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Objective To compare the effectiveness and safety of endoscopic submucosal dissection ( ESD) with endoscopic piecemeal mucosal resection ( EPMR) for early esophageal cancer and precancerous lesions with length more than 5 cm. Methods A retrospective analysis was performed on data of 85 patients diagnosed as early esophageal cancer and precancerous lesions with length more than 5 cm in Fujian Medical Association of Early Esophageal Carcinoma from January 2012 to July 2017. The patients were divided into ESD group (52 cases) and EPMR group (33 cases), and the effectiveness and safety between the two groups were compared. Results There was no significant difference on the complete resection rate between the two groups[86. 5％ (45/52) VS 87. 9％ (29/33), P>0. 05]. The operative time (58. 53±30. 50 min VS 32. 06±9. 12 min), postoperative fasting time (4. 18±1. 30 d VS 3. 67±0. 96 d), postoperative hospital-stay time (7. 45±2. 44 d VS 6. 54±1. 73 d), and postoperative antibiotics using time (3. 48±2. 33 d VS 1. 96±2. 20 d) in ESD group were higher than those in EPMR group (all P<0. 05). There were no significant difference in the rate of intraoperative complication and short-term postoperative complication, such as fever, chest pain, and postoperative bleeding, between the two groups ( all P>0. 05 ) . But the postoperative stricture rate of ESD group was higher than that of EPMR group[23. 1％ (12/52) VS 6. 1％(2/33), P<0. 05]. During the follow-up of 3-63 months, 5 cases recurred in ESD group and 1 case in EPMR group, with no significant difference ( P>0. 05). Conclusion ESD and EPMR have equivalent efficacy and safety on the treatment of early esophageal cancer and precancerous lesion. EPMR has a shorter operative time, lower rate of post-operative stricture, and is easier to master.
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Objective To investigate the survival status and related influencing factors of very low birth weight infants(VL-BWI) and very early preterm infants(VPI).Methods One hundred and forty-two very low birth weight and very preterm infants in our hospital from April 2012 to January 2016 and contemporaneous 140 non-low-birth-weight and non-very-preterm infants were selected.The survival status of newborns and long-term prognosis were compared.The low birth weight children and very preterm infants were divided into the death group and survival group according to the survival status and long-term prognosis.The clinical data in the two groups were performed the univariate and multivariate Logistic regression analysis.Results The incidence rate of poor prognosis had statistically significant difference among neonates with birth weight less than 1 500,1 500-2 500 and＞2 500 g(P＜0.05).The incidence rate of poor prognosis had statistically significant difference among neonates with the gestational age≤32 weeks,32-37 weeks and≥37 weeks(P＜0.05).The proportions of gestational age,birth weight and antenatal dexamethasone use in the death group were significantly lower than those in the survival group,while the proportions of maternal age,asphyxia,meconium aspiration,pregnancy induced hypertension and mechanical ventilation in the death group were significantly higher than those in the survival group,the difference between two groups was statistically significant(P＜0.05).The gestational age≤28 weeks,birth weight≤1 000 g and asphyxia were the independent risk factors affecting the survival status in very low birth weight infants and extremely preterm infants(P＜0.05).Conclusion In VLBWI and VPI the living status,and long-term prognosis are poor and prone to mental and movement disorders.
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Objective To analyze the relationship and significance between plasma level of thyroid hormone and ovulation disorder of (polycystic ovary syndrome)PCOS.Methods Eighty-nine cases with PCOS were induced ovulation by CC+HCG.During menstrual cycle of induced ovulation,PCOS patients were divided into two groups according to Ovulation (No ovulation 40,ovulation 49).The level of thyroid hormone at different follicular development period and ovulatory time were detected.Result Levels of thyroid hormone at two groups were no difference at 5 mm,10 mm,15 mm size follicular phase(P＞0.05).But there was significant at follicular 20mm size(F inner groups=4.38,50.34,48.65;P＜0.05).The level of T3 an T4 at No ovulation group was lower than those in ovulation group(T3:(2.69±0.15) nmol/L vs.(1.97±0.17) nmol/L;T4:(124.38±0.29) nmol/L vs.(97.43±0.16) nmol/L).The level of TSH at No ovulation group was (3.43±0.10) mU/L,higher than that in ovulation group ((1.38 ± 0.18) mU/L;P ＜ 0.05).Conclusion The level of thyroid hormone in patients of ovulation group is at a normal level when the follicle is mature,and the level of thyroid hormone can affect the normal ovulation of patients with PCOS.
