OBJECTIVETo evaluate the use of Delorme procedure for full-thickness rectal prolapse.

METHODSA series of 25 patients with full-thickness rectal prolapse were treated by Delorme procedure in four institutions between March 2005 and June 2010. The clinicopathological data were analyzed retrospectively.

RESULTSThere were 9 males and 16 females. The mean age was 52(46-72) years old. All the procedures were successfully performed. There were no perioperative deaths. The mean operative time was 65(45-150) min. The intraoperative bleeding was 58(20-200) ml. The mean length of hospital stay was 8.5(5-14) days. Anastomosis dehiscence occurred in 1 patient at post-operative day 7 who was managed under anesthesia. Minor complications occurred in 8(32%) patients, including urinary retention(n=3), intractable pain(n=1), and bowel obstruction(n=4). The follow up time ranged from 2 to 6 years with a median of 3.5 years. Prolapse recurrence was observed in 1(4%) patient during the follow up. The remission rates of fecal incontinence, constipation, bleeding were 37.5%(6/16), 45.5%(5/11), and 15.4%(2/11), respectively. The Wexner incontinence score significantly decreased (median, 5.0 vs. 9.0, P<0.01). The resting pressure and maximum squeeze pressure increased significantly after surgery, while the initial volume and maximal tolerance volume decreased significantly(All P<0.01).

CONCLUSIONSDelorme procedure is safe and easy to perform. The anorectal function is improved after surgery. Therefore it should be considered the procedure of choice for rectal prolapsed.

Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Rectal Prolapse ; surgery ; Retrospective Studies ; Treatment Outcome

Adult ; Biomarkers, Tumor ; biosynthesis ; Carcinoma, Hepatocellular ; diagnosis ; enzymology ; DNA-Binding Proteins ; Female ; Humans ; Liver Neoplasms ; diagnosis ; enzymology ; Male ; Prognosis ; Telomerase ; biosynthesis ; genetics

OBJECTIVETo investigate the clinicopathologic factors and the distribution pattern of N2 lymph nodes, to analyze the relationship between the survival rate and skip metastasis of non-small cell lung cancer (NSCLC) patients.

METHODSThe clinical data of 478 patients with a pN2 stage who underwent resection for non-small cell lung cancer from January 2000 to December 2004 was retrospectively analyzed. Skip group and non-skip group were defined. Characteristics of tumors, ganglionar involvement and survival were analyzed in both groups.

RESULTSThe incidence rate of skip N2 metastasis in stage IIIA-N2 NSCLC patients was 40.6%, which was correlated to sex, smoking and the type of histology (P < 0.05). Squamous carcinoma was the main type of skip group (chi² = 7.602, P = 0.022). The frequency of skip metastasis was higher in patients with a primary tumor in the upper lobe (57%) compared to the lower lobe (43%) (chi² = 5.097, P = 0.024). Superior nodes were more frequently involved by skip group (chi² = 7.046, P = 0.030). Moreover, the relationship between the primary tumor location and N2 positive lymph nodes were described as follows: right upper lobe cancer displayed skip-N2 nodal metastasis mostly in the 2nd, 3rd and 4th station, right middle and lower lobe mostly in the 7th station, left upper lobe mostly in the 5th and 6th station (71.7%), and left lower lobe mostly in the 7th and 9th station. The 5-year survival rate of pN2 patients with skip metastasis was 22.1% compared to 13.6% in patients with involvement of N1 and N2 nodes (P = 0.001). Survival analysis showed that skip N2 metastasis was an independent risk factor of stage IIIA NSCLC.

CONCLUSIONSThe frequency of skip metastasis was higher in patients with a primary tumor in the upper lobe and in the superior nodes. Skip metastasis is an independent prognostic factor of survival. The presence of skip metastasis seems to be a unique subgroup of pN2 disease in NSCLC.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; pathology ; Female ; Humans ; Lung Neoplasms ; pathology ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Mediastinum ; pathology ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies

OBJECTIVESTo investigate the relationship between the epithelial growth factor receptor (EGFR) mutation status and clinicopathological factors, and to analyze the mutation on the effect in non-small cell lung cancer (NSCLC) after surgery.

