Objective To compare the long-term effects between procedurefor prolapse and hemorrhoids(PPH) and Milligan-Morgan hemorrhoidectomy( MMH ) in the treatment of Ⅲ and Ⅳ degree of hemorrhoids. Method The clinical data of 43 cases with Ⅲ and Ⅳ degree hemorrhoids received PPH (PPH group)and 71 cases received MMH (MMH group) were analyzed retrospectively from October 2001 to July 2003. Results Late bleeding in 5 cases of PPH group and no one of MMH group (P ＜0.05).Hemorrhoidal recurrence prolapsed in 9 cases of PPH group and 5 cases of MMH group (P ＜ 0.05). The rectal neck pressure preoperative,after 6 months, 1 year and 3 years were (122.0 ± 11.3), (90.0 ± 10.4),(103.0 ± 13.8) and (113.0 ± 11.2) cm H2O (1 cm H2O =0.098 kPa) of PPH group,after 6 months was decreased obviously than preoperative (P＜0.05),and they were ( 126.0 ± 13.5), (91.0 ± 12.4), (78.0 ±9.8) and (81.0 ± 7.5 ) cm H2O of MMH group,after 6 months, 1 year and 3 years were decreased obviously than preoperative (P ＜ 0.05). Conclusion PPH is safety and effect at short time,but it brings more late bleeding and anal pain,and its rate of prospective hemorrhoidal recurrence is more higher than MMH.

?AIM: To investigate the corneal high order aberrations in adults with myopia and to study its correlations with myopic degree and keratometry.?METHODS: A total of 63 patients ( 126 eyes ) from the ophthalmology department of our hospital were included in this study during May 2014 to June 2015. Visual acuity, intraocular pressure ( IOP ) , diopter, slit lamp examination, central corneal thickness ( CCT ) , funduscopic examination, corneal topography and corneal total higher order aberrations ( THOAs ) were recorded. Right eye was selected. According to the spherical equivalence ( SE) , 63 eyes were divided into two groups, the mild to moderate myopia group (M-M group, SE<-6. 00D) and the high myopia group (H group, SE≥-6. 00D). The correlations of corneal THOAs with diopter, keratometry, IOP and CCT were analyzed. Kolmogorov-Smirnov Test was used for normality test. Independent-samples t test was used for comparison between two groups. Pearson correlation analysis was for comparison between two continuous variables.?RESULTS: Z44 was found a statistic difference between the M-M group and H group (t=2. 51,P=0. 02). IOP was negatively correlated with Z5-3(r= -0. 52,P=0. 01), and CCT was positively correlated with Z4-4(r=0. 43,P=0. 03) in H group. There was no correlation between higher order aberrations and SE in M-M group ( all P>0. 05 ) Total coma aberration ( TCA ) was negatively correlated with SE (r=-0. 57,P=0. 002) and spherical degree (Sph, r=-0. 55,P=0. 003) in H group. Z40 was positively correlated with average K (AK) (M-M group:r=0. 40,P=0. 02. H group:r=0. 55, P=0. 03), K steep (Ks) (M-M group:r=0.39, P=0.02. H group:r=0.51, P=0.01) and K flat (Kf) ( M-M group:r=0. 40, P=0. 02. H group:r=0. 57, P=0. 01) in both groups. Z53was negatively correlated with Ks(r=-0.4, P=0. 04) in H group.?CONCLUSION: The THOAs parameters are influenced by diopter and keratometry. TCA is negatively correlated with SE and Sph in patients with high myopia, and spherical aberration is positively correlated with keratometry.

Beginning from the tradition branch course obstacle analyzing on college student' practice ability,to define the effect and study domain and key problem about curriculum integration on practice ability cultivation can provide one kind of clear train of thought for the college curriculum adapting even surpassing the demand of this society.

Primary hepatic carcinoma is one of the high incidence malignant tumors and the mortality ranked the second in the death caused by malignant tumors in China. The research progress on the epidemiology of primary hepatic carcinoma, the related environmental factors(virus, parasite, bacterium infected, aflatoxin ingested, drinking water pollution, smoking and drinking alcoholic beverages) and genes were reviewed and the mechanism of primary hepatic carcinoma was discussed in the present paper.

Climacteric ; Depression ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Middle Aged ; Phytotherapy ; Sleep Initiation and Maintenance Disorders ; Syndrome

Animals ; Embryo Culture Techniques ; Embryo, Mammalian ; Female ; Ganglia, Spinal ; cytology ; drug effects ; Glial Cell Line-Derived Neurotrophic Factor ; pharmacology ; Male ; Motor Neurons ; drug effects ; Neurons, Afferent ; drug effects ; Rats ; Rats, Sprague-Dawley

Objective To investigate the effects of warming yang-dispelling turbidity-dredging collaterals method on renal interstitial fibrosis in rats with chronic renal failure caused by 5/6 nephrectomy and explore its mechanisms. Methods Eight rats were randomly chosen as sham operation group (Sham), while the remaining 24 rats underwent 5/6 nephrectomy were divided into model group (5/6Nx), warming yang-dispelling turbidity-dredging collaterals method group (WDD) and Niaoduqing group (NDQ), and the rats in each group were administrated with corresponding drugs. After the intervention of 12 weeks, all the rats were sacrificed and the kidneys were then removed. HE, PAS Masson, Picrosirius red staining were conducted to assess kidney pathological changes and renal fibrosis. The protein expression of Collagen was tested by both immunofluorescence and Western blotting, and the mRNA expression was evaluated using qRT-PCR. The expression of protein related with the process of EMT, including α-SMA, E-Cadherin and Vimentin, were tested with immunohistochemistry and Western blotting. Results Compared with the model group, warming yang-dispelling method alleviated kidney pathological injury and renal fibrosis, and significantly down-regulated the protein and mRNA expression of Collagen . Moreover, warming yang-dispelling turbidity-dredging collaterals method regulated the process of EMT by decreasing the high expression of α-SMA and Vimentin, and increasing the low expression of E-Cadherin. Conclusion Warming yang-dispelling turbidity-dredging collaterals method can effectively attenuate renal fibrosis and injury and its underlying mechanisms may be related with its inhibitory effects on Collagen expression and regulation of EMT.

