Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 172
Filter
1.
Chinese Journal of Geriatrics ; (12): 305-310, 2021.
Article in Chinese | WPRIM | ID: wpr-884885

ABSTRACT

Objective:To analyze the effects of proton pump inhibitors(PPIs)on the prevention of stress ulcers(SU)in elderly patients with acute respiratory distress syndrome(ARDS), and to analyze related factors for the risk of short-term death.Methods:This study was a multicenter retrospective cohort study.Two hundred elderly ARDS patients diagnosed and treated at Peking University International Hospital, Anzhen Hospital and Ezhou Central Hospital from November 2017 to December 2019 were continuously included.These patients were treated with PPIs(omeprazole, pantoprazole, rabeprazole, lansoprazole and esomeprazole)within 48 hours after ICU admission to prevent SU and were considered as the PPI group.According to the propensity score matching method, 200 elderly ARDS patients admitted to the hospitals with similar ages, medical history and sequential organ failure assessment(SOFA)scores who did not use PPIs were selected as the control group.All patients were followed up for 30 days.Kaplan-Meier survival analysis and the log-rank test were used to compare the 30-day mortality risk between the two groups.Cox regression analysis was used to analyze the relevant factors affecting the 30-day mortality.The 30-day mortality risk and the incidence of clinically significant gastrointestinal bleeding were evaluated among patients using different PPIs.Results:The average time of PPI use was 8.4±4.4 d in the PPI group.In the control group, 38.0% of patients were treated with H 2 receptor antagonists, and the average time of use was 8.1±5.2 days.There was no significant difference in the 30-day all-cause mortality risk between the two groups(20.5% or 41 cases vs.23.5% or 47 cases, P>0.05). The incidences of clinically significant upper gastrointestinal tract bleeding(2.5% or 5 cases vs.7.0% or 14, P<0.05), gastrointestinal bleeding(5.5% or 11 cases vs.12.5% or 25 cases, P<0.05)and hospital-acquired pneumonia(9.0% or 18 vs.4.0% or 8 cases, P<0.05)had significant differences between the PPI group and the control group.Multivariate Cox regression analysis showed that age>70 years( HR=1.845, 95% CI: 1.131-3.010, P<0.05), arterial oxygen partial pressure <78.0 mmHg(1 mmHg=0.133 kPa, HR=2.143, 95% CI: 1.317-3.487, P<0.01), SOFA score>14( HR=3.603, 95% CI: 1.741-7.456, P<0.01)and blood lactic acid>3.8 mmol/L( HR=2.725, 95% CI: 1.437-5.167, P<0.01)were related factors for the 30-day mortality.Compared with the control group, there was no significant difference in 30-day mortality between the five subgroups taking different PPIs including omeprazole, pantoprazole, rabeprazole, lansoprazole and esomeprazole( P>0.05), and the incidence of clinically significant gastrointestinal bleeding was significantly reduced( P<0.05), but there was no significant difference between the five PPIs subgroups( P>0.05). Conclusions:Although PPIs have no effect on short-term death in elderly ARDS patients, it can increase the risk of hospital acquired pneumonia while reducing the occurrence of gastrointestinal bleeding.With PPI use, advanced age, low arterial oxygen partial pressure, high SOFA score and high blood lactate are risk factors for the 30-day mortality.

2.
Article in Chinese | WPRIM | ID: wpr-883581

ABSTRACT

Objective:To explore the application value of case three-dimensional teaching method combined with standardized patient (CTTM+SP) in the clinical clerkship teaching reform of gastrointestinal surgery.Methods:A total of 120 students of clinical medicine having clerkship in Binzhou Medical University Hospital were recruited in this study, and they were randomized to the experimental group and the control group, with 60 students in each group. The experimental group took the CTTM+SP teaching method, and the control group adopted the lecture-based learning teaching method. The comprehensive ability of the two groups was evaluated by department graduation examination and satisfaction survey.Results:The examination performance and the satisfaction rate of students in the experimental group were significantly higher than those of the control group ( P < 0.05). Conclusion:CTTM+SP teaching method is helpful for the probationers to master the theoretical knowledge of gastrointestinal surgery systematically, improve the clinical thinking ability and the ability to solve practical problems, mobilize the students' learning motivation and interest, and improve the teaching effect of gastrointestinal surgery clinical clerkship.

