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Archive for March 2008

Children of congestive heart failure causes

Monday, March 31, 2008 · Posted in

The etiology of heart failure in children caused a lot during heart failure in children less than 1 year old to the highest incidence rates, particularly in the areas of congenital heart disease were the most common cause, endocardial fibroelastosis, dilated cardiomyopathy, congenital heart disease also an important reason. Induced heart failure often causes bronchial pneumonia, severe anemia, electrolyte imbalance and lack of oxygen, etc..
According hemodynamics and pathophysiological changes of heart failure can be broadly divided into:
1, muscle contraction dysfunction (cardiac failure): congestive heart failure due to various reasons, including myocarditis, dilated cardiomyopathy, endocardial fibroelastosis of Kawasaki disease;
2, Room overloading, is divided into: ventricular overload before (volume overload), including left-to-right shunt congenital heart disease, valvular regurgitation of the disease, such as infusion too much too fast; ventricular after load too heavy (pressure overload), including aortic stenosis and pulmonary valve stenosis, coarctation of the aorta and pulmonary atresia; 3, room filling obstacles include: constrictive pericarditis, pericardial tamponade, restrictive or hypertrophic cardiomyopathy, etc..
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Children of congestive heart failure in the differential diagnosis

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1. Infants with heart failure should distinguish between the following: (1) with gas and severe pneumonia and bronchiolitis: Children have difficulty in breathing, pulse and breathing fast, and so by signs. Since emphysema and diaphragm decline in the liver can Lexia 2 to 3 cm in touch. Signs similar to the above with heart failure, but not to expand its heart, liver blunt edge not round. (2) Purple congenital heart disease: for children with the lack of oxygen, often by breathing faster, irritability, cyanosis and heart rate increased speed up, but there is no other manifestations such as heart failure, such as hepatomegaly.
2. Older infants with heart failure should be under disease identification: (1) acute pericarditis, pericardial effusion and chronic constrictive pericarditis: These plug pericardial disease and venous congestion, and symptoms similar to heart failure, but pericardial disease has the following characteristics to be used as identification: ① surprising veins clear. ② abdominal not more prominent, and other parts of edema disproportionate. ③ not obvious pulmonary congestion and more, the children despite the jugular Nuzhang, ascites and liver, and other signs of significantly increased, but not significantly breathing difficulties, can be more than 15 minutes. ④ x-examination, echocardiography and radionuclide cardiac blood pool scan can also assist in diagnosis. (2) liver and kidney diseases caused significant ascites: with the right heart failure identification.
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And the identification of esophageal diseases

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(1) cardiac disease spastic see more women. Long course of disease, symptoms, light weight, and often with the spirit of factors, vomiting food to the traffic flow, a means of radiation inspection esophageal smooth narrow funnel-shaped. Antispasmodic agents can sometimes application expansion. Esophageal mucosa profiling rules, the top of esophageal stenosis expansion more obvious.
(2) radiation esophageal diverticulum esophageal partial examination showed a clear process of the diverticulum, neck and the bottom width and more consistent, or neck wide, smooth mucosa.
(3) esophageal reflux esophagitis mainly lower heartburn, swallowing, mild pain. With a small number of mucosal edema, convulsions, etc.. There will be difficulties or throughput substernal pain, the majority will disappear after treatment, drawing in the net loss of inspection, and more difficult to succeed because of allergies pharynx, esophagus when necessary for microscopic examination.
(4) esophageal leiomyoma sarcoma, fibrous tissue, rhabdomyosarcoma The most common sources, the larger the tumor, similar clinical symptoms and esophageal cancer, X-ray showed that filling defect, luminal expansion of tumor-and upper and lower esophageal was acute. Be confirmed by biopsy.
(5) papilloma from esophageal mucosa limitations hyperplasia formation of branched-or lobulated tumor cavity highlighted. Follow the normal mucosal surface, a rare form of esophageal squamous cell carcinoma, pathological diagnosis can be identified.
(6) Gas female-nuclear Most of the spirit of obvious factors often, consciously throat foreign body sensation, the vomit no, no less than the pharynx. No radiation inspection found positive.
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The early signs of esophageal cancer

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Speaking of esophageal cancer, we may not unfamiliar, because it is more common in our country a malignant tumor. For esophageal cancer and the number of deaths due to cancer of all deaths in the 1 / 5, second only to gastric cancer, in second place. Why are there so many people suffering from esophageal cancer? In fact, many factors have carcinogenic effects, if people do not pay attention to these factors, the cancer may be subject to torture. On the current information, and the incidence of esophageal cancer-related factors are:
1, fresh overheating. Eating too fast. Long-term smoking. Drink alcohol, oral or unclean dental caries, these factors may have a fresh wall physical, chemical or infectious damage;
2, the consumption of large quantities of nitrite fat food such as pickled food, as is highly carcinogenic nitrosamines;
3, the lack of dietary vitamin A, C and calcium, data confirmed that these nutrients to the water wall has a strong protective effect;
4, HPV infection;
5, genetic factors.
In recent years, due to the popularity of medical knowledge, people of various diseases become more familiar with the typical performance. The typical clinical manifestations of esophageal cancer one by one of swallowing difficulties, we have been familiar for so-called sexual-pharyngeal dysphagia is less difficult at the beginning, only eat dry food are hard; followed eat ordinary food when we difficulties after eating semi-liquid diet also blocked Eventually, even water and saliva can hardly palatable, the overflow mouth water and foam, the pain can even imagine. However, these are all manifestations of advanced esophageal carcinoma performance, if only until there think these performance left the hospital for an examination of esophageal cancer treatment, may already be too late. Any diseases that early discovery, early diagnosis and treatment, particularly of esophageal cancer. This is because, on one hand, good food can chew through a diameter of 0.5 cm of the lumen, and once hypopharyngeal difficulties that have esophageal lumen stenosis; On the other hand, early esophageal cancer resection rate of 100% , and advanced surgical resection rate is very low, at 3% per cent. Literature confirmed that the natural course of esophageal dysphagia there since the beginning, survival was only about a year and the early esophageal cancer from the beginning, the survival period of more than four years; early esophageal cancer surgical resection, and to radiotherapy, chemotherapy, etc. measures, some patients can survive the same as normal.
Thus, the key lies in how to detect early esophageal cancer, our medical research workers have done a lot of work, accumulated a lot of experience. On the one hand, in the high incidence area of esophageal cancer regular census work, through an intensive examination of cytology, endoscopic and Xff barium meal examination and the comprehensive application of technologies such as improved diagnosis rate; On the other hand, summed up the early signs of esophageal cancer, vigorously to popularize science and the masses, enhancing the level of awareness of the disease, self-early discovery, early treatment. Currently found early esophageal cancer can be no obvious symptoms or only as follows:
1, mild or occasional food palatable stems gagging flu;
2, after eating at the sternum. Xinwo Department of acupuncture. Friction like burning or pain;
3, has nothing to do with the consumption of foreign body sensation in the esophagus;
4, dry throat and neck tightening flu;
5, eating at a particular site via esophageal food stagnation flu;
6, retrosternal discomfort nausea expansion.
The feeling of discomfort can stand alone, can be both a number of sustainable existence, but also asked fault occurred.
In short, these are neither obvious nor serious performance, and now mostly disappeared, it is difficult even some patients from non-professional medical vigilance, delays diagnosis and treatment, loss of a full recovery opportunities. If in the above sense, go visit, will be able to seize the opportunity to survive. Of course, the most important thing is to correct unhealthy living habits, particularly eating habits, take precautions.
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What factors can lead to esophageal cancer

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(1) smoking some high incidence area residents esophageal cancer, smoking rate is very high, and some of the residents do not smoke, very rare esophageal cancer. This is because cigarettes contain several nitrosamines, a carcinogenic nitrosamines have a strong role.
(2) drinking Western Europe and North America the survey found that many patients with a large number of drinking wine or most of the workers and staff. Patients with esophageal cancer in the United States drink whisky higher than the general population 25 times, 10 times higher beer. Alcohol itself has no carcinogenic effects, it may be carcinogenic solvents, carcinogens easy access to esophageal mucosa, but also enable the esophageal mucosa alcohol dehydration caused esophageal mucosa injury and create conditions for the occurrence of esophageal cancer.
(3) bad eating habits and long-term malnutrition eating overheating, tough, rough food and spicy food irritation, may cause esophageal mucosal injury, repeated damage can cause mucosal hyperplasia of change, which leads to carcinogenesis. Tumor Institute of the Chinese Academy of Sciences in the human body, the environment, the role of carcinogenic nitrosamines found in a study of esophageal cancer Linxian high incidence area residents eat sauerkraut contains a variety of nitrosamines, and to prove that the consumption of the sauerkraut with esophageal cancer incidence rate is proportional. In addition, Shantou University Medical College, the high incidence area of Guangdong Province esophageal cancer Nan'ao county water, fish sauce, gravy, vegetables, dried turnip containing a variety of nitrosamines in both, and these foods preserved in the course of fungal contamination often , mold can promote food nitrosamine content increased significantly. Mold and animal model of esophageal cancer has been confirmed in the mold role in the pathogenesis of esophageal cancer.
Generally high incidence area of esophageal cancer in infertile soil, poor nutrition in poor areas, lack of dietary vitamin, and particularly vitamin C and vitamin B2, the lack of protein and essential amino acids. The esophageal mucosa can be hyperplasia change as further cause cancer. Trace elements iron, molybdenum, zinc, and also the lack of related to the occurrence of esophageal cancer.
(4) the esophageal mucosa chronic inflammation of the esophagus stimulated some state and abnormal esophageal diseases such as diverticulitis, narrow scar clip, esophageal inflammation, Achalasia, Meku can happen and malignant form of esophageal cancer.
(5) genetic susceptibility scientists after extensive investigation and found that esophageal cancer has been significantly family aggregation.
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Common for esophageal cancer

