The purpose of this study was to evaluate the value of Chinese herbal fumigation in the postoperative anal disease. The authors randomly divided 348 patients into treatment group and control group with 174 cases in each group. The treatment group was given to the Chinese herbal medicine hemorrhoids lotion for fumigation based on conventional anti infective therapy, routine dressing change and relaxing bowel. The control group was given to 1 000 mL 1: 5 000 potassium permanganate solution for sitz bath, fumigation based on conventional anti infective therapy, routine dressing change and relaxing bowel. The pain score, edema score, bleeding score, granulation tissue growth score and wound healing time of two groups were compared after operation. The results showed that the postoperative 6 h pain scores were higher in the two groups, the postoperative 3,5,7 d pain scores gradually decreased, the difference was statistically significant (P < 0.05). The difference of postoperative 6 h pain scores was no significant difference between the two groups, while postoperative 3,5,7 d pain scores in the treatment group were significantly lower than those in the control group (P < 0.05). 7 days after operation, anal margin of edema score and blood in the stool score in the treatment group were lower than those in control group, meat medicine growth score was higher than that of the control group, the difference had statistical meaning (P < 0.05). The healing time of two groups was respectively (13.89 + 2.78), (18.45 + 1.65) d (P < 0.05). This study suggested that Chinese herbal fumigation and washing could reduce the pain degree of patients, the anal margin of edema, and the blood in the stool, also could promote granulation tissue growth and shorten the time of wound healing, deserve the clinical expansion.
Adult ; Anal Canal ; surgery ; Digestive System Surgical Procedures ; adverse effects ; Drugs, Chinese Herbal ; administration & dosage ; Edema ; drug therapy ; etiology ; Female ; Hemorrhage ; drug therapy ; etiology ; Hemorrhoids ; Humans ; Male ; Middle Aged ; Pain, Postoperative ; drug therapy

Congresses as Topic ; Humans ; Otorhinolaryngologic Surgical Procedures

ObjectiveTo study the change of autophagy of human pancreatic cancer cell MiaPaCa-2 before and after Ad5-KAI1 tranfection,and to investigate the possible mechanism.MethodsThe MiaPaCa-2 cells without KAI1 expression were infected with Ad5-KAI1 with KAI1 target gene,and Ad5-null was used as negative control,and parental cell was used as blank control.The formation of autophagosomes was observed by electromicroscopy.The green fluorescent protein-labeled light chain 3 (LC3) associations with autophagosome membranes was detected by confocal microscopy.PD98059,LY294002 were applied to pre-treat the cells.The expression levels of beclin 1,AKT,ERK,the phosphorylation of AKT and ERK protein and the ratio of LC3-Ⅱ to LC3- Ⅰ were detected by Western blotting.ResultsAfter 100 MOI Ad5-KAI1 infections for 24 h,the rate of cell expressing KAI1 protein reached (84.97 ±8.56)％,number of LC3 increased from 4 to 20; and swelling,degeneration of mitochondria was observed,and bilayer-like structure in cytoplasm was found.The expression of beclinl increased (1.4 ±0.3 ) folds,and the expression of LC3-Ⅱ/LC3- Ⅰ increased (8.00 ±2.78) folds.PI3K blockade LY294002 pretreatment significantly suppressed the phosphorylation of AKT of MiaPaCa-2 (2.756 vs 1.516),but it did not inhibit the increase of ratio of LC3-Ⅱ to LC3- Ⅰ(0.770 vs 1.403).ERK blockade PD98059 pretreatment not only significantly suppressed the phosphorylation of ERK of MiaPaCa-2 ( 1.637 vs 0.403 ),but also inhibit the up-regulation of beclin 1 protein expression ( 2.377 vs 1.150) and increase of ratio of LC3- Ⅱ to LC3- Ⅰ (2.225 vs 0.680).ConclusionsKAI1 can significantly induce autophagy of human pancreatic cell line MiaPaCa-2 through phosphorylation of ERK rather than AKT.

