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At present, there is no effective treatment method of radiation-induced intestinal injury. Clinically, only symptomatic remission therapy can be used. Intestinal stem cells (ISCs) have strong renewal ability, which is an important part of intestinal structure regeneration. To promote the recovery of the number and function of ISCs has been a research hotspot in the treatment of radiation gastrointestinal syndrome. This article introduces the important role of ISCs in the protection of radiation-induced intestinal injury and its clinical application significance from the classification and regulatory mechanism of ISCs, and drugs that regulate the damage, apoptosis and repair of stem cells, so as to provide reference for the future research on the role of intestinal stem cells in radiation protection.
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Objective: To evaluate the effect of pneumatic tourniquet on perioperative period of total knee arthroplasty (TKA). Methods: The perioperative period data of 116 patients over 60 years old with severe knee osteoarthritis treated with TKA between January 2018 and January 2019 were retrospectively analyzed. According to whether pneumatic tourniquet was used during operation, the patients were divided into trial group (49 cases, pneumatic tourniquet was not used during operation) and control group (67 cases, pneumatic tourniquet was used during operation). There was no significant difference in gender, age, body mass index, lesion side, disease duration, and preoperative hemoglobin between the two groups ( P>0.05). The operation time, actual total blood loss, overt blood loss, hidden blood loss, and percentage of hidden blood loss, knee swelling at 3 days after operation, and range of motion of knee at 2 weeks after operation were recorded and compared between the two groups. Results: The operation time of the trial group was significantly longer than that of the control group ( t=14.013, P=0.000). The actual total blood loss, hidden blood loss, and percentage of hidden blood loss in the trial group were significantly lower than those in the control group ( P<0.05); there was no significant difference in the overt blood loss between the two groups ( t=-1.293, P=0.200). The knee swelling degree in the trial group was significantly slighter than that in the control group at 3 days after operation, and the range of motion of knee in the trial group was significantly better than that in the control group at 2 weeks after operation ( P<0.05). Conclusion: Pneumatic tourniquet can reduce the operation time of TKA significantly. However, it may increase the hidden blood loss and knee swelling, and negatively impact the recovery of knee function in the early postoperative stage of TKA.
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Methods: A retrospective analysis was made in the data of 83 patients with unilateral osteonecrosis of the femoral head between March 2014 and May 2017. Forty-eight patients were treated with THA via PA (PA group) and 35 patients were treated with THA via DAA (DAA group). There was no significant difference in gender, age, body mass index, stage of osteonecrosis of the femoral head, and disease duration between 2 groups ( P>0.05). The length of incision, operation time, total amount of bleeding, the time of first postoperative walking with crutch, the time of first postoperative walking without crutch, the Harris scores, and the visual analogue scale (VAS) scores of 2 group were recorded and compared.
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Objective: To evaluate the effectiveness of open wedge high tibial osteotomy (OWHTO) in treatment of medial unicompartmental knee osteoarthritis (MUKOA). Methods: A clinical data of 61 cases with MUKOA who were treated with OWHTO between January 2015 and January 2017 were retrospectively analyzed. There are 14 males and 47 females with an average age of 52.8 years (mean, 44-60 years). The body mass index ranged from 19.1 to 34.7 kg/m 2 (mean, 25.3 kg/m 2). Twenty-seven cases were left side and 34 cases were right side. The disease duration was 1-9 years (mean, 5.3 years). The MUKOA was rated as stage Ⅱ in 33 cases and stage Ⅲ in 28 cases. Preoperative Hospital for Special Surgery (HSS) score was 56.0±3.7. Walking visual analogue scale (VAS) score was 4.6±1.0. Results: The operation time was 49-85 minutes (mean, 66.5 minutes). The length of incision was 10-13 cm (mean, 11.0 cm). The total overt blood loss was 80-210 mL (mean, 139.1 mL). The postoperative bed-rest time was 1-10 days (mean, 4.7 days). All patients were followed up 12-24 months (mean, 17.3 months). The bearing area of tibial platform at 3 months after operation was 60.3%-66.8%, with an average of 63.4%. At 3 and 6 months after operation, the HSS score was 79.1±4.2 and 85.3±3.1 respectively, and the VAS score was 1.7±0.7 and 0.6±0.5 respectively, all showing significant differences ( P<0.05). Conclusion: OWHTO is an ideal choice for treating MUKOA with less postoperative complications. The force line could be corrected by OWHTO. However, the preoperative preparations are very important, especially that the open angle should be measured accurately.
