Objective This study was designed to evaluate the effect of laparoscopic-assisted subtotal colectomy(LASC)and modified Duhamel procedure in the treatment of severe functional constipation(SFC).Methods From June 2005 to October 2007,100 cases of SFC were treated by LASC combined with modified Duhamel procedure in our institute.After freed the colon under a laparoscope,we made a small incision in the lower abdomen to perform subtotal colectomy while preserved the ileocecal region.Then a side-to-side colorectal anastomosis was conducted.Results In this study,98 cases of LASC were successively completed and 2 cases were converted to open surgery.The operation time of LASC in the 98 cases ranged from 48 to 125 min mean,(76?23)min],and the total operation time was 140-225 min mean,(170?42)min].The intraoperative blood loss was 10-160 m1 mean,(35?18)m1].In the patients,the intestinal function was recovered within 25-52 hours mean,(42?12)h] after the operation;none of them developed postoperative wound infection,anastomotic stoma,or other complications.One week after the operation,2 of the 100 patients showed mild dehydration,and 2 were diagnosed as having incomplete small bowl obstruction.All of the four were cured by conservative treatments.The other 96 patients who had no complication were discharged from the hospital in 5-11 days mean,(7.0?1.5)days] postperation.One year later,the symptoms of constipation were significantly alleviated(defecation 1-3 times/d)in 90 patients;7 cases had various degrees of diarrhea(defecation 4-6 times/d);and 3 patients showed recurrence of mild constipation(defecation 1 time/2-3 d).The gastrointestinal quality of life index(GIQOL)determined in 1 year postperation was(109?20)points,which indicated good results compared to(94?23)points before the operation(maximum:144).Eighty-three cases were satisfied with their frequency of defecation.Conclusions LASC combined with modified Duhamel procedure is an effective method for the treatment of SFC,resulting in less damage,less influence to the internal environment,and quick recovery.The procedure is worth being wildly used.

Objective To investigate changes of serum proteins and related enzymes in patients with schizophrenia and its relationship to metabolic syndrome.Methods Five hundred and three inpatients with schizophrenia and 60 healthy volunteer were selected in this study.The demographic information and medical history data of them were recorded and levels of serum proteins and enzymes were measured,and the metabolic syndrome (MS) was diagnosed according to IDF criteria.Results Serum protein contents of schizophrenic patients (total protein (71.14 ±6.13) g/L,albumin (44.56 ±4.24)g/L,globulin(26.35 ±5.04) g/L,apoprotein A(10.97 ± 0.27) g/L,and apoprotein B (0.69 ± 0.25) g/L) were significantly lower than control group (79.96 ± 6.10) g/L,(49.44 ±5.63) g/L,(30.52 ±4.00) g/L,(10.97 ±0.27) g/L,and(0.69 ±0.25)g/L (P＜0.01).Urea nitrogen ((4.36± 1.36) mmol/L) was lower than control group ((5.22 ± 1.31) mmol/L) and C-reaction protein ((3.17 ± 6.58) mg/L) was higher than control group (1.35 ± 1.83) (P ＜ 0.01).Alanine aminotransferase ((24.28 ± 32.76) IU/L),a-L Fucosidase((17.49 ± 4.83) U/L),adenosine dehydrogenase((17.81 ± 5.67) U/L),and creatine kinase isoenzyme((10.50 ±4.92)IU/L) were higher than control group (18.12 ±9.77)IU/L,(15.98 ± 3.58)U/L,(11.75 ±5.48) U/L,and (9.12 ±3.62)IU/L,P＜0.01),but AST isoenzyme ((5.97 ±4.97) U/L)was lower than control group ((7.05 ± 6.72) U/L).Alanine Aminotransferase,alkaline phosphatase,γ-glutamyl transpeptidase,and a-L Fucosidase,AST isoenzyme and cystatin-c of schizophrenic patients with MS were significantly higher than non-MS patients(P ＜ 0.05).Conclusion There are significant metabolic disorders of proteins and enzymes in patients with schizophrenia,and abnormal changes of many enzymes are significantly associated with metabolic syndrome.