METHODSThe NSCLC patients who were resected and detected EGFR gene from March 2009 to March 2011 were retrospectively reviewed. The relationship between EGFR mutation status and clinicopathological factors, tumor markers, prognostic was analyzed.

RESULTSThe mutation and the wild group had 169 and 214 patients respectively. EGFR mutation in female, non-smoking, adenocarcinoma and less than 60 years old accounted for 63.91%, 61.54%, 88.76% and 62.13% with statistical significance compared with male (χ(2) = 53.490, P = 0.000), smoking (χ(2) = 48.568, P = 0.000), non-adenocarcinoma (χ(2) = 105.560, P = 0.000) and more than 60 years old (χ(2) = 6.057, P = 0.017). Disease free survival (DFS) of the wild group was better than mutation group (χ(2) = 11.329, P = 0.001). In addition, there were some relations between mutation status and excision repair cross complementing (ERCC1) protein, carcinoembryonic antigen (CEA), squamous cell carcinoma (SCC) and Cyfra21-1. ERCC1(+) (χ(2) = 6.739, P = 0.012), SCC(χ(2) = 16.839, P = 0.000) and Cyfra21-1(χ(2) = 6.638, P = 0.013) more than normal value was common in wild group. Increased CEA was common in mutation group (χ(2) = 5.436, P = 0.023).

CONCLUSIONSEGFR mutation is commonly found in female, non-smoking, adenocarcinoma and less than 60 years old NSCLC patients. The wild group obtains better DFS than mutation group. Tumor markers may predict the mutation status, which need further research.

Carcinoma, Non-Small-Cell Lung ; genetics ; mortality ; pathology ; Disease-Free Survival ; Female ; Humans ; Lung Neoplasms ; genetics ; pathology ; surgery ; Male ; Middle Aged ; Mutation ; Prognosis ; Receptor, Epidermal Growth Factor ; genetics ; Retrospective Studies

OBJECTIVETo observe the clinical efficacy on superior cluneal nerve entrapment syndrome treated by relaxation therapy of in-row multi-needling technique.

METHODSOne hundred and twenty cases were randomized into a multi-needling group, an acupotomy group and a conventional acupuncture group, 40 cases in each one. In the multi-needling group, the perpendicular or oblique puncture was applied to the affected area of the lumbar and gluteal region. The chief needling sites were determined in terms of the strong response of acupuncture to be the chief points. The in-row multi-needling technique was applied around the chief needling sites, with lifting, thrusting penetrating method to different directions. Two chief points were connected with the G6805 low frequency pulse therapeutic apparatus. In the acupotomy group, the acupotomy was applied to 3 to 4 affected sites in each treatment. In the conventional acupuncture group, Shenshu (BL 23), Dachangshu (BL 25), Jiaji (EX-B 2) in the lumbar region, Zhibian (BL 54) and the others were selected and connected with the G6805 low frequency pulse therapeutic apparatus. The cases in each group were treated for 4 weeks. The improvements of pain score, therapeutic efficacy and comprehensive satisfaction assessment were compared among 3 groups in 2 and 4 weeks of treatment separately.

RESULTSThe pain scores in each group were reduced apparently in 2 and 4 weeks of treatment separately (all P<0.05), and the pain score in the acupotomy group was lower than that in the conventional acupuncture group in 2 weeks of treatment. In 4 weeks of treatment, the pain scores in the multi-needling group and the acupotomy group were lower than that in the conventional acupuncture group (both P<0.05) and the pain score in the multi-needling group was lower than that in the acupotomy group (P<0.05). In 2 weeks of treatment, the remarkable effective rate in the acupotomy group was 62.5% (25/40), which was superior significantly to 25.0% (10/40) in the conventional acupuncture group (P<0.05). The other differences among the groups were not significant statistically in comparison. In 4 weeks of treatment, the remarkable effective rate was 90. 0% (36/40) in the multi-needling group and was 67.5% (27/40) in the acupotomy group, which were superior to 35.0% (14/40) in the conventional acupuncture group (both P<0.05). The remarkably effective rate in the multi-needling group was better than that in the acupotomy group (P<0.05). The satisfaction for the patients in the multi-needling group was higher obviously than that in any of the other two groups (P<0.05).

