Early esophageal cancer treatment, as well as performance

He McNair: esophageal cancer in the early performance is generally a relatively early, for example, when to eat or occasional burning sensation of pain or discomfort, such immediately to the hospital to check. General inspection in several ways, the common methods of early esophageal cancer is drawing in the net, we pushed a small balloon into the small balloon pull network, we search the Internet link cells.

Second, the contrast study of the esophagus. Third, and most accurate approach is the gastroscope, can be seen in the open.

Generally the early detection of esophageal cancer survival rates after surgical treatment in the 80% to 90%, or even completely cured, early detection of early treatment is very high cure rate.

Moderator: just talking about lung cancer treatment, the next step would like to talk about the treatment of esophageal cancer.

He McNair: esophageal cancer treatment currently the main treatment is surgery, Why? Because of the location of particular importance esophagus is a major channel to eat, if it of things, no matter what method you use a solution obstruction, a meal solution, we can easily understand that only surgery can make this clear, Therefore, surgical treatment is the most important, and even in some respects is very important.

As for why esophageal cancer found that a lot of people especially to the late, and some do not eat any more to come, the timing of surgery on the delay, of course, such a situation may not be surgery, esophageal cancer also involves early detection and treatment .

Moderator: Some patients may feel that their eating difficulties other diseases.

He McNair:, which means that all the people all the knowledge of cancer are not yet in place, and in fact this is very easy to find, easy to esophageal cancer than lung cancer found that much. Very simple, not to eat a comfortable, immediately to the hospital for an examination, esophageal cancer will soon be checked, it is more convenient, easy screening method, not a lot of the trauma, basic no pain, esophageal cancer checks should be relatively simple and easy trip.

Waist soft tissue injury

Waist mainly involved in the soft tissue and spinal movement control muscles, tendons and connectivity of the vertebral body and the back of the fascia ligament, such as synovium. Under normal circumstances, the common link vertebral played the role of flexible and coordinated participation in the activities of the function of spine. Once, directly or indirectly, by the sudden violence external stimulation, impact and twisting flash or excessive traction, causing waist certain soft tissue injury, waist normal physiological function has been damaged, and a low back pain, incoordination, and other symptoms waist. Commonly known as Zhou Yao, blinking waist Chaqi, was particularly prevalent in young adults.
Acute lumbar sprain occurred in the lumbosacral, sacroiliac, and sacral spine on both sides of the joint and muscle, ligament.
Chinese medicine said: “Congestion low back pain, and powerful flash down in the weightlifting. Covered waist, one of the must, pitching flexion and extension, all from the. If there is damage, blood coagulation Shibuya, Meridian Yongzhi, a rate Zhuaice not pain, the clock Shibuya, the light weight is the night ( “Golden wing Juanlu”). briefly described acute lumbar sprain of the etiology, pathology and symptoms.

[Clinical]
One or both sides of the waist pain, lumbar muscle tension, stiffness, restricted activities. Patients often hands hold down the waist to prevent the activities of even more intense pain, the pain may be due to its activities, cough, exacerbated by deep breathing. Can be involved with lower extremity pain, worse not sitting. Apart from the impact of violence, more than local swelling not obvious.

[Signs and inspection]
(1) Discussion
1. Bent down if forced to move heavy objects improperly admitted, could easily lead to the spine and the spine ligament between the ligament injury, pain often injured between spinous process.
2. If forced to carry goods carrying improper, it could easily lead to lumbar muscle injury, pain points in the regular bilateral or unilateral psoas (equivalent Shenshu, sanjiao Yu regional).
3. Bent down, if inadvertently reversed, it could easily lead to iliac after parts of the upper edge of soft tissue injury (or colorectal Yu, Yaowen Point Regional), a tenderness.
4. Walk if inadvertently slipping, with unilateral or bilateral hip, it could easily lead to the sacroiliac joint dislocation and soft tissue damage, pain points in the regular sacroiliac joint region.
(2) function
Make do with flexion, extension, lateral bending, rotation, etc. movements, observe their activities to achieve functional sites, in accordance with the posture with limited activities can be judged from the damaged site.
1. About Cejue are limited and pain, injury and more on both sides psoas.
2. in the spinous process of multiple injuries.
3. If the sacroiliac joint injury, a stretch waist and contralateral Ceque restricted, the affected hip outreach and external rotation limited.
4. If confined to the site of pain and joint tenderness regional Obviously, waist significantly restricted activities of the parties could be considered small joint disorders.
(C) palpation
Patients admitted seat, releasing belts, exposed waist. Doctors used his hands to thumb along the spine, from top to bottom to touch pressure, observe whether spinal scoliosis, whether partial distortion spinous process, there uplift and depression, supraspinous ligament whether peeling, lumbar muscle spasm and whether both sides cord-like reaction and pain points.
In addition, the severe sprain and contusion, to make X-ray, to exclude such as vertebral fractures and spondylolisthesis.