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Objective To evaluate the short-term outcomes and analyze the complications of medial unicompartmental knee osteoarthritis (MUKOA) treated by unicompartmental knee arthroplasty (UKA).Methods Retrospectively analyzed the patients suffered with MUKOA and registered into our department from Jul 2015 to Jan 2017.71 cases were enrooled in the study,of which 17 are male (19 UKA) and 54 are female (66 UKA).The general information,perioperative data,Hospital for Special Surgery (HSS) score,visual analogue score (VAS) and complications of the group were analyzed.Results Females were three times more than males (54∶ 17).The average age of female subjects was lower than that of male,the difference was significant (P ＜ 0.05).The rate of Osteoporosis of females was significantly higher than that of males (P ＜ 0.05).The operative time,length of incision,total overt blood loss and postoperative in-bed time were (54.06 ± 6.24) min,(8.56 ± 0.83) cm,(86.10 ± 5.44) ml,(3.51 ± 1.01) d,respectively.No significant differences were found between males and females (P ＞ 0.05).The preoperative,3 months and 6 months postoperative HSS scores were 45.2 ± 4.5,80.3 ± 5.7 and 88.4 ± 4.2,respectively.No differences were found between males and females (P ＞ 0.05).The preoperative,3 months and 6 months postoperative VAS scores were 6.6 ± 1.2,1.7 ± 0.7 and 0.5 ± 0.5,respectively.No differences were found between males and females (P ＞ 0.05).There were 2 revised cases,and the reasons for revision were infection and unstability caused by sport injury.Conclusions UKA is an ideal choice for patients with MUKOA,Especially for the ones older than 60 years.However,the corrections on lower-limb forceline and joint unstability are limited,thus,the indications for UKA should be controlled strictly.
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Objective To study the shadowing effect when using UWB bio-radar to detect multiple static human targets to solve the problem in multi-target detection.Methods With simulated breathing apparatus as detection targets,the UWB bioradar multi static targets respiration detection experiment was designed,and the influences of distance and angle between targets and its respiratory frequency and amplitude on the shadowing effect were studied.Result The shadowing effect was mainly affected by the relative position of the multiple targets,while the respiratory frequency and amplitude of the target had less influence on it.Conclusion When multi static human targets are detected the shadowing effect does exist,and the effect mainly derives from the block of electromagnetic wave by the front target,while the change of respiratory parameters of the front target has little influence on the effect.
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Objective To evaluate effect of continuous pelvic floor muscle training(PFMT) during pregnancy on delivery outcome, and to provide reference for clinical nursing work. Methods By searching database, the literature about continuous PFMT during pregnancy on delivery outcome were included,then EndNote was used to check the literature and RevMan5.2 was applied for Meta-analysis of the literature which met the inclusion criteria. Results A total of 11 papers were included. Meta-analysis showed that continuous PFMT during pregnancy can reduce lateral perineal resection rate (OR=0.66, 95%CI 0.48-0.89), increase rate of natural childbirth (OR=1.70, 95%CI 1.32-2.19) and promote progress of the first (MD=-0.52, 95%CI-0.92--0.12) and second (MD=-0.18, 95%CI-0.30--0.06) stage of labor. The intervention group shortened the first and the second stage of labor for 0.18h and 0.52h compared with the control group respectively. Conclusions Continuous PFMT during pregnancy can improve natural delivery rate, reduce the incidence of perineal side incision and shorten the time of labor, it is worthy of being promoted in clinical practice.
