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Objective:To investigate the clinical efficacy of Da Vinci robotic assisted and laparos-copic assisted complete mesocolic excision (CME) for right hemicolon cancer.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopatho-logical data of 119 patients with right hemicolon cancer who were admitted to Daping Hospital, Army Medical University from July 2016 to July 2019 were collected. There were 63 males and 56 females, aged (61±11)years. All the 119 patients underwent CME of right hemicolon. Of 119 patients, 37 cases undergoing Da Vinci robotic assisted CME of right hemicolon were divided into robotic group and 82 cases undergoing laparoscopic assisted CME of right hemicolon were divided into laparoscopic group. Observation indicators: (1) the propensity score matching conditions and comparison of general data between the two groups after propensity score matching; (2)intraoperative and postoperative situations; (3) postoperative pathological examination; (4)follow-up. Follow-up was conducted by outpatient examination or telephone interview to detect tumor metastasis and survival of patients after surgery up to August 2019. The propensity score matching was conducted by 1∶1 matching using the nearest neighbor method. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Count data were represented as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. The Kaplan-Meier method was used to calculate survival rate and the GraphPad Prism 5 software was used to draw survival curve. The Log-rank test was used for survival analysis. Results:(1) The propensity score matching conditions and comparison of general data between the two groups after propensity score matching: 68 of 119 patients had successful matching, including 34 cases in each group. Before propensity score matching, cases undergoing surgery by surgeon A or surgeon B were 32, 5 of the robotic group, versus 49, 33 of the laparoscopic group, showing a significant difference between the two groups ( χ2=8.381, P<0.05). After propensity score matching, the gender (males or females), age, body mass index (BMI), cases with tumor classified as stageⅠ, stage Ⅱ or stage Ⅲ of TNM staging, cases with tumor located at ileocecal region, ascending colon, hepatic flexor of colon or transverse colon, cases undergoing surgery by surgeon A or surgeon B were 17, 17, (62±10)years, (22.4±2.7)kg/m 2, 4, 14, 16, 3, 15, 10, 6, 29, 5 of the robotic group, versus 15, 19, (62±11)years, (22.4±2.8)kg/m 2, 4, 18, 12, 2, 19, 7, 6, 30, 4 of the laparoscopic group, showing no significant difference between the two groups ( χ2=0.236, t=0.127, 0.044, χ2=1.071, 1.200, 0.000, P>0.05). (2) Intraoperative and postoperative situations: after propensity score matching, the operation time, volume of intraoperative blood loss, cases undergoing conversion to open surgery, time to postoperative initial out-of-bed activities, time to postoperative first flatus, time to postoperative initial liquid food intake, duration of postoperative hospital stay and treatment expenses were (235±50)minutes, (73±45)mL, 0, (1.9±0.7)days, (2.9±1.2)days, (3.1±2.4)days, (9.1±4.9)days, (9.6±1.8)×10 4 yuan of the robotic group, versus (183±35)minutes, (74±74)mL, 1, (2.1±0.6)days, (3.3±1.4)days, (3.5±4.2)days, (9.1±3.9)days, (6.3±1.6)×10 4 yuan of the laparoscopic group, respectively. There were significant differences in the operation time and treatment expenses between the two groups ( t=5.050, 8.165, P<0.05) while there was no significant difference in the volume of intraoperative blood loss, time to postoperative initial out-of-bed activities, time to postoperative first flatus, time to postoperative initial liquid food intake or duration of postoperative hospital stay between the two groups ( t=0.118, ?0.462, ?1.129, ?1.291, 0.027, P>0.05). There was no significant difference in the conversion to open surgery between the two groups ( P>0.05). Five patients of the robotic group and 7 patients of the laparoscopic group had postoperative complications. There was no significant difference in the postoperative complications between the two groups ( χ2=0.405, P>0.05). (3) Postoperative pathological examination: after propensity score matching, cases with R 0 resection, the number of lymph node dissected, cases with lymph node metastasis and cases with tumor differentiation as well differentiated adenocarcinoma, moderately differentiated adeno-carcinoma, poorly differentiated adenocarcinoma or mucinous adenocarcinoma were 34, 17±5, 14, 1, 22, 6, 5 of the robotic group, versus 34, 17±5, 12, 2,20, 2, 10 of the laparoscopic group, respectively. There was no significant difference in the R 0 resection between the two groups ( P>0.05) and there was no significant difference in the number of lymph node dissected, lymph node metastasis and