Objective: To compare the effectiveness of qualitative and quantitative fecal immunochemical tests (FIT) in identifying colorectal cancer, so as to provide insights into perfecting screening strategies for colorectal cancer. Methods: Participants in the Colorectal Cancer Screening Program for Key Populations in Zhejiang Province from May 2020 to December 2021 were recruited, and their demographic information, lifestyle and disease history were collected through a questionnaire survey. Qualitative or quantitative FIT along with a questionnaire-based risk assessment were employed as the initial screening tests. Individuals who were positive in any FIT or had high-risk assessment results were required to attend a subsequent colonoscopy examination. The positive rate, detection rate of colorectal cancer, positive predictive value and number of colonoscopies required were compared between qualitative and quantitative FITs, and stratified analyses by gender and age were conducted. Results: Totally 4 099 769 participants were included. The qualitative FIT group included 3 574 917 individuals, yielding a positive rate of 11.35%, a detection rate of 1.19%, a positive predictive value of 0.48% and 83.84 colonoscopies required to detect one cancer case. The quantitative FIT group involved 524 852 individuals, yielding a positive rate of 6.70%, a detection rate of 2.31%, a positive predictive value of 1.01% and 43.23 colonoscopies required to detect one cancer case. The quantitative FIT group showed significantly higher detection rate of colorectal cancer, higher positive predictive value and less number of colonoscopies required compared to the qualitative FIT group (all P<0.05). The same results were obtained after stratification by gender and age. Conclusion Compared to qualitative FIT, quantitative FIT improves the detection of colorectal cancer and reduces the workload of colonoscopy examinations, making it more suitable for colorectal cancer screening in large-scale populations.

Objective To construct luciferase reporter vector containing full-length high-mobility group box 1 ( HMGB1, GenBank NM-010439) promoter for the screening of medicine. Methods The full-length HMGB1 promoter was amplified by polymerase chain reaction ( PCR) , and then was inserted into GV238 vector to construct plasmid GV238-HMGB1-P-Luc. GV238-HMGB1-P-Luc combined with internal reference plasmid pRL was co-transfected into Hela cells ( GV238-HMGB1-P-Luc group, which served as positive control group) . Plasmid pGL3-basic combined with pRL was co-transfected into Hela cells (pGL3-basic group, which served as negative control group) . Additionally, lipopolysaccharides ( LPS, 0.2 μg/mL) was used as the activator for the positive control group (LPS group), and then sodium butyrate (SB, 10 mmol/L) was used as the inhibitor for LPS group ( SB group) . At the end of experiment hour 24, luciferase activity was detected. Results The results of digestion, amplification, sequencing and identification showed that the full length of HMGB1 promoter was 2 140 bp, and the DNA sequence was correct, without mutation. Luciferase activity in GV238-HMGB1-P-Luc group was increased as compared with that of the pGL3-basic group ( P<0.05) . Luciferase activity in the LPS group was increased ( P<0.01, compared with that of GV238-HMGB1-P-Luc group) , and then was decreased after the administration of SB ( P<0.01, compared with that of the LPS group) . Conclusion A model of luciferase reporter vector containing HMGB1 promoter has been successfully constructed. Its activity can be increased by LPS, and then is in hibited by SB. The model can be used for further screening of medicine with the activities of regulating HMGB1 promoter.

OBJECTIVETo explore whether fractional anisotropy (FA) value could be taken as a quantitative indicator for tracing and reexamining amyotrophic lateral sclerosis (ALS), and to analyze the correlation between FA value and integrative medical treatment.

METHODSTotally 18 ALS patients were recruited in this study. All patients received diffusion tensor imaging (DTI) using 3. OT (Propeller HD) MRI twice. Six regions of interest (ROI) were selected to measure FA values. Survival analyses were performed in 11 cases of end point events.

RESULTS(1) Three ROI (cerebral peduncle, posterior limb of internal capsule, and corona radiata) all indicated that FA value was the highest in patients with mild health status scale of amyotrophic lateral sclerosis (ALS/HSS). (2) There was statistical difference in the means of FA values in cerebral peduncle, posterior limb of internal capsule, and corona radiata of 18 cases between initial examination and reexamination (P < 0.01). (3) Kaplan-Meier survival curve showed the survival rate of ALS patients decreased as time went by, with the median survival time of 48 months.

CONCLUSIONSFA value was inversely proportional to the severity of ALS, the more severe, the lower FA values. FA value was an objective indicator for assessing the severity of ALS. ALS is an incurable disease till now. Integrative medical treatment might become one direction for ALS patients.

