Objective: To study the influence of clinicopathologic factors on the recurrent pattern of colorectal cancer after radical treatment. Methods: There were 464 consecutive patients with colorectal cancer treated with radical surgery between January 1998 and December 2002 in our hospital. The clinicopathologic features of 90 patients with relapse of colorectal cancer after radical surgery were analyzed. According to the interval between radical surgery and recurrence, these 90 patients were divided into subgroups, the early recurrent group (within 30 months after surgery) and the late recurrent group (more than 30 months after surgery). Chi-square test was used for univariate analysis, and the Logistic regression model was performed for multivariate analysis. Result: There were 78 (86%) patients in the early recurrent group and 12 (14%) patients in the late recurrent group. The median time of recurrence was 17.4 months. The median recurrent time in stage I patients was 35.1 months, 13.6 months in stage II patients, and 12.9 months in stage III patients, respectively. Univariate analysis showed that the depth of penetration, the number of positive lymph nodes, and the gross appearance of tumor were predictors for early recurrence. Multivariate analysis revealed that the depth of penetration (T category) of the primary tumor significantly predicted for early recurrence (P= 0.049). Conclusion: A great proportion of recurrence in patients with colorectal cancer occurred within 30 months after radical treatment, but the late recurrence which occurs at more than 30 months after radical surgery should not be neglected. Patients with different patterns of recurrence had different intervals between radical surgery and recurrence. DM (distant metastasis) occurs earlier than LR (local recurrence). The depth of penetration of the primary tumor is an independent predictor for early recurrence of colorectal cancer patients after radical surgery.

Objective:To observe characteristics of TCM syndrome types in the patient of cerebral infarction,and cerebral infarction with respiratory disorder at sleep.Methods:90 in-patients of cerebral infarction were monitored by polychannel sommocinematogram (PSG)within 72 hours of admission,which were used as diagnosis of respiratory disturbance at sleep,and all of the patients with apoplexy involving the channels and collaterals were divided into 3 types,collaterals hollow and pathogenic wind attacking the interior;Yin-deficiency of the liver and kidney,and wind-Yang stirring upper,hot phlegm and excess of Fu-organs,and wind- phlegm stirring the upper.Results:The patient had sleep structure disorder,with large change of blood pressure and lower heart variety,and decrease of degree of blood oxygen saturation.The apnea indexes were the highest for the patient with phlegm-heat hollow-organ excess,wind-phlegm stirring the upper,and baic normal for collateral hollow and pathogenic wind attacking the interior.Conclusion:There is close relation of cerebral infarction,especially in the patient of hot phlegm and excess of Fu-organ, with respiratory disorder at sleep.

Objective To investigate the protective effects of cardioplegic solution containing different concentrations of Shenfu injectio on isolated rabbit heart against ischemia-reperfusion(I/R)injury.Methods Forty adult long-ear white rabbits weighing 3.8-4.2 kg were anesthetized with intraperitoneal thiopental 40 mg?kg~(-1).Heparin 4 mg?kg~(-1) was injected Ⅳ.Hearts were immediately removed and mounted on a Langendorff apparatus and perfused via aorta with Krebs-Henseleit solution aerated at 37℃ with 95 % O_2 and 5 % CO_2.Forty isolated hearts were randomly divided into 5 groups(n=8 each):control group in which cardiac arrest was induced with St Thomas hyperkkaelemic cardioplegic solution and 4 Shenfu groups(SF)in which cardiac arrest was induced with St Thomas cardioplegic solution containing different concentrations of Shenfu injectio:1%(SF1), 5%(SF5),10%(SF10)and 15%(SF15).All hearts in the 5 groups were subjected to global ischemia for 45 min followed by 40 min reperfusion.Coronary effluent was collected after reperfusion for determination of CK-MB activity.Mitochondria were isolated arid Ca~(2+) and MDA content was measured.Myocardial ultrastructure was observed using electron microscope.Mitochondrial injury was assessed by using Flameng score and stereology(NA and ?).Results The CK-MB activity in coronary effluent,mitochondrial MDA and Ca~(2+) content and Flameng score were decreased and NA was increased in group SF1,SF5 and SF10 as compared with control group(P＜ 0.05 or 0.01).The ? of mitochondria was increased in group SF5 and SF10 as compared with control group(P＜ 0.01).The CK-MB activity and Ca~(2+) content were increased and MDA content was decreased in group SF15 as compared with control group(P＜0.05).The pathological damage to myocardium was significantly less in group SF5 and SF10 than in control group.Conclusion Shenfu injectio added to St Thomas cardioplegic solution at concentration of 5%～10% can protect myocardial mitochondria against I/R injury.