3.
Article in Chinese | WPRIM | ID: wpr-882571

ABSTRACT

Objective:To evaluate the clinical efficacy of Shiwei-Jinghuang Ointment combined with Chinese herbal external washing prescription in the treatment of acute paronychia. Methods:A total of 126 patients with acute paronychia in Xiyuan Hospital of China Academy of Chinese Medical Sciences from January to December 2019, who met the inclusion criteria, were divided into 3 groups according to the random number table method (42 in each group). The treatment group was treated with Shiwei-Jinghuang Ointment combined with Chinese herbal external washing prescription. The control group 1 and group 2 were simply applied with Chinese herbal external washing prescription and mupirocin ointment, respectively. All groups were treated for 2 weeks and followed up 2 months. Serum CRP level was determined by ELISA method, and neutrophil percentage (NEU%) was measured by automatic hematology analyzer. The subsided time of red swelling and inflammatory exudation in nail groove of the paronychia patients were observed and recorded. Results:The total effective rate was 90.5% (38/42) in the treatment group, 71.4% (30/42) in the control group 1 and 66.7% (28/42) in the control group 2. The statistical difference were significant among three groups ( χ2=7.350, P=0.025). After treatment, the serum CRP level and NEU% in three groups were decreased ( P<0.01), and the serum CRP and NEU% level in treatment group were significantly lower than those in the control group 1 and group 2 ( F values were 6.482, 33.619, respectively, all Ps<0.001). After 2 months of follow-up, the incidences of chronic paronychia were 50.0% (6/12) and 57.1% (8/14) in control group 1 and group 2, respectively, but no chronic paronychia occurred in the treatment group. The difference among three groups was statistically significant ( χ2=9.355, P=0.009). Conclusion:The combination of Shiwei-Jinghuang Ointment and Chinese herbal external washing prescription can promote paronychia red swelling, reduce the inflammatory exudation time and the incidence of chronic paronychia, effectively improve the in vivo decrease inflammation index and clinical efficacy.

4.
Article in Chinese | WPRIM | ID: wpr-867155

ABSTRACT

Inflammatory response is an important mechanism of secondary nerve injury in ischemic stroke, which is still a research hotspot in the field of neuroscience at present. Astrocytes are characterized by extensive distribution in brain, strong hypoxia tolerance, and the ability to interact with almost all cells in neurovascular unit, thus becoming potential therapeutic targets for alleviating ischemic injury. After ischemic stroke, astrocytes quickly become reactive astrocytes, releasing a large number of inflammatory cytokines, promoting the activation and invasion of other inflammatory cells, triggering a cascade of inflammatory responses, and aggravating ischemic injury. A variety of basic studies have shown that inhibiting the astrocytes activation and astrocytosis can significantly reduce neuroinflammatory response and infarct volume, and significantly improve the neurological function recovery in a model of middle cerebral artery occlusion. In this paper, the research progress of inflammatory response of astrocytes after ischemic stroke was reviewed from the aspects of astrocyte activation and polarization, release of inflammatory cytokines, interaction of inflammatory cells and corresponding targeted therapy strategies.

