Objective To review the preliminary experience of primary laparoscopic pull-through for Hirschsprung's Disease in children.Methods Since May 2000,25 patients with Hischsprung's disease underwent Laparoscopic Pull-Through. The oldest age was 6 years old and the youngest was 20 days. All patients underwent anesthesia and tracheal intuition, carbon dioxide was insufflated into abdominal cavity via a Veers needle, reaching a insulation pressure of 1.33～1.86 kPa (10～14 mmHg). One umbilical camera port one-instrument port at left abdomen and one instrument port at right abdomen were made.Results The mean operative time was 165-min. Oral feeding was started 3 days postoperatively. The average hospitalization was 9 days (7～10 days).No complication was encountered.Conclusions Primary laparoscopic Pull-Through for Hirschsprung's Disease in children is safe and feasible.

Objective To present our experience with laparoscopic pyloromyotomy and laparoscopically assisted endorectal pull through for Hirschsprung's disease (HD) in newborns and infants.Methods Twenty newborns or infants with hypertrophic pyloric stenosis and HD,age ranged from 16～120 days and weight from 2.7～8 kg.Under epidural anesthesia and tracheal intubation,carbon dioxide was insufflated into abdominal cavity via a Veress needle,reaching an insufflative pressure of 12～14 mm Hg.One umbilical and two or three subcostal canulas for instrumentation were demanded.The pyloromyotomy was performed in patients with hypertrophic pyrolic stenosis and in patients with HD the affected colon and rectum were mobilized by dissecting the supplying vessels and cutting the peritoneal reflection,and pull-through procedure was carried out.Results The operation time was 25～150 minutes with rare complications.Oral feeding was resumed on the following day postoperation.The patients recovered and discharged from hospital 3～7 days after operation.Conclusions Laparoscopic pyloromyotomy and laparoscopic endorectal pull-through for HD in newborns and infants are safe and feasible.The advantages of this procedure include minimal trauma to abdomen,rapid restoration of stomach and bowel function and quick rehabilitation.

Objective To explore the clinical effect of traditional Chinese medicine and western medicine in treatment of patients with angina pectoris. Methods 120 cases with angina pectoris admitted in the Fourth Hospital of Baotou City from May 2012 to August 2013 were randomly divided into treatment group (n=60)and control group (n=60). All patients were given secondary prevention of coronary heart disease,and besides this, treatment group were added nitrates medications and traditional Chinese medicine treatment,while control group were only given nitrates medications.The treatment course was 14 days. The efficacy of angina pectoris,nitroglycerin loss rate and electrocardiogram efficacy were compared and the safety were evaluated between two groups. Results The efficacy of angina pectoris in treatment group was 90.00%,while control group was 71.67%,the difference was statistically significant(P<0.05 ). ECG efficiency in treatment group was 68.33%,while control group was 48.33%,the difference was statistically significant(P<0.05 ). The reduction of nitroglycerin was 86.67%,while control group was 61.67%,the difference was statistically significant(P<0.05). In addition,there were no adverse reaction in two groups. Conclusion Compared with nitrates medications,combined Chinese and Western medicine in treatment of patients with angina pectoris on basis of secondary prevention of coronary heart disease has better therapeutically effective rate.

0.05), but the symptom of fever and character of respiratory tract's secretion of the patients in experiment group took turns for better obviously than the control group's ( P

Objective To investigate the clinical effects of comprehensive rehabilitation treatment for patients with a diabetic foot. Methods Fifty-two patients with one diabetic foot were randomly divided into a rehabilitation group ( n =26 ) and a control group ( n =26).The patients in the control group received conventional treatment including health education,basic medical therapy and focal treatment of the foot.In addition to the conventional treatment,the rehabilitation group was treated with aerobic exercise,Beecher's exercise regimen,infrared therapy and ultrashortwave therapy 6 days a week for 4 weeks.The therapeutic effect and quality of life were evaluated before and after treatment. Results The effectiveness rate of the rehabilitation group was significantly higher than that of the control group ( 88.46％ vs 73.08％ ) after treatment.The quality of life scores in both groups were significantly better than those before treatment,including on the social relationship dimension,the physiological function dimension,the mental/psychology dimension and the therapy influence section.Average quality of life scores in the rehabilitation group had improved significantly more than in the control group. Conclusion Comprehensive rehabilitation is beneficial to prevent the progress of diabetic foot and to improve the quality of life of patients with a diabetic foot.

