Objective To investigate the long-term follow up results of patients with gastroduodenal ulcer perforation managed by simple suture and pharmacal management.Methods 74 patients with perforated gastroduodenal ulcer operated with simple closure and pharmacal management in hospital from February 1990 to May 2005 were observed,after operation the patients underwent follow-up.According to follow-up data,the long-term therapeutic results of these patients were determined.Results The rate of symptomatic ulcer recurrence(Visick Ⅲ-Ⅳ)was14.9%(26.9% in patients with gastric ulcer and 8.3% in duodenal ulcer)in 74 patients with perforated gastroduo denal ulcer operated on with simple closure and pharmacal management after operation.Both of them showed significant difference(Fisher' s Exact Test:P = 0.043).The incidence of long-term complications was 10.8% and there was no statistical difference between the patients with gastric ulcer and those with duodenal ulcer(Fisher's Exact Test:P =0.440).56 patients were surveyed by endoscopy or upper gastrointestinal series within 6 months after operation.The rate of cure was 91.1% ,significant difference was not observed between the patients with gastric ulcer and those with duodenal ulcer(Fisher' s Exact Test:P = 0.336).But after a year ulcer recurrence rate of total 46 patients was 10.9% and the gastric ulcer recurrence rate significantly higher than that of duodenal ulcer(Fisher's Exact Test;P = 0.047).Conclusion Long-term effect of patients with perforated gastroduodenal ulcer operated by simple closure and pharmacal management was satisfactory.But the former was less effective than the latter.

Objective To explore the effects of melatonin (MT) on the expression of interleukin (IL)-10,interleukin-6 and interleukin-8 as well as the inflammatory reaction and nerve repair after acute spinal cord injury (SCI).Methods One hundred and eight Sprague-Dawley rats were randomly divided into a spinal cord injury group (group A),an MT treatment group (group B) and a sham operation group (group C),each with 36 rats.SCI models were established in the rats of groups A and B using a version of Allen's weight drop method (50gcf at the T12 level).Group C had removal of the lamina only.Ten minutes later,group A was injected with 5％ ethanol in saline (the MT solvent) and group B with 100 mg/kg of melatonin preparation.At 6,12,18 and 24 hours,IL-6,IL-8 and IL-10 levels in serum were detected in 6 rats of each group.At 18 hours post-surgery,spinal cord specimens were taken from 6 rats of each group for hematoxylin eosin staining,morphological examination and immunohistochemical SP detection of IL-10 expression.Results The specimens of group A showed inflammatory reaction and ulceration at 48 h; groups B and C had no ulcers.Group B showed the highest levels of IL-10 in serum and IL-10 mRNA in the spinal cord,while group C showed the lowest level.The differences were statistically significant.Group A had the highest levels of IL-6 and IL-8 and group C had the lowest.The difference between group B and groups A and C was significant.The morpho-logical observation showed that after melatonin treatment the IL-10 levels in the spinal cord's central canal and around the gray matter improved.Conclusions Melatonin can improve nerve lipid peroxidation and inflammatory reaction in the treatment of spinal cord injury by increasing IL-10 expression and inhibiting IL-6 and IL-8 expression.

OBJECTIVE: To determine the ratio of deficient mismatch repair (dMMR) proteins and Lynch syndrome among patients undergoing colorectal cancer resection. METHODS: From June 2014 to May 2016, immunohistochemistry for mismatch repair proteins including mutL homolog 1 (MLH1), mutS homolog 2 (MSH2), mutS homolog 6 (MSH6) and PMS1 homolog 2 (PMS2) were carried out on 207 surgically resected specimens. Samples with lost expression of MMR proteins underwent genetic testing. RESULTS: Loss of expression of MMR proteins were found among 21 patients and accounted for 10.14% of the colorectal cancers. dMMR was more common in patients ≤50 years old, or with proximal tumor at splenic flexure and mucinous adenocarcinoma. Ten patients underwent genetic testing, with three pathogenic mutations (MSH6 c.3013C>T, MLH1 c.199G>A and a novel MSH6 c.584delT) and four ambiguous mutations identified. At least 1.4% of the colorectal cancers were diagnosed as Lynch syndrome. CONCLUSION Routine screening for Lynch syndrome among patients with colorectal cancer with MMR protein immunohistochemistry as preliminary screening method and MMR gene sequencing as diagnostic method is effective and feasible. It can reduce missed diagnosis of Lynch syndrome and bring lifelong benefit to patients and their families.
Adolescent ; Colorectal Neoplasms, Hereditary Nonpolyposis ; Early Detection of Cancer ; Humans ; Immunohistochemistry ; Middle Aged ; Mismatch Repair Endonuclease PMS2 ; MutS Homolog 2 Protein

