Objective To explore the effect of comprehensive intervention on constipation caused by antipsychotic drugs.Methods Ninty patients with antipsychotic drug induced constipation who were admitted to our hospital from June 2012 to October 2013 were enrolled in this investigation and randomly assigned to the comprehensive intervention group(CIG,n=46) and the routine care group(RCG,n=44).The subjects of the RCG received routine diet and medication therapy; and those of CIG received comprehensive intervention of life style,psychological ability,cognition,nursing and traditional chinese medicine(TCM) for 3 months.Constipation symptoms scale and Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) were assessed before and after the intervention.Results CIG showed significant improvement in defecation difficulty,defecation force,defecation duration,frequency,abdominal distension,total symptom score,PAC-QOL,physical discomfort,psycho-social discomfort,anxiety and treatment satisfaction were(2.8±2.1),(2.2±1.6),(2.4±1.3),(2.1±1.7),(1.5±0.9),(14.0±8.1)respectively (t values were 2.629,3.818,2.328,2.593,2.578,2.913,7.499,2.570,5.012,2.249 and 12.259,respectively; all P＜0.05).Conclusion Comprehensive intervention may be an effective therapy against psychiatric drug induced constipation.

BACKGROUND: Clinically, in patients undergoing hematopoietic stem cell transplantation (HSCT), human cytomegalovirus (HCMV) can be associated with delayed platelet engraftment, phenotypically abnormal peripheral blood leukocytes, and graft rejection, possibly through a direct viral effect on hematopoietic progenitor cells after HCMV infection. OBJECTIVE: To investigate the inhibitory effect of ganciclovir (GCV) on proliferation of colony forming unit (CFU) granulocyte-macrophage (CFU-GM), CFU-erythroid (CFU-E), CFU T-lymphocyte (CFU-TL), CFU-multipotential (CFU-Mix) and CFU-megakaryocyte (CFU-Mk) progenitor cells of cord blood (CB) and the protective effects on them. DESIGN: Contrast observational study.SETTING: Department of Molecular Biology, Affiliated Hospital of Luzhou Medical College.PARTICIPANTS: A total of 20 cord blood (CB) samples (with 10 mL for each sample) from fetal umbilical vein of normal term spontaneous delivery neonates were provided by the Department of Gynaecology and Obstetrics, Affiliated Hospital of Luzhou Medical College. All the patients were informed and agreed with the experiment.METHODS: The experiment was carried out in the Department of Molecular Biology, Affiliated Hospital of Luzhou Medical College from June 2004 to December 2006. Colony forming unit-assay was applied to observe the suppression effect of HCMV-AD169 strain on CFU-GM, CFU-E, CFU-TL, CFU-Mix and CFU-Mk of CB with the presence of GCV. The techniques of polymerase chain reaction (PCR) and fluorescence quantification PCR were used to demonstrate the existence of HCMV-AD169 DNA in the colony cells of cultured CFU-GM, CFU-E, CFU-TL, CFU-Mix and CFU-Mk. Normal progenitor cells culture system was regarded as blank control group; normal progenitor cells culture system with inactivated HCMV fluid as inactivated (IV) control group.MAIN OUTCOME MEASURES: ① The number and maintaining duration of colonies of cultured progenitor cells were counted by using a light inverted phase contrast microscope. ② The techniques of PCR and fluorescence quantification PCR were used to demonstrate the existence of HCMV-AD169 DNA in the colony cells of cultured progenitor cells.RESULTS: ① Number and lasting time of colonies: The numbers of CFU-GM, CFU-E, CFU-TL, CFU-Mix and CFU-Mk colonies in the HCMV infection group were significantly less than those in the blank control group (P < 0.01). The maintaining duration of colonies in the HCMV infection group was significantly shorter than that in the blank control group (P < 0.01). HCMV-DNA copies of colony cells of GCV group decreased significantly by using fluorescence quantification PCR compared with HCMV group (P < 0.01), while negative in blank control and inactivated control in CFU-MK and CFU-Mix. ② CFU Growth rate: The Growth rate of colonies was 37.4%, 74.2%, 40.1%, 67.4% and 38.9% of CFU-GM, CFU-E, CFU-TL, CFU-Mix and FU-MK, respectively. ③ CFU-HCMV-AD169 DNA: Fluorescence quantification PCR showed that nucleonic acid content of progenitor cells after GCV-affected HCMV infection was decreased as compared with that after HCMV infection (P < 0.01).CONCLUSION: The differentiation and proliferation of CFU-GM, CFU-E, CFU-TL, CFU-Mix and CFU-Mk are significantly inhibited after infected with CMV-AD169 strain. The growth of hematopoietic progenitor cell after HCMV-AD169 infection is promoted by GCV, which suggests that GCV has an effect of anti-HCMV in vitro.

