Objective To evaluate the effect of probiotics on inducing and maintaining remission of ulcerative colitis (UC). Methods PubMed, EMBase, Web of Science and The Cochrane Central Register of Controlled Trials from 1966 to 2009 (up to August), and China Journal Full-text Database, Chinese Technologic Journal Database (Weipu), Wan Fang Digital Journal Full-text Database from 1978 to 2009 (up to August) were retrieved in order to collect clinical randomized controlled trials regarding the effect of probiotics in remission induction and maintenance in UC patients. Statistical analysis was performed by meta-analysis using Review Manager 4.2.10. Results Eleven randomized controlled trials met the inclusion criteria, of which five studies were included in the control trial of probiotics and placebo to evaluate the clinical remission rate, seven studies were included to compare probiotics with placebo (3 trials) or with mesalazine (4 trials) to evaluate the clinical relapse rate (one of the trials was included in the induction treatment group and the maintenance treatment group). Meta-analysis showed that: a) On the basis of combining with conventional therapy, probiotics were superior to placebo in clinical remission rate (OR=0.28, 95%CI: 0.16-0.49, P

Objective To observe the effect of alteplase intra-arterial thrombolysis combined with continuous monitoring of transcranial Doppler (TCD) in patients with acute cerebral infarction. Methods Fifty-four patients with acute cerebral infarction were divided into TCD group and control group by random digits table method. The patients of 2 groups were given alteplase intra-arterial thrombolysis, and the patients of TCD groups were combined with continuous monitoring of TCD. The degree of clinical neurologic impairment was evaluated by National Institutes of Health stroke scale (NIHSS) and Barthel index (BI). The condition of vascular recanalization was evaluated by the change of blood flow signal of TCD. CT was performed within 1 d after thrombolysis to detect intracranial hemorrhage and other adverse reaction. The degree of clinical neurologic impairment, blood vessel recanalization rate after thrombolysis and recanalization time and incidence of intracranial hemorrhage and other adverse reaction were compared between 2 groups. Results There were no statistical difference in NIHSS score before thrombolysis and 1 h after thrombolysis between 2 groups (P>0.05). The NIHSS scores 7 and 30 d after thrombolysis in TCD group were significantly lower than those in control group:(8.1 ± 4.9) scores vs. (12.1 ± 4.2) scores and (6.9 ± 3.1) scores vs. (10.9 ± 3.9) scores, there were statistical differences (P<0.05). The BI scores 7 and 30 d after thrombolysis in TCD group were significantly higher than those in control group: (78.5 ± 13.8) scores vs. (60.8 ± 12.4) scores and (82.6 ± 13.5) scores vs. (63.2 ± 12.9) scores, and there were statistical differences (P<0.05). The blood vessel recanalization rate 24 h after thrombolysis in TCD group was significantly higher than that in control group: 70.4% (19/27) vs. 44.4% (12/27), the recanalization time after thrombolysis was significantly shorter than that in control group: (36.4 ± 9.5) min vs. (58.5 ± 12.4) min, and there were statistical differences (P<0.05). No adverse reaction like intracranial hemorrhage and so on was found by CT detection within 1 d after thrombolysis in the 2 groups. Conclusions Alteplase intra-arterial thrombolysis combined with continuous monitoring of TCD in acute cerebral infarction has good curative effect, and no obvious adverse reaction.

Objective To investigate the effects of transcranial electrotherapy stimulation (TES)on patients with generalized anxiety disorder (GAD). MethodsA total of 62 patients with GAD were randomly divided into two groups,the study group (treated with TES and venlafaxine) and the control group (treated with venlafaxine only).TES was administered 1 time per day for 14 days,while venlafaxine was administered with oral intake of 75-150mg/d for 4 weeks.The clinical effects were assessed by using Hamilton anxiety scale (HAMA).ResultsThere was no difference between the two groups in average HAMA total scores,psychic and somatic factor scores before the treatments (P ＞ 0.05).The effective rate of study group was significantly higher ( P ＜ 0.05 ) at the end of the 1 st week after treatment than,but similar at the end of the 2nd and 4th week after treatment (P ＞ 0.05 ) to that,of control group,with regard to HAMA total score and psychic factor score.With regard to the HAMA somatic factor score,the effective rate of study group was not significantly different from that of control group at the end of the 1st,2nd and 4th week after treatment (P ＞ 0.05).ConclusionTranscranial electric stimulation in conjunction with venlafaxine may improve the symptoms of anxiety of patients.

