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Objective:To analyze the relationship between mesenteric fat or creeping fat and bowel stricture or penetrating disease of Crohn's disease (CD).Methods:Clinical data of 101 CD patients undergoing bowel surgery at Department of General Surgery in our hospital between Mar 2021 and Dec 2021 were retrospectively analyzed. The characteristics of mesenteric fat, creeping fat, luminal cross-section diameter, and the intestinal stricture index were analyzed. The Spearman correlation analysis was used to evaluate the correlation between disease behavior and mesenteric fat score or creeping fat score.Results:Totally 101 CD patients were enrolled, with 68 stricturing diseases and 33 penetrating diseases. CD patients with stricturing diseases had higher score of mesenteric disease activity index (4.6±1.9 vs. 3.7±2.0, t=2.212, P=0.029) and creeping fat index (4.2±2.0 vs. 2.9±1.6, t=3.154, P=0.002) than those in patients with penetrating diseases. The mesenteric fat and creeping fat score positively correlated with the intestinal stricture index, C-reactive protein, and fecal calprotectin, and negatively correlated with minimum luminal cross-section diameter. Conclusion:The higher score of mesenteric fat and creeping fat were observed in CD patients with stricturing disease, which were associated with intestinal stricture index and inflammation status.
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Objective:To analyze the risk factors for postoperative surgical site infections (SSIs) in patients with Crohn's disease (CD).Methods:This retrospective observational study included CD patients undergoing bowel resection between July 2015 and July 2018. The prevalence and risk factors of SSIs were evaluated. The microbiological evaluation from patients with SSIs was performed by bacterial culture and drug sensitivity test.Results:There were 66 patients suffering SSIs, with 41 incisional SSIs and 32 organ/space SSIs. Multivariate analysis identified the preoperative infliximab therapy ( OR 2.338,95% CI 1.192-4.587, P=0.013), laparoscopic surgery ( OR 0.460,95% CI 0.226-0.936, P=0.013), and preoperative white blood cell ( OR 2.008,95% CI 1.018-3.961, P=0.044) as independent factors for SSIs. Fifty-nine strains of pathogenic bacteria were detected in 66 cases of CD combined with SSIs, including 36 strains of gram-negative bacteria, 5 strains of gram-positive bacteria, and 2 strains of fungi. Escherichia coli and Klebsiella pneumoniae were main G - bacteria, with high resistance to common used antibiotics. Enterococcus faecalis and Enterococcus faecium were main G -. 62.1% of the SSIs grew extended-spectrum β-lactamase (ESBL)-producing pathogens in their bacteria cultures and 37.9% grew non-ESBL microbes. Conclusion:The incidence of SSIs was higher in CD patients. Preoperative infliximab therapy, preoperative white blood cell, and laparoscopic surgery were predictors of SSIs.
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Objectives:To assess bowel function and quality of life in patients with ulcerative colitis (UC)after ileal pouch anal anastomosis (IPAA).Methods:Clinical data of 37 UC patients after IPAA between 2014 and 2017 were retrospectively analyzed at Sir Run Run Shaw Hospital School of Medicine Zhejiang University. The IBDQ and Bowel Function questionnaire were used for analyzing correlation between clinical variables and quality of life or bowel function.Results:Laparoscopic operation was performed in 12 cases at stage 2 and 25 cases at stage 3. Postoperative defecation of stage 3 patients were better than that of stage 2 ( t=6.72, P<0.05). The number of daily defecation in age >45-year-old group was more than that in <45-year-old ( t=3.49, P<0.05), and the rate of evening stool seepage in the older group was higher than in the younger group( t=5.28, P<0.05). The total score of intestinal symptoms of IBDQ in patients of pouchitis was lower than that without pouchitis ( r=0.330, P<0.05). The total score in age >45 in terms of systemic symptoms ( r=0.349, P<0.05) and emotional function ( r=0.379, P<0.05) was higher than age <45. Conclusions:Outcomes of UC patients after IPAA are satisfactory, bowel function and quality of life is related with age, and stage of IPAA affect postoperative defecation.
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Objective:To evaluate the feasibility and safety of strictureplasty in the surgical management of Crohn′s disease.Methods:A retrospective study on patients receiving strictureplasty from Jan 2015 to Jun 2019 was conducted.The clinical data and the surgical outcomes were evaluated.Results:35 patients undering 72 episodes of strictureplasty (H-M, 70; Finney, 2) were involved in the study. The most common site of strictureplasty was small bowel, followed by upper gastrointestinal tract and previous site of anastomosis. 7 patients developed postoperative complication, and all of them were cured with conservative management. The median postoperative hospital stay was 8 days.Conclusion:Stricturoplasty——a bowel-sparing option was feasible and safe for the management of Crohn′s disease obstruction related bowel and could reduce the risk of short bowel syndrome.
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Objective To construct a new biomechanical testing system of in vitro spine based on LabVIEW and six-axis robot arm and conduct preliminary reliability studies, so as to make preparation for further studies on coupled motion testing. Methods By programming on LabVIEW platform, using Ethernet and Profibus to communicate the data of the robot arm with PC in real time, the displacement control and load control were realized, and the end position and rotation angle of the robot arm were read in real time. Through the force/torque sensor and data acquisition (DAQ), board DAQ, processing, storage and other functions were acquired. Using the digital micrometer and special stationary fixture, the 6-direction translation accuracy test was completed, and the data were analyzed. The flexion, extension, lateral flexion and rotation were applied on sheep spine specimen to draw the load-displacement curve, analyze and compare the experimental result, and verify the effectiveness of the biomechanical platform. Results A biomechanical test system with high precision for spine in vitro based on LabVIEW and 6-axis robot arm was developed and established, of which the average translational precision was 8.1 μm and the average translational accuracy was 56.7 μm. The program of control, data acquisition, data processing and storage were written, and the biomechanical test of the sheep spine was completed effectively. Conclusions This biomechanical test system based on Labview and 6-axis robot arm could complete the conventional three-dimensional spinal motion test with high precision and be used to conduct coupled motion test research in the next step.
