Objective To explore the effect and mechanism of intrathecal injecting κ-opioid receptor agonist U50, 488H on the rats with myocardial ischemia/reperfusion injury.Methods 50 Sprague–Dawley rats were randomly divided into five groups (n=10): sham group (Sham), ischemia/reperfusion group (IR), high-dose intravenous injection group (IV1), low-dose intravenous injection group (IV2), and intrathecal injection group (IT).In sham group the rats were followed by the modeling step without ligation of the left coronary and no drug injection by intravenous or intrathecal; in IR group the rats were underwent 30 minutes of myocardial ischemia followed by 120 minutes of reperfusion, and were not treated with any drug.All the rats in IV1, IV2 and IT groups were intravenous injected with U50, 488H at 1 hour before they were underwent myocardial ischemia/reperfusion as in IR group.IV1 and IV2 groups were intravenous injected with U50, 488H respectively at the dose of 0.1 mg/kg and 0.01 mg/kg, while the IT group was intrathecal injected with U50, 488H at the dose of 0.01mg/kg.All the rats from 5 groups were observed with cardiac ultrasound, myocardial sirius staining, serum CGRP and ET level.Results Compared to IR group(EF%=35.4 ±1.1,FS% =21.1 ±1.1), the rats in IT group (EF%=49.1 ±1.2,FS%=27.1 ±1.0) and IV1 group (EF%=46.3 ±2.2,FS%=26.6 ±0.6) showed better myocardial contraction (P<0.05) and reduced myocardial fibrosis (P<0.05).IT group and IV1 group also showed reduced ET but increased CGRP in the serum (P<0.05).There were no difference between IV2 group and IR group in both observation.Conclusion Pretreatment with intrathecal injection of opium κ-receptor stimulant U50, 488H not only protected the myocardial function from myocardial ischemia/reperfusion injury, but also repressed myocardial fibrosis.The protection may result from modulation of CGRP and ET.

Objective:To investigate the prognostic factors for long-term outcomes in elderly patients after colorectal cancer(CRC)resection.Methods:Patients(aged ≥60 years)undergone CRC resection in 2004 with more than 10-year survival records from the SEER database were retrospective analyzed.Potential prognostic risk factors for survival, such as age, sex, race, marital status, tumor site and size, clinical staging, TNM staging and lymph node clearance(lymph nodes dissection)were assessed by using the Cox proportional hazards model.Results:A total of 15 775 CRC patients were enrolled in this study, including 7 828(49.6%)males and 7 947(50.4%)females.The 10-year overall survival(OS)was shorter in patients aged over 80 years than in patients aged 60 years( P=0.000). Multivariate analysis showed that females had a better 10-year OS than males( P=0.000). Univariate analysis showed no difference in 10-year OS between females and males( P=0.837). Compared with married patients, single, unmarried or widowed patients displayed a poorer 10-year OS( P=0.000)and that patients with cecum and appendix cancer had the worst 10-year OS( P=0.000), but it did not find any difference between primary tumors in different sites.Patients with a tumor size over 5 cm or at advanced stage(T3-T4, N1-N2 and M1)had a low 10-year OS( P=0.000). Conclusions:Old age, black race, single, unmarried or widowed status, tumor size over 5 cm and advanced stage(T3-T4, N1-N2 and M1)are negative predictors for 10-year OS in CRC patients and these findings can be used for education and treatment improvement strategies for CRC in future.

Objective To investigate the drainage volume and nursing method of lifted tube drainage and continuous negative pressure drainage after lower lumbar surgery.Methods A total of 248 consecutive patients undergoing the first or second lumbar spine surgery from January 2008 to July 2013 were prospectively randomly divided into two groups.116 patients in the experimental group (group A) took the lifted tube drainage and 132 patients in the control group (group B) took the normal continuous negative pressure drainage protocol after surgery.The total drainage volume,pre-and post-operative hemoglobin,post-operative temperature,complications and JOA score in the two groups were compared.Results The average drainage volume after single or two segment surgery were (97.0 ± 34.2)ml and (108.5 ± 32.7)ml in group A.The average drainage volume after single or two segment lower lumbar surgery were (393.4 ± 143.5) ml and (448.2 ± 169.6) ml in group B,the difference was statistically significant (t =14.43,17.55,respectively;P ＜ 0.01).There was no significant difference in drainage volume in single or two segment in group A and B (P ＞ 0.05).The post-operative hemoglobin level was (121.7 ± 13.4) and (117.8 ± 12.5) g/L in group A and B respectively,the difference was statistically significant (t =2.38,P ＜ 0.05).Conclusions Based on the findings in this study,lifting the drainage tube to an appropriate height is a simple and safe way to reduce postoperative drainage volume in lower lumbar spine surgery which is worthy of further investigations.

Objective To summarize the clinical experiences of liver transplantation.Methods Of the nine patients, four operation was standard orthotopic liver transplantation,the latter five were the piggyback liver transplantation.The immunosuppressive protocols included methylprednisolone FK506 and mycophenolatemofeti. Meanwhile intravenous antihepatitis B immunoglobulin and Lamivudine were used to prevent hepatitis B recurrence.Results All patients were cured.Conclusion Liver transplantation can be employed for liver disease both cirrhosis and carcinoma as a conventional surgery.It is an effective way for the treatment of no metastatic liver carcinoma.The immunosuppressive protocols included methylprednisolone FK506 and mycophenolatemofeti,it can prevent immune rejection.

