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Objective: To compare the mid- and long-term outcomes between natural orifice specimen extraction surgery (NOSES) and conventional laparoscopic surgery with abdominal auxiliary incision in the treatment of rectal cancer. Methods: A propensity score matching study was conducted. Patients with pathological diagnosis of rectal adenocarcinoma, preoperative imaging assessment of T1-3 and body mass index <28 kg/m(2) were included. Those who underwent local resection or abdominoperineal resection, had simultaneous multiple primary cancers, malignant intestinal obstruction or perforation, received neoadjuvant radiotherapy, and were unsuitable for laparoscopic surgery were excluded. From January 2017 to January 2019, 264 patients undergoing laparoscopic rectal cancer surgery at the Department of Colorectal Tumor Surgery, Shengjing Hospital of China Medical University were enrolled in this study, and divided into the NOSES group (52 cases) and the auxiliary incision group (212 cases). Propensity score matching method was used as 1:1 to match the initial data, and 46 pairs were finally obtained. SPSS 26.0 was used for data analysis, and 2-year disease-free survival, intraoperative and perioperative indicators were compared between the two groups. Results: The tumor short diameter in the NOSES group and the auxiliary incision group was (2.9±0.8) cm and (3.1±1.0) cm (t=0.842, P=0.402) respectively. Other baseline data were also comparable between the two groups(all P>0.05). There were no significant differences in operative time, intraoperative blood loss, length of hospital stay and postoperative complication rate between the two groups (all P>0.05). The time to first flatus [2 (1-6) days vs. 3 (1-6) days, Z=-3.035, P=0.002] and to liquid food intake [3 (1-6) days vs. 3 (2-7) days, Z=-2.587, P=0.010] after surgery in the NOSES group were earlier than those that in the auxiliary incision group. Compared with the auxiliary incision group, the postoperative pain score was lower [3 (2-5) vs. 4 (3-7), Z=-5.477, P<0.001], and the aesthetic score was higher [8 (6-9) vs. 7 (5-8), Z=-6.329, P<0.001] in the NOSES group. The distal resection margin in the NOSES group was longer than that in the auxiliary incised group [(3.7±1.2) cm vs. (2.9±1.4) cm, t=3.287, P<0.001]. There were no significant differences in proximal resection margin the number of harvested lymph nodes and positive rate of circumferential resection margin between the two groups (all P>0.05). The 2-year disease-free survival rate in the NOSES group and the auxiliary incision group was 93.5% and 89.1% respectively, and the difference was not statistically significant (P=0.466). Conclusions: NOSES has similar mid- and long-term outcomes to conventional laparoscopic surgery and the advantages of better cosmetic effect, less postoperative pain and faster recovery, which is more in line with the concept of minimally invasive and worthy of clinical promotion.
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Humans , Colorectal Surgery , Laparoscopy , Propensity Score , Rectal Neoplasms/surgery , Retrospective StudiesABSTRACT
Schizophrenia is a common disease characterized by thinking obstructions and accompanied by cognitive, emotional and behavioral disorders. Under the control of psychiatric symptoms, patients with schizophrenia may self-injure or impulsively wound others, resulting in public risk and increase in the burden of family and society. In recent years, many studies have shown that the violent behavior of patients with schizophrenia is related to genetic factors. This article reviews the research progress on the relationship between genetic polymorphism and violent behavior of patients with schizophrenia, analyzes the possible mechanism of the correlation between the two, puts forward the limitations of current research and the directions of future research, and provides scientific basis for risk assessment and prevention of violent behavior of patients with schizophrenia.
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Humans , Aggression , Polymorphism, Genetic , Risk Assessment , Schizophrenia/genetics , Schizophrenic Psychology , ViolenceABSTRACT
The fungal microbiota from self-retained soil and tongue coating of 18 patients with precancerous lesions of upper gastrointestinal (PLUG) were sequenced. The diversity of α, β in and the structure of the microbial community were analyzed, and the association of them was quantified by using the Spearman rank correlation method. The richness index (1.67±2.79) and the diversity index (0.25±0.10) of the fungal microbiota from tongue coating of PLUG patients were significantly lower than those from soil (4.00±4.69; 0.99±0.18) (all P values<0.001). The relative abundance of 11 taxa from tongue coating of these PLUG patients was positively associated with that from soil (all P values<0.05).
