Objective To analyse the CT findings of Bochdalek hernia in adult.Methods The CT scan of 42 cases were reviewed showing a mass abutting the upper surface of the diaphragm, the defect was located in the posteromedial aspect of hemidiaphragm with continuity of subdiaphragmatic and supradiaphramatic densities through the diaphramatic defect. Among these, 25 cases were male and 17 cases female. The average age was 64 years, 71.4%≥60 old.Results 53 Bochdalek hernias were identified in 42 cases, 11 cases were bilateral, 21 cases were on the left and 10 cases were on the right side. The diaphragmatic defects diameter ranged 0.5～6.7 cm, the median was 2.8 cm. The range of Bochdalek hernias diameter was 1.5～9.0 cm, with median of 3.7 cm. There was a significant association between diaphragmatic defects and size of hernias (r s=0.72,P

Objective To develop a rapid, accurate, specific method to detect causative agent of hand, foot and mouth disease (HFMD). Methods Specific primers and probe were designed based on highly conserved VP1 region of enterovirus 71, coxsackie virus A16 and enterovirus. The sensitivity and specificity of the real-time RT-PCR was evaluated with 35 stool samples collected from pediatric patients with suspected HFMD and 20 clinical samples from health pediatric patients. Results Out of 35 clinical samples from suspected HFMD, 35 samples were identified as positive for enterovirus, 25 clinical samples were identified as positive for enterovirus 71, 8 clinical samples were identified as positive for coxsackie virus A16, among which 3 clinical samples were identified as positive for enterovirus 71 and coxsackie virus A16. The clinical diagnostic accordance rate is 85.71%. Out of 20 clinical samples from normal pediatric patients, 5 clinical samples were identified as positive for enterovirus, 20 clinical samples were negative for enterovirns 71 and coxsackie virus AI6. Conclusion Our results indicate real-time RT-PCR offers a rapid, sensitive, specific and cheap method to detect pathogen of HFMD from clinical specimens.

Objective To investigate the factors related to the occurrence of in-stent restenosis (ISR) after percutaneous coronary drug-eluting stent (DES) implantation. Methods A total of 258 consecutive patients with coronary angiography confirmed ISR that occurred at least one year after coronary sirolimus-eluting stent implantation, who were encountered at the Affiliated Ruijin Hospital of Shanghai Jiaotong University during the period from September 2010 to September 2014 , were collected as ISR group; and other 260 age-and sex-matched patients with no ISR at least one year after coronary sirolimus-eluting stent implantation, who were encountered at the same hospital and during the same period, were collected as the control group. The clinical characteristics, biochemical measurements, postoperative medications, left ventricular ejection fraction (LVEF), and coronary interventional features were determined;using multivariate logistic regression analysis the independent factors related to the occurrence of ISR were evaluated. Results Compared to the control group, in ISR group the history of previous myocardial infarction , presence of diabetes mellitus and cigarette smokers were more often seen; serum levels of high-sensitivity C-reactive protein(hs-CRP), glycosylated hemoglobin, low-density lipoprotein cholesterol (LDL-C)and apoliprotein B in ISR group were significantly increased (P<0.05), while LVEF was decreased (P<0.05). Although the number of coronary lesions and the site of stent implantation were quite similar in both groups , the stents used in ISR group were smaller and longer (P<0.05), and bifurcation stenting procedure was more employed in ISR group (P<0.05). Multivariate Logistic regression analysis revealed that the history of previous myocardial infarction, diabetes, cigarette smoking, elevated serum hs-CRP and LDL-C levels, and longer stent length were independent risk factors for the occurrence of ISR, whereas stent diameter and LVEF bore a negative correlation with ISR. Conclusion The occurrence of ISR after coronary sirolimus-eluting stent implantation is related to multiple clinical and coronary angiographic and interventional factors. Effective control of risk factors of coronary heart disease and improvement of left ventricular function play an important role in preventing ISR, especially for the patients who has small vessel disease, and in whom longer stents are employed and bifurcation stenting procedure is carried out.

