Objective To compare postoperative outcomes and complications between subtotal colectomy combined with modified Duhamel procedure and simple subtotal colectomy for severe functional constipation (SFC). Methods Between January 2006 and June 2010,40 SFC patients after strict but inefficient nonoperative treatments were randomized by number table method to control group (20 cases, receiving simple subtotal colectomy) and combined group (20 cases,receiving subtotal colectomy and modified Duhamel procedure). The selection criteria were normal colonoscopy,and abnormal dynamic proctography (DPG). The functional outcomes after surgery were assessed from 6 months to 2 years period. Results The preoperative clinical manifestations of the two groups were similar. No statistically significant difference was observed between the two groups for time for recovery of the bowel function,length of postoperative hospitalization.and the early postoperative complications (P > 0.05). Functional outcomes of combined group with CIQOL score [(110.5 ±5.0) scores],relieving of costive gastrointestinal symptoms [(79.0 ±6.5)%], recurrent constipation rate [10.0% (2/20)], satisfaction rate of defecation frequency [85.0%(17/20)], satisfaction rate of quality of life[90.0%(18/20)] were significantly better than those of control group[(90.5 ± 3.5) scores, (60.5 ± 2.8)% ,35.0%(7/20), 15.0%(3/20),20.0%(4/20)](P< 0.05). Conclusion Combined application of subtotal colectomy and modified Duhamel procedure for SFC has better outcomes.

The hepatic portal system is a unique circulatory system that connects two systems of capillary beds ; one in the wall of the small intestine and spleen and the second in the sinusoidal area of the liver.Therefore,alterations in vasoreactivity (vasodilation and vasoconstriction) play a critical role in the pathophysiology of portal hypertension (PHT).The RhoA/ ROCK pathway exerts an important role in the Ca2+-independent mechanism in vascular smooth muscle (VSM).This mechanism not only modulates the constriction of intrahepatic small vessels and hepatic stellate cells (HSCs) but also effects the hyperdynamic circulation due to vascular hyporesponsiveness.Understanding the detailed mechanism and role of the RhoA/ROCK signal pathway in portal hypertension could be of great utility in providing a new target for portal hypertension therapy.

The surgical intervention and criteria of severe acute pancreatitis has significantly changed in the last several years with the advent of enhanced imaging techniques and minimally invasive surgery.Many kinds of minimally invasive technologies which take laparoscopy as a representative are constantly applied to the treatment of severe acute pancreatitis and make its mortality and postoperative complication rate decrease obviously.However,there are many different ways using laparoscopic techniques to treat severe acute pancreatitis.In this review,the author will discuss the current status of the different approaches.

Objective: To determine the distribution of Actinobacillus actinomycetemcomitans (Aa) in subgingival plaques in the patients with chronic periodontitis(CP). Methods: Samples of subgingival plaque were detected for Aa distribution by oligonucleotide probe from 60 sites of CP patients and 10 healthy sites of healthy people.Each sample was obtained from each site of each people. Results: Aa was detected in 19 out of 60 diseased sites(31.67%); Aa wasn't detected in healthy sites.The age(28.68±7.33) of Aa-positive patients was younger than that (44.48±12.48) of Aa-negative patients(P<0.05).Conclusion: Aa is possibly to cause chronic periodontal infection in younger people.

BACKGROUND: A considerable number of epilepsy patients cannot be treated sufficiently by drug. Epilepsy surgery is a treatment option in these cases. However, precisely localizing epileptogenic zone in epileptic patients is a successful element of epilepsy surgery. Its goal is to remove a minimum volume to control the seizures without cognitive impairment. Presurgical evaluation typically involves electroencephalogram (EEG), video-EEG monitoring, magnetic resonance imaging (MRI), single photon emission computed tomography and neuropsychological testing. Magnetoencephalography (MEG) has been as a noninvasive technique to be used to epilepsy surgical planning and brain functional study in many countries.OBJECTIVE: To preoperatively localize epileptogenic zone in patients with lesion-associated epilepsy using magnetoencephalography, compare with noninvasive video-EEG, and assess its localizing value according to the surgical outcomes. DESIGN, TIME AND SETTING: A retrospective case analysis was performed at the Magnetoencephalography Laboratory, Guangdong 999 Brain Hospital, China between November 2001 and December 2005.PARTICIPANTS: A total of 618 epileptic patients undergoing magnetoencephalography. Spontaneous magnetic field signal was collected to analyze single dipole location. Of them, 149 patients with MRI-documented epilepsy underwent surgery. The history of disease was at least 2 years. The course of disease ranged 2-35 years, with an average of 9.5 years. METHODS: MEG was recorded by a 148-channels whole head type MEG system (Magnes WH2500, 4-D Neuroimaging, San Diego, CA, USA) in Magnetically Shielded Room (MSR, Germany). Sampling rate: 508.63 Hz, 30-minutes interictal MEG (Bandpass: 1.0-100 Hz). For magnetic source imaging, the nasion and preauricular points were applied as fiducials. Single equivalent current dipole (ECDs) and head sphere model were applied for analysis. Estimated ECDs were overlaid on T1-weighted MRI of each subject.MAIN OUTCOME MEASURES: Preoperative MEG, MRI, and video-EEG and postoperative follow-up were measured. RESULTS: The sensitivity of the interictal MEG for detecting epileptiform activity was found in 91% of the patient. In most cases, the equivalent dipoles were mainly distributed over the border and neighborhood of the structural lesions. By MEG, we were able to localize the resected region in a greater proportion of patients (62.4%, 93/149) than with noninvasive vedio-EEG (38.9%, 58/149) in all patients with MRI-documented lesions. A total of 89 patients were followed up from 3-35 months, averagely 9 months. Of the 89 patients, 72 patients (80.9%) had no postoperative seizures (EngelⅠ); 7 (7.9%) cases obtain Engel Ⅱ and Engel Ⅲ outcomes. Favorable outcomes were not seen in 10 patients (11.2%) cases (Engel Ⅳ and Engel Ⅴ). Total effective rate was 88.8% (EngelⅠ-Ⅲ). CONCLUSION: MEG is not only most useful for presurgical planning in epilepsy patients with MRI-documented lesions, but is also a noninvasive method to identify the spatial relationship between the lesion and epileptogenic zone, a precise localization of the epileptogenic zone is correlated to a favorable outcome.