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Objective@#To analyze the diagnostic value of ultrasound guided 14 gauge coreneedle biopsy (US-CNB) in breast nodules.@*Methods@#We retrospectively analyzed the pathological results of US-CNB and surgical excision from 373 breast nodules in Peking University International Hospital from Sep 2016 to Nov 2018 to evaluate the accuracy of 14g US-CNB.@*Results@#A total of 349 patients(373 nodules)underwent US-CNB. US-CNB reported 282 benign lesions(75.6%, 282/373), 20 high-risklesions(5.4%, 20/373), and 71 malignant lesions(19.0%, 71/373). For 282 CNB reported benign lesions, the surgical pathology confirmed 235 lesions , 46 for high-risk lesions and 1 for malignant lesion with a concordancy of 83.3%(235/282)and the underestimation rate was 16.7%(47/282). US-CNB identified 20 high-risk lesions. According to surgical results, 15 were high-risk lesions and 5 were malignant lesions with a concordancy of 75% (15/20)and the underestimation rate was 25%(5/20). When it comes to malignant lesions, the excision results showed that 70 were malignant lesions and 1was high-risk lesion with a concordancy of 98.6%(70/71)and the overestimation rate was 1.4%(1/71). The concordance of the histological type , calculated for 50 invasive carcinomas, was 92% (46/50) with a kappa value of 0.77.The concordance of the histological grade could be calculated for 38 invasive ductal carcinomas with the Elston-Elllis Method . It was 89.5% (34/38) with a kappa value of 0.57.@*Conclusions@#The pathology result of 14gUS-CNB is in good consistency with surgical excision for breast benign and malignant lesions.
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Objective To analyze the diagnostic value of ultrasound guided 14 gauge coreneedle biopsy (US-CNB) in breast nodules.Methods We retrospectively analyzed the pathological results of US-CNB and surgical excision from 373 breast nodules in Peking University International Hospital from Sep 2016 to Nov 2018 to evaluate the accuracy of 14g US-CNB.Results A total of 349 patients (373 nodules) underwent US-CNB.US-CNB reported 282 benign lesions (75.6％,282/373),20 high-risklesions (5.4％,20/373),and 71 malignant lesions(19.0％,71/373).For 282 CNB reported benign lesions,the surgical pathology confirmed 235 lesions,46 for high-risk lesions and 1 for malignant lesion with a concordancy of 83.3％ (235/282)and the underestimation rate was 16.7％ (47/282).US-CNB identified 20 high-risk lesions.According to surgical results,15 were high-risk lesions and 5 were malignant lesions with a concordancy of 75％ (15/20) and the underestimation rate was 25％ (5/20).When it comes to malignant lesions,the excision results showed that 70 were malignant lesions and 1 was high-risk lesion with a concordancy of 98.6％ (70/71) and the overestimation rate was 1.4％ (1/71).The concordance of the histological type,calculated for 50 invasive carcinomas,was 92％ (46/50) with a kappa value of 0.77.The concordance of the histological grade could be calculated for 38 invasive ductal carcinomas with the Elston-Elllis Method.It was 89.5％ (34/38) with a kappa value of 0.57.Conclusions The pathology result of 14gUS-CNB is in good consistency with surgical excision for breast benign and malignant lesions.
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Objective:To develop an HPLC method for the simultaneous determination of vitamin B 1(thiamine), vitamin B2(ribo-flavin), vitamin B3(niacinamide), vitamin B5(pantothenic acid) and vitamin B6(pyridoxine) in complex vitamin B tablets.Meth-ods:An Alltima C18 column (250 mm ×4.6 mm, 5μm) was used for the separation , and 50 mmol· L-1 ammonium dihydrogen phos-phate ( adjusting pH to 3.0 with H3 PO4 ) and acetonitrile were used as the mobile phase with gradient elution at the flow rate of 0.5 ml · min-1 .The detection wavelength was set at 275 nm for vitamin B1 , vitamin B2 , vitamin B3 and vitamin B6 , and 210 nm for vitamin B5 .The column temperature was 30℃and the injection volume was 5μl.Results:The linear range of vitamin B 1 , B2 , B3 , B5 and B6 was 39.48-197.40, 40.16-200.80, 39.36-196.80, 38.80-194.00 and 41.76-208.80 μg · ml-1(r≥0.9999).The average recov-ery was 98.70％, 99.91％, 99.04％, 99.63％and 98.75％, and the RSDs were 0.40％, 0.27％, 0.40％, 0.92％ and 0.39％(n =9), respectively.Conclusion:The established method is accurate , simple and rapid, and can be utilized for the simultaneous determination of vitamin B 1 , B2 , B3 , B5 and B6 in complex vitamin B tablets .
