[Surgical treatment for gastric cancer in western countries].
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Objective To investigate the clinical features of gastric cancer,the choice of surgical approach and perioperative treatment.Methods The clinical data of 38 cases(aged 21 to 82 years) of gastric cancer from January 2006 to June 2012 were analyzed retrospectively.The age in 28 of them was more than 60 years.Results The surgical treatment were performed in all 38 cases,including radical(D2 or D3) resection in 27 patients(71.0%),short circuit procedures or ostomy surgery in 8 cases(21.0%),widely metastatic cancer was founded in the operation and abdominal exploration was performed to prepare biopsy in 3 cases(8.0%).Seven cases were with postoperative complications(18.4%).One case died(2.6%).Conclusion The gastric cancer patients are commonly with multiple clinical stage Ⅲ to Ⅳ,most of them are elderly patients often combined with multiple organ chronic degenerative conditions.A reasonable choice of surgical treatment is the key to improve survival rate of patients with gastric cancer.
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Aerosolized medications are used as airway clearance therapy to treat a variety of airway diseases. These guidelines were developed from a systematic review with the purpose of determining whether the use of these medications to promote airway clearance improves oxygenation and respiratory mechanics, reduces ventilator time and ICU stay, and/or resolves atelectasis/consolidation compared with usual care. Recombinant human dornase alfa should not be used in hospitalized adult and pediatric patients without cystic fibrosis. The routine use of bronchodilators to aid in secretion clearance is not recommended. The routine use of aerosolized N-acetylcysteine to improve airway clearance is not recommended. Aerosolized agents to change mucus biophysical properties or promote airway clearance are not recommended for adult or pediatric patients with neuromuscular disease, respiratory muscle weakness, or impaired cough. Mucolytics are not recommended to treat atelectasis in postoperative adult or pediatric patients, and the routine administration of bronchodilators to postoperative patients is not recommended. There is no high-level evidence related to the use of bronchodilators, mucolytics, mucokinetics, and novel therapy to promote airway clearance in these populations.
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