BACKGROUND:Conventional prosthetic vessel replacement has been gradually replaced by endovascular covered stent graft exclusion in the treatment of abdominal aortic aneurysm (AAA).However,whether it has advantages over conventional prosthetic vessel replacement in clinical curative effects and biocempatibility produced in the implantation of new type of biomaterials remains unclear.OBJECTIVE:To compare the curative effects and complications of endovascular covered stent graft exclusion and prosthetic vessel replacement in the treatment of AAA.DESIGN: A controlled observation analysis.SETTING: Department of Vascular Surgery,Wuhan nion Hospital.PARTICIPANTS: Forty-two patients with AAA (renal artery not involved) who received the treatment in the Department of Vascular Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology between September 2001 and July 2006,were recruited in this study.They were all confirmed by CT angiography (CTA) and other examinations.According to the selected operative way,patients were allocated into interventional therapy group (n =17) and conventional therapy group (n =25).In the interventional therapy group,the patients,including 16 males and 1 female,were averaged (68±10)years old,and their mean tumor diameter was (6.4±1.3) cm.In the conventional therapy group,the patients,including 23 males and 2 females,were averaged (64±9) years,and their mean tumor diameter was (6.2±1.1) cm.Significant difference did not exist in the baseline material between two groups (P ＞ 0.05).This study was approved by the Hospital Ethics Committee.Written informed consents were obtained from all the patients.METHODS:In the interventional therapy group,patients underwent ndovascular covered stent graft exclusion by an interventional means.After being generally anesthetized,patients were dissected at unilateral femoral artery.Under the perspective condition,a covered stent graft was placed at a proper position with a forwarder,and then it was released and expanded.Following the position and xpansion of a covered stent being examined by CTA,femoral artery was anastomosed and incision was closed.If arteria iliaca was involved,then another covered stent was implanted from contralateral femoral artery and connected to stem.In the conventional therapy group,patients underwent prosthetic vessel replacement by a conventional means.Postoperatively,patients in the two groups all received anti-inflammation,anti-coagulation and other symptomatic and supportive treatments necessarily.MAIN OUTCOME MEASURES:① Postoperative complications of patients in two groups.② Recovery was observed by B-ultrasonography and CTA examination 1,3,6 and 12 months after operation.③ Follow-up of biocompatibility of biomaterials and host during 1 year postoperatively.RESULTS:Forty-two patients participated in the finial analysis.①Patients who exhibited pulmonary infection and renal function deterioration in the interventional therapy group were fewer than those in the conventional therapy group (P ＜0.05).② In the interventional therapy group,patients with covered-stent graft displacement,aortic injury and hematoma formed at the puncture point of femoral artery were not found.In the conventional therapy group,one patient died of acute large-area myocardial infarction at the 6th week postoperatively,and patients,who suffered from stomal leakage,prosthetic vessel thrombogenesis and infection,etc.,were not found.③ Neither obvious inflammatory reactions in the peripheral tissue of prosthetic vessel nor thrombogenesis in the prosthetic vessel was found in patients of two groups.It was demonstrated that both covered stent graft and prosthetic vessel had good biocompatibility.CONCLUSION:Endovascular covered stent graft exclusion can treat AAA due to its less surgical trauma,rapid postoperative recovery,good biocompatibility and other advantages.

Objective To investigate the status of cancer pain and the usage of complementary and alternative medicine among gynecological cancer pain patients.Methods Thirty-one patients with cancer pain were investigated with self-designed questionnaire in the Gynecology Department of the First Hospital of Lanzhou University.Results The average score of age was (51.23 ± 11.34) years old,the youngest patient was 23 years old.During the period of cancer,54.84％ (17/31) of the average degree of cancer pain was mild,77.42％ (24/31) of the most severe degree of cancer pain was severe,51.61％ (16/31) of the patients experienced two or more parts of the pain,75.47％ (40/53) of the cancer pain was pelvic pain,72.72％ (24/33) was dull pain.The higher the degree of cancer pain was,the worse the subjective sleep quality was.Merely 25.81％ (8/31) of the patients used complementary and alternative medicine methods to treatment cancer pain,6 cases of them considered that the methods were effective.Conclusions Patients with gynecological cancer became younger and younger,their cancer pain was severe and mostly was pelvic pain and dull pain.Patients' subjective sleep quality was affected by cancer pain.Complementary and alternative methods might mitigate cancer pain but their usage frequency was low,which was anticipated to be more used in clinic.