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Esophageal cancer is the world some countries and regions common malignancy. The World Health Organization released statistics show that the mortality rates of esophageal cancer in China as the highest male death of esophageal cancer for the second place, after gastric cancer. Esophageal cancer is the third woman, after gastric cancer and cervical cancer.
China's great differences in the incidence, Henan, Hebei, Shanxi provinces at the junction of the Taihang Mountains area, Henan Province Linxian, and Cixian County in Hebei Province in Yangcheng County, as the representative of the highest incidence rates. Jiangsu areas such as the northern part of the higher incidence of Henan Linxian 35 ~ 64-year-old males the incidence of esophageal cancer is one of the world's high incidence area.
Distribution of 15,000 foreign esophageal cancer in the vicinity of Central Asia, Africa, Latin America and northern France. Esophageal high incidence area of drinking water, grain and vegetables in manganese, molybdenum, iron, chlorine, zinc, sodium, selenium, phosphorus, low iodine content of food in the higher levels of nitrosamines, fungal contamination more, a some fungi can promote the formation of nitrosamines. Inhalation potent tobacco, chronic stimulation, inflammation and trauma, such as the perfect food, the Food and overheating, excessive eating, long-term alcohol drinking, oral or unclean dental caries, the lack of food in vitamin A, B, C, or the lack of protein in the food, fresh vegetables and fruit, etc., as well as genetic factors may be related to the occurrence of esophageal cancer. In short many of the causes of esophageal cancer, to be continued in-depth study.
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The clinical symptoms of esophageal cancer

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Dysphagia is the early symptoms of esophageal cancer. Initially only after swallowing food Ougan sternum after stagnation or foreign body sensation, does not affect consumption, and sometimes was intermittent, and often do not pay attention to. After emerging Yanxia sexual difficulties, whenever that is, flu Yanxia eating difficulties, the first solid food stems gagging flu, and then for the development of the semi-liquid, liquid diet also have difficulties, there are usually about six months. Most patients can be clearly pointed out that difficulties in the sternum after Yanxia the site, consistent with the obstruction site. Sometimes eat when, in addition to Yanxia difficulties, accompanied substernal burning sensation, Duntong, particularly in the stimulation of food intake, such as overheating, the acid, such as food Guoxian, the pain obvious, but could be short break ease their own. If cancer erosion and ulcers caused by or associated with esophagitis. Au often involving the sternum, scapula, neck, back. Advanced, have continued thoracic back pain.
Because esophageal obstruction, can reflux, appeared in more advanced patients. Reflux of a mucus, and sometimes a bloody, the next day of food, taste and even Sou necrotic tissue loss. Lack of long-term intake may be significantly dehydration, malnutrition, emaciation, or even evil of quality.
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The differential diagnosis of esophageal cancer

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The disease should identify with the following diseases:
(1) of esophageal achalasia patients with a predilection for young women, of course, be re-light symptoms. Esophageal barium meal examination showed lower esophageal a smooth funnel-shaped narrow, Antispasmodic agents can use the expansion.
(2) benign esophageal stenosis can be swallowed Fushiji, esophageal burns, foreign body injury, such as chronic ulcers caused by the scar. Longer course, Yanxia difficult development to a certain extent that is no longer increasing. He asked in detail about the history of X-ray and barium meal examination can be identified.
(C) mainly benign esophageal leiomyoma rare, longer course, Yanxia more difficult for intermittent. X-ray inspection may show that there esophageal circular, oval or lobulated filling defect, edge, looked around normal mucosa profiling.
(D) hysteria of the ball was particularly prevalent in young women, pharynx when the ball like a foreign body sensation, eating disappear, and often induced by psychological factors. The disease virtually no organic esophageal lesions, it is not difficult to identify with esophageal cancer.
(5) Iron deficiency Jiemo esophagitis mostly women, with the exception of Yanxia difficulties, can still have low pigment small cell anemia, Shetan, and the lack of anti-acid-level performance.
(6) esophageal diseases such as peripheral organs mediastinal tumor, aneurysm, goiter, such as increased heart. In addition to mediastinal tumor invasion esophagus, the X-ray can show that the barium meal examination of the esophagus is smooth pressure trace, profiling normal mucosa.
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How early detection of esophageal cancer

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　　Q: My father has been more than 70 years old, in a major hospital diagnosis of advanced esophageal cancer, the doctor said surgery has not only carried out chemotherapy, radiotherapy, medicine and other non-surgical treatment. How can early detection of esophageal cancer?
A: The symptoms do not obvious early esophageal cancer, cancer of the esophagus only confined to the mucosal layer, the scope of generally less than 2 cm, but not without symptoms. If foreign body sensation in the esophagus, burning sensation, eating sometimes stranded flu or flu substernal pain, these symptoms have mostly been neglected patients, it is caused by eating unawareness, or are perceived to be caused by pharyngitis. As the disease has increased gradually, patients, there may be eating Yingyi flu, eating influent difficulties. At this time treatment of esophageal cancer is more advanced, long eating difficulties, the patient malnutrition, coupled with getting on in age, lost the opportunity to surgery. So in the early symptoms of the above should go to the hospital, esophageal barium X-ray examination. If the diagnosis is also not clear, microscopic examination should be carried out esophagus, esophageal fiber inspection accuracy rate of 99%, generally not missed. Early treatment of esophageal cancer by surgery, the five-year survival rate of more than 80%, so a patient should be early discovery, early diagnosis and treatment, and this is the key to the treatment of esophageal cancer.
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Understanding of the pathogenesis of esophageal cancer

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Bad eating habits: Food and rough, quality hardware and eating overheating, excessive drinking, and so on, are concerned with the incidence of esophageal cancer.
Other esophageal lesions: Some esophageal lesions, such as esophageal achalasia, esophagitis, benign esophageal stenosis, esophageal mucosa, such as leukoplakia patients with esophageal disease, the higher the incidence of esophageal cancer, esophageal mucosa lesions may be stimulated by the long-term .
Nitrite Derivatives Impact: This is a highly carcinogenic substances, esophageal high incidence area residents like to mouldy food such as sauerkraut, dried turnip, miso, cornmeal, etc., containing more nitrite and its predecessor Substances (nitrate, nitrite), the role of nitrate can be fungal or by the acid in the stomach role can be reduced to nitrite. Streptomyces Decomposable food protein content increased 2 amine, and promote Synthesis of nitrite. Trace Elements: According to epidemiological survey found that esophageal cancer in the high incidence area of water and soil molybdenum, copper, cobalt, manganese, iron, nickel, zinc, and other trace elements in the low incidence of esophageal cancer may be related. Mo, nitrate accumulation in plants, and under certain conditions will promote the formation of nitrite amine carcinogens.
Genetic factors: high incidence area of esophageal cancer in patients with positive family history, there are up to 27% ~ 61% of patients with familial chromosomal aberrations in peripheral lymphocytes higher rate. Thus, genetic factors in the pathogenesis of esophageal cancer to a certain extent, may be the common role of internal and external factors.
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Breast Cancer Prevention

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Promoting women's self-breast examination, easy early detection of breast abnormalities. Regularly carry out census of breast cancer prevention, early detection easy, early diagnosis and early treatment, early treatment can improve survival rates and reduce the relapse rate, a very important practical significance.
Is a benign disease of the breast cell proliferation diseases, but there are still a small number of atypical hyperplasia can be changed dysplasia, not only in the number of cells increased, there are abnormal changes in the structure and eventually develop into breast cancer and therefore need timely treatment and regular inspections to prevent breast cancer misdiagnosis.
Although the breast lumps are mostly benign, but there are also small malignant tumor mixed with benign tumors, it is necessary to make full use of modern methods can support early detection of breast cancer. Breast cancer is a serious disease endangering the health of women, in the promotion of breast self-examination and breast census carried out at the same time, the whole of society will actively carry out health education, universal anti-cancer knowledge to improve the detection rate of early breast cancer, is of great significance .
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And as a causal factor in breast cancer prevention

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The etiology of breast cancer:
Judging from the current clinical practice as well as in animal experiments, and other relevant information and analysis of the incidence of breast cancer related to the following factors:
1, hormone secretion disorder: the so-called hormone disorder mainly refers to estrogen secretion disorder. Because in the age of high incidence of breast cancer is 40 to 60-year-old woman. This stage is the age of women estrogen secretion disorders, estrogen is high time. As in increasing the secretion of estrogen, this could make breast ductal epithelial cells hyperplasia and cancer.
2, childbirth and breast-feeding: In recent years by a large number of investigations proved that, without a maternity and childbirth or breastfeeding women rarely occurred repeatedly breast cancer than breast-feeding, breast-feeding women in a long time more. This shows that fewer births, less breast-feeding may increase the chance of breast cancer occurred.
3, fiber cystic breast disease: This lesion is a pre-cancerous lesions, easily transformed into breast cancer.
4, genetic factors: major performance in a family history of breast cancer. According to information abroad, the positive family history may be in two forms: as a mother suffering from breast cancer, his daughter also good breast cancer, breast cancer occurred in this amenorrhea, often bilateral; for another mother has never been suffering from breast cancer, but in a family, there are at least two sisters with breast cancer, this family of the incidence of breast cancer than non-family history of breast cancer in the family a high incidence of 2-3 times and that breast cancer will occur in amenorrhea, often unilateral.
Breast cancer prevention methods:
1, once found themselves with fiber cystic breast disease, it should be treated immediately and not to delay treatment of the time.
2, breast-feeding women, in every breast-feeding, should be as much as possible from the milk. On the one hand, this can increase milk secretion, on the other hand, can reduce the secretion of the last in the breast milk stranded time.
3, reduce Jiuliang or alcohol. Some Western countries Studies have shown that women have the habit of drinking alcohol than women prone to breast cancer.
4, a family history of breast cancer women, in addition to the self-examination should be carried out regularly to the hospital to a more comprehensive examination.
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What are the characteristics of early breast cancer

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Breast Cancer Breast cancer accounted for 80 per cent. Prominent positions in the breast skin, breast relatively slow pace of development, this is the early detection of breast cancer favorable conditions. Some scholars believe that benign breast diseases are pre-cancerous lesions, such as chronic cystic breast disease, papilloma, nipple prolonged Buyu scaling, and keratosis acquired the nipple inverted, such as bleeding of the breast. Active treatment of these diseases, but also to prevent breast cancer. Breast cancer early, and often no specific symptoms, the majority of the accidental breast with a painless, hard single small mass, its uneven surface, it is not easy, and the surrounding tissue boundaries unclear, gradually increasing mass , and linked to the mass skin sag, with a tangerine peel. Furthermore, the breast can be reduced, acting like nipple fixation, compared with the contralateral visible nipple elevation, may also see nipple discharge, bleeding nipple, nipple discharge if we can take for pathological examination, we find that cancer cells. The development of modern medicine, many methods have been used for early detection of breast cancer, and breast X-ray, mammography, radionuclide inspection, infrared thermography display, liquid crystal thermal imaging examination method and ultrasonic inspection, and so on. However, the most fundamental way, or self-breast examination, pay attention to the size of the breast symmetry, whether there is a small nodule, the breast skin, and whether changes in the location of the breast, found suspicious changes in the specialist should be promptly went to the hospital to check.
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Breast cancer surgery to levy?