Amyotrophic Lateral Sclerosis ; diagnosis ; therapy ; Anisotropy ; Diffusion Tensor Imaging ; Humans ; Integrative Medicine

Objective: To understand school physician in primary and secondary schools in Yichang City, Hubei Province from 2019 to 2020, and to provide a reference for strengthening the school physician team in primary and secondary schools. Methods: 149 and 102 primary and secondary schools from 6 municipal districts in Yichang City, Hubei Province, were randomly selected in November 2019 and November 2020, respectively, and were administered by questionnaire survey. Results: The proportion of school physicians increased from 39.6% in 2019 to 65.7% in 2020. In the past two years, the equipment rate of school physician in both central and fringe urban areas increased, especially the fringe urban areas, number of school physician increased from 38 to 96. A total of 93 and 141 school physicians were selected to pariticipate in questionaire survey in 2019 and 2020 respectively. The survey showed that more than 90% of school physicians in primary and secondary schools in Yichang received training, and 74.5% had college education level. However, most of them lack professional qualification and medical background. Conclusion School physician of primary and secondary of Yichang is well development over the past two years, and the proportion substantially increased. However, there is still room for improvement in the quantity and quality of school physicians, and professional qualification needs to be improved. More attention should be paid to the marginal urban areas to achieve a balance between quantity and quality.

OBJECTIVE: To prospectively compare facial pain outcomes for patients having either a repeat microvascular decompression (MVD) or percutaneous balloon compression (PBC) as their surgery for trigeminal neuralgia (TN) recurrence.METHODS: Prospective cohort study of 110 patients with TN recurrence who had either redo MVD (n=68) or PBC (n=42) from July 2010 until September 2016. The mean follow-up was 45.6 months.RESULTS: After redo MVD, 65 patients (95.6%) experienced immediate relief of pain. After PBC, 34 patients (81%) were immediately relieved of their neuralgia. After 1 month, the clinical effect of redo MVD was better than PBC (p < 0.01). Patients who had redo MVD more commonly were pain free off medications (93.4% at 1 year, 78.2% at 4 years) compared with the PBC patients (85.1% at 1 year, 59.3% at 4 years). However, mean length of stay was longer (p>0.05). Patients after PBC who occurred developed herpes simplex (35.7%), facial numbness (76.2%), and annoying dysesthesia (21.4%) more frequently compared with patients after redo MVD who occurred developed herpes simplex (14.7%), facial numbness (8.8%), and hypoesthesia (5.9%) (p < 0.05). The symptoms recurred respectively in 15 patients (22.1%) and 19 patients (45.2%) after redo MVD and PBC within the entire 6-year follow-up period.CONCLUSION: For the patients with TN recurrence, redo MVD was a more effective procedure than PBC. The cure rate and immediate relief of pain were better, and the incidence of complications was lower.
Cohort Studies ; Facial Pain ; Follow-Up Studies ; Herpes Simplex ; Humans ; Hypesthesia ; Incidence ; Length of Stay ; Microvascular Decompression Surgery ; Neuralgia ; Paresthesia ; Prospective Studies ; Recurrence ; Trigeminal Neuralgia

Polysialic acid(PSA)is a homopolymer consisting of N-acetylneuraminic monomers linked by α-2,8 and(or)α-2,9 glucoside bonds.As an endogenous polysaccharide,PSA has good biocompatibility,biodegradability,high hydrophilicity,non-immunogenicity,long-term circulation,easy modification and specific targeting to selectins.In the field of drug delivery research,PSA not only can be connected with small molecule drugs,active peptides or proteins,but also can be grafted or electrostatic cross-linked with polymers to build a variety of drug delivery systems,such as nanogels,polymer micelles,liposomes,etc.It has shown great potential value in the treatment of various disease models such as tumors,inflammatory diseases and neurological diseases.In this paper,the biological functions of PSA,the classification of drug delivery systems based on PSA and its application progress were reviewed,in order to provide reference for further application and research of PSA.

OBJECTIVETo investigate the application of percutaneous endoscopic gastrostomy (PEG) to patients with severe craniocerebral injury for the purpose of nutritional support therapy and pulmonary infection prevention.

METHODSA total of 43 patients with severe craniocerebral injury admitted to our department from January 2008 to December 2012 received PEG followed by nutritional therapy. There were other 82 patients who were prescribed nasal-feeding nutrition. Nutrition status was evaluated by comparing serum albumin levels, and the incidence of pulmonary infection 1 week before and 2 weeks after operation was identified and compared.

RESULTSBoth PEG and nasal-feeding nutrition therapies have significantly elevated serum albumin levels (P<0.05). Serum albumin levels before and after nutritional therapies showed no significant difference between the two groups (P>0.05). The incidence of pulmonary infection in PEG group was significantly decreased compared with that in nasal-feeding nutrition group (P<0.05).

CONCLUSIONPEG is an effective method for severe craniocerebral injury patients. It can not only provide enteral nutrition but also prevent pulmonary infection induced by esophageal reflux.

Craniocerebral Trauma ; therapy ; Gastroesophageal Reflux ; prevention & control ; Gastroscopy ; Gastrostomy ; methods ; Humans ; Lung Diseases ; prevention & control ; Nutritional Support ; Serum Albumin ; analysis

OBJECTIVETo assess zero drift of intraventricular and subdural intracranial pressure (ICP) monitoring systems.

METHODSA prospective study was conducted in patients who received Codman ICP monitoring in the neurosurgical department from January 2010 to December 2011. According to the location of sensors, the patients were categorized into two groups: intraventricular group and subdural group. Zero drift between the two groups and its association with the duration of ICP monitor were analyzed.

