Objective To compare the recent clinical efficacy between ileal neobladder and orthotopic ileal neobladder.Methods The clinical data of 62 patients with bladder cancer who were performed with cystectomy plus urinary diversion were retrospectively analyzed.Among them,32 patients were performed with orthotopic ileal neobladder(orthotopic ileal neobladder group)and 30 patients were performed with ileal neobladder(ileal neobladder group).The operation time,intraoperative bleeding,intestinal function recovery time,hospital stay,early postoperative complications were compared between two groups.Results All the patients were successful,and there was no operative deaths occurred.There was no significant difference in the postoperative intestinal function recovery time between two groups(P ＞ 0.05).The operation time,intraoperative bleeding,hospital stay in orthotopic ileal neobladder group was higher than that in ileal neobladder group [(463.59 ± 50.24)min vs.(436.07 ± 44.91)min,(1081.16 ± 320.49)ml vs.(867.53 ± 224.61)ml,(46.88 ± 4.67)d vs.(20.37 ± 5.24)d],but the incidence of early postoperative complications in orthotopic ileal neobladder group was lower than that in ileal neobladder group [25.0％(8/32)vs.53.3％(16/30)],and there were significant differences between two groups(P ＜0.05).Conclusions Two kinds of urinary diversion surgical urinary diversion are clinically more mature manner,in clinical practice.Clinicians should be based on the patient's comprehensive situation,combined with the clinical experience to select the most appropriate surgical procedures.

Objective To investigate the expression of p21-activated kinase 1 (PAK1) protein in patients with colorectal carcinoma and evaluate its clinicopathological significance. Methods The expression of PAK1 was detected by the immunohistochemical method (SABC) in 50 cases of colorectal carcinoma and pericancerous normal specimens, and the relationship between the expression of PAK1 protein and clinicopathological parameters was analyzed. Results The positive rate of PAK1 in colorectal carcinoma was significantly higher than that in normal pulmonary tissues (58 % vs 22 %, P <0.01), and the expression of PAK1 protein was significantly correlated to lymph node metastasis (χ2 =8.872, P =0.003) and degree of differentiation (χ2 =6.344, P =0.042), but not to tumor location, size, age and sex (P >0.05). The positive staining of PAK1 protein was mainly located in the cytoplasm of tumor cells. Conclusion Overexpression of PAK1 is closely related with tumor biological behavior and it may play important role in the development of colorectal carcinoma.

Objective To investigate the efficacy of combined monitoring of motor evoked potentials with transcranial electrical stimulation (TES-MEP),somatosensory evoked potentials (SEP) and spontaneous electromyo-graphy (s-EMG) in tuberculosis surgery involving the thoracic,lumbar and sacral vertebrae.Methods Twenty-seven patients with tuberculosis of the thoracic vertebrae (T2-L2) received intra-operative SEP and TES-MEP monito-ring.Combined SEP,TES-MEP and spontaneous EMG monitoring were employed in 11 patients with tuberculosis of the lumbar or/and sacral vertebrae (L3-S1).SEP and TES-MEP were used to precisely observe the status of the sen-sory and motor pathways; s-EMG responses were used to more accurately localize nerve root irritation.ResuIts (1) SEP monitoring was successful in all of the operations.TES-MEPs were successfully monitored in 35 of them (92.1％).Combined motor and sensory monitoring was successfully achieved in 35 cases (92.1％).Abnormal SEPs were observed in 3 cases (7.9％),while abnormal MEPs were observed in 11 cases (28.9％).Abnormality in both the SEP and TES-MEP occurred in 2 cases (5.3％).There were 9 cases (23.7％) where the SEPs were nor-mal and the TES-MEPs were abnormal.In only 1 case (2.6％) was the SEP normal and the MEP abnormal.The false negative rate was 0％ with combined SEP and TES-MEP monitoring,while the false positive rate was 5.3％.There were 2 cases complicated by post-operative neurological deficits.(2) Spontaneous EMG monitoring can accu-rately determine the functioning of lumbar nerve roots during lumbar or lumbosacral tuberculosis surgery.Among 5 cases where EMG responses were observed,4 cases occurred during the spinal canal and nerve root decompression,1 case occurred in the orthopedic reset phase.Conclusions (1) During tuberculosis surgery involving thoracic,lumbar or sacral vertebrae,combined monitoring of SEPs and TES-MEPs can reflect the physiological and pathological condition of the spinal cord after ruling out interfering factors.This can improve monitoring and help assure the safety of lumbar surgery.(2) Intra-operative s-EMG monitoring can accurately reveal nerve root function in real time,help-ing to avert nerve root injury in lumbar and lumbosacral tuberculosis surgery.