5.
Chinese Journal of School Health ; (12): 908-910, 2020.
Article in Chinese | WPRIM | ID: wpr-822539

ABSTRACT

Objective@#To investigate the antibiotic resistance spectrum and genetic characteristics of multidrug-resistant Staphylococcus aureus(MDRSA) nasal isolate among primary school students, and to provide a scientific basis for the prevention and control of masal MDRSA resistance and the selection of clincal drugs in children.@*Methods@#Antibiotic susceptibility experiments were performed on all SA isolates of 1 705 primary school students from 8 primary schools in Guangzhou selected by using multistage cluster stratified sampling method. MDRSA antibiotic susceptibility spectrum was analyzed, and the resistant, virulence and immune evasion cluster(IEC) genes detected by polymerase chain reaction(PCR).@*Results@#The prevalence of MDRSA nasal carriage was 20.76%(354/1 705), and the proportion of multidrug resistance among SA isolates was 96.20%(354/368). The predominant resistant antibiotics of MDRSA isolates were penicillin(99.72%), erythromycin(96.33%), clindamycin(90.96%) and teicoplanin(90.11%). Notably, 240(67.80%, 240/354) MDRSA isolates were resistant to more than six antimicrobial categories. And the predominant detection rates of resistant genes were BlaZ(92.66%), Tet(M)(49.72%), virulence genes Tst(25.42%) and IEC genes Sak(92.09%), Hlb(61.58%).@*Conclusion@#We found high prevalence of nasal colonization MDRSA from healthy children. Moreover, MDRSA isolates has a high resistant rate to multiple antibiotics, and the proportion of resistant to ≥6 antimicrobial categories is high.

6.
Chinese Journal of School Health ; (12): 588-590, 2020.
Article in Chinese | WPRIM | ID: wpr-821434

ABSTRACT

Objective@#To investigate the distribution and drug resistance situation of staphylococcus aureus (SA) and methicillin-resistant staphylococcus aureus (MRSA) from the classroom environments in primary schools of Guangzhou.@*Methods@#The air and the surfaces of door handles, desks, chairs, light switches and floor were sampled in the classrooms of 8 primary schools selected through stratified clustering method in Guangzhou from May to June, 2016. SA and MRSA were isolated and identified, and drug sensitivity tests were conducted.@*Results@#A total of 760 samples were collected, the detection rate of SA and MRSA were 8.8% and 4.2%, respectively. There were statistically significant differences in the detection rate of staphylococcus aureus among different sampling sites(P<0.01).Detection of SA and MRSA on the floor,light’s witches and surface of deskes was both above 6.0%. The multiple drug resistance rate of MRSA was up to 100.0%, and the main resistance mode was Penicillin-Erythromycin-Rifampin-Tetracycline-Teicolanin.@*Conclusion@#MRSA can be detected in air, door handles, desk surface, chair surface, light switch and floor of primary schools. Relevant administration departments should pay attention to the environments health of Guangzhou primary schools.

7.
Article in Chinese | WPRIM | ID: wpr-803605

ABSTRACT

Objective@#To investigate the current situation of risk assessment of neonatal pressure injury (PI) and using of the assessment scale from 8 hospitals in Zhejiang Province,providing reference for further improvement of the scale.@*Methods@#A cross-sectional study was used to investigate 184 nurses in the department of neonatal intensive care unit admitted to 8 hospitals in Zhejiang Province by using a self-made questionnaire.@*Results@#Three of the eight hospitals did not use scale for neonatal PI assessment routinely. Of the remaining five hospitals, three hospitals used Neonatal Skin Risk Assessment Scale (NSRAS), one hospital used Braden Q Pediatric Skin Risk Assessment Scale (Pediatric Braden Q Scale) and one hospital used Neonatal/Infant Braden Q scale (Neonatal/Infant Braden Q Scale). 129 nurses from 5 hospitals evaluated the scales routinely used by the department.Nearly 93.80% (121/129) of the nurses thought the scales were easy to understand, 76.74% (99/129) of the nurses thought the scales were easy to measure, 76.74% (99/129) of the nurses thought the scales were good at predicting, 75.19% (97/129) of the nurses thought the scales were suitable for newborns, 37.21% (48/129) of the nurses thought the scales did not adequately assess the severity of the condition, 34.11% (44/129) of the nurses thought the scales did not adequately assess the medical device factors, 24.81% (32/129) of the nurses thought the scales scores were not clearly defined.@*Conclusion@#The use of risk assessment scale for neonatal PI has not been unified yet, and the three scales need to be improved. The department should pay attention to the risk assessment of newborn PI and strengthen the awareness of PI prevention.

