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Objective To investigate the therapeutic effect and prognostic significance of lateral lymph node dissection (LPLND) in patients with lateral lymph node (LPLN) metastasis. Methods The clinicopathological data of rectal cancer patients who underwent total mesorectal excision (TME) combined with LPLND and pathologically confirmed as LPLN metastasis after operation were retrospectively analyzed. The clinicopathological characteristics and metastasis rules of patients with LPLN metastasis were discussed, and the survival prognosis after LPLND was analyzed. Results A total of 102 rectal cancer patients with pathologically confirmed LPLN metastasis were included. The common sites of LPLN metastasis were internal iliac vessels lymph nodes (n=68, 66.7%), followed by obturator lymph nodes (n=44, 43.1%), and common iliac vessels or external iliac vessels lymph nodes (n=12, 11.8%). There were 10 patients (9.8%) with bilateral LPLN metastases, and the mean number of LPLN metastases was 2.2±2.4, among which 16 patients (15.7%) had LPLN metastases number≥2. The 3-year OS (66.8% vs. 7.7%, P < 0.001) and DFS (39.1% vs. 10.5%, P=0.012) of patients with LPLN metastases to the external iliac or common iliac lymph node were significantly lower than those with metastases to the internal iliac or obturator lymph node. The multivariate analysis showed that LPLN metastasis to external iliac or common iliac lymph node was an independent risk factor both for OS (HR=3.53; 95%CI: 1.50-8.31; P=0.004) and DFS (HR=2.40; 95%CI: 1.05-5.47; P=0.037). Conclusion LPLN mainly metastasizes to the internal iliac or obturator lymph node areas. The survival of patients with metastasis to the external iliac or common iliac lymph node cannot be improved by LPLND, and thus systemic comprehensive treatment is often the optimal treatment option.
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Objective:To explore the testicular descent process and temporal morphology and position changes of its neighboring tissues and organs in mice with three dimensional (3D) histological reconstruction technique.Methods:Tissue below the kidney plane of male Kunming mice was harvested on gestation days (GD)15, GD17, GD19, postnatal days (PD)3 and PD7.The tissue was then serially sectioned and stained with hematoxylin and eosin (HE). Slices were scanned and saved by the PerkinElmer automatic section analysis system.Afterward, Photoshop software was used for image registration and alignment, and 3D-doctor software was employed for 3D reconstruction and analysis.Results:(1)The epididymis enveloped the testis, and the tail of the epididymis was connected with the gubernaculum, but no direct connection was found between the lower pole of the testis and the gubernaculum.During pregnancy, each part of the epididymis and the vas deferens of mice were piled up into a mass, making it hard to identify the epididymis.The gubernaculum leads to " swelled" . After birth, the epididymis became large, elongated, and morphologi-cally recognizable, and the gubernaculum degenerated into fibrous cords.During the whole process, the volume of gubernaculum was significantly smaller than that of testicle.(2)Testicles on both sides were similar in shape and asymmetrical in position.The left testicle was lower than the right testicle, and descended before the right one.During pregnancy, testicles on both sides descended from the lower pole of the kidney, the left testical stopped at the lower part of the bladder.and the right one stopped at middle part of the bladder.After birth, the left testicle dropped below the neck of the bladder.Finally, the left testicle was lower than the right testicle.(3) The epididymis descend prior to the testicles.Throughout the process, the tail of the epididymis descended before the testicles, and it pulled the whole epididymis down.Testicles entered the scrotum along the descending path of the epididymis.After the complete descent, the tail of the epididymis remained below the testicles.Conclusions:Through observation, the testicular descend process in mice includes the following steps.First, the tail of the epididymis is pulled down to the inner ring by the gubernaculum, and the tail and body of the epididymis expand the inner ring and the inguinal canal through their morphological changes.The epididymis then continues to go down into the scrotum and expands it.Finally, the testicles and the head of the epididymis follow the epididymis body and enter the scrotum through the enlarged inner ring and inguinal canal.
