OBJECTIVETo observe the therapeutic effect and safety of retention enema with compound glutamine entero-soluble Capsule (CGC) on active ulcerative colitis (UC).

METHODSOne hundred and sixty-eight patients with active UC were randomly assigned to the treatment group (86 patients) and the control group (82 patients). Besides the basic treatment of oral taking salicylazosulfapyridine or mesalazine, they were treated by retention enema with predisolone plus metronidazole injection. In addition, the patients in the treatment group were treated by retention enima with GGC and orally took CGC, 0.8 g each time, thrice a day. The efficacy of treatment and the changes in the principal symptoms 2 months after treatment were evaluated.

RESULTSThe total effective rate in the treatment group was 94.2% (81/86 cases), and that in the control group was 82.9% (68/82 cases), the difference between the two groups was significant (P <0. 05). The symptoms of hemafecia and abdominal pain were improved, the disease active index (DAI) was lowered after treatment in both groups (P <0.01), but the improvement of hemafecia, time of disappearance of mucous bloody stool and decrease of DAI in the treatment group were superior to those in the control group (P <0.05 or P <0.01). No adverse reaction was found in all patients.

CONCLUSIONThe retention enema with glucocorticoid plus metronidazole combined with CGC shows an immediate effect obviously superior to that treated with glucocorticoids and metronidazole alone, and with no adverse reaction.

Adolescent ; Adult ; Aged ; Capsules ; Colitis, Ulcerative ; drug therapy ; Drug Therapy, Combination ; Enema ; Female ; Glucocorticoids ; therapeutic use ; Glutamine ; therapeutic use ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

Objective: To learn the trend of death from injury in Fengcheng residents from 2009 to 2017 and predict from 2018 to 2021,in order to provide the basis for injury prevention and control. Methods: All cause of death monitoring data and demographic data of Fengcheng from 2009 to 2017 were collected,injury mortality,standardized mortality and annual change percentage（APC）were calculated,and GM（1,1）was established to predict the injury mortality from 2018 to 2021. Results: From 2009 to 2017,the injury death rate in Fengcheng was 52.68 per 100 000 and the standardized death rate was 46.50 per 100 000. The APC of the total standardized mortality was -5.10%,showing a decreasing trend year by year（P<0.05）. The injury mortality and standardized mortality in males were higher than that in female（both P <0.05）. The highest injury mortality lay in the group aged 65 years and above,which was 108.13 per 100 000. The top five causes of injury death were traffic accident,suiside,poisoning,fall and drowning,their mortality rate were 27.03 per 100 000,7.84 per 100 000,5.62 per 100 000,5.08 per 100 000 and 2.36 per 100 000,respectively. The mortality of traffic accident in males and suicide in females showed a decreasing trend（P<0.05）,while the mortality of fall showed an increasing trend（all P<0.05）. The model of GM（1,1）predicted that the injury mortality from 2018 to 2021 would be 48.00 per 100 000,44.15 per 100 000,40.61 per 100 000 and 37.35 per 100 000,which showed a decreasing trend year by year. Conclusion The injury death rates in Fengcheng dropp year by year from 2009 to 2017 and will probably keep dropping from 2018 to 2021. Men and people aged 65 years or over are at high risk of death from injury,traffic accident and fall are the main causes.

The expressions of StAR (steroidogenic acute regulatory protein) mRNA in testes from 7,14,23 and 37 day-old piglets were studied by tissue in situ hybridization. The results indicated that in the testes of piglets, StARmRNA was expressed in Leydig cells of pig testes. The expression level of StARmRNA was lower in 7 days piglets but higher in 14,23,37 days. The results indicated that StAR gene played an important role in steroid biosynthesis.

