RESUMO
Objective:To study the protective effect of Mongolian medicine Bateri-7 on radiation-induced intestinal injury in mice.Methods:C57BL/6J male mice were randomly divided into control group, irradiation group and irradiation plus drug administration group, with 10 or 15 mice in each group. For irradiation group, the mice were given a single dose of 12 Gy 60Co γ-rays with total body irradiation. For drug treatment, the mice were gavaged with Bateri-7 (530 mg/kg) 7 d before irradiation until 3 d after IR. At 6 h and 24 h after irradiation, the Tunel positive cells in intestine were detected immunohistochemically. At 3.5 d after irradiation, the structure of intestinal villi was observed by HE staining, and the BrdU and Ki67 positive cells were detected immunohistochemically. The expression levels of IL-6, TNF-α and Cxcl-5 were detected by qPCR. The FITC-dextran in peripheral blood was also determined. Results:The survival of irradiated mice was significantly increased by Bateri-7 ( χ2= 5.84, P < 0.05), but there was no significant difference in weight between two groups ( P > 0.05). The villi length of small intestine in the irradiation plus drug group was significantly longer than that in the irradiation group ( t = 20.24, P < 0.05), and there was no significant difference in the depth of intestinal crypt between two groups ( P > 0.05). At 6 and 24 h after irradiation, the number of Tunel positive cells in intestinal crypts in the irradiation plus drug group was significantly reduced in comparison with the irradiation group ( t = 3.52, 2.90, P < 0.05). At 3.5 d after irradiation, the level of FITC-dextran in serum and the expressions of IL-6, TNF-α and Cxcl-5 in small intestine of mice in the irradiation plus drug group were significantly lower than those in the irradiation group, respectively( t = 6.92, 7.01, 7.18, 13.16, P < 0.05). The number of BrdU and Ki67 positive cells in the crypt of mice in the irradiation plus drug group was higher than that of the irradiation group ( t = 3.91, 2.57, P < 0.05). Conclusions:Mongolian medicine Bateri-7 can effectively alleviate irradiation-induced intestinal injury of mice, which may have a good preventive and therapeutic effect on radiation enteritis.
RESUMO
Objective:To investigate the efficacy and pregnancy outcome of fertility-preserving treatment for patients with stage Ⅰa, grade 2 endometrial cancer (EC).Methods:Clinical data was retrospectively collected for EC or atypical endometrial hyperplasia (AEH) patients treated in Peking University People's Hospital, Foshan First People's Hospital of Guangdong Province and First Affiliated Hospital of Sun Yat-sen University, from 2010 to 2019. Inclusion criteria for fertility-preserving treatment included: (1) Age ≤45 years. (2) EC with histological differentiation of G 1, G 2 or endometrial AEH. (3) EC disease should be stage Ⅰa, confined to the endometrium without myometrial invasion, lymph node or extrauterine metastasis. Treatment regimen: patients were given oral progestin therapy and endometrial pathology was evaluated every three months. Patients were divided into three groups as G 2 EC group, G 1 EC group and AEH group based on the histological differentiation. Oncological and pregnancy outcomes were compared among them. Results:(1) Totally 57 eligible patients were included in this study, including 11 cases with G 2 EC, 22 cases with G 1 EC, and 24 cases with AEH. (2) Oncological outcome: among the three groups of G 2 EC, G 1 EC and AH, the complete remission rates (9/11, 91% and 96%, respectively) and recurrence rates (3/9, 30% and 22%, respectively) were not significantly different (all P>0.05). Median remission time was significantly longer in the G 2 EC group than those in the other two groups (8, 6 and 4 months; P=0.046). Among 9 G 2 EC patients who recurred after complete remission, three patients relapsed at 7, 18 and 53 months, respectively. All 3 patients chose fertility-sparing treatment again, and all achieved complete remission after retreatment. (3) Pregnancy outcome: among the three groups, the assisted reproduction technology rates (4/8, 5/18 and 36%, respectively) and pregnancy rates (6/8, 5/18 and 36%, respectively) had no significant difference ( P>0.05). However, time interval to pregnancy was shorter in G 2 EC patientsthan the other two groups (4, 9 and 22 months, respectively; P=0.006). Conclusions:Fertility-preserving treatment for patients with stageⅠa, G 2 endometrial cancer, may obtain a relatively high remission rate and an acceptable pregnancy rate. However, further exploration is needed due to the limited number of cases.