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For more surgery for early breast cancer is a radical approach, the later of breast cancer band as a palliative treatment. Many methods of breast cancer surgery, all kinds of technique has its indications, as described in the following test:
(1) applicable to radical operation Phase Ⅱ night and Ⅲ breast cancer.
(2) applicable to simplify radical operation; ① Ⅰ and Ⅱ earlier period. ② lobular carcinoma in situ and ductal carcinoma; clinical examination only have eczema-like lesions of eczema-like nipple cancer. ③ certain low-grade malignant breast cancer such as papillary carcinoma, adenocarcinoma, cancer of the Zhuang and adenoid cystic carcinoma. ④ Ⅰ, Ⅱ, Ⅲ breast cancer in patients who are elderly, the infirm.
(3) applicable to the expansion of radical: ① Ⅱ and Ⅲ breast cancer from tumor site, axillary lymph node metastasis and pathological type effects. ② suited to the expansion of radical operation, such as carcinoid tumor rupture, the poultices will be dealt with infection control, during tight bandaging the affected area, and do not hinder expansion of radical operation.
(4) All simple mastectomy applies to: ① some special type of breast cancer such as cystic papillary adenocarcinoma, early papillary carcinoma and eczema very early stage breast cancer, including carcinoma in situ, has not shown up to the regional lymph node metastasis. ② patients because of age is too high or there are other diseases, very difficult to accept the rule of those. ③ certain patients with advanced (such as carcinoid tumor rupture), in order to disarm local pain.
(5) local tumor resection applicable to late stage breast cancer, and the preoperative and postoperative radiotherapy, or regional arterial chemotherapy after surgery.
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Breast cancer is a major cause of what

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The exact cause of breast cancer has not been determined. Because the etiology of breast cancer may be related to a variety of factors, therefore, can only say that the incidence of breast cancer may be related to the following factors:
(1) genetic susceptibility: family history of the survey data indicates that there is a family history of breast cancer incidence than those without a family history should be high. Especially in patients with bilateral breast cancer and age of onset less, these women in the risk of breast cancer for women in general of the nine times, and genetic factors may be related to breast cancer susceptibility of the physical and internal lesions.
(2) endocrine factors: endocrine disorders is one of the causes of breast cancer. Because of long-term breast-endocrine abnormalities stimulation, resulting in cancerous breast tissue, estrogen and progesterone is the most malignant breast closely with the two-endocrine. This has been many clinical, pathological and confirmed by the physiologist.
(3) virus: the virus particles can be transmitted through breast-feeding, resulting in breast cancer, this has been through more animal experiments confirmed, so some scholars speculate the cause of breast cancer may be a virus, but it does not have sufficient epidemiological evidence, to be further studied.
(4) other factors: the body immunocompromised cancer, cancer of the immune function by the inhibition and stimulation breast trauma, radiation damage, and so on, are prone to breast cancer coverage.
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The factors leading to breast cancer

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Breast cancer, the factors are as follows: (1) the real causes of breast cancer is not yet clear, only to understand the occurrence of breast cancer and endocrine, genetic, viral, immunologic, and environmental factors. At the same time clear that some factors and breast cancer are more closely related to these factors have also been described as a susceptibility factor, which includes: Any family history of breast cancer, especially compatriots is a natural mother or sister with breast cancer, if the breast Cancer incidence in premenopausal women, the risk of breast cancer or both, then the genetic susceptibility to markedly stronger. The side of patients suffering from breast cancer, contralateral breast easily than other people suffering from breast cancer, such as pathological diagnosis of lobular carcinoma in situ or focal cancer, breast cancer is just the other side of. Suffered from cystic disease of the breast, especially pathologically confirmed duct with active papilloma, also susceptible to breast cancer. More than the normal two or three times, early menarche (<12 years old), amenorrhea late (greater than 55 years), via life for more than 35 years above. Older unmarried, not pregnant or first child, 35-year-old full-term births in the future. Married not sterile, sterile, not breast-feeding. Pneumothorax or died of tuberculosis, several times to thoroughly chest X-ray examination or chest radiography History. History of dysfunctional uterine bleeding, or Palace of adenocarcinoma. Obese patients, especially in postmenopausal significantly obese or those with hypothyroidism. Immunocompromised persons or lack of. All these factors are more alert to the occurrence of breast cancer. (2) It is reported regular abortion women, the chance of getting breast cancer more. When abortion sudden termination of a pregnancy, is a fight against ovarian function, hormone sudden drop suddenly stop breast growth, acinar atrophy. The ups and downs of this phenomenon is a kind of inverse physiological state, in addition to ovarian dysfunction, but also may cause breast stasis caused mass in a variety of breast disease, breast cancer will increase the possibility. Therefore, many abortion is harmful to health, the incidence of breast cancer is related to, we should pay attention to doing well the initiative of contraception to avoid repeated abortions. (3) breast cancer is not hereditary breast cancer families very sensitive issue from many facts to prove that the incidence of breast cancer is the existence of tendency of family history. Clinical often visible in the mother of breast cancer and breast cancer in daughters are opportunities than women to be more than 2-3 times, and age of onset about 10 to advance. The incidence is even more common among sisters Obviously, if the mother suffering from breast cancer, while the mother is a sister of breast cancer, then his daughter in the risk of breast cancer before the age of 40 of the dangers of breast disease than no family history of the proportion of women suffering from breast cancer 40-50 times higher. If the previous generations are suffering from bilateral breast cancer and their descendants risk of breast cancer than the proportion of families with unilateral breast cancer three times higher, the general women 6-9 times.
In fact, breast cancer is not genetic, and the high incidence of breast cancer families, is the human genetic factors on the incidence of breast cancer by various indirect effects of what happened. Therefore, in patients with hereditary breast cancer is not on the tumor itself, but a tumor susceptibility. On this basis, exempt from the environment, diet, psychological state, endocrine status of a combination of factors such as the impact is a more ordinary people are more likely to have tumors. In short genetic breast cancer will not directly or indirectly there is the susceptibility, is continuing exploration and research.
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And the status quo against breast cancer

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Breast cancer is endangering the health of women malignant tumors, the incidence of breast cancer with misprision, after more poor characteristics. Breast cancer occurred mainly in the female, male rare, the incidence of women for men nearly a hundredfold. North America, is the Nordic regions with a high incidence of breast cancer, the incidence rate of about Asia, Africa, Latin America four times. Although China is the low areas of breast cancer, but its incidence is increasing year by year, especially Shanghai, Beijing, Tianjin and China's coastal regions with a high incidence of breast cancer, the highest in Shanghai, Shanghai in 1972 of breast cancer incidence rate of 20.1 / 100000, 28/10 million in 1988 compared with an annual average of 2% - 7 percent increase. According to statistics, there are about 1.2 million worldwide each year of breast cancer in women, there are 500,000 women die from breast cancer. Currently the incidence of breast cancer has been the first female malignancy leapt to the first two, the mortality rate as high as 40 percent. On the serious harm to human health has caused the World Health Organization and the medical profession are highly valued.
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The incidence and mortality of breast cancer

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Each of the new world of female breast cancer patients found that more than 1.3 million, oh desires of the women in each of 25 ~ 45 million. Breast cancer has become a threat to the health of women a major cancer types. According to the information released by the World Health Organization, in 1982 the world of breast cancer standardized incidence rate of about 11 to 80/10 million, the mortality rate is about 0.7 ~ 28.6/10 million. However, different countries and regions of morbidity and mortality significantly different. China's relatively low level of breast cancer, no significant regions with a high incidence of breast cancer, deaths were distributed state, usually in large cities and the mortality rate higher than that of small and medium-sized cities, urban than rural areas, which may be related fertility, nutrition, and environmental factors .
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Breast Fibroadenoma the diagnosis and treatment

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Breast Fibroadenoma of the above symptoms, signs, diagnosis is not difficult, there are difficulties when feasible breast X-ray and B-ultrasonic examination, chest Perspective infrared inspection and, if necessary, to fine needle aspiration, to learn to check cells confirmed.
Once the diagnosis of breast fibroadenoma, should visit local excision of the breast, more than can be cured. From time after relapse. Should be included in tumor resection, as well as the surrounding tissue at least 0.5 cm in normal tissues, or to resection of the breast section, a few recurrent again surgical resection, and more good results. After resection of tumor histologic must send checks to clear pathological diagnosis.
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Breast Fibroadenoma in which the symptoms are?

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1, mass. Most inadvertently discovered a breast tumor, 2 / 3 the size of the mass in the 1 cm-3cm, the individual reached 10 cm or more, up to 24 cm. In many parts of the breast above, mostly single, a few more hair, a round or oval-shaped, clear borders, smooth surface, with toughness, good activities, and the breast skin and no adhesion.
2, and the pain is mostly painless mass, and only 14 percent had mild pain, or with intermittent or occasional periods when excited.
3, a Qingliang nipple discharge, but rare, accounting for 0.75 percent.
4, axillary lymph node enlargement is not.
Fibroadenoma increased slowly, a few years or more than ten years did not change, but pregnancy and lactation often sharply increased, to the tremendous development, called adenofibroma of the giant, in the event of menarche before the fibroadenoma called puberty fibroadenoma.
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Genetic breast cancer will be discussed

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Genetic breast cancer is not sensitive to the issue of breast cancer families from many facts to prove that the incidence of breast cancer is the existence of tendency of family history. Clinical often visible in the mother of breast cancer and breast cancer in daughters are opportunities than women to be more than 2-3 times, and age of onset about 10 to advance. The incidence is even more common among sisters Obviously, if the mother suffering from breast cancer, while the mother is a sister of breast cancer, then his daughter in the risk of breast cancer before the age of 40 of the dangers of breast disease than no family history of the proportion of women suffering from breast cancer 40-50 times higher. If the previous generations are suffering from bilateral breast cancer and their descendants risk of breast cancer than the proportion of families with unilateral breast cancer three times higher, the general women 6-9 times.
In fact, breast cancer is not genetic, and the high incidence of breast cancer families, is the human genetic factors on the incidence of breast cancer by various indirect effects of what happened. Therefore, in patients with hereditary breast cancer is not on the tumor itself, but a tumor susceptibility. On this basis, exempt from the environment, diet, psychological state, endocrine status of a combination of factors such as the impact is a more ordinary people are more likely to have tumors. In short genetic breast cancer will not directly or indirectly there is the susceptibility, is continuing exploration and research.
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What are the signs had breast cancer