Objective To investigate the effects of Jiawei Danshen Decoction on endothelial cell ultrastructure, serum NO and ET in apolipoprotein E-knockout atherosclerosis (AS) mice;To discuss its mechanism of anti-atherosclerosis.Methods Totally 24 7-8 weeks old ApoE -/- mice were fed with a high fat diet for 12 weeks until the a mature atherosclerotic plaque was formed. They were randomly divided into four groups:model group, control group,Jiawei Danshen Decoction of low-dose group and high-dose group, 6 mice in each group. Another 6 normal C57BL/6J mice with the same strain were set as the blank group, and fed with general diet. After medicine intervention by gavage for 8 weeks, blood was extracted from orbital venous to measure serum NO and ET;aortic endothelial cell ultrastructure changes were observed by transmission electron microscope.Results Compared with the blank group, the level of NO obviously decreased and ET significantly increased in the model group (P<0.01). Compared with model group, medicine intervention increased NO and reduce ET level (P<0.05). Electron microscopy results showed that the model group showed fatty streaks stage performance;endothelial damage in each administration group was improved compared with model group.Conclusion Jiawei Danshen Decoction can improve the endothelial cell ultrastructure and functions and protect endothelial cells, with a purpose to delay the AS process.

Objective To study the effects of verussurinine (VSRN), an alkaloid isolated from Veratrum nigrum var. ussuriense alkaloids (VnA), against thrombosis and its platelet aggregation inhibitory activity in rats in order to find out whether VSRN is the antithrombotic active ingredient of VnA. Methods The electrically induced rat carotid artery thrombosis and stasis-induced rat inferior vena cava thrombosis models were used to evaluate the anti-arterial and anti-venous thrombosis effect of VSRN, respectively. Borns turbidimetric method was used to examine the in vivo and in vitro anti-platelet effect so as to investigate the antiplatelet aggregation of VSRN. Results In comparison with saline, VSRN in five different doses (1.25—20.00 ?g/kg) showed significantly and dose-dependently prolonged occlusion time (OT) of carotid artery injured by electrical stimulation and reduced thrombus dry weight of inferior vena cava ligated for 4 h to cause stasis. Platelet aggregation was found to be inhibited by VSRN in the doses of 1.25—5.00 ?g/kg and at the concentration of 6.25—50 ?g/L in both in vivo and in vitro test. Conclusion VSRN has powerful arteriovenous antithrombosis and antiplatelet aggregation of rats. The antithrombotic effect of VSRN is related to its platelet aggregation inhibitory activity. The above findings indicate that VSRN is an antithrombotic active ingredient of VnA.

Objective:To analyze the correlation factors between peripapillary duodenal diverticulum (PDD) and choledochectasia by CT scan.Methods:The clinical data of 220 patients with duodenal diverticulum detected by multi-slice spiral CT scan and confirmed by gastrointestinal angiography or endoscopic retrograde cholangiopancreatography (ERCP) in Dahua Hospital, Xuhui District of Shanghai City were retrospectively analyzed. The correlation of the PDD, the contact of common bile duct (CBD), length of contact and exudation with choledochectasia in patients with PDD were analyzed.Results:A total of 236 duodenal diverticulum were found in 220 patients. Among them, there were 152 PDD, 41 diverticulum located superior to the duodenal papilla, 28 diverticulum located inferior to the duodenal papilla, 3 diverticulum located lateral to the duodenal papilla, and 12 diverticulumlocated in the horizontal portion. The incidence of choledochectasia in patients with PDD contacted with CBD was significantly higher than that in patients with PDD not contacted with CBD: 59.35% (73/123) vs. 37.93% (11/29), and there was statistical difference ( P<0.05); the incidence of choledochectasia in patients with contact length of PDD and CBD ≥1.5 cm was significantly higher than that in patients without contact of PDD and CBD and patients with contact length of PDD and CBD <1.5 cm: 82.43% (61/74) vs. 24.49% (12/49) and 37.93% (11/29), and there was statistical difference ( P<0.05); the incidence of choledochectasia in PDD patients with exudation was significantly higher than that in PDD patients without exudation: 10/11 vs. 52.48% (74/141), and there was statistical difference ( P<0.05). Conclusions:The patients with contact length of PDD and CBD ≥1.5 cm and patients with PDD combined with exudation could be prone to choledochectasia.