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Objective To assess the association between helicobacter pylori (HP) infection and dyslipidemia in different gender population.Methods We conducted cross-sectional analysis using data of 1921 cases of demographic characteristics,anthropometry,life style,lipid profile,etc.,from the subjects who received health examination from January 2010 to June 2012 in Department of Geriatrics,Tongji Hospital.Diagnosis of HP infection was achieved by using 14C-Urea Breath Test (14C-UBT).The participants were divided into HP infection positive group and HP infection negative group by 14C-UBT.Results In female subjects,the levels of total cholesterol/high-density lipoprotein cholesterol (TC/HDL-c) were higher in HP positive group than HP negative group (P ＜ 0.05),but there was no obvious difference between the levels of low density lipoprotein cholesterol (LDL-c) in HP positive group and HP negative group.However,in the male subjects,the levels of LDL-c and TC/HDL-c were significantly increased in HP positive group than HP negative group (P ＜ 0.05).HP positive group had a greater risk for high TC/HDL-c both in female and male subjects.In female subjects,the risk for high TC/HDL-c in HP positive group was 1.90 times of that in HP negative group (95％ CI,1.06 ～ 3.38).In male subjects,the risk for high TC/HDLc in HP positive group was 1.56 times of that in HP negative group (95％ CI,1.21 ～ 2.00).But only in male subjects,the risk for high LDL-c in HP positive group was 2.33 times of that in HP negative group (95 ％ CI,1.34 ～ 4.06).Conclusions We observed that HP infection was probability associated with dyslipidemia.
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Objective To observe the effects of central exudative chorioretinopathy(central exudative chorioretinopathy,CEC)treated with blood-activating and stasis-removing Chinese medicines.Methods All 339 cases of central exudative chorioretinopathy with 346 infected eyes were randomly recruited into a treatment group(176 cases with 181 infected eyes)and a control group(163 cases with 165 infected eyes).The treatment group was treated with traditional Chinese medicine by dialectical combination of syndrome and disease,while the control group was treated with conventional treatment.Results The corrected visual acuity was 0.01～1.2 in the treatment group.Of all 181 eyes in 176 patients,76 eyes were cured(41.98%),85 eyes were improved(46.96%),and 20 eyes were ineffective(11.6%),with a total effective rate being 88.94%.BY contrast,in the control group,of all 165 eyes in 163 patients,62 eyes were cured(37.57%),67 eyes were improved(40.60%),and 36 eyes were ineffective(21.83%),with a total effective rate being 78.17%.There was significant difference in the total effective difference between the two groups(U=2.05693,P＜0.05).FFA and OCT were reexamined for the patients in the treatment group three menths after the treatment.The results showed that fluorescein leakage and choroidal neovascularization(choroid al neovascularisation,CNV)lesions disappeared in 76 eyes;fluorescein leakage and CNV lesions relieved in 85 Eyes;fluorescein leakage still existed in 12 eyes;and sear formed in 8 eyes.Conclusion Blood-circulating and stasis-removing Chinese medicines have good effects in promoting subhyaloid hemorrhage and exudation,eliminating retinal oedema,and improving eyesight.
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To explore the application of potassium titanyl phosphate (KTP) laser delivered via bronchofiberscope in the treatment of endobronchial tuberculosis. 36 patients with a diagnosis of endobronchial tuberculosis, with age ranging from 15 to 40 y were treated with KTP laser between Dec. 2002 and July 2004 (designated as treatment group). The other 36 patients diagnosed as having endobronchial tuberculosis (aged 18 to 42 y, with a mean age of 33. 5 y) without having received KTP laser treatment were included in a control group. Our results showed that the effective rates, in terms of recovery of bronchial lumen and cleanup of caseous necrotic mass were significantly higher in the treatment group 8 weeks after the treatment (P0.05). No significant changes were found in SaO2 and HR before, during and after the operation in the treatment group (P>0.05). It is concluded that KTP laser is an effective therapy for endobronchial tuberculosis.