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According to illness sooner or later breast cancer and different types of pathology, clinical performance is not the same. In addition to breast cancer lumps early, the overwhelming majority of patients do not have breast pain and cosmetic change. Breast cancer early, as single or multiple small lesions, and gradually increase, when the development of breast cancer to a certain degree before clinical symptoms appear.
(1) mass: the majority of patients in the breast lumps inadvertently got to the hospital before diagnosis, this is the most important symptom of breast cancer. Most irregular, spherical or elliptical mass, border-less, and some can also be a flat, small nodular or irregular shapes. Masses will promote early and late can be fixed.
(2) mass surface skin: Breast cancer can be developed to a certain degree of skin, the skin over the place, the signs of levy known as the dimple. Thickening of the skin edema, a "orange peel-like edema." Advanced mass surface skin ulcers, easy bleeding, its unpleasant smell.
(3) nipple discharge: a few patients papillary serous outflow of blood or liquid, for the performance of the cancer early.
(4) changes in nipple: mass can increase breast deformation, nipple retraction, invagination, a contralateral elevation.
(5) pain: the pain of breast cancer does not generally, about 1 / 3 of patients with pain or tingling in varying degrees.
(6) the transfer: the development of breast cancer to a certain degree can be transferred to the lung, liver, bone, brain and other distant organs.
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Thyroid terminally ill breast vigilance

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Thyroid disease-hyperthyroidism, goiter, to the beginning of the Bore hyperhidrosis irritability, loss of appetite, weight loss in the medium-term flustered, rapid heartbeat, fatigue way to insomnia, thick neck late, exophthalmos, tongue trembling hand, women do not menstruation tune.
Improper treatment of hyperthyroidism, will be complicated by heart disease, diabetes, myasthenia gravis, cancer, liver disease. Research shows that long hyperthyroidism, antithyroid drugs will be used to accelerate the occurrence of thyroid cancer, and promote liver cirrhosis, liver ascites. 90% of patients with hyperthyroidism died of liver damage in the merger. This is modern medicine can not overcome the problem, the experts stressed that attaching importance to long-term treatment of traditional Chinese medicine, once.
Mastitis and Breast Disease-proliferation performance for Xiongle pain, irritability, lymphoid hyperplasia and breast, head back discomfort Irregular Menstruation, carcinogenesis.
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Intestinal obstruction in children with fever should?

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Obstruction is more common in children during a disease caused by many reasons, a clinical paroxysmal abdominal cramps, vomiting, defecation or anal not exhaust for the main performance. Fever is not the specific performance of intestinal obstruction, but it can be found in many cases the intestinal obstruction. So under what circumstances this disease, there may be fever? Develop fever which issues they should pay attention to?
Fever generally seen with intestinal obstruction due to severe pneumonia, intestinal infections, peritonitis and sepsis caused by pathogenic intestinal paralysis, which caused the obstruction was particularly prevalent in young infants. In other words, especially when the children are small baby in severe diseases, in addition to fever, the symptoms, if there intestinal obstruction typical performance, should be on high alert, to avoid adversely affect the condition.
From such severe intestinal obstruction secondary infection with fever, clinical treatment of the primary disease-based, that is, non-surgical therapy, to the anti-inflammatory, antipyretic cooling At the same time, should be fasting, gastrointestinal decompression, needles thorn Zusanli, Gegujue, confirmed no mechanical intestinal obstruction, can be prescribed for the new Andean peristalsis.
In short, with fever, intestinal obstruction, that is, to attach importance to the evolution of intestinal obstruction, can not neglect the treatment of the primary disease. So children can resume as soon as possible guarantee health.
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Obstruction of prevention and care

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Nursing: fasting water, gastrointestinal decompression to relieve abdominal distention. Semi-supine posture elections, so as to reduce the pressure on the diaphragm. Closely observe the changes of the disease, if the disease increased. Should be vigilant strangulating intestinal obstruction occurred, timely surgical treatment.
Prevention: the adhesive bowel obstruction in remission should pay attention to diet, not eating hard food, catering mainly to dilute Ruan Yi. Ease of roundworm intestinal obstruction after insecticide treatment should be held, with the exception of drugs, insecticide can be used oxygen therapy expelled intestinal roundworm. Do not eat three square meals after a fierce campaign to prevent the occurrence of volvulus.
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Breast Fibroadenoma will deteriorate?

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This is most concerned with the issue of breast fibroadenoma Although benign, there are a very small number of malignant transformation possible. Tianjin Tumor Hospital Liyunyang such reports, the hospital treatment in 1945-1990, a total of 10,316 cases of breast fibroadenoma both the pathological diagnosis and surgical resection, four cases of malignant breast fibroadenoma, breast fibroadenoma for the same period of 0.038 %. This shows that the tumor is cancerous, but a very low rate of malignant transformation. Generally believed that less than 1 per cent.
Therefore, once the diagnosis of breast fibroadenoma, surgical resection should be held. If after many years of static mass suddenly increases rapidly, there pain and axillary lymph nodes should be highly suspected malignant transformation possible, should be to find specialists immediately clear diagnosis, aggressive surgical treatment.
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Mechanical treatment of intestinal obstruction

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All patients with suspected small bowel obstruction should be hospitalized, the treatment of acute intestinal obstruction and diagnosis must be at the same time. Treatment should be based on this fact: surgery on clear strangulating obstruction diagnosis is essential.
Small bowel obstruction nasal catheter insertion, and to attract. Small bowel obstruction, using a long tube rather than surgery, a simple intubation aspiration can be tested in the treatment of early postoperative adhesions or obstruction caused by repeated obstruction without abdominal symptoms. Although to spend two or three hours to improve the situation of the poor state of patients with dehydration and access to certain Bainiaoliang, but most surgeons tend to early Caesarean section.
Indwelling catheter in the bladder to monitor Bainiaoliang. Should start intravenous fluids (Ringer's lactate solution suitable) and the electrolyte. If repeated vomiting, serum sodium and potassium may be reduced, should be added, and must continue to maintain fluid balance, every day should be at least a determination of serum electrolytes. Dehydration of patients, the determination of central venous pressure can be helpful. If possible, try to remove the primary lesion. Measures should be taken to prevent recurrence, including hernia repair, and removal of foreign body completely releasable adhesive.
Obstruction of gallstones can be removed stones resection, but also at the same time or after a cholecystectomy (see section 48 of cholelithiasis). Gastrolithiasis is another reason for the cause of the obstruction can be removed by endoscopy (see section 24). More common approach is adopted by the laparotomy intestinal resection removed. Diffuse involvement of the small intestine, peritoneal cancer adult small bowel obstruction due to the leading cause of death. Short-circuit any obstruction to the efforts seems to be the only short-term help.
Adults, including the treatment of duodenal obstruction removal or resection of the lesion could not be used in palliative gastrojejunostomy of (the child patient's treatment can be found in section 201 of gastrointestinal defects).
Basically, the treatment of intestinal obstruction and similar small-bowel obstruction. In the need for emergency surgery before nasal gastric attract, intravenous fluids and electrolytes and indwelling catheter.
Usually be Ⅰ stage resection and anastomosis of the treatment of obstructive colon cancer. Other options include changing the colon ostomy and anastomosis, the occasional need to make ostomy for further extension of resection. When diverticula inflammation caused obstruction, it may be associated with perforation. If a perforation and diffuse peritonitis, although it is very difficult to involvement with the region, but there are indications for surgery, colon resection and postoperative stoma, the anastomosis should be postponed. Fecal impaction often occurred in the rectum, fingers will be available feces removal. However, the mere bezoar or barium or with a mixture of acid can cause complete obstruction (often in the sigmoid colon), the need for laparotomy.
Cecal reverse involvement Changduan including the treatment of resection and anastomosis or by cecal ostomy will be fixed in the caecum normal position. Reversed in the sigmoid colon, abdominal X-ray that the expansion of intestinal loop of sigmoid colon, rectum or long endoscopic tube can be used for regular bowel loop decompression, surgical resection and anastomosis may be delayed a few days, not for resection, recurrence is almost inevitable.
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Surgical treatment of intestinal obstruction

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Various types of strangulating intestinal obstruction, gastro-intestinal cancer and congenital deformities caused by intestinal obstruction, as well as non-surgical treatment of patients null and void, to surgical treatment. Acute intestinal obstruction due to the patient's general condition often more serious, and the principle of operation is: surgery in the shortest possible time, the simplest way to disarm intestinal obstruction and the restoration of the patent. Specific surgical methods according to the obstruction causes, nature, location and general conditions.
(1) small-bowel obstruction: The simple small-bowel obstruction, the general response from the direct reasons for the lifting of obstruction, such as adhesion release, with narrow Changduan, if not impossible, to be obstructive near the distal intestinal loop to do side-to-side anastomosis surgery to restore lumen patency. The patient generally poor or partial resection of the lesion could not low obstruction, intestinal fistulization feasible, the temporary lifting of obstruction. Intestinal obstruction such as high as ostomy can cause plenty of liquids and electrolyte loss, it should not be used.
Strangulated of small bowel obstruction, should fight for the lifting of the necrotic bowel obstruction before and restore intestinal blood circulation. Correct judgement of the importance of the vitality of intestine, such as obstruction reason for the lifting of any of the following performance. No vitality intestine is illustrated:
① wall appears dark black or Ziheise;
② tension and wall has lost its ability to wiggle, a bowel paralysis, expanding, and to stimulate a contraction;
③ corresponding terminals small mesenteric artery without throb.
If suspicious, available isotonic saline gauze fomentation, or 0.5% procaine solution for the mesenteric root closed. If the observation of 10 to 30 minutes, no improvement has been the intestinal necrosis should be intestinal resection.
(2) acute colonic obstruction: As the role of ileocecal valve, colon more complete obstruction of a closed loop obstruction, pressure within the lumen at much smaller intestinal obstruction, the blood supply to the colon or small intestine as rich as to cause intestinal wall revascularization obstacles, and the bacteria in the colon, so a bowel resection and anastomosis, and often not easily healed smoothly. Therefore, the simple colonic obstruction, the general obstruction proximal (cecal or transverse colon) ostomy to relieve the obstruction. If there intestinal necrosis, are advised to stump removal and external necrosis Changduan for fistulization, and so after two operations to resolve the colon lesions.
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Obstruction of prevention

