Objective To investigate the clinical efficacy of uterine incision diverticulum type repair after cesarean section treated by laparoscopy and transvaginal combined with repair in.order to provide the reference for the clinical operation scheme selection.Methods Fifty-two patients who underwent uterine incision diverticulum type repair after cesarean section in the Second People's Hospital of Jingzhou were randomly divided into observation group and control group with 26 cases in each.Patients in the observation group were treated with laparoscopy combined with repair treatment,and patients in the control group were treated with transvaginal repair treatment.The operation periods,cut bleeding volume,postoperative anal exhaust time for the first time,postoperative highest temperature and length of hospital stay were recorded to evaluate the repair and uterine diverticula recovery at 3 months after operation.Results The operation periods in the observation group was (119.91 ± 35.73) min,longer than that in the control group ((62.32 ± 31.83) min ; t =3.514,P ＜0.05).There were on significant differences between two groups in terms of the amount of bleeding,anal discharge first time,the highest postoperative temperature and contrast after a few days in hospital (P＞ 0.05).After treatment,the observation group menstrual recovery rate was 84.62％ and 88.46％ in the control group.The differences were not statistically significant (x2 =1.14,1.76,P ＞ 0.05).Conclusion Laparoscopy hemiorrhaphy and transvaginal repair are effective treatment for uterine incision diverticulum after caesarean operation.The corresponding treatment plan can be made according to the patient's condition.

Objective To compare the clinical effect of digital orthopedic three-dimensional visualization technology combined with image-based computer navigation and simple image-based computer navigation for percutaneous screw fixation of acetabulum anterior column fractures.Methods A retrospectivecase-control analysis was made on 19 cases undergone percutaneous screw fixation of acetabular anterior column fractures under image-based computer navigation from January 2015 to 2016 March.There were 12 males and 7 females,aged from 21 to 66 years (mean,39.3 years).AO fracture classification was A3 type in 17 cases and B1 type in 2.Based on the application of three-dimensional digital programming,the cases were assigned to two groups:group A (n =9),virtual three-dimensional model was reconstructed and the virtual screw were inserted to uninjured side by software Mimics and group B (n =10),patients were only prepared for routine preoperative preparation.Time of anterior column screw insertion,intraoperative bleeding,intraoperative fluoroscopy frequency,fracture reduction and Majeed score were compared between the two groups.Results All cases were followed up for mean 8.4 months (range,3-12 months).There were no significant differences between groups A and group B in iutraoperative bleeding [(14.1 ± 3.0) ml,(15.1 ± 2.2) ml],good to excellent rate of reduction (89％,80％),good to excellent rate of Majeed score (89％,80％) (P ＞ 0.05).Time of anterior column screw insertion [(22.4-± 3.4) min] and intraoperative fluoroscopy frequency [(24.9 ± 3.8)times] in group A were significantly less than those[(29.4 ± 4.5)min,(30.5 ± 5.8)times] in group B (P ＜ 0.05).Conclusion Digital orthopedic three-dimensional visualization technology is associated with shortened time of anterior column screw insertion and reduced intraoperative fluoroscopy frequency,indicating an effective adjuvant technique for percutaneous screw fixation of acetabulum anterior column under navigation.

