Cardiomyopathy, Hypertrophic ; Humans ; Pulmonary Edema

Objective To evaluate the effect of errorless learning on memory processes.Methods Eight- y-four participants were randomly divided into three groups:a group which received computer-assisted memory train- ing (CAMG,n=30) ,a therapist-administered memory training group (TAMG,n=24) and a control group (CG,n =30).A 20-session training course with a Chinese cultural background was tailor-made for Chinese subjects with memory disorders.It was administered over the course of one month to the test groups with a similar course structure and content but different delivery modes.The control group had no training.The Rivermead Behavioral Memory Test- Chinese Version (RBMT-CV) and the Hong Kong List Learning Test (HKLLT) were used to assess memory ability and process at the start and end of the training,and one month later.A repeated measures analysis of variance was used to compare differences across the three groups.Results Comparing pre-training with post-training and follow- up,RBMT-CV and HKLLT scores improved significantly.The CAMG group demonstrated better progress encoding and storage on the HKLLT (including the random and blocked conditions) than the TAMG group.Conclusions Errorless learning is likely to be an effective technique for improving memory function in patients with traumatic brain injury.Its effects last for at least one month.Computer-administered training was more effective than therapist-admin- istered face to face training,especially in improving encoding and storage memory processes.

Objective:To study the influence of triptolide on neutrophils asthmatic mice of WBC and EOS in bronchoalveolar lavage fluid.Methods:Using ovalbumin ( OVA) combined with lipopolysaccharide ( LPS) method to establish sensitized asthmatic mice,BALB/c mice were randomly divided into 32 neutrophilic asthma group ( NA group ) , neutrophil triptolide intervention group (TLN group),neutrophil dexamethasone group (DXN group) and normal control group (NC group),n=8,hemocytometer calculated for each group of mice bronchoalveolar lavage fluid ( BALF) of the total number of WBC and EOS;smears stained Switzerland View in-flammatory cell infiltration.Results: In bronchioalveolar lavage fluid, numbers and infiltrations of WBC and EOS were significantly decreased in the DXN,TLN group than those in the NA group(P<0.05);but were significantly higher than the NC group (P<0.05), the DXN group above parameters were significantly higher than the TLN group ( all P<0.05 ) .Conclusion: Triptolide can reduce the total number of BALF WBC and EOS,inhibit lung WBC,EOS infiltration,ease neutrophilic airway inflammation.

Objective To investigate the accuracy of 320-slice row CT system for the detection of coronary artery disease(CAD)in high pre-test probability population without heart rate/rhythm control.Methods Thirty patients with a high pre-test probability of CAD underwent 320-slice row CT without preceding heart rate/rhythm control.Invasive coronary angigraphy(ICA)served as the standard reference.Data sets were evaluated by 2 observers in consensus with respect to stenoses≥50% decreased diameter.The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and Youden index were analyzed;the impact of heart rate and calcification on image quality as well as diagnostic accuracy were also analyzed by Chi-square test Results Mean heart rate during scanning was 73.7±15.4 beats per min(bpm),and median(QR)of Agatston score of segment was 45.6(181).On a per-segment analysis,overall sensitivity was 96.1%(74/77,95%CI:89.03%-99.19%),specificity was 98.3% (337/343,95%CI:96.23%-99.36%),PPV was 92.5% (74/80,95%CI:84.39%-97.20%),NPV of 99.1% (337/340,95%CI:97.44%-99.82%)and the Youden index was 0.94.In both heart-rate subgroups(242 in heart rate＜70 bpm group,169 in heart ratet≥70 bpm group),diagnostic accuracy for the assessment of coronary artery stenosis was similar(P＜0.05).The accuracy and the quality score of the subgroup Agatston score≥100 were lower than that of the subgroup Agatston score＜100;however,the difiercnce of results between 320-slice row CT and ICA was not significant(P＜0.05).Conclusion 320-detector row CT can reliably detect coronary artery stenoses in a high pre-test probability population without heart rate/rhythm control.

OBJECTIVETo determine Campylobacter contamination level and antimicrobial resistance patterns from chicken carcasses in supermarkets and farmer's markets of 9 districts in Beijing.