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Based on the causes of intestinal obstruction, targeted to take certain preventive measures, which can effectively prevent and reduce the occurrence of bowel obstruction.
1. Of patients suffering from abdominal hernia should be timely treatment to avoid incarceration, a strangulating obstruction.
2. Strengthening health information, education and form good health habits. Prevention and treatment of intestinal ascariasis.
3. Peritonitis after major abdominal surgery and the sick should be a good gastrointestinal decompression, a surgical procedure to be flexible, to reduce or avoid abdominal infection.
4. Early detection and treatment of gastro-intestinal tumor.
5. Early activities after abdominal surgery.
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Obstruction of ambulance measures

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1  lifting of the reasons for intestinal obstruction and restore intestinal patency. (1) bumpy therapy, applied early volvulus, adhesion caused by intestinal obstruction. Method: for patients who remain behind or the side, the patient abdominal relax ptosis, Hebao hands of those patients Fuxia, Picking up patients after abdominal suddenly relaxed, and gradually increase bumpy. Each row 3 to 5 minutes, rest 1 to 2 minutes, at least three to four times more patients with euphoria, and then relieve symptoms, defecation flu. If invalid taken to the hospital for treatment as soon as possible. (2) air enema reduction of oral or vegetable oil caused by the obstruction of intussusception in children effectively. (3) surgery. Especially the imposition of extra intestinal obstruction and intestinal tumors caused by obstruction.
2  gastrointestinal decompression reduce gastrointestinal fluid and reduce abdominal distension, to prevent vomiting, and can be injected into medicine. 3  intravenous infusion supplementary nutrition and water. 4  painkillers and antiemetic generally does not work, not as far as possible.



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Chronic intestinal pseudo-obstruction of clinical features and diagnosis

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Chronic intestinal pseudo-obstruction (CIP) is a neuromuscular disease intestine caused by intestinal motility disorders, recurrent or performance to the continued existence of intestinal obstruction without evidence of mechanical obstruction is a rare disease. In order to analyze the performance of the CIP clinical features and diagnostic methods. We Beijing Union Medical College Hospital from November 1978 to December 2000 CIP diagnosis of 23 cases of patients with clinical data are summarized and analyzed.
CIP diagnostic criteria: (1) on the clinical signs and symptoms of intestinal obstruction (2) abdominal plain film confirmed the existence of obstruction; (3) the inspection clearly ruled out mechanical intestinal obstruction (4) gastrointestinal imaging examination revealed dilated intestine, or bowel movements slowed, disappeared or (5) of abnormal pressure on the digestive tract, gastrointestinal transit time was significantly longer.
The results showed that 23 cases of male patients with CIP nine cases and 14 females, aged 4 to 75 years (median age 50 years). Course of a month to 20 years (median 3). Seven cases of intestinal obstruction for intermittent seizures. CIP main symptoms in patients with abdominal distension: (87%), abdominal pain (56.52%), diarrhea (65.22%), constipation (47.83%), vomiting (39.13%) and weight loss (82.61%). The group highlighted abdominal distention and abdominal pain in patients with relatively light, with diarrhea, weight decreased significantly and the other parts of digestive tract abnormalities dynamic performance. Penglong patients with abdominal CIP is the most common abdominal signs (65.22%), 7 cases of intestinal type (30.43%), 3 cases peristalsis wave (13.04%) in the presence of obstructive Changming sound normal (30.43%), or weakened (47.83%), there are very few signs of mechanical intestinal obstruction. 85% of patients with intestinal obstruction in the attack on the presence of abdominal plain film of a number of gas plane, we can see that universal expansion intestine, colon Gas (65%). Gastrointestinal barium contrast clearly showed that intestinal expansion (82.61%), bowel movements slow and disappeared (73.91%), all patients had not found evidence of mechanical obstruction. Some patients with gastrointestinal dynamic low anorectal dysfunction, gastrointestinal through prolonged. Mainly involving small bowel lesions (82.61%), colon (39.13%). Four cases accepted laparotomy and surgery. 18 patients with chronic idiopathic intestinal pseudo-obstruction, including one case of the family of visceral myopathy; five cases secondary to connective tissue disease.
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Five symptoms of intestinal obstruction

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Obstruction is the main clinical manifestations of abdominal pain, vomiting, abdominal distension, no anus and no stool exhaust.
(1) abdominal pain: simple mechanical intestinal obstruction is generally intense paroxysmal colic.
(B) vomiting: vomiting in the obstruction can occur soon after, and then enter a period of quiescent, then vomiting of time depending on the site of obstruction.
(C) abdominal distension: obstruction occurred in the stomach generally for a period of time after beginning to emerge.
(D) exhaust stop defecation: Complete obstruction after defecation exhaust stop.
(5) shock: Early simple obstruction sick, and no significant changes in body, later, there will be small pulse rate, blood pressure dropped and looking pale, eyeball depression, skin elasticity diminishes, cold extremities, and other signs.
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Adhesion of the clinical symptoms of intestinal obstruction?

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(1) abdominal pain: general for the intense paroxysmal colic. Less pain began, and then her illness became more serious, reached a peak after colic, and the pain is gradually reduced until disappeared. Had a short break after the symptom onset again. Strangulating intestinal obstruction, abdominal pain often persistent pain with paroxysmal intensified.
(2) and vomiting: obstruction early for reflection vomiting, and vomit for food or gastric juice. High small-bowel obstruction, vomiting more frequently, vomiting large number of gastric, duodenal fluid and bile. Small bowel obstruction low, there may be vomiting quiescent 1-2 days, after the vomiting, vomit for the soiled with feces kind of stinky. If the strangulating obstruction, can be a bloody vomit or brown.
(3) abdominal distension: intestinal obstruction in general after a period of time. Abdominal distension and extent of the obstruction site. High obstruction, abdominal distension less, but sometimes that gastric type. Obstruction is low performance for the whole abdominal swelling, accompanied intestinal type.
(4) Exhaust anal stop defecation: acute complete obstruction, no anus defecation exhaust. As peristalsis in the early increase in the following positions obstruction of gas and fecal residue can be discharged. Therefore, a small amount of exhaust early bowel obstruction in the diagnosis can not be ruled out. Strangulating intestinal obstruction may be discharged liquid or blood samples would jam.
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The basis for obstruction

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1. Correct water, electrolyte and acid-base balance disorders: regardless surgical and non-surgical treatment to correct water, electrolyte and acid-base balance disorder is a very important measure. Is the most commonly used intravenous infusion of glucose solution, isotonic saline; such as obstruction has been in existence for a few days, and potassium to the high frequency of small bowel obstruction and vomiting patients is particularly important. However, the capacity and type of infusion required to be in accordance with vomiting, dry signs, blood concentration of the urine output and proportion and, in conjunction with serum potassium, sodium, chlorine and carbon dioxide combination of the results of monitoring. Simple intestinal obstruction, especially early, the physiological disorder more easily corrected. Late in the simple obstruction and strangulating intestinal obstruction, remains to be lost to the plasma, whole blood or plasma substitutes to compensate for the loss to the abdominal cavity or lumen and blood plasma.
2. Gastrointestinal decompression: treatment of intestinal obstruction is one of the important methods. Through the gastrointestinal decompression, the gastrointestinal absorption of gases and liquids, can alleviate abdominal distension, intestinal reduce the pressure to reduce the intestinal bacteria and toxins, improve blood circulation intestinal wall, and is conducive to improving the situation of local and systemic disease.
Gastrointestinal decompression generally use the shorter cavity-gastric tube. But low intestinal obstruction, can be used longer M-A double-lumen tubes, the gas injection can be lower with the film capsule by peristalsis promote balloon catheter obstruction brought to a site, decompression effective.
3. Toxemia and infection prevention: use of antibiotics to combat bacterial infections, thereby reducing toxins have a certain role. Applications may generally simple obstruction, but simple intestinal obstruction late, especially strangulating intestinal obstruction, as well as surgical treatment of patients, should be used.
In addition, can also be applied tranquilizers, Antispasmodic agents generally symptomatic treatment, the application of pain is to follow the principle of treating acute abdomen.
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The importance of a clear diagnosis of intestinal obstruction

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Paroxysmal abdominal cramps, vomiting, abdominal distension, and stop defecation, venting, intestinal, Chang Ming Yin hyperthyroidism, gas, the sound of water is the basis for the diagnosis of intestinal obstruction. Finally, the X-ray examination can confirm that the clinical diagnosis. Therefore, inquired in detail about history of the development process, the systematic physical examination is extremely important. However, it must be pointed out that in some cases it is impossible to these typical symptoms shown. Even, it is possible confusion with a number of other diseases, such as acute necrotizing pancreatitis, ureteral stones, such as ovarian cyst torsion. Thus, accurate diagnosis of intestinal obstruction is very important.
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How simple diagnosis and strangulating intestinal obstruction?