Obiective To study and design a real-time monitoring system based on ZigBee wireless technology in ICU wards. Methods The framework and function of this system are analyzed and designed, which specifies the main function of physiological data acquisition and wireless transmission mode, monitor base and monitor center, and introduces the development environment and important technology realizing this system. Results The system is convenient to the treatment of patients, and the monitor base and monitor center can assist doctors to diagnose and treat patient's condition effectively. Conclusion The system utilizes ZigBee wireless communication technology as the communication technology of physiological data acquisition, which is well suited to organize the preceding wireless sensor network of 1CU ward monitor, and can reduce the cable wire splices on patient* largely, and is convenient for the treatments of patients. The monitor base and monitor center of the system can comprehensively and accurately record the vital signs, medical treatment and nursing of patients and it is convenient for doctors to supervise patients' condition, providing medical treatment, and nursing strategy pointer.

[Objective] To study the apoptosis after long time of heart preservation,and the barrier of caspase (Ac-DEVD-CHO) in prolonged heart transplantation.To improve the techniques on the preservation of donor heart.[Methods] Donor rat hearts were subjected to group A (non-Ac-DEVD-CHO-treated),group B (Ac-DEVD-CHO-treated) of hypothermic storage,after 9 hours of heart preservation,then performed heterotopic heart transplantation,followed by 60 min of normothermic reperfusion (n ＝ 6 in each group).[Results] After 60 min reperfusion,compared with group A,① a significant improvement in the percent recovery of HR was observed in group B (P ＜ 0.05);② Caspase-3 activity was decreased in group B (P ＜ 0.01);③ an apparent decline in the expression of infarct area was observed in group B (P ＜ 0.01);④ an apparent decline in the expression of TUNEL-positive cardiomyocyte was observed in group B (P ＜ 0.01);⑤ Group B shows the least disease.[Conclusion] ① After preservation and reperfusion,cardiomyocyte apoptosis was observe evidently,which led to irreversible heart dysfunction.② The administration of caspase-3 inhibition after reperfusion attenuates ischemia-reperfusion injury by suppressing apoptosis in heart transplantation.Furthermore,the use of caspase inhibition was investigated as a strategy for the preservation donor heart in transplantation.③ The relationship of dose-response and time-effect is still unknown.

Objective To investigate the epidemiological characteristics of adverse reaction induced by Chinese herbal injection. Methods Multiple cases report in domestic medical periodicals were searched and analysed by bibliometric and statistic meth-ods. Results Fifty-six reports on muti-ADR cases related to 16 different kinds of Chinese herbal injection were collected. There were 67299 patients and 1348 ADR cases related to Chinese herbal injection. The average ADR incidence was 2.00 % ;the highest incidence of 43.28 % was shown in cinobufotalin injection and the lowest incidence of 0. 25 % in zedoary turmeric oil injection). Skin lesion, and circulatory and digestive lesion dominated in ADRs. Conclusion we should use Chinese herbal in-jection more rationally, and enhance prevention awareness to reduce the incidence of ADR induced by Chinese herbal injection.

10.3969/j.issn.2095-4344.2013.26.020

Objective To explore the clinical application value of serum procalcitonin (PCT) detection in diagnosis of neonatal infection disease.Methods The serum PCT,CRP values,routine blood test,blood cultures of 50 children with suspected infection was detected at admission and five days after admission.According to the clinical manifestations and the test results,50 children were divided into the bacterial infection group (32 cases) of and non-bacterial infection group (18 cases),and the value of PCT,CRP,routine blood test,blood culture was compared.Results Of bacterial infection group at admission,the serum PCT values in 27 cases were more than or equal with 2μg/L,white blood cell (WBC) increased in 6 cases,CRP of 7 cases were positive,blood cultures (3d) of 4 cases were positive,and of non-bacterial infection group at admission,the serum PCT value in 2 cases were more than or equal with 2μg/L,WBC increased in 2 cases,blood cultures (3d) of 1 case was positive ; Of bacterial infection group 5 days after admission,the serum PCT value in 23 cases were more than or equal with 2μg/L,WBC increased in 15 cases,CRP of 6 cases were positive,blood culture (5d) of 9 case were positive,and of non-bacterial infection group 5 days after admission,the serum PCT value in 1 cases was more than or equal with 2μg/L,WBC increased in 3 cases,CRP of 4 cases were positive,blood culture (5d) of 1 case was positive.At admission the cases of WBC increasing,CRP positive,blood culture positive of the two groups had no statistically significant differences (x2 =0.50,0.19,0.62,all P ＞ 0.05),but the cases of the PCT value which was more than or equal with 2μg/L had statistically significant differences between the two groups (x2 =25.30,P ＜ 0.05).5 days after admission the cases of WBC increasing,PCT,blood culture positive of the two groups had no statistically significant differences (x2 =4.39,20.30,8.56,all P ＜ 0.05),but the cases of the CRP value significant differences between the two groups (x2 =0.83,P ＞ 0.05).Conclusion The detection of serum PCT can be used as an important index of diagnosis for early neonatal infections,and its sensitivity and specificity are better than,blood routine and blood culture.