[Syndrome Type]
1. Qichixieyu: blinking down and the strong load, waist severe pain, lumbar muscle cramps, not to straighten her waist, pitching flexion Zhuaice difficulties, or stasis Anjiang Tongue Point, Moss thin veins string tight.
2. Hot and humid Meaning: Labor or improper posture when flash after twisting waist Banchi pain, heartburn flu, with abdominal pain and constipation big knot Niaohuang red, yellow greasy tongue fur, pulse Wenru few.

[Diagnosis]
1. Waist injury history are found mostly in young adults.
2. Waist side or both sides of severe pain, restricted activities, to recover, sitting and walking, and often forced to maintain a certain posture.
3. Gluteal muscle tension and back muscle spasm, can be hit or cord-like reaction, the injury site and obviously anti-Tiaotong point tenderness, spinal curvature physiological changes.

[Diagnosis]
1. Lumbar disc herniation: low back pain associated with radioactive lower extremity pain, functional limitation waist; straight leg raising test, abdominal tests are very positive X-ray, CT can help diagnosis.
2. Vertebral compression fractures: a history of falling from height or waist indirectly History of Violence, accompanied by abdominal distention and constipation, and other symptoms. X-ray showed a wedge-shaped vertebrae change.
3. Renal colic: back side of the Department of colic to the perineum radiation, can be difficult with urine, hematuria, nausea, vomiting, sweating and other symptoms of the hill.

[Prevention and care]
1. Lying hardware Banchuang, waist braking 3 to 5 days.
2. Conservation fixed waist belt.
3. Partial warm.
4. Symptoms after remission, and gradually strengthen the psoas training.

Neck trauma emergency treatment

Neck injury and other parts of the body compared injury is not common. To the neck of an important blood vessels and nerves, there trachea, cervical, thyroid, neck injury is a serious injury, due to vascular rupture, and massive blood loss, cause rapid death.

Neck trauma common in sharps injuries, bullet penetrating wound.

Vascular neck injury

Vascular injury is a special injury, carotid artery injury, mainly massive bleeding, and bleeding jet-like, bright red color in a short time can be fatal. Neck vein injury, blood Chengangongse, in addition to loss of blood, venous air can be inhaled through the heart, more dangerous. The wounded immediately face pale, flustered, shortness of breath, dizziness, nausea, thirst, cold sweat on our journey, such as not timely rescue can quickly produce serious consequences.

Emergency neck vascular injury: vascular neck injury is the focus of the scene of the emergency temporary hemostasis; on arterial bleeding usually in the proximal扎tourniquet to stop bleeding wound, or compression bandaging venous bleeding or hemorrhage capillary pressure law generally available bandaging bleeding, and emergency personnel quickly please.

The larynx and trachea injury

Laryngeal and Tracheal pronunciation and breathing is an important organ. Once the laryngeal and tracheal injury suffered by the violence, their pronunciation and breathing can be a barrier, if not promptly rescue the wounded will appear life-threatening.

Laryngeal and tracheal injury main performance difficulty in breathing, and wound air bubble emitted blood sample, can be accompanied by severe irritation at the same time cough, blood into the trachea, there will be stifled.

Laryngeal and tracheal injury of the emergency: the disarmament of inhalation of suffocation, and maintain respiratory flow such as tracheal injuries, no massive bleeding and partial to clean the processing, removal of foreign body, blocked the wound, covered with gauze disinfection, and taken to the hospital; anti-shock treatment, pain bleeding, blood transfusion.

