Objective To explore the influence of hospital- based transitional care on the rehabilita-tion of patients with enterostomy, and provide evidence- based reference for specialist care of the enterostomy patients. Methods The randomized controlled trials on the hospital- based transitional care in enterostomy patients were collected by computer using China National Knowledge Infrastructure Database, Chinese Science Technology Periodical Database, Wanfang Periodical Database, Foreign Medical Information Resources Database and PubMed from the building of the database till December 2014, and analyzed by RevMan 5.2 software. Results Sixteen articles were included in the study, involving 1 263 patients with enterostomy. The results of Meta- analysis revealed that the incidence of complications in transitional care patients was lower than that in conventional discharge guidance patients, odds ratio(95% confidence interval) was 0.31 (0.21-0.45), the difference was significant (Z=6.02, P<0.01), and the quality of life was raised (including the physical function, cognitive function, role function, emotional functions, social function and the total quality of life), weighted mean differences (95% confidence interval) were 13.81 (8.23-19.39), 22.00 (17.21-26.79), 15.22(11.71-18.73), 16.68(13.01-20.35), 22.60(16.58-28.62), 17.46(13.53-21.38),the differences were significant(P<0.01). Conclusions The transitional care model giving priority to hospital service resources can provide a higher level professional care for patients after enterostomy, and avoid or reduce the complications, promote the recovery earlier as well as constantly improve the quality of life.

Objective To determine the correlation between aquaporin-4 antibody (AQP4-Ab) and optic neuropathy in patients with neuromyelitis optica spectrum disorder (NMOSD).Methods The clinical and biochemical data of 53 patients with NMOSD diagnosis based on AQP4-Ab level in Changhai Hospital between January 2010 and October 2015 were retrospectively analyzed.According to optic neuropathy occurrence,the NMOSD patients were divided into optic neuropathy and non-optic neuropathy groups.Clinical and biochemical characteristics were compared between the two groups.According to the serum AQP4-Ab levels,the NMOSD patients were divided into AQP4-Ab seropositive and seronegative groups.The incidence of optic neuropathy was compared between the two groups.The correlation between optic neuropathy and AQP4-Ab levels was analyzed.Results Between the optic neuropathy and non-optic neuropathy groups,no significant differences in sex,age at onset,disease course,serum alanine aminotransferase levels,protein levels in cerebral spinal fluid,IgG index,and oligoclonal band were observed (P ＞ 0.05).However,statistically significant differences were found in frequency,superficial sensory impairment,serum creatinine level,and serum AQP4-Ab level (P ＜ 0.05).Between the AQP4-Ab sempositive and semnegative groups,a statistically significant difference in the incidence of optic neuropathy was observed (F =4.93,P ＜ 0.05).The incidence of optic neuropathy positively correlated with AQP4-Ab levels (r =0.297,P ＜ 0.05).Conclusion NMOSD patients with AQP4-Ab seropositivity could be prone to optic neuropathy,and the correlation may be beneficial to early diagnosis,therapy,and monitoring of NMOSD.

Objective To study the changes of the symptoms and quality of life (QOL) in patients after the Transvaginal tape-obturator (TVT-O) treatment and weather would this treatment lead to bladder outlet obstruction (BOO) and bladder function change. Methods A total of 82 stress urinary incontinence (SUI) women who had underwent TVT-O were included, age from 39-82 years, 3-60 months after operation. All patients were divided into 5 groups by the time post-operation. The ICI-Q-SF scores were collected to study the change of the symptoms and QOL of each group perioperation. Qmax, PVR, bladder weight, wall thickness of each group were collected to study whether would TVT-O lead to BOO and bladder function change. Results Forty-five (55%) patients were cured and 33(40 %) improved after TVT-O. Total cure rate was 95 %. There was a significant improvement of average symptom and QOL in all of the 5 groups (3-month, 6-month, 1-year, 2-year, above-2-year) (P＜0. 05). Qmax changed from (32. 17±10.74), (25.64±6.05), (25.68±11.36), (25.70±10. 28), (25.29±15. 10)ml/s pre-operation to (28.30±15.21), (25.64±10. 48), (24. 49±7.96),(25.43±11.92), (25. 92± 10. 17)ml/s post-operation in 5 groups(P＞0. 05). PVR changed from (0.04±0.20), (0. 00±0.00), (0. 17±0. 39), (2.70±6.01), (1. 96±5.10)ml pre-operation to (1. 79±6.16), (0.00±0.00), (12. 50±29.89), (5.00±15. 54), (33. 70±92.10)ml post-operation in 5 groups(P＞0.05). The bladder weight changed from (43. 62±7.81), (41. 57±8. 63), (46.11±8.12), (42. 50±3. 85), (44. 52±4. 38)g pre-operation to (45. 62±5.32), (47.21±5. 47),(44.89±4. 65), (45. 14±4. 13), (46. 70±5.84)g post-operation, which differed significantly in 6-month, 2-year, above-2-year groups (P＜0. 05). The bladder wall thickness changed from (2.23±0.51), (2.22±0.47), (2.04±0.38), (2. 19±0. 43), (2. 19±0. 38)mm pre-operation to (2.25±0. 40), (2. 18±0.47), (2. 07±0.47), (2.22±0. 47), (2. 20±0. 44)mm post-operation(P＞0. 05).Conclusions TVT-O has a high cure rate for SUI and there was a significant improvement of average symptom and QOL of all patients after the treatment. But TVT-O may lead to BOO and bladder function change since bladder weight increases significantly in some patients.

