Objective To evaluate the clinical effect of restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for refractory ulcerative colitis (UC).Methods In this study 60 refractory UC patients received IPAA operation during the period of 1990 to 2010.Data were collected regarding early and late postoperation complications,anal continence function,and characteristics of feces.The patients' quality of life was objectively accessed using the Clevend Global Quality of Life (CGQL)index.0ne-way analysis of variance was used.Results Mean follow-up period was 2 years.Early postoperative complication rate developed in 15％ (9/60),including abdominal or pelvic infection,anastomotic leak,pouch bleeding,pouch-vaginal fistula,and intestinal obstruction.Late postoperative complication rate was 12％ (7/60),including pouchitis,intestinal obstruction,and male sexual dysfunction.Stool frequency per 24 hours and that at night was 3.5 ± 1.3 and 1.4 ±0.6.93％ (56/60)patients differentiated gas and feces well and 3％ (2/60) needed daily pads.According to Kirwan Grading Scale,anal function outcomes were Grade Ⅰ:54 (90％),Grade Ⅱ:4 (7％),and Grade Ⅲ:2 (3％).According to Bristol Stool Form Scale,characteristics of feces were Grade Ⅳ:31 (52％),Grade Ⅴ:25(42％),and Grade Ⅵ:4 (6％).Postoperative CGQL result showed a much better quality of life than preoperative CGQL (F =12.368,P ＜ 0.05).Conclusions Refractory UC is surgically indicated and IPAA is the operation of choice with safety,satisfactory long-term outcome and improved quality of life.

To make a systematic analysis on literatures concerning traditional Chinese medicine (TCM) advices in Treatise on Febrile Diseases, and summarize the main connotations of traditional Chinese medicine advices, relevant TCM advices in Treatise on Febrile Diseases were collected, screened, compared, summarized and analyzed according to TCM dosage form preparation methods, TCM administration methods, medication contraindications and nursing after TCM administration. The literatures concerning medications in Treatise on Febrile Diseases were consulted, summarized and compared to standardize medicine advices and facilitate rational clinical application of TCMs. The standard medicine advices were as follows. The boiling water for TCMs shall be tap water and well water. The decoctions that have effects in promoting blood and meridians can be boiled with wine. The decoctions containing toxic components can be boiled with honey. Some TCMs shall be boiled with special methods, e. g. Herba Ephedra that could be boiled before other medicine and skimmed. Japonica rice could be added in decoctions to measure the duration of decoctions. Different dosages were required for different forms (litre, pill, medicine spoon). Administration times, temperature and frequency shall be adjusted according to target positions, functions and stage of illness. As for dietary contraindications during medication, thick porridges are recommended, where foods impacting medicine efficacy are prohibited. Regarding nursing after medication is important to recover physical functions, particularly warm porridges can go with diaphoretic recipes, while thick porridges can go with purgative recipes. And drug efficacies shall be defined by observing urine and excrements, and blood form. In conclusion, Treatise on Febrile Diseases is the first book that discusses TCM advices and records them in details. In this study, new standard medicine advices were proposed to provide important basis for improving clinical advices of TCMs and supports for developing the TCM dispensing technology.
Chin ; Cooking ; Drug Administration Routes ; Drug Administration Schedule ; Drug Interactions ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; history ; Fever ; drug therapy ; history ; History, Ancient ; Humans ; Medicine in Literature

