Objective To analyze postoperative effect of a new rectopexy technique with Douglas pouch elevation for complete rectal prolapse (CRP) in adults.Methods From January 2010 to May 2011, 52 CRP cases were treated by rectopexy with Douglas pouch elevation.In terms of different surgical techniques, patients were divided into two groups : Group A (n =28) received laparoscopic rectopexy with Douglas pouch elevation;and Group B (n =24) received laparoscopic rectopexy with Douglas pouch elevation combined with procedure for prolapse and hemorrhoids (PPH).Rectal prolapse, constipation, and fecal incontinence in the two groups were assessed respectively before surgery, and on the 6th, 12th, and 24th month after surgery, postoperative complications were evaluated with severe grading of surgical complications.Results Symptoms of rectal prolapse disappeared at half a year after surgery in all patients, and relapsed to different extent afterwards.However, two years after operation, the status of rectal prolapse in Group B tended to be stable.The trend of constipation after surgery was consistent with that of rectal prolapse.In addition, fecal continence improved gradually on half a year after surgery in the two groups and recovered to the optimal status in the first postoperative year.However, in the second year, the results of fecal incontinence reduced slightly in Groups A, and Group B became stable.Two years after surgery, four cases in Groups A relapsed while there was no recurrence in Group B.Difference of Grade I to Grade Ⅲ complications among the two groups was statistically insignificant (x2 =0.05, P ＞ 0.05).Conclusions The clinical effect of laparoscopic rectopexy with Douglas pouch elevation associated with the procedure for prolapse and hemorrhoids (PPH) is better than that without PPH for female and male CRP patients with severe symptoms.

0.05).The positive rate of Uu in biovar 2 show a significant difference(P0.05).(2)The fallopian tubes infected by biovar2 have a high rate(90%)of ciliary adhesion and exuviation.While there is a low rate(10%)for biovarl with ciliary adhesion and exuviation.There was significant difference between the two groups of Uu (P

Objective To investigate the stress status of neurology nurses and related factors in grade Ⅲclass A hospital.Methods 185 neurology nurses selected by the convenience sampling method were surveyed with a questionnaire for basic information and work stressor scale and analysed by SPSS 11.5.Results The major source of work stress of neurology nurses was shown to be nursing profession and work(3.00±0.56)score,the overall score of the work stress was (2.52 ±0.46).Factors shown signigicant affect on the work stress included the marital status single(2.43 ±0.42) and married(2.60±0.48)(t =6.382,P ＜0.05) ; professional ranking between entry rank and junior professional rank;entry rank and medium rank (t=25.258,4.185,respectively;P ＜0.05),health condition:between very good and bad;good and average;good and bad (t =4.058,10.734,8.215,respectively;P ＜0.01) and sleep quality:between no sleep disorders and suspicious of insomnia;no sleep disorders and insomnia (t =4.061,9.195,respectively;P＜0.05).Related factors of work stress of neurology nurse by linear regression analysis were educational level,whether the individual has siblings or not,professional ranking,marital and family status,work schedule,sleep quality,self-evaluation of work performance and health.Conclusions Administrative staft of hospital should value the related factors affecting working stress of neurology nurses and take targeted measures to cope with these factors,relieve the stress of neurology nurses and improve the nursing quality.

Objective To explore the optimal diagnosis and treatment strategy of tumors at the foramen magnum,the clinical characteristics were analyzed retrospectively.Methods The clinical data of 58 cases with foramen magnum tumors treated with microsurgery in our department were collected and analyzed retrospectively.And intraoperative neurophysiological monitoring was employed in later 21 cases.Results Gross total resection was achieved in 48 of the 58 cases ; Five of the 10 patients with VA encased by tumors were totally resected.Full resection was achieved in 43 of the last 48 cases.Forty-three of the 47 cases with intradural tumors got complete resection,and total resection was achieved in 3 and 2,respectively,in 9 intra-extradural communicated tumors and 2 extradural ones.Symptoms were significantly improved in 50 cases,worsened in 5 patients,and maintained stable in the last 3 patients.Post-operative symptoms were obviously improved in the later 21 cases with intraoperative neurophysiological monitoring employed and the therapeutic effect of the treatment was much better than the former cases.Three patients died postoperatively.Fifty cases got complete follow-up from 6 months to 3 years.Among them,forty-four patients had a KPS score of 80-100,but the other 6 patients less than 80.Conclusion Microsurgical treatment for foramen magnum tumors is effective.Optimal surgical approaches and precise micro-operative techniques are crucial for the tumor removing.It is quite difficult and risky to fully resect the intra-extradural communicated tumors and the ones encasing vertebral artery.Preoperative evaluation should be profound.The application of intra-operative electrophysiological monitoring and the timely management of post-operative complications can improve the prognosis obviously.