8.
Article in Chinese | WPRIM | ID: wpr-801342

ABSTRACT

Objective@#To investigate the safety and efficacy of surgical treatment for chronic radiation intestinal injury.@*Methods@#A descriptive cohort study was performed. Clinical data of 73 patients with definite radiation history and diagnosed clinically as chronic radiation intestinal injury, undergoing operation at Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University from January 1, 2012 to February 28, 2019, were reviewed and analyzed retrospectively. Patients did not undergo operation or only received adhesiolysis were excluded. All the patients had preoperative examination and overall evaluation of the disease. According to severity of intestinal obstruction and patients′ diet, corresponding nutritional support and conservative treatment were given. Surgical methods: The one-stage bowel resection and anastomosis was the first choice for surgical treatment of chronic radiation intestinal injury. Patients with poor nutritional condition were given enterostomy and postoperative enteral nutrition and second-stage stoma closure and intestinal anastomosis if nutritional condition improved. For those who were unable to perform stoma closure, a permanent stoma should be performed. Patients with severe abdominal adhesion which was difficult to separate, enterostomy or bypass surgery after adhesiolysis would be the surgical choice. For patients with tumor metastasis or recurrence, enterostomy or bypass surgery should be selected. Observation parameters: the overall and major (Clavien-Dindo grades III to V) postoperative complication within 30 days after surgery or during hospitalization; mortality within postoperative 30 days; postoperative hospital stay; time to postoperative recovery of enteral nutrition; time to removal of drainage tube.@*Results@#Of the 73 patients who had been enrolled in this study, 10 were male and 63 were female with median age of 54 (range, 34-80) years. Preoperative evaluation showed that 61 patients had intestinal stenosis, 63 had intestinal obstruction, 11 had intestinal perforation, 20 had intestinal fistula, 3 had intestinal bleeding, and 6 had abdominal abscess, of whom 64(87.7%) patients had multiple complications. Tumor recurrence or metastasis was found in 15 patients. A total of 65(89.0%) patients received preoperative nutritional support, of whom 35 received total parenteral nutrition and 30 received partial parenteral nutrition. The median preoperative nutritional support duration was 8.5 (range, 6.0-16.2) days. The rate of one-stage intestine resection was 69.9% (51/73), and one-stage enterostomy was 23.3% (17/73). In the 51 patients undergoing bowel resection, the average length of resected bowel was (50.3±49.1) cm. Among the 45 patients with intestinal anastomosis, 4 underwent manual anastomosis and 41 underwent stapled anastomosis; 36 underwent side-to-side anastomosis, 5 underwent end-to-side anastomosis, and 4 underwent end-to-end anastomosis. Eighty postoperative complications occurred in 39 patients and the overall postoperative complication rate was 53.4% (39/73), including 39 moderate to severe complications (Clavien-Dindo grade III-V) in 20 patients (27.4%, 20/73) and postoperative anastomotic leakage in 2 patients (2.7%, 2/73). The mortality within postoperative 30 days was 2.7% (2/73); both patients died of abdominal infection, septic shock, and multiple organ failure caused by anastomotic leakage. The median postoperative hospital stay was 13 (11, 23) days, the postoperative enteral nutrition time was (7.2±6.9) days and the postoperative drainage tube removal time was (6.3±4.2) days.@*Conclusions@#Surgical treatment, especially one-stage anastomosis, is safe and feasible for chronic radiation intestine injury. Defining the extent of bowel resection, rational selection of the anatomic position of the anastomosis and perioperative nutritional support treatment are the key to reduce postoperative complications.