Objective To study the influence of overactive bladder (OAB) on the symptoms and quality of life (QoL) in patients after Transvaginal Tape-Obturator (TVT-O) treatment for stress urinary incontinence (SUI).Methods Eighty-two SUI women underwent TVT-O were included in this study.The perioperative ICI-Q-SF scores,including frequency of leakage,volume of leakage,and QOL scores,were collected to study the perioperative OAB prevalence and the influence of OAB on the improvement on the symptoms and QOL after TVT-O.Results The total efficacy of TVT-O was 95%.The average symptom and QOL scores in all patients decrease from (8.17±2.29)and (7.95±2.16)to (1.84±2.34)and(1.32±2.24)after TVT-O,P＜0.05.The prevalence of OAB decreased from 46% to 24% after TVT-O,P＜0.05.The average post-operation symptom and QOL scores of the pre-operation non-OAB group were (1.09±1.60)and(0.82±1.45),while those of the OAB group were (2.71±2.75) and (1.89±2.82),P＜0.05.The average post-operation symptom and QOL scores of the post-operation non-OAB group were (1.06±1.68) and (0.56±1.15),while those of the OAB group were (4.25±2.49) and (3.65±3.10),P＜0.05.Conclusions TVT-O is effective for female stress urinary incontinence and contributes to the significant improvement of symptoms and QOL in patients with OAB.The treatment will not raise the prevalence of OAB in itself.

Objectives To explore the correlation between the cerebrospinal fluid protein and facial paralysis in pa?tients with Guillain-Barre syndrome (GBS). Methods Clinical and biochemical data of 111 patients with GBS in depart?ment of neurology from January 2005 to September 2015 were retrospectively analyzed. According to facial paralysis, GBS patients were divided into the facial normal and paralysis groups. Their clinical and biochemical characteristics were compared between the two groups. According to level of cerebrospinal fluid protein, GBS patients were divided into cerebrospinal fluid protein normal, mild high and severe high groups. Incidences of facial paralysis were compared among these three groups. The correlation between the cerebrospinal fluid protein and facial paralysis was analyzed. Results There was no significant difference in gender, age, respiratory infection and other clinical symptoms (P>0.05), whereas there were statistically significant differences in cerebrospinal fluid protein, immunoglobulin G, and cerebrospinal fluid albumin/serum albumin ratio between the facial normal and paralysis groups (P<0.05). Among the three groups by differ?ent levels of cerebrospinal fluid protein, there were statistically significant differences in the incidence of facial paralysis (F=3.48,P=0.03). Cerebrospinal fluid protein was positively correlated with facial paralysis (r=0.288,P<0.01). Conclu? sions The incidence of facial paralysis is associated with the levels of cerebrospinal fluid protein. Thus, cerebrospinal flu?id protein may be helpful in monitoring of GBS patients with facial paralysis.

