Objective To exprole the effect of surgical management of obstructive colorectal carcinoma. Methods A restrospective analysis was made on the clinical data of 76 cases of acute obstructive colorectal carcinoma treated by emergent operation in Xiangya Hospital from October 1997 to October 2002.Among the 76 cases,there were 23 cases of right colon obstruction and 53 cases of left colon or rectal obstruction. Results All the 76 patients received opreation , 55 patients received one stage tumor resection and large intestinal anastomosis, including 19 in right colon and 36 in left colon or rectal obstruetion.Postoperative complications rate was 15.7%(11/76) in this series,including anastomotic leakage in 2, disruption of wound in 1, infection of incisional wound in 6, and pneumonia in 2.Expect one patient died of MSOF,the others were curred by non-operation therapy.The postoperative 1,3,5year survival rate was 98.3%,55%,38.5% in this series.Conclusions One stage resection and anastomosis is a feasible operation for obstructive colorectal carcinoma.Appropriate choice of the operative procedure, skillful operative technique,and prudential perioperative treatment can enhance the cuerative effect and the patients quality of life.

Objective To explore the correlative factors of mental disorder in patients with head injury. Methods 255 subjects sustained with head injury and survived from traffic accident in Chengdu were assessed with Structured Clinical Interview for DSM-Ⅳ axis Ⅰ disorders (SCID-I/P) , Personality Disorder Questionaire for CCMD-2-R(PDQC), Structured Clinical Interview for CCMD-2-R(SCICP), WAIS-RC, WMS, brain electric activity mapping (BEAM) after completion of clinical management. Based on the diagnostic criteria of organic mental disorder in CCMD-3, mental disorders in 255 subjects were diagnosed. Results The incidence of mental disorders in the patients with head injury was 72.5% (185/255). Mental disorders in patients with head injury were correlated with educational level, type and severity of the head injury, or injuries involving the left frontal lobe injury, the left temporal lobe or multiple lobes and BEAM abnormality. Conclusion The incidence of mental disorder is high in the patients with head injury. Educational level, type and severity of the head injury, the location of the injured brain, injury involving multiple lobes of the brain may affect morbidity of mental disorders in patients with head injury.

OBJECTIVE To study the correlation between nosocomial infection rate and hand hygiene compliance rate in health care workers.METHODS We analyzed the data about hand hygiene compliance rate in health care workers,nosocomial infection rate and meticillin-resistant Staphylococcus aureus(MRSA) infection rate from 2004 to 2007.RESULTS A total of 6350 hand hygiene times in health care workers in 4 years were observed.The hand hygiene compliance rate increased significantly from 34.58% to 74.52%(P

Objective To study the effect of different family nursing methods on major catheter-re-lated complications in cancer patients with peripherally inserted central catheter (PICC) during chemother-apy intermission so as to reduce the incidence of complications and prolong the indwelling time and service life of the catheter. Methods We randomly divided 213 cancer patients who were discharged from hos-pital with PICC into two groups. One group(108 cases) routinely came back to our outpatient clinic and the other (105 cases) went to the community for nursing of the catheter. Results The total incidence rate of complications of the group who came back to our outpatient clinic for nursing of the catheter was 13.8%(15/ 108) and the other group was 51.4%(54/105). There existed statistical significance between the two groups (P<0.01). Conclusions There exists correlation between different family nursing methods and catheter complication rate. We suggest patients come back to our outpatient clinic for nursing of the catheter as pos-sible as they can.

