Objective:To investigate the significance of small intestinal manometry in clinical diagnosis and treatment of patients with gastrointestinal motility disorders.Methods:The clinical data of 20 suspected patients with gastrointestinal motility disorders from February 2019 to January 2020 in Shanghai Jiaotong University Affiliated Ninth People′s Hospital were retrospectively analyzed. All patients were performed small intestinal manometry, and the influence on diagnosis and treatment as well as the clinical value of this technique were analyzed.Results:Among the 20 patients, 18 patients successfully accepted small intestinal manometry. Among the 18 patients, 14 patients showed significant motility abnormalities, among which 9 patients showed significant nutritional improvement after treatment and 5 patients were treated with maintaining nutritional support. In 10 patients, small intestinal manometry served as a deciding diagnostic tool, and in 12 patients, major modifications of treatment strategy were made according to results of small intestinal manometry.Conclusions:The small intestinal manometry significantly improves diagnosis and treatment decision in the patients with gastrointestinal motility disorders and shows great value on the clinical practice on this group of patients.

Objective:To investigate the clinical characters of enteric dysmotility (ED), in order to improve clinical diagnosis and treatment capabilities.Methods:The clinical data of 13 ED patients underwent small intestinal manometry from August 2019 to July 2022 in the Shanghai Jiaotong University Affiliated Ninth People′s Hospital and the Fourth Affiliated Hospital of Nanjing Medical University were retrospectively analyzed, including the clinical manifestation, small intestinal manometry result, treatment and prognosis.Results:Among 13 patients, 1 abnormality was presented in 9 cases, 2 abnormalities presented in 2 cases and 3 abnormalities presented in 2 cases. All 13 cases presented a history of constipation, 5 cases started with constipation and underwent subtotal colectomy. Three patients showed severe chronic abdominal pain with one of them opiate dependence. Eight patients underwent surgical treatment, all of which achieved nutritional improvement and symptom relief.Conclusions:ED is a concisely defined disease with clear diagnostic criteria. The surgery can increase the symptoms of some patients.

Objective:To investigate the expression of p21-activated kinase 2 (PAK2) in laryngeal squamous cell carcinoma and its relationship with the clinicopathological characteristics and chemosensitivity of patients.Methods:Transcriptome sequencing (RNA-seq) data for laryngeal squamous cell carcinoma were downloaded from the Cancer Genome Atlas (TCGA) database, and 123 patients were included in the study (12 cases had cancer tissues and normal tissues data, and the remaining 111 only had cancer tissues data). Differential expression of PAK2 in cancer and para-cancer tissues was analyzed by using R software, and the potential function of PAK2 in laryngeal squamous cell carcinoma was investigated by using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database signaling pathway enrichment. A total of 34 patients with primary laryngeal squamous cell carcinoma tissues and corresponding para-carcinoma 34 tissue specimens who underwent surgical resection were retrospectively selected from Chaoyang Central Hospital between April 2016 and June 2021, and 20 cases of normal laryngeal mucosa tissues were selected as the controls. Immunohistochemistry was used to detect the expression of PAK2 in various tissues, and its correlation with clinicopathological factors was analyzed. A total of 35 supraglottic primary laryngeal squamous cell carcinoma patients were retrospectively collected before induction chemotherapy during the same period, including 20 patients sensitive to chemotherapy and 15 patients resistant to chemotherapy. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the relative expression level of PAK2 mRNA in cancer tissues.Results:Analysis of TCGA database data showed that PAK2 expression was increased in cancer tissues compared with that in para-cancer tissues ( P = 0.012); KEGG database signaling pathways showed that the high expression of PAK2 in laryngeal squamous cell carcinoma was related to signal transduction pathways, cell cycle, and cancer. Immunohistochemistry showed that the proportion of PAK2 positive in 34 cases of laryngeal squamous cell carcinoma tissues was higher than that in adjacent tissues and normal tissues [58.82% (20/34) vs. 0.03% (1/34), 0 (0/20), all P < 0.001]. There were statistically significant differences in the proportion of PAK2 positive patients stratified with different degrees of differentiation [high differentiation vs. low or middle differentiation: 33.33% (6/18)vs. 87.50% (14/16)], lymph node metastasis [presence vs. absence: 90.91% (10/11) vs. 43.48% (10/23)], TNM staging [stage Ⅲ-Ⅳ vs. stage Ⅰ-Ⅱ: 82.35% (14/17) vs. 35.29% (6/17)] (all P < 0.05), and PAK2 positive patients were not associated with clinical type, tumor size, smoking history, drinking history, and age (all P > 0.05). qRT-PCR showed that the relative expression level of PAK2 mRNA in the chemotherapy-resistant group was higher than that in the chemotherapy-sensitive group (3.89±0.12 vs. 0.78±0.23, P < 0.001). Conclusions:The expression level of PAK2 in laryngeal squamous cell carcinoma tissues is increased, and the high expression of PAK2 is closely related to the malignant clinical characteristics of patients with laryngeal squamous cell carcinoma. The high expression of PAK2 may indicate the insensitivity to traditional chemotherapy regimens, and PAK2 may be a potential gene that targets and regulates the chemosensitivity of laryngeal squamous cell carcinoma.