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The importance of follower loads in maintaining spine biomechanics was described, and the various methods and means of follower load simulations of human spine specimens in vitro in recent years were summarized. By comparison with the real data of range of motion (ROM) and intervertebral disc pressure of human vertebral body, the feasibility of various simulation methods was analyzed from the perspectives of mechanics, and the optimal loading load and torque of human cervical, thoracic and lumbar vertebrae biomechanical experiments were summarized. The effects of conventional spinal internal fixation on biomechanical properties of the spine were also discussed.
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Objective To investigate the predictive factors for postoperative intra-abdominal septic complications (IASCs) after intestinal resection in patients with Crohn's Disease (CD).Methods Clinical data from patients who underwent intestinal resection for CD at Sir Run Run Shaw Hospital between June 2011 and July 2016 were retrospectively analysed.The patients were divided into IASCs group and non-IASCs groups by whether suffering from postoperative IASCs.Univariate analysis and multivariate logistic regression analysis were performed to identify the predictive factors for postoperative IASCs,and the receiver operating characteristic curve (ROC) was used to analyse the diagnostic value of the results.Results Among one hundred and seventy-three patients who underwent intestinal resection for CD,15(8.7％) patients experienced postoperative IASCs.The results of univariate and multivariate analysis showed that preoperative CRP ≥ 10 mg/L (OR =4.920,95％ CI:1.137-21.287,P =0.033) was an independent trisk factor for postoperative IASCs,and the laparoscopic surgery (OR =0.070,95％ CI:0.007-0.701,P =0.024) was the independent protective factor for postoperative IASCs.By analyzing ROC curve,preoperative CRP level had the diagnostic value of predicting the postoperative IASCs.The areas under the ROC curves of preoperative CRP for postoperative IASCs were 0.729 with an optimal diagnostic cut-off value of 10.75 mg/L,and with sensitivity of 80.0％ and a specificity of 67.1％.Conclusions Preoperative CRP level is an independent risk factor for postoperative IASCs,and laparoscopic surgery is an independent protective factor for IASCs.
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Objective To evaluate the feasibility and safety of laparoscopy in complex Crohn's disease.Methods A retrospective study of patients with complex Crohn's disease from Jan 2013 to Dec 2015 was conducted.The clinical data and the surgical outcome were evaluated.Results 137 patients with complex Crohn's disease were involved in the study.81 patients underwent laparoscopic procedure,the conversion rate was 30％.56 patients underwent conventinal laparotomy.The blood loss (50ml vs.100 ml,Z =-4.84,P ＜ 0.001),stoma rate (28％ vs.45％,x2 =6.03,P =0.05),interval to bowel movement (3 d vs.4 d,Z=-3.69,P =0.001) and postoperative hospital stay (8 d vs.14 d,Z=-5.41,P＜0.001) were more favourable in laparoscopic surgery group than in laparotomy group.Conclusion Laparoscopy is feasible and safe in complex Crohn's disease.In well indicated patients,preoperative optimization and surgical expertise can improve the outcome of Crohn's disease.
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Objectives To investigate the association between health belief and medication adherence in hypertensive patients.Methods A total of 232 hypertensive patients who visited Outpatient Department of Huashan Hospital between October 2013 and May 2014 were recruited in this cross-section study.The degree of medication adherence was measured with Morisky scale and health belief was evaluated with questionnaires of Health Belief Model (HBM).Results Of the 232 participants,61 (26.3％),51 (22.0％) and 120 (51.7％) showed low,medium and high medication adherence in Morisky scale,respectively.Logistic analysis showed that the perceived susceptibility (P ＜ 0.001),and cues to action (P =0.004) were positively correlated,and perceived barriers (P ＜ 0.001) was negatively correlated with medication adherence of patients.Conclusion Effective interventions to improve antihypertensive medication adherence should increase perceived susceptibility,cues to action,and reduce the barriers to medication adherence of patients.
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Background and purpose:In in vivo and vitro studies, Rhodiola shows anti-cancer effect, but there were few reports about the effects of Rhodiola on growth of breast cancer and its possible mechanism. Methods:Xenograft of Human breast cancer cells MDA-MB-435 in female BALB/c nude mice were treated with and without Rhodiola extracts. The tumor volume and proliferation index (PCNA and Ki67) of the xenograft were studied.Results:After Rhodiola was given to nude mice for 4 weeks, the mean tumor volume was smaller (99.95mm 3 vs. 174.60mm 3 ) compared to untreated group,but there was no statistical significance(P=0.535). The proportion and intensity of cellular Ki-67 staining in Xenografts were decreased as compared to the untreated group, (average H-score 152.8 vs. 86, P=0.014), the same trend could be found for cellular PCNA staining, but there was no statistical significance(242 vs.210,P=0.221).Conclusions:The mechanism of anti-cancer effect of Rhodiola may be partly through inhibiting the proliferation of cancer cells in vivo.