RESUMO
Congenital portosystemic venous shunts (CPSVS) are defined as abnormal vascular communications between the portal and the systemic venous circulation,which is a rare vascular malformations,but with potentially devastating complications.In order to better understand the diagnosis and prenatal counselling,here we summarized some literatures about the embryologic origins,ultrasound image features,prenatal diagnosis,classifications and postnatal clinical presentations,treatment and prognosis of CPSVS.
RESUMO
Objective To explore the effect of probucol on the inflammatory response in rabbits with arteriosclerosis obliterans.Methods SPF male new zealand white rabbits were subjected to incomplete right femoral artery ligation model of arteriosclerosis obliterans.The model rabbits were divided into experimental group and control group.The rabbits in experimental group were treated by probucol.After treatment for 4 weeks,HE staining was used to evaluate the injury severity of right femoral artery in rabbits;ELISA was used to measure the levels of IL-1,IL-6,TNF-α and CRP;Realtime PCR was used to detect the expressions of IL-1,TNF-α in right femoral artery;Western blot was used to measured the nucleus accumulations of NF-κB,and the phosphorylation of IκB.Results Compared with control group,the degree of pathological injury of right femoral artery was significantly atteunated,the levels of IL-1 、IL-6 、TNF-α and CRP in plasma,the mRNA expressions of IL-1 、TNF-α and the nucleus accumulations of NF-κB,and the phosphorylation of IκB in right femoral artery decreased significantly.Conclusion Probucol attenuates the inflammatory response in rabbits with arteriosclerosis obliterans significantly.
RESUMO
BACKGROUND:To improve local microenvironment and reduce local scars is conducive to peripheral nerve regeneration that promotes nerve function recovery.OBJECTIVE:To evaluate the effect of fresh amniotic membrane on the regeneration of tinjured peripheral nerve.METHODS:Sixty healthy Sprague-Dawley rats were randomly divided into three groups (n=20 per group) after constructing a model of sciatic nerve injury of the unilateral leg. In group A, the nerve was wrapped with fresh human amnion at the anastomosis end after the repair of nerve. In group B, the nerve was wrapped with biofilm at the anastomosis end after the repair of nerve. In group C, no treatment was conducted after the repair of nerve (blank control). The effects were evaluated by anatomical observation, light microscope observation, immunohistochemical detection (2, 4, 8, 12 weeks after surgery), transmission electron microscope observation, axon imaging analysis, action potential detection, and sciatic nerve function index (4, 8, 12 weeks after surgery).RESULTS AND CONCLUSION: (1) Gross observation. The amniotic membrane and biofilm were absorbed partialy at postoperative 2 weeks, mostly at postoperative 4 weeks and completely at postoperative 8 weeks. In the groups A and B, the nerve was adhered slightly and loosely to the surrounding tissues, with a fair range of motion. In the group C, the nerve was tightly adhered to the surrounding tissues, with a poor range of motion. (2) Observation under light microscope. The nerve regeneration was better in the groups A and B than group C at 2, 4, 8, 12 weeks postoperatively. (3) Observation under electron microscope. Regenerated nerve fibers were rarely seen and lamelar structures were unclear in the three groups at 4 weeks postoperatively. Then, increased regenerated nerve fibers, thickened myelin sheath, clear lamelar structure and enlarged axon diameter were found in the groups A and B compared with the group C at 8 and 12 weeks postoperatively. (4) Immunohistochemical detection. The expression and distribution of S-100 protein in the groups A and B were better than those in the group C. (5) Axon image analysis. Groups A and B were superior to the group C in the diameter of myelinated nerve fibers, thickness of myelin sheath and number of regenerated nerve fibers. There was a significant difference by statistical analysis (P < 0.05). (6) Electrophysiological examination. Shorter latency period, higher amplitude and faster nerve conduction velocities were observed in the groups A and B compared with the group C (P < 0.05). (7) The sciatic function index. The sciatic function index in group A or B was significantly higher than that in group C (P < 0.05). To conclude, the human amniotic membrane can reduce adhesion between the damaged nerve and surrounding tissues, and prevent scarring at the anastomosis end. In addition, it promotes the regeneration of nerve fibers, increase axon diameter and myelin sheath thickness, and ease inflammatory and immune responses at the neural incision.