Objective:The composition of thrombi obtained during mechanical thrombectomy in patients with acute ischemic stroke is analyzed to investigate its relation with stroke etiology and its influence in surgical parameters and clinical prognoses.Methods:The thrombi and clinical data of 41 patients with acute ischemic stroke directly treated by mechanical thrombectomy in our hospital from January 2019 to December 2019 were collected. Hematoxylin-eosin (HE) staining was used to quantitatively analyze the composition of thrombi, and the components of thrombi in patients with different causes of stroke (large artery atherosclerosis [LAA], cardiogenic embolism [CE], and unexplained type) were compared. These patients were divided into erythrocyte-rich group (erythrocyte content>fibrin content) and fibrin-rich group (erythrocyte content0.05). Conclusion:Thrombus composition has influence in surgical parameters, but no influence in clinical prognoses.

OBJECTIVETo assess the association of VKORC1 gene -1639G/A polymorphism with atrial fibrillation (AF) in ethnic Uygurs and Hans from Xinjiang.

METHODSThe above polymorphism was detected among 100 Uygur and 102 Han AF patients and 103 Uygur and 111 Han subjects that have no AF with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.

RESULTSA statistically significant difference was detected between the patient and control groups of Uygur origin in terms of genotypic and allelic frequencies (P<0.05). Logistic regression analysis also indicated the -1639G/A polymorphism as an independent risk factor for AF in Uygur population (OR=2.085, 95% CI: 1.067-4.072, P=0.031). No similar statistical difference was found between the patient and control groups of Han origin (P>0.05).

CONCLUSIONThe -1639G/A polymorphism of VKORC1 gene is associated with AF in the Uygur population but not in Hans.

Adult ; Aged ; Asian Continental Ancestry Group ; ethnology ; genetics ; Atrial Fibrillation ; ethnology ; genetics ; Base Sequence ; China ; ethnology ; Female ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Polymorphism, Single Nucleotide ; Vitamin K Epoxide Reductases ; genetics

ObjectiveTo investigate the current status and influencing factors of hand hygiene practices among primary healthcare workers， and to provide a reference for improving hand hygiene behavior in primary healthcare institutions. MethodsA self-designed questionnaire was used to conduct a survey among medical staff of seven community health service centers in Jiading District， Shanghai， using a cluster random sampling method. The data collected were subjected to descriptive statistics， reliability and validity tests， correlation analysis， and structural equation model fitting. ResultsA statistical difference in hand hygiene compliance was found among medical staff with varying occupational types and educational levels （P<0.05）， and medical staff in clinical departments exhibited higher levels of hand hygiene compliance （P<0.05）. In the health belief model， among the core variables， healthcare workers’ perceived benefits， perceived barriers， and self-efficacy had a direct impact on hand hygiene behavior， with direct effect values of 0.341， -0.152， and 0.234， respectively. Meanwhile， cues to action and perceived severity of COVID-19 infection indirectly affected hand hygiene behavior， with an indirect effect value of 0.066 and 0.062， respectively. ConclusionHealthcare workers generally exhibit a high degree of hand hygiene compliance， but there are variations in hand hygiene scores among healthcare workers with different characteristics. Enhancing healthcare worders’ perception of benefits， action cues， and self-efficacy while reducing perceived barriers can effectively improve their hand hygiene behavior.