Objective To investigate the effect of hyperacute intensive antihypertensive treatment on the prognosis of intracerebral hemorrhage in basal ganglia region. Methods From January 2013 to December 2015,100 patients with intracerebral hematoma in basal ganglia region (onset ≤3 h)at the Neurological Intensive Care Unit,the First Affiliated Hospital of Dalian Medical University were enrolled prospectively. They all randomly received the intensive antihypertensive or standard antihypertensive treatment voluntarily. They were divided into either an intensive antihypertensive group or a standard antihypertensive group according to the random number table (n = 50 in each group). Within 1 h after beginning to treatment,the target systolic blood pressure was controlled in 130 -140 mmHg in the intensive antihypertensive group,the target systolic blood pressure was controlled in 160 -180 mmHg in the standard antihypertensive group,and the target systolic blood pressure was maintained respectively in the following 7 d. Head CT was performed gain at 24 h after treatment. The intracranial hematoma expansion was evaluated. The National Institutes of Health Stroke Scale (NIHSS)and the modified Rankin scale (mRS)were used to
evaluate their prognoses. The differences of the cumulative mortality in both groups were compared at the same time. Results The incidences of hematoma expansion of the intensive antihypertensive group and the standard antihypertensive group were 12. 0% (6/ 50)and 30. 0% (15/ 50)respectively. There was significant difference between the 2 groups (χ2 = 4. 882,P = 0. 027). There were no significant differences in NIHSS scores within or between both groups at each time points (all P > 0. 05). They were followed up for 90 d,no adverse events occurred in both groups. The favorable prognosis rates of the neurological function were 36. 0% (18 / 50)and 18. 0% (9 / 50)respectively in the intensive antihypertensive group and the standard antihypertensive group. There was significant difference between the 2 groups (χ2 = 0. 411,P =0. 043). Kaplan-Meier curves showed that the cumulative mortality at 24 h,within 7 d and 90 d in the intensive antihypertensive group and the standard antihypertensive group were 4. 0% (2 / 50),6. 0%(3 / 50),and 10. 0% (5 / 50),respectively,those of the standard antihypertensive group were 10. 0%(5 / 50),24. 0%(12 / 50),and 30. 0%(15 / 50),respectively. The results of Log-rank test found that there was significant difference in cumulative mortality between the 2 groups (χ2 =6.280,P =0.012). Conclusions The intensive antihypertensive treatment in the hyperacute cerebral hemorrhage is safe and feasible in basal ganglia region. It contributes to improve prognosis of neurological function,and reduce the incidence of hematoma expansion and the 90 d cumulative mortality.

Objective To observe the effects of tissue factor pathway inhibitor(TFPI) on thrombosis formation in rabbit carotid arteries after ballon injury. Methods Fouty rabbits with the weight 2.5-3.0 kg were respectively divided into 4 groups, Ad-TFPI, Ad-LacZ, PBS and normal control groups. The normal control group was not given any treatment and other 3 groups were given 0.2 ml Ad-TFPI, Ad-LacZ or PBS reproduced by the Dispatch catheter respectively after the PTCA balloon iniury on the right carotid arteries. Ten days after gene transfer the repeated balloon injury was performed in the 3 groups, and the first balloon injury was performed in the normal control group by the same method. The carotid blood flow was recovered immediately after the injury. Thirty minutes later all the animals were sacrificed. The injured carotid arteries and one part of contralateral normal artery were cut down, scissored along the long axis, flattened and fixed in the 2% glutaral. The platelet aggregation and thrombosis formation on the luminal surfaces was observed under electron microscope. Results The electron microscope results showed that the vascular endothelial cell structure was integrated and lined up in order in the nomal artery which had no any injury. After the balloon injury in the normal control group, the structure of the endothelial cell was disintegrated, and there was some platelet aggregation but no fibrosis formation. A large amount of platelet aggregated but no fibrosis formed in Ad-TFPI group after the repeated balloon injury. A large amount of fibrosis formed and red cells piled up in the Ad-LacZ and PBS group. The positive rate of thrombosis formation among groups had siginificant differences(χ2=14.95, P<0.01). The positive rate in Ad-TFPI group(20%) was lower than that in Ad-LacZ group(80%, χ2=7.20, P<0.01) and PBS group(70%, χ2=5.05, P<0.05), but was higher than that in the normal control group(10%, χ2=0.39, P>0.05). The positive rate in Ad-LacZ group(80%) was higher than in the normal control group(10%, χ2=9.90, P<0.01) and in the PBS group(70%, χ2=0.27, P> 0.05). The positive rate in PBS group(70%) was higher than that in the normal control group(10%, χ2=7.50, P< 0.01). Conclusions The repeated balloon injury method can cause a large amount of fibrosis formation in the rabbit carotid. TFPI gene inhibits thrombosis formation in balloon-injured rabbit carotid arteries.