Objective To study the possibility of umbilical cord blood mononuclear cells(UCB MNCs) having polydifferential potention to be induced and differentiated into hepatic stem/progenitor cells.Methods Collecting 32 cases fresh UCB from mature delivery,UCB MNCs were isolated by density-step centrifugal effect and were randomly divided into two groups:(1) control group 8 cases:the basic medium supplemented without cytokines;(2) trial group 24 cases,divided into four groups randomly,and the experimental results were detected at 0d,7d,14d,21d,respectively.The basic medium supplemented with various combinations of growth /differentiation factors(FGF-1,FGF-2,LIF,SCF,HGF,and OSM);cell morphological change was observed,hALBmRNA was examinated using RT-PCR methods,the expressions of ALB、CK18、CK19 were detected by immunohistochemistry.Results In trial group cell number increased,cell volume enlarged,refraction strong,polymorphic cells(mostly oval cells) appeared and obviously attached on the culture dishes.The expression of CK18、CK19、ALB were positive by immunohistochemistry,and the level of hALBmRNA improved along with the culture time.Conclusions UCB MNCs can be induced and differentiated into hepatic stem/progenitor cells in vitro.Human umbilical cord blood mononuclear cells may be a new source of transplantable hepatic stem/progenitor cells and hepatocytes.

Objective To evaluate the clinical results of patients submitted to laparoscopic assisted supracervical hysterectomy for benign uterine disease.Methods Women referred for supracervical hysterectomy for benign uterine diseases were divided into laparoscopy group(n=34)or open group(n=30).The operative time,blood loss,complications,morbidity,ileus,wound infections were compared between the two groups.Results In terms of Operative time,both of total operative time and oophosalpingorectomy time,there was no significant difference between laparoscopic group and open group.Less blood loss was found in laparoscopic group than open group.No complications were found in both groups.Conclusions Laparoscopic assisted supracervical hysterectomy is a safer and easier approach to complete supracervical hysterectomy with reduced blood loss and quick convalescence.It can be successfully integrated into a large health maintenance organization/residency-training program.

Objective To understand the effect of butylbenzyl phthalate(BBP) on the levels of DNA-protein crosslinks(DPC) in hepatic cells of mice.Methods Twenty-five male Kunming mice were randomly assigned into five groups(n=5).BBP was administered by intraperitoneal injection at doses of 0(control group),125,250,500,1 000 mg/kg respectively for 14 consecutive days.Then the levels of DNA-protein crosslinks were detected.Results DPC coefficient increased with concentration of BBP increasing.Treatments of 500 and 1 000 mg/kg BBP significantly increased the levels of DPC compared with the control group. Conclusion BBP can not cause DPC at low levels(125 mg/kg),but it can cause DPC significantly at high levels(500 and 1000 mg/kg),which may cause serious DNA damages.

0.05).This study was approved by the Hospital Ethics Committee.Written informed consents were obtained from all the patients.METHODS:In the interventional therapy group,patients underwent endovascular covered stent graft exclusion by an interventional means.After being generally anesthetized,patients were dissected at unilateral femoral artery.Under the perspective condition,a covered stent graft was placed at a proper position with a forwarder,and then it was released and expanded.Following the position and expansion of a covered stent being examined by CTA,femoral artery was anastomosed and incision was closed.If arteria iliaca was involved,then another covered stent was implanted from contralateral femoral artery and connected to stem.In the conventional therapy group,patients underwent prosthetic vessel replacement by a conventional means.Postoperatively,patients in the two groups all received anti-inflammation,anti-coagulation and other symptomatic and supportive treatments necessarily.MAIN OUTCOME MEASURES:① Postoperative complications of patients in two groups.② Recovery was observed by B-ultrasonography and CTA examination 1,3,6 and 12 months after operation.③ Follow-up of biocompatibility of biomaterials and host during 1 year postoperatively.RESULTS:Forty-two patients participated in the finial analysis.①Patients who exhibited pulmonary infection and renal function deterioration in the interventional therapy group were fewer than those in the conventional therapy group(P