Objective To investigate the clinical application of pedicle screw placement technique for pelvic external fixation.Methods A retrospective review was made on 63 patients (37 males and 26 females;23-67 years of age) managed with anterior or combined anterior and posterior external fixation of pelvic fracture between February 2011 and May 2014.According the ways of screw insertion,the study was divided into two groups:observation group (screw was inserted using the pedicle screw placement technique,n =36) and control group (screw was inserted directly,n =27).Tile fracture classification was 11 patients with type B1,7 type B2,7 type B3,5 type C1,3 type C2 and 3 type C3 in observation group,and 9 patients with type B1,7 type B2,4 type B3,4 type C1,2 type C2 and 1 type C3 in control group.Operation time,rate of the penetration,X-ray fluoroscopy times,screw loosening rate,and postoperative complication rate were documented.Radiologic evaluation of the pelvis was detected with the Matta' s criteria.At the final follow-up,functional evaluation of the pelvis was evaluated with the score proposed by Cole et al.Results Period of follow-up was (14.7 ± 3.2)months in observation group and was (13.8 ± 3.1) months in control group.A total of 190 screws were placed in observation group and 138 screws in control group.Better results were found in observation group than in control group with respect to operation time [(18.8 ± 4.1) min vs.(22.6 ± 5.4) min],rate of the penetration (1.6％ vs.8.7％),X-ray fluoroscopy times (1.6 ± 0.8 vs.2.2 ± 0.9),and screw loosening rate (1.6％ vs.6.5％).There were no significant difference between observation and control groups in percentage of good to excellent reduction(89％ vs.85％) and function score [(35.6 ±3.0) points vs.(34.8 ± 3.9) points] (P ＞ 0.05).After operation,3 patients with lateral femoral cutaneous nerve paralysis and none with wouud infection were found in observation group;3 patients with lateral femoral cutaneous nerve paralysis and one patient with wound infection were found in control group.Conclusion Either the pedicle screw placement technique or conventional technique achieves satisfactory clinical effect,but the former owns better results in operation time,screw insertion accuracy,fluoroscopy frequency and rate of screw loosening,suggesting a fast,safe,and effective screw placement method in pelvic external fixation that should be widely applied.

Objective To explore the clinicopathologic factors impacting recurrence and survival in rectal cancer patients after radical resection.Methods Clinicopathologic data of 1 166 patients with rectal cancer in Changhai Hospital,were recruited between 2005 and 2010.Kaplan-Meier analysis and the logrank test were used to evaluate the effects of the pathology on patients' survival.Cox regression model was used to assess independent factors associated with clinical prognosis.Results The 1,3,5-year overall survival rates were 94.3％,81.2％ and 76.5％,median survival time was 53 months.328 patients had recurrence and metastases,with a median recurrence time of 18 months.The independent prognostic factors for overall survival time were CEA,CA19-9,tumor distance to dentate line,surgical modality,radical operation,tumor invasion,tumor differentiation,lymph node metastasis and postoperative treatment.Surgical treatment,radical operation or not,tumor invasion and lymph node metastasis were statistically significant associated with tumor recurrence and metastases.Conclusions The important factors inffuencing the prognosis of rectal cancer patients were CEA,CA19-9,tumor distance to dentate line,surgical modality,radial operation,tumor in vasion,tumor differentiation,lymph node metastasis,and post operative treatment.

Objective: Hippocampal neuron apoptosis contributes to autism, while METTL3 has been documented to possess great potentials in neuron apoptosis. Our study probed into the role of METTL3 in neuron apoptosis in autism and to determine the underlying mechanism. Methods: Bioinformatics analysis was used to analyze expressed genes in autism samples. Institute of Cancer Research mice were treated with valproic acid to develop autism models. The function of METTL3 in autism-like symptoms in mice was analyzed with behavioral tests and histological examination of their hippocampal tissues. Primary mouse hippocampal neurons were extracted for in vitro studies. Downstream factors of METTL3 were explored and validated. Results: METTL3, MALAT1, and Wnt/β-catenin signaling were downregulated, while SFRP2 was upregulated in the hippocampal tissues of a mouse model of autism. METTL3 stabilized MALAT1 expression by promoting m6A modification of MALAT1. MALAT1 promoted SFRP2 methylation and led to reduced SFRP2 expression by recruiting DNMT1, DNMT3A, and DNMT3B to the promoter region of SFRP2. Furthermore, SFRP2 facilitated activation of the Wnt/β-catenin signaling. By this mechanism, METTL3 suppressed autism-like symptoms and hippocampal neuron apoptosis. Conclusion This research suggests that METTL3 can reduce autism-like symptoms and hippocampal neuron apoptosis by regulating the MALAT1/SFRP2/Wnt/β-catenin axis.

