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Addiction is a state of chronic neurological dysfunction with repetitive and compulsive behavior as the main manifestation. One of the characteristics of this state is that addicts have significantly reduced autonomy for compulsive behaviors. The emergence of addictive behavior is based on the impaired autonomy of addicts, so the assessment of their condition, prognosis, and related moral responsibility are all related to their autonomy. By exploring whether the treatment of addicts should be based on autonomy as the core indicator to evaluate whether they can end treatment, and exploring the debate on addicts’ autonomy based on the disease model and moral model of addiction, it is believed that whether addicts have autonomy cognition is influenced by the causes of addiction. Furthermore, the issue of moral responsibility of addicts after treatment termination and the quantitative feasibility of autonomy were discussed, and it was advocated to determine the moral responsibility after addiction treatment based on their autonomy.
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Objective@#To compare the clinical effects of laparoscopic repair and open repair of gastroduodenal ulcer perforation.@*Methods@#Retrospective analysis was performed on 117 patients with perforated gastroduodenal ulcer admitted to Sijing Hospital of Shanghai Songjiang District from October 2005 to February 2018, including 86 males and 31 females. The average age was 35.56 years with a range from 17 to 68 years. Patients were divided into two groups according to different surgical methods: laparoscopic group (n=56) and open group (n=61). Patients in the laparoscopic group were received laparoscopic repair for perforated gastroduodenal ulcer, while patients in the open group received open repair for perforated gastroduodenal ulcer. Comparison of two groups of patients with operation time, intraoperative blood loss, postoperative first anal exhaust time, analgesic utilization rate, length of hospital stay, the body′s inflammatory response [preoperative and 24 h, 72 h, 120 h of postoperative peripheral white blood cell (WBC)], C-reactive protein level (CRP), postoperative complications (postoperative incision infection, incision dehiscence, gastric duodenal fistula, abdominal abscess, adhesion intestinal obstruction and lung infection). Measurement data were expressed as mean±standard deviation (Mean±SD), and t-test was used for comparison between groups; count data were compared by Chi-square test.@*Results@#All the patients in the two groups successfully completed the operation, and there were no cases transferred to laparotomy in the laparoscopic group. Intraoperative blood loss[(15.3±9.5) ml vs (30.5±11.3) ml, P<0.001], time of first anal exhaust[(56.5±9.8) h vs (83.8±15.6) h, P<0.001], analygesic utilization rate (10.71% vs 52.46%, P<0.005), and length of hospital stay [(7.5±1.5) d vs (10.0±3.4) d, P<0.001] of the laparoscopic group were significantly better in the open group, the differences were statistically significant. The WBC and CRP at 24 h, 72 h and 120 h after surgery of the laparoscopic group were also significantly better than in the open group [WBC: 24 h, (14.55±3.44) ×109/L vs (16.02±4.12) ×109/L, P=0.020; 72 h, (10.25±2.32) ×109/L vs (14.22±3.29) ×109/L, P<0.001; 120 h, (8.12±3.11)×109/L vs (11.58±2.33) ×109/L, P<0.001. CRP: 24 h, (50.35±13.73) mg/L vs (80.11±13.56) mg/L, P<0.001; 72 h, (29.37±7.81) mg/L vs (53.57±8.05) mg/L, P<0.001; 120 h, (17.71±7.01) mg/L vs (34.35±7.72) mg/L, P<0.001], the differences were statistically significant. There was no significant difference in operation time and postoperative complications between the two groups (P>0.05).@*Conclusion@#Compared with open gastroduodenal ulcer perforation repair, laparoscopic gastroduodenal ulcer perforation repair surgery trauma are smaller, and the body′s inflammatory response are lighter, postoperative complications is no statistical significance, but will look from actual data, the cases of complications is less, is now a better surgical treatment of gastroduodenal ulcer perforation.
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Objective To compare the clinical effects of laparoscopic repair and open repair of gastroduodenal ulcer perforation.Methods Retrospective analysis was performed on 117 patients with perforated gastroduodenal ulcer admitted to Sijing Hospital of Shanghai Songjiang District from October 2005 to February 2018,including 86 males and 31 females.The average age was 35.56 years with a range from 17 to 68 years.Patients were divided into two groups according to different surgical methods:laparoscopic group (n =56) and open group (n =61).Patients in the laparoscopic group were received laparoscopic repair for perforated gastroduodenal ulcer,while patients in the open group received open repair for perforated gastroduodenal ulcer.Comparison of two groups of patients with operation time,intraoperative blood loss,postoperative first anal exhaust time,analgesic utilization rate,length of hospital stay,the body's inflammatory response [preoperative and 24 h,72 h,120 h of postoperative peripheral white blood cell (WBC)],C-reactive protein level (CRP),postoperative complications (postoperative incision infection,incision dehiscence,gastric duodenal fistula,abdominal abscess,adhesion intestinal obstruction and lung infection).Measurement data were expressed as mean ± standard deviation (Mean ± SD),and t-test was used for comparison between groups;count data were compared by Chi-square test.Results All the patients in the two groups successfully completed the operation,and there were no cases transferred to laparotomy in the laparoscopic group.Intraoperative blood loss [(15.3 ± 9.5) ml vs (30.5 ±11.3) ml,P ＜ 0.001],time of first anal exhaust [(56.5 ± 9.8) h vs (83.8 ± 15.6) h,P ＜ 0.001],analygesic utilization rate (10.71％ vs 52.46％,P ＜ 0.005),and length of hospital stay [(7.5 ± 1.5) d vs (10.0 ±3.4) d,P ＜ 0.001] of the laparoscopic group were significantly better in the open group,the differences were statistically significant.The WBC and CRP at 24 h,72 h and 120 h after surgery of the laparoscopic group were also significantly better than in the open group [WBC:24 h,(14.55 ± 3.44) × 109/L vs (16.02 ± 4.12) × 109/ L,P =0.020;72 h,(10.25 ± 2.32) × 109/L vs (14.22 ± 3.29) × 109/L,P ＜ 0.001;120 h,(8.12 ±3.11) ×109/Lvs (11.58 ±2.33) × 109/L,P ＜0.001.CRP:24 h,(50.35 ± 13.73) mg/L vs (80.11 ±13.56) mg/L,P＜0.001;72 h,(29.37 ±7.81) mg/Lvs (53.57 ±8.05)mg/L,P＜0.001;120h,(17.71 ±7.01) mg/L vs (34.35 ± 7.72) mg/L,P ＜ 0.001],the differences were statistically significant.There was no significant difference in operation time and postoperative complications between the two groups (P ＞ 0.05).Conclusion Compared with open gastroduodenal ulcer perforation repair,laparoscopic gastroduodenal ulcer perforation repair surgery trauma are smaller,and the body's inflammatory response are lighter,postoperative complications is no statistical significance,but will look from actual data,the cases of complications is less,is now a better surgical treatment of gastroduodenal ulcer perforation.
