Objective To explore the value of low resection of rectal carcinoma in pull-through anus operation and its influence factor with rectal carcinoma distant metastases along intestine wall.Method Clinical pathological and visited data of 43 patients with rectal carcinoma were analyzed prospectively.Resuits Forty--one cases were successfully accepted resection in pull-through anus (95.3%).No patient suffered from stoma leak,3 cases appeared recurrence after operation.Compared between high differentiation patients and mid differentiation patients,there was no significant difference, while the difference of comparing between high or mid differentiation patients and low differentiation patients respectively,there was significant difference.The difference of comparison among Dukes stage A,B or C was significant.Conclusions The right length of incising distant intestine tube is more than 2.0,3.0,4.0 cm respectively for rectal careinoma of high,mid and low differentiation or that of Dukes stage A,B or C.low resection of rectal carcinoma in puB-through anus should be considered as a regular operation.

Objective To compare the dosimetric differences of target volume and organ at risk between intensity-modulated arc therapy (IMAT) and simultaneously integrated boost intensity-modulated radiotherapy (SIB-IMRT) in nasopharyngeal carcinoma. Methods IMAT and SIB-IMRT treatment plans of 10 nasopharyngeal carcinoma cases were generated by Varian Eclipse ver8. 6 treatment planning system. The dosimetric parameters of target volume and organ at risk (OAR), the monitor units (MU) and treatment time were compared between IMAT and SIB-IMRT treatment plan. Results The conformal index ( CI ) of PTV, PTV1, PTV2 of IMAT and SIB-IMRT were 0. 71 and 0. 75 ( Z = - 2. 32, P ＜ 0. 05 ), 0. 54 and 0. 59 (Z= -2.56,P＜0.05), 0.71 and 0.78(Z= -2.52,P＜0.05), respectively. the homogenous index (HI) of PTV, PTV1, PTV2 of IMAT and SIB-IMRT were 10.5 and 11.2(Z= -0. 84,P＞0.05),13. 1 and 17. 1(Z= -1.68,P＞0.05) and 14. 1 and 13.3(Z= -1. 01,P＞0.05) respectively;the brain-stem mean does were 3512. 8 cGy ± 406. 2 cGy and 3384. 3 cGy ± 361.3 cGy ( Z= - 1.82, P ＞ 0. 05 ); the brain-stem maximum dose were 5528. 1cGy ± 192. 9 cGy and 5727. 5 cGy ± 356. 3 cGy ( Z = - 1.12, P ＞ 0. 05 ); the maximum dose of spinal-cord were were 4186. 1cGy ± 88.7 cGy and 4390. 2 cGy ± 74. 9 cGy ( Z =-2. 38 ,P ＜ 0. 05 ). There were no significant differences between parotid dose and normal tissue ( P ＞0. 05. ) MU were 606 ± 96 and 1308 ± 213 for IMAT and SIB-IMRT ( Z= - 2. 52, P ＜ 0. 05 ). Conclusions The IMAT plan showed a better conformal index than SIB-IMRT plan, with the same dosimetric parameters of the target volume and OAR. The IMAT plan could reduce normal tissues dose, monitor units and treatment time in the treatment of nasopharyngeal carcinoma.

ObjectiveTo evaluate the app li cation value of the Dipstick Dye Immuno assay (DDIA) for screening chemotherapy targets of schistosomiasis in a lower endemic area. Methods[ WT5”BZ]In a lower endemic area of schistosomiasis a random sample of 463 individuals from a natural village were examined using miracidium hatching metho d, Kato Katz's method, DDIA, DGS COPT and ELISA. The positive rates of these a ss ays were compared. ResultsThe positive rate of stool examination was 3.9% in 463 individuals. The positive rate of DDIA was 15 8%. The positive rate in 18 stool positive subjects was 94 4% with Youden In dex 0 81. The positive rate of DGS COPT was 8 9% . The positive rate in 18 stool po sitive subjects was 72 2% with Youden Index 0 66. The positive rate of ELISA w as 18 4%. The positive rate in 18 stool positive subjects was 83 3% with Youden In dex 0 68. ConclusionDDIA was more suitable for application in screening target population in lower endemic areas than other im munoassys.