The cyanuric chloride linkers have been used for cyclizing polypeptide, but not used for α-conotoxin, the peptides with rich disulfide bonds and more amino acid residues. In this study, cyclic peptides c[A10L]PnIA-1-4 were synthesized efficiently by lysine assisted cyanuric chloride linkers with 28.92%-52.00% yields. The activity evaluation showed that the IC₅₀ values of c[A10L]PnIA-1 against α7 and α3β2 nAChR subtypes were 5 and 7 times higher than [A10L]PnIA respectively, and the subtype selectivity was maintained. The results of circular dichroism show that this cyclization method had no significant effect on its secondary structure. Compared with the commonly used head-to-tail cyclization in conotoxin cyclization, this method has the advantages of rapid reaction and high yield, which is expected to be further applied to the cyclization study of various α-conotoxins.

Adult ; Blood Pressure ; Extracorporeal Membrane Oxygenation ; Female ; Heart Rate ; Humans ; Myocarditis ; complications ; physiopathology ; therapy ; Shock, Cardiogenic ; etiology ; physiopathology ; therapy

Objective To investigate the left ventricular remodeling (LVR) patterns and its relationships with cardiovascular risk factors in patients with obstructive sleep apnea syndrome (OSAS).Methods 148 patients with habitual snoring were diagnosed OSAS by polysomnography with AHI≥5 /h and blood pressure was monitored at same time.The clinical characteristics were collected and echocardiography was done next morning.LVR patterns was categorized as normal geometry (NG),concentric remodeling (CR),eccentric hypertrophy (EH) and concentric hypertrophy (CH) on the basis of RWT ＞0.42 and LVMI ＞46.7 g/m2.7 (female) or 49.2 g/m2.7 (male).Multinomial logistic regression was used to analysis the correlation of cardiovascular risk factors and LVR patterns.Results ①Of 148 OSAS patients,there were 115 (77.7％) with abnormal LVR,NG 33 (22.3％),CR 35 (23.6％),EH 37 (25％)and CH 43 (29.1 ％).②General clinical characteristics:Compared with NG group,BMI and waistline were increased in EH group (P ＜0.05 or P ＜0.01) ; Age,BMI,waistline,hypertension,dSBP and nSBP were increased in CH group (P ＜0.05 or P ＜0.01).Compared with CR group,male,age,BMI and waistline were increased in EH group (P ＜0.05 or P ＜0.01).Male,age,BMI,waistline,hypertension,nSBP and TG were increased in CH group (P ＜ 0.05 or P ＜ 0.01); Compared with EH group,the prevalence of hypertension was increased in CH group (P ＜0.05); Compared with EH group,the prevalence of hypertension was increased in CH group (P＜0.05).③Polysomnography parameters:Compared with NG group,AHI and ODI were increased in CR group (P＜0.05 or P＜0.01).AHI,ODI and T90 were increased,while Mean SaO2 and Lowest SaO2 were decreased in CH group (P ＜0.05 or P ＜ 0.01);Compared with CR group,AHI was decreased in EH group (P ＜0.05).Mean SaO2 was decreased,but T90 was increased in CH group (P＜0.05 or P ＜0.01); Compared with EH group,Lowest SaO2 was decreased in CH group (P＜0.05).④Blood pressure:Compared with NG group,4:00 SBP and 6:00 SBP were increased in CH group (P＜0.05) ;Compared with CR group,22:00 SBP was increased in CH group (P ＜0.05).⑤ In multinomial logistic regression analysis,after adjusting the confounding factors,CR was associated with AHI [odds ratio (OR) 1.035,P =0.024.EH was associated with Age (OR 1.094,P =0.016),BMI (OR 1.397,P =0.011) and 4:00 SBP (OR 1.124,P =0.026).CH was associated with Age (OR 1.084,P =0.028).Conclusions OSAS could cause result in LVR and the prevalence of four patterns were similar..Age and AHI were significant determinants of CH and CR respectively.Age,BMI and 4:00 SBP were significant determinants of EH.

