Objective To investigate the clinical effective of laparotomy or laparoscopic total mesorectal excision surgery for patients with colorectal cancer. Methods One hundred and one patients with colorectal cancer in the Beijing Jiangong Hospitalour were selected as our subjects and divided into control group and treatment group. Patients in control group were received laparotomy and patients in treatment group were performed laparoscopic total mesorectal excision surgery. Clinical effective were recorded. Results The blood loss volume,postoperative discharge time,postoperative indwelling catheter time,hospital stay in treatment group were(143. 9 ± 32. 3)ml,(3. 1 ± 1. 2)d,(3. 5 ± 1. 4)d and(11. 9 ± 2. 1)d,less than those in control group ((198. 9 ± 41. 2)ml,(5. 3 ± 1. 3)d,(6. 1 ± 1. 5)d and(16. 9 ± 2. 3)d respectively). And the differenced were significant(t = 4. 994,9. 858,6. 543,6. 593;All P < 0. 05). The operation time,hospital cost in treatment group were(213. 4 ± 45. 3)min,(3. 5 ± 0. 5)ten thousands,higher than those in control group((153. 4 ± 43. 4)min, (2. 8 ± 0. 4)ten thousands),and the differences were significant(t = 7. 653,6. 593;P < 0. 05). There was no significant difference between the two group in term of the number of resected lymph nodes( t = 0. 882,P> 0. 05). There were no significant difference between two group in terms of NK,CD3 + ,CD4 + and CD8 + level (P > 0. 05)at before treatment. The NK,CD3 + ,CD4 + and CD8 + levels in control group after treatment were 8. 3 ± 0. 9,(64. 5 ± 4. 8)% ,(34. 3 ± 3. 0)% and(32. 8 ± 2. 4)% and those were 13. 0 ± 1. 0,(71. 9 ± 5. 1)% ,(45. 2 ± 3. 2)% and(26. 1 ± 2. 2)% in treatment group after treatment. The differences were significant( t = 5. 488,8. 481,4. 954,7. 493;P < 0. 05 ). The wound infection rate of control group was significantly higher than this of treatment group(1. 8% vs. 11. 4% ;χ2 = 4. 103;P < 0. 05). There was no significant difference between the two group in terms of other complications( P > 0. 05). Conclusion The clinical effective of laparoscopic total mesorectal excision surgery is better than laparoscopic surgery.

Aim To evaluate the effect of 15d-PGJ2 on up-regulated expression of PPAR? and inducing HSC apoptosis and inhibiting HSC proliferation. Methods The rat liver stellate cell line (HSC-T6) was cultured in DMEM, and treated with PPAR? agonist 15d-PGJ2 of different concentrations. The expression of PPAR? mRNA was detected by RT-PCR. The protein expression of NF-?B was examined by Western blot. The cell proliferation rate of HSC-T6 was determined by MTT colorimetric assay. The cell cycle and apoptosis ratio were measured using flow cyto -metry analysis. Results The proliferation rate of the rat liver stellate cell line (HSC-T6) was significantly inhibited by 15d-PGJ2 (vs controls, P

Objective:To investigate the risk factors, clinical features and prognosis of abnormal liver function after receiving oxaliplatin-containing chemotherapy regimen in patients with colorectal cancer, and to provide a relevant basis for clinical diagnosis and treatment.Methods:The clinical data of 108 colorectal cancer patients who received XELOX (oxaliplatin+capecitabine) or mFOLFOX6 (oxaliplatin+leucovorin+ 5-fluorouracil) chemotherapy regimen from October 2017 to May 2019 in the First Hospital of Shanxi Medical University were analyzed retrospectively. According to the liver function indexes after chemotherapy, the patients were divided into abnormal liver function group and normal liver function group. The observation indexes included alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, alkaline phosphatase, γ-glutamyl transpeptidase. The clinical characteristics of liver dysfunction after oxaliplatin-containing chemotherapy were analyzed and the related factors that might lead to liver dysfunction were analyzed by using multivariate logistic regression analysis.Results:Among 108 patients receiving chemotherapy, there were 67 (62.0%) cases of abnormal liver function. The main grades of liver dysfunction were grade 1 and grade 2, including 49 cases of grade 1 (73.1%) and 16 cases of grade 2 (23.9%). After chemotherapy, the abnormal liver function usually began in 1-4 cycles, of which 22 cases were 1 cycle (32.8%), 17 cases were 2 cycles (25.4%), 20 cases were 3 cycles (29.8%), and 4 cases were 4 cycles (6.0%). Univariate analysis showed that the age <60 years old, chemotherapy cycle >6, the use of mFOLFOX6 regimen, unprotected hepatoprotective drugs were related to liver dysfunction ( χ2 values were 3.910,4.799, 12.861, 4.044; all P < 0.05). Multivariate logistic regression analysis showed that mFOLFOX6 regimen and unprotected hepatoprotective drugs were independent risk factors of abnormal liver function ( HR = 3.405, 95% CI 1.266-9.159, P = 0.015; HR = 2.348, 95% CI 1.012-5.477, P = 0.047). Conclusions:For patients with colorectal cancer who have a high risk of liver dysfunction after chemotherapy, it is recommended to prefer XELOX regimen among oxaliplatin-containing chemotherapy regimens and to take preventive liver protection treatment.