Objective To observe the effect of Arm Spasticity Inhibitor worn in rehabilitation training on patients with upper extremities spasticity and shoulder subluxation after stroke. Methods 80 stroke patients with flexor spasm in upper extremities complicated with subluxation of shoulder were divided into treatment group and control group equally. Both groups accepted routine medicine and rehabilitation, and the treatment group wore the Arm Spasticity Inhibitor developed ourselves during the rehabilitation training. Their acromio-humeral interval (AHI) was measured with the X- ray; and they were assessed with modified Ashworth Scale (MAS), range of motion of shoulder (ROM) and elbow before and 2 months after treatment. Results It improved more in the AHI, score of MAS and ROM in the treatment group than in the control group after treatment (P<0.001). Conclusion Wearing Arm Spasticity Inhibitor during rehabilitation training may release the spasticity of upper extremities and shoulder subluxation, and improve shoulder function in patients after stroke.

Objective To evaluate values of Serum IgG 4,IgG4/IgG ratio,and IgG4/IgG1 ratio for distinguishing Mikulicz′s disease(MD)from primary Sj?gren′s syndrome(pSS).Methods It retrospectively analyzed 186 patients subjected to serum IgG subclass testing to differentiate MD from primary Sj?gren′s syndrome(pSS)at Peking University People′s Hospital from July 2012 to July 2016.This sample included 42 MD patients and 144 pSS patients.Serum IgG subclass concentrations were measured using Siemens reagents with nephelometry and BNⅡinstrument.In partial patients,serum antinuclear antibodies (ANA)were detected by indirect immunofluorescence assay, and serum anti-SSA antibodies and anti-SSB antibodies were detected by Western blot.Serum IgG subclass test results,ANA test results,serum anti-SSA antibody,and anti-SSB antibody test results were collected.The quantitative data were represented by median(quantile range).The Mann-Whitney U test was used to compare the medians between the two groups.Categorical variables were analyzed with a χ2test and were shown as percentages.The ROC curve was constructed to identify the optimal cut-off values and the area under the curve(AUC)values of the serum IgG4,IgG4/IgG ratio,and IgG4/IgG1 ratio for distinguishing MD patients from pSS patients.Results The medians of serum IgG4, IgG4/IgG ratio and IgG4/IgG1 ratio in MD patients were 11 200 mg/L(17 330),0.444(0.314)and 1.318(1.920), as compared with 329 mg/L(490),0.016(0.025)and 0.023(0.039)respectively in pSS patients(Z=-9.368, -9.560, and -9.571, respectively, P<0.001).For distinguishing MD from pSS, the optimal cut-off values of serum IgG4, IgG4/IgG ratio, and IgG4/IgG1 ratio were 1 870 mg/L,0.111, and 0.206, respectively.The corresponding AUC values were 0.976,0.985,and 0.986,respectively.Comparison of the ROC curves showed that there was no significant difference between AUC of serum IgG4/IgG ratio and IgG4/IgG1 ratio(Z=0.283, P=0.777).But AUC of serum IgG4/IgG ratio and IgG4/IgG1 ratio were significantly higher than AUC of serum IgG 4(Z=2.360 and 1.975,repectively,P=0.018 and 0.048,respectively).The positive rates of serum ANA in MD and pSS group were 10%and 85.8%,respectively(χ2=71.340,P<0.001).The positive rates of anti-SSA antibody and anti-SSB antibody in MD were 6.7%and 0%,respectively.Compared to 72.3%and 38.3%in pSS group, they were lower(χ2=44.773 and 16.792, P<0.001).Conclusions Measurements of serum IgG4 concentration,IgG4/IgG ratio, and IgG4/IgG1 ratio were of important values in differentiating MD from pSS.Serum IgG4/IgG ratio or IgG4/IgG1 ratio was superior to serum IgG4.