Background Studies showed that activation of microglia-derived nicotinamide adenine dinucleotide phosphate (NADPH) oxidase plays a key role in the neurodegenerative diseases and neural cell death in central nervous system.The effect of NADPH on cone degeneration have been determined in rd rats,its role in rod degeneration is relatively less studied.Objective This study was to study the expression of NADPH oxidase in the retinal degenerative process in rd mice and further explore its role in the photoreceptor degeneration.Methods rd Mice at postnatal day 8 (P8),P10,P12,P14,P16 and P18 were collected.The mice were sacrificed,and retinal sections,RNAs and proteins were prepared in above-mentioned time points.The expressions of the gp91 phox,a major subunit of NADPH oxidase,in transcript level and protein level in the retinas were semi-quantitatively detected by real-time PCR and Western blot respectively.Expression of gp91phox was localized in the rd retinas as ageing by immunohistochemstry,and the co-expression of gp91phox with CD11b,a specific marker of microglial cells,was assayed by immunofluorescent double labeling.The C57BL/6N mice were served as controls.The use and care of the animals complied with the Guideline of ARVO.Results Real-time PCR showed that gp91phox mRNA was not expressed in the retinas of C57BL/6N mice.Gp91phox mRNA was found to have less expressed in retinas of P8 rd mice.With aging,the expression level of gp91phox mRNA (gp91phox mRNA/β-actin) in rd mouse retinas was gradually increased with the highest level in P14 mice(1.136±0.370).A significant difference was seen in the gp91 phox mRNA expression among various groups of mice (F=17.81,P =0.00),and gp91phox mRNA expression was significantly elevated in P10,P12,P14,P16 and P18 rd mice compared with P8 rd mice(all at P＜0.05).The expression level of gp91phox protein (A value) in the retinas presented with a similar trend in the rd mice,with a significant difference among the various ages of rd mice and C57BL/6N mice (F =354.00,P＜0.01).The expression level of gp91 phox protein was increased in the rd mice in comparison with the C57BL/6N mice (all at P＜0.05).Immunochemistry revealed that the positive response cells for gp91phox increased in the inner layers of retinas in P10 rd mice and peaked in P14 mice.Immunofluorescent double labeling exhibited that gp91phox were seen to present a co-expression with CD11b,showing an orange fluorescence.Conclusions Expression of NADPH oxidase in the rctinas in the rd mice up-regulates and is parallels to the microglial activation and photoreceptor degeneration,suggesting that NADPH oxidase plays a role in the retinal dystrophy associated with microglial activation.

Objective:To determine the value of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) scans in identify-ing the residual retroperitoneal tumor after chemotherapy of testis germ cell tumors. Methods:Sixteen testis germ cell tumor patients with metastasis of retroperitoneal lymph nodes who were treated in our hospital from February 2014 to December 2016 were select-ed for the study from February 2014 to December 2016. After 4-6 cycles of chemotherapy, their CT scans showed residual masses with diameters greater than 2 cm. The retroperitoneal lymph nodes were dissected after the 18F-FDG PET exam. The post-surgery pathology results were compared with the results of the 18F-FDG PET exam. Results:Residual tumors were found in 5 of 10 patients with 18F-FDG PET positive. Residual tumor was absent in 4 of 6 patients with 18F-FDG PET negative, while residual mature teratoma tumors were found in two patients. The accuracy rate, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the 18F-FDG PET exam were 56.25%(9/16), 71.42%(5/7), 44.44%(4/9), 50.00%(5/10), and 66.67%(4/6), respectively. Conclusion: 18F-FDG PET is highly sensitive. However, many factors influence the result of 18F-FDG PET. Mature teratoma leads to a false negative re-sult, whereas massive tissue inflammation leads to a false positive result. Therefore, more clinical examinations should be made.

Objective To explore the relationship between the clinical features,serological markers and European League Against Rheumatism SS Disease Activity Index (ESSDAI) scores of primary Sj(o)gren's syndrome (SS).Methods We enrolled 106 patients,who fulfilled the 2002 classification criteria for primary SS from December 2008 to January 2015,to evaluate the relationship among the clinical characteristics,laboratory features,serological variables and ESSDAI scores.According to serological variables,the prognosis was subdivided into three distinct groups:favourable (no serological markers),intermediate (one serological marker) and poor (two or more serological markers).These data were analyzed by Chi-square test and variance analysis.Results The mean ESSDAI score of 106 pSS patients was (11±7).ESSDAI score was categorized according to the EULAR-SS recommendations as low activity,moderate activity and high activity (scores of 0-4,5-13 and ≥14,respectively),and the positive rate of antinuclear antibody (ANA) 1:100 (6 cases,37.5％;37 cases,66.1％;32 cases,94.1％) in three different ESSDAI levels was statistically different (x2＝18.110,P＜0.01).Those with positive ANA 1:100[positive (13±7) and negative (7±4)],anti-SSA antibody postive (12±7) and negative (9±7),anti-RNP antibody (positive 16±9 and negative 10±6) had higher ESSDAI scores than those with negative ones (F=8.812,P=0.0001;F=3.862,P=0.024;F=5.786,P=0.004).No statistical difference in ESSDAI means were found between patients with positive anti-SSB antibody,rheumatoid factor (RF),FS level,dry mouth,Raynoud's phenomenon and psychosomatic diseases.The ESSDAI scores of favourable group,intermediate group and poor group were significantly different (8±5,10±7,14±7,F=8.715,P=0.000 1).In comparison with the other two groups,the poor pSS patients had a higher frequency of positive ANA 1:100 (15 cases,55.6％;20 cases,57.1％;40 cases,90.9％),anti-SSA antibody(11 cases,0.7％;23 cases,41.1％;36 cases,81.8％),anti-SSB antibody (6 cases,2 2.2％;13 cases,37.1％;23 cases,52.3％),anti-RNP antibody (0 case,0;2 cases,5.7％;9 cases,20.5％) (x2=17.408,P=0.002;x2=14.306,P=0.006;x2=12.330,P=0.015;x2=1 1.482,P=0.022).Conclusion Patients with two or more serological markers may have higher ESSDAI score,and which in turn may associate with poor prognosis.