tumor differentiation between the two groups ( t=0.488, χ2=0.249, 4.095, P>0.05). (4) Follow-up: after propensity score matching, 68 patients were followed up for 1?36 months, with a median follow-up time of 24 months. The follow-up time was (20±13)months of the robotic group, versus (21±13)months of the laparoscopic group, showing no significant difference between the two groups ( t=0.409, P>0.05). During the follow-up, 3 cases of the robotic group and 4 cases of the laparoscopic group had tumor distant metastasis. The disease-free survival rate and overall survival rate at postoperative 3 years were 83.9% and 86.8% of the robotic group, versus 82.0% and 86.6% of the laparoscopic group, showing no significant difference between the two groups ( χ2=0.188, 0.193, P>0.05). Conclusion:Da Vinci robotic assisted CME for right hemicolon cancer is safe and feasible.
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To evaluate the effectiveness of health belief model-based health education intervention in improving blood pressure control of patients with hypertension in community settings. From September 2016 to September 2017, 400 newly diagnosed patients with hypertension were recruited from 6 community healthcare centers with comparable population size and health services in the Shunyi District of Beijing. All community healthcare centers were randomly assigned to the intervention group (206 patients) and the control group (194 patients). Patients in the intervention group received 3 lectures (20-30 min for each) of health belief model-based health education. Patients in the control group received usual care. The basic characteristics, health beliefs, and health literacy were collected, and blood pressure was measured before and after the intervention, respectively. The difference-in-difference model was used to analyze the change of blood pressure and the influencing factors between two groups before and after the intervention. A total of 134 patients in the intervention group and 129 patients in the control group completed the study. After adjusting for the age, gender, family income, medical insurance, chronic diseases and family history, the score of perceived barriers was increased by 1.65 (0.016), and perceived seriousness was decreased by 0.73 (0.018). The systolic blood pressure of patients was decreased by 7.37 mmHg (1 mmHg=0.133 kPa, 0.001) and diastolic blood pressure was decreased by 4.07 mmHg (0.014), respectively. The β (95) values were -7.37 (-11.88,-2.86) and -4.07 (-7.30, -0.84). The perceived susceptibility and self-efficacy had a significant influence on the blood pressure of patients (0.05). Health belief model-based health education intervention could significantly improve the blood pressure control of patients with hypertension in the community settings.
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ObjectiveTo characterize Torso-like (tsl) gene and investigate its expression characteristics in Anopheles dirus, so as to provide a theoretical basis for subsequent functional studies of the tsl gene. MethodsAccording to the coding sequences of Drosophila melanogaster and An. gambiae tsl genes, the complete genome of An. dirus was retrieved and the An. dirus tsl gene was characterized. Specific primers were designed and the target gene was amplified using PCR and reverse-transcription PCR assays. The physicochemical properties, signal peptide, transmembrane structure, secondary structure and tertiary structure of the encoded protein TSL were analyzed using bioinformatics tools, and a phylogenetic analysis was performed. In addition, the specific expression of the tls gene was detected in various tissues of An. dirus using a quantitative real-time PCR assay. Results The An. dirus tsl gene was 16 751 bp in length with a CDS region of 1 134 bp, encoding 377 amino acids, and the encoded TSL protein was a stably hydrophilic protein. The TSL protein was predicted to be a secretory protein that was located in extra-membrane regions containing signal peptides. The secondary structure of the TSL protein contained α-helix (51.72%), extended strand (12.20%), β-bridge (4.78%) and random coil (31.30%) in the secondary structure, and a 3D homology model was generated using 5cj9.1.A as a template. Phylogenetic analysis revealed a close genetic relationship in the TSL protein between An. dirus and An. farauti. In addition, quantitative real-time PCR assay detected the tsl gene expression in the head, chest, abdomen and foot of An. dirus, with the highest expression in the head and low expression in the foot. Conclusions The tsl gene is characterized in An. dirus at a genomic level, and the prediction of the TSL protein structure and the elucidation of the tissue-specific tsl gene expression in An. dirus provide a basis for the further studies on the gene functions.