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Objective To investigate the clinical characteristics,early diagnosis,and rational treatments of traumatic renal artery thrombosis or other traumatic emboli.Methods We summarized the clinical data of 10 patients with traumatic renal artery thrombosis or other traumatic emboli.Results Six of ten patients had left renal artery thrombosis,while four of the ten patients had right renal artery thrombosis.Ultrasonography reported a reduced blood flow signal in one patient,and then renal artery embolism was confirmed by enhanced CT.The other nine patients were directly definitely diagnosed as renal artery embolism by enhanced CT.Four patients were treated with low molecular weight heparin calcium,in whom the CT follow-up showed no obvious blood reperfusion in injured kidneys,but the renal function was in normal range.Renal hypertension occurred in two patients,and one of them received nephrectomy because of poorly controlled hypertension with medication.Conclusions Clinical symptoms,signs and laboratory examinations show no specific findings for diagnosis of traumatic renal artery thrombosis.The color Doppler ultrasound is a preliminary screening method for,and an enhanced CT scan is an effective method for,diagnosis of renal artery thrombosis.The early recovery of renal blood circulation is an evidence of effective treatment.Major concerns are supposed to focus on renal function and blood pressure during followup.
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Objective@#To investigate the effect and safety of percutaneous vertebroplasty(PVP) and percutaneous kyphoplasty(PKP) in the treatment of osteoporotic vertebral compression fractures, thus to provide reference for clinical treatment.@*Methods@#67 patients with osteoporotic vertebral compression fractures were selected as study subjects.According to the different operation type, the patients were divided into PVP group(n=32) and PKP group(n=35). The operation condition, pain degree, relative height of vertebral body, Cobb angle and incidence of cement leakage were compared between the two groups.@*Results@#The operation time, X-ray times, bone cement injection volume, postoperative injury vertebral height of the PKP group were significantly higher than those of the PVP group(all P<0.05), the bone cement leakage rate of the PKP group was significantly lower than that of PVP group(P<0.05).12 months after operation, the vertebral compression rate of the PKP group was lower than that of PVP group(P<0.05), there were no statistically significant differences in VAS scores and Cobb angle between the two groups(all P>0.05).@*Conclusion@#PVP and PKP are the effective methods for the treatment of osteoporotic vertebral compression fractures, which can significantly improve the degree of pain in patients, but PKP surgery is more conducive to promote the restoration of vertebral height, and can reduce the occurrence of bone cement leakage.
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Objective To observe the effect of insulin glargine combined with methimazole treatment of senile diabetes mellitus complicated with hyperthyroidism.MethodsThe clinical data of 80 cases in People's Hospital of Haiyan from May 2014 to May 2016 were elderly diabetic patients with hyperthyroidism were analyzed.ResultsThe combined treatment group of patients with fasting blood glucose, 2h postprandial blood glucose was significantly lower than the average water alone treatment group (P<0.05), TSH level was significantly higher than that of single treatment group (P<0.05), FT3, FT4, TGAb, TMAb levels were significantly lower than the single treatment group (P<0.05), the total efficiency of 85% treatment (34/40) was significantly higher than that of single the treatment group of 40% (16/40) (P<0.05), insulin was significantly less than single treatment group (P<0.05), blood glucose time, hospitalization time were significantly shorter than single treatment group (P<0.05), the incidence of adverse reactions was 12.5% (5/40) was significantly lower than that of single treatment group 47.5% (19/40) (P<0.05).ConclusionInsulin glargine combined with methimazole in treatment of elderly diabetes mellitus complicated with hyperthyroidism was better than insulin glargine treatment alone.
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Objective To analyze the demands of Chongqing municipal medical and health institutions at grass-roots level for the graduates of clinical medicine,pharmacy and medical laboratory science and biotechnology.Methods The Chongqing medical and health institutions at grass-roots level served as the objects and their professionals and administrators were randomly performed the talents demands investigation by adopting the questionnaire investigation as the principal thing assisted by the interview on the spot or informal discussion.Results In the aspect of talents demands,the demands for internist,general practitioner and clinical examination staff were greater,which reached to 36.54％,30.77％and 78.10％respectively;in the aspect of professional knowledge demands,the demands for clinical diagnosis,general practice,clinical medication,clinical laboratory and blood test were greater.Con clusion The school talents cultivation does not understand the true requirements of medical and health institutions at grass-roots level and is inconsistent with the practical demands.