OBJECTIVETo evaluate the clinical efficacy of treating myelodysplastic syndrome (MDS) by hematopoietic stem cell transplantation (HSCT) combined with Chinese medical syndrome typing.

METHODSFrom July 2009 to July 2013, 6 MDS patients were treated with allo-HSCT combined with Chinese medical syndrome typing from HLA-identical sibling donors at Department of Hematology, Zhejiang Provincial Hospital of Chinese Medicine. Patients were classified as refractory anemia (RA, 2 cases), refractory anemia with ringed sideroblast (RARS, 1 case), refractory cytopenia with multilineage dysplasia (RCMD, 2 cases), and RA with excess blasts-I (RAEB-I , 1 case). Modified BuCy conditioning regimen was used in all 6 cases. Two patients received bone marrow transplantation (BMT), 1 patient received peripheral blood stem cell transplantation (PBSCT), and 3 patients received BMT + PBSCT. In order to prevent the occurrence of graft-versus-host disease (GVHD), all patients were treated with cyclosporine + methotrexate + mycophenolate mofetil. Different Chinese medical treatment methods (by syndrome typing) were given to patients according to different criticality of international prognostic scoring system (IPSS, 5 at moderate risk and 1 at high risk).

RESULTSAll 6 patients successfully reconstructed their hematopoietic system. The time from transplantation to ANC ≥ 0.5 x 10(9)/L and platelet (PLT) ≥ 20 x10(9)/L were 13 (9-15) days and 11 (9-22) days respectively. Main complications were GVHD. Acute GVHD (aGVHD) occurred in 4 cases, 3 cases of grade I and 1 case of grade II, and local chronic GVHD (cGVHD) occurred in 1 patient. All cases survived with median follow-up of 18 (11-58) months. The overall survival (OS) and disease-free survival (DFS) rate were 100%.

CONCLUSIONSHSCT combined with Chinese medical syndrome typing could improve clinical symptoms, reduce transplant as- sociated complications. So it was an effective treatment choice for MDS.

Biomedical Research ; Blood Platelets ; Bone Marrow Transplantation ; Cyclosporine ; therapeutic use ; Disease-Free Survival ; Drugs, Chinese Herbal ; therapeutic use ; Graft vs Host Disease ; prevention & control ; Hematopoietic Stem Cell Transplantation ; Humans ; Medicine, Chinese Traditional ; Methotrexate ; therapeutic use ; Myelodysplastic Syndromes ; therapy ; Transplantation Conditioning ; Transplantation, Homologous ; Treatment Outcome