Objective:To investigate the predicting value of European system for cardiac operative risk evaluation ( EuroSCORE ) and sino system for coronary operative risk evaluation ( SinoSCORE ) in early quality of life of patients after coronary artery bypass surgery (CABG).Methods:A total of 218 consecu-tive patients who underwent CABG from March 2010 to January 2013 were evaluated with both systems before operation .Health related quality of life ( QoL) was estimated by using 36-item short form health survey ( SF-36) preoperatively and postoperatively in order to evaluate the predicting value of the two sys -tems in early post-operative QoL.Calibration was evaluated by Hosmer-l,emeshow goodness-of-fit test. Discrimination was tested by determining the area under the receiver operating characteristic ( ROC ) curve .Results:There was no significant difference between the accumulation of the EuroSCORE and SinoSCORE in the all patients (t=-0.904, P=0.368), When using Wilcoxon test on life quality in the preoperative and postoperative patients respectively ,the data showed that the quality of life improved significantly in various dimensions of the postoperative patients (Z=-2.886, P<0.001).Except for bodily pain (BP) and mental health (MH), statistically significant correlation was found between the preoperative risk evaluation scores and the postoperative QoL scores (r:-0.203 to -0.493, P<0.05). Logistic regression analyses indicated that both the scores emerged as the independent predictor for a relatively worse QoL ( OR>1 , P<0 .05 ) .Furthermore , the EuroSCORE predicted the outcome with a higher OR.For SinoSCORE the Hosmer-Lemeshow test was significant (P=0.628) and the area under ROC curve was 0.754.For the EuroSCORE the Hosmer-Lemeshow test was significant (P=0.538) and the area under ROC curve was 0.854.Conclusion:Both EuroSCORE and SinoSCORE could be viewed as a predictor for several aspects of postoperative QoL , while EuroSCORE might have a greater predicting value.

Microglia (MG) are resident immune cells in the central nervous system (CNS) and the first defense line of CNS damage. The maintenance of MG function requires abundant energy, and lipid can serve as an energy source for the brain when glucose utilization is limited, and lipid can also function as signaling molecule. Alzheimer's disease (AD) is the most common neurodegenerative disease, and MG lipid metabolism plays an important role in the development of this disease. Drugs targeting lipid metabolism provide a new direction for AD treatment. This review starts with the specific mechanism of lipid metabolism in MG, and briefly introduces the effect of lipid metabolism on MG function and its role in AD.

Objective:To discuss the improvement effect of uric acid(UA)on the postoperative cognitive dysfunction(POCD)in the mice anesthetized with isoflurane for a long duration,and to clarify its possible mechanism.Methods:Twenty-four healthy male C57BL/6 mice were randomly divided into blank control group,anesthesia group,and UA group,and there were eight mice in each group.The mice in UA group were injected intraperitoneally with 200 μL UA solution daily for 2 d before anesthesia.The mice in blank control group and anesthesia group were given the same volume of saline;the mice in anesthesia group and UA group were used to prepare the models of long-duration isoflurane anesthesia,while the mice in blank control group were untreated.Y-maze tests was used to detect the alternation success rate,movement distances,and movement speeds of the mice in various groups;situational fear experiment was used to detect the percentages of freezing time;Western blotting method was used to detect the expression levels of interleukin(IL)-1β,IL-10,and mature brain-derived neurotrophic factor(mBDNF)proteins in hippocampus tissue of the mice in various groups.Results:The Y-maze test results showed that compared with blank control group,the alternation success rate of the mice in anesthesia group was significantly decreased(P<0.01);compared with anesthesia group,the alternation success rate of the mice in UA group was significantly increased(P<0.01).The situational fear experiment results showed that compared with blank control group,the percentage of freezing time of the mice in anesthesia group was significantly decreased(P<0.01);compared with anesthesia group,the percentage of freezing time of the mice in UA group was significantly increased(P<0.05).The cued memory experiment resutls showed that there were no significant differences of the percentage of freezing time of the mice between various groups(P>0.05).The Western blotting results showed that compared with blank control group,the expression level of IL-1β protein in hippocampus tissue of the mice in anesthesia group was increased(P<0.01),while the expression levels of IL-10 and mBDNF proteins were decreased(P<0.01);compared with anesthesia group,the expression level of IL-1β protein in hippocampus tissue of the mice in UA group was decreased(P<0.05),and the expression levels of IL-10 and mBDNF proteins were increased(P<0.05 or P<0.01).Conclusion:UA can improve the POCD in the mice,and its mechnasim may be related with its anti-inflammatory activity inhibiting the central inflammation and upregulating the mBDNF protein expression.