Hemoglobin-loaded nano-sized particles with oxygen carrying capacity were prepared. All experiments were performed using biodegradable polymer poly (polyepsilon-caprolactone) (PCL) as matrix polymer. Optimized preparation parameters led to nanoparticles with well-defined characteristics such as size <200 nm, P50 27 mmHg and high encapsulation efficiency up to 99.4%. The results of in vitro and vivo studies suggested that Hb-loaded particles did not activate complements. After the nanoparticles suspension was injected into the mice via tail vein, the particles did not cause significant changes in total platelet counts. Apparently, the hemoglobin-loaded nanoparticles can serve as a potential candidate in substitution for red cells.
Animals ; Biocompatible Materials ; chemistry ; Blood Substitutes ; chemical synthesis ; chemistry ; Cattle ; Hemoglobins ; chemistry ; Materials Testing ; Mice ; Nanoparticles ; chemistry ; Particle Size ; Polyesters ; chemistry

Objective: To investigate the effect of Gradient treatment for acute superior mesenteric venous thrombosis (ASMVT). Methods: Clinic data of 68 patients of ASMVT admitted in Department of General Surgery, Jinling Hospital, Medical School of Nanjing University from January 2009 to December 2014 were analyzed retrospectively. There were 50 male and 18 female patients with a mean age of (45±12) years. These patients were conducted by the stepwise treatment model (endovascular treatment-damage control surgery-surgical intensive care-intestinal rehabilitation treatment). Clinical outcomes and complications were compared during the follow-up period. Differences about bowel resection length of endovascular treatment and surgical procedures were evaluated with t test. Results: In the 68 cases, 24 cases were cured simply by endovascular treatment, 19 cases received surgical procedures alone (group surgery). Twenty-five patients received endovascular treatment combined with surgical procedures (group combined), including 6 cases temporary abdominal closure. The overall mortality rate was 2.9% (2/68) during hospitalization. The range of bowel resection of group combined significantly reduced compared with group surgery ((92±14) cm vs. (162±27) cm, t=-2.377, P=0.022). During 1-year follow-up period, 4 cases suffered from short bowel syndrome, whom underwent surgery alone. Conclusions Early diagnosis and treatment is the key to treatment of ASMVT, the rapid improvement of intestinal ischemia is particularly important for prognosis. Combination therapy significantly save more residual small intestine and avoid short bowel syndrome. The selection of early gradient treatment can significantly reduce the mortality and improve the prognosis of ASMVT patients.

Objective:To evaluate the clinical performance of anti-peptidylarginine deiminase 2 (PAD2) and anti-PAD4 antibodies combined testing in a Chinese rheumatoid arthritis (RA) cohort.Methods:A total of 148 RA inpatients and 35 patients with non-RA arthritis as controls (DC) were recruited from November, 2018 to November, 2019 in Peking University People′s Hospital. In addition, a total of 44 healthy controls (HC) who went to Peking University People′s Hospital for annual physical examination were collected from June 2019 to July 2019. The α-PAD2 and α-PAD4 level in clinical specimens were determined by ELISA. Statistical analysis was performed by the Mann-Whitney U test, the Kruskal-Wallis (KW) test, the χ 2 test or the Fisher′s Exact Test, as necessary. Correlation analysis were performed by logistic regression. Results:α-PAD2 and α-PAD4 were present in 26.4% (39/148) and 20.9% (31/148) patients with RA, 5.7% (2/35) and 5.7% DC (2/35) and 4.5% (2/44) and 2.3% HC (2/44), respectively. α-PAD4-positive RA patients displayed significantly longer disease duration compared to α-PAD4-negative RA patients (17.3±13.2 years vs 8.6±10.2 years, P<0.001). α-PAD4-positive RA patients showed a significantly higher incidence of interstitial lung disease (ILD) compared to those without α-PAD4 (54.8% vs 25.6%, P=0.002). No associations between α-PAD2 and ILD were found ( OR: 0.797, P=0.579). In contrast, significant associations between α-PAD4 and ILD were found ( OR: 3.521, P=0.002). In seropositive RA, α-PAD4 displayed a weak correlation with ILD ( OR: 2.324, P=0.046), but this association was greatly enhanced when combined with α-PAD2 [anti-PAD2 (-)] ( OR: 4.059, P=0.007). Conclusions:The findings delineate the clinical relevance of α-PAD2 and α-PAD4 in RA and suggest that the combined testing for α-PAD2 and α-PAD4 may provide additional diagnostic value to the current clinically available assays in RA, in particular in identifying patients at risk of RA-ILD.