RESULTSTotally, 22 patients undergoing intraventricular ICP monitoring and 27 receiving subdural ICP monitoring were enrolled. There was no significant difference in duration of ICP monitoring, zero drift value and its absolute value between intraventricular and subdural groups (5.38 d+/-2.58 d vs 4.58 d+/-2.24 d, 0.77 mm Hg+/-2.18 mm Hg vs 1.03 mm Hg+/-2.06 mm Hg, 1.68 mm Hg+/-1.55 mm Hg vs 1.70 mm Hg+/-1.53 mm Hg, respectively; all P larger than 0.05). Absolute value of zero drift in both groups significantly rose with the increased duration of ICP monitoring (P less than 0.05) while zero drift value did not. Moreover, daily absolute value in the intraventricular group was significantly smaller than that in the subdural group (0.27 mm Hg+/-0.32 mm Hg vs 0.29 mm Hg+/-0.18 mm Hg, P less than 0.05).

CONCLUSIONThis study demonstrates that absolute value of zero drift significantly correlates with duration of both intraventricular and subdural ICP monitoring. Due to the smaller daily absolute value, ICP values recorded from intraventricular system may be more reliable than those from subdural system.

Aged ; Cerebral Ventricles ; Female ; Humans ; Intracranial Pressure ; Male ; Middle Aged ; Monitoring, Physiologic ; Prospective Studies ; Subdural Space

Objective:To explore the clinical efficacy of microsurgical technique combined with cosmetic suture technique in situ replantation of total scalp avulsion.Methods:The clinical data of patients with total scalp avulsion admitted to the Department of Burn and Plastic Surgery of General Hospital of Northern Theatre Command from January 2015 to December 2020 were collected. All patients were treated by microsurgical technique combined with cosmetic suture technique. Thorough debridement was performed during the operation. Active anti-shock treatment was given to the patient with hemorrhagic shock. The vascular was explored and labeled. The vascular anastomosis was conducted by microsurgical technique. The venous anastomosis was performed in the first place. The arterial anastomosis was performed according to the patient's condition. Symptomatic treatment, such as routine anti-coagulation, was given to patients after the operation. An infection prevention strategy was performed in patients. The recovery of patients was observed.Results:A total of six patients were involved in this study. All patients were females, aged from 36 to 55 years old. Various degrees of wound contamination can be seen, and one patient with hemorrhagic shock. The superficial temporal vein, supraorbital vein and sentinel vein were anastomosed in two patients, and the superficial temporal vein and sentinel vein were anastomosed in four patients. The superficial temporal artery and supratrochlear artery were anastomosed in two patients, and the superficial temporal artery was anastomosed in four patients. All patients were followed up for 3 months to 2 years, averaging 13.71 months. More than 90% of the scalp survived in three patients, 80% in two patients, and 50% in one patient. The necrotic area survived after replantation of a split-thickness skin graft. The sensory function of surviving scalp after replantation was slightly regressed. The hair growth was normal. Only superficial linear scar left. All patients were satisfied with the efficacy.Conclusions:The application of the microsurgical technique for vascular anastomosis combined with cosmetic suture technique for repair can achieve good clinical efficacy in situ replantation of total scalp avulsion.

Objective:To explore the clinical efficacy of microsurgical technique combined with cosmetic suture technique in situ replantation of total scalp avulsion.Methods:The clinical data of patients with total scalp avulsion admitted to the Department of Burn and Plastic Surgery of General Hospital of Northern Theatre Command from January 2015 to December 2020 were collected. All patients were treated by microsurgical technique combined with cosmetic suture technique. Thorough debridement was performed during the operation. Active anti-shock treatment was given to the patient with hemorrhagic shock. The vascular was explored and labeled. The vascular anastomosis was conducted by microsurgical technique. The venous anastomosis was performed in the first place. The arterial anastomosis was performed according to the patient's condition. Symptomatic treatment, such as routine anti-coagulation, was given to patients after the operation. An infection prevention strategy was performed in patients. The recovery of patients was observed.Results:A total of six patients were involved in this study. All patients were females, aged from 36 to 55 years old. Various degrees of wound contamination can be seen, and one patient with hemorrhagic shock. The superficial temporal vein, supraorbital vein and sentinel vein were anastomosed in two patients, and the superficial temporal vein and sentinel vein were anastomosed in four patients. The superficial temporal artery and supratrochlear artery were anastomosed in two patients, and the superficial temporal artery was anastomosed in four patients. All patients were followed up for 3 months to 2 years, averaging 13.71 months. More than 90% of the scalp survived in three patients, 80% in two patients, and 50% in one patient. The necrotic area survived after replantation of a split-thickness skin graft. The sensory function of surviving scalp after replantation was slightly regressed. The hair growth was normal. Only superficial linear scar left. All patients were satisfied with the efficacy.Conclusions:The application of the microsurgical technique for vascular anastomosis combined with cosmetic suture technique for repair can achieve good clinical efficacy in situ replantation of total scalp avulsion.