Objective:To observe the therapeutic effect of vibrating the abdomen on anorexia model rats,as well as its effects on cholecystokinin octapeptide(CCK-8)and motilin(MTL)in the peripheral blood. Methods:Forty young rats were randomly divided into a normal group(n=10)and a modeling group(n=30).Rats in the normal group were fed common feed.The anorexia model was established by the etiological simulation method in the modeling group,and these rats were further randomly divided into a drug group,a vibrating abdomen group,and a model group 3 weeks after the anorexia model was induced,with 10 rats in each group.The drug group was given Jian Wei Xiao Shi Pian by intragastric administration at a dose of 0.72 g/(kg·bw)(0.72 g drug was dissolved in 10 mL purified water).The normal group and the model group were given purified water once a day in the morning.The vibrating abdomen group was treated with vibrating the abdomen once a day for 21 times.The body mass,food intake,serum CCK-8,MTL,gastrin(GAS),neurotensin(NT)levels,and the intestinal propulsion rate of rats in each group were measured. Results:Compared with the model group,the body mass,food intake,serum MTL and GAS levels,and the small intestine propulsion rate increased significantly,and the serum CCK-8 and NT levels,the gastric residual rate decreased significantly in the vibrating abdomen group and the drug group(P<0.05).There were no significant differences between the vibrating abdomen group and the drug group(P>0.05). Conclusion:Vibrating the abdomen increases the food intake and body mass of anorexia model rats,reduces the residue of gastric contents,improves the small intestine propulsion rate,and therefore has a good therapeutic effect on anorexia.The mechanism may be related to inhibiting the secretion of CCK-8 and NT in plasma and promoting the release of MTL and GAS in serum.

Objective Collecting the loosening periprosthetic interface-membrane, to discuss the mechanism of hip arthroplasty loosening. Methods The periprosthetic interface tissues of 29 hip arthroplasty revision cases from February 1995 to December 2003 were collected. The retrieved periprosthetic interface tissues were detected by immunohistochemistry. Some of them were studied by electronic microscope. Results (1)Transmission electronic microscope examination: the mitochondria swell. There were some substantia like lipid in the plasm of macrophages. Wear particles could be seen under scaning electronic microscope.(2)Immunohistochemistry: there were 22 IL-1? positive cases in cells of interface membrane. There were 29 IL-6 positive cases in cells of interface membrane. There were no positive results in TNF-? test. Conclusion (1)The wear particles of arthroplasty are important factors which cause biological reaction.(2)The interface membranes contain cytokine IL-1? and IL-6, which may play an important role in periprosthetic osteolysis and arthroplasty loosening.

Objective: To observe the clinical efficacy of Tuina (Chinese therapeutic massage) plus oxiracetam in treating mild vascular dementia (VD) and seek its underlying mechanism. Methods: Ninety-six patients with mild VD were randomized into an observation group and a control group, with 47 cases in the observation group and 49 cases in the control group. The control group received oral oxiracetam capsules for treatment, and the observation group was given additional Tuina treatment. Before and after treatment, the mini-mental state examination (MMSE) was adopted to assess the patient's cognitive function; the activities of daily living (ADL) scale was used to evaluate their ability to conduct daily activities; changes in the serum inflammatory factors and oxidative stress indicators were also detected. Results: After treatment, the serum content of malondialdehyde (MDA) decreased in both groups (P<0.05) and was lower in the observation group than in the control group (P<0.05); the serum contents of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) increased in both groups (P<0.05) and were higher in the observation group than in the control group (P<0.05); the serum contents of interleukin (IL)-1, tumor necrosis factor (TNF)-α, IL-6, and IL-8 declined in both groups (P<0.05) and were lower in the observation group than in the control group (P<0.05). After the intervention, the levels of systolic velocity (Vs) and mean velocity (Vm) of the middle cerebral artery elevated, and the pulsatility index (PI) dropped in patients in the two groups, showing significant intra-group differences (P<0.05); the levels of Vs and Vm in the observation group were higher than those in the control group, and the PI was lower in the observation group than in the control group, showing significant between-group differences (P<0.05). The MMSE and ADL scores increased in both groups after the intervention (P<0.05) and were higher in the observation group than in the control group (P<0.05). Conclusion: In the treatment of mild VD, Tuina plus oxiracetam can improve the cerebral blood supply, ADL, and cognitive function; the mechanism may be associated with the reduction of oxidative stress damages and inflammatory reactions.