According to the principle of evidence-based medicine (EBM), Chinese medical literatures based descriptive statistical analysis of common Chinese medical syndrome types were performed. By data extraction, standardization, and frequency calculation of disease names and syndrome types from 286 literatures in line with the inclusion criteria, the frequencies of diseases and syndromes were obtained to analyze common syndrome types in clinical practice, to analyze the distribution features of disease related syndromes and syndrome related diseases, to analyze the distribution of basic Chinese medical syndrome types in clinical common diseases as a whole, thus providing reference for clinical and basic researches.
Evidence-Based Medicine ; Humans ; Medicine, Chinese Traditional

0.01),which were significantly different from group Ⅲ(P

OBJECTIVETo evaluate the effect of laparoscopic surgery in resection of suspected gastrointestinal stromal tumors.

METHODSA retrospective analysis was conducted among 50 patients with suspected gastrointestinal stromal tumors. All the patients underwent laparoscopic tumor resection. Thirty-eight of the patients had a preoperative diagnosis of gastric submucosa tumor by gastroscopy, and 12 had a diagnosis of small intestinal tumor by small intestinal endoscopy. The surgical procedure, operative time, estimated blood loss, time for passage of flatus, time for eating, postoperative hospital stay, operative complications, pathology and the results of follow-up were analyzed.

RESULTSIn these cases, the mean operative time was 90.84-/+26.69 min, with the mean estimated blood loss of 57.80-/+67.48 ml, mean time for passage of flatus of 50.90-/+18.87 h, mean time for eating of 2.94-/+0.79 days, and postoperative hospital stay of 8.62-/+3.56 days. No patient developed surgical complications, and all the lesions showed negative results on the margins of the resection.

CONCLUSIONAs a minimally invasive surgical approach, laparoscopic resection of suspected gastrointestinal stromal tumors reduces the intraoperative blood loss, promotes postoperative recovery of the patients and achieves R0 resection without causing serious complications.

Gastrointestinal Stromal Tumors ; surgery ; Humans ; Laparoscopy ; methods ; Retrospective Studies ; Stomach Neoplasms ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the test-retest reliability of Nordic Musculoskeletal Questionnaire in nurses and to provide supplementary data for evaluating the reliability of the questionnaire in different occupational populations.

METHODSNordic Musculoskeletal Questionnaire was translated into Chinese according to the Guidelines for the process of cross-cultural adaptation of self-report measures. We carried out a study to examine the reliability of Chinese-version Nordic Questionnaire among Chinese nurses. This study was conducted in 120 nurses recruited from our hospital, who underwent questionnaire survey twice within one week. The test-retest reliability of questionnaire was analyzed.

RESULTSThe Chinese-version Nordic Questionnaire showed a high test-retest reliability, with a Kappa coefficient of 0.72∼1.00.

CONCLUSIONThe Chinese-version Nordic Questionnaire has a high test-retest reliability in nurses, so it can be used for the screening and epidemiological investigation of musculoskeletal disorders in this population.

Humans ; Musculoskeletal Diseases ; diagnosis ; Nurses ; Reproducibility of Results ; Surveys and Questionnaires

OBJECTIVETo construct a clinical database for laparoscopic colorectal surgery in Chinese population using computerized technique.

METHODSA clinical database system was constructed and used in multi-/single-center studies on laparoscopic colorectal surgery.

RESULTSThe data of more than 1200 cases in the Nanfang Hospital during the past year were collected retrospectively. The database was used as the platform for "Southern China Laparoscopic Colorectal Surgery Study Group (SCLCSG)" and was used in the first stage of the clinical research of "Multicenter retrospective study of laparoscopic and open procedure for colorectal cancer" among 11 hospitals in Southern China. In order to test the system, the database was also used in "comparative study on oncologic results of laparoscopic versus open radical resection for rectal carcinoma".

CONCLUSIONSThe evaluation system is reliable and efficient. This system has established a clinical database for laparoscopic colorectal cancer surgery and can be widely applied for the clinical research for colorectal cancer.

Colectomy ; Colorectal Neoplasms ; surgery ; Colorectal Surgery ; Data Mining ; Databases, Factual ; Humans ; Laparoscopy ; Treatment Outcome

OBJECTIVETo develop a clinical database system of gastric cancer surgery integrated with data mining function for better management of clinical data and better performance of both retrospective and prospective studies.

METHODSCore fields for clinical data were determined based on the JGCA(13th and 14th edition) and UICC gastric cancer staging system. Microsoft Visual Basic and VistaDB were used for programming. The database structure was designed according to data mining theory and clinical workflow.