OBJECTIVETo discuss the operative techniques of endoscopic endonasal transsphenoidal surgery and perioperative management for treatment of acute pituitar y apoplexy (PA).METHODS A retrospective analysis was conducted on the clinical data of 51 pathologically diagnosed acute PA after transsphenoidal endoscopic endonasal resection at the TianJin HuanHu hospital between January 2000 and December 2013. There were 28 males and 23 females,with median age of 47 and disease course of 4h-7d.The typical clinical manifestations included headache, visual interference and pituitary dysfunction. CT scan, MRI scan and endocrinological examinations were performed in all cases before operation. Glucocorticoids were used during perioperatve period, The postoperation symptoms and the results follow-up visit after operation were recorded. RESULTS The tumors were totally removed in 42 cases and sub-totally removed in 9 cases without operative death and serious complications. The follow-up period was 1 year to 14 years. Of 47 patients with headaches before the operation, all patients were resolved after the operation; In 38 patients with sight disturbance before the operation,the sight was recovered very well in 34 patients after the operation. The visual field was recovered very well in all patients. Of 28 patients with endocrine disturbance before the operation, 22 were improved in endocrine symptom after the operation. No patient recurred.CONCLUSION The endoscopic endonasal transsphenoidal operation is safe and effective for treatment of acute PA.Appropriate perioperative management is important for the success of operation.

Adult ; Endoscopy ; Epistaxis ; etiology ; surgery ; Female ; Humans ; Middle Aged ; Nasal Cavity ; surgery ; Telangiectasia, Hereditary Hemorrhagic ; complications ; surgery

Objective To investigate the effects of inhibiting ubiquitin proteasome pathway(UPP) on proliferation of gastric carcinoma cells and the possible mechanism was discussed. Methods The gastric carcinoma cell strain SGC 7901 was treated with MG 132 to inhibit its UPP specially. The effect of growth suppression on cells was evaluated with MTT assay. Cell cycle and apoptosis were detected by flow cytometry(FCM). DNA fragment analysis was used for confirming the presence of apoptosis. The activity of telomerase was examined by TRAP PCR ELISA. Expression of p27kip1 was detected by immunocytochemical technique. Results MG 132 had great inhibitory effect on the growth of SGC 7901 cells. The FCM analysis showed that the ratio of G0/G1 phase of control group was (46.3?4.1)%, the ratio of G0/G1 phase of SGC 7901 cells treated with MG 132 increased to (72.1?5.0)% ( P

Objective To investigate the effects of alcohol extract of Kunmu decoction on proliferation and apoptosis of rheumatoid arthritis fibroblast-like synoviocytes (RA-FLS). Methods Synovial tissues were obtained from patients with active RA received joint replacement or arthroscopy. The surface antigen and the amount of apoptotic cells were determined by flow cytometry. The inhibitive effect was detected by MTT assay. Results The CD90+surface antigen of synoviocytes was (94.78 ± 0.98)%. The inhibitive effect on the proliferation in all treatment groups were in a time-and dose-dependent manner. The apoptosis rate was increased in a dose-dependent manner among all dosage alcohol extract groups. Conclusion Kunmu decoction might inhibit proliferation and induce apoptosis of RA-FLS.

Objective To investigate the effect of gradient heat stress on phagocytosis of hepatic Kupffer cells (KCs) in vitro in rats. Methods Rat Kupffer cells were isolated in vitro and the temperature for gradient heat stress was set at 37, 39, 41 and 43℃. After thermal stimulation, cell injury was detected by PI and Hochest33342 staining. CCK-8 assay was used to investigate difference in cellular proliferation rate over 24h between the groups. Flow cytometry was used to investigate the influence of heat stress on the phagocytosis of KCs. Results Compared to the normal control group, cells in each heat stress group exhibited varying degrees of damage, especially cells in 43℃ group. The ratio of damage cells increased with the increase of heat stress severity (P<0.05). Proliferation assay indicated that the proliferation rate of cells in each heat stress group was significantly decreased in comparison with normal control group 6h after heat stress (P<0.05). After 12h recovery, decrease in proliferation rate was observed only in 43℃ group (P<0.001), and no difference in the rate of proliferation could be observed between the heat stress groups and normal control group after 24h recovery. Flow cytometry showed, that the phagocytosis of KCs decreased in heat stress groups compared with control group, especially in 43℃ group (P<0.05). This phenomenon disappeared after 24h recovery. Conclusion Heat stress can inhibit the phagocytosis of rat liver KCs through its cytotoxic effect on KCs, and subsequently inhibits its proliferative ability. Further investigation of the effect of heat stress on KCs may help understand the pathogenesis of heat stress.