Objective To explore the pathway of KAI1 induced autophagy regulating apoptosis in human pancreatic cancer cell line MiaPaCa-2.Methods There were three groups in the experiment,which were extracellular regulated protein kinases (ERK) phosphorylation inhibitor PD98059 pretreated group,Caspase-3 activation inhibitor VAD-FMK pretreated group and no PD98059 or VAD-FMK pretreated groups.And each group was divided into three sub groups with different treatment,which were adenovirus AD5-null vector infected control group,the human KAI1 gene recombinant adenovirus vector AD5 KAI1 infected group and autophagy inhibitor 3-MA pretreated and AD5-KAI1 infected group.The cell apoptosis was observed by AnnexinV-FITC/PI double staining.Caspase-3 activation level was evaluated by flow cytometry.ERK phosphorylation and poly(ADPribose) polymerase (PARP) cleavage were determined by Western blot.Results After the cancer cells infected with AD5 KAI1,KAI1 protein was expressed and GFP-LC3 green particles increased.Caspase-3 activation,PARP cleavage,ERK phosphorylation and apoptosis increased obviously.After autophagy inhibitor 3-MA pretreated,the percentage of apoptosis increased from (63.0 ± 7.9)％ to (88.0±4.5) ％ and Caspase-3 activation increased from (34.0±2.8) ％ to (44.2±4.0) ％ and PARP cleavage more.The apoptosis induced by 3-MA could be totally inhibited by Caspase-3 activation inhibitor VAD-FMK pretreated but could not be inhibited by ERK phosphorylation inhibitor PD98059.Conclusion KAI1- induced autophagy inhibits apoptosis through the downregulation of Caspase-3activation and PARP cleavage instead of ERK phosphorylation.

Objective To investigate the relationship between nutritional risk and cognitive score in pa-tients with acute stroke .Methods From January 2015 to December 2015, 160 inpatients with acute stroke were observed and divided into two groups according to Nutritional Risk Screening 2002 (NRS 2002) scores.All the patients were on natural diets and did not receive enteral or parenteral nutrition support .Cognitive functions were evaluated using the Mini-Mental State Examination ( MMSE) within 24 hours and 6 months after the acute cere-bral artery diseases .Logistic regression analysis was performed to investigate the effects of nutritional risks on the cognition.Results Totally 145 patients entered the final analysis , among whom 72 had nutritional risks and 73 had no nutritional risks .The average ages of patients with nutritional risks were significantly older than those without nutritional risks [ (67.04 ±8.95) years vs.(63.10 ±9.12) years, P=0.027], along with significantly higher incidence of diabetes (75.0%vs.49.3%, P=0.001).The lesion locations showed no statistically signif-icant difference between two groups ( frontal lobe 24.5%vs.17.5%, P=0.670;parietal lobe and occipital lobe 40.8%vs.26.3%, P=0.398;basal ganglia region 51.0%vs.49.1%, P=0.490;brain stem and cerebellum 53.0%vs.42.1%, P=0.777).Compared to the patients without nutritional risks , the MMSE scores of the pa-tients with nutritional risks were lower within 24 hours, but without statistical significance (27.45 ±2.21 vs. 28.09 ±1.27, P=0.209);however, six-month follow-up showed that the MMSE scores were significantly differ-ent between two groups (24.70 ±2.16 vs.27.43 ±2.32, P=0.036).Univariate Logistic regression analysis was used to evaluate factors associated with cognitive impairment (MMSE<27).NRS 2002, ages, diabetes mellitus history, and body mass index entered in the Logistic regression analysis .In all patients, ages and NRS 2002 had a positive correlation with cognitive impairment (P=0.000, OR=1.156;P=0.004, OR=2.341).Conclusion The cognitive function in stroke patients with nutritional risks is worse than in patients without nutritional risks .

Objective To evaluate the clinical features, diagnosis, and outcome of the treatment of cytomegalovirus (CMV) retinitis, and the relationship between CMV retinitis and acquired immunodeficiency syndrome (AIDS). Methods A total of 95 eyes of 56 patients with cytomegalovirus retinitis and AIDS were studied. The fundus feature, visual acuity and CD4 + T lymphocyte counts were analyzed and the follow up periods ranged from 2 weeks to 18 months. Results Before the definitive diagnosis of CMV retinitis, the courses of AIDS were 4 to 26 months in all patients. In the initial examination, the granular form of CMV retinal lesion was noted in 55 eyes (57%) in which retinal lesion of 46 eyes was peripheral. The fulminant form of CMV retinitis of 25 eyes (26%) was found in the posterior pole and consisted of densely opaque retinal lesions with blotchy hemorrhage and vasculitis. The overlap between these two presentations was noted in 15 eyes. Papillitis was observed in 7 eyes of CMV retinitis in this series of patients. The visual acuity ranged from finger counting to 0.5. The patients with extensive CMV retinitis or CMV retinitis in the posterior pole got poorer vision. The CD4 + T lymphocyte counts of 30 patients was 0 30 (mean, 15?9/?l), and the survival time ranged from 2 weeks to 18 months (mean, 6.4?3.3 months). The vision was improved and CD4 + T lymphocyte counts was significantly higher in the group treated with ganciclovir, and progression of CMV retinitis occured and the vision decreased in the non treated group. Conclusion CMV retinitis is the most common intraocular complication in patients with AIDS. Diagnosis of CMV retinitis is based on the characteristic of necrotizing retinitis which was typically associated with retinal hemorrhage and vasculitis. Ganciclovir is effective for the treatment of CMV retinitis.

