ObjectiveTo evaluate the reliability and validity of Chinese version of Asia-Pacific functional gastrointestinal disorders (FGIDs) questionnaire. Methods The standardized scale translation program was used to translate the Asia-Pacific functional gastrointestinal disorders questionnaire into Chinese version.From April to May 2011,the functional gastrointestinal disorders (FGID) out-patients of the Department of Gastroenterology at the First Affiliated Hospital of Sun Yat-Sen University were asked to complete the Chinese version of the questionnaire,then the feasibility,reliability and validity of the questionnaire were evaluated.ResultsA total of 58 FGIDs patients finished the questionnaire,of which 37 patients with good compliance finished the 2-week interval questionnaire.The retest reliability of the first part of the questionnaire was good (including basic information,disease duration and alarm symptoms),all the test-retest coefficients were more than 0.70.The percentage of poor,medium and good retest reliability items of the second part of the questionnaire (including the symptoms of gastrointestinal system) was 27.8％,61.1％ and 11.1％respectively.After the data was transformed into binary data according to Rome Ⅲ diagnostic criteria,the percentage of poor,medium and good retest reliability items was 5.5％,41.7％ and 52.8％respectively.The percentage of poor,medium and good retest reliability items of the third part of the questionnaire (including previous medical treatment,medication and the impact of the disease on life,etc) was 36.0％,40.0％ and 24.0％ respectively.The validity of the questionnaire was moderate according to the Rome Ⅲ diagnostic criteria.Conclusion The Chinese version of Asia-Pacific functional gastrointestinal disorders is feasible and can be used to screen the adult FGIDs under the Chinese cultural background.

BACKGROUND: Treatment of ulcerative colitis (UC) with herbs-partition moxibustion is of good intervenient effect, whether the effect is related to neutrophil apoptosis in the pathogenic process of UC?OBJECTIVE: To investigate the changes of neutrophil appptosis rate of rats with UC and the regulative effect of medicinal cake moxibustion. DESIGN: A randomized controlled trial based on SD rats.SETTING: Shanghai Research Institute of Acupuncture and Meridian.MATERIALS: The experiment was completed from August 2002 to June 2003. A total of 30 healthy male SD rats of clean grade, weighing (140±20) g,provided by Experimental Animal Center of Shanghai University of Traditional Chinese Medicine, were at random divided into 2 groups: model building group (n=20) and normal control group (n=10).METHODS: Rat UC models were set up with immunological method. After the models were successively set up, four model rats and two normal rats were randomly selected for pathological observation of distal colon tissue. The rest models were divided as model group and herbs-partition moxibustion group with 8 rats for each, and the rest 8 normal rats were taken as control group. The rats of herbs-partition moxibustion group were given herbs-partition moxibustion at tian shu (ST-25) of both sides and qi hai (CV-6) points; the herbs cones was made from Radix Aeoniti Praeparata,Cortex Cinnamoni, and so on. About 90 mg moxa cone was put on the herbs cones for moxibustion, once a day, for 10 times. After treatment, all rats of the three group were executed, then the peripheral monocytes were isolated for cell culture. A 1:50 diluted supernatants of each group were taken, and the same volume of RPMI-1640 culture fluid was used as blank control group. They were respectively incubated together with neutrophils of peripheral blood of normal rats. The neutrophil apoptosis rates were measured by using flow cytometry.MAIN OUTCOME MEASURES: Comparison of neutrophil apoptosis rates of rats in each group.RESULTS: Totally 20 rats in model group and 10 in normal control group were accepted. Then 4 rats in model group and 2 in normal group were sacrificed and observed with tissue pathology, and 16 and 8 rats entered the final analysis in model and normal control groups respectivelly. ① The neutrophil apoptosis rate of UC rats was significantly lower that that of rats in blank control group [(16.34±2.80) ％, (52.33±9.94) ％, q= -35.99, P＜ 0.01]; but there was no significant diffenence between normal control group [(48.79±11.33) ％] and blank control group, (P＞0.05). ② After treatment the neutrophil apoptosis rate of herbs-partition moxibustion group [(36.03±8.31) ％] was significantly higher than that of UC model group (q=19.69, P ＜ 0.01), but it was still lower than that of normal control group (q= -16.30, P ＜ 0.05).CONCLUSION: One of the main mechanism for herbs-partition moxibustion to treat UC might be regulating and/or reducing the inhibited state of neutrophil apoptosis in UC.

