Glycerol enema, mainly composed of glycerol, sorbitol, and magnesium sulfate, was a kind of OCT caccagogue. The application of convenience, low prices made it used widely in patients with constipation. However, if the drug should not follow the indications and application of Methods , a series of improper consequences will be caused. The authors reviewed the application of Glycerol Enema, rectal injury and rectal ulcer in patients with constipation.

Objective To analyze the fusion genes derived from 29 types of chromosome structural aberrations in leukemia patients,and the significances on the MICM typing,risk grouping,and minimal residual disease(MRD)monitoring of leukemia.Methods The bone ulan-ow or blood samples from 141 leukemia patients were analyzed with a novel multiplex nested RT-PCR.In addition.chromosomal karyotypes were investigated in some patients.Results Of the 141 leukemic samples,66(46.8%)carried 13 types of MLL/AF6,MLL/AF9,dupMLL MLI/ENL,CBFβ/MYH11 and TLS,ERG.Fusion genes were positive in 27 of 57 ALL patients(47.4 q%),and 33 of 78 AML patients(42.3%),respectively.In these ALL or AML patients,7 or 6 chromosome structural aberrations were found. Conclusion This multiplex nested RT-PCR reaction could screen 29 types of chromosome structural aberrations at the same time. It may be helpful for the diagnosis, risk grouping,prognosis evaluation and the detection of minimal residual diseases after chemotherapy and bone marrow transplantation in these leukemia patients.

One hundred and twenty stroke patients were randomly divided into rehabilitation group (n =60) and control group (n =60).Patients were assessed with National Institute of Health Stroke Scale (NIHSS) ,Fugl-Meyer Assessment (FMA),Bathel Index (BI) and World Health Organization Quality of Life Assessment Instrument Brief Version(WHOQOL-BREF) before and 6 weeks after treatment by the same doctor.The scores of NIHSS,FMA,BI and WHOQOL-BREF were improved significantly in rehabilitation group after treatment; while those of control group were no improved.The scores after treatment of rehabilitation group were significantly higher than those of control group ( P ＜ 0.05 ).

Objective To discuss the clinical value of new- utility anal vacuum tube in preventing anastomotic fistula after colorectal cancer anterior resection. Methods Ninety-six patients having underwent the colorectal cancer anterior resection were divided into new-utility anal vacuum tube group and normal anal vacuum tube group by random digits table method with 48 cases each. The complication, anus exhaust time and postoperative drainage volume were compared between 2 groups. Results The incidences of tube defluxion, proctalgia, anus skin damage, bed sheet pollution and anastomotic fistula in new-utility anal vacuum tube group were significantly lower than those in normal anal vacuum tube group: 6.25% (3/48) vs. 31.25% (15/48), 10.42% (5/48) vs. 41.67% (20/48), 0 vs. 25.00%(12/48), 6.25%(3/48) vs. 60.42%(29/48), 2.08%(1/48) vs. 12.50%(6/48), the anus exhaust time was significantly shorter than that in normal anal vacuum tube group:(44.1 ± 8.9) h vs. (48.9 ± 9.6) h, the postoperative drainage volumes form the first day to fifth day were significantly more than those in normal anal vacuum tube group: (31.2 ± 15.1) ml vs. (15.6 ± 8.2) ml, (25.3 ± 13.2) ml vs. (15.8 ± 6.5) ml, (15.6 ± 9.1) ml vs. (10.3 ± 4.5) ml, (104.3 ± 38.2) ml vs. (90.6 ± 12.3) ml and (93.7 ± 32.5) ml vs. (80.7 ± 18.9) ml, and there were statistical differences (P<0.01 or <0.05). The patients in new-utility anal vacuum tube group had different symptoms, but patients could tolerate. Conclusions The new-utility anal vacuum tube can reduce the incidence of anastomotic fistula, and be safe and reliable, which is worthy of wide application.

Five hundred elderly patients with ischemic stroke admitted from January 2008 to December 2010 were enrolled in the study,including 352 recurrent cases and 148 primary cases.There was a positive correlation of stroke recurrence with age,blood pressure,blood glucose and lipid levels,smoking and alcohol consumption of patients(P ＜0.05 ); while the stroke recurrence was negatively correlated with physical exercise(P ＜ 0.05).Stepwise multiple regression analysis indicated that the blood pressure,blood glucose and lipid levels were risk factors for the recurrence of ischemic stroke in elderly patients.

Objective:To study the feasibility and efficacy of the modified posterolateral laparoscopic approach for resection of massive splenomegaly.Methods:The data of 48 patients who underwent laparoscopic splenectomy for massive splenomegaly at the Affiliated Hospital of Jiangnan University (Wuxi 4th People's Hospital) from January 2016 to July 2019 were retrospectively analyzed. There were 29 males and 19 females, with an average age of 55.8 years. These 48 patients were divided into two groups according to the operative approach, the study group ( n=26) using the modified posterolateral approach which treated the splenic pedicle as the last step; and the control group ( n=22) which used the posterior tunnel of splenic pedicle established by anterior approach to treat the splenic pedicle first. The operation time, gastrointestinal function, recovery time, intraoperative blood loss, rates of conversion to laparotomy and postoperative complications were compared between two groups. The follow-up data were also analyzed. Results:There were no significant differences in operation gastrointestinal function recovery and hospitalization time between the two groups (all P>0.05). The intraoperative blood loss, numbers of patients with convention to open surgery and intraoperative blood transfusion, were (50.2±15.1) ml vs (160.1±40.3) ml, 2 patients (7.7%) vs 7 patients (31.8%), and 1 patients (3.8%) vs 5 patients (22.7%), in study group and control group respectively. The differences between groups were significant (all P<0.05). The complications of the study group and control group were 9 patients (34.6%) vs 13 patients (59.1%), which were significantly in the two groups ( P<0.05). On follow-up which ranged from 1 to 15 months, the numbers of patients with thrombocytosis and portal vein thrombosis in the study group and the control group were 20 patients (76.9%) vs 17 patients (77.3%), and 7 patients (26.9%) vs 6 patients (27.3%), respectively. Conclusion:The modified posterolateral laparoscopic approach for resection of massive splenomegaly was safe and feasible. It should be promoted to treat massive splenomegaly.