9.
Article in Chinese | WPRIM | ID: wpr-745873

ABSTRACT

Objective To investigate the risk factors of acute pancreatitis after endoscopic retrograde chloangiopancreatography (ERCP).Methods Clinical date of 1 041 patients who underwent therapeutic ERCP from January 2016 to August 2017 in department of gastroenterology,Zhongnan Hospital of Wuhan University,were retrospectively studied.Among them post-ERCP pancreatitis developed in 53 patients (PEP group) and the remaining 988 patients were assigned in the non-PEP group.The clinical characteristics,procedures of ERCP,gastrointestinal symptoms and laboratory findings after ERCP were compared between two groups.The SPSS software (version 22.0) was applied to analyze the risk factors of PEP.Results The overall incidence rate of PEP was 5.09% (53/1 041).There were statistic difference in the number of white cells [8.56(5.43,12.23)× 109/L vs.7.12(5.58,9.20)× 109/L,Z=-2.122] and the ratio of neutrophils [0.82 ± 0.11 vs.0.76 ± 0.12,t=-3.612] after ERCP operation;the incidence of endoscopic sphincterotomy (EST) [60.37%(32/53) vs.43.72%(432/988),x2=5.646] and endoscopic papillary balloon dilation (EPBD)[50.94%(27/53) vs.33.00%(326/988),x2=7.230] during operation,and periampullary diverticula [35.85%(19/53) vs.52.98%(523/988),x2=4.619] (all P<0.05).Logistic analysis indicated that the ratio of neutrophils was independent risk factor of PEP(OR=1.058,95%CI:1.019-1.098,P=0.003).Conclusion The number of white cells,the ratio of neutrophils after ERCP and endoscopic sphincterotomy,endoscopic papillary balloon dilation and periampullary diverticula are associated with PEP,while the ratio of neutrophils is the independent risk factor of PEP.

10.
Article in Chinese | WPRIM | ID: wpr-823781

ABSTRACT

Objective To investigate the current situation of risk assessment of neonatal pressure injury (PI) and using of the assessment scale from 8 hospitals in Zhejiang Province,providing reference for further improvement of the scale. Methods A cross-sectional study was used to investigate 184 nurses in the department of neonatal intensive care unit admitted to 8 hospitals in Zhejiang Province by using a self-made questionnaire. Results Three of the eight hospitals did not use scale for neonatal PI assessment routinely. Of the remaining five hospitals, three hospitals used Neonatal Skin Risk Assessment Scale (NSRAS), one hospital used Braden Q Pediatric Skin Risk Assessment Scale (Pediatric Braden Q Scale) and one hospital used Neonatal/Infant Braden Q scale (Neonatal/Infant Braden Q Scale). 129 nurses from 5 hospitals evaluated the scales routinely used by the department.Nearly 93.80% (121/129) of the nurses thought the scales were easy to understand, 76.74% (99/129) of the nurses thought the scales were easy to measure, 76.74% (99/129) of the nurses thought the scales were good at predicting, 75.19% (97/129) of the nurses thought the scales were suitable for newborns, 37.21%(48/129)of the nurses thought the scales did not adequately assess the severity of the condition, 34.11%(44/129)of the nurses thought the scales did not adequately assess the medical device factors, 24.81% (32/129) of the nurses thought the scales scores were not clearly defined. Conclusion The use of risk assessment scale for neonatal PI has not been unified yet, and the three scales need to be improved. The department should pay attention to the risk assessment of newborn PI and strengthen the awareness of PI prevention.

11.
Article in Chinese | WPRIM | ID: wpr-774406

ABSTRACT

The surgical treatment of low rectal diseases has gradually changed from open radical operation to endoscopic minimally invasive operation. Transanal total mesorectal excision (taTME) combines endoscopic technique with transanal approach, and solves the problem of surgery exposure in lower rectal cancer. It has become an option for colorectal surgeons in lower rectal cancer. We named this operation as transanal endoscopic surgery, for the appropriateness when it is applied for other colorectal diseases. Transanal endoscopic surgery belongs to the category of natural orifice transluminal endoscopic surgery, which achieves the same pathological outcomes with less invasiveness and better organ functions compared with traditional surgery. It represents the tendency of low rectal surgery.


Subject(s)
Digestive System Surgical Procedures , Humans , Minimally Invasive Surgical Procedures , Natural Orifice Endoscopic Surgery , Rectal Neoplasms , Transanal Endoscopic Surgery
12.
Article in Chinese | WPRIM | ID: wpr-338415

ABSTRACT

Radical surgeries and(neo) adjuvant therapies have significantly prolonged survival of patients with colorectal cancer. Microinvasive surgery and function preservation become more important with the prerequisite of R0 resection. As for colorectal cancer, long term survival after laparoscopic curative surgery is proved non-inferior to its open counterpart. The new transanal approach of total mesorectal excision, while avoiding abdominal incision for extraction, may as well improve surgical quality. Local excision and the "watch and wait" strategy, though attractive for organ-preservation, are undermined by suboptimal clinical and radiographic assessment of lymph node and treatment response, respectively. Meanwhile, fresh changes are challenging long-established perioperative regiments. Shortening of adjuvant chemotherapy to 3 months reduces adverse events without compromising survival. Moving part of, or all, adjuvant courses to before surgery may improve response, thereby omitting protectomy or radiotherapy. To summarize, function preservation and quality of life has, together with survival, increasingly become the ultimate aim of colorectal cancer treatment, a field of constant evolvement.