Objective To observe the clinical effect of combining hyperbaric oxygen (HBO) with repeated transcranial magnetic stimulation (rTMS) in the treatment of vascular cognitive impairment (VCI).Methods A total of 56 hospitalized VCI patients were randomly divided into an HBO+rTMS group (n =25) and an rTMS group (n =27).The patients of both groups were given routine medication,rehabilitation and rTMS treatment,while the HBO+rTMS group was additionally provided with HBO.The mini mental state examination (MMSE),the Montreal cognitive assessment (MoCA),the Lo Winston occupational therapy cognitive assessment (LOTCA) and the modified Barthel index (MBI) were used to evaluate the cognitive function of both groups before and after 4 weeks of treatment.Results Before the treatment there were no significant differences between the two groups in any of the average measurements.After the treatment,significant improvement was observed in the average MMSE and MBI scores in both groups,with significantly greater improvement in the HBO+rTMS group.After the treatment,all the average subscores except that of naming and the total MMSE score of the rTMS group had improved significantly,together with all the average sub-scores and total scores of the HBO+rTMS group.After the treatment the average visual space and execution,abstraction,delayed recall,orientation and the total MoCA score of the HBO+rTMS group were all significantly higher than those of the control group.Conclusion HBO combined with rTMS can improve cognitive function and the life quality of VCI patients.

Objective To evaluate the effect of oxycodone on function of GABAA receptors in dor-sal root ganglion ( DRG ) neurons of rats with neuropathic pain ( NP ) . Methods Thirty-six adult male Sprague-Dawley rats, weighing 180-220 g, aged 10 weeks, were allocated into 3 groups ( n=12 each) u-sing a random number table method: sham operation group ( group S ) , group NP and oxycodone group ( group O) . The sciatic nerve was only isolated but not ligated in group S. NP was induced by chronic con-striction injury. The sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4-0 chromic catgut. Oxycodone 15μg∕kg was intraperitoneally injected once a day for 14 con-secutive days from ligating the sciatic nerve to satisfaction in group O. The thermal paw withdrawal latency( TWL) was measured at 1 day before establishing the model ( T0 ) and 3, 5, 7, 10 and 14 days after es-tablishing the model ( T1-5 ) . The rats were sacrificed after measurement of pain threshold at T5 , and DRG neurons were acutely isolated for recording the amplitude of GABAA receptors-activated currents using whole-cell patch-clamp technique. Results Compared with group S, the TWL was significantly shortened at T1-5, and the amplitude of GABAA receptors-activated currents in DRG neurons was decreased in NP and O groups (P<0. 05). Compared with group NP, the TWL was significantly prolonged at T1-5, and the ampli-tude of GABAA receptors-activated currents in DRG neurons was increased in group O ( P<0. 05) . Conclu-sion Oxycodone can enhance the function of GABAA receptors-activated currents in DRG neurons and thus enhance GABAA receptors-mediated presynaptic inhibition, which may be related to the mechanism of oxyc-odone-induced reduction of NP in rats.