Objective: To evaluate the incidence, clinical features, diagnosis and treatment of primary ex-tranodal non-Hodgkin' s lymphoma (PE-NHL). Methods: The data of 110 patients diagnosed as PE-NHL be-tween January 2001 and May 2008 were reviewed. Results: These PE-NHL patients counted 60.11% of the 183 malignant lymphoma patients at the same period. The primary sites affected were the gastrointestinal tract 21.82% (24/110), Waldeyer ring 10.91% (12/110), nasal cavity 9.10% (10/110), soft tissue 9.10% (10/110), mediastinum 7.27% (8/110) and other unusual sites 41.82% (46/110). Symptoms and signs of PE-NHL were not specific, and 77.27% of these cases had a swelling organ or lump of the primary organ affected. Ac-cording to the International Prognosis Index (IPI), the percentage of patients in low, intermediate, and high group was 41.11%, 44.44% and 14.44%, respectively. Immunophenotype was assayed in 93 cases. The per-centage of B-cell lymphoma was 69.90% while that of T-cell lymphoma was 30.10%. For those 95 cases treat-ed, the effective rate including complete remission (61.05%) and part remission (16.84%) was 77.89%, the median survival was 30 months, and the 5-year overall survival (OS) was 27%. While, for patients with prima-ry gastrointestinal non-Hodgkin' s lymphomas (PGIL), the complete remission rate, part remission rate and the effective rate was 65.21%, 17.39% and 82.80%, respectively. The median survival was 24 months, and the 5-year overall survival (OS) was 30%. Conclusion: PE-NHL is more common than nodal lymphoma. The symptoms and signs of PE-NHL of different sites are quite different. To improve the curative strategies of PE-NHL, it is important to make an allround understanding of PE-NHL and follow reasonable mode of diagno-sis and therapy.

Objective To explore the relative factors of aggressive behaviors in inpatients with schizophrenic.Methods 178 cases of continuously admitted schizophrenic patients were divided into attack group and non aggressive group according to the aggressive behavior of preadmission.Single factor analysis and multi factor regression analysis was applied to two groups in situation(such as age,gender,education level,course of disease,past aggressive behaviors and so on),Brief Psychiatric Rating Scale (BPRS) and Eysenck Personality Questionnaire (EPQ).Results By single factor analysis,attack group had significantly longer course of disease(7.73±6.67) than non aggressive group (5.22 ± 5.47,t =2.631,P＜ 0.01).The score of hostile suspicious factor in BPRS (13.73 ± 3.098) in attack group was significantly higher than that in nonaggressive group(11.47±3.93) (t=4.063,P＜ 0.01),but anxiety factor (7.18± 3.583) was significantly lower than that in nonaggressive group (8.70 ± 3.89) (t=2.679,P＜0.01).The score of E scale of EPQ(11.99±4.340) in attack group was significantly higher than that in nonaggressive group(10.67±4.293) (t=1.990,P＜0.01).Attack group's proportion of patients of previous attacks (71.1％) was significantly higher than that in non aggressive group (16.0％),(x2 =39.082,P＜ 0.01).(2) Logistic analysis showed that hostile suspicious factor in BPRS and past aggressive behaviors entered the regression equation.Condusions Aggressive behavior in schizophrenic patients occurs mainly with psychiatric symptoms and the past history of aggressive behavior.The patients should be treated actively to control the symptoms and prevent the disease recurrence.

Objective To study the optimal procedure of digestive tract reconstruction after total gastrectomy.Methods The clinical data of 122 patients who underwent total gastrectomy in the recent 6 years were(analyzed) retrospectively.Three types of reconstruction procedures,including Orr-type Roux-en-Y(esophagojejunostomy),P-type jejunal pouch Roux-en-Y esophagojejunostomy and distal jejunal aboral pouch Roux-en-Y esophagojejunostomy,were performed.Results There were no significant differences among the three procedures in heartburn and the amount of food intake,frequencies of meal,weight loss,dumping(syndrome),and hemoglobin and albumin levels.The operation time in P-type group was longer than the other two group(P