Objectives:To analyze the effect of vertebral or intraspinal abnormalities on the efficacy of pos-terior corrective surgery for scoliosis patients with arthrogryposis multiplex congenita(AMC).Methods:A retro-spective study was conducted on 30 scoliosis patients with AMC who underwent posterior corrective surgery in the Department of Spine Surgery of Drum Tower Hospital between August 2001 and November 2021.There were 18 males and 12 females with a mean age of 15.9±5.8(6-32)years.The patients were divided into ab-normal group(15 cases)and control group(15 cases)according to with or without vertebral or intraspinal ab-normalities.The types of vertebral or intraspinal abnormalities in the abnormal group were recorded,and the number of fusion segments,operative time and intraoperative blood loss were compared between groups.The complications during follow-up were also collected.The flexibility of major curve was assessed on Bending radiographs,and the main curve Cobb angle,the distance between C7 plumb line and center sacral vertical line(C7PL-CSVL),the sagittal vertical axis(SVA),the thoracic kyphosis(TK),and the lumbar lordosis(LL)were measured on the standing whole spine anteroposterior and lateral X-ray images at pre-operation,postoperative two weeks and two years,and the correction rate of major curve was calculated at 2 weeks after surgery and the final follow-up.Results:There were 10 cases of simple poor segmentation(66.6％),2 cases of poor seg-mentation combined with tethered cord(13.3％),and 1 case of poor segmentation combined with arachnoid cyst,simple hemivertebra,and simple wedge-shaped vertebra(6.7％)each in the abnormal group.There were no significant differences between abnormal group and control group in the number of fusion segments,opera-tive time and intraoperative blood loss(P＞0.05).No complication was observed during operation in the abnor-mal group,and 3 complications were observed during follow-up,including 2 cases with screw misplacements and 1 case with thoracic effusion and the right brachial plexus paralysis;5 cases of complications in the control group were observed,including 1 case with malignant hyperthermia and cardiac arrest during the surgery,3 cases with screw misplacements and 1 with thoracic effusion and screw placement failure.The in-cidence of complications was not statistically different between the two groups(P=0.628).The flexibility of ma-jor curve before operation was not statistically different between the two groups(P＞0.05);The major curve Cobb angle,C7PL-CSVL,SVA,TK and LL at pre-operation,post-operative two weeks and 2 months were not statistically different between groups(P＞0.05);The correction rate of major curve at 2 weeks and 2 months after surgery were not significantly different as well(P＞0.05).Conclusions:Vertebral or intraspinal abnormali-ties have no obvious effects on the efficacy of posterior corrective surgery for the treatment of scoliosis pa-tients with AMC,and there is no significant increase in the incidence of intraoperative and postoperative com-plications.

Objective To document the impact of conversion to mycophenolate mofetil (MMF)at different time points after transplantation on the renal function of renal function.Methods A longterm,multicenter,non-interventional and observational study was done.Two cohorts were included:One was Switch cohort (340 cases) including renal allograft recipients who switched to MMF at least 6 months after renal transplantation and followed up for 4 years after switch; The other was Stay cohort (123 cases),including renal allograft recipients who received MMF treatment after transplantation and followed up for 4 years after enrollment.Results GFR values of patients in Switch cohort was significantly increased after switch,and the change in GFR slope was 3.1 mL· min-1 · year-1 (P＜0.01).GFR values of patients in Stay cohort kept steady before and after enrollment,and the change in GFR slope was 0.44 mL·min-1 ·year-1 (P＞0.05).Statistically significant difference in the onset time of GFR decline (defined as 20％ decline from the baseline) was observed among subgroups within Switch cohort (P＜0.01),but there was no significant difference among subgroups within Stay cohort (P＞0.05).Stay cohort was 12％ higher than in Switch cohort every year.Conclusion Conversion to MMF ＞6 months or even many years after transplantation can obviously improve the renal function of recipients.The earlier conversion can benefit improvement of the renal function.