13.
Article in Chinese | WPRIM | ID: wpr-338410

ABSTRACT

Chronic radiation proctopathy (CRP) is the delayed adverse effect after radiotherapy for pelvic malignancies. It is characterized as progressive fibrosis in pathology. The symptoms are usually unspecific which include rectal bleeding, perianal pain, tenesmus, stool frequencies and so on. The course of CRP can present from months to years after radiation. Severe complications can occur in the late stage and will greatly affect the quality of life. Currently, there is no standard guides for diagnosis and treatment of CRP. For advancing the knowledge and proposing new treatment modalities of CRP, this article summarizes our 10-year experience as follows: (1) Except the existence of vessel damage, interstitial fibrosis, mucous ulcer, edema and inflammatory cell infiltration in the radiation-injury area, the capillary count was obviously reduced in mucous substratum and angiostatin expression up-regulated remarkably in above area, resulting in the continuous development of compensatory capillary expansion and interstitial fibrosis in mucous layer. (2) Rectal ultrasound examination was used the first time to diagnose CRP. According to thickness change of rectal wall layer and increase of blood signal, severity of CRP activity was evaluated with good diagnostic value. (3) For slight-moderate rectal bleeding, moderate-heavy bleeding and heavy bleeding, application of retention enema with compound preparation based on mucoprotective agents, regional perfusion hemostasis with formaldehyde and proximal colostomy gained satisfactory efficacy. (4) Improved Parks operation should be recommended for CRP patients with advanced complications. (5) For rectal cancer patients receiving neoadjuvant chemoradiotherapy, "proximal extended excision" should be performed innovatively to decrease the risk of anastomotic complications (Tianhe Procedure).

14.
Article in Chinese | WPRIM | ID: wpr-338407

ABSTRACT

<p><b>OBJECTIVE</b>To explore the feasibility and clinical significance of precision low inferior mesenteric artery (IMA) ligation with the left colonic artery (LCA) preservation and root lymph node dissection in laparoscopic radical resection for rectal cancer, according to the inferior mesenteric artery (IMA) types.</p><p><b>METHODS</b>One Hundred and fore cases of rectal cancer patients who underwent laparoscopic resection in The Sixth Affiliated Hospital of Sun Yat-sen University from October 2015 to June 2016 were selected and divided into study group and control group according to different surgical methods. The study group (52 cases) accepted precision low IMA ligation with the LCA preservation and root lymph node (No.253) dissection, according to the IMA types and length examined by preoperative computed tomography angiography (CTA) reconstruction. The control group (52 cases) accepted the traditional high IMA ligation. The perioperative efficacy indexes and postoperative recovery situation of the two groups were compared.</p><p><b>RESULTS</b>The IMA types, IMA length and preoperative clinical stages were not significantly different between the two groups (all P>0.05). The surgery was completed smoothly for patients in both groups, with no conversion to open surgery. But two patients in the study group underwent left colonic artery ligation for intra-operative need. There were no significant differences in the operative time, intra-operative blood lose, the rate of protective ileostomy and post-operative pathological stages between the two groups (all P>0.05). More total lymph nodes [(24.9±5.7) vs. (16.9±4.2), P=0.001] and No.253 lymph nodes [(2.4±1.1) vs. (1.5±0.8), P=0.001] were harvested in study group as compared to control group. However, the positive rate of total harvested lymph nodes and No.253 lymph nodes between the two groups were not significantly different (P>0.05). There were no significant differences between the two groups in postoperative first anal exhaust time, postoperative hospital stay, total volume of postoperative intraperitoneal drainage, postoperative abdominal drainage tube retention time, postoperative anal drainage tube retention time and postoperative catheter retention time (All P>0.05). There were 2 cases of postoperative dysuria and 1 case of anastomotic bleeding in study group. There were 3 cases of postoperative dysuria and 2 cases of anastomotic leak in control group. Less postoperative complications (5.8% vs. 9.6%, P<0.05) in study group as compared to control group. There was no rehospitalization or death case in two groups within 30 days after operation.</p><p><b>CONCLUSIONS</b>In the laparoscopic radical resection of rectal cancer, preserving LCA and cleaning the root lymph nodes according to IMA types, which could increase the number of harvested lymph nodes and reduce the postoperative complications was safe and effective.</p>

