Advances in colonic manometry in adults with colonic motility disorders / 中华胃肠外科杂志

In recent years, colonic manometry has been gradually introduced into clinical practice. It helps clinicians to gain a better understanding of the physiology and pathophysiology of colonic contractile activity in healthy adults and patients with colonic dysfunction. More and more patterns of colonic motility are being discovered with the help of colonic manometry. However, the clinical significance of these findings still needs to be further investigated. This review enhances our understanding of colonic motility and the current state of development and application of colonic manometry, as well as the limitations, future directions and potential of the technique in assessing the impact of treatment on colonic motility patterns, by analyzing and summarizing the literature related to colonic manometry.

Conservative treatment of supination and external rotation for type Ⅲ and Ⅳankle fracture by bone setting / 中国骨伤

OBJECTIVE@#To explore curative effect of conservative treatment of supination-lateral rotation (SER) with type Ⅲ and Ⅳ ankle fracture by bone setting technique.@*METHODS@#From January 2017 to December 2019, 64 patients diagnosed with SER with type Ⅲ and Ⅳ ankle fracture were treated with manipulative reduction and conservative treatment (manipulation group) and surgical treatment with open reduction and internal fixation (operation group), 32 patients in each group. In manipulation group, there were 17 males and 15 females, aged from 15 to 79 years old with an average of (51.42±13.68) years old;according to Lauge-Hansen classification, there were 8 patients with supination external rotation type Ⅲ and 24 patients with type Ⅳ. In operation group, there were 13 males and 19 females, aged from 18 to 76 years old with an average of (47.36±15.02) years old;7 patients with type Ⅲ and 25 patients with type Ⅳ. Displacement of ankle fracture was measured by Digimizer software, and compared before treatment, 3 and 12 months after treatment between two groups. Lateral medial malleolus displacement, lateral medial malleolus displacement, lateral malleolus displacement, lateral malleolus displacement, lateral malleolus contraction displacement and posterior malleolus displacement were measured and compared between two groups. Mazur score was used to evaluate ankle joint function.@*RESULTS@#All patients were followed up from 12 to 36 months with an average of (17.16±9.36) months. There were statistical differences in lateral medial malleolus displacement, lateral medial malleolus displacement, lateral malleolus displacement, lateral malleolus displacement, lateral malleolus contraction displacement and posterior malleolus displacement in manipulation group before and after reduction(P<0.05). Compared with operation group, there were no statistically significant differences in lateral malleolus shift, lateral malleolus shift, lateral malleolus contraction shift(P>0.05), while there were statistically significant differences in lateral malleolus shift, posterior malleolus shift up and down (P<0.05). Mazur scores of ankle joint at 3 months after treatment in manipulation group and operation group were 68.84±13.08 and 82.53±7.31, respectively, and had statistical differences(P<0.05), while there was no difference in evaluation of clnical effect(P>0.05). There were no differences in Mazur score and evaluation of clnical effect between two groups at 12 months after treatment (P>0.05).@*CONCLUSION@#Bone setting technique could effectively correct lateral displacement of medial malleolus, lateral displacement of medial malleolus, lateral displacement of lateral malleolus and lateral contraction displacement of lateral malleolus in supination lateral rotation type Ⅲ and Ⅳ ankle fracture, and has good long-term clinical effect, which could avoid operation for some patients and restore ankle function after fracture.

Clinicopathological features and risk factors of neuroendocrine tumors in 256 patients / 天津医药

Objective To investigate the epidemiology, clinical manifestations, diagnosis, treatment and prognosis of neuroendocrine tumors (NETs). Methods Medical records of 265 patients with neuroendocrine tumors diagnosed and treated in our hospital from January 2006 to August 2015 were collected and retrospectively reviewed in this study. The clinicopathological data including gender, age of onset, initial symptoms, primary site, pathological conditions, diagnosis, treatment, prognosis and follow up were analyzed. Results The gender ratio M/F of the 265 cases was 160:105 (1.5:1), with mean age of (55.8±2.7) years, and the high incidence was in age of 55-65 years. The tumors were located in the colon and rectum (127 cases, 47.9％), lung (59 cases, 22.3％), stomach (21 cases, 7.8％), appendix (15 cases, 5.7％), small intestine (especially in the duodenum and pancreas, 10 cases, 3.8％), mammary gland (11 cases, 4.2％), neck (10 cases, 3.8％) and unknown primary site (12 cases, 4.5％). Patients with different tumor sites showed different symptoms. Patients with colorectal tumors mainly manifested as changes in bowel habits, such as diarrhea, constipation and blood in stool. The main manifestation of patients with primary pulmonary symptoms was cough or bloody sputum. The patients with tumors at stomach, appendix or small intestine showed many discomfort, such as abdominal pain and abdominal distention. Among the 265 cases, 186 patients were diagnosed as phase G1 (70.2％), 54 patients were diagnosed as phase G2 (20.4％) and 25 patients were diagnosed as phase G3 (9.4％). Immunohistochemistry showed that synaptophysin (Syn) was positive in 228 cases (86.4％), chromaffin A (CgA) was positive in 102 cases (38.5％), and C56 was positive in 74 cases (27.9％). A total of 232 patients were treated with surgery (87.5％), 28 patients received radiotherapy or chemotherapy treatment (10.6％) and 5 patients were not treated. One hundred and ninety-eight patients were followed up at least 1 time, and the follow-up rate was 74.7％. The median follow-up time was 38 months. No tumor related death was found in patients with phase G1 during the follow-up, 6 cases of tumor associated death were found in patients with phase G2 and 19 cases of cancer related death were found in patients with phase G3. Metastasis was found in all 23 patients with tumor related death. The survival rate of patients with neuroendocrine tumor (G1+G2) was significantly higher than that of patients with neuroendocrine carcinoma (G3, Log rankχ2=13.774,P<0.01). Conclusion The males have a higher incidence rate of NETs than females. Patients with different tumor sites showed different symptoms. The most common primary sites of NETs are the digestive tract, especially in patients with colorectal cancer. The more late the pathological stage, the worse the prognosis.