Wrist Injury

From the radial carpal tunnel wrist joints, carpal joints between the radial and ulnar joint and the carpometacarpal joint composition. major role to the wrist, wrist flexion and forearm rotation. Twisting causes of the most common injuries, and if they fall, carrying palm or hand to support excessive force wrist , palmar flexion, or screw fastening, such as excessive force, excessive wrist rotation. There are also excessive strain on the wrist, caused by occupational injury. Clinical manifestations swollen wrist pain, sore weakness, wrist pain activities. Inspections: dysfunction, local tenderness Obviously, the grip strength decreased.

Knee Injury

Knee by the Unit, tibia and patella, a fibula, the structure is complicated, prone to sports injuries is the key. The primary function of the knee flexion and extension movement in the semi-flexor flexor 90 ° or a slight rotational movement. And the muscles around the knee tendon, and lateral collateral ligament, the former, and the posterior cruciate ligament and lateral meniscus, and to maintain the stability of the knee.

A knee injury reasons for the different structures and principles are different, specific below:

Medial collateral ligament: knee flexion (about 130 ~ 150 °), the calf suddenly outreach external rotation, or foot and leg fixed, or thigh sudden internal rotation, will keep the medial collateral ligament injury. Reverse of the size and extent of closely related injury

Lateral collateral ligament: knee-buckling, in a sudden resumption of leg spin, or thigh suddenly outreach swing, the lateral collateral ligament injury occurred, the less damage to the ligament.

Cruciate ligament: a total of two in the joint capsule, the main function is to limit excessive anterior tibial or after the shift. Knee flexion-rotation suddenly and completed within finish outreach movement is an important injury mechanism.

Meniscus: knee-buckling of leg spin, or outreach to the internal rotation, two meniscus sliding disharmony, it will meniscus caught in the femoral condyles and the tibial plateau between by the rapid grinding, Nianzhuai and tear.

Second, the knee injury main clinical manifestations include the following five areas:

① knee pain. Mild ligament sprain, knee pain suddenly somewhere often, but often immediate alleviation, and will continue its adherence to the competition, such as knee injuries have Pala sound, accompanied by limitations like tearing pain, limb not Chichong, not walking, suggesting that may be completely torn ligament in the knee joint or injury.

② knee swelling. Knee sprains, swelling lighter, confined to a particular, if fully ligament rupture, local swelling larger, and subcutaneous plaque deposition, floating patella test positive.

③ knee tenderness. Sprain will arise in different parts tenderness, as in the tender point palpable defect to the local organization of depression, to do more to complete ligament rupture performance.

④ knee activities obstacles. After the knee injury muscle spasm around, a mild knee flexion position, but patients can take the initiative to be slowly knee flexion or extension to the normal range.

⑤ knee locked. Joint interlocking seen some meniscus tear cruciate ligament and medial collateral ligament rupture; stump medial collateral ligament in the joint space between incarcerated caused.

Three knee injuries screening method includes the following three tests:

① knee lateral exercise test. Used to check collateral ligament. This test checks to both sides, preferably at the time of the injury immediately, so as to avoid false positives.

② drawer test. Is to check whether cruciate ligament after relaxation method.

③ McNamara test. Knee meniscus injury is to check the method.

Chest trauma

Chest injury to the chest direct impact of violence, resulting in injury and the closure of open chest wound. Ribs in which to pack, such as pneumothorax and hemothorax . Cardiac trauma area, we should pay attention to cardiac and pericardial tamponade of hemorrhage. Common reasons for stab wounds, blunt object, caused by accidents and gunshot wounds. At the same time, chest trauma often associated with other abdominal viscera, and other body parts damage. These are serious life-threatening injury, and should be dealt with urgently, to relevant Hospital rescue.

1, open chest wound dressing should be closed immediately (do not use packing chest wound dressing to prevent the slide into).

2, removing the blood and respiratory tract mucus; when necessary, under emergency conditions permit, or incision of tracheal intubation.

3, and more fractured ribs and chest wall are obvious abnormal respiratory movement, or thick dressing kits pressure in it and plus tape bandages.

