Advances in recurrence risk assessment of gastrointestinal stromal tumor / 中华胃肠外科杂志

Identification of prognosis-related risk factors and accurate assessment of risk stratification in patients with gastrointestinal stromal tumor (GIST) is of great significance not only for establishing a reliable prognostic model and developing a follow-up plan but also for selecting potential populations benefiting from neoadjuvant therapies. Although several risk stratification models have been established, it is still challenging to accurately assess patients' risk of recurrence, and the performance of these prediction models still needs to be improved. This review focused on the latest studies in recurrence risk assessment for GIST patients, and summarized potential predictive markers and recurrence risk models related to tumor-related characteristic parameters, novel laboratory examinations, radiological imaging signatures and molecular pathological features, which could provide a reference for accurate risk stratification and individualized targeted therapies for GIST patients.

Etiology and clinical classification of constipation / 中华胃肠外科杂志

The causes of constipation are extremely complex and are still not fully clear. In addition to secondary factors such as organic diseases and drugs, constipation may also be related to genetics, diet, intestinal flora, age, gender and so on. At present, according to the etiology, chronic constipation is divided into primary constipation and secondary constipation. However, there are significant differences among current clinical guidelines in the clinical classification of primary constipation. Some guidelines classify primary constipation as slow-transit constipation (STC), outlet obstruction constipation (OOC), and mixed constipation; however, some guidelines classify primary constipation as STC, defecation disorder (DD), mixed constipation, and normal-transit constipation (NTC); what's more, some even propose types which are different from the above sub-types. There are also differences in the understanding of the relationship between functional constipation (FC) and primary constipation and the classification of irritable bowel syndrome predominant constipation (IBS-C) among various clinical guidelines. By reviewing domestic and international guidelines and relevant literature on constipation, the following conclusions are drawn: primary constipation can be divided into IBS-C and FC, and FC can be further divided into STC, OOC, and mixed constipation; primary constipation should not be confused with FC, nor should IBS-C be classified as FC.

Dietary Protein Intake in a Multi-ethnic Asian Population of Healthy Participants and Chronic Kidney Disease Patients

<p><b>INTRODUCTION</b>Clinical practice guidelines recommend different levels of dietary protein intake in predialysis chronic kidney disease (CKD) patients. It is unknown how effectively these recommendations perform in a multi-ethnic Asian population, with varied cultural beliefs and diets. We assess the profi le of protein intake in a multi-ethnic Asian population, comparing healthy participants and CKD patients.</p><p><b>MATERIALS AND METHODS</b>We analysed the 24-hour urine collections of the Asian Kidney Disease Study (AKDS) and the Singapore Kidney Function Study (SKFS) to estimate total protein intake (TPI; g/day). We calculated ideal body weight (IDW; kg): 22.99 × height2 (m). Standard statistical tests were applied where appropriate, and linear regression was used to assess associations of continuous variables with protein intake.</p><p><b>RESULTS</b>There were 232 CKD patients and 103 healthy participants with 35.5% diabetics. The mean TPI in healthy participants was 58.89 ± 18.42 and the mean TPI in CKD patients was 53.64 ± 19.39. By US National Kidney Foundation (NKF) guidelines, 29/232 (12.5%) of CKD patients with measured glomerular filtration rate (GFR) <25 (in mL/min/1.73 m2) had a TPI-IDW of <0.6 g/kg/day. By Caring for Australasians with Renal Impairment (CARI) guidelines, 76.3% (177/232) of CKD patients had TPI-IDW >0.75g/kg/ day. By American Dietetic Association (ADA) guidelines, 34.7% (44/127) of CKD patients with GFR <50 had TPI-IDW between 0.6 to 0.8 g/kg/day. Only 1/6 non-diabetic CKD patients with GFR <20 had a protein intake of between 0.3 to 0.5 g/kg/day. A total of 21.9% (25/114) of diabetic CKD patients had protein intake between 0.8 to 0.9 g/kg/day.</p><p><b>CONCLUSION</b>On average, the protein intake of most CKD patients exceeds the recommendations of guidelines. Diabetic CKD patients should aim to have higher protein intakes.</p>