ObjectiveTo investigate prevalence of metabolic syndrome (MS) and related factors in patients with schizophrenia.MethodsFive hundred and three inpatients with schizophrenia and 60 healthy volunteers were included in this study.The demographic information and medical data of these participants were recorded,and their physiological and biochemical parameters were measured,the MS was diagnosed according to CDand IDF criteria.ResultsThe MS prevalence in patients with schizophrenia was 12.1％ according to CDS criteria and 28.4％ based on IDF standard,significantly higher than control group; the prevalence of MS was higher among female patients ( 15.3％ or 39.8％ ) than male patients ( 10.4％ or 22.4％ ) ; the prevalence of MS was higher among patients aged 40 or over ( 14.3％ or 30.9％ ) than patients aged 40 below (6.4％ or 22.1％ ).Dyslipidaemia (elevated TG and reduced HDL-C),obesity (BMI and waist) and increased blood glucose were the most important risk factors ( OR value ＞ 6.0),increased total cholesterol,high blood pressure,elevated LDL-C,increased uric acid,female,in marriage,and paranoid type were also important risk factors (OR value ＞ 2.0).Stepwise discriminate analysis showed triglyceride (0.569),BMI (0.451 ),HDL-C ( -0.298 ),gender (0.297 ),age (0.294)and LDL-C (0.210) 6 factors had a separate identification role in MS.ConclusionThe prevalence of MS in patients with schizophrenia in significantly higher than that in the general population,females are higher than males in the patients with patients,and older patients are higher than younger patients.Dyslipidemia,obesity and elevated blood glucose are the most important risk factors and predictors of the MS.

0. 05); lung field Az_1=0.6964, Az_2=0.7958, showing significant difference (?~2=4.9947, P

Objective:To investigate the effects of rituximab on lymphocytes and immunoglobulin in the treatment of focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD).Methods:The subjects were FSGS and MCD patients admitted to Ruijin Hospital affiliated to Shanghai Jiaotong University on July 1, 2014 and July 1, 2019. All the enrolled patients were confirmed by clinical examination and renal biopsy, and received rituximab treatment (4 infusions of 375 mg/m 2 with the interval of 7-14 d). The levels of immunoglobulin IgA, IgG, IgM, and lymphocytes of CD19 +, CD20 +, CD3 +, CD3 +CD4 +, CD3 +CD8 + and natural killer cells (CD56 +CD16 +) were compared between baseline and the third month, the sixth month, the ninth month and the twelfth month after treatment. Results:Ninety-six patients with FSGS or MCD were enrolled in this study. The midian age was 28 years old (14-77 years old). The ratio of men to woman was 1.8∶1. There were 65 cases of MCD and 31 cases of FSGS. After rituximab treatment, the 24 h-proteinuria was significantly lower than that before treatment, and the serum albumin level was increased (both P<0.05). After rituximab treatment of 3 months, 6 months, 9 months and 12 months, CD19 + and CD20 + lymphocyte counts were significantly decreased (all P<0.01), and gradually recovered after 6 months. Compared with baseline, at 3, 6, 9, 12 months after rituximab treatment, the level of blood IgG was significantly increased ( P=0.004,<0.001,<0.001,<0.001, respectively), and the level of blood IgM was significantly decreased ( P<0.001, =0.008, =0.005,<0.001, respectively) but the median level still within the normal range (400-3 450 mg/L). The level of blood IgA was not significantly changed (all P<0.05). T lymphocytes (CD3 +, CD3 +CD4 + and CD3 +CD8 +) and natural killer cells (CD56 +CD16 +) showed no significant difference from baseline (all P>0.05). Conclusions:Rituximab can effectively eliminate CD19 + and CD20 + lymphocytes, and has little influence on peripheral blood lymphocyte count and immunoglobulin level except CD19 + and CD20 + lymphocytes. The standard administration of rituximab is safe for patients with FSGS and MCD.

Objective: To explore the effect of chest physical therapy guided by ultrasound in patients with severe pneumonia. Methods: One hundred patients with mechanical ventilation in the ICU were divided into a control group and a test group according to the occupancy time. The control group was given chest physical therapy according to routine imaging data and pulmonary auscultation. The experimental group was given physical therapy of the chest according to the routine imaging and pulmonary auscultation, also according to the BLUE ultrasound protocol. The mechanical ventilation time, ICU hospitalization time and the drainage capacity of 1 day, 2 days, 4 days, and 7 days after treatment were observed. Results: The mechanical ventilation time was (7.82±1.38) days and ICU hospitalization time were (10.16±1.88) days in the test group. The mechanical ventilation time was (10.14±1.73) days and ICU hospitalization time were (12.78±2.11) days in the control group. There were significant differences between the two groups (t=7.42, 6.56, P<0.05). There was a significant difference in the ability of spontaneous drainage on the 4th and 7th day after treatment between the two groups (Z=-2.47, -2.52, P<0.05). The sputum ability on the first and second day after treatment were not statistically significant between the two groups (P>0.05). Conclusions Pulmonary ultrasound can continuously monitor lung changes. Nurses can perform targeted nursing treatment on the basis of ultrasound.