RESUMO
Objective To discuss the influence of bath frequency on neonatal skin condition and body temperature. Methods 108 newborns from obstetrics of People′s Hospital of Peking University during November 2015 to December 2015 were selected, and were randomly distributed t into two groups by lottery. The control group took bath every day, whereas the experimental group did every three days. The newborns were followed up for 4 weeks on their skin condition and body temperature. Then the data were systemized and performed statistical analysis. Results During the first 4 weeks after babies were born, the control group and experimental group showed no significant difference on their skin condition (P>0.05). When compared at the time of first 3 days, 1 week and 2 weeks after the babies were born, body temperature of the experimental group were (36.693±0.182), (36.738±0.174), (36.772±0.185)℃, while the control group were (36.591 ± 0.160), (36.671 ± 0.158), (36.684 ± 0.155)℃,which tended to be significantly lower than the experimental group (t values were -2.697,-2.087,-2.669, P 0.05). Conclusions Reducing the bath frequency form once a day to every third day showed no influence on neonatal skin condition. Meanwhile, it did avoid significant reduce of body temperature after bath. This may help improve healthy skin care of newborns, promote their growth, and at the same time, redistribute the clinical nursing work efficiently.
RESUMO
Objective:To evaluate the seven existing vaginal birth after cesarean (VBAC)screening tools and to identify additional factors that may predict VBAC or failed trial of labor in China.Methods:In the study,53 patients with 1 previous cesarean delivery who then delivered between January 1,2007 and Novenber 31,2014 were recruited.The average age of the patients was (32.1 ±3.5 )years,the average gestational age was (38.0 ±2.3)weeks.There was no significant difference of the successful group and the failed group in the maternal /neonatal mortality and morbidity,also in the incidence of the postpartum hemorrhage and the postpartum infection.The probability of VBAC was calculated for each participant using 7 prediction models created by Weinstein,Flamm,Grobman,Gonen,Troyer,Smith and Torri.The data were analyzed using t test,rank-sum test,and receiver operating curve analysis. Results:44 trial of labor patients had a vaginal birth after cesarean delivery,and the successful rate was 83%.The scores between the successful group and the failed group had significant difference when eva-luated by Weinstein and Grobman scoring models only.After recalculating the successful rate of VBAC in different score levels according to the references,there was significant difference between the rates of dif-ferent score levels when evaluated by the Weinstein model.The successful rates of different score levels were higher compared to the references (<50%)when evaluated by the Troyer (70%),Gonen (60%),Torri (85.7%)models.The area under the receiver operating characteristic curve of Weinstein prediction model (0.746)and Flamm prediction model (0.723)were more than 0.7,and there was no significant difference between the seven models.Conclusion:Among the seven scoring models,the Weinstein model is more applicable to the population of our country,but a new model more applying to Chinese women still needs to be created.