RESULTSAfter one year of development and refinement, data of over 600 patients from our hospital were retrospectively entered, and function tests were satisfactory. This system was accepted as the database platform for the Chinese Laparoscopic Gastrointestinal Surgery Study Group (CLASS) and was successfully used in the first stage of the Multicenter Retrospective Study of the Feasibility of Laparoscopy for Gastric Cancer among 30 hospitals from both Mainland China and Hong Kong. The data mining function met the requirements, which could carry out complex search with visualized presentation. Descriptive analyses could be performed with the analysis function. Efficient communication among institutions could be executed by data import and export with excellent compatibility and without errors.

CONCLUSIONThe system has established a clinical database of approximately 4000 fields with data mining function. This system can be widely applied for the clinical research for gastric cancer.

Data Mining ; Databases, Factual ; Humans ; Software Design ; Stomach Neoplasms ; surgery

OBJECTIVETo investigate the effect of laparoscopic-assisted resection of rectal carcinoma on perioperative levels of C-reactive protein (CRP), immunoglobulins(Ig) and complements.

METHODSFifty-four patients with rectal carcinoma were divided into laparoscopic group (n=26) and open operation group(n=28) according to the patients' will. C-reactive protein (CRP), IgG, IgA, IgM, C(3), C(4) and CH(50) of peripheral blood were assayed preoperatively and on the 1st, 2nd, 3rd and 7th day postoperatively.

RESULTSCompared with the preoperative period, the CRP levels in both groups were significantly increased on the 1st, 2nd, and 3rd day(P<0.01) and peaked on the 2nd day postoperatively. The postoperative CRP levels were significantly lower in the laparoscopic group than those in the open operation group(P<0.01). After operation, the immunoglobulin levels were significantly decreased in both groups(P<0.01), and there were no significant differences in IgG and IgM. The levels of C(3), C(4) and CH(50) were significantly decreased after operation in both groups(P<0.05) and returned to the preoperative levels during postoperative 48-72 hours in laparoscopic group.

CONCLUSIONLaparoscopic-assisted resection of rectal carcinoma results in less wound, lower levels of stress response, and less effect on immune function compared to open surgery, which recovers the immune function of patients more rapidly after operation.

C-Reactive Protein ; metabolism ; Female ; Humans ; Immunity, Humoral ; Laparoscopy ; Male ; Middle Aged ; Rectal Neoplasms ; blood ; immunology ; surgery

OBJECTIVETo explore living anatomy of pancreas and peripancreatic spaces,as well as their implications on laparoscopic gastrectomy with D(2) lymphadenectomy for distal gastric cancer.

METHODSLiving observation was carried out in 132 patients diagnosed as distal gastric cancer and undergoing laparoscopic gastrectomy with D(2) lymphadenectomy.

RESULTSSpaces between greater omentum and transverse mesocolon continued to pre-pancreatic and retro-pancreatic spaces at inferior margin of pancreas. The pre-pancreatic and retro-pancreatic spaces continued each other at inferior and superior margin of pancreas and extended in all directions. Left gastroepiploic vessels were located in pre-pancreatic spaces at superior margin of pancreatic tail. In retro-pancreatic space at inferior margin of pancreatic neck, superior mesenteric veins were located. In retro-pancreatic spaces or in gastric mesenteries inferior to gastric antrum, right gastroepiploic vessels were located. In spaces between gastric antrum and pancreatic heads, gastroduodenal arteries were located and traced to locate common hepatic arteries. In retro-pancreatic spaces at superior margin of pancreatic body, common hepatic arteries, left gastric arteries,celiac arteries and splenic arteries were located. Hepatopancreatic folds and gastropancreatic folds were landmarks respective to locate common hepatic arteries and left gastric arteries. The aforementioned vessels and spaces in their vagina vasorum continued each other and united as a whole.

CONCLUSIONSLaparoscopic gastrectomy with D(2) lymphadenectomy for distal gastric cancer is carried out in macroscopic surgical planes of pre-pancreatic space and retro-pancreatic space, as well as their extensions in all directions, and in microscopic surgical planes of spaces in vagina vasorum of perigastric vessels which continue each other, under the guidance of central landmarks of pancreas and concrete landmarks of vessel trunks and their furcations.

Adult ; Aged ; Female ; Gastrectomy ; methods ; Humans ; Laparoscopy ; Lymph Node Excision ; methods ; Male ; Middle Aged ; Neoplasm Staging ; Pancreas ; anatomy & histology ; Stomach ; anatomy & histology ; Stomach Neoplasms ; pathology ; surgery ; Treatment Outcome