Objective: To investigate the effects of tumor-associated macrophages (TAM) on proliferation, migration, invation and apoptosis of gastric cancer MGC-803 cells and the possible mechanisms. Methods: Human monocyte THP-1 was cultured in vitro. After being added with PMA and IL-4, the levels of interleukin-12 (IL-12) and interleukin-10 (IL-10) in cell supernatant were detected by enzyme-linked immunosorbent assay (ELISA). MGC-803 cells at logarithmic phase and M2-type TAM cells were divided into single cell culture group, non-contact co-culture group and contact co-culture group according to different culture methods. MTT assay was used to detect the proliferation of MGC-803 cells, Transwell assay was used to detect cell migration and invasion, andAnnexin V-FITC/ PI staining flow cytometry was used to examine the apoptosis and cell cycle changes of MGC-803 cells; In addition, the mRNAand protein expressions of matrix metalloproteinase-9 (MMP-9) and MMP-2 were detected by Real-time fluorescence quantitative PCR (qPCR) and Western blotting. Results: Compared with PMA group, the level of IL-12 in cell supernatant of PMA+IL-4 group decreased significantly while the level of IL-10 increased significantly (all P<0.05), indicating THP-1 cells were successfully induced to differentiate into M2-type TAM. Compared with the single cell culture group, the non-contact co-culture group and the contact co-culture group exhibited: (1) significantly increased proliferation rate of MGC-803 cells (P<0.05)； (2) increased number of migrated and invaded cells (all P < 0.05)； (3) significantly decreased apoptotic rate (P<0.05)； (4) increased proportion of S, G2 phase cells and decreased proportion of G1 phase cells (all P<0.05)；and (5) significantly increased mRNA and protein expressions of MMP-9 and MMP-2 (all P<0.05). Conclusion: TAM can promote the proliferation, migration and invasion of gastric cancer MGC-803 cells, relieve G1 phase arrest and reduce cell apoptosis, which may be related to the up-regulation of MMP-9 and MMP-2 expression in gastric cancer cells.

