Objective To assess the effectiveness of increasing water intake for the prevention of urinary calculi and its recurrence. Methods We defined the searching area, which included Medline, Embase, Cochrane CCTR and CBMA, and found the relevant materials by computer search and document search. At least two reviewers assessed trials quality and extracted data independently. Results A total of 4 studies met the inclusion criteria (I RCT, I CCT and 2 prospective cohort studies). Meta-analysis’ results showed that the aggregate OR and 95%CI of the effect of increasing water intake for the prevention of urinary calculi were 0.64 and 0.53-0.77; the aggregate OR and 95%CI of the effect of increasing water intake for the prevention of recurrence were 0.56 and 0.37-0.84; increasing water intake can prolong the recurrence interval (P=0.016). Each result had statistical significance. Conclusion Increasing water intake can prevent urinary calculi and its recurrence. Increasing water intake can prolong the recurrence interval.
ObjectiveTo investigate the diagnosis and treatment value of multi-disciplinary team (MDT) model in patient with gastrointestinal stromal tumor (GIST) with liver metastasis.MethodThe experiences of MDT model in treating huge (>10 cm) GIST with liver metastasis in the Affiliated Hospital of North Sichuan Medical College on August 2018 were summarized.ResultsThe 46 years old female patient diagnosed with intestinal stromal tumor with liver metastasis at the initial visit. There was no chance of surgery. After the neoadjuvant therapy, the tumor was shrunk. After 2 MDT discussions, the R0 resection of the primary tumor or metastases was successfully performed. And then the patient continued to receive the oral imatinib 600 mg/d. The current overall survival was 31 months till now. No recurrence of the tumor was observed and the follow-up was still continued.ConclusionsTyrosine kinase inhibitors combined metastasectomy may be the most appropriate treatment for patient diagnosed with GIST with liver metastasis, which can improve the survival. In clinical work, MDT model could be used reasonably and carried out during the whole treatment process to provide the best treatment option for patient with GIST with liver metastasis.
目的 研究需要行颈动脉外膜剥脱术脑瘫患儿全身麻醉（全麻）诱导时给予盐酸戊乙奎醚预防术后口腔分泌物过多的效果。 方法 2009年12月－2011年12月选择60例美国麻醉医师协会分级Ⅰ～Ⅱ级的需要在全麻下行颈动脉外膜剥脱术的脑瘫患儿，随机分为两组，每组30例。A组于麻醉诱导时静脉注射阿托品10 μg/kg，B组于麻醉诱导时静脉注射戊乙奎醚10 μg/kg。分别记录两组的麻醉持续时间、入室心率、气管插管后10 min的心率差、停药后的拔管时间及拔管时口腔分泌物评分[采用视觉模拟评分法（VAS）]。 结果 两组相比，患儿麻醉持续时间、入室心率和停药后拔管时间差异均无统计学意义（P＞0.05），而拔管时口腔分泌物的VAS评分差异有统计学意义（P＜0.05），其中口腔分泌物过多（VAS＞2分），A组为46.67%，B组为16.67%，B组比A组口腔分泌物更少，气管插管后10 min心率A组为（28.30 ± 9.73）次/min，B组为（9.93 ± 10.25）次/min，两组差异有统计学意义（P＜0.05）。 结论 盐酸戊乙奎醚能够有效减少需要行颈动脉外膜剥脱术的脑瘫患儿术后口腔分泌物过多的情况，且比常规应用阿托品的效果更好。