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Objective@#To evaluate the effectiveness of health belief model-based health education intervention in improving blood pressure control of patients with hypertension in community settings.@*Methods@#From September 2016 to September 2017, 400 newly diagnosed patients with hypertension were recruited from 6 community healthcare centers with comparable population size and health services in the Shunyi District of Beijing. All community healthcare centers were randomly assigned to the intervention group (206 patients) and the control group (194 patients). Patients in the intervention group received 3 lectures (20-30 min for each) of health belief model-based health education. Patients in the control group received usual care. The basic characteristics, health beliefs, and health literacy were collected, and blood pressure was measured before and after the intervention, respectively. The difference-in-difference model was used to analyze the change of blood pressure and the influencing factors between two groups before and after the intervention.@*Results@#A total of 134 patients in the intervention group and 129 patients in the control group completed the study. After adjusting for the age, gender, family income, medical insurance, chronic diseases and family history, the score of perceived barriers was increased by 1.65 (P=0.016), and perceived seriousness was decreased by 0.73 (P=0.018). The systolic blood pressure of patients was decreased by 7.37 mmHg (1 mmHg=0.133 kPa, P=0.001) and diastolic blood pressure was decreased by 4.07 mmHg (P=0.014), respectively. The β (95%CI) values were -7.37 (-11.88,-2.86) and -4.07 (-7.30, -0.84). The perceived susceptibility and self-efficacy had a significant influence on the blood pressure of patients (P<0.05).@*Conclusion@#Health belief model-based health education intervention could significantly improve the blood pressure control of patients with hypertension in the community settings.
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SATB1 plays a crucial role in the invasion and metastasis of breast cancer,and inhibition of SATB1 expression can effectively control breast cancer metastasis. In this study,homogeneous polysaccharides were isolated from Poria cocos and their sulfated derivatives were prepared to screen out the polysaccharide compositions with inhibitory effects on SATB1 expression. Smal-molecule components were removed from P. cocos by ethanol extraction,and P. cocos crude polysaccharide PPS was obtained by water extraction and ethanol precipitation. Then PPS was successively separated by DEAE Sepharose fast flow anion-exchange and Superdex-75 gel permeation chromatographic steps to give PPSW-1. The structure of PPSW-1 was identified and its sulfated derivatives were prepared. Then their inhibitory effects on human breast cancer MDA-MB-231 cells were investigated. A kind of polysaccharide,PPSW-1 with inhibitory effect on human breast cancer MDA-MB-231 cells,was obtained from P. cocos,with a relative molecular weight of 3. 06×104,and structure of 1,6-branched 1,3-α-D-galactan. PPSW-1 and its sulfated derivative Sul-W-1 showed good inhibitory effect on cells migration,and the water solubility of Sul-W-1 was better than that of PPSW-1. In addition,it was found that polysaccharide of P. cocos and its sulfated derivative can inhibit expression of SATB1. In this study,a kind of homogeneous polysaccharide with inhibitory effect on human breast cancer MDA-MB-231 cells was isolated from P. cocos,and its sulfated derivative with similar efficacy but better solubility was prepared,laying the foundation for the substance basis study of P. cocos.