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OBJECTIVE: To establish a method for simultaneous determination of vitamin B1, dihydralazine sulfate, vitamin B6 and vitamin B5 in Compound Apocynum venetum tablets I.METHODS: HPLC method was used for content determination of 8 batches of samples from 2 enterprises. The determination was performed on Waters XBridge C18 column with mobile phase consisted of acetonitrile-0. 2％ phosphoric acid (gradient elution) at the flow rate of 0. 5 mL/min. The detection wavelengths were set at 285 nm (vitamin Bi, dihydralazine sulfate, vitamin B6) and 210 nm (vitamin B5). The column temperature was 30 ℃, and sample size was 10 μL. RESULTS: The linear ranges of vitamin Bi, dihydralazine sulfate, vitamin B6 and vitamin B5 were 41. 66-208. 3 μg/mL (r=0. 999 9), 127. 0-635. 0 μg/mL (r=0. 999 9), 40. 74-203. 7 μg/mL (r=0. 999 9) and 22. 72-113. 6 μg/mL (r= 0. 999 9), respectively. The limits of quantitation were 0. 267, 0. 274, 0. 062, 0. 124 μg/mL, respectively. The limits of detection were 0. 095, 0. 088, 0. 021, 0. 039 μg/mL, respectively. RSDs of precision, stability and reproducibility tests were all lower than 2. 0％ (n=6). The average recoveries were 98. 70％ (RSD=0. 69％, n=9),99. 74％ (RSD=1. 2％, n=9), 99. 89％ (RSD= 1. 0％, n=9), 99. 25％ (RSD=1. 2％, n=9), respectively. Among 8 batches of samples, the contents of vitamin B1, dihydralazine sulfate, vitamin B6 and vitamin B5 were 91. 44％-98. 74％, 36. 68％-95. 23％, 92. 42％-97. 90％, 91. 36％-99. 48％ of labelled amount, respectively. The contents of dihydralazine sulfate were significantly different and differed by 2. 6 times between the lowest and the highest threshold value. CONCLUSIONS: The method is accurate, reliable, simple and can be used for simultaneous determination of the above 4 components in Compound A. venetum tablets I.
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Objective To develope a high performance liquid chromatography ( HPLC) method for simultaneous determination of benzoic acid and salicylic acid in compound benzoic acid embrocation. Methods An Alltima C18 column (150 mm×4.6 mm,5 μm) was used for the separation, with methanol-0.1％ phosphoric acid (50:50) as the mobile phase at the flow rate of 1.0 mL?min-1 .The detection wavelength was set at 236 nm.The column temperature was 35 ℃ . Results The good linearity was obtained with the correlation coefficient (r) of 1.0000 for benzoic acid and salicylic acid;the precisions and stability were satisfactory, and the relative standard deviations (RSDs) were less than 0.3％.The average recoveries (n= 9) were 100.15％ and 99.85％ for benzoic acid and salicylic acid, respectively. Conclusion The established method is accurate, simple and rapid, and can be utilized for the simultaneous determination of benzoic acid and salicylic acid in compound benzoic acid embrocation.
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Phage (bacteriophage) is a kind of viruses which can infect bacteria,actinomyces and spirochetes.The phage can only reproduced by host bacteria instead of living independently.The process of phage reproduction is also the process of sterilization.Nowadays,the "post-antibiotic era" that leading by global rise in bacterial resistance,urges scientists to explore alternative therapies for antibiotics.The phage therapy has attracted the attention of researchers.Several researchers has successfully treated bacterial keratitis,endophthalmitis and conjunctivitis by using bacteriophage and phage lyzyme.Phage not only kills pathogenic bacteria,but also maintains the structural integrity of eye.This article reviewed the phage structure and classification,the process of its discovery and development,the bactericidal mechanism of phage,its application and therapeutic characteristics in the treatment of ophthalmological diseases.