Objective To investigate the diagnosis and treatment of primary hyperparathyroidism ( PHPT) initially with urinary calculus .Methods The clinical data of 26 patients who diagnosed as PHPT ini-tially with urinary calculus were retrospectively reviewed .Results There were 22 cases with bilateral urinary calculus and 4 cases with unilateral relapsed urinary calculus .Ultrasonography , CT and radionuclide were helpful to determine the location of the neoplasia .24 cases underwent percutaneous nephroscope or ureteroscopy pneu-matic ballistic lithotripsy , 2 cases discharged ureteral calculi by themselves .All patients were performed surgical treatment of PHPT , which was confirmed by intraoperative frozen pathology and postoperative pathological exami -nation.There was great improvement of clinical symptoms after surgical procedures .The preoperative serum calci-um, urine calcium and parathyroid hormone elevated , while serum phosphate decreased .The postoperative indi-cators were just the opposite .The difference had statistical significance ( P<0.05 ) .Conclusions Laboratory investigations and imaging studies are very important to diagnose PHPT initially with urinary calculus .The para-thyroid surgery can remarkably reduce the calculus recurrence and improve renal function .

Objective To describe the clinical presentations,radiographic findings and histological pathology of bones,diagnosis,treatment options and prognosis for patients with Gorham-Stout syndrome (GSS).Methods Clinical data of 5 GSS patients seen from January 1980 to January 2008 were reviewed.Results(1)There were 2 males and 3 females,aged 15 years to 37 years(mean age was 30.2 years).(2)All of thern had osteolysis,but the site and extent of involved bones were not the same.Three cases had large amount of bloody pieural effusion and two of them had also chylous effusion.All of the 5 cases had no evidence of malignancies.Four cases accepted bone biopsy.Among them,2 cases having local puncture and open biopsy showed typical bone pathologic manifestations.(3)Various forms of treatment including bisphosphonates,calcium supplementation,active vitD3 treatment,local radiation therapy and surgical ligation of thoracic duct were tried.(4)Follow up and clinical outcomes:the two cases,who had only bone osteolysis remained stable.Of the other three cases who had bone osteolysis associated with pleural effusion,one patient needed interrupted effusion drainage with stable bone impairment and the other two cases were out of contact.Conclusions GSS is a rare disorder charactcrized by progressive osteoIysis.The clinical presentations of this disease are variable and depend on the sites of involvement.There were no standard therapy available.Prognosis depends on the site of involvement,extent of the disease and presence of complications.Those who have plueral effusion had poor prognosis.

A total of 120 patients with initial stroke at a community health service center in Shanghai from January 2009 to March 2011 were divided randomly into intervention group (n =60) and control group (n =60).Individual comprehensive rehabilitation was carried out based on the evaluations in the intervention group.Routine therapy was given to the patients in the control group.General data evaluations were conducted at pre-intervention and 1 year post-intervention respectively.The levels of blood pressure,blood glucose and blood lipid(LDL-C) were all lower in the intervention group than those in the control group (P ＜ 0.05).The rates of proper behavior were all higher in the intervention group than those in the control group (P ＜ 0.05).And the rates of recurrence and mortality were lower in the intervention group than those in the control group (P ＜ 0.05).

Objective: In the authors' previous study, acupuncture had an effect along meridians. The effect ofacupuncture can be represented by local energy metabolism which can be expressed by transcutaneous CO2 emission (TCE). To study the transportation of the effect of acupuncture and the influence to the transportation when blocking the meridians, the following experiment was carried out. Methods: Twenty healthy volunteers (male 8, female 12, average age 29) were examined on pericardium meridian at points between Quze (PC 3) and Tianquan (PC 2) (Point a), between Ximen (PC 4) and Quze (PC 3) (Point b), two control points (c and d) beside a and b and Quze (PC 3). TCE was measured on these five points before, during and after acupuncturing Neiguan (PC 6) by a high sensitive CO2 instrument (Frewil-Q.F., made in China). Mechanical pressure of 1 kg (2 cm～ 1 cm area) was given on Ximen (PC 4) or Daling (PC 7) during the acupuncture and TCE were measured before acupuncture, during acupuncture and mechanical pressing, withdrawing acupuncture but keeping pressing and after withdrawing the pressure. Results: TCE increased significantly on point a, b and Quze (PC 3) during and after acupuncture without mechanical press. When mechanical press was given at Ximen (PC 4), no significantly increase was found on above three points during and after acupuncture. When pressing Daling (PC 7), there was still significant (P<0.05) increase at Quz～ (PC 3) and point during acupuncture and significant increase (P<0.05) at point b after acupuncuture while pressing was kept. Conclusion: Acupuncture can enhance the energy metabolism expressed by TCE along meridians and this effect can be eliminated by mechanical pressing along meridians on the way between acupuncture point and measured point.