Objective:To investigate the clinical efficacy and prognosis of simultaneous resection of synchronous colorectal liver metastasis in patients admitted in different phases.Methods:The retrospective cohort study was conducted. The clinicopathological data of 346 patients who underwent simultaneous resection of synchronous colorectal liver metastasis in the First Affiliated Hospital of Naval Medical University (Changhai Hospital of Shanghai) from January 2000 to April 2021 were collected. There were 217 males and 129 females, aged (58±12)years. Patients under-went simultaneous resection of synchronous colorectal liver metastasis. Observation indicators: (1) clinicopathological features of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021; (2) surgical and postoperative situations of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021; (3) analysis of prognosis of patients with synchro-nous colorectal liver metastasis in 2000?2010 and 2011?2021. Follow-up was conducted using telephone interview or outpatient examination to detect survival of patients. The follow-up was performed once every 3 months, including blood routine test, liver and kidney function test, car-cinoembryonic antigen (CEA) test, CA19-9 test, abdominal B-ultrasound examination, and once every 6 months, including chest computed tomography (CT) plain scan, liver magnetic resonance imaging (MRI) and/or CT enhanced scan, abdominal or pelvic MRI and/or CT enhanced scan, within postoperative 2 year. The follow-up was performed once every 6?12 months within postoperative 2?5 years including above reexaminations. Electronic colonoscopy was performed once a year after operation. The follow-up was up to November 12, 2021. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distuibution were represented as M(range). Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the rank sum test. Kaplan-Meier method was used to calculate survival rates and draw survival curves, and Log-Rank test was used to conduct survival analysis. Results:(1) Clinicopathological features of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021. Of the 346 patients, 59 cases underwent simultaneous resection within 2000?2010 and 287 cases underwent simultaneous resection within 2011?2021. The gender (males and females), cases with or without fundamental diseases, cases with the number of lymph nodes harvested in primary lesion as <12 or ≥12, the tumor diameter of primary lesion, the tumor diameter of liver metastasis lesion, the number of liver metastasis lesions, cases with or without preoperative treatment, cases with or without postoperative treatment, cases with adjuvant therapy as perioperative treatment, surgery or other treatment were 47, 12, 36, 23, 19, 40, (5.5±2.4)cm, (2.1±0.7)cm, 1.6±0.5, 59, 0, 16, 16, 0, 16, 43 in patients admitted in 2000?2010, respectively. The above indicators in patients admitted in 2011?2021 were 170, 117, 121, 166, 58, 229, (4.2±2.0)cm, (3.0±2.0)cm, 1.9±1.4, 208, 79, 34, 235, 74, 29, 184, respectively. There were significant differences in the above indicators between patients admitted in 2000?2010 and 2011?2021 ( χ2=8.73, 7.02, 4.07, t= 4.40, ?6.04, ?3.10, χ2=21.05, 28.82, 26.68, P<0.05). (2) Surgical and postoperative situations of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021. Cases with surgical methods as complete open surgery or laparoscopy combined with open surgery, the operation time, time to postoperative initial liquid food intake, cases with or without postoperative complications, cases with postoperative duration of hospital stay as ≤10 days or >10 days were 58, 1, (281±57)minutes, (5±1)days, 33, 26, 14, 45 in patients admitted in 2000?2010, respec-tively. The above indicators in patients admitted in 2011?2021 were 140, 147, (261±82)minutes, (3±1)days, 233, 54, 198, 89, respectively. There were significant differences in the above indicators between patients admitted in 2000?2010 and 2011?2021 ( χ2=49.04, t=2.24, 7.53, χ2=17.56, 26.02, P<0.05). There was no death in the 346 patients. (3) Analysis of prognosis of patients with synchro-nous colorectal liver metastasis in 2000?2010 and 2011?2021. Of the 346 patients, 295 cases were followed up for 47(range, 1?108)months. Of the 29 patients admitted in 2000?2010 who were followed up, there were 27 cases died. The median survival time, 1-, 3-, 5-year overall survival rates, 1-, 3-, 5-year disease free survival rates of patients admitted in 2000?2010 were 18.0 months (95% confidence interval as 12.7?23.3 months), 82.8%, 11.5%, 3.8%, 53.6%, 8.3%, 4.2%, respec-tively. Of the 266 patients admitted in 2011?2021 who were followed up, there were 109 cases died. The median survival time, 1-, 3-, 5-year overall survival rates, 1-, 3-, 5-year disease free survival rates of patients admitted in 2011?2021 were 54.0 months (95% confidence interval as 38.1?70.4 months), 93.3%, 61.8%, 47.0%, 68.2%, 33.7%, 28.3%, respectively. There were significant differences in overall survival rate and disease free survival rate between patients admitted in 2000?2010 and 2011?2021 ( χ2=47.57, 9.17, P<0.05). Conclusions:With the increase of the operation volume of simultaneous resection of synchronous colorectal liver metastasis, the operation time, time to postoperative initial liquid food intake, postoperative duration of hospital stay and postoperative complications have significantly decreased, while the overall survival rate and disease free survival rate have significantly increased.

