should be avoided.
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ObjectiveTo study the expression of ING1 mRNA and its mutation status in human colorectal cancer. MethodsSamples of normal mucosa and cancer tissues from 52 patients with colorectal cancer were detected for their expression of ING1mRNA with RT PCR, and screened for its mutation with PCR SSCP. The expression of p53 protein was detected with immunohistochemical staining.ResultsThe impaired expression of ING1mRNA in colorectal cancer was associated with an advanced Dukes′ stage and metastasis of lymph nodes ( P ≤ 0 01). The expression of ING1mRNA positively correlated to that of p53 protein ( P ≤0 01). And a infrequent mutation of ING1 was also observed. Conclusion Our results suggest that ING1 contributes to the tumorigenesis and progression of colorectal cancer through down regulating its expression rather than through mutation.
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Objective To investigate the anti-gastric cancer effects of dendritic cells tumor vaccine loaded with heat shock protein gp96 polypeptide complex. Methods Con A sepharose affinity chromatography and mono Q ion exchange chromatography were applied to purify gp96 polypeptide complex from gastric cancer tissues and DC was loaded with gp96 polypeptide complex to prepare tumor DC vaccine. Fluorescence-activated cell sorter (FACS) was used to detect surface molecules expression of dendritic cells. Enzyme-linked immunosorbent assay ( ELISA) was used to detect IL-10 and interferon-? (IFN-?) of the supernatant secreted by activated T lymphocytes and 51Cr release test was performed to evaluate the gp96 peptide specific CTL response. Results DCs derived from patient's peripheral blood mononuclear cells loaded with gp96 polypeptide complex had high express surface molecule of GD1? (79. 3 ?4. 1)% , CD80 (84. 3 ? 2. 4) % , CD83 (85. 7 ? 3. 2) % and HLA-DR( 83.4 ? 2. 9) %. The effector T lymphocytes induced by DCs vaccine loaded with gp96 polypeptide complex had rised killing effect to primary culture gastric tumourcells(58.47?10. 71)% when compared with SGC 7901 cells(23. 98 ?4. 16)%. The level of IFN-? (2875 ? 177.66 pg/ml) significantly increased and that of IL-10 (36 ? 6.72 pg/ml) decreased. Conclusion Autologous heat shock protein gp96 polypeptide complex/DC vaccine induces strong peptide complex specific CTL response with high specificity.