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Objective To observe the effects of myelotomy on autophagy activation after traumatic spinal cord injury (SCI) in rats. Methods 54 adult female Sprague-Dawley rats were randomly assigned to sham-operated group (SG, n=18), contusion group (CG, n=18) or myelotomy group (MTG, n=18). The T10 SCI model in rats was induced with a New York University (NYU) impactor and myelotomy was performed 24 hours after SCI. They were evaluated with the BBB score 1, 7, 14 days after injury. The expression of mRNA of Beclin-1 and Bcl-2 were detected with real-time quantitative reverse transcriptase polymerase chain reaction (RT-PCR). The formation of autophagosome was investigated under electronic microscope (EM) 3 days after injury. Results BBB score was more in the MTG than in the CG 7 and 14 days after injury (P<0.05), while the expression of Beclin-1 mRNA was less (P<0.05). The expression of Bcl-2 mRNA was more in the MTG than in the CG 3 and 7 days after injury (P<0.05). The expression of Beclin-1 mRNA was negatively correlated with BBB scores (P<0.05). The formation of autophagosome was less in the MTG than in the CG. Conclusion Myelotomy can improve the recovery of motor function in rats after acute traumatic SCI, which may associate with neuroprotection mediated by inhibition of autophagy through the Bcl-2 signaling pathway.
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@#Objective To observe the effects of myelotomy on autophagy activation after traumatic spinal cord injury (SCI) in rats. Methods 54 adult female Sprague-Dawley rats were randomly assigned to sham-operated group (SG, n=18), contusion group (CG, n=18) or myelotomy group (MTG, n=18). The T10 SCI model in rats was induced with a New York University (NYU) impactor and myelotomy was performed 24 hours after SCI. They were evaluated with the BBB score 1, 7, 14 days after injury. The expression of mRNA of Beclin-1 and Bcl-2 were detected with real-time quantitative reverse transcriptase polymerase chain reaction (RT-PCR). The formation of autophagosome was investigated under electronic microscope (EM) 3 days after injury. Results BBB score was more in the MTG than in the CG 7 and 14 days after injury (P<0.05), while the expression of Beclin-1 mRNA was less (P<0.05). The expression of Bcl-2 mRNA was more in the MTG than in the CG 3 and 7 days after injury (P<0.05). The expression of Beclin-1 mRNA was negatively correlated with BBB scores (P< 0.05). The formation of autophagosome was less in the MTG than in the CG. Conclusion Myelotomy can improve the recovery of motor function in rats after acute traumatic SCI, which may associate with neuroprotection mediated by inhibition of autophagy through the Bcl-2 signaling pathway.
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Objective To investigate the pathological changes and mechanism in the urethra by parturition-induced stress urinary incontinence.Methods Sprague Dawley female rats underwent vaginal balloon dilation for 4 hours immediately after delivery.One week later,the rats were anesthetized and both ovaries were excised.Then a rat model of stress urinary incontinence (SUI) was successfully established.One month after ovariectomy,conscious cystometry and Leak-Point Pressure (LPP) were measured by MP150.Histological examination and Western blotting were performed after functional assays.Results (1) 85％ of rats presented astress urinary incontinence in the model group.(2) The urethras in SUI rats had decreased muscles,and striated muscles showed fragmentized and disorganized.(3) Elastic fibers were long,well organized and tightly connected to the muscle bundles in sham group,while elastic fibers showed fragmentation and disorganization in the model group.(4) The protein expression of vascular endothelial growth factor (VEGF) and blood vessels were reduced in SUI rats as compared with the sham rats.Conclusions Muscle and elastic fibers in the urethra are disrupted in SUI rat.VEGF may play an important role in regulation of pathological changes in urethra.
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Objective To analyze the structure and grow th trend of traditional Chinese medicine (TCM ) senior professional and technical personnel in Chongqing from 2001 to 2010 ,and to put forward a proposal on feasible countermeasures of TCM senior pro-fessional and technical personnel development of Chongqing .Methods Literature review of statistical yearbook of ministry of health ,state administration of traditional Chinese Medicine and expert counseling methods were used to analyze the structure and grow th trend of TCM senior professional and technical personnel in Chongqing from 2001 to 2010 .Results From 2001 to 2010 ,the structure of TCM senior professional and technical personnel in secondary senior position accounted for 85 .42% .which with bache-lor degree accounted for 94 .04% ,the growth rate of highly educated professional and technical personnel(15 .13% ) was high than the integral level(12 .25% ) ,but still had low proportion(16 .36% ) .Conclusion A serious lack of master and doctor or senior title of Chongqing TCM professional and technical personnel is not proved ,and the growth slows down in recent years .