BACKGROUND: Unicompartmental knee arthroplasty (UKA) began in the early 1970s, which was once negated due to high postoperative repair rate. The methods for early unicompartment osteoarthritis of the knee include UKA, total knee arthroplasty, high tibial osteotomy and fibular truncation. A large number of retrospective studies and literatures have pointed that UKA is effective for unicompartment osteoarthritis of the knee and holds unique advantages.OBJECTIVE: To review the status and research progress of UKA for anteromedial compartment osteoarthritis of the knee in view of indications, contraindications, operation curve, operation process and main technical points and clinical efficacy.METHODS: The first author retrieved the databases of PubMed and CNKI from March 2006 to September 2016 using the keywords of unicompartmental knee arthroplasty, knee, osteoarthritis, clinical application in English and Chinese,respectively. A total of 95 literatures were searched, and 40 eligible articles were included in accordance with the inclusion criteria.RESULTS AND CONCLUSION: Only unilateral lesion (the degenerative cartilage surface of tibiofemoral joint) is replaced in UKA to treat early unicompartment osteoarthritis of the knee, which exhibits less trauma, rapid recovery, few complications, and normal postoperative proprioception of joint and high patient acceptance. Because of its narrow surgical indications, UKA application has been restricted compared with total knee arthroplasty. Indeed, total knee arthroplasty is matureand, and its long-term curative effect is clear. In contrast, UKA is carried out late in China, has not been popularized, and the long-term clinical efficacy remains to be verified further. But if we can accurately grasp the operation indications, choose appropriate patients, make careful preoperative preparation, and master mature skills, the clinical effect will be satisfactory. With the development of prosthesis, equipment design and operation technology, UKA will be prevailed in the treatment of anteromedial compartment osteoarthritis of the knee.

Objective: To analyze clinical features and prognosis of more than 75-year old patients with heart failure and preserved ejection fraction (HFPEF) through comparing with heart failure（HF）and reduced ejection fraction (HFREF), and provide reference for prevention and treatment of HFPEF. Methods: A total of 134 > 75 years HF inpatients admitted from Jan 2009 to Dec 2011 were selected. With left ventricular ejection fraction (LVEF) 50% as the critical point, patients were divided into HFPER group (n=63) and HFREF group (n=71). Clinical characteristics were compared between two groups. Clinical outcomes (all-cause death and rehospitalization caused by heart failure) were compared between two groups after follow up. Results: (1) Clinical features: compared with HFREF group, there were significant increase in LVEF [(36.46±6.84)% vs. (58.65±5.01)%], percentage of patients with hypertension (49.3% vs. 69.8%), left atrial diameter [(34.98±3.78) mm vs. (40.02±3.29) mm], and significant decrease in level of brain natriuretic peptide [BNP, (1005.62±458.99) pg/ml vs. (646.57±333.56) pg/ml], concentration of hemoglobin [(11.97±1.29) g/dl vs. (10.76±1.21) g/dl] and left ventricular diameter [(57.17±7.52) mm vs. (47.73±5.48) mm] in HFPEF group, P<0.01 all; (2) Patients were followed up for a mean 2.6 years. There were no significant difference in all-cause mortalities（17.5% vs. 19.7%）and mean time without heart failure event (286 d vs. 258 d) between HFPEF group and HFREF group. Conclusion: Compared with HF patients with reduced ejection fraction, hypertension and anemia are more frequent in HF patients with preserved ejection fraction, but there is no significant difference in clinical outcomes between them.

