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Objectives: To evaluate the safety and feasibility of ultra-low anastomosis for anal preservation in laparoscopic rectal can-cer surgery. Methods: The clinical data of 54 patients with low rectal cancer admitted to The Affiliated Hospital of Southwest Medical University from July 2014 to June 2017 were retrospectively analyzed. The short-term effect and complications were analyzed. Results:All patients underwent successful operations; conversion to laparotomy or death was not observed in any of the patients. The mean operative time was (165 ± 31) minutes, and the intraoperative bleeding volume was (12 ± 5) mL. There was no prophylactic ileostomy in all patients. Postoperative anastomotic bleeding and anastomotic leakage occurred in 2 and 3 cases, respectively; these complica-tions were managed with conservative treatment. Postoperative urination and sexual functions of the patients remained good, and most patients were satisfied with their anal function 1 year post-operation. No local recurrences or deaths were noted after follow-up for more than 2 years. However, liver metastases were detected in 3 patients 1 year post-surgery. Conclusions: Laparoscopic transab-dominal ultra-low anastomosis for rectal cancer has a good short-term effect; however, the long-term effect remains to be evaluated.
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Objective To observe the effects of Crk-SH3 domain guanine exchange factor(C3G)overexpression on the pro-liferation and apoptosis of high glucose-induced H9C2 cardiomyocytes.Methods H9C2 cardiomyocytes were transiently transfected with pCXN2-Flag(empty plasmid)and pCXN2-Flag-hC3G(human C3G mRNA)plasmids,then conducted high glucose(HG)in-tervention.The experiment was divided into the blank group,empty vector group,C3G overexpression group,blank + HG group, empty vector + HG group and C3G overexpression+ HG group.The C3G protein expressions,apoptosis and proliferation rate were respectively detected in each H9C2 cardiomyocytes groups.Results The proliferation rate in the blank+ HG group and empty vec-tor+ HG group were significantly decreased compared with the blank group and empty vector group,while the apoptosis rate was significantly increased.Compared with blank group and empty vector group,blank + HG and empty vector + HG group,the C3G protein expression and proliferation rate in the C3G overexpression group and C3G overexpression+ HG group were increased sig-nificantly,while the apoptosis rate was decreased significantly.Conclusion High glucose inhibits H9C2 myocardial cell proliferation and promots its apoptosis;furthermore,C3G overexpression can reversed the decrease of high glucose-induced H9C2 cardiomyocyte prolifer-ation rate and apoptosis increase.C3G overexpression can promote the survivability of high glucose-induced H9C2 cardiomyocytes.
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Objective:To improve the quality and efficiency of pharmaceutical care of clinical pharmacists by standardizing phar-maceutical care process using tracking table design for clinical drug therapy. Methods: The experience and skills of pharmaceutical care performed by clinical pharmacists in endocrinology department were summarized and the tracking table for clinical drug therapy was designed, which could provide information for patients clearly and concisely, and make the process of pharmaceutical care more system-atical. Results:After using the tracking table, clinical pharmacists improved work efficiency significantly. In addition, the average hospitalization, average hospitalization expenses and drug proportion significantly reduced resulting in higher satisfaction of patients. Conclusion:The standardized pharmaceutical care process performed by clinical pharmacists in endocrinology department makes phar-maceutical care more specific, comprehensive and convenient.
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Objective To explore the CT and MRI findings of Kimura disease in different location.Methods The CT and MRI obtained in 19 patients with histologically proved Kimura disease were reviewed retrospectively.Results Of these 19 patients with Kimura disease, the head and neck was involved in 16 patients, other locations less commonly involved were the lung(n=1),chest wall(n=1),liver and spleen(n=1).Kimura disease of head and neck,the density abnormal appeared as nodular,mass or diffuse on CT imaging, the CT value of lesion was similar to muscle, MRI manifested as a slightly hypo-or isointense lesion on T1WI and hyperintense on T2WI,most of the lesions demonstrated moderate or marked enhancement on postcontrast CT and MR images.Kimura disease of lung and chest wall,lesion appeared as a solid mass on imaging, there was moderate enhancement in the lung lesion and rim enhancement in the chest wall lesion.Kimura disease of liver and spleen: lesion showed nodular, mild and gradual upward enhancement.Conclusion Imaging findings of Kimura disease are not characteristic, it is very essential to know the lesion combined with the laboratory and pathologic features.