RESUMO
BACKGROUND:Experiments have demonstrated that biological membranes can be usedtorecon struct thetendon she athandin hibit exogenou shealing of thetendon.Therefore,the semembrane sprovide a good bed for tendon gliding and reduce tendon adhesion. OBJECTIVE:To compare the effectsof acelular amniotic membrane and medical membraneagainst tendon adhesion during the repair oftendon sheath defects. METHODS:ToesIIIfrom the bipeds of 66 leghorns were chosen to prepare tendon injury and tendon sheath defect models, which were randomly divided into three groups (n=22 per group). Amnion group were repaired with acelular amniotic membrane, medical membrane group with absorbable membrane, and control group had no treatment on tendon sheath defects. Gross, histological and biomechanical tests of each group were performed at 2, 4, 8, 12 weeks after surgery. RESULTS AND CONCLUSION:At 12 weeks after surgery, in the amniotic membrane and medical membrane groups, the tendon sheath formed completely, and the tendon healed well, with no adhesion, but in the control group, there was serious tendon adhesion. At 8 weeks after surgery, the number of synovial cells in the false sheath was highest in the amniotic membrane group sequentially followed by the medical membrane group and control group. In the amniotic membrane group, the rough endoplasmic reticulum expanded highly and secreted exuberantly in the matrix, while in the control group, the synovial cells presented with messy arrangement, and expanded vacuoles in the matrix were weaker than those in the other two groups. At 12 weeks after surgery, fibroblasts were arrayedtidily in layerwith dense structure in the medical membrane and amniotic membrane groups;but in the control group, fibroblasts were distributed disorderly with loose structure. Tendon sliding distance and total flexor toe angle in the amniotic membrane and medical filmgroups were significantly larger than those in the control group (P < 0.05),butthere was no significant difference between the medical membrane and amniotic membrane groups. Additionally, the maximum tensile fracture strength had no significant difference among three groups at 12 weeks after surgery. These results indicate that both amniotic membrane and medical membrane can markedlyprotect the tendon from exogenous healing and adhesion.
RESUMO
SUMMARY Pheochromocytomaisrareinpregn’ancy.Clinicalfeaturesofacaseofpheochromocytoma during pregnancy in the Peking University People’s Hospital was investigated and the literature reviewed to discuss the diagnosis and treatment of this disease.The patient manifested with hypertension and pro-teinuria,who was easily misdiagnosed with gestational hypertension disease.When she was transferred to our hospital,the symptoms such as,paroxysmal palpitation,dizziness,vomiting were noticed,and the possibility of pheochromocytoma was considered due to the accompanying abdominal mass.An emergent cesarean section was performed successfully due to preterm labor during the treatment of the disease.Af-ter the delivery the drug preparation continued.And the laparoscopic resection of pheochromocytoma pro-ceeded when the blood pressure was steady.The patient recovered fully after the surgery.The final diag-nosis of pheochromocytoma was confirmed with the pathology.Its diagnosis and treatment experiences could improve our understanding and treatment of secondary hypertension due to pheochromocytoma in pregnancy.
RESUMO
Objective To study the effects of High frequency two -way jet ventilation on the function respiratory and circulation of patients with Trachea and Carinal reconstruction.Methods Fifty patients with lung cancer,who were scheduled for elective trachea and carinal reconstruction,were intubated with double lumen tube following anesthesia induction and general anesthesia.High frequency ventilation was used on the healthful main bronchus during carinal reconstruction,a Hunsaker tube was inserted 3cm into the healthful main bronchus.HFTJV was applied with the respiratory rate of 120 /min,the ratio of inspiration and expiration E =1:1 and drive pressure of 0.2 -0.25Mpa.Blood gas analysis was made before the anesthesia,15 min following one -lung ventilation,10,20, 30 min following HFTJV and 15min following one -lung ventilation,respectively and monitor MAP,HR,SpO2 , PetCO2 .Results PaO2 in high frequency ventilation increased significantly compared with preoperative (78.0 ± 10.5)mmHg,was respectively (161.4 ±10.2)mmHg,(156.0 ±15.7)mmHg,(153.0 ±15.1)mmHg (P 0.05). Conclusion HFTJV is safe and reliable for Trachea and carinal reconstruction.