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Teicoplanin is a kind of glycopeptide antibiotic extracted from actinomycetes after fermentation, which is mainly used for the treatment of multidrug-resistant gram-positive cocci infection. The domestic and overseas research literatures on the advances in the analytical methods for teicoplanin were consulted, reviewed and analyzed. The determination methods of teicoplanin mainly includ-ed in vivo and in vitro pharmaceutical analysis. The analytical methods involved high-performance liquid chromatography analysis, bio-assay determination, liquid chromatography-mass spectrometry analysis and micellar electrokinetic capillary chromatography, and a-mong them, HPLC technology was most commonly utilized in the determination of teicoplanin in biological samples and teicoplanin preparations. Much progress has been made in the analytical methods for teicoplanin, and further exploration of determination methods in vivo and in vitro will be beneficial to the quality control of the drug and guiding clinical rational administration.
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OBJECTIVE: To investigate the chemical differences between Smilacis Glabrae Rhizoma and its adulterants, and provide a basis for the identification and quality evaluation of Tufuling samples purchased from the markets. METHODS: The method of HPLC fingerprinting was used to analyze Smilacis Glabrae Rhizoma, Heterosmilacis Chinensis Rhizoma, Heterosmilacis Yunnanensis Rhizoma, and 102 Tufuling samples which were collected around China. The fingerprints were analyzed by the methods of similarity and principal component analysis (PCA). RESULTS: The analytical method of HPLC fingerprinting was established. Eleven, fifteen and eight common peaks were selected in the fingerprints of Smilacis Glabrae Rhizoma, Heterosmilacis Chinensis Rhizoma, and Heterosmilacis Yunnanensis Rhizoma, respectively. Only five common peaks were found in the fingerprints of the three species, which were No. 1, 2, 3, 13, and 14 peaks. A total of twelve peaks were characterized in the three fingerprints. Nine peaks were characterized in the fingerprint of Smilacis Glabrae Rhizoma, among which, four constituents were characterized for the first time. Six and two constituents were for the first time characterized in the fingerprints of Heterosmilacis Chinensis Rhizoma and Heterosmilacis Yunnanensis Rhizoma, respectively. The result of PCA analysis showed that the chemical differences between the three species were quite obvious and they could be distinguished from each other. The established method was used for the analysis of Tufuling samples purchased from the markets. Sixty-five samples were identified as Smilacis Glabrae Rhizoma, seventeen samples were identified as Heterosmilacis Yunnanensis Rhizoma, and twenty samples were identified as Heterosmilacis Chinensis Rhizoma. CONCLUSION: The established method is simple and reliable, and the development of fingerprint and its chemical pattern recognition provide the way and basis for identification of Smilacis Glabrae Rhizoma and its adulterants.
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OBJECTIVE: To develop an high-performance liquid chromatography (HPLC) method with diode array detector (DAD) for determination of acarbose in acarbose tablets. METHODS: An Alltima C18 column (4.6 mm×250 mm, 5 μm) was used for the separation, with acetonitrile-10 mmol·L-1 ammonium dihydrogen phosphate (containing 0.04% sodium 1-octanesulfonate, adjusted pH to 3.3 with H3PO4) (15∶85) as the mobile phase at the flow rate of 0.8 mL·min-1. The detection wavelength was set at 200 nm and the column temperature was maintained at 30℃. RESULTS: The method showed good linearity with a correlation coefficients (r) of 1.000 0. The specificity study demonstrated satisfactory resolutions between acarbose, other ingredients in the drug and forced degradation products. The precision and stability were satisfactory with the relative standard deviations (RSDs) of 0.088% and 0.22%, respectively. The average spiked recovery was 98.49% with RSD of 0.24% (n=9). The content of acarbose in four batches of acarbose tablets was 51.69, 51.75, 51.72 and 51.62 mg·tablet-1, respectively. CONCLUSION: The established method is accurate, simple and rapid, and can be utilized for determination of acarbose in acarbose tablets.
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?In allusion to the training requirements of eight-year program medical students, combining with our own experience in teaching this type of the students in ophthalmology, we have done some thinking about the training methods of eight-year program medical students in order to improving their comprehensive abilities of ophthalmology. Several suggestions are made in various aspects, including the study of the basic theory of ophthalmology, the training of doctor - patient communication skills, the training of basic clinical skills, the interest developments in ophthalmology subspecialty areas and the training of basic experiment skills.
