ObjectiveTo investigate the influence of internal sphincter deletions on postoperative fecal incontinence in rectal cancer patients after intersphincteric resection (ISR). MethodsSeventy one cases of rectal tumour were respectively treated by low anterior resection (group A, intact internal sphincter),partial ISR (group B,1/3 internal sphincter deletion),subtotal ISR (group C,2/3 internal sphincter deletion) and total ISR (group D,total internal sphincter deletion).Anorectal manometry and Vaizey scoring system were used to trace dynamic changes of fecal incontinence in the four groups in one year follow up. Data were analyzed with repeated-measures analysis of variance and multivariate analysis of variance. ResultsIn all cases the length of postoperative anal high-pressure zone shortened by groups.With time the length of high-pressure zone increased slightly.By the end of postoperative 12 months,there were still significant differences between groups( F =41.873,P =0.000).The maximum resting pressure of anal canal significantly reduced in all groups.By the end of postoperative 12 months,it almost restored to preoperative level in group A,while in group B and C it was about 2/3 of the preoperative level; and 1/3 of the preoperative level in group D.Vaizey score at postoperative 10 days,increased in all groups.In group B and C the score was on continuous decrease until the end of postoperative 12 months(P =0.158) it was close to that in group A.While in group D it was only 13.7 ±3.2 by the end of postoperative 12 months.Multiple regression analysis showed that by the end of postoperative 12 month,the maximum resting pressure of anal canal and postoperative anal high-pressure zone length were significantly and negatively related with the subjective Vaizey score of fecal incontinence ( t =- 4.802,P =0.000 ; t =- 2.011,P =0.048 ).ConclusionsIn patients of ultra-low rectal cancer undergoing intersphincteric resection,fecal incontinence severity indicator vaizey score as evaluated by the end of postoperative 12 months was associated with the maximum resting pressure of anal canal and anal high-pressure zone length.In addition,postoperative fecal incontinence severity carries reversible dynamic changes, and with time, most patients could restore satisfactory stool control function.

Intellectual property in medical institutions has been getting more attention in research activity.Large general hospitals have made significant achievements in intellectual property,and the management of intellectual property right has also gradually become the norm.This article discussed the possibility to carry out the intellectual property management in the primary health care sector,based on their current status and characteristics,proposed an evaluation system which suitable for the primary health care sector.We described the structure and method of this system,explored a standardized intellectual property management process used in primary health care institutions.

Objective Precondition is an approach to myocardial protection during ischemia-reper-fusion by inhibiting myocardial cell apoptosis.The purpose of this study was to evaluate the cardioprotective effect using 99Tcm-syuaptotagmin I (Syt I)-C2A to detect myocardial cell apoptosis in the myocardial is-chemia-repedusion rat model.Methods (1) The C2A domain of Syt I was labeled with 99Tcm using 2-iminothiophene hydrochloride (IT) method.Radiochemical purity was determined with thin layer chroma-tography.The binding activity of radiolabeled protein was assessed using eamptothecin-treated Jurket cells.(2) One group of 6 rats was prepared for myocardial ischemia-reperfusion model(A group),and another group of 6 rats was prepared for myocardial ischemia precondition model(B group).99Tcm-Syt I-C2A was injected via the tail vein at a dosage of about 7.4 MBq.At 1h after injection,the rat was sacrificed,and the heart was removed to rinse with saline and dye with triphenyl tetrazolium eoride (TTC).According to the resdt of myocardial dye,theischemic myoeardium was separated from the viable myocardium and weight was measured,and then its radioactivity was determined by gamma counting.The difference of radioactive uptake in the ischemic myocardium between these two group models was compared using percentage activity of injection dose per gram of tissue(%ID/g)±standard deviation(x±s).SPSS 12.0 was used for data analy-sis,and t-test was used to compare data.Results (1) The radiochemical purity of 99Tcm-Syt I-C2A was (98.90±0.43)%,and the radioactivity in the camptothecin-treated group was (10.99±0.55) folds higher than that of non-treated viable control group.(2)In the ischemia-reperfusion model,the radioactive uptake of 99Tcm-Syt,I-C2A was(2.41±0.32)%ID/g in the ischemic myocardium,and(0.16±O.02)%ID/g in the nomud myocardiunm.However,in the myocardial ischemia precondition model,(0.46±0.05)%ID/g in the isehemic myocardium was measured,and(0.20±0.05)%ID/g in the normal myocardium.Uptake of 99Tcm-Syt I-C2A in ischemic myocrdium showed statistically significant difference (t=8.52,P