Objective:To retrieve, evaluate, and integrate the best evidence for early ambulation in patients undergoing open lumbar surgery.Methods:A systematic search was conducted in databases including UpToDate, British Medical Journal (BMJ) Best Practice, Guidelines International Network (GIN), The National Institute for Health and Care Excellence (NICE), The Agency for Healthcare Research and Quality (AHRQ), Scottish Intercollegiate Guidelines Network (SIGN), Registered Nurses' Association of Ontario (RNAO), Medlive, North American Spine Society (NASS), Best Practice in General Surgery Group from the University of Toronto, ERAS? Society, PubMed, Embase, Web of Science, Medline, CNKI, and Wanfang. The search included literature on early ambulation post-open lumbar surgery, such as guidelines, expert consensus, evidence summaries, recommended practices, systematic reviews, and high-quality original research. The search period was from January 1, 2014, to June 20, 2023. Two researchers independently evaluated the quality of the literature and extracted relevant data.Results:A total of 23 articles were included, comprising three guidelines, two systematic reviews, six expert consensus statements, seven randomized controlled trials, one quasi-experimental study, and four cohort studies. The evidence was categorized into six themes: multidisciplinary team collaboration, health education, facilitation measures, pre-activity assessment, activity content, and safety assurance, resulting in 25 evidence-based recommendations.Conclusions:This study summarizes 25 best evidence-based recommendations for early ambulation in patients undergoing open lumbar surgery. Healthcare providers are advised to apply these recommendations in clinical practice while considering the specific clinical context and individual patient differences. Multidisciplinary collaboration is essential to develop personalized early ambulation plans.

Objective:To investigate the distribution patterns of TCM syndrome elements and syndrome types in cancer-related fatigue (CRF).Methods:A cross-sectional survey was conducted on tumor patients attending the outpatient clinic and wards of the Department of Oncology, Xiyuan Hospital of China Academy of Chinese Medical Sciences from January to December 2021. Descriptive analysis was used to compare the distribution difference of TCM syndrome elements, symptoms and tongue symptoms of CRF and non-CRF patients. The TCM symptoms of CRF were clustered to summarize the common TCM syndromes of CRF.Results:A total of 306 tumor patients were finally included, of which 229 (75%) were CRF and 77 (25%) were non-CRF. Qi deficiency, blood deficiency, and cold-dampness were the most common deficiency and excess syndrome elements in CRF, and liver deficiency, yin deficiency, and blood stasis syndrome elements occurred more frequently in non-CRF than in CRF. TCM symptoms with a frequency greater than 50% in CRF patients, from high to low, were: fatigue > shortness of breath > insomnia or dreaminess > mental fatigue > forgetfulness>lazy speech > impatience, irritability, depression with sighing. The most frequent tongue symptoms, tongue coating, and pulse symptoms were respectively pale tongue, white and greasy coating or smooth white, and pulse deficiency. The symptoms with greater than 30% frequency in 77 non-CRF patients were, from highest to lowest: impatience and irritability or depression with sighing > insomnia or dreaminess > shortness of breath > dry mouth and throat > lumbar spine pain (excluding traumatic) > numbness of limbs > forgetfulness. The highest-ranked tongue, tongue coating, and pulse symptoms were pale tongue, red tongue or less coating, no coating, and thin pulse, respectively. Through clustering analysis, six common syndromes of CRF were obtained, including qi and blood deficiency syndrome, heart and liver blood deficiency syndrome, kidney yang deficiency syndrome, qi and yin deficiency syndrome, spleen deficiency and qi stagnation syndrome, and cold dampness and spleen stagnation syndrome.Conclusions:CRF is a common symptom of different types of tumors. Generally, deficiency syndrome is the main symptom. Qi deficiency and blood deficiency are the common syndrome elements. Common symptoms of high frequency and tongue and pulse are fatigue, shortness of breath, mental fatigue, forgetfulness, pale tongue and thin pulse. The common TCM syndrome types can be preliminarily summarized into 6 types: qi and blood deficiency syndrome, heart and liver blood deficiency syndrome, kidney yang deficiency syndrome, qi and yin deficiency syndrome, spleen deficiency and qi stagnation syndrome, cold dampness and spleen stagnation syndrome.