AIM:To investigate the role of specific binding of precursor form of nerve growth factor(proNGF) to p75NTR(proNGF-p75NTR)in isoflurane-induced cognitive impairment in aging mice.METHODS: Aging C57BL/6J male mice were randomly divided into 3 groups:control group,isoflurane(Iso)group and p75NTR specific inhibitor 2-ami-no-3-methyl-pentanoic acid amide(LM11A-31,LM)+isoflurane(LM+Iso)group.Aging C57BL/6J mice in Iso group and LM+Iso group were exposed to isoflurane,and the mice in control group were exposed to air.The mice in LM+Iso group were treated with LM,which dissolved in normal saline water and was administered daily by oral gavage at 50 mg· kg-1· d-1for 1 month.The mice in control group and Iso group received an equivalent volume of normal saline by the same route.Arterial blood gas analysis was conducted to detect the physiological state of the mice after isoflurane exposure. Morris water maze was performed to evaluate the cognitive function.The protein levels of proNGF,p75NTR,phosphorylated p38 MAPK and cleaved caspase-3 were determined by Western blot.RESULTS: Compared with the control group, the protein expression of proNGF and p75NTR in the hippocampus of Iso group was significantly elevated(P<0.05).The phos-phorylation level of p38 MAPK was higher in Iso group than that in control group(P<0.05),which was reduced in LM +Iso group significantly(P<0.05).A significant increase in the protein level of cleaved caspase-3 was observed in Iso group as compared with control group(P<0.05), while LM11A-31 treatment reversed this elevation significantly(P<0.05).The escape latency prolonged and the number of crossing the original platform location reduced in Iso group com -pared with control group(P<0.05), which were reversed by LM11A-31 in LM+Iso group(P<0.05).CONCLU-SION:ProNGF-p75NTR probably plays an vital role in the apoptotic pathway activation and the cognitive dysfunction in ag -ing mice exposure to isoflurane,which provides a potential target for clinical intervention.

OBJECTIVETo investigate the rate of systemic inflammatory response syndrome (SIRS) among patients treated by intramedullary nail (IMN) for femoral shaft fracture right after the operation, the effect of femoral nailing on SIRS and sought to differentiate any differences between reamed and unreamed IMN.

METHODSThree hundred and twenty-four patients presenting with acute femoral fractured from April 1997 to April 2005, divided into 2 group depending on ISS. Group 1 had 179 patients (ISS < 16, AIS < 2) including 64 reamed cases and 115 unreamed cases; group 2 had 145 patients (ISS >or= 16, AIS >or= 2) including 51 reamed patients and 94 unreamed. All patients were treated by close reduction and intramedullary nail for fixation. The heart rate, breath rate, temperatures were recorded every 6 h before and after operation. If any of the life sign was above normal, then venous blood samples were taken at once to make sure whether SIRS occurred or not. All data were crosstabs analysis by SPSS 10.0.

RESULTSOne hundred and twenty-four patients suffered from SIRS postoperation. In group 1, 24 reamed and 37 unreamed, in group 2, 27 reamed and 36 unreamed. Among those SIRS, 119 cases healed evenly and 5 patients developed further complication. Between reamed and unreamed patients both in group 1 and group 2, there was no significant difference found. The Chi-Square value were 0.159 and 2.885 respectively, total value was 3.467, which P was 0.325, 0.089 and 0.471, all greater than 0.05.

CONCLUSIONSAlthough SIRS will result from IMN, there is no significant different effect on the rate of SIRS found between reamed and unreamed nail in both group.

Adult ; Bone Nails ; adverse effects ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; adverse effects ; methods ; Fractures, Closed ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies ; Systemic Inflammatory Response Syndrome ; etiology ; Time Factors

OBJECTIVETo investigate the renal protective effects of sulodexide and its anti-oxidative stress mechanism in diabetic rats.

METHODThirty male SD rats were randomized into 3 equal groups, namely the control group, diabetic group, and sulodexide treatment group. Twelve weeks after establishment of rat diabetic models and administration of sulodexide, the rats were sacrificed for measurement of the urine volume, body mass, kidney mass/body weight ratio, plasma glucose, and glycosylated hemoglobin (HbA1c). Malondialdehyde (MDA) levels and superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-PX) activities in the renal tissue or serum were tested. Electron microscopy was performed to observe the pathological changes in the kidneys.

RESULTSThe urine volume, renal mass/body mass ratio, serum glucose, HbA1C, and serum and renal MDA levels all significantly increased in the diabetic rats in comparison with the normal controls (P<0.05). But the body weight and activities of SOD, CAT, and GSH-PX in the renal tissue in the normal control group were significantly higher than those in the diabetic and sulodexide group. After 12 weeks of sulodexide treatment, SOD, CAT, and GSH-PX activities in the renal tissue of rats were significantly increased in comparison with those in the diabetic rats (P<0.05). Electron microscopy showed obvious irregular thickening of the glomerular capillary basement membrane in the diabetic group with vacuolization in the mitochondria in the epithelial cells, and such pathological changes were significantly alleviated in the sulodexide treatment group.