Objective To make etiological and epidemiological investigation on the infection of Angiostrongylus canto-nensis in 8 pupils in Changle City. Methods (1) CSF of patients was examined with the conventional method to detect pathogens and eosinophiles. (2) The fecal samples of wild rodents were collected from the spot and examined microscopically to discover the first stage larvae of A. cantonensis. (3) Snails (Pila gigas) were collected in the spot. The smashed head tissue was examined for the third stage larvae of A. cantonensis. (4) The patient's clinical symptoms and physical signs were recorded with an emphasis on central nervous system. Results (1) Two larvae of the third stage of A. cantonensis were found in CSF of one patient. Eosinophiles occupied 68% of the cell number in average (ranged from 47% to 83%) in CSF of the 8 patients. (2) The infection rate of the first stage larvae of A. cantonensis was 39.3% (44/112) in feces of the rodents. (3) The infection rate of the third stage larvae of A. cantonensis was 40. 0% (82/205) in the snails. (4) Major clinical manifestations in the 8 patients included: severe headache(8/8), dizziness(8/8), nausea(8/8), vomiting(8/8), lethargy(7/8), lower limb hypody-namia(7/8). Conclusion The confirmation of severe infection of A. cantonensis in 8 child patients demonstrated that a natural nidus of angiostrongyliasis is present in Chengle City.

OBJECTIVE: To investigate the effect of surgical management and prognosis of left obstructive colorectal carcinoma. METHODS: Clinical data of 109 patients with acute left obstructive colorectal carcinoma treated by emergent operation in Xiangya Hospital from October 2000 to February 2008 were retrospectively analyzed. RESULTS: All the 109 patients received operation. Of them, 66 patients received one stage tumor resection and intestinal anastomosis. Postoperative complication rate was 26.6%(29/109) and mortality rate was 0.9%(1/109). The postoperative 1-, 3-, and 5-year survival rates were 94.4%, 73.3%, and 43.2%, respectively. The 1-,3-,and 5-year survival rates of patients receiving curative resection were 100.0%,93.6%, and 66.7%, respectively. With univariate analysis, radical resection, Dukes stage, tumor differentiation, and chemotherapy were found to be significant factors associating with the overall survival. With multivariate analysis, radical resection independently affected the overall survival. CONCLUSION One stage radical resection and anastomosis are feasible for left obstructive colorectal carcinoma. Appropriate choice of the operative procedure, skillful operative techniques, and prudential peri-operative treatment can enhance the curative effect and patients quality of life.
Adult ; Aged ; China ; epidemiology ; Colorectal Neoplasms ; complications ; surgery ; Female ; Humans ; Intestinal Obstruction ; etiology ; surgery ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Prognosis ; Retrospective Studies ; Survival Rate

Objective To deplore the immunoregulatory function changes of mesenchymal stem cells(MSCs)from multiple myeloma(MM)patients and its effects on the pathogenesis of myeloma bone disease.Methods MSCs from MM patients and normal controls were isolated and the immunophenotype was detected.Real-time PCR was performed to detect the expressions of TGF-β1,TGF-β2,TGF-β3,IL-6,IL3,TNF-α,FasL and RANKL of MSCs.Transwell coculture systems were performed between MSCs and T cells.Lymphocyte proliferative assay was employed to detect the effect of MSCs on T cell proliferation.The effect of MSCs on T cell cycle and T cell activation markers CD25 and CD69 expression were analyzed by flow cytometry.Cleaved caspase 3 protein by western blot and hoechst 33258 staining were employed to detect the apotosis of T cells.Influence of T cells on the osteogenesis potential of MSCs were detected by Von kossa stain,real-time PCR and Western blot.Results MSCs from both MM patients and normal controls possessed similar morphology and immunophenotypes.MM derived MSCs exhibited increased expressions of TGF-β1,IL-6,IL-3,TNF-α and RANKL and decreased expression of TGF-β2,TGF-β3 and FasL.The inhibitory effect of MM derived MSCs on T cell proliferative ability was attenuated compared to control MSCs.MSCs from normal controls silence more T cells in Go/G1 phase than those from MM patients.The daupening effect of MM derived MSCs on activation-induced T apoptosis seemed to be enhanced.Expression of T cell activation markers were significantly inhibited by MSCs from normal controls.Both T cells cocultured with MM deprived MSCs and T cells directly from MM patients inhibited osteogenesis potential of MSCs from normal controls.Conclusion MSCs from MM patients showed impaired immunoregulatory capability on T cells.The activated T cells,in turn,inhibited the osteogenesis potential of MSCs.This may participate in the pathogenesis of myeloma bone disease.