Objective To observe the clinical efficacy of cynanchum corymbosum liquid for radiation skin injury in nasopharyngeal carcinoma patients. Methods A total of 62 patients with nasopharyngeal carcinoma treated with linear accelerator radiotherapy in the Radiotherapy Department of Lishui People's Hospital of Zhejiang Province from July 2014 to June 2015 were randomly divided into observation group (n=30) and control group (n=32) according to the order of admission. Other 60 patients with nasopharyngeal carcinoma treated with Synergy high energy X-ray radiotherapy from July 2015 to June 2016 were randomly divided into observation group (n=30) and control group (n=30). The patients in control group were given routine skin nursing guidance, the observation group were given cynanchum corymbosum liquid to prevent radiation dermatitis based on the control group methods. The occurrence time, cumulative amount and severity of radiation skin injury were observed in the two groups. Results The incidences of skin injury in the observation group of patients treated with linear accelerator radiotherapy were 18 cases, 20 cases and 3 cases respectively in the Ⅰ, Ⅱ, Ⅲdegrees, which were significantly lower than those in the control group (Z=-2.967, P< 0.01). The average cumulative radiation amount were (46.0±4.0), (66.0±2.0) and (68.0±2.0) Gy respectively, which were all greater than those of the control group (t=9.320, 15.445, 8.921; P< 0.01). The incidences of skin injury in the observation group of patients treated with Synergy high energy X-ray radiotherapy were 28 cases and 2 cases respectively in the Ⅰ, Ⅱdegrees, which were significantly lower than those in the control group (Z=-2.967, P< 0.01). The average cumulative radiation amount were (55.2±2.3) Gy and (64.4±2.3) Gy respectively,which were greater than those of the control group (t=17.614, 2.820; P<0.01). Conclusions The cynanchum corymbosum liquid can effectively prevent radiation skin injury in nasopharyngeal carcinoma patients and guarantee the the successful implementation of radiotherapy.

OBJECTIVE:To compare the preventive effects and safety of aspirin and clopodogrel respectively used for vascular restenosis after coronary intimal striping with coronary artery bypass grafting. METHODS:110 patients with coronary atherosclerot-ic heart disease were divided into aspirin group (55 cases) and clopodogrel group (55 cases). All patients intravenously mi-cro-pumped Nitroglycerin injection 10 mg+5% Glucose injection totally 20 mL for maintaining 48-72 h after coronary intimal strip-ing with coronary artery bypass grafting,intravenously pumped Dopamine hydrochloride injection 1-5 μg/kg if necessary. Unplug the endotracheal tube after surgery,patients received Cefuroxime sodium for injection 1.5 g adding into Sterile water for injection 50 mL,intravenous injection,3 times a day,for 2-3 d. Meanwhile,patients were orally given Rosuvastatin calcium tablet 10 mg 30 min after daily dinner,8-week was a course,for 3 courses. Based on it,aspirin group received Aspirin enteric-coated tablet with initial dose of 300 mg,once a day,orally taking 100 mg from the second day,once a day,for 6 months;clopodogrel group received Clopidogrel hydrogen sulfate tablet with initial dose of 300 mg,once a day,orally taking 75 mg from the second day, once a day,for 6 months. Graft patency rate,and platelet aggregation rate,platelet aggregation compliance rate,fibrinogen(Fg), D-dimer (D-D),platelet count (PLT),tissue-type plasminogen activator (t-PA) before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:There were no significant differences in the graft patency rate and inci-dence of adverse reactions in 2 groups (P>0.05). Before treatment,there were no significant differences in platelet aggregation rate,platelet aggregation compliance rate,Fg,D-D,PLT and t-PA in 2 groups (P>0.05). After treatment,platelet aggregation rate,Fg and D-D level in 2 groups were significantly lower than before,platelet aggregation compliance rate,PLT and t-PA level were significantly higher than before,with statistical significance(P<0.05),while there were no significant differences between 2 groups(P>0.05). CONCLUSIONS:Based on conventional treatment,both aspirin and clopidogrel used for coronary intimal strip-ing with coronary artery bypass grafting can inhibit platelet aggregation,reduce thrombosis,maintain vascular patency and prevent vascular restenosis,with good safety.