15.
Article in Chinese | WPRIM | ID: wpr-704211

ABSTRACT

Cellular therapy in acute ischemic stroke (AIS) is a research hotspot in the field of neu-roscience in recent years. Compared with other cells,bone marrow mononuclear cells (BMMNCs) are one of the most attractive therapeutic cells because BMMNCs can be rapidly isolated from bone marrow,are enriched with stem cells and permit autologous applications. Numerous basic researches showed that BMMNCs trans-plantation can decrease infarct volume and promote neurological outcomes in animal stroke model,indicating BMMNCs transplantation may has therapeutic values in acute ischemic stroke,and the transformation from basic research to clinical applications is on the key phase. In this paper,the progress of BMMNCs transplan-tation is reviewed in acute ischemic stroke on the aspects of BMMNCs component,methods of purification, route of transplantation,therapeutic mechanisms and problems from basic research to clinical application.

16.
Article in Chinese | WPRIM | ID: wpr-704193

ABSTRACT

Objective To investigate the effect of donepezil on subventricular zone ( SVZ) neuro-genesis related neurotrophic factors after cerebral infarction. Methods Mice were randomly assigned into three groups: vehicle-treated sham group (Sham+vehicle,n=18),vehicle-treated middle cerebral artery oc-clusion (MCAO) group (MCAO + vehicle,n=30) and donepezil-treated MCAO group (MCAO+donepezil, n=30). Middle cerebral artery occlusion( MCAO) was induced by thread-occlusion method. Nissl staining was used to measure the infarct volume and the modified neurological severity score(mNSS) was used to as-sess neurologic function and brain water content was detected to assess brain edema degree. Proliferative cells and neuroblasts were labeled with 5-bromodeoxyuridine ( BrdU) and doublecortin ( DCX). The SVZ BrdU+/DCX+cells were detected by immunofluorescence. The expression of glial cell line-derived neurotro-phic factor (GDNF),brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were detec-ted by Western blot. Results The infarct volume of MCAO + donepezil group ((13. 33±4. 55)%) was sig-nificantly lower than that of MCAO + vehicle group ((31. 33±3. 93)%,t=7. 34,P<0. 05). The neurologic deficits were significantly ameliorated after donepezil treatment,and the brain water content of MCAO + done-pezil group ((71. 82±10. 18)%)was significantly less than that of MCAO + vehicle group ((85. 93± 7. 54)%,F=13. 480,P<0. 05). All differences were statistically significant (P<0. 05). The area of BrdU+/DCX+cells within SVZ of MCAO + vehicle group ((6. 16±1. 79)%) was significantly larger than that of sham + vehicle group ((2. 25±1. 09)%),and was fewer than that of MCAO+donepezil group ((16. 19± 2. 16)%,F=102. 756,P<0. 05). MCAO significantly promoted the expression of GDNF,BDNF and NGF within SVZ compared with sham operation,and donepezil increased these protein levels(F=15. 114,27. 121, 27. 398,P<0. 05). Conclusion Donepezil regulates neurogenesis via increasesing the expression of GDNF, BDNF and NGF within SVZ after cerebral infarction.