METHODSFrom August 2012 to July 2013, whole chicken carcasses (n = 240) were collected from 27 supermarkets and 18 farmer's markets of nine districts in Beijing. The level of Campylobacter contamination was enumerated by plate counting method using the modified Karmali and modified Preston agar. Presumptive Campylobacter isolates were identified and characterized by gram stain, agglumination test and a multiplex PCR method. The level of Campylobacter contamination was calculated following the USDA/FSIS Campylobacter enumeration method. Selected 151 Campylobacter isolates were further characterized by minimal inhibitory concentrations(MICs) of eight antimicrobials.

RESULTSA total of 26.3% (63/240) of the retail whole chicken carcasses were contaminated by Campylobacter and 151 Campylobacter isolates were recovered, including 85 Campylobacter jejuni isolates and 66 Campylobacter coli isolates. The P25, P50, P75 of Campylobacter contamination concentration were 7.5, 45.0 and 350.0 CFU/g, respectively. The antimicrobial resistance rate of C. jejuni and C. coli were as the following: azithromycin(AZI, 13% (11/85), 82% (54/85)), chloramphenicol (CHL, 33% (28/85), 42% (28/85)), ciprofloxacin (CIP, 95% (81/85), 100% (85/85)), doxycycline (DOX, 38% (32/85), 80% (53/85)), erythromycin (ERY, 12% (10/85), 82% (54/85)), gentamicin (GEN, 25% (21/85), 68% (45/85)), tetracycline (TET, 67% (57/85), 73% (62/85)), all isolates were susceptible to meropenem (MEP). The multi-drug resistance ratio of C. jejuni (55% (47/85) )was significantly lower than that (86% (57/66) )of C. coli (χ(2) = 16.70, P < 0.01). Among 151 Campylobacter isolates, 21 antimicrobial resistance patterns were identified, including 20 patterns among C. jejuni isolates and 10 patterns among C.coli isolates. Among C.jejuni isolates, CIP-DOX-TET was dominant (22% (19/85)), followed by CIP-TET (14% (12/85)), CHL-CIP-TET(9% (8/85)) and CHL-CIP-GEN (7% (6/85)). Among C.coli isolates,AZI-CHL-CIP-DOX-ERY-GEN-TET (35% (23/66)) was the dominant, followed by AZI-CIP-DOX-ERY-GEN-TET (21% (14/66) )and AZI-CIP-DOX-ERY-TET(15% (10/66)).

CONCLUSIONOur findings showed a high prevalence and concentration of Campylobacter contamination in retail chicken carcasses of nine districts in Beijing, especially the on-site slaughtered chicken from the farmer's markets. The resistance levels of these recovered Campylobacter isolates were serious.

Animals ; Anti-Bacterial Agents ; Campylobacter coli ; classification ; drug effects ; Campylobacter jejuni ; classification ; drug effects ; Chickens ; Drug Resistance, Multiple, Bacterial ; Food Microbiology ; Meat ; Microbial Sensitivity Tests

OBJECTIVETo compare the short-term efficacy of laparoscopic and open transabdominal intersphincteric resection (ISR) for low rectal cancer.

METHODSClinicopathological data of 246 patients with low rectal cancer undergoing transabdominal ISR in our department from January 2005 to January 2015 were retrospectively analyzed. According to gender, age, ASA score, neoadjuvant chemoradiotherapy or not, pathological T stage, pathologic N stage, and tumor differentiation, propensity score matching was performed by R plug-in(version 2.8.1). Finally, 74 cases treated by laparoscopic transabdominal ISR(laparoscopic group) and 74 cases by open transabdominal ISR(open group) were enrolled. Short-term efficacy and anal function were compared between two groups.

RESULTSNo perioperative death was found in the two groups. Compared to open group, laparoscopic group had longer operation time [(236±45) minutes vs. (200±46) minutes, P=0.000], less median blood loss [50(10 to 200) ml vs. 100(20 to 400) ml, P=0.000] and shorter hospital stay [(7.8±2.4) days vs. (10.5±6.9) days, P=0.002]. Laparoscopic group and open group had similar morbidity of total complication [17.6%(13/74) vs. 28.4%(21/74), P=0.118]. Incidence of pneumonia was significantly lower in laparoscopic group [4.1%(3/74) vs. 13.5%(10/74), P=0.042), while incidence of anastomotic leakage and stenosis, and complication grading were not significantly different between the two groups (all P>0.05). During a mean follow-up of 52.0 months, anal function analysis was performed in 102 patients with stoma closure and the result showed that the ratio of patients with good continence was 87.1%(54/62) and 87.5%(35/40) in laparoscopic and open group respectively (P=0.066).