Objective To explore the effect of simulated food model on diet education in patients with maintenance hemodialysis. Methods A total of 90 patients who had hemodialysis in the Fifth People's Hospital of Shanghai from March to June 2016 were selected into this study according to convenience sampling. The participants were divided into control group(n=45)and intervention group(n=45)based on the dialysis time. The simulated food model was applied to the diet education in the intervention group while the control group received routine diet education. The knowledge of diet,changes in serum creatinine,hemoglobin and serum albumin,and satisfaction of diet education were compared before and after the intervention. Results After the education, the intervention group had significantly higher scores of diet knowledge and satisfaction level compared with the control group(P < 0.05). There were significant differences in serum creatinine between the two groups(P<0.05). However,no statistical differences were found in hemoglobin or serum albumin between the two groups(P> 0.05). Conclusions The simulated food model can effectively improve the knowledge of diet and the satisfaction of diet education in patients with maintenance hemodialysis. It can also reduce the serum creatinine and has a positive effect on diet education.

Background:Antibiotic resistance rate of Helicobacter pylori (Hp) has increased year by year,which leads to the lowering Hp eradication rate,therefore,it is emergent to find an effective Hp eradication regimen.Aims:To explore the effect of influencing factors on Hp eradication rate,and to investigate the clinical effect of Bifidobacterium on re-eradication of Hp.Methods:A total of 203 Hp-positive patients with gastric diseases diagnosed by gastroscopy and pathology were enrolled.All the patients were given standard triple regimen for 2 weeks,Hp infection was re-examined 4 weeks after treatment.Fifty patients with Hp eradication failure were divided into two groups,patients in experimental group were given Bifidobacterium followed by quadruple therapy,patients in control group were given quadruple therapy directly.Effects of gender,age,gastroscopic diagnosis,pathological diagnosis and different regimens on Hp eradication rate were analyzed,and effect of Bifidobacterium on re-eradication of Hp was evaluated.Results:No significant difference in Hp eradication rate was found between male and female patients (P =0.740).Hp eradication rate decreased with the increase of age,however,the difference was not statistically significant (P =0.872).No significant differences in Hp eradication rate were found between different eradication regimens,gastroscopic diagnosis,and pathological diagnosis (P ＞ 0.05).Reeradication rate of Hp in Bifidobacterium group was higher than that in control group,but the difference was not statistically significant (88.0％ vs.72.0％,P =0.289).Conclusions:The effects of gender,age,gastroscopic diagnosis and pathological diagnosis,different eradication regimens on Hp eradication rate are not statistically different.However,Hp eradication rate is decreased with the increase of age.Hp eradication rate is relatively high in patients with chronic atrophic gastritis.Bifidobacterium can not increase the re-eradication rate in patients with the failure of first time Hp eradication therapy.

Objective To characterize the brain microstructure changes of amyotrophic lateral sclerosis (ALS) patients with various levels of cognitive impairment as measured by diffusion tensor imaging (DTI).Methods A total of 55 ALS patients and 20 healthy controls (HC) were enrolled in the Department of Neurology of Peking Union Medical College Hospital From September 2013 to March 2017,and all participants underwent neuropsychological assessments and DTI scans.According to their cognitive performance,ALS patients were further subclassified into ALS with normal cognition (ALS-Cn,n =27),ALS with cognitive impairment (ALS-Ci,n =17) and ALS-frontotemporal dementia (ALS-FTD,n =11)subgroups.Comparisons of voxel-based and atlas-based fractional anisotropy (FA) and mean diffusivity (MD) data were conducted among the four subgroups.Results In the voxel-based analyses,the FA showed significant differences in cingulate gyms,corpus callosum,brain stem and cerebellum,and MD showed significant differences in bilateral frontal lobe,temporal lobe,cingulate gyms,corpus callosum,and cerebellum among the four subgroups.Besides,when compared to ALS-Ci,ALS-Cn and HC groups in the order,the areas of involvement were larger and differences were more significant in ALS-FTD group.In the atlas-based analyses,the FA and MD of the corticospinal tracts revealed no difference within the patients groups,but decreased FA and increased MD were found compared to HC group.The ALS-IFD patients manifested widespread white matter fiber integrity damage and microstructure impairment in the extramotor areas compared to other three groups.Conclusion The brain white matter structural patterns of ALS patients correlate with their cognitive function,and there is a gradient of alterations across the ALS-Cn,ALS-Ci and ALS-FTD continuum.

Background: Colorectal cancer (CRC) is one of the most common malignancies in clinical practice. Its incidence and mortality rate are increasing in China in recent years. Aims: To analyze the results of CRC screening and the factors affecting the compliance of colonoscopy among community residents in Zhuanqiao Town, Minhang District, Shanghai. Methods: The community residents who were screened for CRC in Zhuanqiao Town from July 2020 to January 2021 were recruited. Both the risk assessment questionnaire and the fecal occult blood test (FOBT) were performed for the primary screening, and those who were positive for primary screening were recommended to undergo colonoscopy. High-risk individuals unwilling to undergo colonoscopy were surveyed for the reason of refusal. Results: During the study period, a total of 6 383 residents participated in the screening program, the positivity rates of risk assessment, FOBT and with either of them were 7.2% (459 cases), 10.5% (670 cases) and 17.2% (1 095 cases), respectively. Two hundred and ninety-seven residents who were positive for primary screening underwent a colonoscopy, with an overall colonoscopic compliance rate of 27.1%. The colonoscopic compliance rate in residents aged from 60-69 years was higher than that in other age groups (P<0.05). The detection rate of CRC was 2.0% (6/297). Insufficient knowledge of CRC and having no obvious physical discomfort were the main factors affecting colonoscopic compliance in high-risk population. Conclusions: Risk assessment combined with FOBT can identify high-risk population of CRC rapidly and efficiently. For the CRC screening program, education of the knowledge on CRC should be strengthened for improving the cognitive level of CRC in community residents. The screening program should be further optimized.