Objective To investigate the molecular mechanism of solanine-induced apoptosis of prostate cancer cells Du145 and LNCaP.Methods The effects of solanine on the viability of Du145 and LNCaP cells were evaluated by MTT assay.The generation of intracellular reactive oxygen species (ROS) and solanine-induced apoptosis were measured by flow cytometry.The protein levels of p38 and p-p38 expressions were examined by Western blot.Results Solanine significantly inhibited the viability of Du145 and LNCaP cells in a dose-dependent manner (P＜0.01).The inhibition of solanine on cell viability was suppressed by the ROS scavenger NAC.ROS generation,apoptosis and phosphorylation of p38 were induced by treatment with solanine at 40 μmol/L for 24 h.The expression of p38 and solanine-induced apoptosis were suppressed by NAC and SB203580.Conclusion Solanine induces the apoptosis of human prostate cancer cell via the RO.S-p38 signaling pathway.

OBJECTIVETo investigate the guidance role of preoperative nutritional risk screening in perioperative nutrition support for colorectal cancer patients in order to provide evidence for the rational clinical application of nutrition support.

METHODSNutritional risk screening was carried out in 290 hospitalized colorectal cancer patients from The Fourth People's Hospital of Wuxi City, Tongji Hospital of Tongji University and The Second Hospital of Soochow University with the nutritional risk screening(NSR) 2002 score summary table. Postoperative bowel function recovery and associated nutritional indices were compared between patients who received preoperative nutrition support according to the risk screening results and those who did not.

RESULTSAmong 110 patients at nutritional risk, 65 received perioperative nutrition support and had faster recovery of intestinal function [time to first flatus (2.3±0.5) d vs. (3.3±0.5) d, time to first defecation (3.5±0.5) d vs. (4.6±0.6) d, semi-fluid intake (10.1±1.2) d vs. (12.4±2.2) d], shorter postoperative stay [(15.7±1.1) d vs. (18.8±1.4) d], and higher albumin, prealbumin and transferrin [(33.2±4.5) g/L vs. (26.0±4.0) g/L, (0.28±0.05) g/L vs. (0.16±0.04) g/L, (1.92±0.33) g/L vs. (1.75±0.45) g/L] at 7-day postoperatively (all P<0.05) as compared to those without perioperative nutrition support(n=45). While among 180 cases without nutritional risk, there were no significant differences in the above indices between patients who received preoperative nutrition support and those who did not (all P>0.05).

CONCLUSIONIt is important to evaluate the nutritional risk in hospitalized patients with colorectal cancer, and to carry out nutrition support actively for those at nutritional risk.

Colorectal Neoplasms ; therapy ; Female ; Humans ; Male ; Middle Aged ; Nutrition Assessment ; Nutritional Support ; Perioperative Care ; Retrospective Studies ; Risk Assessment