CONCLUSIONThe relaxation therapy of in-row multi-needling technique achieves the definite therapeutic effect on superior cluneal nerve entrapment syndrome. The efficacy is superior to acupotomy and the conventional acupuncture. The therapeutic effect is better for the cases of the extensive affected scope, unclear location and large distribution in patches caused by the adhesion of muscles and fascia especially.

Acupuncture Therapy ; instrumentation ; methods ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Nerve Compression Syndromes ; therapy ; Treatment Outcome

OBJECTIVETo observe therapeutic effect of acupuncture combined with inductance coupling for treatment of delayed union and nonunion.

METHODSSixty cases with delayed union and nonunion after operation were randomly divided into 2 groups. The observation group (n=30) received acupuncture with Shenshu (BL 23), Mingmen (GV 4), Guanyuan (CV 4), Qihai (CV 6), Zusanli (ST 36), Xuanzhong (GB 39) and Taichong (LR 3) selected as main points, in combination with inductance coupling treatment and the routine treatment. The patients (n=30) in the control group received routine treatment. Bony callus growth was observed by X-ray 30 and 120 days after treatment respectively.

RESULTSTwenty-three cases 30 days after treatment and 29 cases 120 days after treatment were found the bone callus growth in the observation group , and 11 cases and 17 cases in the control group, with significant difference between the two groups (P<0.05), the observation group being better than the control group, with no bad event and side effect.

CONCLUSIONAcupuncture combined with inductance coupling is a good method for promoting fracture healing.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Child ; Female ; Fracture Healing ; Fractures, Ununited ; therapy ; Humans ; Magnetics ; Male ; Middle Aged

OBJECTIVETo study the influence of Radix Astragali (RA) on pulmonary tissue endothelin-1 (ET-1) and nitric oxide (NO) in hypoxic pulmonary hypertension rats.

METHODSTwenty one healthy male Wistar rats weighing 210-310 g were divided into three group at random with 7 in each. The rats in control group were raised in ordinary room condition; those in hypoxic group were raised in ordinary pressure hypoxic box [concentration of O(2) was (10.0 +/- 0.5)%] for 8 hours a day, for 30 days; those in RA group were raised in the same condition as hypoxic group and treated with an intraperitoneal injection of RA 8 g/kg per day. The rats in the control group and hypoxic group were given the same volume of intraperitoneal injection of normal saline. Mean pulmonary arterial pressure (mPAP), mean carotid artery pressure (mCAP) were measured via right cardiac catheterization, concentration of NO in pulmonary tissue was measured by radioimmunoassay.

RESULTS(1) The mPAP (mm Hg) (21.9 +/- 1.6) and ET-1 (pg/ml) (309.1 +/- 58.1) in hypoxemic group were significantly higher than those in RA group (16.2 +/- 0.8, 287.7 +/- 57.5) and control group (15.3 +/- 0.8, 241.1 +/- 52.5) (P < 0.01, < 0.05), but the difference between RA group and control group was not significant. (2) NO (micromol/L) in pulmonary tissue in hypoxemic group (6.5 +/- 0.3) was lower than that in RA group and control group (9.2 +/- 0.9), NO in RA group was higher than that in hypoxic group but lower than that in control group (P < 0.05). (3) There was no significant difference in mCAP among the three groups (P > 0.05). (4) Under electron microscope, the endothelial cells of arterioles of the lung tissue of control group were flat and had normal morphology. However, in the lung tissue of hypoxic group, there were proliferation, hypertrophy and swelling of endothelial cells of pulmonary medium and small arteries and plenty of mitochondria and endoplasmic reticula in cytoplasm.

CONCLUSIONChronic hypoxia can result in reconstruction and endothelial lesion in pulmonary arterioles of rats, elevation of mPAP and ET-1 in pulmonary tissue, and decrease of NO. Injection of Radix Astraglai can reverse the reconstruction of pulmonary vessels partially, regulate the concentration of ET-1 and NO in pulmonary tissue, which may have certain therapeutic effects on pulmonary arteriolar changes induced by hypoxia.