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Objective To explore the feasibility and efficacy of an MRI-visible,targeted,nano-vector which is synthesized by attaching a targeting ligand,the GD2 single chain antibody (scAb GD2),to the distal ends of PEG-g-PEI-SPION as a carrier for gene delivery into human bone marrow mesenchymal stem cells (hBMSCs) and in vitro cellular MR imaging.Methods scAbGD2-PEG-g-PEI-SPION was synthesized as previously reported.Gel electrophoresis was performed to assess the pDNA condensation ability of scAbGD2-PEG-g-PEI-SPION.The particle size and Zeta potential of scAbGD2-PEG-g-PEI-SPION/pDNA nanocomplexes were observed by dynamic light scattering.Cytotoxicity of scAbGD2-PEG-g-PEI-SPI-ON was evaluated by CCK-8 assay using hBMSCs.Gene transfection efficiency of scAbGD2-PEG-g-PEI-SPION in hBMSCs was quantified by flow cytometry,PEG-g-PEI-SPION,scAbGD2-PEG-g-PEI-SPION,scAbGD2-PEG-g-PEI-SPION+ free AbGD2 and scAbIgG2a-PEG-g-PEI-SPION group was established.The cellular internalization of scAbGD2-PEG-g-PEI-SPION/pDNA nanocomplexes was observed by confocal laser scanning microscopy and Prussian blue staining.MRI of scAbGD2-PEG-g-PEI-SPION was performed by cellular MRI scanning in vitro.Results scAbGD2-PEG-g-PEI-SPION condensed pDNA to form stable nanocomplexes of 80-100 nm in diameter and showed low cytotoxicity to hBMSCs.At the same N/P ratio,the transfection efficiency of scAbGD2-PEG-g-PEI-SPION group was significantly higher than those of other groups (P＜0.001).At the optimal N/P ratio of 20,scAbGD2-PEG-g-PEI-SPION/pDNA obtained the highest transfection efficiency of (59.60 ± 4.50) ％ in hBMSCs.Furthermore,hBMSCs labeled with scAbGD2-PEG-g-PEI-SPION showed sensitive low signal intensity on MRI T2/T2 *-weighted images in vitro.Conclusion scAbGD2-PEG-g-PEI-SPION is an efficient MRL visible targeted nano vector for gene delivery into hBMSCs.
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Objective To explore the feasibility and efficacy of an MRI-visible,targeted,nano-vector which is synthesized by attaching a targeting ligand,the GD2 single chain antibody (scAb GD2),to the distal ends of PEG-g-PEI-SPION as a carrier for gene delivery into human bone marrow mesenchymal stem cells (hBMSCs) and in vitro cellular MR imaging.Methods scAbGD2-PEG-g-PEI-SPION was synthesized as previously reported.Gel electrophoresis was performed to assess the pDNA condensation ability of scAbGD2-PEG-g-PEI-SPION.The particle size and Zeta potential of scAbGD2-PEG-g-PEI-SPION/pDNA nanocomplexes were observed by dynamic light scattering.Cytotoxicity of scAbGD2-PEG-g-PEI-SPI-ON was evaluated by CCK-8 assay using hBMSCs.Gene transfection efficiency of scAbGD2-PEG-g-PEI-SPION in hBMSCs was quantified by flow cytometry,PEG-g-PEI-SPION,scAbGD2-PEG-g-PEI-SPION,scAbGD2-PEG-g-PEI-SPION+ free AbGD2 and scAbIgG2a-PEG-g-PEI-SPION group was established.The cellular internalization of scAbGD2-PEG-g-PEI-SPION/pDNA nanocomplexes was observed by confocal laser scanning microscopy and Prussian blue staining.MRI of scAbGD2-PEG-g-PEI-SPION was performed by cellular MRI scanning in vitro.Results scAbGD2-PEG-g-PEI-SPION condensed pDNA to form stable nanocomplexes of 80-100 nm in diameter and showed low cytotoxicity to hBMSCs.At the same N/P ratio,the transfection efficiency of scAbGD2-PEG-g-PEI-SPION group was significantly higher than those of other groups (P＜0.001).At the optimal N/P ratio of 20,scAbGD2-PEG-g-PEI-SPION/pDNA obtained the highest transfection efficiency of (59.60 ± 4.50) ％ in hBMSCs.Furthermore,hBMSCs labeled with scAbGD2-PEG-g-PEI-SPION showed sensitive low signal intensity on MRI T2/T2 *-weighted images in vitro.Conclusion scAbGD2-PEG-g-PEI-SPION is an efficient MRL visible targeted nano vector for gene delivery into hBMSCs.