OBJECTIVE:To study the effects of Xiaoruzeng capsule on the gastric acid and pepsin in rats. METHODS:Rats were randomized into a blank group (distilled water),a positive control group (3.6 mg/kg omeprazole ) and the groups of low, middle and high doses of Xiaoruzeng capsule [2.25,4.5,9.1 g(crude drug)/kg]. These groups were respectively marked as groups A,B,C,D and E,with 10 rats in each group. All the rats were given corresponding drugs,ig,for consecutive 10 d. Their suc-cus gastricus was collected 3 h after the last administration,and determined for pH value with precision pH test strip and for free acidity and total acidity by acid-base neutralization titration method. The content and activity of pepsin were determined and calculat-ed with the test kit and microplate reader. The pathological change of the stomach was observed under the electron microscope. RE-SULTS:Compared with group A,groups B,C and D had higher pH value of succus gastricus;groups C,D and E had lower free acidity;groups B,C and D had lower total acidity,group E had higher total acidity;groups B,D and E had lower activity of pep-sin;and group C had higher content of pepsin. Compared with group B,group D had lower pH value of succus gastricus;group C had lower total acidity;group E had higher acidity;and groups C,D and E had higher activity of pepsin. There was statistical sig-nificance(P<0.01 or P<0.05). Gastric mucosal erosive haemorrhage was noted in three rats in group E,and other groups demon-strated no obvious pathological change. CONCLUSIONS:Low dose of Xiaoruzeng capsule can slightly inhibit the gastric acid in rats,but will not effect the activity of pepsin.

OBJECTIVETo explore the value of spinal canal and dural sac dimensions for the treatment of lumbar disc herniation in MRI.

METHODSThe clinical data of 144 patients with single-level lumbar disc herniation underwent nonsurgical or surgical treatment from January 2010 to December 2012 were retrospectively analyzed. There were 91 patients in the nonsurgical group, including 55 males and 36 females, ranging in age from 20 to 68 years old with an average of (43.37±12.48) years; and there were 53 patients in the surgical group, including 28 males and 25 females, ranging in age from 20 to 64 years old with an average of (42.98±12.95) years. JOA scores (29 scores) were used to evaluate clinical manifestation (including subjective symptoms, objective findings, limitation of daily activities and bladder function) and outcomes. The parameters related to spinal canal and dural sac dimensions (including spinal canal midsagittal diameter and available diameter, lateral recess width, spinal canal and dural sac cross-sectional area) in the initial axial T2-weighted MRI were measured, and odds ratio of available diameter to midsagittal diameter, odds ratio of lateral recess width to midsagittal diameter and area ratio of dural sac to spinal canal were calculated. Then, the differences of all parameters between two groups, and the correlations with initial JOA scores were analyzed.

RESULTS(1) All patients were followed up from 1 to 3 years with an average of 2.1 years. JOA scores before treatment were 16.27±2.96 in nonsurgical group and 12.64±3.30 in surgical group, there was statistically significant difference (t=6.319, P<0.01). At final follow-up time, there was no statistically significant difference in JOA scores (25.41±2.22 vs 25.76±2.29), improvement rate [(72.95±12.54)% vs (76.80±9.45)%], and the excellent and good rate (84.91% vs 78.02%) between two groups (P>0.05). But, the relapse rate of nonsurgical group was higher than surgical group (14.29% vs 5.67%). (2) Spinal canal midsagittal diameter and available diameter, lateral recess width, spinal canal and dural sac area, the ratio of available diameter to midsagittal diameter, and the ratio of lateral recess width to midsagittal diameter in surgical group were smaller than that of nonsurgical group, but the area ratio of dural sac to spinal canal was larger, and there were statistically significant differences between two groups (P<0.01). (3) The initial JOA scores showed significantly positive correlation with spinal canal midsagittal diameter and available diameter, lateral recess width, and canal and dural sac area (P<0.01); also presented positive correlation with the ratio of available diameter to midsagittal diameter and the ratio of lateral recess width to midsagittal diameter (P<0.05); but there was a significantly negative correlation between initial JOA scores and the area ratio of dural sac to spinal canal.

CONCLUSIONBoth nonsurgical and surgical treatment of lumbar disc herniation can obtain good effect, but the recurrence rate of non-surgical treatment is higher. Preoperative MRI measurement parameters of spinal canal and dural sac dimensions has certain value for the treatment selection of lumbar disc herniation, but further refinement and validation is still required.