Objective Different types of colon cancer have a big difference in their clinical features and prognosis.The article aimed to provide theoretical basis for the diagnosis and treatment of colon cancer patients by analyzing the differences of clinical features and survival rates between hereditary non-polyposis colorectal cancer (HNPCC) and sporadic colon cancer.Methods Retrospective analysis was made on 22 HNPCC cases and 105 cases of sporadic colon cancer in our hospital from January 2007 to January 2012 to get the clinical features and prognosis by comparative analysis.Results Compared with sporadic group, the early onset(under 40 years) (36.37％ vs 9.52％), mucinous adenocarcinoma (59.09％ vs 17.14％), low differentiation (45.45％ vs 16.19％), TNM stage (III+IV) (54.55％ vs 26.66％), lymph node metastasis (81.82％ vs 57.14％), multiple primary carcinoma (36.36％ vs 7.62％) and parenteral tumor (22.73％ vs 5.71％) were higher in HNPCC group, but the 5 year survival rate was lower in HNPCC group, and there were significant differences between two groups(P<0.05);but there were no significant difference in gender, tumor size, location and operation (P>0.05) between two groups.Multiple primary tumors were independent risk factors for survival in HNPCC group (P<0.05), lymph node metastasis and TNM stage were independent risk factors for survival sporadic group (P<0.05).Conclusion Compared with sporadic colon cancer, HNPCC is characterized by early onset, low differentiation, high incidence of multiple primary tumors and poor prognosis, which is of great importance to find HNPCC patients or suspicious HNPCC patients.

Objective To explore the 18F-FDG PET/CT features of sacral insufficiency fracture.Methods 18 F-FDG PET/CT imaging and clinical data of 8 patients with sacral insufficiency fracture were retrospectively analyzed.Results All 8 patients had different degrees of radioactivity uptake in sacra with the maximum standardized uptake value (SUVmax)from 2.7 to 7.2.Four patients had lesions in their left sacra,2 in the bilateral sacral wings and sacral promontories,1 in the bilateral sacral wings,and 1 in the left sacral wing and sacral promontory.There were 8 patients of longitudinal fractures in sacral wings,which of 6 patients involving S1-2 and 2 patients involving S3.Three patients had transverse fractures in sacral promontories,with 2 located at S2 and 1 at S3.The sacral bone density increased in 5 cases,and the density was not changed in 3 cases.Conclusion Sacral insufficiency fracture had specific 18F-FDG PET/CT characteristics.

OBJECTIVE:To prepare Ferulic acid/K/β-CD/metal organic framework (FA/K/β-CD/MOF) inclusion,and to opti-mize its preparation technology. METHODS:K/β-CD/MOF was synthesized by solvothermal method as inclusion material. Using FA as main component,FA/K/β-CD/MOF was prepared by grinding method. The preparation technology was optimized by orthogo-nal test using mole ratio of main component-inclusion material,grinding time,dropping time and inclusion temperature as factors, inclusion rate as index. Prepared FA/K/β-CD/MOF was indentified by IR spectrum and DSC,and inclusion rate and dissolution rate were determined. RESULTS:Optimized preparation technology was as follows as mole ratio of main main component to inclusion material 3∶1,dropping time 60 min,inclusion temperature 40 ℃,inclusion time 60 min. Prepared FA/K/β-CD-MOF had already formed a new kind of phase,and its average inclusion rate was(18.0±1.6)%(RSD=0.9%,n=6);its solubility was 15 times as much as FA(9.582 mg/ml vs. 0.647 mg/ml). CONCLUSIONS:FA/K/β-CD/MOF is prepared successfully;and the preparation tech-nology is reasonable and feasible.

The diagnosis and treatment characteristics of head-wind sha in She medicine were analyzed and summarized. By visiting She-nationality villages and towns in Zhejiang province and Fujian province and interviewing hundreds of doctors of She medicine, the sha diagnosis, sha differentiation, experience and theory of treatment were arranged, and a comprehensive summary on theory and application of head-wind sha in She medicine such as pathogeny, name of disease, mechanism, diagnosis, differential diagnosis and treatment was made. It is believed that the methods of diagnosis and treatment in She medicine for head-wind sha could effectively enhance curative effect, safety and patients' quality of life, and the further research should be carried out.
Acupuncture Therapy ; China ; ethnology ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Headache Disorders ; diagnosis ; drug therapy ; ethnology ; therapy ; Humans