ObjectiveTo evaluate the impact of iFlow in the auxiliary diagnosis of cerebral vascular diseases.Methods Totally 65 patients with cerebral vascular diseases underwent whole brain 2D DSA.Then the data were converted to color coded images with iFlow.The vascular anatomy,the shape and size of lesions,the blood dynamics on 2D DSA and iFlow images were evaluated by junior and senior physicians,who then reported whether iFlow images had supplementary diagnosis value.ResultsiFlow images displayed whole information of lesions more clearly than those of 2D DSA in brain vascular dynamic sequence,including vascular anatomy,hemodynamic changes and tissues perfusions.The evaluation of 2D DSA and iFlow images with junior and senior physicians had statistical difference (x2 =6.032,P=0.014).ConclusionCompared to single DSA,iFlow can facilitate the diagnosis and evaluation of cerebral vascular diseases,especially for junior physicians.

Objective To analyze the effects of community-based intervention on improving early detection of individuals with high risk nasopharyngeal carcinoma and to explore the interventional mechanism of prevention and treatment in nasopharyngeal carcinoma.Methods Total of 139 344 residents of the Second Chinese Medicine Hospi-tal of Guangdong Province Hospital Community were detected per year.Individuals with high risk nasopharyngeal car-cinoma or nasopharyngeal carcinoma patients were divided into intervention group(69 616 cases) and control group (69 728 cases) according to the random number table.The two groups were given conventional treatment (radiothera-py,chemotherapy and surgery treatment) after diagnosed.The intervention group was interfered with long -term prevention,health care,medical care,rehabilitation,health education and psychological intervention by full-time phy-sician,while the control group was only treated by general education intervention.The awareness of early symptoms and the risk factor of nasopharyngeal carcinoma were analyzed.Additionally,the behavior,knowledge and attitude on nasopharyngeal carcinoma were detected before and after the intervention.Results Community-based intervention significantly improved the rate of early detection of nasopharyngeal carcinoma high-risk individuals ( 75.31% vs. 44.37%,χ2 =5.32,P<0.01) .The awareness rates of major symptoms and the damage of nasopharyngeal carcinoma were 89.34%and 91.78%in the intervention group.In the control group,the rates were 42.17%and 28.47%.The differences of the two groups were significant(P<0.05).Additionally,the awareness of diagnosis standard and good habits were improved significantly in the intervention group compared with the control group(P<0.01).Our results showed that intervention changed the attitude and understanding of patients with nasopharyngeal carcinoma and improved the quality of life of patients with nasopharyngeal carcinoma.Conclusion Intervention increased the early diagnostic rate of nasopharyngeal carcinoma and promoted the quality of life of patients with nasopharyngeal carcinoma.