Animals ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Endothelin-1 ; metabolism ; Hypertension, Pulmonary ; complications ; drug therapy ; metabolism ; Hypoxia ; etiology ; metabolism ; Lung ; drug effects ; metabolism ; Male ; Nitric Oxide ; metabolism ; Radioimmunoassay ; Random Allocation ; Rats ; Rats, Wistar

OBJECTIVETo investigate the cell proliferation and differentiation in the developing brain of mouse.

METHODSC57/BL6 mice were divided into 3 groups at random. Bromodeoxyuridine (BrdU) was injected into the brains in different development periods once a day for 7 d. The brains were retrieved 4 weeks after the last BrdU injection. Immunohistochemical and immunofluorescent studies were carried out for detecting cell proliferation (BrdU) and cell differentiation (NeuN, APC, Iba1, and S100beta), respectively.

RESULTSThe number of BrdU labeled cells decreased significantly with the development of the brain. Cell proliferation was prominent in the cortex and striatum. A small portion of BrdU and NeuN double labeled cells could be detected in the cortex at the early stage of development, and in the striatum and CA of the hippocampus in all groups. The majority of BrdU labeled cells were neuroglia, and the number of neuroglia cells decreased dramatically with brain maturation. Neurogenesis is the major cytogenesis in the dentate gyrus.

CONCLUSIONThese results demonstrated that cell proliferation, differentiation and survival were age and brain region related.

Animals ; Animals, Newborn ; Brain ; cytology ; growth & development ; Bromodeoxyuridine ; Cell Count ; Cell Differentiation ; physiology ; Cell Proliferation ; Cerebral Cortex ; cytology ; growth & development ; Corpus Striatum ; cytology ; growth & development ; Fluorescent Antibody Technique ; Hippocampus ; cytology ; growth & development ; Male ; Mice ; Mice, Inbred C57BL ; Nerve Tissue Proteins ; metabolism ; Neuroglia ; cytology ; physiology ; Neurons ; cytology ; physiology ; Nuclear Proteins ; metabolism

The study of sarcosaphagous insects is a subspecialty in forensic medicine based on the knowledge of entomology. It could help to determine the time of death, especially the postmortem interval in decomposed cases. This paper explores its history, species and erosion process of sarcosaphagous insects. It reviews the species identifying methods with molecular biology and entomological morphology. Details of its application in estimating postmortem interval in recent years and study of sarcosaphagous insects in the field of forensic medicine are summarized.
Animals ; Cadaver ; Death ; Diptera/physiology* ; Entomology/methods* ; Forensic Medicine/methods* ; Humans ; Larva/growth & development* ; Postmortem Changes ; Time Factors

Objective: The Schizophrenia Cognition Rating Scale (SCoRS) is an interview-based assessment tool for evaluating the cognitive deficit and daily functioning of patients with schizophrenia. Methods: Sixty-eight patients with schizophrenia and 68 age- and sex-matched healthy individuals were recruited to validate the Chinese version of SCoRS in this study. All participants underwent cognitive assessment using the SCoRS, which was verified by the Brief Assessment of Cognition in Schizophrenia (BACS), and the UCSD Performance-based Skills Assessment, Brief Version (UPSA-B). Patients with schizophrenia were additionally assessed using the Positive and Negative Syndrome Scale (PANSS). Results: SCoRS ratings reported by patients (SCoRS-S), those reported by the interviewer (SCoRS-I), and SCoRS global scores (SCoRS-G) showed significant correlation with all subscales of the BACS and the UPSA-B. On receiver operating characteristic curve analysis, SCoRS-S, SCoRS-I, and SCoRS-G significantly differentiated patients with schizophrenia from healthy controls. Moreover, SCoRS-S and SCoRS-I ratings showed positive correlation with the negative symptoms and general symptoms of PANSS. Conclusion The Chinese version of SCoRS showed good discriminant, concurrent, and external validity, suggesting that it is a useful and convenient tool for assessment of cognitive function among Mandarin-speaking patients with schizophrenia in clinical practice.