Dolor y medicina complementaria y acupuntura / Pain and complementary medicine and acupuncture

El objetivo de este artículo es entregar información documentada sobre la situación actual de la Medicina Complementaria y la Acupuntura en Chile, su definición, reglamentación, mecanismos de acción y evidencia. Busca orientar sobre el uso de estas herramientas terapéuticas que son cada vez más solicitadas en el país.

Noise pollution and its effects on medical care workers and patients in hospitals

The objectives of this study are to investigate the levels of noise pollution in some hospitals in Taiwan and to study the effects of noise pollution on the physiological and psychological reactions and annoyance response of medical care staff, patients and visitors in these hospitals. An instrument for the measurement of sound level was used and a self-answered survey questionnaire on noise pollution was administered. Results showed that the daily average sound levels measured inside these hospitals during daytime were between 52.6 and 64.6 decibels. These are higher than the current daytime environmental noise limit of 50 decibels in Taiwan. Most nursing staff members expressed that "talking of visitors or patient's family members" is the major source of noise inside the wards, whereas "talking of visitors or patient's family members" and "children playing" are the two major noise sources outside the wards. However, most patients or visitors claimed that "doors opening or closing" and "patients moaning or crying" are the two major sources of noise inside the wards. "Footsteps," "renovation of hospitals," "talking of visitors or patient's family members," "shouting of nursing staff" and "doors opening or closing" are the five major noise sources outside the wards. To conclude, noise pollution inside and outside the wards either directly or indirectly affects, in a simultaneous manner, the subjective perception of noise, emotions, physiology and experience of noise inside and outside the wards of both the medical care staff and the patients and visitors

Mycobacterium Leprae in Cultured Mouse Peritoneal Macrophages: In vivo Infection In vitro Cultivation

To grow Mycobacterium leprae in cultured mouse peritoneal macrophages, studies were made on 1) the purification of M. leprae from lepromatous nodules by trypsinization, 2) growth experiment of purified M. leprae in cu1tured macrophages by in vivo infection-in vitro cultivation technique and 3) the observation of pathological changes in sp1eens of mice induced by intraperitoneal inoculation of purified M. leprae. Results are summarized as follows. 1. A simple and effective procedure is described for purification of M. leprae from biopsied nodules of lepromatous leprosy patients by trypsinization and high speed centrifugation. The procedure resulted in a good yie1d of homogeneous preparation of M. leprae with a negligible contamination of tissue debris. 2. Significant decreases were observed in the numbers of acid-fast bacilli in cultured macrophages and of macrophages harboring acid-fast bacilli by the length of intervals between the time of intraperitoneal inoculation of purified M. leprae and the time of initiation of macrophage cultures. 3. Microscopic examination of stained preparations of macrophages cultured by in vivo infection-in vitro cultivation technique indicated that an apparent increase in the number of acid-fast bacilli in the macrophages occurred when the cultures made at 24 hours and 1 week after inoculation were maintained in vitro up to 2 months or more. 4. Pathological changes in the spleens of mice inoculated with purified M. leprae were of mainly degenerative nature in the red pulp. No multiplication of M. leprae was observed in the spleens of mice up to 5 months after inoculation.

Continuous Cultivation of Fibroblast-type Cells Derived from Rabbit Embryos

A line of fibroblast-type cells derived from embryos of a domestic rabbit has been cultivated continuously for over 3 years by serial passages up to the level of the moth passage. The cell line was tentatively named rabbit embryo fibroblast (REF). The establishment of primary culture, serial passages, growth rate and cytology are described in this communication. In addition some of the results of experiments on the detection of Mycoplasma contamination, on storage of the frozen cells and on its susceptibility to vaccinia virus infection are included.