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Identification of the two is very important, because the two obstruction in their prognosis and choice of treatment methods are completely different. Simple adhesion induced intestinal obstruction, should be the first choice of non-surgical treatment. Strangulating intestinal obstruction of the blood supply obstacles exist, intestinal necrosis have occurred at any time, the possibility of peritonitis, surgical treatment should be adopted immediately. Simple and strangulating intestinal obstruction in the differential diagnosis, and sometimes there are some difficulties when any of the following performance, strangulating should consider the possibility of bowel obstruction.
(1) Multi acute onset, may have been secondary to the simple presence of intestinal obstruction.
(3) increasing the pulse of more than a fast early, hypotension or shock, narrow pulse pressure, temperature increase.
(4) abdominal lesions muscle tension, tenderness and anti-Tiaotong fixed.
(5) for the bloody vomit blood from the anus or liquid.
(6) a peritoneal fluid, the liquid can puncture bleeding.
(7) the active non-surgical treatment, the symptoms did not improve.
Early clinical strangulating intestinal obstruction preoperative misdiagnosed as simple obstruction are not uncommon. We think that if we can not rule out strangulating intestinal obstruction, should actively carry out surgical exploration.
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Intestinal obstruction in children

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Intestine, or bowel lesions caused by intestinal contents of obstacles, called intestinal obstruction. Cause intestinal obstruction due to a two categories, one category called mechanical intestinal obstruction, and more as intestinal atresia and stenosis, adhesion, intestinal tumors, intussusception, volvulus, and other causes. Another called functional bowel obstruction, and more as indigestion, colitis, peritonitis, pneumonia, sepsis and after abdominal surgery causes such as paralysis caused by enterovirus. After a bowel obstruction due to intestinal contents blocked intestine peristalsis disorder, in children, there will be Futeng, vomiting, defecation exhaust anal stop, the symptoms of abdominal distention. As the disease progress, the symptoms gradually worsened and abdomen-line perspective can be seen film and intestinal bloating and gas liquid, such as abnormal signs.
At the same time due to the large intestine exudate, vomiting, as well as a large number of gastrointestinal absorption toxin, and other factors, occurred in children dehydration, acidosis, mental sluggishness, irritability or lethargy, fever and a series of systemic change. If with intestinal ischemia and necrosis, intestinal perforation, can be life-threatening.
Once in a timely manner obstruction to the hospital to identify the reasons for obstruction, the timely processing. Despite chronic obstruction disease gentler, but often more severe, but also to early treatment.
Home care to the South
1. Mechanical obstruction of treatment to surgery, especially intestinal some congenital deformities, such as congenital intestinal atresia, the importance of timely surgery, but some diseases, such as intussusception, the overwhelming majority of the gas can be enema treatment, and as adhesion ileus, a considerable part of the children with fasting, gastrointestinal decompression, Chinese medicine, infusion therapy, and other conservative and mitigation.
2. At present the most common mechanical intestinal obstruction three diseases, namely adhesive intestinal obstruction, the assessment of intussusception and groin oblique incarcerated. Functional bowel obstruction caused paralysis against major diseases treatment, such as pneumonia associated with paralytic ileus, the main treatment of pneumonia, accompanied by fasting, gastrointestinal decompression, Xichang and other conservative therapy and reduce the symptoms of intestinal obstruction, the real need surgery rarely.
3. Strangulating intestinal obstruction due to severe illness, rapid development, should be actively treated and timely surgery to prevent serious toxic shock, and intestinal necrosis caused by the excessive deaths.
Notes
1. No matter what obstruction, Weishui or not children can eat, and observing Futeng, vomiting and defecation in the exhaust. Such as sick child or severe abdominal distension Futeng gradually increase, or irritability, phenomena such as fast pulse, her illness became more serious note, should be promptly taken to the hospital clinics.
2. Home after surgery in children must pay attention to diet, eat less or eat cold food, such as Health Boshu, peanuts, beans, and so on, to prevent the stimulation of gastrointestinal obstruction recurrence.
3. Attention to the sick child warm, not cold cold.
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How the clinical diagnosis of intestinal obstruction

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Abdominal pain: for the performance of mechanical obstruction of paroxysmal abdominal colic, which is due to overcome the obstruction, caused by increased intestinal peristalsis, abdominal pain can be accompanied by attack Changming. If the period of intermittent abdominal pain shortened, or even become a persistent abdominal pain, may be strangulating intestinal obstruction performance.
Vomiting: Early obstruction, was vomiting reflex, or out of the Food and gastric juice; general, the higher the position obstruction, vomiting there sooner, and the more frequent, and low obstruction and colon obstruction, vomiting and later appeared less out of can be a fecal sample.
Abdominal distension: There is late. Not obvious obstruction high abdominal distension, intestinal obstruction low abdominal distension and colonic obstruction is obvious.
Exhaust anal stop defecation: complete intestinal obstruction after patients do not exhaust defecation. However, a small number of patients still remaining in the obstruction following stool and gas, can be discharged, it must not be denied the existence of intestinal obstruction.
A general acute physical suffering face, the early signs of life in general a little change. Advanced there will be increased body temperature, shortness of breath, blood pressure decreased by fast pulse performance.
There will be signs of abdominal intestinal type, creeping wave, abdominal tenderness there, there can be a strangulating anti-Tiaotong and muscle tension. Some patients can be touched abdominal mass. Strangulating intestinal obstruction can occur ascites, Kouzhen mobile voiced can be heard. Auscultation: mechanical intestinal obstruction can occur Changming sound of water hyperthyroidism polite tone. Strangulating intestinal obstruction Changming Music weakened or disappeared. Blood: blood leukocyte count in general increased 10 × 1O9 / L, strangulating intestinal obstruction often in the 15 × 109 / L, neutrophils increased.
Determination of serum carbon dioxide: When a metabolic acidosis, the combination of carbon dioxide can be reduced.
Determination of serum electrolytes: there will be hypokalemia, hyponatremia and low chlorine.
X-ray examination: Perspective standing position that many of intestinal bloating and gas plane loop.
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How to diagnose intestinal obstruction

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Abdominal signs: mechanical intestinal obstruction and intestinal peristalsis often visible wave. Volvulus, abdominal distension and more asymmetric. Paralytic ileus abdominal distension uniform; simple expansion of intestinal obstruction, mild tenderness. Strangulating intestinal obstruction can be fixed tenderness and muscle tension, a small number of sick could touch mass. Roundworm intestinal obstruction often touch on the central abdominal cord-like clumps when there peritoneal exudate, there will be mobile voiced; colic attack, Chang Ming Yin hyperthyroidism. Have a gas water, metal sound. With necrotic bowel obstruction, perforation occurs when peritoneal irritation. Paralytic ileus, the Chang Ming Yin weakened or disappeared.
Low obstruction such as digital rectal examination touched mass may colorectal cancer, the development of intussusception extremely hedging, or colon tumor.
X-ray examination: abdominal X-ray examination in the diagnosis of help from vertical perturbation of the best films, such as the frail not desirable left upright and supine positions. Laboratory examination: blood white blood cell count, hemoglobin, hematocrit were higher Nibichong also increased blood pH, and carbon dioxide combining power decline, reducing serum potassium.
Paroxysmal abdominal cramps, vomiting, abdominal distension, and stop defecation, venting, intestinal, Chang Ming Yin hyperthyroidism, gas, the sound of water is the basis for the diagnosis of intestinal obstruction. Finally, the X-ray examination can confirm that the clinical diagnosis.
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Breast Cancer common signs and symptoms?

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Breast cancer is the most common symptom of breast lumps. Moreover, the mass is often the first symptom, breast asked about the total number of cases more than 95 percent, can promote tumor depends on the degree of tumor humid. Breast cancer early and mid-mass Department promoted, advanced liver block is not completely fixed easily promote.
The second most common symptom is nipple discharge, occurred in about 10% of breast cancer cases. A nipple discharge is the only symptom of breast cancer relatively rare, if accompanied by breast lumps, breast cancer on the possibility of a relatively large.
Abnormal changes in the breast skin is also common symptoms of breast purpose. Such as: ① breasts sag or wrinkled skin, the skin cancer have been involved or partial breast tissue tumor infiltration has been caused fibrosis and contracture. ② When breast cancer widespread violations of the skin and subcutaneous lymphangioma, orange peel kind can cause edema. ③ skin ulcer disease was particularly prevalent in the long and bulky advanced breast cancer, and poor prognosis. ④ skin nodules satellite is due to a number of tumor thrombus with lymph backlash, the majority of the development of focal skin metastasis. This is a more advanced signs. ⑤ if multiple sets of the film festival, the skin becomes hard and rough, the color darken, like armor like, such lesions can be extended and large scope.
Reduction in the nipple, elevation, pruritis, such as the cleft or abnormal erosion, malignant breast disease is easy to see the symptoms, which should attract attention and a high degree of vigilance.
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What are the clinical manifestations of breast cancer

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In addition to breast cancer lumps early, the overwhelming majority of patients do not have breast pain and cosmetic change. Breast cancer early, as single or multiple small lesions, and gradually increase, when the development of breast cancer to a certain degree before clinical symptoms appear.
(1) painless mass: is the most common clinical manifestations. Most patients due to the breast painless mass from hospital treatment. Once a breast painless mass, should be asked in detail about history, growth rate, location, tumor size, texture, activities, but the law or the situation, and whether there is a swelling of the lymph nodes, etc.. Painless mass mostly irregular, spherical or elliptical mass, border-less, and some can also be a flat, small nodular or irregular shapes. Masses will promote early and late can be fixed.
(2) changes in the breast skin: cancer violations LOOPER's ligament lead to shorter downward pull the skin, the skin caused partial depression, the so-called "dimple levy." Thickening of the skin edema, hair follicle is particularly deep, a "orange peel-like" change. Advanced mass surface skin ulcers bleeding, Aichou unpleasant. These are the salient points of breast cancer.
(3) nipple discharge: the pathological nipple discharge refers to the unilateral or bilateral non-pregnancy nipple secretion colorless, white, brown or bloody fluid volume can be more than less, a water sample, the sample size or noble sentiments, The pathological nipple discharge are not breast cancer, breast cancer patients to pathological discharge can be found is an important disease symptoms.
(4) changes in nipple: Below at or near the nipple could lead to mass Rutouaoxian or elevation, or the side of bias, can be found on both sides of nipple is not the same level. Eczema carcinoma nipple and areola with eczema-like change, and even scars, fester.
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Prognostic factors affecting breast cancer

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Solid impact on the prognosis of breast cancer in many, their mutual relations complicated, it should be integrated various factors to estimate the prognosis of patients.
The main factors affecting the prognosis in the following areas:
(1)-Clinical storm;
(2) Age: Case is generally believed that the younger the rapid development of tumors, lymph node metastasis, and poor prognosis;
(3) the primary tumor size and local infiltration: in the absence of regional lymph node metastases and distant metastasis circumstances, the primary local infiltration and the greater the more serious, the worse the prognosis;
(4) lymph node metastasis;
(5) the pathological tumor type and degree of differentiation;
(6) steroid hormone receptor;
(7) rate of cell proliferation and DNA content;
(8) oncogene.
The etiology of breast cancer has not solved the problem, it really can be used for a very limited means of prevention, but cautiously to reduce breast cancer risk of several measures it is possible, if appropriate restraint adolescent fat and animal protein intake to increase sports activities to encourage breast-feeding babies, menopausal women to avoid using estrogen after menopause appropriate increasing physical activity, controlling total calorie and fat intake, and avoid unnecessary radiation exposure, etc..
Surgical treatment of breast cancer has a long history, there are various changes in the scope of operations. In recent years, the development of breast cancer because of a new concept, that the incidence of breast cancer is one from systemic disease, breast at the same time in order to keep the shape and upper limb function in a wide range of less than surgical resection of the whole milk and Comprehensive Application of radiotherapy and chemotherapy. In Europe and the United States and other countries, radical or modified radical mastectomy of the application has been reduced for local surgery and radiotherapy for patients with breast cancer cases has reached 20% to 30%, taking into account for breast reconstruction. At present in the diagnosis and treatment of breast cancer, has not only satisfied with the malignancy and whether the lymph node metastasis, but called for postoperative treatment and prognosis provide reference data, such as the observation of blood vessels, lymphatic invasion, receptor determination Flow Detection of DNA content of cells and cell cycle phase in the distribution of monoclonal antibodies for diagnosis and treatment. In recent years, with the cancer gene research has been constantly deepened, and many found the prognosis of breast cancer-related genes. Expected in the near future, people can pass the test to determine the prognosis of patients as well as on the high risk of relapse cases select the appropriate adjuvant therapy to improve the cure rate.
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Breast cancer diagnosis?