AIM:To determine Radix et Rhizoma Rhici in Ganning Granula(Radix et Rhizoma Rhei,Rhizoma Chuanxiong). METHODS: In order to determine five anthraquinone aglycones of Radix et Rhizoma Rhei,the HPLC system consisted of Nucleosil ODS column,methand-0.1% phosphoric acid(85∶15) mixture as mobile phase,with detection wavelength at 430 nm. RESULTS: HPLC showed that the linearity ranges were as follows: aloe-emodin concentration was at the range of 0.041 6-0.291 2 ?g,the rhein concentration was at the range of 0.037 1-0.259 8 ?g,the emodin concentration was at the range of 0.045 8-0.320 3 ?g,the chrysophanol concentration was at the range of 0.049 60.347 2 ?g,the physcion concentration was at the range of 0.020 6-0.144 5 ?g.The average recoveries of five anthraquinone aglycones were between 96.6%-98.4%.CONCLUSION: The method is simple,accurate,sensible and with good repeatability and can be used for quality control of Ganning Granule.

Objective To develop and identify monoclonal antibodies (McAbs) against adult worm of Angiostrongylus cantonensis and observe its applicability. Methods BALB/c mice were immunized with soluble antigen of adult worms of A.cantonensis. The spleen cells of immunized mice were fused with myeloma cell, and the hybridoma secreting high titer of McAbs with high specificity was screened. By using the McAbs, serum of angiostrongyliasis patient and sera of the rats infected with A.cantonensis were detected by Western blotting and double antibody sandwich ELISA respectively. Results Three McAbs were established (2A2,3F1,4H2), which all showed no cross reaction with antigens of Schistosoma japonicum, Paragonimus westermani, Cysticercus cellulosae and Trichinella spiralis. Western blotting analysis demonstrated that the three McAbs recognized a Mr 15 000 soluble antigen of adult worm of A.cantonensis and recognized the Mr 24 000 and Mr 15 000 circulating antigens from the serum of angiostrongyliasis patient. The double antibody sandwich ELISA detection showed a positive rate of 76^5%. Conclusion Three hybridoma cell lines against adult worm of A.cantonensis have been established which secret high titer of McAbs with high specificity and seem promising in detecting the circulating antigen of the angiostrongyliasis patient.

Objective To clone and express prokaryotic recombinant plasmid of nucleoside triphosphate hydrolase (NTPase) gene of Toxoplasma gondii, and analyze its antigenicity. Method NTPase gene was amplified by PCR from RH strain of T. gondii and cloned into pGEM-T Easy vector. Positive clones were screened and identified by BglⅡ, HindⅢ digestion and sequenced. The target gene was then subcloned into prokaryotic expression vector pBAD-HisB and transformed into E. coli BL21(DE3). The expressed recombinant protein was purified with Ni-NTA agarose and further analyzed by sodium dodecyl sulfate polyacrylamide gel electropheresis (SDS-PAGE) and Western blotting. Results NTPase-Ⅱ gene was specifically amplified, and the homology of DNA sequence was 100% to that in the GenBank. SDS-PAGE showed that the recombinant NTPase protein with correct molecular weight was expressed highly in E.coli BL21(DE3). Western blotting testified that the purified recombinant protein could be specifically recognized by mouse serum immunized with T. gondii and mouse anti-recombinant protein serum. Conclusion The NTPase-Ⅱ gene has been cloned and expressed in E.coli BL21(DE3), and the purified protein of NTPase-Ⅱ gene displays a specific antigenicity.

Objective To improve the teaching methods of graduate students, and provide the theoretical basis for other teaching hospitals to extend the preclinical training mode of clinical medicine professional degree students. Methods 90 clinical medical postgraduate students of Grade 2012 were divided into four groups according to their specialized field and 54 hours of pre-job clinical intensive training were conducted at the same time. The training included four modules lectured by teachers with physician-in-charge above title, such as communication between doctors and patients and medical history collection, physical examination, medical record writing as well as theory of knowl-edge. Before and after the implementation of intensive training, these four skills and knowledge of the students were tested and assessed by professional teachers. Relevant data were paired t test, ANOVA and non-parametric tests. Results The test results of patient-doctor communication and patient history collection, physical examination, complete medical records and theoretical examination results of each group after training were improved to be higher than before (P<0.05). And the effect of patient-doctor communication and patient history collection was the most significant. The doctor-patient communica-tion and history acquisition performance of different groups of graduate students had statistically sig-nificant difference (P=0.001). Conclusion Strengthening the preclinical comprehensive training for medical postgraduate can make the students master the basic clinical skills better and more effectively and the corresponding training methods are worthy of popularization to the other teaching hospitals.

OBJECTIVETo explore the effect of jianxin pinglu pill (JPP) on arrhythmia and aquaporin 4 (AQP4) in rats with myocardial ischemia/reperfusion (I/R) injury.

METHODSThe effects of JPP on arrhythmia, mortality and AQP4 on I/R injured rats model induced by blocking left coronary artery were observed using II lead of ECG, HE stain and AQP4 immunohistochemical stain.