4, with a clear breathing difficulties, the examination revealed tracheal biased side should think of the contralateral tension pneumothorax, immediately before the injury side of the chest wall intercostal clavicle in the second superficial puncture exhaust. Taken to the hospital for safety may retain puncture needles, used to stop bleeding in the chest wall clamp fixed, and needle connected to single-phase drainage tube or rubber used fingerstall shear increases the gap, continuing the exhaust.

5, chest trauma should be taken to the hospital where 30 ° from the half-sitting position, and with the upper boosted clothing will be injured, may shock at the same time, lower extremity elevation, must not the first low-pin high.

Head injury

Comparison of head trauma Most of the children in particular. Construction by special scalp, forcing, easy to form laceration, commonly known as “open Issidae.” The scalp is very rich in blood vessels, and sometimes a small bleeding wound will not.

Emergency measures
Sustaining serious head trauma, it is not easy to see bleeding. Common Shouwuzhaotou patients, but Yabuzhu bleeding, blood still streaming out. In fact, if one of the most blood from hair, carefully inspected, we can find bleeding points. Bleeding fingers punctured the side of the skin around the wound or punctured skin, we can stop bleeding. If larger wound can be clean handkerchief Diecheng small pieces, bleeding on top of a finger clamping, we can stop bleeding, and then gave hospitals.

Notes
1. Head injuries when children, often nonchalant, but after a few hours vomiting, should be vigilant, they should immediately go to the hospital to see emergency. Especially infants, if sustained vomiting, dehydration occur, there is life-threatening.
2. Head trauma when often found a skull depression, should be taken to the hospital, otherwise depressed skull will be oppressed brain, which caused brain atrophy, which often become the reasons for the subsequent epilepsy.
3. Serious brain injury can cause nervousness, want people around to take note of the state of the injured, neglected so dangerous situation.
4. Cold compress only effective when the packet from the scalp. This is because the brain, a skull surrounded, but also several layers of protection membrane-like tissue, when a brain lesion, but only on the surface cooling is of no effect.

Abdominal Trauma

Abdominal trauma, especially because of the abdominal injury in traffic accidents, often injured as a result of offal, or even visceral hernia. As intra-abdominal liver, spleen this kind of visceral blood banks, suffered the abdomen when, as long as a broken, blood will be immediately filled with celiac. And not because of external bleeding, a slightly delayed condition will deteriorate. Therefore, the necessary first aid measures, it is extremely necessary.

Emergency measures

1. First to carry the injured to a safe place, so that the injured supine in the below-used clothing, blankets, pillows, etc. pad, the abdominal muscle relaxant.

2. To prevent vomiting injured in the vomit into the throat and should first preference side. In order to prevent looking pale and weak pulse shock symptoms, such as the incidence of injuries to the legs as far as possible elevation, and insulation blankets.

3. If visceral hernia, please note, do not touch hands. Then gauze can be used to clean out the internal organs from live coverage, if the accident took place, a tap water, water will be available to wet a wet gauze, without water, dry can also, if used approximate body temperature and the temperature of water wetting gauze covered offal better. Then tape gently fixed. At the same time, it is necessary to quickly notify the emergency center or call an ambulance.

Notes

1. Covered with a wet gauze offal purpose is to prevent the viscera exposed to air dry, easily piercing. When the abdominal injury occurred when people outside of the medical profession, where work can do little can be done to make these on the responsibility.

2. Emergency observation at the same time we should pay attention to the pulse of the injured and breathe and take appropriate emergency measures.

Movement in the finger injury

Movement in the finger contusion regular catcher in basketball, volleyball pass block hand incorrect, could cause finger contusion interphalangeal joint collateral ligament injury or Shenzhi flexor tendon injury.

Interphalangeal joint collateral ligament mild injury, in the finger straight at the distal joints do contusion pull side, in pain, but no loosening or “Mouth” flu. Processing, can be about one centimeter wide tape that their injuries will not injured finger next to be fixed together.

If joint collateral ligament rupture, should be to the hospital surgical suture.

Finger contusion if there can not be extended or joint deformity should be suspected tendon rupture or avulsion fracture and dislocation. For tendon rupture or avulsion fractures, as soon as possible to deal with, according to the circumstances by conservative treatment or surgical suture; dislocation should be looking for those with experience to the entire complex.