Objective To explore the influence of immune and nutrition therapy on the rehabilitation of patients with severe traumatic brain injury.Methods According to the different nutritional therapy,80 patients with severe traumatic brain injury were divided into the control group and observation group,each group 40 cases.The patients of the two groups were all given similarly conventional methods,and the observation group were given immune nutrition therapy,the control group were given routine nutrition therapy.After 14d,30d treattnent,nutritional status of the two groups were observed.Barthel Index,Fugl-Meyer score of the two groups of patients and recovery of neurological function were compared 3 months after treatment.Results After treatment,ALB and TF increased significantly (t =5.75,6.38,1.27,2.63,all P ＜ 0.05) ；ALB and TF in the observation group 14 d and 30 d after treatment were significantly higher than those of the control group (t =11.26,6.53,1.27,1.68,all P ＜ 0.05).After 3 months of treatment between the two groups,the clinical efficacy of the observation group was 60.00％,which was better than that of control group(37.50％) (χ2 =9.67,P ＜ 0.05),the differences of Barthel Index and,Fugl-Meyer score were statistically significant (t =3.24,2.88,all P ＜ 0.05).Conclusion The immune and nutritional therapy can significantly promote the neurological function recovery of patients with severe traumatic brain injury,so as to improve the prognosis and the patients's quality of life.

BACKGROUND:High-density lipoprotein is related to lipid metabolism, but its function cannot be restricted to the scope of lipid metabolism. Simultaneously, exercise regulation has effects on the activity and amount of high-density lipoprotein, but the optimal movement pattern needs to be studied. OBJECTIVE:To offer the theoretical support for formulating fitness training and prospect the possible direction and reference in fol ow-up studying the biological function and exercise regulation of high-density lipoprotein. METHODS:PubMed database was searched for relevant articles published from 1990 to 2015 using the keywords of“HDL and exercise, HDL and biological function”in English. Final y, 44 articles were included in result analysis. RESULTS AND CONCLUSION:The biological functions of high-density lipoprotein mainly include high-density lipoprotein-mediated metabolism of glucose, protein and fat, anti-inflammation, antioxidation and insulin secretion, and at the same time, we summarize the effects of exercise on the concentration, numbers of molecular and components of high-density lipoprotein. The results indicate that the combination of resistance and endurance training is the best way for raising the concentration and functional effects of high-density lipoprotein.

Carpal Tunnel Syndrome ; etiology ; Humans ; Occupational Diseases ; etiology

Animals ; Creatine Kinase ; blood ; Energy Metabolism ; Lactate Dehydrogenases ; blood ; Male ; Pressure ; adverse effects ; Rabbits ; Serum ; enzymology

Objective To observe the anatomical and biomechanieal properties of the forearm in terosseous membrane (IOM), providing the scientific theoretical basis for the diagnosis and treatment of the IOM injury. Methods Ten radius-IOM-ulna structures (left for 5 and right for 5) were harvested from 5 fresh-frozen adult cadavers to measure the length, width and thickness of the tendinous part. Then the tendi-nous part with its radial and ulnar insertions were isolated, embedding the proximal part of the radius and the distal part of the ttina in commercially available dental base acrylic resin powder. The embedded speci-mens were mounted on MTS 858 testing machine using a 10 000 N load cell for all tensile tests. The speci-mens were tested at a displacement rate of 50 mn/min until failure. The load-displacement curve was de-scribed by the computer while the maximum load and stiffness were recorded. Results The IOM consisted of three components: the tendinous part, the membranous part, and the dorsal oblique accessory cord. The IOM was fiat in the neutral position, while it flexed during the pronation and supination. Six specimens ob-tained the tear of tendinous portion at a maximum load of (1021.50±250.13) N. The stiffness was (138.24±24.29) N/mm with displacement to failure of (9.77±1.77) mm. Other 4 specimens failed by fracture through the ulnar fixed site before there was failure of the IOM at a maximum load of (744.40±109.85) N. The stiff-ness was (151.17±30.68) N/mm with displacement to failure of (6.51±0.51) ram. Conclusion The IOM has stiffness comparable to the ligament between the radius and the ulna and play an important role for the maintenance of longitudinal stability of the forearm. These results can provide objective criteria for the eval-uation of reconstructive methods.