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Human cytochrome P450 (CYP) 3A ,which is widely involved in the various drug metabolism ,is most abun-dant in liver and intestine .The activity of CYP3A enzyme may be induced or inhibited in the process of drug metabolisms ,and affect the metabolism of other CYP3A substrates and modulators vice versa .At present ,in vitro probe drugs and in vivo bio-markers are both available to evaluate the activity of CYP 3A enzyme .The former requires oral probe drugs ,the latter does not need for those drugs and just allows laboratory technicians to detect endogenous substrates ,such as 4β-hydroxycholesterol and 6β-hydroxycortisol .As reported ,studies on CYP3A help to explain the inter-individually variability in drug metabolism ,to in-dicate dose adjustments in combination regimens when drug interactions exist ,to predict drug efficacy and toxicity reaction for providing theoretical guidance for individualized medication ,and to reduce market risk of new drugs for the potential drug inter-actions .We summarized these two kinds of endogenous biomarkers and their clinical application in this review .
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Objective To evaluate the MRI and clinic types of oxfordshire community stroke project(OCSP)in the diagnosis of acute young ischemic stroke patients.Methods 1 64 young patients (18-45 years)and 228 old patients (>60 years)with acute ischemic stroke were analyzed retrospectively.There are four groups according to MR and clinic types of OCSP:total anterior circulation infarct (TACI),partial anterior circulation infarction (PACI),posterior circulation infarction(POCI)and lacunar infarction (LACI).Results Cerebral infarction showed a mild hypo-signal on T1 WI,hyper-signal on T2 WI,FLAIR and DWI.Among the 164 young patients,8 (4.88%)were classified as TACI,72 (43.90%)as PACI,30 (18.29%)as POCI and 54 (32.93%)as LACI.Young and old group image types comparison,χ2 = 1.221,P >0.05.Young stroke patients image and clinical types comparison,Kappa =0.525,P <0.05.Conclusion OCSP imaging types has a good consistency with clinical types,which helps to evaluate ischemic stroke objectively in youth.
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Objective To construct a lentiviral expression vector of peroxiredoxin2(PRDX2) RNA interference (RNAi) and to investigate the effect of siRNA of PRDX2 genes on the proliferation of human colonrectal cancer SW480 cell .Methods RNAi tar‐get sequences were designed and synthesized towards the PRDX2 gene sequences .The lentiviral vector pGC‐EGFP‐shPRDX2 was constructed and identified .The vector was transformed into SW480 cells ,and the transfection efficiency was evaluated by fluores‐cence microscopy .The expression of PRDX2 was detected with Quantitative real‐time PCR (qRT‐PCR) and Western blot in the transfected cells .Cell growth and colony forming ability were detected with MTT and plate cloning technique .Results PRDX2 gene lentiviral vector was successfully established and was proved by gene sequencing .The expression of PRDX2 in mRNA and pro‐tein was significantly reduced(P<0 .05) .The PRDX2 mRNA and protein expression in SW480 transfected with lentiviral were sig‐nificantly reduced (P< 0 .05) ,and the ability of growth and proliferation were significantly reduced(P< 0 .05) .Conclusion PRDX2 gene lentiviral vector could be a stable and reliable tool .The proliferation and growth of SW480 cells transfected by pGC‐EGFP‐shPRDX2 could be effectively suppressed ,which could facilitate further investigation of the roles of PRDX2 gene in the de‐velopment and progression of colorectal cancer .
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Objective To evaluate the value of digital tomosynthesis (TOMOS)in diagnosis of odontogenic cystic lesions of the jaws with oral fixed metal dentures, and compared with multi-slice spiral CT (MSCT). Methods The imaging findings of 40 cases with fixed metal dentures pathologically proved odontogenic cystic lesions of the jaws jn retrospective were retrospectively analyzed.All cases were performed by MSCT and TOMOS scanning,and 13 cases enhanced at the same time. The characteristics of the imaging findings in TOMOS and MSCT were compared. The diagnosis merits and disadvantages, especially their ability to detect the lesions and adjacent structures,were assessed. Results There were no significant difference (consistency check Kappa value>0.4) in evaluating the structure characteristics of the lesions, the relationgship between the lesions and cortex ,and the relationship between the lesions and surrounding organs. TOMOS is superior to MSCT in displaying apical change, the same in pure cystic and cystic-solid lesions interfered by artifacts.However, it is inferior to MSCT in detection of soft tissue invasion. Conclusion There is similar assessment value of TOMOS and MSCT in displaying odontogenic cystic lesions of the jaws. TOMOS can be chosen when the imaging findings of the lesions are interfered by metal artifacts.