Objective:To explore the treatment effect of gefitinib on epidermal growth factor receptor (EGFR)-positive advanced non-small cell lung cancer (NSCLC).Methods:Sixty patients with EGFR-positive advanced NSCLC who were admitted to the 904th Hospital of Joint Logistics Support Force of Chinese PLA from March 2016 to January 2020 were selected. They were divided into gefitinib treatment group (30 cases, treated with gefitinib) and combined treatment group (30 cases, treated with pemetrexed combined with cisplatin) by random number table. The anti-tumor efficacy, levels of tumor markers [serum carcinoembryonic antigen (CEA), cytokeratin 19 fragment antigen (CYFRA21-1) and neuron-specific enolase (NSE)] before and after treatment, adverse reactions and 6-month overall survival (OS) rate were compared between the two groups.Results:The clinical control rate of gefitinib treatment group was higher than that of combined treatment group [76.7% (23/30) vs. 50.0% (15/30), χ2 = 4.593, P = 0.032]. There was no significant difference in the levels of CEA, CYFRA21-1 and NSE between the two groups before treatment (all P > 0.05). The levels of CEA, CYFRA21-1 and NSE after treatment in gefitinib treatment group were (902±41) μg/L, (3.1±0.4) ng/ml and (17.7±2.3) ng/ml. The levels of CEA, CYFRA21-1 and NSE after treatment in combined treatment group were (999±51) μg/L, (4.0±0.5) ng/ml and (19.4±3.1) ng/ml. The levels of CEA, CYFRA21-1 and NSE after treatment in gefitinib treatment group were lower than those in combined treatment group ( t = 7.441, P < 0.01; t = 7.459, P < 0.01; t = 2.486, P = 0.016).The levels of CEA, CYFRA21-1 and NSE after treatment in the two groups were all lower than those before treatment, and the differences were statistically significant (all P < 0.05). There was no significant difference in the incidence of rash, thrombocytopenia, digestive tract reaction, and proteinuria between the two groups [26.7% (8/30) vs. 23.3% (7/30), χ2 = 0.089, P = 0.766; 16.7% (5/30) vs. 13.3% (4/30), χ2 = 0.131, P = 0.718); 30.0% (9/30) vs. 26.7% (8/30), χ2 = 0.082, P = 0.774; 10.0% (3/30) vs. 13.3% (4/30), χ2 = 0.162, P = 0.688]. After 6 months of treatment, the OS rate in gefitinib treatment group was 93.3%, and that in combined treatment group was 83.3%, and there was no statistical difference between the two groups ( χ2 = 1.456, χ2 = 0.228). Conclusion:Gefitinib treatment for EGFR-positive advanced NSCLC patients can enhance the anti-tumor efficacy, reduce the content of tumor markers, and has good safety.

Objective:To explore the clinical curative effect of foot-ankle balance massage combined with herbal fumigation on acute ankle sprain.Methods:According to random number table method, 62 patients with acute ankle sprain meeting the inclusion criteria in the hospital were divided into control group and observation group between January 2018 and January 2021, 31 in each group. The control group was treated with foot-ankle balance massage, while the observation group added herbal fumigation treatment on the basis of the control group treatment. Both were treated for 7 days. The pain degree was evaluated by Visual Analogue Scale (VAS). The pain sites of ankle joint were evaluated by Kofoed ankle scale. The recovery of ankle and foot function was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS). The levels of plasma substance P, neuropeptide, nerve growth factor (NGF), IL-1β, IL-6 and hs-CRP were detected by enzyme-linked immunosorbent assay. The clinical curative effect was assessed.Results:The differences in total response rate between observation group and control group were statistically significant [96.8% (30/31) vs. 77.4% (24/31)] ( χ 2=5.17, P=0.023). At 1st day, 3rd day and 7th day after treatment, VAS scores in observation group were significantly lower than those in the control group ( t=4.86, 5.19, 3.86, P<0.01), Kofoed scores were significantly higher than those in the control group ( t=2.03, 2.58, 2.46, P<0.05), and AOFAS pain scores were significantly higher than those in the control group ( t=2.61, 2.47, 4.90, P<0.05). After treatment, levels of substance P [(2.94±0.91) mg/L vs. (3.69±0.94) mg/L, t=3.19], neuropeptide [(141.06±16.31) ng/L vs. (165.22±17.63) ng/L, t=3.16] and NGF [(43.65±10.15) ng/L vs. (52.26±10.20) ng/L, t=3.33] in observation group were significantly lower than those in the control group ( P<0.01), and levels of IL-1β, IL-6 and hs-CRP were significantly lower than those in the control group ( t=2.60, 2.64, 2.42, P<0.05). Conclusion:The foot-ankle balance massage combined with herbal fumigation can quickly relieve pain, increase levels of pain substances, reduce levels of inflammatory cytokines and improve curative effect in patients with acute ankle sprains.