The first case of acquired syphilitic skull osteitis accompanied by syphilitic meningitis in China is reported.A 55-year-old female presented with a persistent distending pain of the frontal and occipital regions of the skull for two months.T1 weighted magnetic resonance imaging(MR1) showed muhiple lesions in the skull and linear enhancement of the meninge near the lesions.The serum and cerebrospinal fluid (CSF) were positive for Treponema pallidum particle agglutination assay (TPPA) and rapid plasma reagin circle card test(at the dilutions of 1∶32 and 1∶4 respectively).The levels of leukocyte and protein were 10 ×106/L and 0.82 g/L respectively in CSF.TP DNA was detected in the calvarial periosteum.Histopathological examination of the frontal bone showed focally destructive osteolytic lesions with obscure texture of the bone,hyperemia around the destructive bone tissue and in dura mater-like tissues,proliferation of interstitial fibrous tissue,swelling of endothelial cells and inflammatory infiltration predominantly composed of abundant plasma cells.After managed with routine treatment regimen for neurosyphilis,her headache was relieved 3 days later,nearly disappeared 15 days later,completely disappeared 30 days later.No similar headache recurred.A 5year follow up demonstrated a satisfactory long-term and short-term outcome.She was finally diagnosed with syphilitic skull osteitis complicated by syphilitic meningitis.

OBJECTIVEThis study aimed to observe the postoperative pain rate and degree of pain in preschool children with cleft lip and palate, and investigate the effect of nursing intervention on pain relief.

METHODSA total of 120 hospitalized cases of three- to seven-year-old preschool children with cleft lip and palate were selected from May to October 2011. The subjects were randomly divided into the control group and experimental groups 1, 2, and 3. The control group used conventional nursing methods, experimental group 1 used analgesic drug treatment, experimental group 2 used psychological nursing interventions, and experimental group 3 used both psychological nursing intervention and analgesic drug treatment. After 6, 12, 24, and 48 h, pain self-assessment, pain parent-assessment, and pain nurse-assessment were calculated for the four groups using the pain assessment forms, and their ratings were compared.

RESULTSThe postoperative pain rates of the four groups ranged from 50.0% to 73.3%. The difference among the four groups was statistically significant (P < 0.001). The differences among the control group and experimental groups 1 and 2 were not statistically significant (P = 0.871), whereas the differences among experimental group 3 and the other groups were statistically significant (P < 0.001).

CONCLUSIONPostoperative pain in preschool children with cleft lip and palate is common. Psychological nursing intervention with analgesic treatment is effective in relieving postoperative pain.

Child, Preschool ; Cleft Lip ; surgery ; Cleft Palate ; surgery ; Humans ; Pain, Postoperative

Objective To understand the prevalence and distribution characteristics of symptoms of anorectal diseases in Chinese residents(older than 18) as to provide reference for prevention,care and treatment of anorectal diseases.Methods Stratified sampling was used according to the economic level in every province in the country,and each province selected two cities.Face-toface interviews were used to collect data in 68 906 interviewers and SPSS 17.0 was performed to analyze the data.Results Of 68 906 respondents,25 634 (37.20 ％) reported to suffer from at least one symptoms of anorectal diseases.The prevalence of the top 5 main symptoms of anorectal diseases were prolapse of anus neoplasms(14.55％),anal sore(16.53％),anal pendant expansion (14.98 ％),perianal abscess (5.88 ％),hematochezia (22.52 ％).Each symptom frequency difference was statistically significant (x2=7 727.6,P＜0.001).Populations which proned to suffer from symptoms of anorectal disease had the following characteristics:living in city,male,ageing 25-54 years old,having specialist qualifications,lacking of physical.Conclusion The prevalence of symptoms of anorectal diseases among Chinese residents was high,and each symptom had its distribution characteristics.More targeted interventions should be taken in anorectal disease prone people.