The main progress in international critical care medicine in 2020 are: the reflections on the mandatory of implementation of the 1-hour cluster treatment strategy for sepsis are still continuing; the "metabolic resuscitation" therapy, represented by large dose of vitamin C, failed to yield positive results; the global epidemic of coronavirus disease 2019 (COVID-19) continues to spread, with evidences indicating Dexamethasone, Remdesivir or interferon β-1b (IFNβ-1b), Lopinavir/Ritonavir and ribavirin as promising therapy; conservative oxygen therapy did not exert positive effects neither for mechanical ventilated patients nor for acute respiratory distress syndrome (ARDS) patient; the concept of lung- and diaphragm-protective mechanical ventilation illuminates a new opportunity to potentially improve clinical outcomes for critically ill patients; there was no positive evidence for stress ulcer prophylaxis and timing of endoscopy for severe acute upper gastrointestinal bleeding; early initiation of renal-replacement therapy (RRT) for critically ill patients with acute kidney injury (AKI) has not shown positive effect. At last, artificial intelligence (AI) has shown good potential in identifying ARDS phenotypes and early predicting sepsis.

Full-speed development of the primary health care centering on community health service is key to the ongoing health reform in China. Building a new management mechanism for these grass-root health centers is an innovative approach of such a reform as carried out in Zhejiang province.The authors described the present management mechanism in the province, and focused on the specific measures and main outcomes of the nine Group-scale model as used by a district health bureau in Hanzhou since end of 2007. The paper aims at building an ideal model for group-scale management of community health centers, and improving the new city primary health care system centering on community health service.

BACKGROUND:Diameter and length of mini-implant have effects on its stability, which has been reported mostly in I and II osteoid, but less in IV osteoid. OBJECTIVE:To optimize the design of mini-implant diameter and length in IV osteoid by a three-dimensional finite element analysis. METHODS:Implant-mandible solid model was established. A 2 N orthodontic force that was perpendicular to the long axis of the implant and at a 30° angle with the distal central axis was applied onto the top of the implant. The implant was designed for different diameters (1.2-2.0 mm) and lengths (6-10 mm). Peak stress and peak displacement of the mandible were mechanicaly assessed, and stress sensitivity variables were analyzed. RESULTS AND CONCLUSION:The stress and displacement of the implant were mainly concentrated in the neck of the implant. The stress of implant-bone interface mainly focused on the contact area of the implant-cortical bone interface, and the stress of the cancelous bone was relatively smal, but the stress of the cortical bone was weakened faster. When the implant length was constant, the implant diameter had a great effect on stress changes, and the stress of bone tissue was reduced with the increase of implant diameter. When the implant diameter was constant, the implant length had no significant effect on the stress of bone tissue. To sum up, the stress of bone tissue and displacement were sensitive to the change of implant diameter rather than the change of implant length. These findings indicate that implant diameter has a greater effect on stress distribution of bone tissue than the implant length, and the implants with > 1.5 mm in diameter are suitable for IV osteoid.

Objective To compare the dissolution behavior between domestic trepibutone tablets and original reference product, and provide a basis for evaluating the quality consistency of generic drugs. Methods Four dissolution media recommended by Japanese Orange Book and a domestic standard dissolution media were selected to determined the dissolution profile,and f2 factor was calculated to investigate the consistency of stripping curves. Results In water,pH 4.0 and pH 1.2,the f2 of domestic formulation and reference formulation was under 50,and the dissolution profile was inconsistent.Dissolution behavior of domestic preparations of different manufacturers was dissimilar.In water,the f2 of domestic preparations of different batches of the same manufacturer was over 99.9,and the dissolution behavior was similar. Conclusion The dissolution method of existing domestic standard can not distinguish the dissolution behavior of different products,and it should be revised and completed.There is still great difference in quality between the domestic preparations and reference preparations.