RESUMO
OBJECTIVE@#To explore the technique and effect of liver hanging maneuver in anterior approach for isolated complete liver caudate lobectomy.@*METHODS@#We recruited 17 patients with liver caudate lobe tumor (13 primary hepatocellular carcinoma, 3 cholangiocarcinoma and 1 liver metastasis from colorectal cancer). Isolated complete caudate lobectomy with liver hanging maneuver was performed in 17 patients.@*RESULTS@#All 17 patients were successfully received the above-mentioned operation. The operative time was 166-427 (211.5 ± 20.1) min and the intraoperative blood loss was 372-1 208 (472.7 ± 83.6) mL. There was no operative death. The survival rates of follow up for 1, 3 and 5 years were 76.5%, 52.9% and 23.5%, respectively.@*CONCLUSION@#Liver hanging maneuver for isolated complete resection of the caudate lobe is an ideal approach for liver neoplasms resection.
Assuntos
Humanos , Perda Sanguínea Cirúrgica , Carcinoma Hepatocelular , Cirurgia Geral , Colangiocarcinoma , Cirurgia Geral , Neoplasias Colorretais , Patologia , Hepatectomia , Métodos , Neoplasias Hepáticas , Cirurgia Geral , Taxa de SobrevidaRESUMO
Modern information technology was used to establish the simulating interview question bank which includes the parts of medical history,physical examination,primary diagnosis,lab test, treatment,confirmed diagnosis and the final case abstract according to the clinical management process. Results of the application in gynecology and obstetrics teaching assessment among the medical probation showed that the simulating interview question bank had some advantages in assessing the student's ability of the knowledge comprehensive evaluation,self-thinking and synthetic analyzing. It could also make au-tomatic analysis after the examination and provide teaching feedback. This novel teaching assessment could be optimized and applied extensively.
RESUMO
OBJECTIVE@#To evaluate the surgical outcomes of laparoscopic splenectomy and to investigate the learning curve of laparoscopic splenectomy.@*METHODS@#Forty cases of laparoscopic splenectomy (performed by W.Y. between September 2008 and August 2010) in our general surgery department were reviewed, and the cases were divided equally into 4 groups (group I, II, III, IV) according the time sequence of the operations. The operating time, blood loss, conversion to open surgery, conversion to hand-assisted laparoscopic splenectomy, postoperative hospital stay, postoperative liquid diet recovery time, intra- and postoperative complications and the operative frequency were compared.@*RESULTS@#There were no statistical differences among the groups in age and gender (P>0.05). The operating time, blood loss and postoperative hospital stay of groups III and IV were significantly less than those of groups I and II (P0.05). Frequency of conversion to open surgery, of conversion to hand-assisted laparoscopic splenectomy, of complications among the four groups were also not statistically different (P>0.05). The operative frequency of group I-IV increased from 1.25/month to 2.5/month.@*CONCLUSION@#The learning curve of laparoscopic splenectomy for surgeon who was experienced in open splenectomy and laparoscope cholecystectomy is approximately 20 cases, and the operative frequency is about 1.33/month.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Perda Sanguínea Cirúrgica , China , Epidemiologia , Complicações Intraoperatórias , Epidemiologia , Laparoscopia , Métodos , Curva de Aprendizado , Estudos Retrospectivos , Esplenectomia , MétodosRESUMO