Objective To evaluate the safety and efficacy of magnetic resonance-guided focused ultrasound surgery (MRgFUS) in treatment of symptomatic uterine leiomyoma among Chinese reproductive age women.Methods From April 2010 to April 2012,80 premenopausal women with symptomatic leiomyoma volunteered to participate in this prospective study in Department of Outpatient of Peking Union Medical College Hospital.Among 23 reproductive aged patients with size of uterus less than 16th gestational weeks,2.5 to 10 cm of diameter of myoma,less than 10 myomas and expressing symptoms clearly were treated by MRgFUS.Treatment data,non-perfused volume ratio (NPVR) and adverse events were recorded.After treatment,patients were followed up at 1 week,1,3,6,12 and 24 months,respectively.Patients at initial screening and each time of the follow-up filled out uterine fibroid symptoms quality of life (UFS-QOL),which include symptoms severity score (SSS) and health-related quality of life (HRQL).The volumes of leiomyoma and uterine were evaluated on MRI before and after the treatment (at 6 and 12 months,respectively).Before operation,routine blood test were performed on all patients,anemia patients at 3 months and 1 year after treatment were checked with blood test.Results (1) Treatment data and adverse events:the mean therapeutic temperature was (69 ± 7) ℃,the mean treatment time was (144 ±62) min,the mean NPVR was (62 ±23)％.Adverse events included mild erythema(1/23),abdominal cramp(8/23),vaginal discharge (5/23),and leg numbness (4/23).(2) The rate of secondary surgery:one patient was treated by myoectomy and hysterectomy within one year following up and 4 patients chose surgical treatment during the second-year follow-up.(3) Volume change:the volumes of leiomyoma before the treatment and 6,12 months after the treatment are 75.6 (P25 =43.8,P75 =128.9),52.3 (P25 =23.8,P75 =111.2),45.9 (P25 =26.3,P75 =71.7) cm3,respectively; and the volumes of uterine before the treatment and 6,12 months after the treatment are 270.0 (P25 =208.4,P75 =390.3),216.4 (P25 =151.1,P75 =290.0),200.0 (P25 =149.1,P75 =267.6) cm3,respectively.Both leiomyoma and uterine volumes decreased significantly after treatments (P ＜ 0.01).(4) UFS-QOL change:the symptoms severity score (SSS) before the treatment and 3,12 months after the treatment are (34 13),(22 ± 11),(19 ± 12),which decreased significantly (P ＜ 0.01).The health-related quality of life (HRQL) before the treatment and 3,12 months after the treatment are (74 ± 15),(82 ± 13),(89 ± 10),which increased dramatically (P ＜0.01).(5) Hemoglobin(HGB) change:eleven patients suffered from anemia before treatments,the mean HGB before treatment was (87 ±6) g/L and were (106 ± 14) g/L 3 months after treatment,(112 ± 10) g/L 12 months after treatment.The HGB was increased significantly after treatments (P＜0.01).Conclusions MRgFUS is a safe and effective non-invasive management for symptomatic uterine leiomyoma in short-term follow up.But there is additional treatment ratio after MRgFUS.

ObjectiveTo prospectively compare the effects of Prestige LP cervical disc replacement with those of anterior cervical discectomy and fusion (ACDF) in treatment of cervical disc herniation.MethodsFrom January 2008 to March 2010,a total of 87 patients were enrolled at our site as study investigating ACDF versus Prestige LP cervical disc prosthesis.Forty-four patients received the investigational device (arthroplasty group) and 43 underwent a single-level ACDF (fusion group).Visual analogue scale(VAS) neck/arm pain,Japanese Orthopedics Association (JOA) score,Short Form-36 (SF-36) both physical and mental,flexion-extension range of motion of operative and adjacent segments were evaluated preoperatively and 1 week and 3,6,12,24 months postoperatively.ResultsA total of 78 patients (89.7％) were followed up for an average 12.4 months(range,6-24).Both groups have favorably demonstrated improved functional outcomes for JOA,VAS scores and SF-36.The improvement in the VAS and JOA scores were equivalent at each follow-up point between the two groups(P＞0.05).However,arthroplasty group had statistically significant improvement as assessed by the SF-36 scores compared with the fusion group at some follow-up points (P＜0.05).In arthroplasty group,the postoperative range of motion of operative and adjacent segments showed no statistical difference with the preoperative counterpart(P＞0.05),and fusion was successful in 92.1％ of control patients.ConclusionPrestige LP cervical disc replacement is a feasible alternative to ACDF for patients with persistently symptomatic cervical disc disease and matching the inclusion criteria.