CONCLUSIONLaparoscopic transabdominal ISR is safe and feasible, which is minimally invasive with fast recovery, and is worth clinical application.

Aged ; Anastomotic Leak ; Chemoradiotherapy ; Female ; Humans ; Laparoscopy ; methods ; Length of Stay ; Male ; Middle Aged ; Neoadjuvant Therapy ; Operative Time ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo explore the risk factors of anal function after transabdominal intersphincteric resection(ISR) for low rectal cancer.

METHODSClinical and follow-up data of 96 patients with low rectal cancer who underwent transabdominal ISR in our department from January 2005 to December 2012 were analyzed retrospectively. The Wexner scoring scale was used to evaluate the anal function and the risk factors of anal function were analyzed by the Cox proportional hazard model.

RESULTSNinety-six patients completed Wexner scoring scale with mean follow-up of 32.7 months. Eighty-three cases(86.5%) presented good continence with a Wexner score less than 10. There was negative correlation between Wexner score and follow-up duration (Pearson coefficient, -0.078, P=0.003). Univariate analysis suggested the distance less than 5 cm from tumor to anal verge(P=0.043), height less than 2 cm from anastomosis to anal verge (P=0.001) and neoadjuvant chemoradiotherapy(P=0.001) were the risk factors. Multivariate analysis revealed that distance less than 2 cm from anastomosis to anal verge(P=0.020) and neoadjuvant chemoradiotherapy(P=0.001) were independent risk factors for fecal incontinence.

CONCLUSIONSMost patients have good continence after transabdominal ISR. A distance of less than 2 cm from anastomosis to anal verge and neoadjuvant chemoradiotherapy are independent risk factors for poor anal function after transabdominal ISR.

Anal Canal ; physiopathology ; Fecal Incontinence ; Humans ; Rectal Neoplasms ; physiopathology ; surgery ; Retrospective Studies ; Risk Factors

OBJECTIVETo explore predictive factors associated with pathologic complete response (pCR) after neoadjuvant chemoradiotherapy for rectal cancer.

METHODSClinicopathological data of 163 patients with locally advanced rectal cancer who were treated with neoadjuvant chemoradiotherapy followed by radical surgical resection from January 2007 to May 2013 were analyzed retrospectively. Univariate analysis and multivariate logistic regression analysis were performed to analyze associated factors of pCR, including age, gender, body mass index (BMI), diabetes, anemia, tumor diameter, distance of the tumor from the anal verge, circumferential extent of the tumor, tumor pathological types, tumor differentiation, pre-chemoradiotherapy T stage, pre-chemoradiotherapy N stage, pre-chemoradiotherapy CEA level, pre-chemoradiotherapy CA199 level, per-operation CEA level, pre-operation CA199 level, radiation dose, chemotherapy modality, time interval from completion of chemoradiotherapy to surgery, etc.

RESULTSTwenty-nine patients(17.8%) achieved pCR after neoadjuvant chemoradiotherapy for rectal cancer. Univariate analysis showed circumferential extent of tumor(≥1/2 cycle)(P=0.018), tumor pathological types(adenocarcinoma)(P=0.036), tumor differentiation (moderate or high)(P=0.021) and pre-chemoradiotherapy CEA level(≤2.5 μg/L)(P=0.007) were significantly correlated with pCR after neoadjuvant chemoradiotherapy for rectal cancer. Logistic regression revealed that circumferential extent of tumor (≥1/2 cycle)(OR=2.901, P=0.020) and pre-chemoradiotherapy CEA level (≤2.5 μg/L)(OR=2.775, P=0.022) were independent predictive factors of pCR after neoadjuvant chemoradiotherapy for rectal cancer.

CONCLUSIONPatients with circumferential extent of tumor ≤1/2 and pre-chemoradiotherapy CEA level ≤2.5 μg/L are more likely to achieve pCR after neoadjuvant chemoradiotherapy for rectal cancer, and these two indices can be used to predict pCR after neoadjuvant chemoradiotherapy for rectal cancer.