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To explore the application of potassium titanyl phosphate (KTP) laser delivered via bronchofiberscope in the treatment of endobronchial tuberculosis. 36 patients with a diagnosis of endobronchial tuberculosis, with age ranging from 15 to 40 y were treated with KTP laser between Dec. 2002 and July 2004 (designated as treatment group). The other 36 patients diagnosed as having endobronchial tuberculosis (aged 18 to 42 y, with a mean age of 33. 5 y) without having received KTP laser treatment were included in a control group. Our results showed that the effective rates, in terms of recovery of bronchial lumen and cleanup of caseous necrotic mass were significantly higher in the treatment group 8 weeks after the treatment (P＜0.01), and the healing rates of atelectasis and obstructive infection were also significantly higher in the treatment group (P＜0.05 and P＜0.01), but the incidence of complication after 8 weeks was no significant difference (P ＞0.05). No significant changes were found in SaO2 and HR before, during and after the operation in the treatment group (P＞0.05). It is concluded that KTP laser is an effective therapy for endobronchial tuberculosis.
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BACKGROUND: Stimulating cerebellar fastigial nucleus can regulate, dilate blood vessels and greatly increase local blood flow. However, if its mechanism is to improve the function of vascular endothelium is still uncertain.OBJECTIVE: To study the effects of stimulating cerebellar fastigial nucleus by electricity to vascular relaxation of transient ischemic attack(TIA) patients which is induced by blood flow and explore its protective mechanism to blood vessels of TIA patients.DESIGN: Randomized case control study to patients based on diagnosis SETTING: Department of general diseases, rehabilitation room and ultrasound department of a university hospital.PARTICIPANTS: Forty-four TIA patients(＞ 60 years old) admitted into Department of General Diseases of Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology during February 2001 to October 2002 were selected after excluding cerebral hemorrhage or cerebral infarction, atrium fibrillation and other arrhythmia or heart failure and blood system diseases. They were randomly divided into treatmentgroup(22 cases)and control group(22 cases) which were conducted stimulating fastigial nucleus + routine treatment and only routine treatment respectively.METHODS: High resolution ultrasound technique and brachial artery congestion method were used to test the internal diameter change rate of brachial artery in TIA patients before and after treatment.MAIN OUTCOME MEASURES: The internal diameter change rate of brachial artery of TIA pat ients.RESULTS: The internal diameter change rate of brachial artery was (4.59 ± 3.32) % and ( 10. 34 ± 3.13 ) % respectively before and after conducting electric stimulus to fastigial nucleus with significant difference ( t = 5.91, P ＜ 0.01 ). There was significant difference on internal diameter change rate between treatment group and control group( t =5.41, P ＜ 0.01 )while there was no difference in control group before and after treatment [(4.68±3.20) %,(5.10±3.29) %](t=1.72, P＞ 0.05).CONCLUSION: Conducting electric stimulating to fatigial nucleus can greatly improve the reactively vascular congestive function of brachial artery internal diameter and it can improve the vascular endothelial functions of TIA patients.
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Objective To observe plasma concentration of adiponectin and high sensitive C reactive protein (HsCRP) in Type 2 diabetes mellitus(T2DM) with/without lower extremities vascular disease,and explore the influences of adiponectin and HsCRP in the genesis and development of them.Methods We selected 115 subjects in our hospital and divided them into 2 groups:normal control group and T2DM group,including simple T2DM and T2DM with diabetic lower extremities vascular disease;in addition,we measured plasma adiponectin and HsCRP with ELISA and scattered radiation turbidimetry for them.Results Plasma adiponectin concentration in the comparing group was higher than T2DM,and the level in simple T2DM patients was higher than the one with lower extremities vascular disease,showing an obviously decreased tendency,and significant differences were detected in plasma adiponectin concentration between groups (P