ObjectiveTo evaluate the safety and efficacy of total pelvic reconstruction surgery with Prosima in treatment of pelvic organ prolapse (POP) stage Ⅲ.Methods From July 2010 to December 2011,31 patients with POP stage Ⅲ undergoing total pelvic reconstruction surgery with Prosima were enrolled in this prospective study.Among two cases complicated with stress urinary incontinence underwent transobturator tension-freevaginaltapeconcomitantlywithtotalpelvicreconstructionsurgerywith Prosima.Clinical parameters during peri-operation were recorded and compared.Pelvic organ prolapse quantitative examiuation(POP-Q)andanatomicimprovementinthesepatientsafter surgery were analyzed.Comparisons of pelvic floor impact questionnaire-short form 7 ( PFIQ-7 ) and pelvic organ prolapse-urinary incontinence sexual questionnaire-short form 12 (PISQ-12) in these patients before and after surgery were used to evaluate quality of life and quality of sexual life.ResultsThe mean operating time was (55 ± 13) minutes,mean blood loss was (66 ± 25 ) ml.No severe intraoperative complications were observed.All patients were able to recover spontaneous mieturation within 5 days.Two cases experienced pelvic hematoma with diameters less than 7 cm,and resolved later.Another case was urinary tract infection.At the median follow-up 6 months ( 1 - 15 months),the rate of anatomic success defined as the leading vaginal edge above the hymen was 94％ (29/31).There were significant improvements in Aa,Ba,Ap,Bp,and C (P ＜0.01 ) by POP-Q.Two patients showed recurrent prolapse at 3 months and 1 year after surgery,without the need of further operation.The median score of post-operative PFIQ-7 was 0 point at 6 months and 0 point at 12 months after operation,respectively,which were significantly lower than that of 50 points pre-operation ( P ＜ 0.01 ).And there was no significant difference in the average score of PISQ-12 before and after surgery [ ( 30 ± 6) points versus (31 ± 4) points ] ( P ＞ 0.05 ).The rate of mesh exposure was 16％ ( 5/31 ),all the 5 cases occurred within 6 months and was cut in clinic.There was no case of de novo urinary incontinence and de novo dyspareunia.Conclusions Pelvic rcconstruction surgery with Prosima is safe and efficacy in treatment of POP stage Ⅲ.It could improve quality of life remarkably without influence on sexual quality of life.

Objective: To investigate the expression of co-stimulatory molecule CD86 and inducible costimulator(ICOS) in the intestinal mucosa of Crohn disease (CD) and to exlpore its pathologic significance. Methods: Expression of co-stimulator CD86 and ICOS was examined by immunohistoehemistry on paraffin embedded tissue from patients with CD (30 cases) and normal controls (20 cases). The subsets of lamina propria mononuclear cells (LPMC) were also analysed via immunostaining for CD4, CD8 and CD20. Results: Increased amount of CD86 or ICOS positive LPMC was observed in the lesional area of CD when compared with the essentially normal area of CD and normal controls (q = 9. 23 ,P ＜0. 01 and q =5. 46 ,P＜0. 01). In addition, the expression of CD86 or ICOS was higher in intestinal epithelium of CD than that in normal controls (H = 24. 93, P＜0. 01 and H = 4. 66, P＜0. 01 ) , whereas no significant difference was seen between the diseased and the essentially normal area of CD. The amount of CD4 or CD8 positive lymphocytes in lamina propria, epithelium and small vascular walls was also significantly increased in CD than that in normal controls (P＜0. 05 or P＜0. 01). Conclusion: Increased amount of CD86 or ICOS positive LPMC and enterocytes in CD suggests that co-stimulatory molecules may play a role in the pathogenesis of CD. The enterocytes may act as non-specific antigen presenting cells in the process of cellular immunity activation in CD.

OBJECTIVETo evaluate the effectiveness of hypnotic and musical relaxation therapy and psychological consultation for parents of children with cleft lip and/or palate (CLP) and to provide a scientific basis of clinical-psychological treatment options.

METHODSSixty-six subjects with children with CLP participated in this study. The subjects were randomly assigned to a test group (n = 33) and a control group (n = 33). The test group was treated with hypnotic and musical relaxation therapy; the control group were subjected to psychological consultation. Anxiety and depression states were evaluated by using a self-rating anxiety scale (SAS) and a self-rating depression scale (SDS) before and after treatment was administered.

RESULTS1) The test group demonstrated a significant decrease in SAS and SDS scores (t = 2.855, P < 0.01; t = 2.777, P < 0.01). The control group showed a significant decrease in the SAS score (t = 1.831, P < 0.05) but failed to show a significant change in the depression score (t = 0.909, P > 0.05). 2) The test group yielded a higher percentage of remission indicated by the SDS scores than the control group (test group = 75.76%; control group = 60.61%; P < 0.05). The test group also displayed a higher percentage of remission indicated by the SAS scores than the control group (test group = 78.79%, test group = 69.70%; P < 0.05).

CONCLUSIONHypnotic and musical relaxation therapy can more effectively reduce the scores of the anxiety and depression states of the parents of patients with cleft lip and/or palate than psychological consultation.

Anxiety ; psychology ; therapy ; Child ; Cleft Lip ; psychology ; Cleft Palate ; psychology ; Depression ; psychology ; therapy ; Humans ; Hypnosis ; Music ; Parents ; psychology ; Relaxation Therapy ; methods ; Self-Assessment