Adult ; Aged ; Chemoradiotherapy ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Rectal Neoplasms ; therapy ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the influence of anastomotic leakage (AL) on long-term survival after resection for rectal cancer.

METHODSClinicopathological data of 653 rectal cancer cases confirmed by pathology and undergoing R0 resection for rectal cancer in our department from January 2007 to December 2011 were retrospectively analyzed. Anastomotic leakage was found in 40 cases (AL group) and not in the other 613 cases (non-AL group). After median 47 (1-91) months of follow-up, 5-year disease-free survival rate, distant metastasis rate and local recurrence rate were compared between the two groups. Risk factors affecting long-term prognosis were also analyzed.

RESULTSThe 5-year disease-free survival rate, 5-year distant metastasis rate, and 5-year local recurrence rate were 78.1%, 14.2% and 4.2% in the non-AL group, and 74.5%, 20.1% and 8.4% in the AL group respectively, and the differences were not statistically significant (P=0.808, P=0.965, P=0.309). Multivariate analysis showed that preoperative neoadjuvant radiochemotherapy, TNM staging, abnormal CA199, preoperative low level of albumin were independent prognostic factors of rectal cancer patients after R0 resection, while AL was not an independent factor of 5-year disease-free survival (P=0.910). Further multivariate analysis on 507 cases receiving postoperative adjuvant chemotherapy also revealed that AL was not an independent factor of 5-year disease-free survival (P>0.05). Percentage difference of patients finishing postoperative chemotherapy between the two groups was not statistically significant (79.4% vs. 76.3%, P=0.681).

CONCLUSIONAL is not an independent predictor of long-term survival for rectal cancer.

Anastomotic Leak ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Humans ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Postoperative Period ; Prognosis ; Rectal Neoplasms ; pathology ; Retrospective Studies ; Survival Rate

OBJECTIVETo establish a nomogram model to predict the peritoneal metastasis in colon cancer patients without distant metastasis by preoperative imaging examination.

METHODSClinicopathological data of colon cancer patients without distant metastasis by preoperative imaging examination who underwent surgery in our department between January 2000 and December 2014 were retrospectively analyzed. Predictors of peritoneal carcinomatosis were analyzed by univariate and Logistic multivariate analyses. Base on the independent predictors by multivariable analysis results, a nomogram model was formulated with further use of R software. The total score was calculated by the addition of each predictor score, indicating the corresponding risk of peritoneal metastasis. The score was greater in the nomogram, and the risk was higher in peritoneal implantation metastasis. A receiver operating characteristic(ROC) curve was then constructed to evaluate the predictive abilities of the various preoperative factors and nomogram.

RESULTSA total of 1 417 patients were defined as above and enrolled in the study. The median age was (60.5±13.3) years, 835 cases (58.9%) were male, and 132 cases (9.3%, 132/1417) were diagnosed with synchronous peritoneal carcinomatosis during operation. Univariate analysis showed that peritoneal metastasis was associated with age, incidence of abdominal pain, incidence of mucous bloody stool, CEA level, traversible rate, tumor diameter, ratio of infiltrating type cancer, differentiation, histological type, cT staging and cN staging (all P<0.05). Logistic multivariate analysis revealed that younger age (OR:0.974, 95%CI: 0.958 to 0.990, P=0.001), later clinical T stage (OR: 2.949, 95%CI: 1.588 to 5.476, P=0.001), lesion not traversible(OR: 0.519, 95%CI: 0.314 to 0.858, P=0.011), infiltrative gross type (OR: 1.812, 95%CI: 1.099 to 2.987, P=0.020), larger tumor (OR: 1.044, 95%CI: 0.998 to 1.093, P=0.061), higher preoperative serum CEA level(OR:1.004,95%CI: 1.001 to 1.007, P=0.007) and histopathologic type of mucinous or signet ring cell adenocarcinoma (OR:1.642, 95%CI: 1.009 to 2.673, P=0.046) were independent risk factors. The nomogram model was further established based on above 7 independent risk factors, whose total score was 350 and area under the ROC curve was 0.753(P=0.000).

CONCLUSIONThe nomogram model can be helpful to screen the colon cancer patients with high risk of peritoneal metastasis and to avoid unnecessary laparotomy for colon cancer patients without distant metastasis by preoperative imaging examination.