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Early diagnosis of breast cancer is very important, directly related to the prognosis of the disease, so the diagnosis process to master the following points;
(1) history and asked: System asked history, can help us identify the various breast benign and malignant diseases of the necessary information. Encountered middle-aged and older patients, the tumor appeared to be asked the time, location, speed and growth have made the detection and treatment, with a past of the serious illnesses, whether in the immediate family members of patients with malignant tumors. But also the patients marriage, menstruation, childbirth and lactation history.
(2) physical examination: Apart from the understanding of heart, lung, liver, kidney and central nervous system and other vital organs, but also have to check surface lymph nodes, in particular the Department of the PWC, and other cities in the ipsilateral axillary lymph node size, shape, texture. Liver inspection also can not be overlooked. Local breast cancer screening is an important step in the clinical diagnosis, observation breast skin, and abnormal nipple there, and palpation of skin tumors and tumor extent of the adhesions texture, activity, size, the border is clear, carefully attending areola and palpable good, site, whether orange peel levy, dimple levy, satellite nodules, skin ulcers, such as nipple discharge.
(3) Other inspections: if not diagnosed on clinical examination can be carried out various special inspection. Them to X-ray inspection (mammography or dry plate radiography, duct angiography), cytology (needle aspiration, and the filtrate smears), biopsy, a computer tomography X-ray and B-ultrasonic methods most commonly used, It has high diagnostic accuracy rate.
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Eight-induced breast cancer risk

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Familial:
Those with family history of hereditary breast cancer can be expressed as two forms: as a mother suffering from breast cancer, her daughter has a good breast cancer, age at onset of light, and often occurred in amenorrhea, more bilateral; for another not a mother suffering from breast cancer, but in a family, there are at least two sisters with breast cancer, such families in the incidence of breast cancer than non-family history of breast cancer in the family a high incidence of 2-3 times, and This breast cancer occurred in amenorrhea, often unilateral;
Menstrual factors:
Menarche as early as the age of 12 years old, in the risk of breast cancer 17 years of age at menarche than the 2.2 times menopause late in the 50-year-old, 45-year-old than to risk of breast cancer after menopause increase the risk of a times.
Abortion excessive:
Normal spontaneous abortion does not increase the risk of breast cancer, and repeated abortions, or 18-year-old abortion done many times before, easily trigger breast disease, increase the risk of getting breast cancer.
Artificial feeding:
Breastfeeding is the best natural breast cancer prevention one of the means of Health breastfeeding can reduce the risk of breast cancer 20 to 30 percent.
Poor quality of life:
Breast disease and is closely related to sexual life, women's sexual repression can increase breast lobular hyperplasia and the incidence of breast cancer risk. Related investigations revealed that the breast lobular hyperplasia with 86 percent of the women in the sex life has never reached orgasm; age at marriage is, the higher the incidence of breast cancer.
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When the breast-cancer TB

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Breast TB is supposed to come from? Pathogenesis of a four: First, direct contact, that is the nipple or breast tuberculosis skin wound infection directly. Second, blood infections, such as pulmonary tuberculosis, blood disseminated. Third, the spread of neighbouring TB lesions, such as ribs, sternum, pleural the spread of tuberculosis. Fourth, the lymphatic retrograde disseminated, ipsilateral axillary lymph nodes, neck retrograde supraclavicular lymph node spread to the breast. Tuberculosis with other organs of women, when immune to the low, easy multiple organ of TB infection.
Breast tuberculosis performance diversification, and can generally be their palpable breast nodules or a small abscess, small ulcers, to the hospital at this time should be to inspect the puncture through breast nodules, can be confirmed. Once collapse to wear, fistula formation, wound dressing Fuyu long-term, it should be done from the wound exudates tuberculosis smear and culture, in order to get the bacteriology confirmed.
Breast Cancer Breast misdiagnosed as tuberculosis, as high as 50 percent. A patient has the right breast fester eight months, has been misdiagnosed as breast cancer, several open Bainong, are the purposes of each radial incision, a wheel-like countless scars that breast has become like a squash DISRUPTION Doushabao. After eight months of misdiagnosis, and finally for the pathological diagnosis of breast tuberculosis.
Once diagnosed breast tuberculosis, generally the formal anti-TB medication. TB lesions of the breast alone, the treatment can be completely absorbed. After a cold abscess to be done Bainong incision or puncture. Ulceration of breast tuberculosis, in addition to daily medication, they need daily dressing change. Generally speaking, the formal treatment (6-9 months) anti-TB treatment, the prognosis is good, rare recurrence.
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Breast Cancer What are the different types of pathology

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Pathological types of breast cancer by means of tumor specimens pathological morphology, thereby determining the degree of development of breast cancer, sources, change of the degree of differentiation, and so on. Many types of breast cancer pathology, and some sources named the organization: as lobular carcinoma, ductal adenocarcinoma; some organizational characteristics of the lesions named: If medullary carcinoma, hardware cancer, cancer alone; named in some lesions: If carcinoma in situ, early cancer, invasive carcinoma, but some cancer cells to the differentiation of naming: If undifferentiated carcinoma, and poorly differentiated carcinoma, differentiated carcinoma, well-differentiated carcinoma.
With histopathological closely integrated with the clinical, pathological types of cancer cells gradually to the surrounding tissues based on the extent of violations and the possibility of distant metastasis size classification. Roughly divided into: Non-invasive cancer, early invasive carcinoma, and invasive carcinoma.
(1) non-invasive cancer: also known as carcinoma in situ, that cancer cells confined to the basement membrane of epithelial growth of tumors did not transfer. Including lobular carcinoma in situ and ductal carcinoma. Accompanied the various breast diseases, and sometimes can be seen next in invasive carcinoma. Carcinoma in situ development has been slow and become invasive several years.
(2) early invasive carcinoma: from the development of invasive carcinoma in situ in the early stages of cancer of the epithelial basement membrane breakthrough, but the extent is still infiltrating shallow, less foci in the transfer. Including early invasive lobular carcinoma in situ and ductal carcinoma in early infiltration.
(3) invasive cervical cancer: cancer of the epithelial basement membrane breakthrough has been restricted, widespread violations of the surrounding tissue, tumor metastasis is high. Based on the original cancer site from the mammary epithelial organizations, or other organizations, is divided into invasive cancer special, special non-invasive cancer.
① special non-invasive cancer: including invasive lobular carcinoma, invasive ductal carcinoma, only cancer, medullary carcinoma, hardware carcinoma, adenocarcinoma.
② special invasive cancer include: papillary carcinoma, medullary carcinoma, adenocarcinoma, adenoid cystic carcinoma, adenocarcinoma sweat, squamous cell carcinoma, nipple Pagets disease.
③ rare cancer include: spindle cell carcinoma, sarcoma cancer, signet ring cell carcinoma, fibroadenoma, such as cancer.
Such classification of clinical prognosis is more practical guidance. Generally believe that: good prognosis carcinoma in situ, followed by the early invasive carcinoma, and invasive carcinoma of the poor prognosis. Special invasive cancer and the prognosis is better than non-special invasive cancer.
In addition, pathological classification of breast cancer by histological features are divided into: epithelial tumors, epithelial tissue and mixed connective tissue tumors. Haagensen also Classification: special-cancer and non-specific cancer.
Pathological type is a highly professional in the diagnosis process. First need to obtain accurate breast tumors large enough samples were fixed, technical professionals to deal with pathology (embedding, slicing, staining, etc.), can be processed under the microscope to watch the pathological biopsy, finally, the need to have extensive experience of Pathology doctor "Film" - a pathological diagnosis. Often encountered in clinical practice in other hospitals some patients were diagnosed as breast cancer, treatment in the hospital needs to be done pathological diagnosis. At this point, we must proceed from the original treatment of hospital pathology borrowed have produced good slice of organizations or wax block, to the pathological diagnosis by doctors, not to make accurate pathologic diagnosis.
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What is a pseudo-obstruction, and what are the reasons for the cause?

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Refers to a mechanical intestinal obstruction in patients with clinical manifestations, Caesarean section inspection found only mesocaval expansion blocking lesions. Pseudo-obstruction common causes are:
① intestinal smooth muscle disease;
② myenteric plexus lesion;
③ collagen disease (systemic sclerosis, dermatomyositis);
④ nerve lesions (muscle tension malnutrition, Parkinson's disease);
⑤ endocrine diseases (myxedema, pheochromocytoma);
⑥ Drugs (Clonidine, phenothiazines, tricyclic antidepressants, vincristine). At this point intestinal Electromyography contraction wave lack of visible range or lower, the response of the intestinal expansion disappear or decrease.
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Simple Obstruction

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[Causes pathological]
Obstruction more simple reason for the tumor and inflammation narrow minority of elderly stool for obstruction. Most parts obstruction sigmoid colon and the rectum is regional.
[Clinical]
Abdominal distention, abdominal pain and constipation are the main clinical symptoms, nausea and vomiting for minor symptoms. See physical abdominal distention, abdominal compression is still under soft, no obvious tenderness, and anti-Tao Tong, and occasionally can be mass.
[Imaging performance]
Due to various reasons are simple colonic obstruction intestinal obstruction above and the expansion of effusion, and expand the colon to the proximal colon cavity (from the beginning of the rectum) Obviously, the point of obstruction of the colon near the cavity became smaller, standing films that on both sides of a more lenient abdominal fluid in the pelvic or-see-generous allocation, supine films that expand the colon Commelina benghalensis-like cavity and a half months with mucosal fold cavity wall to enter into and not connecting with the opposite wall, Unlike the jejunal mucosa wrinkle wall. Sometimes, because of the proximal colon obstruction inflatable expand, gas will be beautiful to see the lumen stenosis or obstruction of soft tissue mass kind of direct video features. X-ray can see inflatable expanded the small intestine, but the degree of expansion of the colon than a lighter. Proximal colon obstruction to the main fluid will be misdiagnosed as low small-bowel obstruction, even sigmoid colon obstruction, and if mainly to the lack of contrast effusion, also easily lead to misdiagnosis. At this point should stand perspective, hepatic flexure observed rotational position, inflatable splenic flexure has expanded and inflatable expanded lumen bags, it has not colon lumen of the Trans-wrinkle wall stripes, the judge has important significance of colonic obstruction.
Barium enema (generally with low concentration) to clear the site of obstruction, obstruction and even the nature of obstruction. So for the guitar in the diagnosis of intestinal obstruction, most patients will do dilute barium enema examination clear reasons.
[Diagnosis]
Small bowel obstruction and simple to identify.