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Humans , Breast Neoplasms , Pathology , Cell Line, Tumor , Cell Movement , Matrix Attachment Region Binding Proteins , Metabolism , Phytochemicals , Pharmacology , Polysaccharides , Pharmacology , Sulfates , Wolfiporia , ChemistryABSTRACT
OBJECTIVE@#To explore mechanism of health beliefs by application of health belief model (HBM) and structural equation modeling (SEM) with regard to recreational physical activity (PA), to identify the differences of among population with high risk of chronic diseases and healthy people, and to provide the specific interventions of recreational physical activity and reference for health relevant policy-making in the future.@*METHODS@#A total of 2 736 residents with high risk of chronic diseases and 1 514 healthy people were involved. A questionnaire survey, physical examination and biochemical examination were conducted. The questionnaire based on HBM had acceptable validity and reliability. The proposed model based on the total sample size of the two groups was developed using the structural equation modeling and multi-comparison in the ways of appearance and parameters were also validated.@*RESULTS@#The median amount of recreational (PA) among population with high risk of chronic diseases and healthy people were 0.0 thousand-step equivalent with quartile of (0.0, 4.6) and 0.0 thousand-step equivalent with quartile of (0.0, 4.0) respectively. The results of SEM suggested that the direct effects of perceived objective barriers (β=-0.245), perceived subjective barriers (β=-0.057), cues to action (β=-0.043) and self-efficacy (β=0.117) on recreational (PA) were significant. Self-efficacy was the most important mediator. The multi-group comparisons indicated that the models of the two groups had the same appearance but the parameters between them were significant (δ χ2=27.4, P<0.05). The multi-group structural equation model (MSEM) indicated that two paths from cues to action and from perceived subjective barriers to recreational (PA) were not statistically significant among the population with high-risk of chronic diseases. In the two groups, one path coefficient from perceived objective barriers to subjective barriers (P=0.007) was statistically significant (P<0.05).@*CONCLUSION@#The recreational (PA) levels of both groups were lower. Health beliefs on recreational (PA) of the two groups played different roles and some paths were also different. Therefore, specific interventions and strategies should be developed for different people. For residents with high risk of chronic diseases, much more attention should be paid to reduce the objective and subjective barriers of recreational physical activity and to improve self-efficacy so as to delay or prevent the occurrence of chronic diseases and then to improve the quality of life of this kind of population.
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Humans , Chronic Disease , Exercise , Health Status , Quality of Life , Reproducibility of Results , Surveys and QuestionnairesABSTRACT
Objective:To study the status quo of directive and nondirective support from family or friends among patients with diabetes in community and to explore the association between directive, nondirective support from family or friends and self-management behaviors.Methods: The data of the subjects were from the Community Diagnosis in Tongzhou District, Beijing survey.Questionnaire-based investigation, physical examination and glycated hemoglobin test were conducted on 474 eligible patients in community.The summary of diabetes self-care activities measure (SDSCA) was adopted to investigate the self-management behaviors, and directive and nondirective support scale among patients with diabetes (DNSS-PD) was adopted to measure the directive and nondirective support among patients with diabetes.Results: A total of 452 patients with diabetes were included in the analysis.The average score of directive support was 2.53±1.07, and only 27.6% patients had high level directive support.The average score of nondirective support was 3.13±1.12 and 50.8% patients had high level nondirective support.The average SDSCA total score was 35.38±14.21 and the corresponding scoring percentage was 45.95%.Only 20.6% patients had optimal self-management.The total score, score of diet and physical activity, general self-management situation, diet self-management situation and physical activity self-management situation of the patients in high level directive support group were significantly better than in low level directive support group.The total score, score of self-management behaviors in five aspects (diet, physical activity, blood glucose self-monitoring, foot care and smoking), general self-management situation, self-management situation of five aspects of patients in high level nondirective support group were significantly better than in low level nondirective support group.Gender (OR=2.729), nondirective support level (OR=4.890), age (OR=0.969) and body mass index (BMI) (OR=0.819) were important influencing factors of self-management behavior.Conclusion: The status quo of self-management among patients with diabetes is not optimistic.Patients obtain more nondirective support than directive support from family and friends.However, the support level of both nondirective and directive support should be improved in the future.Both high level directive support and high level nondirective support had positive correlation with better self-management behaviors.Nondirective support had positive correlation with five aspects of self-management behavior, while directive support had positive relation with self-management behavior in aspects of diet and physical activity.In addition, more consideration and support of self-management should be provided for older obese male patients with diabetes in community, especially nondirective support.
