Objective To analyze postoperative effect of a new rectopexy technique with Douglas pouch elevation for complete rectal prolapse (CRP) in adults.Methods From January 2010 to May 2011, 52 CRP cases were treated by rectopexy with Douglas pouch elevation.In terms of different surgical techniques, patients were divided into two groups : Group A (n =28) received laparoscopic rectopexy with Douglas pouch elevation;and Group B (n =24) received laparoscopic rectopexy with Douglas pouch elevation combined with procedure for prolapse and hemorrhoids (PPH).Rectal prolapse, constipation, and fecal incontinence in the two groups were assessed respectively before surgery, and on the 6th, 12th, and 24th month after surgery, postoperative complications were evaluated with severe grading of surgical complications.Results Symptoms of rectal prolapse disappeared at half a year after surgery in all patients, and relapsed to different extent afterwards.However, two years after operation, the status of rectal prolapse in Group B tended to be stable.The trend of constipation after surgery was consistent with that of rectal prolapse.In addition, fecal continence improved gradually on half a year after surgery in the two groups and recovered to the optimal status in the first postoperative year.However, in the second year, the results of fecal incontinence reduced slightly in Groups A, and Group B became stable.Two years after surgery, four cases in Groups A relapsed while there was no recurrence in Group B.Difference of Grade I to Grade Ⅲ complications among the two groups was statistically insignificant (x2 =0.05, P ＞ 0.05).Conclusions The clinical effect of laparoscopic rectopexy with Douglas pouch elevation associated with the procedure for prolapse and hemorrhoids (PPH) is better than that without PPH for female and male CRP patients with severe symptoms.

Weighted topsis method is applied to evaluate the key factors in medical management of diabetes mellitus.The key factors are admission examinations,drug selection,patient serf-management skills,nursing quality,and physicians'capability.

Objective To investigate the neuroprotective effects and mechanisms of 5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/ IMP cyclohydrolase(AICAR) supplement (AMPK activator) in different stages of neonatal rats sufferring from hypoxia-ischemia encephalopathy ( HIE). Methods Neonatal rat hypoxia-ischemia brain injury model was employed in this study. A total of 160 neonatal rats were distributed into five groups: sham, model control,AICAR30 min, AICAR24 h and AICAR72 h. The neuroprotective effects of AICAR supplement (30 min, 24 h, 72 h post operation) were compared by cresyl violet staining; Expressions of P-AMPK,AMPK in the brain tissue were measured by Western blotting.Foot-faults method was used to evaluate the long-term prognosis of the rats. Results Compared with the sham group, the survival of rats brain in model control group was significantly decreased [(100.0± 0.1)% and (45.3± 6.3)%, P< 0.05]. AICAR had neuroprotective effects when treated at 30 min and 24 h post operation,while the protective effects disappeared when treated later (72 h post operation) (P>0.05). Compared with the sham group, the expression of P-AMPK significantly increased about three times, while ATP level decreased close to the same. Conclusion Early AICAR treatment can protect hypoxia-ischemia brain injury by increasing AMPK-ATP level.

As a kind of commonly used traditional Chinese medicine, ginseng has a high reputation at home and abroad. The research of ginseng has been expanded to medicine, pharmacy, biology, food science and other fields, with great achievements in recent years. Ginseng contains ginsenosides, volatile oil, carbohydrates, amino acids, polypeptides, inorganic elements and othser chemical constituents. Each component has extensive physiological activity, and is the base of ginseng's effect. After processing, the complicated changes are taken place in the constituents of ginseng, and some new substances produced. This paper aims to review the studies on chemical constituents and their mechanisms during ginseng processing, and the ideas, methods and the direction of the development of traditional Chinese medicine processing in the future.
Chemistry, Pharmaceutical ; methods ; Drugs, Chinese Herbal ; chemistry ; Panax ; chemistry ; Plants, Medicinal ; chemistry

The primary processing is important links and closely related to the quality of traditional Chinese medicinal materials, and is not only cleaning of remove the non-officinal parts, drying for termination the physiological status of organisms, but also retaining the most active substances, decreasing the toxic components, and promoting the transformation among chemical ingredients through primary processing. So the traditional primary processing endows with characters, quality, specifications and properties of traditional Chinese medicine, and embodies some important science truth. The traditional primary processing method and technology systems are derived from the long-term practices and experiences, which are distinctive, colorful, diverse, and scientific, which are helpful to development and utilization of traditional Chinese medicine resources. This paper systemically expounds the research status of the Chinese medicine processing method, summarizes the problems in the primary processing of traditional Chinese medicinal materials research, and prospects its bright future.
Chemistry, Pharmaceutical ; methods ; trends ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Medicine, Chinese Traditional