CONCLUSIONSSulodexide can effectively lower the urinary albumin excretion rate, improve the ultrastructural renal pathologies and prevent glomerular basement membrane thickening in diabetic rats, probably in association with the reduction of the MDA levels and enhancement of SOD, CAT, and GSH-PX activities.

Animals ; Antioxidants ; pharmacology ; therapeutic use ; Body Weight ; drug effects ; Catalase ; metabolism ; Diabetes Mellitus ; drug therapy ; metabolism ; pathology ; Glutathione Peroxidase ; metabolism ; Glycosaminoglycans ; pharmacology ; therapeutic use ; Kidney ; drug effects ; metabolism ; pathology ; Male ; Malondialdehyde ; metabolism ; Organ Size ; drug effects ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism

BACKGROUND: The authors experienced cholangiocarcinomas associated with intrahepatic duct stones, so we reviewed and summarized the clinical features of these patients to shed light on the pathogenetic implication of hepatolithiasis on the development of cancer and to emphasize the role of hepatic resection in the management of hepatolithiasis. METHODS: We performed 54 hepatic resections in 106 hepatolithiasis patients (51%) during 5 years from Sep. 1993 to Jun. 1998. The medical records of these patients were retrospectively reviewed. Clinical and demographic findings were analyzed and compared with those for all the hepatolithiasis cases. Statistical analysis was done with the chi-square test and Student t-test. RESULTS: Eight patients out of 106 intrahepatic duct stone patients were associated with a cholangiocarcinoma (7.5%). The mean age was 59.5 13.4 years, and the male to female ratio was 1:3. Chief complaints were right upper quadrant pain (87.5%), fever (50%), jaundice (25%), indigestion (25%), and weight loss (12.5%). Clinically, 4 cases were presented as acute cholangitis, and 1 case was pancreatitis. The locations of the tumors were the right lobe in 2 cases, the left lobe in 3 cases, and the hilar portion in 3 cases. Preoperative diagnosis was clinically possible only in one case. Intraoperative diagnoses were possible in 5 cases with clinical suspicion of cancer and were confirmed by using frozen biopsy. Three cases were incidentally diagnosed as cancer by postoperative pathological reports. We missed the presence of cancer in these cases due to associated hepatic abscesses. The operations performed were a right lobectomy in 1 case, an extended right lobectomy in 1 case, a left lobectomy in 2 cases, a left lateral segmentectomy in 2 cases, and an extrahepatic bile duct resection with hepaticojejunostomy in 1 case. A palliative hepaticojejunostomy was done in 1 case, and the patient died 3 months later. Another patients survived for over 2 years after operations. CONCLUSION: Aggressive hepatic resection for hepatolithiasis is recommended in view of highly coincident hidden cancer and the difficulty in diagnosis that cancer. Molecular and genetic investigations are needed to verify the etiological correlation between hepatolithiasis and cholangiocarcinomas.
Bile Ducts, Extrahepatic ; Biopsy ; Cholangiocarcinoma* ; Cholangitis ; Diagnosis ; Dyspepsia ; Female ; Fever ; Humans ; Jaundice ; Liver Abscess ; Male ; Mastectomy, Segmental ; Medical Records ; Pancreatitis ; Retrospective Studies ; Weight Loss

BACKGROUNDOld pelvis fractures are among the most challenging fractures to treat because of their complex anatomy, difficult-to-access surgical sites, and the relatively low incidence of such cases. Proper evaluation and surgical planning are necessary to achieve the pelvic ring symmetry and stable fixation of the fracture. The goal of this study was to assess the use of three-dimensional (3D) printing techniques for surgical management of old pelvic fractures.

METHODSFirst, 16 dried human cadaveric pelvises were used to confirm the anatomical accuracy of the 3D models printed based on radiographic data. Next, nine clinical cases between January 2009 and April 2013 were used to evaluate the surgical reconstruction based on the 3D printed models. The pelvic injuries were all type C, and the average time from injury to reconstruction was 11 weeks (range: 8-17 weeks). The workflow consisted of: (1) Printing patient-specific bone models based on preoperative computed tomography (CT) scans, (2) virtual fracture reduction using the printed 3D anatomic template, (3) virtual fracture fixation using Kirschner wires, and (4) preoperatively measuring the osteotomy and implant position relative to landmarks using the virtually defined deformation. These models aided communication between surgical team members during the procedure. This technique was validated by comparing the preoperative planning to the intraoperative procedure.