RESULTSJPP showed significant effect in lowering the arrhythmia occurrence and mortality, reducing myocardial ischemic edema and injury, strengthening AQP4 expression in myocardial tissue.

CONCLUSIONJPP has the effect of preventing I/R induced arrhythmia, it might be related with its action in up-regulating AQP4 expression level in myocardium and reducing the intracellular edema.

Animals ; Anti-Arrhythmia Agents ; pharmacology ; Aquaporin 4 ; Aquaporins ; analysis ; biosynthesis ; Arrhythmias, Cardiac ; metabolism ; prevention & control ; Drugs, Chinese Herbal ; pharmacology ; Female ; Male ; Myocardial Reperfusion Injury ; complications ; metabolism ; Rats ; Rats, Sprague-Dawley ; Water-Electrolyte Balance ; drug effects

Objective: To analyze the postoperative complications of Da Vinci robotic total gastrectomy for gastric cancer, and explore the risk factors for postoperative complications. Methods: The retrospective case-control study was conducted. The clinicopathological data of 173 patients with gastric cancer who were admitted to the First Affiliated Hospital of Army Medical University from March 2010 to March 2019 were collected. There were 138 males and 35 females, aged from 34 to 76 years, with an average age of 60 years. All the 173 patients underwent Da Vinci robotic total gastrectomy for gastric cancer. Observation indicators: (1) postoperative complications; (2) analysis of risk factors for postoperative complications of Da Vinci robotic total gastrectomy for gastric cancer. Count data were expressed as absolute numbers or percentages. Univariate analysis was performed using the chi-square test or Fisher exact probability. Indicators with P<0.1 were included into multivariate analysis, and multivariate analysis was performed using logistic regression model. Results: (1) Postoperative complications: of the 173 patients, 45 had postoperative complications, with a incidence rate of 26.0%(45/173). Among the 45 patients, 5 had gradeⅠpostoperative complications, 31 had grade Ⅱ postoperative complications, 2 had grade Ⅲa postoperative complications, 3 had grade Ⅲb postoperative complications, 1 had grade Ⅳa postoperative complications, 1 had grade Ⅳb postoperative complications, and 2 had grade Ⅴ postoperative complications. The incidence of serious complications was 5.2%(9/173). Of the 5 patients with gradeⅠcomplications, 1 of fever was improved after antipyretic treatment, 2 of incisional fat liquefaction were improved after dressing change, 1 of vomiting was improved after being given antiemetic, and 1 of delayed recovery of gastrointestinal function was improved after symptomatic treatment. Among 31 patients with gradeⅡcomplications, 12 patients had pulmonary infection, including 6 of pulmonary infection alone, 3 combined with pleural effusion, 1 combined with abdominal infection, 2 combined with intestinal obstruction, and all were improved after conservative treatment; 7 of fever were improved after anti-infection treatment; 4 patients had deep venous catheter infection including 1 combined with bilateral pleural effusion, and were improved after removing catheter and anti-infection treatment; 3 patients had anastomotic leakage including 1 with pulmonary infection and abdominal infection, and were improved after conservative treatment; 2 patients had duodenal stump leakage (1 combined with pulmonary infection, 1 combined with pulmonary infection and pleural effusion) , and were improved after conservative treatment; 1 patient had abdominal hemorrhage, and was improved after conservative treatment; 1 patient had intestinal obstruction, and was improved after conservative treatment; 1 patient had abdominal infection, and was improved after conservative treatment. Of the 2 patients with grade Ⅲa complications, 1 had duodenal stump leakage combined with abdominal abscess, and was improved after puncture and drainage; 1 had pleural effusion combined with pulmonary infection, and was improved after puncture and drainage. Among the 3 patients with grade Ⅲb complications, 1 of abdominal hemorrhage was improved after reoperation, 2 of anastomotic leakage were improved after being placed jejunal nutrition tube under painless gastroscopy. Of the 2 cases, 1 combined with abdominal infection and 1 combined with pleural effusion and abdominal infection were improved after puncture and drainage. Among the 2 patients with grade Ⅳ complications, 1 of Ⅳa encountering respiratory failure was improved after treatment due to misinhalation of anesthesia, and 1 of Ⅳb suffered from multiple organ failure and was improved after treatment due to anastomotic leakage. Two patients with grade V complication died, including one with anastomotic leakage, abdominal hemorrhage, and multiple organ failure, and the other with respiratory failure and cardiac insufficiency. In the 173 patients, the incidence of comprehensive complication index (CCI) ≥ 25.2 was 11.0%(19/173). (2) Analysis of risk factors for postoperative complications of Da Vinci robotic total gastrectomy for gastric cancer: univariate analysis showed that body mass index (BMI), volume of intraoperative blood loss, and operation time were the related factors affecting the postoperative complications (χ²=4.275, 5.057, 5.463, P<0.05). BMI and volume of intraoperative blood loss were the related factors affecting the postoperative serious complications (χ²=7.517, 5.537, P<0.05). Age, BMI and Charlson Comorbidity Index were the related factors affecting CCI ≥25.2 (χ²=8.946, 7.890, 4.062, P<0.05). Multivariate analysis showed that tumor diameter ≥ 3 cm and tumor located at esophagogastric junction were independent risk factors for postoperative complications [odds ratio (OR) =4.350, 2.175, 95% confidence interval (CI): 1.352-14.000, 1.018-4.647, P<0.05)]. BMI ≥25 kg/m² was an independent risk factor for serious complications after operation (OR=5.156, 95%CI: 1.120-23.738, P<0.05). Age ≥60 years, BMI ≥25 kg/m², and history of abdominal surgery were independent risk factors for CCI≥25.2 (OR=30.928, 3.557, 6.009, 95%CI: 1.485-644.19, 1.082-11.691, 1.358-26.592, P<0.05). Conclusions The Clavien-Dindo classification of patients after Da Vinci robotic total gastrectomy for gastric cancer is mostly gradeⅡ. The main complications are pulmonary-related complications. CCI can better predict the risk factors for serious complications after operation. Tumor diameter ≥ 3 cm and tumor located at esophagogastric junction are independent risk factors for postoperative complications; BMI ≥25 kg/m² is an independent risk factor for serious complications; age ≥60 years, BMI ≥25 kg/m², and history of abdominal surgery are independent risk factors for CCI≥25.2.