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Neural intestinal obstruction syndrome

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[Summary]
Neural ileus (Neurosis Intestinal Obstruction) also known as spastic bowel obstruction, functional bowel obstruction, power intestinal obstruction, Shell homes Mishiji disease, the physician Chercherski levy from the first description of the Soviet Union is also known as the Chercnerski disease. China also reported a small number of cases, the actual levy is not uncommon.
[Diagnosis]
Asked detailed history and physical examination, the vast majority of it is not difficult, in the diagnosis of problems, feasible or abdominal X-ray radiography inspection, such as a gas found in the small intestine and the presence of liquid plane, which is the content of the soup through obstacles, suggested that the possibility of a bowel obstruction, but the disease can be no obvious early X-ray signs of intestinal obstruction, should be particularly vigilant, the diagnosis of this disease primarily on the basis of clinical manifestations, we must not rely solely on X-ray examination to confirm or deny.
[Treatment]
The point is the correct treatment of intestinal obstruction due to the water, electrolyte and acid-base-thin disorders, gastrointestinal decompression to relieve abdominal distention, obstruction top Changduan improve blood circulation, and infection control, Chinese medicine, acupuncture for a certain effect.
[Clinical]
Neural intestinal obstruction can be divided into one. Paralysis of the muscles due to wall movements have lost their inhibitory ability to wiggle, intestinal contents can not run down, found acute diffuse peritonitis, retroperitoneal bleeding or infection.
2. Spastic bowel wall muscle contraction-crack, and often within and outside because of intestinal injury or inflammation, and stimulate foreign body, such as with efficiency. Paralytic ileus minor abdominal pain, mainly as a defecation or exhaust, serious abdominal distention, can cause breathing and heartbeat accelerate and oliguria. Early in the obstruction can be no systemic symptoms, when accompanied by repeated vomiting, dehydration and electrolyte can produce disorder. Paralytic ileus Changming sound extremely weakened or disappeared.
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What is the adhesive bowel obstruction?

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Caused by adhesions is the primary cause of intestinal obstruction, about 40-60% of intestinal obstruction. Adhesions in the abdominal wall and bowel or intestine and bowel between. The formation of adhesions in abdominal surgery, a small number of intra-abdominal inflammation caused. Adhesion to intestinal distorts normal course changes, intestinal contents through these adhesion sites, will be moving in the direction of radical change, if triggered by a blockage of acute obstruction.
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Paralytic ileus

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Paralytic ileus (dynamic obstruction) is due to the normal contraction of intestinal movement arising from the suspension of a bowel obstruction.
With the same mechanical obstruction, paralytic ileus also in the intestinal content of the campaign to stop the gastro-intestinal tract. However, mechanical obstruction difference is that the paralytic ileus were rare cause of intestinal perforation.
Paralytic ileus reasons infection, abdominal or vascular blocking the formation of blood clots within the intestinal blood, atherosclerosis or intestinal artery or vein injury而使intestinal blood obstacles. , Intestinal diseases such as kidney failure or blood electrolyte abnormalities (such as hypocalcemia or hypercalcemia) also can cause paralysis of obstruction. There are also certain drugs for other reasons and hypothyroidism. After abdominal surgery in 24 to 72 hours, often varying degrees of intestinal paralysis.
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Strangulated small-bowel obstruction

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Strangulated small bowel obstruction due to common diseases: reversed, hernia, such as adhesion and invagination. As a small mesenteric involvement, loop activities have been pinned down. Limited extension, and hence loop to a fixed location aggregation performance. Circulatory disturbance caused by bowel wall thickening wall, mucosal fold thickening, enteral fluid, such as high surface change. Closed loop of bowel obstruction, can also be found in "false tumors" sign. Strangulating intestinal obstruction later, the merger ascites, as merger dynamic factors, colon and rectum can be inflated.
Due to different causes strangulating intestinal obstruction it has certain performance characteristics of the X-ray. For example, small mesenteric reversed, hernia and adhesive intestinal obstruction Changduan reverse merger, is often associated with "false tumors" sign; adhesive bowel obstruction in different positions on the X-ray pictures, such as the supine position and after-lateral level, This shows that the small intestine inflatable effusion-reducing activities, in some cases, there may be signs of intestinal and bowel-mustered more acute angle-the performance of acute intussusception in the ileum (or combined appendectomy) sets this type of the most common colon. Major abdominal plain film for the low performance of small bowel obstruction, and sometimes Youfu or upper abdominal mass that gut-shaped distal colon and overlaying plot and sets sheath gas levy. Barium, air enema kits that include all of the obstruction by the end of a cup-shaped or circular mouth filling defect and presentation sheath for barium or gases into the wall between the two tiers of the spring-form video.
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Common cause of intestinal obstruction due to what

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Various types of intestinal obstruction due to the following reasons;
(1) mechanical intestinal obstruction
(1) parenteral factors: ① adhesion and adhesion with oppression. Adhesions can cause intestinal folding, reverse, resulting in obstruction. Congenital adhesions seen more children because of abdominal surgery and intraperitoneal adhesions, the inflammation was particularly prevalent in adults. ② incarcerated hernia, or hernia. ③ parenteral tumor or abdominal mass oppression. ④ volvulus. As often caused by adhesions.
(2) the reasons for the intestine itself: ① stenosis and congenital deformities obturator. ② inflammation, tumor, anastomosis and other factors caused by stenosis. For example, inflammatory bowel disease, intestinal tuberculosis, radiation injury, intestinal tumors, such as intestinal anastomosis. ③ intussusception. See fewer adults, often caused polyps or other lesions.
(3) lumen within reason: As a group of Ascaris lumbricoides, cholelithiasis, and foreign body Fenkuai caused not common.
(B) Power Ileus
(1) of paralytic: major abdominal surgery, peritonitis, abdominal trauma, retroperitoneal bleeding, anesthetics, pneumonia, empyema, hypokalemia, and other systemic metabolic disorder can cause paralytic ileus.
(2) spastic: intestinal inflammation and nervous system dysfunction may lead to temporary intestinal cramps.
(3) obstruction of blood supply
Mesenteric artery thrombosis and embolism or mesenteric venous thrombosis is the main reason.
Intestinal pseudo-obstruction, it is a bowel obstruction signs and symptoms, but no evidence of mechanical obstruction syndrome, it could be acute and chronic, growing attention in recent years, is generally considered to be intestinal neuromuscular degeneration results. Connective tissue diseases, primary myopathy, certain endocrine diseases, diseases of the nervous system and some drugs can cause secondary intestinal pseudo-obstruction, intestinal pseudo-obstruction of the primary reasons is not very clear.
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Colon, rectal cancer in the early signal

Sunday, March 30, 2008 · Posted in

Colon, rectal cancer is a common cancer in the elderly one, as the special characteristics of the incidence, clinical, is likely to result in misdiagnosis. Now its early performance on the following: Food absorption in the small intestine is to be completed until the food arrived in the colon and rectum, has become excretion of waste. People swallow food, first through the small intestine right colon, and then to the left colon, rectum finally arrived. Food residue to right colon, there are still some liquid was not completely absorbed, then the gut contents of a liquid due to right colon wide, it seldom occurred obstruction. But such tumors often secondary infection and chronic toxic absorption characteristics, therefore, the right colon cancer patients suffering from often low-grade fever, night sweats, malaise, anemia and other symptoms. To the food residue left colon, can not be absorbed completely into the waste, from the liquid into a semi-solid. Left colon lumen due to the narrower, smaller lumen to narrow soon change, it appeared easy abdominal distention, abdominal pain, constipation, and other symptoms of low intestinal obstruction. Rectal the end of the digestive tract, early cancer lesions only in the intestinal mucosa, can be no obvious symptoms. But illness gradually worsened, it can stimulate the local tumor symptoms, manifested as increased frequency of stool from 1-2 times the normal daily increased 3-4 times or more, Buchengxing stool. Anal discomfort, a sense of falling, and sometimes abdominal pain, and sometimes blood in the stool and mucus. Colon rectal cancer will occur in the elderly, young people in recent years has significantly increased the incidence, so when you have stool habits change, we, the reasons for the increase or no mucus, it Nongxue For unknown reasons, the low-grade fever, night sweats , anemia or chronic obstruction, it must be vigilant with colon, rectal cancer. If the symptoms should promptly to the hospital for an examination. In the absence of a clear diagnosis, not long-term on-enteritis, diarrhoea treatment, so as to avoid delay in diagnosis.
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Postoperative care how acute appendicitis

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Health acute appendicitis at any age can be a stage, is the most common surgical disease one. Characterized by symptoms of right lower quadrant pain continued, rapid development illness. Should be treated early, which normally takes emergency surgery to be cured, or else they may lead to complications such as perforation. Health acute appendicitis operation after six hours, it is desirable semi-supine, to facilitate drainage and prevent confined to the pelvic inflammatory exudation. After 24 hours encourage patients to get up activities to promote bowel movement and prevent adhesion occurred. Simple acute appendicitis after the first day juice diet flow can eat, eat Ruanshi 2-3 days, four days to eat fresh Pu. If a patient is elderly, the infirm, we should pay attention to warm after a day back to help make the cough and prevent falling plot pneumonia. Bao stool patency.
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