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BACKGROUND:Bone marrow mesenchymal stem cels have a therapeutic effect on acute lung injury, but the mechanism is unclear. If the mechanism is understood, the majority of patients with acute lung injury can obtain a benefit. OBJECTIVE:To explore the possible mechanism underlying bone marrow mesenchymal stem cels in the treatment of acute lung injury with sepsis in rats. METHODS: (1) Thirty-six adult Wistar rats were randomly divided into three groups, sham operation group (sham group), sepsis group and bone marrow mesenchymal stem cels group (cel treatment group). In the sepsis and cel treatment groups, animal models of sepsis with acute lung injury were established by cecal ligation and puncture, while in the sham group, the cecum was not ligated and punctured. Then, 1 mL normal saline was injected via the femoral vein in the sepsis and sham groups, and 1 mL bone marrow mesenchymal stem cel suspension (1×109/L) was injected into the cel treatment group. After 6 hours, interleukin 10 and macrophage inflammatory protein-2 levels in serum were measured in the three groups. Lung tissues were taken for pathological observation using hematoxylin-eosin staining. (2) Rat alveolar macrophages were obtained by bronchoalveolar lavage, seeded into 24-wel culture plates, and divided into three groups: control group (group A), sepsis model group (group B) and intervention group of bone marrow mesenchymal stem cels (group C). Normal saline, septic plasma, and co-intervention of septic plasma and mesenchymal stem cels were used in the groups A, B, C, respectively. Then, cels in the three groups were cultured in a 5% CO2 incubator at 37℃ for 1 hour. After that, alveolar macrophages were taken to detect whether nuclear factor-κB (P65) protein entered into the nucleus using laser scanning confocal microscopy. RESULTS AND CONCLUSION: (1) The results of animal experiments showed that compared with the sham group, the macrophage inflammatory protein-2 levels in the sepsis group and cel treatment group were significantly increased (P 0.05); inflammatory cel infiltration, interstitial pulmonary edema and pulmonary hemorrhage existed in the sepsis and cel treatment groups, but these symptoms were significantly reduced in the cel treatment group compared with the sepsis group. (2) Results from cel experiments showed that compared with the group A, in group B and group C, the number of nuclear factor-κB (P65) proteins into the nucleus was significantly higher (P < 0.05), but it was lower in the group C than the group B (P < 0.05). These findings indicate that bone marrow mesenchymal stem cels in acute lung injury with sepsis can regulate nuclear factor-κB (P65) protein of alveolar macrophages into the nucleus, reduce expression of macrophage inflammatory protein-2, and thereby play a protective role in the lungvia reducing neutrophil infiltration. Temporarily, this study cannot explain whether bone marrow mesenchymal stem cels have an effect on interleukin 10.
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Objective To study the influence of biofeedback combined electrical stimulation therapy in parturients occurred breast pain under the cooperation between doctors and nurses. Methods Method of randomized controlled study was adopted. 112 puerperants were randomized chosen to experimental group (56 cases) and control group (56 cases). Diagnosed by doctors and confirmed that was normal. One group received biofeedback combined electrical stimulation therapy, the other group received regular therapy. Results There were great differences in breast hardness and milk volume ,when 3 days after the intervention, Z=5.91, P<0.01 (the cases of one degree of swelling in the two groups was 19 and 1 respectively). There were great differences in breast swelling and the hardness and milk volume, when 7 days after therapy and postpartum 42 days. The score of cooperation between doctors and nurses were (98.66±2.96) points, the satisfaction to this therapy was 94%(47/50). Conclusions Biofeedback combined electrical stimulation therapy can reduce breast pain and hardness in puerperants, it has great difference in breastfeeding status under the cooperation between doctors and nurses.
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BACKGROUND:Traditional coculture methods for directional differentiation of bone marrow mesenchymal stem cells, such as direct contact method and Transwel coculture system, appear to have low purity and slow proliferation. OBJECTIVE:To compare the inductive effect of microcapsule coculture system and traditional transwel coculture system on the differentiation of bone marrow mesenchymal stem cells. METHODS:The passage 2 microcapsuled chondrocytes and the passage 3 bone marrow mesenchymal stem cells harvested from rabbits were co-cultured at a ratio of 1:1 in a Transwel chamber. Another passage 2 chondrocytes and passage 3 bone marrow mesenchymal stem cells were co-cultured using traditional transwel coculture system. Pure bone marrow mesenchymal stem cells were served as controls. MTT assay was used to compare cellproliferation, toluidine blue staining and safranine O staining were used for observation of cartilage matrix synthesis, alcian blue staining and ELISA test were used to measure glycosaminoglycans and synthesis of type II col agen, respectively. RESULTS AND CONCLUSION:Compared with the traditional co-culture method, the microcapsule coculture system and pure culture method showed better cellproliferation (P<0.05). The levels of glycosaminoglycans and type II col agen were higher in the microcapsule coculture group than the traditional coculture group and pure culture group (P<0.05). Moreover, the microcapsule coculture group showed better outcomes in toluidine blue staining and safranine O staining than the traditional coculture group and pure culture group. These findings indicate that the microcapsule coculture system is more effective in the induction of bone marrow mesenchymal stem cells than traditional Transwel coculture system.