目的 研究七氟醚诱导气管插管减轻短期内行两次手术的脑性瘫痪患儿术前焦虑的效果。 方法 2009年12月－2011年7月选择需要短期内行两次全身麻醉（全麻）手术的痉挛性脑性瘫痪患儿60例，美国麻醉医师协会（ASA）Ⅰ～Ⅱ级。随机分为A组常规麻醉诱导气管插管（30例）和B组七氟醚诱导气管插管（30例）；分别在一期及二期手术术前访视时（M1、M3）、入手术室时（M2、M4）对两组患儿进行改良耶鲁围术期焦虑量表评估；并分别在一期及二期手术麻醉诱导期（N1、N2）对两组患儿进行诱导期合作度量表的标准评定。 结果 同组一期、二期手术比较，A组患儿二期手术术前焦虑更明显（P＜0.05），二期入手术室时焦虑更明显（P＜0.05），二期手术合作度更差（P＜0.05）；B组患儿两次手术术前焦虑无明显变化（P＞0.05），一期入手术室时焦虑明显（P＜0.05），一期手术合作度较差（P＜0.05）。两组之间，一期手术两组患儿焦虑情况无明显区别（P＞0.05），二期手术A组比B组的患儿焦虑更明显（P＜0.05），两次手术B组都比A组的患儿合作度更好（P＜0.05）。 结论 七氟醚麻醉诱导气管插管能够有效减轻短期内需要进行两次手术的痉挛性脑性瘫痪患儿的术前焦虑，提高患儿二期手术的合作度，提供良好的手术麻醉条件，保证患儿的围术期安全。
目的 探讨在耻骨后前列腺癌根治术中尿控功能和性功能保护的手术技巧和疗效。 方法 2001年8月-2010年1月，行耻骨后前列腺癌根治术21例，其中2例经腹腔镜施行。均早期控制缝扎背静脉复合体，并妥善处理前列腺尖和尿道。21例通过保护控尿神经、保护尿道横纹括约肌等措施，保护尿控功能；17例通过保留神经血管束技术（12例保留双侧，5例仅保留一侧）保护性功能。 结果 手术均成功完成，无围术期严重并发症。2周拔出尿管后，排尿通畅，无尿道狭窄。手术后3、12个月内恢复尿控能力分别为：6例、13例，持续性轻-中度尿失禁2例。21例中，手术前勃起功能正常，并于手术中保留神经血管束17例，手术后3、12个月内勃起功能恢复分别为：2、8例，4例勃起功能减弱，3例不能勃起。手术后病理报告均为前列腺腺癌，未侵及精囊．膀胱颈，双侧淋巴结阴性。后尿道切缘阳性1例。手术后6、24、54个月各有1例出现生化复发。 结论 精细解剖并注意手术技巧，可有效保护性功能和尿控功能，并达到肿瘤根治的疗效。
ObjectiveTo explore the risk factors associated with severe hand-food-mouth disease (HFMD) in Chongqing, in order to carry out intervention work in the future, provide reference for reducing the incidence and fatality rate of severe HFMD cases. MethodsNinety severe HFMD cases treated between 2011 and 2014 in Chongqing were enrolled as case group while another 90 mild HFMD cases were randomly selected as control group in the same period. All subjects’ parents or babysitters were asked to fill in a questionnaire which included demography, ways of babysitting, behavior and the like. All HFMD cases were diagnosed by both clinical symptoms and nuclear acid testing. Data were processed by EpiData 3.1 and analyzed by SPSS 13.0. ResultsSingle-factor analysis showed that there were 14 risk factors of severe HFMD including virus type, registered residence type, current address type, cultural degree of their caregivers, season of the onset, existence of fever and rash, first hospital diagnosis type, and whether the first diagnosis was HFMD (P ＜ 0.05) . Multifactor analysis showed the risk factors included the current rural residence type [OR=27.29, 95%CI (3.71, 200.72) ], misdiagnosis as disease other than HFMD in the first visit to the hospital [OR=141.03, 95%CI (12.43, 1 599.70) ], and virus type of EV71 [OR=244.32, 95%CI (18.99, 3 143.74) ]. ConclusionsActive surveillance should be carried out on the risk factors of severe HFMD. At the same time, active and effective preventive measures, and timely treatment of patients with severe HFMD can help to reduce the incidence and case fatality rate.