Objective To study the effect of different concentrations of fluoride on cultured human umbilical vein vascular endothelial cells(HUVEC). Methods Different doses of sodium fluoride (NaF) were added to HUVEC culture medium, fluoride concentrations were 0(control), 100,400,700,1000,2000 μmol/L, respectively,6 re-set hole in each group. After continuous culture for 48 h, cells and culture medium were collected. Cell morphology was studied by Wright-Giemsa staining; cells apoptosis was determined by acridine orange fluorescence staining; cell activity was measured by methyl thiazolyl tetrazolium (MTT) assay; superoxide dismutase (SOD),glutathione peroxidase(GSH-Px) activity, malonaldehyde(MDA) content, induced nitricoxide synthase(iNOS), and endothelia nitricoxide synthase(eNOS) activity in cell culture medium were determined by spectrophotometry; cell iNOS mRNA and eNOS mRNA expression were detected by RT-PCR; intercellular adhesion molecule-1 (ICAM-1)and vascular cell adhesion molecule-1 (VCAM-1) levels were detected by double antibody sandwich ELISA method.Results With increased dose of fluoride, HUVEC cells decreased, the structure changed. In 400 - 2000 μmol/L group, the SOD activity[(6.627 ± 0.213), (6.668 ± 0.152), (5.935 ± 0.122), (4.755 ± 0.182)kU/L] was lower than those of the control group[(7.457 ± 0.398)kU/L, P ＜ 0.05 or ＜ 0.01], GSH-Px activity[(481.284 ± 43.785),(492.223 ± 16.474), (382.762 ± 25.167), (293.687 ± 24.881 )kU/L] was also lower than those of the control group [(585.078 ± 47.323)kU/L, P ＜ 0.05 or ＜ 0.01], MDA level[(0.609 ± 0.011 ), (0.646 ± 0.016), (0.852 ± 0.013),(1.188 ± 0.045)nmol/L] was higher than those of the control group[(0.512 ± 0.027)nmol/L, P ＜ 0.05 or ＜ 0.01];iNOS activity[(3.604 ± 0.115), (3.615 ± 0.075), (3.848 ± 0.103), (4.275 ± 0.079)kU/L] also was higher than those of the control group[(2.798 ± 0. 136)kU/L, all P ＜ 0.01], iNOS mRNA expression increased, eNOS activity [(5.539 ± 0.079), (5.503 ± 0.064), (5.226 ± 0.142), (4.809 ± 0. 107)kU/L] decreased compared to those of control group[(5.996 ± 0.155)kU/L, P ＜ 0.05 or ＜ 0.01], eNOS mRNA expression decreased; ICAM-1 levels [(0.852 ± 0. 102), (0.886 ± 0.061 ), (0.961 ± 0.158), (1.418 ± 0. 167)μg/L] increased compared to those of the control group[(0.687 ± 0.046)μg/L, P ＜ 0.05 or ＜ 0.01], VCAM-1 levels[(2.719 ± 0.197), (2.946 ± 0.167),(3.173 ± 0.225 ), (3.613 ± 0. 153 ) μg/L] was higher than those of the control group [(2.375 ± 0.067 ) μg/L, all P ＜0.01]. Conclusions High concentrations of fluoride reduce the activity of antioxidant enzymes, which leads to metabolic disorders of nitric oxide and abnormal cytokines expression, thereby inhibiting vascular endothelial cell growth, structural change and induced apoptosis. This is an important factor in high fluoride-induced vascular endothelial injury.

Objective - To analyze the relationship between cobalt level of post shift urine and individual exposure level of ， cobalt and its compounds in cobalt exposed workers and to explore the feasibility of using urine cobalt as a biomarker. Methods - A total of 148 occupational cobalt exposed workers from a new material company were selected as the exposed ， - - group and 44 non occupational cobalt exposed workers from the company were selected as the control group using the typical sampling method. The exposure concentration of time weighted average of cobalt and its compounds in the workplace air of the - two groups was determined by inductively coupled plasma mass spectrometry as the individual exposure level. The cobalt levels - - of pre shift and post shift urinary samples of the two groups were detected by this method. The linear relationship between the - cobalt level of post shift urine and the individual exposure level of cobalt and its compounds in the air of the workplace was Results - 3 analyzed. The individual exposure level of cobalt and its compounds in the exposed group was 1.10 131.71 μg/m with （M） 3 the median of 12.23 μg/m. No cobalt and its compounds were detected in the workplace air in the control group. The cobalt - - levels of pre shift and post shift urines in exposed group were higher than those in the control group at the same time point （M： vs ， vs ， P ） - - 1.54 0.56 μg/L 8.77 0.83 μg/L all <0.01 . The cobalt level of post shift urine was higher than that in pre shift （M： vs ，P ）， urine in the exposed group 8.77 1.54 μg/L <0.01 and it was positively correlated with the individual exposure level （ ，P ） ， of cobalt and its compounds Spearman correlation coefficient=0.86 <0.01 . After common logarithm conversion the linear regression equation of the cobalt level of post shift urine and the common logarithm of individual exposure level of cobalt and （x） ：ŷ x（ ；F ， its compounds in the exposed group was as follows = −0.178 + 0.988 coefficient of determination=0.72 =374.75 P ；t ， P ） Conclusion - <0.01 = - 19.36 <0.01 . There was a linear correlation between cobalt level of post shift urine and occupational cobalt exposure level of cobalt exposed workers. Urinary cobalt can be used as a biomarker of occupational cobalt