Objective To investigate the effects of combined use of an allograft and vascularized fibular flap for the reconstruction of bone defects after intercalary resection of long bone malignancy.Methods From April 2006 to October 2009,19 patients that had intercalary resection of long bone malignancy (5 in humerus,7 in femur,7 in tibia)underwent reconstruction with an allograft and vascularized fibula construct,including 11 males and 8 females with an average age of 18.5 years.The average length of the defect was 13.2±4.3 cm.Free vascularized fibula flaps were used in 16 patients and ipsilateral pedicle vaseularized fibula grafts in 3.Time to union was recorded through evaluation of plain radiographs.Bone scan was used to evaluate the viability of the vascularized fibula.Patients were examined oncologically and radiographically and were assessed functionally with MSTS-93.Results The mean follow-up time was 27.5 months.The average length of the fibula flap was 17.9±5.2 cm.Viability of the fibular grafts was verified in all cases.The average time for bone union at allograft-host junction was 11.3±2.8 months in femur,14.1±3.3 in tibia,6.8±1.4 in humerus,respectively.The MSTS-93 average score at final follow-up was 95.2% in upper extremity and 91.8% in lower extremity.The oncology result in patients with follow-up more than 2 years was continuous disease free in 11 patients.no evidence of disease after recurrence following resection in 1,alive with tumor in 1,and died of lung metastasis in 1.Conclasion Vascularized fibular flap in combination with massive allograft provide an option for reconstruction of large bony defects after long bone malignancy extirpation.The viability of the fibula is a cornerstone in success of reconstruction that prevents allograft nonunion and result in decreased time to bone healing,leading to earlier patient's recovery of function.

Objective To analyze the security and effectiveness of the accurate resection and reconstruction of pelvic tumor with computer navigation and to evaluate the feasibility of pelvic ring structure and mechanics reconstruction using finite element analysis.Methors From December 2008 to June 2010,tumor resections assisted by computer navigation technology and pelvic reconstructions with assembly prosthesis designed by finite element analysis were performed in 12 patients with internal hemi-pelvic malignant tumors.There were 8 male and 4 female patients,with the average age of 39.7 years(range,25-53).The malignant tumors involved chondrosarcoma(4 cases),osteosarcoma(2),Ewing sarcoma(2),malignant fibrohistiocytoma(1),and metastatic tumor(3,in which including renal cell carcinoma 1 case,thyroid carcinoma 1,and breast carcinoma 1).According to Enneking staging classification,there were 1 case in Ⅰ A,2 cases in ⅠB,2 cases in Ⅱ A.and 4 cases in Ⅱ B.The local recurrence of tumor and functional results were followed up postoperatively.Results There were no nerves,vessels and pelvic organs injuries intra-operatively.The postoperative X-rays showed that the excised regions were proper to the preoperative schedule and en bloc resections were performed in all patients.All assembly prostheses were in satisfactory position.and the screw fixation was accordance with the finite element biomechanical analysis.All the cases were followed up for average 18.2 months (range,8-26).There were 1 case with local recurrence and pulmonary metastasis,1 case with deep infection,and 1 case with deep vein thrombosis.No prosthesis dislocation,loosening,breaking,and limb length discrepancy occurred in all patients.The average MSTS93 functional score was 70%in all patients at 6 months,and 68 % in 6 patients at 20 months follow.up.Conclusion The resection and reconstruction of pelvic tumor assisted by computer navigation is a safe and effective procedure.The finite element analysis can provide accurate biomechanical guidance to the reconstruction of pelvic ring.

Aim To investigate the effects of 6% hydroxyethyl starch 130/0.4(6%HES 130/0.4)and Ringer's solution resuscitation on early lung injury in hemorrhagic shock rats and its mechanisms.Methods Twenty-four male SD rats were divided into 4 groups:sham,Ringer's solution(RS),two HES groups(H1,H2).Group H1,H2 received HES 33,50 ml·kg~(-1) and Ringer's solutions respectively after 90-minute shock(the dose of Ringer's solutions was 3 times as muchas the maximum shed blood volume minus the dose of HES).Blood samples were taken from artery for blood analysis and the expression of CD11b/CD18 at T_0,T_1,T_4,T_5.The lungs were removed for ultrastructure examination.Results PaO_2 increased in group H1 at T_(1～5) and group H2 at T_5 as compared with T_0.PaCO_2 decreased in all the resusitation groups.The ultrastructure was basically normal except that the mitochondria changed slightly in group H1.In group H2,the perinuclear space was dilated slightly and the rough endoplasmic reticulum expanded slightly,and the degranulation was observed.Compared with group RS,the expressions of CD11b and CD18 decreased at T_4,T_5;compared with group H1,the expressions of CD11b and CD18 in group H2 increased.Conclusions Treatment with 6%HES(130/0.4)33 ml·kg~(-1)and Ringer's solution can attenuate hemorrhagic shock,and the resuscitation reduces lung injury through inhibition of expressions of CD11b and CD18.