Objective:To further optimize the nutritional support program for elderly neurocritical patients, analyze the changes and influencing factors of serum albumin levels in elderly neurocritical patients after surgery, and explore the impact on prognosis.Methods:A retrospective cohort study was conducted to investigate the medical records of neurosurgical intensive patients in Shanghai Tenth People's Hospital from May 2015 to September 2019. All the patients were treated for at least 5 days after operation. Patients with severe liver and kidney dysfunction, mental illness and incomplete medical records were not included in the study. Patients aged ≥65 years were included as the experimental group and patients aged <65 years served as the control group. Generalized estimating equation and other models were used to analyze the difference in the trend of albumin level and its influencing factors between the two groups. Automated machine learning was used to explore the influence of factors such as albumin level, nutrition mode, age, sex, diagnosis, preoperative consciousness level on the prognosis of patients.Results:A total of 284 patients were included in the study, including 85 in the experimental group and 199 in the control group. There were no significant differences in baseline data such as sex, age, and proportion of nutritional patterns between the two groups. Generalized estimating equation and generalized mixed additive equation showed that albumin level in both groups reached the minimum on the 3rd day after operation, and the average level in the experimental group was significantly lower than that in the control group ( P=0.03). Cerebral hemorrhage, emergency surgery, and low preoperative albumin were risk factors ( P<0.05); intravenous supplementation of human albumin might have an adverse effect on the experimental group ( P = 0.047). Machine learning models suggested that the higher the serum albumin level at discharge, the better the prognosis at 1 month after surgery. The area under ROC curve was 0.906, the specificity was 93.7%, and the sensitivity was 67.0%. Conclusions:The changes of albumin level in elderly patients with neurological critical illness after surgery are basically the same as those in young patients, with the lowest albumin level on the 3rd day after surgery, and the albumin levels even lower on the 3rd day after surgery in patients with cerebral hemorrhage, emergency surgery and preoperative low albumin. The higher the albumin level at discharge, the better the prognosis of patients may be.

Objective To evaluate the effect of TBL (team-based learning) method in pharmacology teaching for the foreign students of clinical medicine. Methods In the course of pharmacology teaching of the foreign students of clinical medicine, TBL method was performed in the 2012-year students and tradi-tional teaching method was performed in the 2011-year students. After the teaching, students' grades in the ordinary performance, their final exam scores and their evaluation of the two teaching methods were com-pared. Graph pad 5 was used to analyze the data and the t test was performed. Results The average ordi-nary performance of the students with TBL was significantly higher than that with the traditional teaching [(84.94 ±12.66) vs. (72.30 ±4.90), P=0.000] and the final examination scores were significantly im-proved [(74.00±6.76) vs. (69.00±6.20), P=0.023]. The survey showed students were more satisfied with the TBL teaching mode than traditional teaching mode [(8.40±0.71) vs. (7.12±1.07), P=0.000]. Conclusion TBL teach-ing mode can effectively improve the pharmacology teaching effect of foreign students.

Objective To observe the expression of TGF?RⅠ,TGF?RⅡ and Smad7 in oxazolone-induced colitis of mice and to investigate the role of the TGF? signal transduction on pathogenesis of colitis. Methods Balb/c mice were pre-sensitized by skin painting with 0.2 ml 3% oxazolone on day 0 and 1 followed by intrarectal administration of 0.15 ml 1% oxazolone on day 7. The mice were sacrificed after 3 days. Colitis was evaluated by macroscopic and microscopic examination. The expressions of TGF?RⅠ, TGF?RⅡ and Smad 7 were examined by immunohistochemical study and Western blot respectively. All the results were compared with the controls. Results Twenty-four hours after intrarectal administration of oxazolone, the mice presented anorexia, less moving, loose stool, hematochezia or occult blood(+) and weight loss. The macroscopic and microscopic scores in two groups were 0.17?0.41, 2.67?1.03 and 2.33?0.52, 8.17?0.75, respectively. In the normal intestine, TGF?RⅠ, TGF?Ⅱ and Smad7 were mainly co-localized on the upper part of the villus. However, their expression was not only throughout the villus including fundus of crypts, but also in the mononuclear cells of the lamina propria and submucosa in the experimental intestine. The amounts of TGF?RⅠ, TGF?Ⅱ, Smad7 and the ratio of TGF?RⅠ/Ⅱ in control and colitis groups were 3.40?1.25, 21.71?6.97, 8.95?2.12, 0.16?0.01 and 6.49?3.18, 4.40?3.34, 17.92?6.80, 2.14?1.61, respectively. Conclusions Decreased TGF?RⅡ and increased Smad7 expressions indicate the abnormality of TGF? signal transduction in oxazolone-induced colitis. These pathologic and immunologic characteristics may resemble human ulcerative colitis.