Objective:To propose and verify a surgical classification system for the axial primary malignant and aggressive benign tumor.Methods:The CZH surgical classification system was originally developed for the axial primary malignant and aggressive benign tumor. The CZH surgical classification system includes seven types, according to the anatomic features and the extension of tumor violation. A total of 136 patients (79 males and 57 females) with axial primary malignant and aggressive benign tumor from multiple tertiary centers who received surgery from July 2006 to July 2019 were included. The average age was 44.40±17.55 years (8-83 years) old. There were 99 malignant tumors and 37 aggressive benign tumors included. The number of patients with each classification was presented as followed, Type I 13, Type II 15, Type IIIa 3, Type IIIb 20, Type IVa 43, Type IVb 12, Type Va 21, Type Vb 3, Type VI 2, Type VIIa 3 and Type VIIb 1. Surgical procedures were selected according to different types in classification. The inter- and intra-observer consistencies were evaluated by the Kendall's W test. The VAS, Frankel score, overall survival and recurrence free survival were recorded during the follow-up. Results:The inter- and intra-observer consistent coefficient was 0.973 and 0.996, respectively ( P<0.05). The single posterior approach was adopted for the Type II tumors. Other patients underwent surgery by the combined antero-posterior approach. The majority in anterior approach (113 cases) was the modified submandibular approach. The reconstruction modes included anterior "T" shape titanium mesh (112 cases) or the 3D printed prothesis (7 cases) combined with the posterior occipto-cervical fusion (92 cases) or the pedicle screw system (44 cases). The average surgical duration and the volume of intraoperative bleeding was 348.40±136.14 min (60-760 min) and 1 225.69±859.40 ml (80-4 000 ml), respectively. The operation duration and volume of intraoperative bleeding among each type were with statistical difference. The patients with Type IV, V tumors had longer operation duration than those with Type II tumors. Those with Type V and VII tumors had longer operation duration than those with Type I tumors. The patients with Type V tumors had more intraoperative bleeding than those with Type I-IV tumors. The average preoperative VAS score was 4.15±2.25 and then was reduced significantly to 0.62±0.71 and 0.38±0.59 at one and three months after operation, respectively. The Frankel score was also significantly ameliorated at one and three months postoperatively. There were 22 postoperative complications (16.2%). The complications included cerebral spinal fluid leak (12.5%), dysphagia and/or dysphonia (7.4%), dyspnea (5.1%), wound infection (3.7%), wound hemorrhage (2.2%) and pharyngeal dehiscence (1.5%). The incidence of postoperative complication was 25.9% in Type IV-VII tumors, while 11.8% in Type I-III tumors. Conclusion:CZH surgical classification system was verified with high observer consistency. This classification system could assist surgeons to select proper surgical approaches, resection modes and reconstruction modes, and thus ensure the safety of surgery and reduce the recurrence. The tumors in Type IV, V and VII may be with more challenging for surgeons. The incidence of postoperative complication in Type IV-VII tumors may be higher than that in Type I-III tumors.