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Objective To retrospectively analyze the significance of dynamic intracranial pressure monitoring and routine monitoring in the treatment of severe traumatic brain injury.Methods Forty-two patients with severe craniocerebral trauma who were admitted into our hospital from March 2013 to December 2015 and underwent intracranial pressure monitoring were enrolled in this study as the observation group.Thirty-nine patients with severe traumatic brain injury who were routinely monitored within 3 hours after admission were selected as the control group in the corresponding period.Timely take drugs or surgical treatment according to the monitoring results,and analyzed the clinical efficacy,craniotomy cases,time of admission to craniotomy,and complications of the two groups.Results The cases with good prognosis in the control group was 24 (61.5％) while it was 31 (73.8％) in the observation group,and the difference was statistically significant (P ＜ 0.05).The cases with poor prognosis in the control group was 15 (38.5％) while it was 11 (26.2％) in the observation group,and the difference was statistically significant(P ＜0.05).Therer were 13 cases (30.1％) of craniotomy in the control group and 5 cases (12.8％) in the observation group with statistically significant difference (P ＜ 0.05).The time of admission to craniotomy in the control group was (24.5 ± 1.7) hours,and it was (18.3 ± 2.4) house in the observation group with statistically significant difference (P ＜ 0.05).The incidence of intracranial infection complication was 9.5％ in the control group and 8％ in the observation group.There was no significant difference between the two groups (P ＞ 0.05).Conclusion Invasive intracranial pressure monitoring can reflect the changes of patients in time,which can improve the clinical curative effect and would not increase the incidence of intracranial infection.
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<p><b>OBJECTIVE</b>To investigate the change in the expression of tight junction protein ZO-1 in intestinal epithelial cells (Caco-2 cells) and the protective effect of eicosapentaenoic acid (EPA) after adherent-invasive Escherichia coli (E.coli) LF82 infection.</p><p><b>METHODS</b>The Caco-2 cell line was used to establish an in vitro model of tight junction of intestinal epithelial cells. Caco-2 cells were divided into EPA treatment groups (0, 25, 50, 100, and 200 μmol/L EPA) and EPA (0, 25, 50, 100, and 200 μmol/L EPA)+E.coli LF82 treatment (0, 6, and 12 hours) groups. A microscope was used to observe the morphological characteristics of the cells. MTT assay was used to determine the cell growth curve. The activity of alkaline phosphatase (ALP) at both sides of the cell membrane was compared to evaluate the Caco-2 cell model. MTT assay and flow cytometry were used to investigate the effects of different concentrations of EPA on the survival rate and apoptosis rate of Caco-2 cells. RT-qPCR was used to measure the mRNA expression of ZO-1 in Caco-2 cells after EPA and/or E.coli LF82 treatment. ELISA was used to measure the change in the level of tumor necrosis factor-α (TNF-α) in culture supernatant.</p><p><b>RESULTS</b>After EPA treatment (25 and 50 μmol/L), the proliferation of Caco-2 cells was induced in a dose-dependent manner. The survival rates of the cells were significantly higher than those in the control group (P<0.05). The EPA treatment (100 and 200 μmol/L) groups had a significant inhibitory effect on the proliferation of Caco-2 cells in a dose-dependent manner. The survival rates of the cells were significantly lower than those in the control group (P<0.05). The EPA treatment (100 and 200 μmol/L) groups had a significant increase in cell apoptosis rate compared with the control group (P<0.05). The 6- and 12-hour E.coli LF82 treatment groups had decreasing mRNA expression of ZO-1 in Caco-2 cells over the time of treatment and had significantly lower mRNA expression of ZO-1 than the untreated group (P<0.05). The Caco-2 cells treated with E.coli LF82 and 25 or 50 μmol/L EPA for 6 or 12 hours showed an increase in the mRNA expression of ZO-1 with the increasing concentration of EPA, as well as significantly higher mRNA expression of ZO-1 than the Caco-2 cells treated with E.coli LF82 alone (P<0.05). The Caco-2 cells treated with E.coli LF82 alone for 6 or 12 hours had increasing secretion of TNF-α over the time of treatment and had significantly higher secretion than the untreated Caco-2 cells (P<0.05). The Caco-2 cells treated with E.coli LF82 and 25 or 50 μmol/L EPA for 6 or 12 hours showed a reduction in the secretion of TNF-α with the increasing concentration of EPA and had significantly lower secretion than the Caco-2 cells treated with E.coli LF82 alone (P<0.05).</p><p><b>CONCLUSIONS</b>EPA can effectively prevent the destruction of tight junction of intestinal epithelial cells induced by E.coli LF82 infection and inhibit the secretion of inflammatory factors. Therefore, it has a certain protective effect on intestinal mucosal barrier.</p>