AIM: To compare the safety and efficacy of conjunctival autograft transplant ( CAT ) and limbal - conjunctival autograft transplant (LCAT) for primary pterygium.
METHODS: In this prospective, randomized and controlled clinical study, 120 patients ( 120 eyes ) diagnosed with primary pterygium were collected in NO. 474 Hospital of Chinese PLA from January 2014 to January 2015. The 120 patients enrolled in the study in turn, and divided into two group by the odd and even number. The odd number underwent CAT and the even number underwent LCAT.
RESULTS:One hundred and seven patients (107 eyes) completed the follow-up of 1a, including 54 patients (54 eyes) from the CAT group and 53 patients (53 eyes) from the LCAT group. Four patients (4 eyes, recurrence rate 7. 4%) in the CAT group and 2 patients ( 2 eyes, recurrence rate 3. 8%) in the LCAT group developed recurrence. However, there were no significant in recurrence rate between CAT group and LCAT group (P =0. 678).
CONCLUSION: CAT and LCAT might be both effective treatment for primary pterygium for reducing the recurrence rate of pterygium. However, LCAT is the optimal surgical method for primary pterygium.

Objective To explore the efficacy and safety of mild hypothermia (MH) in treating the infants with moderate-to-severe neonatal hypoxic-ischemic encephalopathy(HIE),and to make a follow-up of the nerve motor development of the infants at 18 months old after discharge.Methods Totally 61 neonates with moderate-to-severe HIE in Neonatal Intensive Care Unit (NICU) from Jan.2007 to Dec.2013 were retrospectively analyzed.According to before and after MH therapeutic apparatus was used by NICU of Shanghai Children's Hospital,61 neonates of HIE were divided into 2 groups,the conventional treatment group(25 cases) and MH treatment group(36 cases).The patients in both groups were measured respectively by using the amplitude integrated electroencephalography (aEEG) before MH treatment and at 72 hours after M H treatment,by neonatal behavioral neurological assessment(NBNA) on the 28th day after birth,and by adopting Bayley Scales of Infant Development at 18 months old.The adverse reactions,serious disability cases and deaths of MH treatment were recorded.Results Compared with the conventional treatment group,aEEG recording before treatment showed no statistically significant differences in MH treatment group [maximum voltage:(22.4 ±3.1) μV vs(18.6 ±2.5) μV,maximum voltage:(8.2 ±2.6)μV vs(6.5 ±1.9) μV,t =1.264,0.852,all P ＞ 0.05].However,aEEG recording at 72 h after treatment showed statistically significant differences in MH treatment group [maximum voltage:(24.1 ± 3.2) μV vs (30.6 ± 2.8) μV,maximum voltage:(9.7 ± 3.4) μV vs (13.3 ± 2.2) μV,t =6.376,4.257,all P ＜ 0.05].Severe disability cases [24.0％ (6/25 cases) vs 5.6％ (2/36 cases),x2 =4.405,P ＜ 0.05] and deaths [16.0％ (4/25 cases) vs 0 (0/36 case),x2 =6.1 64,P ＜ 0.05] in MH treatment group were significantly decreased,and there was significantly difference in NBNA on the 28th day after birth[(35.9 ± 2.1) vs(39.1-± 1.6),t =3.361,P ＜ 0.05],and scales of neurobehavioral evaluation through follow-up of 18 months old [mental development index (MDI):(85.2 ± 10.7) vs (96.5-± 13.1),t =7.839,P ＜ 0.05].Very few neonates had apnea,coagulation dysfunction,arrhythmia and other adverse reactions in MH treatment course.Conclusions MH treating moderate-to-severe HIE is safe and effective.MH is effective in reducing death and major disabilities in neonates with moderate-to-severe HIE and without significant side effects.MH can obviously improve the development of nervous system disorders in 0-18 months infants,and can significantly improve these infants' Bayley developmental scale neurobehavioral scores.