Objective To explore the immune mechanism of negative results of immune tests of schistosomiasis japonica pa?tients. Methods Totally 142 schistosomiasis patients(positive stool examinations)of Poyang Lake region were tested by ELI?SA method,and the ROC curve was applied to determine the high and low response of the patients. The levels of cellular immu?nity and cytokines of high and low responders were compared. Results Totally eight schistosomiasis patients were found as low responders. Besides SWAP?IgA(t= -1.588,P > 0.1),the levels of isotype antibodies were significantly lower in the low re?sponders compared with those in the high responders(t = -14.517 to -2.866,all P < 0.05). In the low responders,the propor?tion of CD3+T was increased;and the proportions of CD4+T,CD8+T,CD4+CD25+Treg,and the ratio of CD4+/CD8+ were all de?creased,but all of them were not significant(t = -1.72 to 0.974,all P > 0.05)compared with those in the high responders. The differences of IFN?γ and IL?10 between the high and low responders were both not significant(t= -2.426 to 0.216,all P >0.05). Conclusions There is a significant difference between the high and low responders only in the levels of isotype antibod?ies. One of the reasons of low response in the immune tests is the much lower antibody level after the antigen?antibody compound is completely formulated.

Objective:Rapid assessment of the outcome after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) is an important clinical issue. In this study, an electrocardiogram (ECG) analysis method based on dynamic learning was proposed.Methods:A total of 203 patients with ACS after successful PCI were enrolled for prospective analysis at the Emergency Department of Qilu Hospital of Shandong University from April 2019 to December 2020. All patients were divided into group without ≥70% postoperative stenosis ( n=72) and group with ≥ 70% postoperative stenosis ( n=131) according to the presence of 70% or more stenosis after PCI. The clinical data of ACS patients were collected and analyzed by χ2 test, t-test, or Mann-Whitney test. ECGs were recorded before and 2 h after PCI, and were dynamically analyzed to generate cardiodynamicsgram (CDG) using dynamic learning. In the group without ≥ 70% postoperative stenosis, the model and CDG index for evaluating myocardial ischemia were obtained by training support vector machine (SVM) using 10 times 10-fold cross-validation. Results:There was no significant difference in clinical data between the two groups. The prediction accuracy and sensitivity of the support vector machine model for myocardial ischemia in group without≥70% postoperative stenosis were 73.61%, and 84.72% respectively. CDG transformed from disorderly to regular after PCI, and CDG index decreased significantly ( P<0.001): 90.28% (65) patients in group without≥70% postoperative stenosis, and 79.39% (104) patients in group with≥70% postoperative stenosis had lower CDG indexes than before PCI. Conclusions:In this study, CDG obtained by dynamic learning can intuitively and effectively evaluate the changes of myocardial ischemia before and after PCI, which is helpful to assist clinicians to formulate the next treatment plan.

Objective To explore the effects of C/EBPα knockout in podocyte on diabetic nephropathy and its mechanisms.Methods C/EBPαloxp/loxp mice were crossed with podocin-cre mice to obtain F1 hybrids and then propagated until homozygous mice (C/EBPαf/f) were obtained.Diabetic nephropathy (DN) models were established by low-dose streptozotocin (STZ,100 mg/kg) administration after 25 weeks of normal diet or 45％ high-fat diet treatment,and biochemical indicators of blood and urea were measured.The morphological characteristics and the proteins regulating oxidative stress and mitochondrial function were detected.Results The type 2 DN models were successfully constructed based on transgenic mice.The kidneys of 8-month-old C/EBPαf/f mice did not show obvious morphological changes,but after constructing DN models,they showed obvious renal impairment,inflammation and oxidative stress.Compared with wild-type DN mice,the protein levels of nephrin and E-cadherin in DN C/EBPαf/f mice with DN were significantly decreased (P ＜ 0.01);fibronectin and Nrf2 protein levels were all increased (all P ＜ 0.05).Keap1,phospho-AMPK and mitochondrial function related genes Pgc-1α protein levels were all decreased (all P ＜ 0.05).Conclusion Podocyte C/EBPα knockout exacerbates diabetic nephropathy by promoting fibrosis and inhibiting Pgc-1α-mediated mitochondrial antioxidant function.

Objective To understand the distribution of allergens in children with common allergic diseases in Guangzhou, and to provide evidence for the prevention and treatment of environmental allergens in children with different allergic diseases. Methods This study enrolled a total of 6 869 children with allergic diseases, including wheezing diseases and asthma (1 013 cases), allergic rhinitis (660 cases), allergic conjunctivitis (422 cases), eczema (2 762 cases), atopic dermatitis (831 cases) and urticaria (1 181 cases). Western blotting was used to detect the serum allergen type E specific antibodies (sIgE) of the patients. The results were statistically analyzed. Results The total positive rate of sIgE in 6 869 children was 74.01%. The positive rate of male children (75.02%) was higher than that of female children (72.25%). The positive rate of inhalation allergens (53.47%) was higher than that of food allergens (57.39%). House dust mites and milk were the most common inhalation allergens and food allergens, respectively. Eczema was the most common allergic disease in infants and toddlers. Allergic rhinitis and urticaria were common in school-age children. Conclusion The main allergens causing allergic diseases in children in Guangzhou were dust mites and milk. Different allergic diseases had its specific allergens. It is necessary to take targeted prevention measures accordingly.