Treatment of thoracolumbar fractures with three-dimensional reduction method and external fixation devices under analgesia / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinical effects between open reduction internal fixation and three-dimensional reduction with external fixation under analgesia in treating fresh thoracolumbar fractures, and explore the simple and effective method for thoracolumbar fractures.</p><p><b>METHODS</b>The clinical data of 40 patients with thoracolumbar fractures who met the inclusion and exclusion criteria in the department of orthopaedics affiliated to Suzhou Hospital of Nanjing University of Chinese Medicine from February 2013 to August 2017 were retrospectively analyzed. According to therapeutic methods, the patients were devided into treatment group and control group, 20 cases in each group. Treatment group was treated by three-dimensional reduction method and external fixation devices under analgesia, and control group was treated by open reduction and common spinal fixation system. In treatment group, there were 9 males and 11 females, aged from 26 to 68 years old with an average of (52.8±11.3) years; and in control group, there were 10 males and 10 females, aged from 26 to 64 years old with an average of(50.6±8.8) years. Anterior vertebral body compression(AVBC), Cobb angle and visual analogue scale(VAS) were measured and compared in two group.</p><p><b>RESULTS</b>All 40 patients finished follow-up. The follow-up time in treatment group was 5 to 37 months with average of (16.1±8.8) months, in control group was 5 to 29 months with an average of(17.3±6.0) months. There was no significant difference between two groups(>0.05). AVBC, Cobb angle, VAS score were obviously improved in all patients after treatment(<0.05), but there were no significant difference between two groups(>0.05).</p><p><b>CONCLUSIONS</b>Clinical effect of two methods was similar in treating thoracolumbar fractures, but three-dimensional reduction and external fixation devices under analgesia has advantage of easy operation, smaller trauma and no need secondary surgery for removed internal fixation.</p>

Percutaneous poking reduction with bone grafting and limited internal fixation for the treatment of calcaneal fractures / 中国骨伤

<p><b>OBJECTIVE</b>To investigate clinical effects of percutaneous poking reduction with bone grafting and limited internal fixation for the treatment of calcaneal fractures.</p><p><b>METHODS</b>From May 2013 to October 2016, 53 patients with closed calcaneal fractures were analyzed, and were divided into treatment group and control group. There were 33 patients in treatment group including 25 males and 8 females, aged from 15 to 82 years old with an average of(44.7±14.2) years old; 17 cases were type II and 16 cases were type III according to Sanders classification; treated by percutaneous poking reduction with bone grafting and limited internal fixation. There were 33 patients in control group, including 20 males aged from 25 to 62 years old with an average of (42.2±11.3) years old; 8 cases were type II and 12 cases were type III according to Sanders classification; treated by open reduction and internal fixation. Imaging indicators, hospital stays and preoperative waiting time were observed and compared, Maryland scoring were applied to evaluate foot function.</p><p><b>RESULTS</b>Fifty-three patients were followed up, and treatment group was followed up from 8 to 40 months with an average of (19.9±7.2) months; while control group was followed up from 12 to 40 months with an average of (21.7±7.7) months, and there were not significant differences between two groups in follow-up time (>0.05). There were no obvious meaning in Böhler angles, Gissane angles between two groups (>0.05). There were significant differences in hospital stays and preoperative waiting time(<0.01). There were no significant differences in Maryland score between treatment group(90.45±5.76) and control group(89.10±6.16).</p><p><b>CONCLUSIONS</b>Percutaneous poking reduction with bone grafting and limited internal fixation for the treatment of calcaneal fractures could obtain satisfied effects, and has advantages of less trauma and complications, rapid recovery and good clinical effects.</p>

Chemical constituents from flower of Gentiana tibetica / 中草药

Objective: To investigate the chemical constituents in flowers of Gentiana tibetica. Methods: The chemical constituents were isolated from the 95% alcohol extract of G. tibetica flowers by silica column chromatography, Sephadex LH-20, C18 and RP-HPLC. Their chemical structures were elucidated on the basis of IR, ESI-MS, 1H-MNR, and 13C-MNR spectroscopic data. Results: Twelve compounds, including chromene, flavones C-glycosides, secoiridoid glycosides, iridoid glycosides, aliphatic alcohol, and disaccharide, were obtained from the 95% alcohol extract of G. tibetica flowers, Their structures were identified as macrophylloside D (1), orientin 7-caffeate (2), 7-O-feruloylorientin (3), isovitexin (4), saponarin (5), isoorientin (6), 6'-O-β-D-glucopyranosyl gentiopicroside (7), sweroside (8), swertiamarine (9), loganic acid (10), 1-heneicosanol (11), and sucrose (12). Conclusion: Compounds 1-12 are isolated from G. tibetica for the first time.

Monascus Citrinin Analysis Methods and A Study on Formation of Citrillin by Monascus / 微生物学通报

A HPLC method of analysis of Monascus citrinin was established. More than 30 strains of Monascus spp. were cultured in steamed rice at solid state or in MSG liquid medium composed of monosodium glutamate as sole nitrogen source and glucose as sole carbon to investigate their ability of producing citrinin. The results indicated that most of the Monascus strains are able to produce citrinin. MSG medium can be used as a specific culture medium to qualitatively identify if the strain is the potential citrinin producer. But to confirm whether the Monascus strains are potential citrinin producers, these strains should be cultured in several cultivation methods, as the culture states and culture conditions influence the citrinin production greatly.