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This study is to develop an HPLC method for the simultaneous determination of (-)-epicatechin, 5-O-caffeoylshikimic acid, neoisoastilbin, astilbin, neoisoastilbin, isoastilbin and engeletin in Smilacis Glabrae Rhizoma. Samples of Smilacis Glabrae Rhizoma, Heterosmilacis Chinensis Rhizoma and Heterosmilacis Yunnanensis Rhizoma were separated on an Agilent Zorbax SB-C18 column with gradient elution of acetonitrile-0.05% phosphoric acid at a flow rate of 1.0 mL · min(-1). The detected wavelength was set at 230 nm and the column temperature was maintained at 35 °C. The contents of (-)-epicatechin, 5-O-caffeoylshikimic acid, neoastilbin, astilbin, neoisoastilbin, isoastilbin and engeletin in 84 Smilacis Glabrae Rhizoma samples were in the range of trace-1.381, trace-9.913, trace-3.673, 0.6706-27.08, trace-1.181, trace-4.833 and trace-2.754 mg · g(-1), respectively. The established method was used for analysis of common adulterants. The results demonstrated that the contents of (-)-epicatechin in Heterosmilacis Yunnanensis Rhizoma and Heterosmilacis Chinensis Rhizoma were 0.01163-0.06007 mg · g(-1) and 0.01583-0.08585 mg · g(-1), respectively, while the other six constituents were not detected. The method is simple and accurate, and can be used for the quality control of Smilacis Glabrae Rhizoma. The constituents of Heterosmilacis Yunnanensis Rhizoma and Heterosmilacis Chinensis Rhizoma are significantly different from Smilacis Glabrae Rhizoma, and they are not suitable for using as Smilacis Glabrae Rhizoma.
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Chromatography, High Pressure Liquid , Methods , Drugs, Chinese Herbal , Liliaceae , Chemistry , Rhizome , ChemistryABSTRACT
[Objective]To explore the mechanism of hip joint capsule contracture induced by intragluteal injection. [Method]Thirty young Chinese rabbits were divided into four groups of A(n=6),B(n=6),C(n=6) and D(n=12) at random.Rabbits in groups A,B and C were treated with deep intragluteal injection of penicillin dissolved in 2% benzyl alcohol(group A),2% benzyl alcohol(group B)and penicillin dissolved in physiologic saline(group C).Rabbits in group D were treated with immobilization of unilateral hip joint and deep intramuscular injection of physiologic saline on the homolateral buttock.Each rabbit was injected twice a day for 20 days.Specimens were obtained at 30,60 and 90 days after first injection and the evaluation of the functions of hind limbs was obtained at the same time.The thickness of hip joint capsules were measured with micrometer and sections of joint capsules were stained by Sirius red and were observed with microscope and polarization microscope.[Result]Capsules of hip joint in group A and B became thicker and contractural,and the change of joint capsules was reflected in the change of motion of hind limbs.Sections in groups A and B showed shrinked capsules with thick collagens in disordered arrangement;while there were no gluteus contracture and contracture of joint capsule in the other groups.[Conclusion]Deep intragluteal injection of penicillin dissolved in 2% benzyl alcohol or 2% benzyl alcohol into young rabbits can cause contracture of hip joints.The contracture of joint capsule is largely induced by tissue trauma and repair of joint capsules.The limited locomotion of hip joint induced by the contracture of gluteal muscle does not play an important role in the contracture of joint capsule.
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[Objective]To discuss the perioperative management of thoracolumbar fractures fixed with latero-anterior screw-plate system.[Method]The entry point and direction of screw on 30 thoracic and lumbar vertebra specimens were marked based on the principle and demand of implantation of latero-anterior screw-plate system and were determined exactly by anatomic landmarks in order to make reference for operation.Sixty patients with thoracolumbar fractures were treated with anterior decompression,bone grafting and internal fixation from January 2000 to June 2007.Reference data such as the length of vertebral body screw and plate and the height of bracing gotten from the patients'X-ray and CT findings before operation were compared with practical data measured during operation.The entry point and the direction of screw were determined exactly by anatomic landmarks of thoraco lumbar vertebrae and were checked by X-ray during operation.[Result]The judgement of the entry point and the direction of screw was easy and accurate during operation and the reference data were in coincidence with practical data.The effects of operation were satisfactory.[Conclusion]The perioperative management is both scientific and practical.The surgical complications can be reduced in this way.