Objective To evaluate the potential use of a probe melting analysis (PMA) assay in detecting the embB mutations which confer resistance against ethambutol in Mycobacterium tuberculosis. Methods The analysis sensitivity and specificity of PMA were investigated by detecting a serially diluted H37 Rv DNA and a reference panel from National Institute for the Control of Pharmaceutical and Biological Product. Six hundred and thirteen sputum samples were collected from the Xiamen Center for Disease Control and Prevention, Xiamen First Hospital and Center for Zhangzhou Disease Control and Prevention from September 2009 to April 2010. The PMA assay was then evaluated by detecting 613 clinical isolates and the results were compared with the sequencing results. Results The PMA assay could specifically detect Mycobacterium tuberculosis and had a limit of detection of 3 copies per reaction. The assay results with 613 clinical isolates showed that PMA gave a 100% concordance with sequencing in the 583 qualified samples, among which 34 were mutations at embB 306,23 at embB 378-380, 3 at embB 406 and 3 at embB 497. Conclusions PMA assay is a sensitive and specific method enabling efficient detection of common embB mutations causing ethambutol-resistance. The rapidness of this method together with its reliability would facilitate its use in routine testing.

OBJECTIVETo investigate the effect of peritoneal dialysis on fluid balance and outcome in children who receive cardiac operation.

METHODSFrom July to Dec. 2000, 12 (2.08%) patients of 576 consecutive children who underwent heart operation required peritoneal dialysis because of acute renal failure. The mean age of these 12 patients was (2.9+/-2.0) years (range, 5 months-7 years) and the mean body weight was (12+/-3) kg (range, 7.4-18.5 kg).

RESULTSThe interval between the operation and the initiation of peritoneal dialysis was (21.2+/-11.4) hours (4.4-42 hours). The duration of peritoneal dialysis was (6.3+/-4.8) days (0.47-15 days). Mortality in these 12 patients was 25%. Fluid removed by peritoneal dialysis was (34.7+/-17.8) ml x kg(-1) x day(-1). Asymoptomatic hypokalemia, thrombocytopenia and hyperglycemia were frequent complications, which were easily managed. Hemodynamics and pulmonary function improved during the study period.

CONCLUSIONThe early initiation of peritoneal dialysis is an effective and safe method to treat acute renal failure after cardiac operation in children.

Acute Kidney Injury ; etiology ; therapy ; Child ; Child, Preschool ; Female ; Heart Defects, Congenital ; surgery ; Humans ; Infant ; Male ; Peritoneal Dialysis ; Postoperative Complications

Objective To compare the therapeutic efficacy between emergency and non-emergency operation for ruptured intracranial aneurysms. Method A retrospective analysis of 184 patients with ruptured intracranial aneurysms the Second Affiliated Hospital Zhejiang University College of Medicine, admitted from Dec 2008 to Sep 2009, was carried out to evaluate the efficacy of operation to be done earlier. The patients were divided into 2groups according to the time of surgery. In the early operation group ( n = 102), the patients were operated on within 3 days of rupture of aneurysms, and in the delayed operation group ( n = 82), the patients were operated on after 3 days. The comparison in the rate of rebleeding before surgery, rate of complete occlusion of the ruptured aneurysm and rate of major complications such as cerebral infarction and hydrocephalus between two groups was made. The Glasgow outcome scale (GOS) scores of these patients were also evaluated by 6- 12 months follow-up after operation. Results Preoperative re-bleeding happened in 2 patients of the early operation group and in 7 patients of the delayed operation group. The rates were significantly different ( P ＜ 0.05). The complete occlusion rate in the early operation group was 91.2 % ( 93/102 ), while was 80.5 % ( 66/82 ) in the delayed operation group (P＜0.05). There were no statistically significant differences in post-operative cerebral infarction rate, post-operative hydrocephalus rate or GOS scores on follow-up between two groups. Conchusions Early operation can significantly reduce the re-bleeding before surgery, reducing the risk of death and disability. In early operation, the continuous lumbar drainage by cannulation and other methods can be used to reduce intracranial pressure, significantly increasing the rate of complete occlusion, and promoting rehabilitation.