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Objective To establish diagnostic standards of colorectal tubular adenocarcinoma with confocal laser endomicroscopy(CLE), and to evaluate its diagnostic value in vivo.Methods The confocal images of 12 cases, which were pathologically confirmed colorectal tubular adenocarcinoma(4 well differentiated, 4 moderately differentiated and 4 poorly differentiated), were collected and analyzed to establish diagnostic standards of the disease with CLE.Then 49 lesions were prospectively evaluated based on CLE standards,which were compared to histopathology results.Results The sensitivity, specificity, accuracy, positive predictive value(PV +)and negative predictive value(PV -)of CLE in diagnosing tubular adenocarcinoma were 94.7%, 90.9%, 93.9%, 100% and 76.9%, respectively.The corresponding data of well differentiated adenocarcinoma were 100%, 83.3%, 88.9%, 85.7% and 87.0%, those of moderately differentiated adenocarcinoma were 86.7%, 90.5%, 86.1%, 86.7% and 90.5%, and those of poorly differentiated adenocarcinoma were 77.8%, 92.6%, 88.9%, 100% and 86.2%.Conclusion CLE is able to diagnose and grade colorectal tubular adenocarcinoma.
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<p><b>OBJECTIVE</b>To evaluate the safety and effectiveness of direct gastroscopy for detecting gastric cancer.</p><p><b>METHODS</b>Clinical screening by direct gastroscopy was performed for gastric cancer (GC) from September 1985 to July 1998. 3048 elderly people were screened. Their age ranged from 60 to 93 years, and 2034 of the 3084 were followed up.</p><p><b>RESULTS</b>Ninety-two patients with gastric cancer were discovered by gastroscopy, representing 3.02% of the screened population. The rate of early gastric cancer (EGC) was 63.04% (58/92) of all gastric cancers detected. The rate was up to 79.59% (39/49) on follow-up, and was 74.14% (43/51) in asymptomatic patients with gastric cancer. The excision rate was 88.89% for patients with gastric cancer, and 100% for patients with early gastric cancer. The 5-year survival rate was 91.89% for patients with gastric cancer, and 96.30% for patients with early gastric cancer.</p><p><b>CONCLUSION</b>Clinical screening and follow-up by direct gastroscopy in persons over 60 years of age are a safe and effective method for raising the 5-year survival and detection rate of gastric cancer, especially early gastric cancer.</p>
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Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Follow-Up Studies , Gastroscopy , Prognosis , Stomach Neoplasms , Diagnosis , Mortality , Survival RateABSTRACT
To study the significance of detection of K ras mutation in stool samples in the diagnosis of large intestinal cancer, stool and local tissue samples were collected from consecutively diagnosed patients, among them 23 cases suffered from large intestinal cancer, 20 cases from colorectal adenomatoid polyps and 20 healthy subjects. DNA was extracted from both the stool and the tissue, K ras gene mutations at the first and second base of codon 12 were studied by allele specific mismatch method in both of them. The results showed that K ras mutation rate in large intestinal cancer was 56 52%(13/23), which was much higher than 5%(1/20)in healthy subjects( P 0 05). There was a 92 31%(12/13)incidence of K ras mutation at the second base of codon 12 in large intestinal cancer. The results of detecting the K ras mutation were highly identical in both the stool and the tissue ( P
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Objective To evaluate the importance of clinical screening and follow up by direct colonoscopy for colorectal cancer at an early and curable stage. Methods There were 2 196 elderly people aged between 60 to 89 years. The clinical screening by direct colonoscopy was performed according to the protocol. 1 740 of 2 196(79.2%) patients were followed up every year. Results Fifty two elderly persons were found to be colorectal cancer patients by colonoscopy, with the detectable rate being 2.4%. Nineteen were diagnosed early stage colorectal cancer, accounting for 36.5% of the detected colorectal cancer. Nine among the followed up cases were detected early colorectal cancer, accounting for 45 0% of the detected colorectal cancer. The resectable rate and the 5 year survival rate was 97 7% and 80 9% for colorectal cancer, respectively. 98 9% of the cecum intubation cases was successful. The incidence of complication for colonoscopy was 0 05%. Conclusions By clincal colonscopy screening and follow up study for colorectal cancer and precancerous changes in the elderly, the patients with adenomatoid polyps were early diagnosed and treated, so it raised the detectable rate of early colorectal cancer and the level of grade prevention of colorectal cancer.
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To assess the value of capsule endoscopy in digestive tract examination, the results of 10 healthy volunteers who received the whole digestive tract examination by capsule endoscopy were analyzed. The manipulation of capsule endoscopy was simple, the image was clear, and no side effect was found. Intestinal diseases could been diagnosed by capsule endoscopy, and the stomach could been partly observed. Capsule endoscopy is a best visual diagnostic tool of intestinal diseases, and can be used in clinic.