Middle cerebral artery occlusion(MCAO) can be used to establish the standard model of focal cerebral ischemia. The method for establishing focal cerebral ischemia model has been improved continuously, from simple behavior score, measurement of infarcted brain area, and morphological observation in the past to functional study, neurobiochemistry, molecular biology, etc. The research of MCAO provides a basis for further study of the pathological characteristics, mechanism and prevention of human cerebral ischemia. This article reviews the recent advancement in the study of MCAO model and cerebral ischemia.

Geriatrics develops relatively late in medical education, but geriatric medical education is rapidly rising for aggravation of the aging of population.And geriatric medical education is desired of the properties medical sciences, and is also the need of the development itself. Therefore, geriatric medical education should be internationalized, to eventually form distinctive education.

Ascites ; complications ; etiology ; Heart Failure ; complications ; etiology ; Hemochromatosis ; complications ; diagnosis ; Humans ; Middle Aged

BACKGROUND: Although improvement could be achieved after the first operation, limb symptoms of patients would aggravate with the progress or reoccurrence of Parkinson disease (PD), thereby second operation would become necessary if symptom could not be controllel by medication.OBJECTIVE: To investigate the improving rate of symptoms and complications of patients with PD after the second operation.DESIGN: Case analysisSETTING: Neurosurgery Department of 153th Military Central Hospital and Neurosurgery Department of Tangdu Hospital Affiliated to the Fourth Military Medical University of Chinese PLA.PARTICIPANTS: Totally 387 primary PD patients were collected from Neurosurgery Department of 153th Military Central Hospital and Neurosurgery Department of Tangdu Hospital Affiliated to the Fourth Military Medical College of Chinese PLA from October 1997 to December 2002.Totally 350 patients received two operations in the same hospital, and other 37 patients received the first operation at other hospital and the second operation in our hospital. The intervals of two operations were within half a year in 36 cases, 0.5-0.9 year in 72 cases, 1.0-1.9 years in 108 cases and 2.0-5.0 years in 171 cases respectively.METHODS: Under the stereotactic microelectrode-guidance, the targets of all patients were subjected to iconographical orientation, microelectrode record, microelectrode stimulation and exploration and radio frequency microelectrode verification before just stage bilateral posteroventral pallidotomy (PVP) or thalamus ventral intermediate nucleus damage(TVIND),unified Parkinson's disease rating scale (UPDRS) was used at preoperative and postoperative "on" state (at the beginning of medication, patients move freely and stays in "on" state) as well as "off" state (when medication loss function, patients displays moving disability and stays in "off" state).complication between two operation .RESULTS: Data of 387 patients were remained in the results analysis.operation was lower than that of first operation (tremor 95.4%, 96.9%;rigidity 94.6%, 95.1%; bradykinesia 88.9%, 92.3%; gait 62.3%, 67.1%;balance 65.1%, 69.4%, akinesia and cramp 95.8%, 98.0%), but no diffor UPDRS were lower than that of preoperative scores (P ＜ 0.01). The mean total UPDRS scores improved by 46.8% in the "on" state and 53.5% in the "off" state after second operation, lower than that of first tive complications: The occurrenceof complications that was specific for the second operation including fatigue, salivation, reduced voice, fake bulbar paralysis, lethargy, hiccough, urinary incontinence, urinary retention were found higher than that of after the first operation (P ＜ 0.05).The occurrence of cerebral hemorrhage was also lower than that of after first operation.UPDRS were lower in the second operation, which may be due to that PD of postoperative complications which was specific for the second operation was obviously increased, which possibly associated with age, state of illness, constitution, operation type and interval between operations. But occurrence of non-specific postoperative complications was basically the same in two operations (cerebral hemorrhage and inflammation), suggesting that hemorrhage risk did not increased due to the second operation.