Objective To compare the differences and similarities between the diagnostic criteria of obstetrics and internal medicine in China with that of Hibbard for peripartum cardiomyopathy (PPCM).Methods From March 1995 to September 2009, a total of 49 patients were diagnosed as PPCM at the Peking University People's Hospital and the Fu Wai Hospital in Beijing, China. Obstetric diagnostic criteria was:PPCM was one of dilated cardiomyopathy,occurred during the third trimester of pregnancy through the 6th month postpartum,and without cardiovascular diseases before. Internal medicine diagnostic criteria was:PPCM was unexplained cardiomegaly and heart failure, occurred during the last month of pregnancy through the 5th month postpartum, and meet the echocardiographic criteria of dialated cardiomyopathy as follows:left ventricular end-diastolic dimension (LVEDd) greater than 5.0 cm; left ventricular ejection fraction (LVEF)less than 45% , and(or) left ventricular fractional shortening (LVFS) less than 30% ; or LVEDd greater than 2. 7 cm/body surface area (m2) ; or LVEDd > 117% of age and body surface area predictive value. Hibbard diagnostic criteria was: All four of the following: (1) heart failure within last month of pregnancy and 5 months postpartum; (2) absence of prior heart disease; (3) no determinable cause; (4) strict echocardiographic indication of left ventricular dysfunction; LVEF less than 45% , and/or LVFS less than 30% , and LVEDd greater than 2. 7 cm/m2. The compliance between obstetric and internal criteria with Hibbard criteria, and the reasons of incompliance between Chinese and international criteria were analyzed. Results Eight patients were diagnosed of PPCM by obstetricians according to Chinese obstetric criteria. Among them, 6 patients (6/8) did not meet Hibbard criteria. 2 of the six did not reach the time regulated in the criteria. All of the six had other determinable causes for heart failure, and their echocardiographic results did not meet the diagnostic standard either. The other 41 patients were diagnosed of PPCM by physicians according to Chinese internal medicine criteria. Among them, 7 patients (17%) did not meet Hibbard criteria, 3 of the seven did not reach the time regulated in the criteria, and had other determinable causes for heart failure either. 4 of the seven did not meet the echocardiographic standard part in the criteria. The Chinese internal medicine diagnostic criteria has a significant higher coincidence rate with Hibbard criteria, compared to Chinese obstetric criteria (83% vs. 25% ; P <0. 01). Among all 13 patients whose PPCM diagnosis did not meet Hibbard criteria, 5 cases did not reach the time regulated in the criteria, 9 cases had other determinable causes for heart failure, and 10 cases did not meet the echocardiographic standard part in the criteria. Preeclampsia was the most common determinable causes for heart failure, accounted for 7 cases. Conclusion There is obvious difference between Chinese and Hibbard diagnostic criteria for PPCM, especially Chinese obstetric criteria.
RESUMO
ObjectivesTo improve the efficacy of postoperative choledochofiberscopy for residual hepatolithiasis.MethodFrom 1982 to 2001,2?856 cases with residual hepatolithiasis were treated by postoperative choledochofiberscopy through the T tube fistula in our department.ResultsThe success rate was 93 0% and failure rate was 7 0% by using choledochofiberscope.ConclusionsThe postoperative choledochofiberscopy is the mainstay for the treatment of postoperative residual gallstones with a very high success rate and low complications.
RESUMO
Objective To study the effect of expression of myoglobin which mediated by adenovirus,on ATP value of liver and the protective effect on liver ischemia reperfusion injury.Methods Adenovirus carrying CMV promoter sequences linked to the human myoglobin gene(AdCMVMyo) were transfected into rats liver. Then myoglobin, hepatic ATP levels and liver function were evaluated. Results Myoglobin expression was verified in rat livers after AdCMVMyo transfection. The ATP levels in rat livers 72 hours after AdCMVMyo transfection were significantly higher than that in control group(P
RESUMO
Objective To evaluate the effect of surgical therapy for hepatolithiasis by hepatectomy and choledochofiberscopy. Method We retrospectively analyzed hepatolithiasis patients in our hospital during the past 5 years, comparing the therapeutic effect of different surgical modality. Data were analyzed by chi-square test. Result A total of 469 patients underwent surgical treatment, 412(87.85%) cases were followed up for an average of 3 years and 6 months. The residual calculus rate was 5. 14% and 14. 81% (x2 =9.32,P
RESUMO
upper and they were all higher compared with the control (P