Subject(s)
Humans , Apoptosis , Caco-2 Cells , Eicosapentaenoic Acid , Pharmacology , Escherichia coli , Virulence , Intestinal Mucosa , Metabolism , Microbiology , RNA, Messenger , Tight Junctions , Tumor Necrosis Factor-alpha , Bodily Secretions , Zonula Occludens-1 Protein , GeneticsABSTRACT
OBJECTIVE: To introduce the implementation method and design ideas to achieve automatic NIR (near-infrared spectroscopy) modeling and comparison function during the construction of "National Rapid Drug Testing Database Network Platform" and investigate and verify the feasibility of constructing the automatic rapid drug testing module using workflow technology. METHODS: Both the scientific data workflow and analysis tool Pipeline Pilot and the basic principle of two quick comparison algorithms of NIR were employed to construct a spectral processing and modeling workflow of drugs. Moreover, validation and comparison were carried out between our method and the instrument workstation software OPUS. RESULTS: The established workflow method was not only consistent with the results of OPUS, but also had the advantages of automation and easinessto use. CONCLUSION: The scientific workflow technology can be used to achieve automatic modeling and comparison function of NIR and easily introduce other chemometrics method in the future.
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Objective: To research and establish an analysis model for chemical drug standards to provide the reference for the standard exploration jobs. Methods:The standard variation was studied by comparing and analyzing every version standard for the same drug to look for the change rule. Results:The standard items of the drug had some change rules in indicator numbers, testing methods and limits according to the order of issue time. The standard development trends could be described by making specific indicators and drawing evolution figures of the items. Conclusion:By the standard analysis model, the same item of the same drug can be compared to provide the reference for data collecting of experts. Meanwhile, formulate standard can be calculated to provide the reference for the standard improvement without drug standards.
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The growing status of Anoectochilus roxburghii seedling was observed and the survival rate of seedlings, height, stem diameter and plant fresh weight under the conditions of different transplanting substrate compositions, planting density, shading rate were measured. The results showed that the effects of different transplanting substrates, planting densities, shading rates and nutrient solutions on the growing status of A. roxburghii plantlets varied greatly. A. roxburghii plantlets demonstrated a high survival rate and better growing status under the Following conditions: the ratio of peat and river sand as 2: 1, the planting density as 3 cm x 3 cm, the shading rate as 70%, and the nutrient solution as 1/4MS. The findings of the study provide a solid technical solution for the artificial cultivation of A. roxburghii plantlets.
Subject(s)
Breeding , Methods , Culture Media , Chemistry , Pharmacology , Orchidaceae , Seedlings , Survival AnalysisABSTRACT
Nine morphologic traits, plant height, ground diameter, leaf length, leaf width, leaf area of plant, leaf fresh weight, blades, length/width ratio, plant fresh weight of Anoectochilus roxburghii from 13 different areas were determined for correlation analysis, path analysis and principal components analysis. Different source of morphological trait variation coefficient of A. roxburghii was 2.96% -12.59%, plant fresh weight was significant positively correlated with ground diameter, plant height and leaf number, and positively correlated with leaf fresh weight. Path analysis showed that plant height had the largest positive direct effect on plant fresh weight, the leaf fresh weight and blades number had indirect effects on the plant fresh weight. Through principal component analysis, morphological traits of A. roxburghii can be divided into "Determinants of high-yielding morphology" and "Determinants of leaf production". In the actual process of production and breeding of A. roxburghii, we should pay attention to plant height, leaf fresh weight, blades numbers and other traits.