RESULTSThe accuracy of the 3D printed models was within specification. Production of a model from standard CT DICOM data took 7 hours (range: 6-9 hours). Preoperative planning using the 3D printed models was feasible in all cases. Good correlation was found between the preoperative planning and postoperative follow-up X-ray in all nine cases. The patients were followed for 3-29 months (median: 5 months). The fracture healing time was 9-17 weeks (mean: 10 weeks). No delayed incision healing, wound infection, or nonunions occurred. The results were excellent in two cases, good in five, and poor in two based on the Majeed score.

CONCLUSIONSThe 3D printing planning technique for pelvic surgery was successfully integrated into a clinical workflow to improve patient-specific preoperative planning by providing a visual and haptic model of the injury and allowing patient-specific adaptation of each osteosynthesis implant to the virtually reduced pelvis.

Adolescent ; Adult ; Female ; Fractures, Bone ; diagnosis ; pathology ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Middle Aged ; Pelvic Bones ; surgery ; Reconstructive Surgical Procedures ; Young Adult

OBJECTIVETo improve the ability of recognizing, diagnosing and treatment for the femoral shaft fractures combined with ipsilateral occult femoral neck fractures, and reduce the rate of loss-diagnosis.

METHODSBy retrospective study of 50 patients who sustained ipsilateral femoral shaft and neck fractures from March 1998 to October 2003, 9 cases were femoral shaft fractures combined ipsilateral femoral neck fractures. The neck fractures were diagnosed separately before, during and after operation. Among the 9 cases, 5 cases treated with reconstructive intramedullary nail to fix both shaft and neck fractures; 3 cases were treated with retrograted intramedullary nail to fix shaft fractures and with canulated screws to fix neck fractures; another one was sustained two operations, after the fixation of shaft by intramedullary nail, the neck fracture was found, the neck fracture was fixed with canulated screws anterior and posterior of the nail.

RESULTSNine cases were followed up for average 20 months. All femoral shaft fractures were united during 6 months; and all neck fractures were united during 3 months.

CONCLUSIONSFemoral shaft fractures combined with ipsilateral occult femoral neck fractures have a high rate of loss-diagnosis during the early stage after injure, the orthopaedic surgeons should consider the femoral neck fracture by analyzing the mechanism of high energy injury patient with femoral shaft fracture. The occult femoral neck fractures can be diagnosed by CT scan before operation. During and after the operation of fixing the femoral shaft fractures, the femoral neck should be observed intensively to identify the exist of fractures.

Adult ; Femoral Fractures ; complications ; diagnostic imaging ; surgery ; Femoral Neck Fractures ; complications ; diagnostic imaging ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the results of intra-articular calcaneal fractures treated with open reduction and internal fixation.

METHODSThirty-five displaced intra-articular calcaneal fractures in 34 patients were treated with open reduction and internal fixation from August 2001 to April 2003. Fracture classification was based on Sanders classification. Extended lateral approach, and fixed the fractures with AO titanium plate for calcaneus were performed. Bone graft was used in selected patients. Thirty-five fractures in thirty-four patients were evaluated using radiographic examinations and ankle hindfoot clinical rating system of the American Orthopaedic Foot and Ankle Society (AOFAS). Average follow-up was 18.3 months (range from 12 to 32 months).

RESULTSThere were 30 type II fractures and 5 type III fractures. Average Böhler's angle was 5.6 degrees preoperatively and 28.2 degrees finally. Roentgenographic evaluation of calcaneal body dimensions showed restoration of heel height (97.7%) to virtually normal. Anatomic or near anatomic reductions were obtained in 80% of the cases. The average score was 88.1 for type II fractures, and 78.8 for type III fractures. Excellent or good clinical results occurred in 82.8% type II fractures, and 60.0% type III fractures. The overall excellent or good rate was 79.4%.

CONCLUSIONFrom the results, open reduction and internal fixation for Sanders type II and type III fractures are recommended.

Adult ; Calcaneus ; diagnostic imaging ; injuries ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; methods ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Treatment Outcome