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Objective:To retrospectively analyze the clinical characteristics of elderly patients who received colonoscopy and to explore the clinical value of regular colonoscopy for the elderly.Methods:This was a retrospective cohort study.A total of 1 154 patients aged 75 years and over undergone colonoscopy in Guangdong General Hospital from January 2015 to March 2018 were enrolled and divided into three groups, including 605 cases aged 75-79 years, 527 cases aged 80-89 years and 22 cases aged 90 years and over.Detection rates of colorectal lesions by colonoscopy were recorded.The clinical value of annual colonoscopy on the detection of colorectal lesions in elderly patients 75 years and older were analyzed to assess the necessity for regular monitoring.Results:Overall, 569 cases(49.3%)underwent colonoscopy with sedation and 585 cases(50.7%)underwent colonoscopy without sedation.The total positive detection rate was 83.4%(962/1 154), and the main lesions were polyps(858 cases, 74.4%), including 605(52.4%)cases of adenomas.Among the three groups, gastrointestinal bleeding was the main cause for colonoscopy in the group aged 90 years and over, while abdominal discomfort, elevated immunological tumor markers and history of non-colon cancer were the main reasons for colonoscopy in the group aged 75-79 years( P<0.05). A total of 153 cases underwent annual colonoscopy.The detection rate of polyps and adenomas decreased in the second exam, but still higher than 40.0%. Conclusions:Colonoscopy is a safe and effective method for the elderly population aged 75 years and over.Polyps and adenomas are the most common lesions.Recurrence of polyps after colorectal cancer and polypectomy is common and it is necessary to receive colonoscopy regularly.
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Objective To study the etiology,relevant factors and endoscopic characteristics of acute lower gastrointestinal tract hemorrhage.Methods A total of 938 patients receiving emergency colonoscopy for acute lower gastrointestinal tract hemorrhage were collected to study the etiological profiles.Different causes between young group and elderly group were also recorded.Results The total detectable rate of acute lower gastrointestinal tract hemorrhage in respect of causes was 96.16％ (902/938).The five leading causes were colorectal malignancy (41.26％),erosive colorectal polypus (12.37％),inflammatory bowel disease (9.59％),erosive and ulcer colitis (10.34％) and hemorrhoids (8.64％).Compared with youth and middle age patients,the incidence of colorectal malignancy (x2 =68.116,df =2,P =0.000) and colorectal polyps (x2 =9.101,df =2,P =0.011) were significantly increased in elderly patients,while incidence of inflammatory bowel disease (x2 =62.150,df=2,P =0.000) and erosive and ulcer colitis (x2 =20.292,df =2,P =0.000) were significantly decreased in those patients.Conclusions Emergency colonoscopy for diagnosis of acute lower gastrointestinal tract hemorrhage is an important measure.The major manifestation is bleeding resulting from colorectal malignancy,erosive colorectal polypus,inflammatory bowel disease,erosive and ulcer colitis and anal hemorrhoid.Age is associated with the cause of lower gastrointestinal tract bleeding induced by different kinds of lesions at the colorectum.
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Objective To observe the change of regulatory T cells expression in severely burned rats gut ,To investigate the effects of regulatory T cells on CD3+CD4+ /CD3+CD8+lymphocytes and its relation with gut-origin endotoxin translocation .Meth-ods Fifty SD male rats were randomly divided into normal control group(n=10)and burn model groups(n=40) .Rats were burned to achieve Ⅲ degree scalding ,and a 30% total body surface area(TBSA) burn model was made .Rats were sacrificed before(normal control group) and after 0 .5 ,1 ,2 ,4 burn hour(PBH groups) .Flow cytometry techniques were used for the detection of the expres-sions of regulatory T cells and CD3+CD4+ /CD3+CD8+ lymphocyte in intestinal lymph nodes which were separated .The dynamic turbidity method was used for detection of endotoxin levels in portal vein blood .Results The expression of regulatory T cells was negativelycorrelatedwithCD3+CD4+ /CD3+CD8+ lymphocyteratio(r= -0.827,P<0.01)inintestinallymphnodeofrats,while the regulatory T cells was positively correlated with ET levels in portal vein blood plasma .(r=0 .782 ,P<0 .01) .Conclusion The expression of the regulatory T cells in intestinal lymph node in severely burned rats was increased compared to that in normal con-trol group .Regulatory T cells suppressed the expression of intestinal T lymphocytes ,leading to gut immune inhibition .The translo-cation of intestinal endotoxin has a close relationship with regulatory T cells in severely burned rats .Regulatory T cells could have portal effects on intestinal immunity barrier .
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A total of 79 tibial fracture patients (47 males and 32 females; 16 to 73 years old) were selected from Department of Orthopedics, Huangbu Hospital of Huidong City, including 19 cases of open fractures and 60 of closed fractures. Forty-eight fractures in 79 patients were fixed with interlocking nails, 19 by revolving self-locking nail, and 12 by auto compressive locking nail. Operations were all successful. The average operation time was (102 ?10) minutes in the interlocking group, (65?10) minutes in the revolving self-locking nail group and (100?10) minutes in the auto compressive locking nail group. The patients were followed up for 6-10 months. In the interlocking group, one breakage of the screws was found, with one superficial infection and the other 3 achieved delayed bone fracture. The healing time of interlocking group was (21.0?3.2) weeks and the excellent rate of function recovery was (85.42?5.20)% by Johner-Wruh. In the revolving self-locking nail group, one developed delayed bone facture and the other one achieved dislocation; the healing time was (20.0?3.6) weeks and the excellent rate of function recovery was (84.21?4.10)%. In the auto compressive locking nail group, one had loosening screw and the other one achieved superficial infection. The healing time was (17.0?2.8) weeks and the excellent rate of function recovery was (91.67?3.70)%. The excellent and good rate in auto compressive locking nail group was significantly greater than the other groups (P