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Objective To observe the influence of the sperm abnormalities on conventional invitro fertilization therapy outcome. Methods Sperm of 105 infertile husband's semen was analyzed. The patients were divided into three groups according to the sperm morphology observed Using Kruger 's criteria: normal sperm morphology group (sperm normal morphology ≥ 15 % ), mild sperm abnormalities group( sperm normal morphology 10%- 15%), middle sperm abnormalities group (sperm normal morphology 5 % - 10 % ). Fertilization rate, cleavage rate, good quality embryo rate, implantation rate, clinical pregnancy rate and abortion rates were compared to study the influence of the sperm abnormalities on conventional IVF outcome. Results ①Fertilization rate(79.4 % vs 78.3 % ), cleavage rate(104. 6% vs98. 6%), good quality embryo rate(58. 1% vs 53. 9%), implantation rate (31.7% vs 30. 8%), clinical pregnancy rate(48.1% vs 42. 3%)and abortion rates(13.0% vs 18. 2%)were not significantly different between normal sperm morphology group and mild sperm abnormalities group(P>0. 05). ②The fertilization rate (79.4% vs 63.9%), good quality embryo rate(58. 14% vs 48.23%), implantation rate (31.7% vs 16. 7%) and clinical pregnancy rate(48.1%vs24.0%) of the normal sperm morphology group were higher than middle sperm abnormalities group(P<0.05). The abortion rates(13.04% vs 28. 57%) and cleavage rates(104.6% vs 102.9%) were not significantly different(P>0. 05). ③The fertilization rate (78.3% vs 63.9%), good quality embryo rate (53. 9%vs 48. 2%) of the mild sperm morphology group were higher than middle sperm abnormalities group(P <0.05). Implantation rate (30.8% vs 16. 7%) , clinical pregnancy rate(42.3% vs 24.0%) , abortion rates(13. 0% vs 28. 6%) and cleavage rates(104.6% vs 102.9%) were not significantly different (P>0. 05). Conclusions There is a significant influence of middle sperm abnormalities on IVF fertilization rate, good quality embryo rate, implantation rate and clinical pregnancy rate. However, it could not be influenced on mild sperm abnormalities.
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With the pluralistic need of medical service in the country,non-technical ser-vice has become the crucial part of core competencies of the medical institution.Therefore,pro-fessional ethics is considered the most important by the units in employing new members.It’s necessary to train students with good morality by combining the moral education with profes-sional education so as to meet the changes in the social needs.
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Filtering is very important in acquiring EC G signals.With the characteristics of ECG signals analyzed,this paper designs and achieves a filtering circuit.The result of the experiment is also given.
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Objective To observe effects of four extracts (water, n-butanol, acetoacetate and petro-leum benzine extracts) from Hippocampus japonicus on kidney-yang deficiency mice induced by extradiol, and reveal the modern scientific connotation about sweet-flavor, warm-nature, meridian tropism in liver and kidney. Methods Kidney-yang deficiency mice was induced by intraperitoneal injection of estradiol benzoate. Effects of four extracts from H. japonicus were observed by measuring physical signs, rectal temperature, grip strength, swimming time, autonomic mobility, creatinine (Cr) and urea (UR) level in serum, haematological indexes, testis index and seminal vesicle index. Results All the four extracts from H. japonicus could markedly improve physical signs and increase seminal vesicle index, RBC, Hb and PLT in blood, and decrease UR level in serum of kidney-yang deficiency mice, water extract and petoleum benzine extract could increase rectal temperature, grip strength, swimming time, autonomic mobility, testis index, WBC, lymphocyte (LY), monocyte (MO), and neutrophilic granulocyte (NE), n-butanol extract could increase autonomic mobility and NE, acetoacetate extract could enhance grip strength and prolong swimming time. Conclusion All above effects of extracts from H. japonicus could be as the basic of improving kidney-yang deficiency, could be an important part of the modern scientific connotation about sweet-flavor, warm-nature, meridian tropism in liver and kidney. Effects of water extract and petroleum ether extract were closer and stronger, which offer enlightenment for searching the common effective substance groups of H. japoniacs.