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Objective To study the metabolic characteristics of temporal lobe injury during the radiotherapy in the elderly with nasopharyngeal carcinoma through 1H- magnetic resonance spectroscopy (MRS). Methods The 15 aged and 23 young cases among 80 cases with nasopharyngeal carcinoma confirmed clinically and receiving radiotherapy for the first time were involved in the same period of July 2006 to May 2009. Conventional MRI scanning and bilateral temporal MRS were performed before and during radiotherapy at radiation dosages of 20 Gy, 40 Gy, and 60 Gy respectively. The spectroscopy morphology and the ratios of the three main metabolites were compared and analyzed. Results The values of N-acetylasparate (NAA)/creatine (Cr) was lower and choline-containing compound (Cho)/Cr ratio was higher in aged group than in young group before radiotherapy (P＞0.05). The spectroscopy morphology stepped down, NAA, Cho, NAA/Cr, Cho/Cr and NAA/Cho decreased to some extent along with the adding of radiation dosages in the course of radiotherapy. At the end of radiotherapy, the decreased amplitude of NAA/Cr value was larger in aged group than in control group (P＜0.01), and the amplitude of Cho/Cr value was lower than other group. Conclusions The neurons of aged patients with nasopharyngeal carcinoma have a weak tolerance to the radiation, brain injury occurs earlier and heavier in aged patients than in young patients. It is necessary to prevent neuron injury early.
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Objective To study the metabolic characteristics of neuronal injury in the temporal lobes during the radiotherapy in the elderly patients with nasopharyngeal carcinoma by 1H-MR spectroscopy.Methods Conventional MRI and 1H-MRS were performed in 21 elderly (age ≥60 years) and 33 young (age ≤ 45 years) patients who were historically confirmed with nasopharyngeal carcinoma and received radiotherapy for the first time.MR data were collected before and during the therapy at the radiation dosages of 20,40 and 60 Gy,respectively.Student t test was used to compare the NAA/Cr,Cho/Cr and NAA/Cho ratios of 1H-MRS in the temporal lobes between the two groups.Results The ratios of NAA/Cr,Cho/Cr before radiotherapy were 1.94 ± 0.15,1.86 + 0.20 in the elderly group,and 2.12 + 0.25,1.82 ± 0.24 in the young group respectively,but the difference was not statistically significant ( t =1.417,1.070,P ＞ 0.05 ).At the radiation with dosages of 20,40,and 60 Gy,the ratios of NAA/Cr were 1.81 ± 0.14,1.53 + 0.16,1.06 ±0.08 in the elderly group respectively,and were 2.03 ±0.16,1.92 ±0.21,1.77 ±0.18 in the young group respectively.There were statistical differences between two groups ( t =8.386,9.113,13.729,respectively,P＜0.05,＜0.05,＜0.01).The ratios of Cho/Cr were 1.82 +0.16,1.61 +0.29,1.37 +0.13 in the elderly group respectively,and were 1.77 + 0.19,1.48 + 0.17,1.06 + 0.14 in the young group respectively.There were statistical differences between the two groups at dosages of 40 and 60 Gy ( t =5.230,9.322 respectively,P ＜ 0.05 ).The ratios of NAA/Cho were 1.17 + 0.15,1.10 ± 0.08,0.83 ±0.05 in the elderly group respectively,and were 1.52 ±0.13,1.36 +0.15,1.10 +0.17 in the young group respectively.There were statistical differences between two groups ( t =5.862,2.560,9.754 respectively,P ＜0.05,＜0.05,＜0.01 ).At the dosages of 20,40 and 60 Gy,the decreases of NAA/Cr in the elderly group (6.70％,14.43％,24.23％ respectively) were more significantly higher than those in the young group(4.25％,5.19％,7.08％ respectively).The decrease of Cho/Cr in the elderly group (2.15％,11.29％,12.90％ respectively) were lower than those in the young group ( 3.30％,15.93％,17.58％ respectively).And the decrease of NAA/Cho in the elderly group (8.59％,5.47％,21.09％ respectively) were higher than those in the young group (2.56％,10.26％,16.67％ respectively).Conclusion Under the same radiotherapy pattern and radiation dosage,the injury to the neurons in the temporal lobes is significantly greater in the elderly patients than in young patients.Since the injury is smallest at the dose of 20 Gy among the doses evaluated,the intervention conducted in the elderly patients at this dose may help to minimize the injury to the neurons.