Adult ; Aged ; Dura Mater ; pathology ; Female ; Humans ; Intervertebral Disc Displacement ; pathology ; therapy ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Spinal Canal ; pathology

Papers published by 70 public hospitals in Jilin Province from 2011 to 2015 were retrieved from CNKI, China Citations Database, and Wanfang Database. The scientific papers and their research hot spots were analyzed in aspects of the total number of published papers and different institutions-published papers, high output authors, cited papers, journals that published the papers, and foundation-supported papers in order to provide reference for subsequent research and policy-making.

OBJECTIVETo investigate the density and distribution of nerve endings and neuropeptide Y (NPY) in lumbar facet joints of patients with low back pain.

METHODSFifteen patients without low back pain were selected as control group (group A). Facet joint samples in group A were obtained during the operation or lumbar spinal canal tumor they suffered from. Those patients with low back pain were divided into three groups according to their different origins of pain, such as not from facet joint (group B, 15 patients) ,from facet joint only (group C, 20 patients), or from facet joint partially (group D, 20 patients). Different origins were determined by VAS after facet joint block. The density and distribution of nerve ending and neuropeptide in the capsular tissues were analyzed by a modified gold chloride staining and immunochemistry respectively.

RESULTSCompared with the ones in group A and B, the fact joints in group C and D were more inclined to be degenerated and got more nerve endings. NPY was expressed mainly in the facet joint of patients with low back pain in group C and D. In addition, there was a significant relationship between the distribution of nerve endings and NPY expression,while none of them were related with MRI Fujiwara grade of facet joint.

CONCLUSIONThese results suggest that the number of mechanoreceptors, neural sprouting and secreted peptides in the facet joint capsules vary with the change of mechanical or nociceptive stimulation, which may promote the development of low back pain in return.

Adult ; Aged ; Case-Control Studies ; Chronic Pain ; etiology ; metabolism ; pathology ; Female ; Humans ; Low Back Pain ; etiology ; metabolism ; pathology ; Male ; Mechanoreceptors ; physiology ; Middle Aged ; Nerve Endings ; pathology ; Neuropeptide Y ; analysis

Nine hundred and forty nine general physicians in Beijing urban area received surgical skill assessment in 2008.The assessment results of five surgical skills (taking out stitches,changing dressings,skin suture,knot with gloves and wearing isolation gown) were analyzed with the relations of different gender,age,educational background,professional title,specialty,hospital grade,length of service and times of test taking.The average score of the total assessment was 71.The score was lower in the practitioners who were male,older than 50 years,higher educational background,lower professional tide,more than 2 times of test taking,and who were specialized in traditional Chinese medicine,ophthalmology and otorhinolaryngology and emergency medicine.Results suggest that the levels of surgical skills in general practitioners are generally low and periodical training is needed.

Objective To investigate the clinical efficacy and mechanism of vacuum-assisted closure (VAC) in the preoperative and postoperative treatment of bedsore united with skin flap.Methods Twenty two cases with bedsore were randomly divided into experimental and control groups.In the control group,the surgery of flap was performed after the treatment of continuous negative pressure about 7-10 days and the VAC was not applied after operation.While in the experimental group,VAC was not used before operation.It was applied on flaps as soon as sutured the border of flap and decubitus ulcers and removed after 7-10 days.By comparing the general appearance of two groups,microvessel count and the detection rate of bacterial culture and other indicators,the clinical effects of two treatments were investigated and the preliminary mechanism was analyzed.Results After preoperative VAC treatment,11 cases of control group showed a little granulation tissue growth,less subcutaneous hematoma and wound effusion,increased microvessel count and negative bacterial culture.However,there were 4 cases of death cavity residual,subcutaneous hematoma and wound effusion,positive bacterial culture and another 4 cases of delayed healing with skin flap repairing bedsore.The application of VAC in experimental group showed close contact of flap with the basement,less effusion,increased microvessel count and negative bacterial culture.One case of skin flap had a small area of separation,after the dressing of skin and the flap survived.The other wounds healed by first intention.Conclusions The use of VAC to repair bedsore can reduce the number of operation,and it is beneficial to the flap survival.

Objective To evaluate the diagnostic value of contrast-enhanced digital subtraction MRI in vertebra]metastatic tumors.Methods Forty-four vertebral metastatic tumors in thirty patients were scanned by routine MRI including SE T_1WI,SE T_2WI,STIR and enhanced T_1WI with an injection of Gd-DTPA(0.1 mmol/kg).Digital subtraction was performed between pre-contrast and enhanced T_1 weighted images.All the images of vertebral malignant tumors were evaluated by means of signal intensity ratio(SIR) and nose ratio(NR).The quality of images was also evaluated by comparing subtraction MRI with routine MRI.Results SIR and NR of subtraction MRI was 2.93,0.98 respectively.SIR of routine MRI (enhanced T_1WI,SE T_1 WI,SE T_2WI,STIR)was as follows:1.15,1.16,1.26,1.69.While NR of those was 5.25,3.44,4.56,23.32 respectively.SIR and NR of subtraction MRI images had significant statistical differences from those of routine MRI images(P