Objective To investigate the relationship between single nucleotide polymorphism (SNP) of Fas ligand (FasL) and fulminant hepatitis B in Han Chinese. Methods HBV infected subjects were enrolled in this case-control study, including 233 cases of inactive HBsAg carrier, 68 patients with fulminant hepatitis B,100 cases of spontaneous hepatitis B clearance, 102 patients with hepatitis B virus (HBV) related cirrhosis and 112 patients with HBV related primary hepatocellular carcinoma. The blood samples and clinical data were collected. FasL-844T/C polymorphisms of enrolled subjects were examined by TaqMan real time fluorescent genotyping polymerase chain reaction (RT-PCR). A adjusted odds ratios (OR)and 95% confidence intervals (CI)were calculated using the Logistic regression model. Results After adjusting the factors of gender and age, binary Logistic regression analyses indicated that the genotype frequencies of FasL-844 CC,CT,TT in inactive HBsAg carriers were 50. 64% ,39. 91% and 9. 44% respectively, and those in cases of fulminant hepatitis B were 79. 41%, 17. 65% and 2. 94%, respectively. The analysis also revealed that FasL-844CC genotype in inactive HBsAg carriers was high risk factor of developing fulminant hepatitis B (OR =4. 729,95%CI:0. 510 - 21. 282,P = 0. 043), while there were no statistic significances in other cases (P>0. 05). Conclusion The inactive HBsAg carriers harboring FasL-844CC may have greater susceptibility to fulminant hepatitis B, which need arouse high attention.

OBJECTIVETo study the effect of NOD2 on colitis pathogenesis in experimental rats, and discuss therapeutical effect and mechanism of kushenin injection (OMT) on colitis in experimental rats.

METHODFourty Sprague-Dawley (SD) rats were randomly divided into four groups: the normal control group, the model group, the SASP group, and the OMT group, with 10 rats in each group. Except the normal control group, models were established in the remaining three groups with TNBS. The OMT group was injected with kushenin injection, the SASP group was orally administered with mesalazine suspension, the model group and the normal group were orally administered with distilled water for 15 days. Colon lesion score and histological score of experimental rats were observed. Expression of NOD2, NF-kappaB p65 protein in rats colonic mucous was detected by immunohistochemistry. Expression of IL-6 in rat colon mucous was detected by ELISA.

RESULTCompared with normal control group, the expression of NOD2, NF-kappaB p65 and IL-6 in colonic mucosa of the model group were significantly increased (P < 0.01). The SASP group and the OMT group showed lower expressions of NOD2, NF-kappaB p65 and IL-6 in colonic mucosa than the model group (P < 0.01, P < 0.05).

CONCLUSIONThe over expression of colonic mucosa proteins NOD2 and NF-kappaB p65 and increasing secretion of IL-6 take part in the appearance and development of ulcerative colitis. OMT can attenuate ulcerative colitis and protect colonic mucosa by inhibiting expression of NOD2, NF-kappaB p65 and decreasing IL-6.

Animals ; Colitis ; metabolism ; pathology ; physiopathology ; prevention & control ; Colon ; drug effects ; metabolism ; pathology ; physiopathology ; Eating ; drug effects ; Gene Expression Regulation ; drug effects ; Injections ; Intestinal Mucosa ; drug effects ; metabolism ; pathology ; physiopathology ; Male ; Nod2 Signaling Adaptor Protein ; metabolism ; Organ Size ; drug effects ; Pterocarpans ; administration & dosage ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Transcription Factor RelA ; metabolism