Objective:To evaluate the effect of pancreatic duct stenting in the treatment of severe acute pancreatitis (SAP).Methods:The clinical data of 68 patients with SAP admitted to the Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University from January, 2019 to July, 2020 were retrospectively analyzed, including 38 males and 30 females, aged (44.85±8.51) years old. The patients were divided into two groups according to the treatment modality: the conservative group ( n=41) which received the conservative management, and the stent group ( n=27) which underwent pancreatic duct stent implantation and conservative management. The basic information, parenteral nutrition support time, fasting days, and other clinical data of patients were collected. Serum amylase, white blood cell count, acute physiology and chronic health (APACHE) II score and CT score were compared between the two groups at admission and 48 hours after treatment. Results:The serum amylase, white blood cell count, APACHE II score and CT score of the two groups were significantly lower after treatment (all P<0.05). Compared with the conservative group, the APACHE II score [(5.52±2.15) vs. (8.76±2.50)] and CT score [(4.85±1.96) vs. (6.18±1.07)] of patients were lower in the stent group after treatment (both P<0.05). Pancreatic duct stents were successfully implanted in all 27 patients of the stent group. Intubation to the main pancreatic duct failed in one patient, while the accessory pancreatic duct was alternatively intubated through the accessory nipple. No severe complications such as iatrogenic pancreatitis, bleeding, and perforation occurred after endoscopic retrograde cholangiopancreatography. The incidence of postoperative local complications was lower [18.52%(5/27) vs. 41.46%(17/41)], the proportion of antibiotic use>3 types [29.63%(8/27) vs. 56.10%(23/41)] decreased, and the analgesic episodes decreased [2(1, 3) vs. 4(3, 6)] in the stent group. The antibiotic usage duration [8(3, 11) d vs. 13(10, 19) d], the parenteral nutrition time [7(4, 15)d vs. 15(8, 18)d], the fasting time [5(3, 11) d vs. 11(6, 13)d] and the hospital stay [10(5, 16) d vs. 15(13, 23)d] were all shortened (all P<0.05). Conclusion:Both conservative management and pancreatic duct stenting can alleviate the clinical symptoms of SAP, and pancreatic duct stenting could help reduce local complications, relieve symptoms, and shorten hospital stay.

Objective:To investigate the characteristics and clinical significance of distribution of bacteria and fungi in pancreatic fluid and bile in patients with acute biliary pancreatitis (ABP).Methods:The clinical data of patients with ABP who underwent endoscopic retrograde cholangiopancreatography (ERCP) and pancreatic duct stenting with simultaneous bacterial and fungal culture of bile and pancreatic fluid at the Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University from January 1, 2019, to June 30, 2021 were retrospectively analyzed. Of 202 patients, there were 102 males, and 100 females, aged (54±16) years old. Patients were divided into two groups by presence or absence of pancreatic infection: the pancreatic infection group ( n=20) and the non-pancreatic infection group ( n=182). Of the 76 patients with positive bile bacterial cultures, 60 patients with positive pancreatic fluid bacterial cultures were included in the positive pancreatic fluid culture group and 16 patients with negative pancreatic fluid cultures were included in the negative pancreatic fluid culture group. The clinical data including the type and distribution of bacteria cultured, complications, and co-infections of patients were compared. Factors associated with pancreatic infection were analyzed using logistic regression and the value of assessment of the associated factors was analyzed by plotting the receiver operating characteristic (ROC) curve. Results:Of 404 specimens (202 each of pancreatic fluid and bile) were sent for examination, 152 (37.6%) were positive. 174 strains were isolated from the 152 positive specimens, 96 (55.2%) gram-negative, 70 (40.2%) gram-positive and 8 (4.6%) fungal strains. Compared to the pancreatic fluid culture-negative group, patients in the pancreatic fluid culture positive group had a statistically significant ( P<0.05) increased risk of neutrophil to lymphocyte ratio, duration of fever, Balthazar CT score, complication rate, and development of pancreatic necrosis, pancreatic infection and systemic inflammatory response syndrome (SIRS). Compared to patients in the non-pancreatic infection group, patients in the pancreatic infection group had a statistically significant ( P<0.05) increase in duration of fever on admission, duration of fasting, and proportion of patients with combined SIRS, positive bile cultures, positive pancreatic fluid cultures, and diabetes mellitus. Logistic regression analysis showed that positive pancreatic fluid cultures ( OR=6.699, 95% CI: 1.159-38.725) and diabetes mellitus on admission ( OR=4.625, 95% CI: 1.304-16.394) were risk factors for late pancreatic infection ( P<0.05). The area under the ROC curve for the combination of both positive pancreatic fluid culture and diabetes mellitus in predicting late pancreatic infection in patients was 0.788, with a specificity of 59.30% and a sensitivity of 90.00%. Conclusions:Bacterial culture in pancreatic juice and bile of ABP patients showed mainly Gram-negative bacteria. Early culture of pancreatic juice and bile had positive significance in ABP evaluation, infection prediction and anti-infection treatment.