Background: Recent studies indicate that C-X-C motif chemokine receptor 4 (CXCR4) and its ligand, C-X-C motif chemokine ligand 12 (CXCL12), stimulate expression of the cell cycle regulatory protein Cyclin D1 in neurofibroma-tosis 1-associated malignant peripheral nerve sheath tumor (MPNST) cells and promote their proliferation. In this study, we measured the expression of CXCR4, CXCL12, and Cyclin D1 proteins in sporadic MPNST tissues from Chinese patients and investigated their prognostic values. Methods: CXCR4, CXCL12, and Cyclin D1 protein expression in samples from 58 Chinese patients with sporadic MPNST was assessed with immunohistochemical staining. Their prognostic values were evaluated with Kaplan–Meier analysis and a log-rank test. Multivariate Cox regression analysis was used to identify independent prognostic factors. Results: High expression of CXCR4, CXCL12, and Cyclin D1 was observed in 19 (32.8％), 32 (55.2％), and 16 (27.6％) samples, respectively. CXCR4 expression was positively correlated with CXCL12 expression (r= 0.334,P= 0.010) and Cyclin D1 expression (r= 0.309,P= 0.018). Patients with high CXCR4 expression showed longer overall survival than those with low CXCR4 expression (χ2= 4.642,P= 0.031). Conclusion: High CXCR4 expression may define a specific subtype of sporadic MPNST with favorable prognosis.

OBJECTIVETo investigate the effect of hyperbaric oxygen (HBO) treatment on the expression of nitric oxide synthase (NOS) mRNA in cortex after acute traumatic cerebral injury, and to study the mechanism of HBO on brain injury.

METHODSAcute traumatic brain injury model was established with rest received free fall injury method in SD rats. 0.25 MPa HBO treatment was used 1 h or 12 h after brain injury and the cortex was isolated 6 h or 24 h after brain injury respectively. The expression of mRNA coding for nNOS, eNOS or iNOS were assayed using reverse transcription polymerase chain reaction (RT-PCR).

RESULTSThe expression of nNOS, eNOS and iNOS mRNA were significantly decreased in 0.25 MPa HBO treatment groups than those in acute cerebral injury groups (P < 0.01). The amount of nNOS, eNOS and iNOS mRNA was significantly lower in HBOT 24 h group than those in HBOT 6 h group (P < 0.05, P < 0.01). There was no significantly difference among nNOS, eNOS and iNOS mRNA in 0.25 MPa normoxic hyperbaric nitrogen groups and acute cerebral injury groups (P > 0.05).

CONCLUSIONHBO may exert significant effects on the expression of nNOS mRNA/iNOS mRNA and protect cortical neuronal from traumatic cerebral injury.

Animals ; Brain Injuries ; metabolism ; therapy ; Female ; Hyperbaric Oxygenation ; Male ; Nitric Oxide Synthase ; genetics ; metabolism ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley

Objective: To explore the safety and strategy of thoracic endovascular aortic repair (TEVAR) combining coronary artery bypass grafting (CABG) as one-stop performance in treating the patients with coronary artery disease (CAD) and thoracic aorta disease. Methods: A total of 20 patients received one-stop treatment of TEVAR combining CABG in our hospital from 2009-04 to 2016-01 were retrospectively analyzed. There were 18 male and the mean age of patients was (65.2±8.5, 51-82) years. The performance strategy and peri-operative management were studied. Results: There were 1/20 patient received 2 stents implantation in thoracic aorta and 19 received 1 stent in thoracic aorta those including 1 case with endovascular repair of abdominal aortic aneurysm, 1 with right iliac artery stent implantation and 1 with carotid endarterectomy at meanwhile. The average number of coronary artery bypass branch was (2.4±0.94, 1-4) and 10 (50%) patients received internal mammary artery grafting. The average in-hospital time in all 20 patients was (22.4±11.6, 8-58) days. There were 6 (30%) patients received blood transfusion; 1 (5%) having low cardiac output syndrome received extracorporeal membrane oxygenation (ECMO), then received the second thoracotomy for hemostasis due to excessive pleural effusion; 2 (10%) patients died at 30 days post-operation. 1 patient lost contact and 17 received clinical or telephone follow-up visit at the average of (13.4+13.6, 1-49) months; 2 patients died for cerebral hemorrhage at 12 and 49 months post-operation, the rest 15 had disappeared symptoms and improved quality of life, no operation related death occurred. Conclusion: TEVAR combining CABG as one-stop performance presented good mid-term effect in treating the patients with CAD and thoracic aorta disease; in otherwise, the operative time and risk might be increased by two step performance.

ObjectiveTo explore the effect of the calcium phosphate cement (CPC) /calcium polyphosphate fiber (CPPF) composites mixed with different proportion of minimal morselized bone on repair of bone defect in vivo. MethodsA total of 36 New Zealand white rabbits were completely randomly designed into A, B, C, D groups and their bilateral radial bone defect model was prepared. The minimal morselized bone (300-500 μm in diameter) was made from the iliac of those rats. The CPPF and CPC were evenly mixed into CPC/CPPF composites which were divided into four groups in accordance with the CPPF weight O, 10％, 30％ and 50％ in CPC/CPPF composite. The CPC/CPPF composites of the four groups was mixed with the minimal morselized bone with ratio of 6:4 and then the mixture was implanted the bone defect of the rabbits in four groups. The gross, X-ray and histological observations were done at four and eight weeks. The biomechanical test was performed at eight weeks. Results When CPPF occupies 30％ of the CPC/CPPF composite, the maximum compressive load and bending loads were better than those in the other groups ( P ＜ 0.05 ), when the histological observation showed the most tight link between the artificial composite and the bone interface and the closest similarity between material degradation rate and the ossification rate, with the best osteogenesis and the optimal ratio.ConclusionThe repair of bone defect can attain the optimal outcome through adding a certain ratio of minimal morselized bone into the CPC/CPPF to adjust the degradation rate of composites.

Fifteen known compounds were isolated from Swertia delavayi by silica gel, Sephadex LH-20 and Rp-18 column chromatographies. Based on extensive spectroscopic analysis (MS, 1H, 13C-NMR), their structures were identified aserythrocentaurin (1), erythrocentaurindimethylacetal (2), sweroside (3), swertiamarin (4), gentiopicroside (5), swertiakoside A (6), 2'-O-acetylswertiamarin (7), 4'-O-[(Z) -coumaroyl] swertiamarin (8), 1,5,8-trihydroxy-3-methoxyxanthone (9), 8-O-β-D-glucopyranosyl-1-hydroxy-2,3, 5-trimethoxyxanthone (10), 8-O-[β-D-xyl- opyranosyl-(1 --> 6)-β-D-glucopyranosyl]-7,8-dihydroxy-3-methoxyxanthone (11), isovitexin (12), β-sitosterol (13), daucosterol (14), and oleanolic acid (15). Among them, ten ones (14, 7-11, 13) were obtained from S. delavayi for the first time. The isolates were evaluated for their anti-HBV activities in HepG 2. 2. 15 cell line in vitro. The results showed that compound 1, 2, 6, 7, 9 and 12 exhibited significant inhibitory activity on HBV DNA replication with IC50 values from 0.05 to 1.46 mmol x L(-1).
Antiviral Agents ; chemistry ; isolation & purification ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Hepatitis B virus ; drug effects ; genetics ; Magnetic Resonance Imaging ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization ; Swertia ; chemistry

OBJECTIVETo observe the intervention effect of Leihong Granule (LG) in in-stent restenosis (ISR) after endovascular therapy for lower extremity arterial occlusive diseases (LEAOD).