17.
Chinese Mental Health Journal ; (12): 207-214, 2018.
Article in Chinese | WPRIM | ID: wpr-704003

ABSTRACT

To explore how to formulate the case conceptualization of obsessive-compulsive disorder (OCD) in the perspective of cognitive theory and behavioral theory. The current study utilized the cognitive behavioral conceptualization model to account for the development and maintenance of obsessive-compulsive symptoms of a college student with OCD. An intervention strategy combining exposure and reaction prevention (ERP) with cognitive techniques was implemented within a 17-session individual counseling in 13 weeks. Client's anxious, depressive and obsessive-compulsive symptoms were assessed at baseline and after 13-week intervention with the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS), respectively. Results showed a significant decrease in anxiety and depressive symptoms. The score of Y-BOCS decreased from 25 to 11 after intervention, which indicated normal social functioning. These findings suggested that the cognitive theory and behavioral theory of OCD could effectively guide the process of case conceptualization and the counselling practice.

18.
Article in Chinese | WPRIM | ID: wpr-702416

ABSTRACT

Liver metastasis is the most common cause of death for patients with colorectal cancer.Surgical resection is the first choice for colorectal cancer liver metastasis (CRLMs),but only 10%-25% of them are resectable.Patients with unresectable CRLMs are usually treated with systemic chemotherapy and/or local ablative therapies as alternative options.The safety and efficiency of thermal ablation therapies have been improved in recent years.The 5-year survival rate of patients underwent thermal ablation is higher than that of patients underwent chemotherapy for treating CRLMs.A consensus for thermal ablation of colorectal liver metastasis was provided by international experts panel on 2013.The recommendations and indications of thermal ablation for CRLMs were considered and documented according to the literature review based on radiofrequency ablation with long-term follow-up.The main content of the consensus from international experts for thermal ablation of colorectal liver metastasis were reviewed in this article.

19.
The Journal of Practical Medicine ; (24): 877-881,884, 2018.
Article in Chinese | WPRIM | ID: wpr-697713

ABSTRACT

Objective To investigate the effects of cholinergic signal on neural stem cell(NSC)differenti-ation in peri-infarction region after ischemic stroke. Methods Mice were randomly assigned into sham + vehicle group,middle cerebral artery occlusion(MCAO)+ vehicle group,MCAO + donepezil group and MCAO + atro-pine group(n = 25). MCAO was induced by thread-occlusion method. Modified neurological severity score (mNSS)was used to evaluate neurological function recovery,and the brain water content was measured by dry-wet weight method. NeuN/5-bromodeoxyuridine(BrdU),CNPase/BrdU,GFAP/BrdU double-labeled cells were tested by immunofluorescence. Results Brain water content of MCAO + vehicle group was significantly higher than that of sham operation group(P < 0.05). Donepezil-treated MCAO mice had lower neurologic deficit scores and brain water content than of MCAO + vehicle group(P < 0.05). On day 14 and day 28 after MCAO,the NeuN/BrdU, CNPase/BrdU and GFAP/BrdU immune-positive cells of MCAO + vehicle group were markedly increased as com-pared with that of sham+vehicle group(P<0.05).Compared with that of MCAO+vehicle group,the number of NeuN/BrdU-positive cells,CNPase/BrdU-positive cells and GFAP/BrdU-positive cells was higher in MCAO+done-pezil group,and the number of NeuN/BrdU-positive cells and CNPase/BrdU-positive cells of MCAO + atropine group was lower(P < 0.05). Conclusions Cholinergic signal could promote NSCs differentiation in peri-infarc-tion region,a lleviate cerebral edema,and improve the brain function restoration after stroke.

20.
Article in Chinese | WPRIM | ID: wpr-691341

ABSTRACT

Rectal cancer is one of the most common malignancies in China. Total mesorectal excision (TME) plus neoadjuvant therapy is the standard treatment for locally advanced rectal cancer. After a development of over 20 years, neoadjuvant synchronous chemoradiotherapy has become the standard treatment and cornerstone of neoadjuvant therapy for rectal cancer. However, radiotherapy does not really increase the overall survival and is associated with long-term impact on the functions of anus, sex, urinary system and fertility, so the application of simple neoadjuvant chemotherapy rises gradually and becomes a potentially better treatment option. This paper elaborates the reason, present research status and future trend of the rising neoadjuvant chemotherapy.


Subject(s)
Chemoradiotherapy , China , Humans , Neoadjuvant Therapy , Neoplasm Staging , Rectal Neoplasms , Therapeutics , Treatment Outcome
SELECTION OF CITATIONS
SEARCH DETAIL