Cough ; diagnosis ; physiopathology ; Dyspnea ; diagnosis ; physiopathology ; Female ; Humans ; Hyperparathyroidism, Primary ; diagnosis ; physiopathology ; Middle Aged

Eight new C-diterpenoid alkaloid arabinosides, named aconicarmichosides E-L (-), were isolated from an aqueous extract of the lateral roots of (Fu Zi). Their structures were determined by spectroscopic and chemical methods including 2D NMR experiments and acid hydrolysis. Compounds -, together with the previously reported four neoline 14--arabinosides from the same plant, represent the only examples of glycosidic diterpenoid alkaloids so far. At a dose of 1.0 mg/kg (i.p.), as compared with the black control, compounds , , and - exhibited analgesic effects with >65.6% inhibitions against acetic acid-induced writhing of mice. Structure-activity relationship was also discussed.

OBJECTIVE: To investigate the surgical efficacy and prognostic factors of T3NxM0 middle-low rectal cancer without neoadjuvant therapy. METHODS: Clinical data of patients with middle-low rectal cancer undergoing TME surgery with T3NxM0 confirmed by postoperative pathology at Colorectal Surgery Department of Changhai Hospital from January 2008 to December 2010 were analyzed retrospectively. INCLUSION CRITERIA: (1)no preoperative neoadjuvant chemoradiotherapy (nCRT); (2) complete preoperative evaluation, including medical history, preoperative colonoscopy or digital examination, blood tumor marker examination, and imaging examination; (3) distance between tumor lower margin and anal verge was ≤ 10 cm; (4) negative circumferential resection margin (CRM-). Finally, a total of 331 patients were included in this study. According to the number of metastatic lymph node confirmed by postoperative pathology, the patients were divided into N0 group without regional lymph node metastasis (190 cases) and N+ group with regional lymph node metastasis (141 cases). The perioperative conditions, local recurrence, distant metastasis and prognostic factors were analyzed. RESULTS: Compared to N0 group in the perioperative data, N+ group had higher ratio of tumor deposit [29.8%(42/141) vs. 0, χ²=64.821, P<0.001] and vascular invasion [7.1%(10/141) vs. 0.5%(1/190),χ²=10.860, P<0.001]. There were no significant differences in tumor diameter, number of lymph nodes detected, positive nerve invasion, degree of tumor differentiation, morbidity of postoperative complication and postoperative adjuvant chemotherapy rate between the two groups (all P>0.05). The median follow-up period was 73.4 months. The merged 5-year local recurrence rate was 2.7%(9/331), 5-year distant metastasis rate was 23.3% (77/331), 5-year disease-free survival (DFS) rate was 73.4%, and 5-year overall survival (OS) rate was 77.2%. Multivariate analysis showed that lymph node metastasis (HR=3.120, 95%CI: 1.918 to 5.075, P<0.001), nerve invasion (HR=0.345, 95%CI: 0.156 to 0.760, P=0.008) and vascular invasion (HR=0.428, 95%CI: 0.189 to 0.972, P=0.043) were independent risk factors for DFS in patients with T3NxM0 rectal cancer after operation. Preoperative carcinoembryonic antigen level (HR=1.858, 95%CI:1.121 to 3.079, P=0.016), lymph node metastasis (HR=3.320, 95%CI: 1.985 to 5.553, P<0.001) and nerve invasion (HR=0.339, 95%CI: 0.156 to 0.738, P=0.006) were independent risk factors for OS in patients with T3NxM0 rectal cancer after operation. CONCLUSIONS Optimal local control rate of middle-low rectal cancer patients with T3NxM0 and CRM- can be achieved by standard TME surgery alone. For patients with preoperative elevated blood carcinoembryonic antigen level, regional lymph node metastasis, or neurovascular invasion confirmed by pathology after surgery, adjuvant chemoradiotherapy should be actively applied after surgery to improve prognosis.
Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; Mesocolon ; surgery ; Neoadjuvant Therapy ; Neoplasm Staging ; Proctectomy ; methods ; Prognosis ; Rectal Neoplasms ; pathology ; surgery ; Retrospective Studies