Objective To summarize clinical application, method and result of extra-corporeal membrane oxygenation ( ECMO) used during beating heart coronary artery bypass grafting ( CABG) in high risk patients. Methods Twenty one patients [ mean age ( 75. 7 ± 3. 6 ) years old ] who received beating-heart CABG surgery assisted with ECMO were included in the study. We observed the condition when ECMO weaned off, the duration on mechanical rentilato time of ICU stay and the occurance of related complications. Results Among the 21 patients, ECMO was weaned off uneventfully after surgery in 8 patients. Immediate weaning was failed in another 8 patients and required gradual weaning in 2. 0-4. 5 hrs. Five patients could not wean off the ECMO in operation room needing continuous ECMO support in CCU. ECMO was weaned off in CCU gradually with IABP support [mean IABP support time: (115. 0 ± 25. 9) hrs]. Among the 5 patients admitted into CCU, 1 patient had oozing from insertion site at femoral artery/rein region and was stopped with compressive bandage. Lower limb ischemia happened in another 1 patient and was recovered after set up of by-pass circulation. All 21 patients recovered well and smoothly. Mean in-hospital stay was (17. 4 ± 2. 8) d. Conclusions ECMO is a safe and effective circulatory support during beating heart coronary artery bypass surgery for high-risk patients with severe coronary artery disease in reducing the mortality and complications.

Objective To investigate IL-17 as adjuvant effect on the humoral and cellular immune responses to HIV DNA vaccine by immunizing mice with HIV DNA vaccine plus IL-17. Methods We immunized the BALB/c mice with pGX-Env alone, or with pcDNA3-IL-17 by intramuscular injection. The immunization was performed on week 0, 2. The concentration of the anti-Env IgG, the stimulated index of T lymphocyte proliferation, and the expression of IFN-γ, IL-4 and IL-17 in CD4~+T cell and IFN-γ in CD8~+ T cell, specific in vivo cytotoxic T lymphocyte (CTL) activity were detected at week 4. Results We show here that IL-17 as a molecular adjuvant with the HIV DNA vaccine, pGX-Env, can enhance immune responses. Interestingly, IL-17 has no adjuvant effect on the responses for T cell proliferation, antibody production and expressions of IFN-γ, IL-4 and IL-17 in CD4~+ T cells, but rather on the up-regulation of IFN-γ in CD8~+ T cells and CTL in vivo significantly(P<0.05). Conclusion The data suggest that IL-17 as the molecular adjuvant may not effect the development and differentiation of CD4~+ Th cells, but directly affect on the CD8~+ T cell functions. The novel functionality of IL-17 on adaptive immunity may lead to develop effecfive HIV DNA vaccination targeted to potentiate the CD8~+ T cell functions.

Objective To investigate the characteristics of mental rotation in stroke patients and the relationship between mental rotation and visual-spatial cognitive function. Methods From March, 2012 to October, 2013, 30 stroke patients were selected as experimental group and 30 healthy subjects as control group. They were tested with hand mental rotation task, and assessed with visuospatial abilities from Mon-treal Cognitive Assessment (MoCA). Results The reaction time of hand mental rotation task was significantly longer in the experimental group than in the control group (F=95.6, P<0.001). The reaction time was longer with the increase of rotation angle in both groups, and was the longest as 180° of rotation (F=345.672, P<0.001). The response accuracy rate of hand mental rotation task was significantly lower in the experimental group than in the control group (F=6.444, P<0.05). The response accuracy rate was lower with the increase of rotation angle in both groups, and was the least as 180° of rotation (F=102.911, P<0.001). The reaction time negatively correlated with the score of visuospa-tial abilities, while the response accuracy rate positively correlated with it in the stroke patients (P<0.05). Conclusion The mental rotation ability is impaired in stroke patients, however, the respondent pattern is similar to healthy people. The mental rotation ability is correlated with visual-spatial cognitive functions in stroke patients.