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Objective To evaluate the clinicopathological characteristics of early gastric carcinoma for prognosis and the long term consequences of gastrectomy for quality of life in the aged. Methods The clinicopathological features and late postoperative complications by follow up study for 71 patients during 1973 1999 with early gastric cancer were reviewed by using hospital records. Results Forty six cases(64.8%) were diagnosed by routine gastroscopic checkup. 56 cases out of 71 (74.6%) were mucosal cancer without lymph node metastasis, 18 cases were submucosal cancer with lymph node metastasis in 2 cases. By histological study, we found that 32 lesions (45.1%) were located at the antrum, differentiated tubular adenocarcinoma was found in 43 cases, and multiple primary carcinoma in 5 cases and gastric stump cancer in 3 cases. The disorders of gastric stump included anastomotic gastritis, empting disturbance, erosion, ulcer, reflux esophagitis were found in 31, 7, 6, 4 and 3 cases, respectively. Fourteen patients showed weight loss and 9 showed anemia. Patients with proximal gastrectomy suffered more from disoders than the patients with distal gastrectomy. Conclusions Our results suggest that special attention should be given to the patients with chronic atrophic gastritis diagnosed by routine gastroscopy. Lymph node metastasis, multiple primary cancer and gastric stump cancer might affect the prognosis. Our results support the fact that the incidence of disorders of gastric stump are high; and the surgical treatment with gastroscopic procedure is recommended for the mucosal cancer in order to improve the patients' quality of life.
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Objective To assess the evolution of gastric epithelial dysplasia (GED). Methods We reviewed the history of 239 of patients with gastric dysplasia diagnosed by endoscopic biopsy, and 195 were followed up for 61. 37 months. Results Among 239 cases of dysplasia (261 lesions) , there were 119, with mild dysplasia, 77 with moderate dysplasia, and 43 with severe dysplasia. The gastric dysplasia lesions are mainly in lesser curvature, and its endoscopic appearance mostly is localized erosion. In the follow - up group, regression of dysplasia was demonstrated in 86. 36% , 81. 25% , and 47. 62% of mild, moderate and severe dysplasia respectively. Progression to gastric cancer was detected in 8. 18% , 15. 63% , and 72. 09% of mild, moderate, and severe dysplasia, respectively. The relative risk (RR) of mild, moderate, severe dysplasia was 1. 96, 3. 74, and 17. 25 respectively. Conclusion Carcinomatous evolution of GED increases proportionally with its histological grade. Gastroscopy biopsy follow-up should be held up for all grades of GED, especially, in high grade GED, gastroscopy and biopsy should be taken as soon as possible.
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Objective To assess the detection of intestinal lesions by capsule endoscopies in Chinese patients. Methods To review the history and outcomes of 53 patients underwent 55 times ol capsule endoscopies from April 2002 to January 2003. Results Fifty-three patients received 55 times of capsule endoscopies , only one patient failed due to weak gastric peristalsis. Complication never happened. The capsule remained in the stomach and small intestine for an average of 44 minutes (range 6 - 135 minutes) and 334 minutes (range 90 -433 minutes) respectively. Three patients did not discard the capsule properly due to the stricture of small intestine. The diseases detected were small intestinal cancer, lymphoma, polyps, leio-myoma, xanthoma, Crohns disease, intestinal erosion and congestion, ascariasis, triehuriasis, foreign body and angiodysplasia. Conclusion This study demonstrates that the manipulation of capsule endoscopy is simple and safe, and provides excellent visualization of small intestine. Capsule endoscopy is superior to radiography or angiography in detecting lesions of small intestine, but it cannot afford enough information on orien-tation and histology.
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Objective To assess the security and the values of capsule endoscopy in examining the GI tract diseases in elderly people Methods The results of 13 patients aged 62 86 years who accepted the whole digestive tract examination by capsule endoscopy were analysed Results Complications and side effects were not found in these patients Capsule endoscopy was useful in diagnosing intestinal diseases The intestinal diseases were diagnosed as enteritis in 2 patients, intestine xanthoma in 2 patients, active intestine bleeding in 1 patients, and benign tumor in 1 patient Six out of 7 patients(85 7%)showed no symptom Conclusions Capsule endoscopy is a secure diagnostic means for the intestinal diseases, especially in elderly people