Ankle Injury

Ankle ligament sprain campaign is the most injury-prone joints, it is that the lateral ankle ligament, medial collateral ligament and joint tibiofibular ligament injury. Usually, tibiofibular ligament joint tenacity and flexibility, it is not easy injured the medial collateral ligament area, ligament fibers meticulous and tenacious than simply the medial collateral ligament injury also see less; lateral collateral ligament for the most vulnerable injured ankle ligament, lateral ankle sprain of the ankle sprain of 80%. 

(1) the lateral ankle ligament injury 
1. In the cause of Running, Jumping exercise, athletes in the vacated state, naturally enough on the toe, he showed a long, the tendency of foot inversion. If the focus of instability floor to tilt or hit in the side of the feet or hit another ball into the pit Under such circumstances, will be adequate to the anterolateral, inversion, resulting in the lateral collateral ligament injury. 
2. Signs of lateral ankle ligament sprain, a lateral ankle pain, pain and injury severity closely related.
Lateral ankle ligament sprain with enough Chichong, limp; lateral mild ankle swelling; ankle forced inversion test (check who single-handedly hold fixed leg above the ankle with one hand and hold the outer edge will be enough ankle up) to increase the pain, but the ankle stability, and no unusual activity. If the lateral ankle ligament rupture completely, with not enough Chichong, leaping limp; lateral ankle pain; serious and extensive swelling, skin lateral malleolus and the dorsalis pedis plaque deposition; ankle forced inversion test Shangchu pain, At the same time there are ankle instability and abnormal activities. 
3. Treatment
(1) the scene where
It should be used immediately after injury cold therapy, such as cold water immersion, ice massage. Then pressurized dressing with a bandage, as far as possible, not ankle, Chigaohuanshi delivery hospitals. This treatment can make local swelling, bleeding, pain reduction for subsequent treatment and rehabilitation to create good conditions. 
(2) mildly sprained lateral collateral ligament
With a bandage will be packed in mild ankle dorsiflexion-valgus, brake 4 to 7 days, will be able to cope with topical analgesics Huoxue powder deposition swelling medicine. Once the swelling and pain started easing, it is necessary to actively carry out joint exercises around the muscle strength and range of motion. Generally four days later to maintain the fixed Shimoji walk, and with massage, physical therapy and ankle背伸SLR practice. Massage methods can be used to push the lateral ankle Mount practices, the lateral dorsal foot and leg before with pinch and kneading practices. 1 to 2 weeks can be cured. 
(3) heavier lateral collateral ligament sprain (ligament rupture of the fault or completely)
Compression bandage to stop bleeding, and with full pallet will be fixed in the light of valgus dorsiflexion, Chigaohuanshi rest, to meet Chinese Herbs Huoxue pain treatment. Three days later, removing pressure bandaging materials, continue to pallet fixed about three weeks, and in line with massage, and topical and internal Effects of Shujin active Chinese medicine, acupuncture, physiotherapy and other treatment methods. After the lifting of fixed can continue treatment in the elastic bandage under the protection of, and gradually participate in the general training. We must actively engage in exercise, such as walking, ankle flexion and extension movement, Shizhong, and so on, until completely healed up. Weight of the lesion without pain, ankle forced inversion test no pain, can be completely removed with support resume normal movement. 
4. Prevention peacetime attention around the ankle joint coordination and muscle strength training, such as load Shizhong, rope skipping, toe-walking and other exercises. Select flat sports venues campaign to fully prepare.

(2) the medial ankle ligament injury 
Because for some reason the body to lose balance valgus foot outreach can cause medial ankle ligament injury. After a clear diagnosis, treatment and the principle of lateral ankle ligament injury basically the same, and fixed the opposite direction.

(C) lower tibia and fibula ligament injury 
Suddenly foot fixed to the outside, inside leg spin, it may sometimes be in the bottom of the tibia and fibula ligament injury. Its symptoms like lateral ankle ligament sprain, but careful inspection of the injury pain and tenderness and swelling in the ankle occurred prior to and not in the lateral ankle, heel to again hold sway on both sides, such as talus in abnormal activities in the most distal tibiofibular ligament disruption. Suspected the injuries to be timely transferred to a hospital for treatment.