METHODSRecruited 80 LEAOD patients who successfully underwent endovascular therapy (balloon dilation and stent implantation) were randomly assigned to two groups, the control group and the LG group, 40 in each group. Patients in the control group received basic treatment, while those in the LG group additionally took LG for 3 months. Plasma levels of IL-10, IL-18, CRP, and the intima-media thickness (IMT) of lower extremity artery were observed in the two groups between and after treatment. The rate of stent patency, ABI, intermittent claudication, rest pain, and the incidence of amputation the two groups were recorded and observed in the two groups.

RESULTSIn the control group, serum levels of IL-10, IL-18, CRP, and IMT were significantly higher one month after surgery than before surgery (P < 0.05). There was no significant difference in serum levels of IL-10, IL-18, CRP, or IMT between the two groups before surgery (P > 0.05). These indices were obviously lower in the LG group than in the control group after surgery (P < 0.05). Compared with the control group, the incidence rates of intermittent claudication and the rest pain at 6 months and 12 months after surgery significantly decreased (P < 0.05). The stent patency rate at 6 months and 12 months after surgery, and ABI were significantly higher than those of the control group (P < 0.05). There was no statistical difference in the amputation rate between the two groups (P > 0.05).

CONCLUSIONLG might effectively improve ischemic symptoms of affected limbs possibly through lowering the ISR rate after endovascular therapy for LEAOD through preventing immunosuppressive actions.

Aged ; Aged, 80 and over ; Arterial Occlusive Diseases ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Graft Occlusion, Vascular ; therapy ; Humans ; Interleukin-10 ; blood ; Interleukin-18 ; blood ; Lower Extremity ; blood supply ; Male ; Middle Aged ; Phytotherapy ; Stents ; Treatment Outcome

Background and Objective: For neck and upper thoracic esophageal carcinoma.three dimensional conformal radiation therapy(3DCRT)does not necessarily meet all clinical requirements while intensity modulated radiation therapy(IMRT)may take up a lot of labour power and material resources.This study was to explore the feasibility of simplified IMPT(sIMRT) and concurrent chemotherapy for neck and upper thoracic esophageal carcinoma,and to jnvestigate the acute toxicities and short-term efficacy of this treatment modality.Methods:sIMRT plans were designed for 30 patients with neck and upper thoracic esophageal carcinoma.Two target volumes were defined:PTV1, which was designed to irradiate to 64 Gy (2.13 Gy×30 fractions);PTV2,which was given to 54 Gy(1.8 Gy × 30).The sIMRT plan included five equiangular coplanar beams. All patients concurrently received DDP+5-FU regimen with radiotherapy on d 1-5 and d29-33. Chemotherapy was repeated for two cycles 28 days after radiotherapy.Results:The treatment was completed for all patients within 6 weeks, and only one patient had Grade 3 acute bronchitis.The complete response(CR)rate was 90.0%(27/30)and the partial response(PR)rate 10.0%(3/30).Overall response was 100%for esophageal lesions and the CR rate 76.5%(13/17).The PR rate was 23.5%(4/17)in lymph node lesions.The major toxicities observed were Grades Ⅰ-Ⅱ leukocytopenia.Conclusions: sIMRT can generate desirable dose distribution for neck and upper thoracic esophageal carcinoma,which is similar to sophisticated IMRT but obviously better than 3D-CRT.The short-term efficacy of sIMRT is satisfactory and its acute toxicities are tolerable.