Objective To explore the effect of macrolide antibiotics(erythromycin) on tumor necrosis factor(TNF)-α and interleukin(IL)-8 in hyperoxia-induced lung tissue of premature newborn rats,and to study the intervention effect of erythromycin on hyperoxia-induced lung injury.Methods One-day old preterm Sprague Dawley rats were randomly divided into four groups by random number table method:air + sodium chloride group,air + erythromycin group,hyperoxia + sodium chloride group,hyperoxia + erythromycin group.Hyperoxia groups were continuously exposed to oxygen (oxygen ＞ 0.85) and air group in room air.After 1,7,14 days of exposure,the preterm rats of four groups were sacrificed,whole lung of these rats were isolated,the lung histological changes were observed by hematoxylin-eosin staining,TNF-α and IL-8 in pulmonary tissue homogenate were detected by ELISA.Results The results showed that:(1) Compared with air + sodium chloride group,TNF-α and IL-8 expression in hyperoxia + sodium chloride group were significantly increased(P ＜ 0.05) after 1,7 days of exposure [1 d:TNF-α:(16.163 ± 0.574) ng/ml vs.(21.923 ±2.066) ng/ml,IL-8:(18.214 ±3.649) ng/ml vs.(23.546 ± 5.240) ng/ml ;7 d:TNF-α:(15.940 ±0.821) ng/ml vs.(19.688 ±0.764) ng/ml,IL-8:(18.541 ± 4.114) ng/ml vs.(24.255 ±4.692) ng/ml],in particular,TNF-α expression appeared to increase earlier,their expression became significantly weak in 14 days (P ＜ 0.05).(2) Compared with hyperoxia + sodium chloride group,TNF-α and IL-8 expression in hyperoxia +erythromycin group became significantly weak after 1,7,14 days of exposure(P ＜0.05) after the intervention of erythromycin [1 d:TNF-α:(21.923 ± 2.066) ng/ml vs.(18.903 ± 1.851) ng/ml,7 d:IL-8:(24.255 ±4.692) ng/ml vs.(23.508 ±3.543) ng/ml,14 d:TNF-α:(16.443 ±5.466) ng/ml vs.(14.453 ±0.963)ng/ml],but their expression became weaker in 14 days than that in 1,7 days.Conclusion The release of inflammatory mediators TNF-α and IL-8 induced by oxidation outbreak participates in the development of hyperoxia induced lung injury,erythromycin may regulate immune function,inhibits the levels of oxidant-mediated TNF-α and IL-8 induced by oxidation outbreak,and alleviate hyperoxia lung injury in premature rats.

Objective Although heart transplantation (HTx) has become a standard therapy for end-stage heart diseases,experience with pediatric HTx is limited in China.In this article,we will try to provide the experience with indications,complications,perioperative management,immunosuppressive therapy,and survival for pediatric HTx based on our clinical work.Method This is a retrospective chart review of the pediatric patients undergoing HTx at Department of Cardiovascular Surgery of Union Hospital from September 2008 to December 2015.We summarized the indications,surgical variables,postoperative complications,and survival for these patients.Result Twenty-three pediatric patients presented for HTx at Union Hospital of Tongji Medical College,of whom 12 were male.The age at the time of transplantation ranged from 3 months to 18years (median 14 years).Patient weight ranged from 5.2 kg to 57.0 kg (median 36.0 kg).Pretransplant diagnosis included cardiomyopathy (16 cases),complex congenital heart disease (5cases) and tumors (2 cases).All recipients received ABO compatible donor hearts.Postoperative complications occurred in 14 patients,including cardiac dysfunction,arrhythmia,pulmonary infection,renal dysfunction,and rejection.Two of them experienced cardiac failure and required extracorporeal membrane oxygenation.The immunosuppression regimen was comprised of prednisone,a calcineurin inhibitor,and mycophenolate.All patients recovered with New York Heart Association (NYHA) Class Ⅰ Ⅱ cardiac function and were discharged.Only one patient suffered sudden death 19 months after transplantation.Conclusion Orthotopic HTx is a promising therapeutic option with satisfactory survival for the pediatric population in China with end-stage heart disease.

Objective:To compare immune effects of hepatitis B-BCG combined vaccine and hepatitis B vaccine.Methods:The vaccines were administered to the guinea pig at 0, 1, 2 months. The tests were divided into three parts. The immune effects were compared in three kinds of the combined vaccine and hepatitis B vaccine(Part One), in three lots of the combined vaccine and hepatitis B vaccine(Part Two), in the group of combined vaccine and the group of hepatitis B vaccine and BCG(Part Three). After 1 month of each vaccine dose, serum specimens were measured for anti-HBs by ELISA.Results:The several studies have documented the serum anti-HBs concentritious in the group of combined vaccine in first dose were lower than those of the group of control, and the data showed no significantly difference. However, anti-HBs levels of the combined vaccine group in second vaccine dose and third vaccine dose were higher than those of the control group, and this difference was no longer statistically significant in group of combined vaccine and control, and among groups of combined vaccine.Conclusion:The immune efficacy of HBsAg in group of combined vaccine is similar to the group of hepatitis B vaccine in three doses immunization schedules.