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China , Orchidaceae , Chemistry , Classification , Phenotype , Plant Leaves , ChemistryABSTRACT
Objective To investigate effects of very early hyperbaric oxygen treatment (HBOT) on patients with malignant brain edema after surgical operation for treatment of severe traumatic brain injury (TBI).Methods A total of 146 patients who suffered from malignant brain edema after last surgical operation for severe TBI were enrolled for this study.According to the intervention time of HBOT,they were randomized into a very early group (HBOT within 3 days after operation,n =55),an ordinary group (HBOT at 4 to 10 days after operation,n =65) and a control group (non-HBOT,n =26).Mortality rate of the 3 groups were recorded within 4 weeks after operation,and GCS (Glasgow Coma Scale) score were assessed in 1,2,3 and 4 weeks after operation.Dynamic head CT scan were performed for detecting brain status and for determine the duration of brain edema.Results The mortality of the very early group,the ordinary group and the control group were 10.9％,7.7％ and 11.5％,respectively,and no statistically significant difference was revealed among the groups (P ＞ 0.05).In very early group,the GCS scores of 1,2,3 and 4 weeks after operation were (8.837 ±3.350),(10.755 ± 3.388),(11.633 ± 3.408) and (12.367 ± 3.408),respectively,with significant difference between the time points 1 week and 2,3 and 4 weeks as well as 2 and 4 weeks after surgery (P ＜0.05),but not between 2 and 3 as well as 3 and 4 weeks after surgery (P ＞ 0.05).In ordinary group,the GCS scores at 1,2,3 and 4 weeks after surgery were (8.509 ±3.042),(9.458 ±3.115),(10.186 ±3.203) and (10.627 ±3.439),respectively,with significant difference between 1 week and 2,3 and 4 weeks after operation (P ＜ 0.05).In control group,the GCS scores at 1,2,3 and4 weeks after surgery were (8.042 ±2.881),(8.417 ±2.962),(8.542 ±3.02) and (8.958 ± 3.043),with no statistical difference among different time points (P ＞ 0.05).When compared with the very early group,the GCS sores of the ordinary group and the control group were significantly lower after intervention (P ＜ 0.05),and the GCS of control group was lower than that of the ordinary group (P ＜ 0.05).As for brain edema duration,the very early group was the shortest among the 3 groups (P ＞ 0.05) Conclusion Very early hyperbaric oxygen treatment could improve consciousness state and alleviate malignant brain edema after surgical operation in TBI patients.
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<p><b>OBJECTIVE</b>To study the extent of distal intramural spread of distal 2 cm rectal carcinoma over the dentate line, and to improve quality of life for these patients through providing pathological evidence of operation mode choice.</p><p><b>METHODS</b>Specimens of thirty patients with rectal carcinoma, operated with ISR(intersphincter resection) or Miles procedure from May 2005 to July 2007, were collected, and their large and histology pathologic slices were examined. Specimens were dissected distally to the dentate line per 2 mm within 1cm and per 5 mm exceed 1cm. The length of distal intramural spread to rectal carcinoma was measured under light microscope.</p><p><b>RESULTS</b>Among the 30 specimens, distal intramural spread over the dentate line was observed only on one case and the invasion length over the dentate line was more than 2 cm, the invasion lengths of the other 29 cases were within the dentate lines.</p><p><b>CONCLUSION</b>Distal 2 cm rectal carcinomas seldom spread over dentate lines. Anus discomfortableness of these patients and other complications could be reduced through reserving more skin over the dentate line, which are important for the improving of quality of life in these patient.</p>