Objective To study the prevalence of mental disorders among the Chinese youths aged 15-34 years,in rural areas and to identify risk factors related to suicide.Methods A consecutive sampling strategy was used for suicidal cases in 16 randomly selected counties in Hunan,Liaoning,and Shandong provinces.Between 2005 and 2008,a total of 392 suicide cases were recruited with 416 community controls at the same age range,selected from the same areas one family member together with one close friend of each suicidal case were interviewed,using the psychological autopsy (PA) method.The same method with structured instruments was performed on the two informants for each control in the same community.SCID was used for the diagnosis of mental disease.Results 48.0％ of the suicides were diagnosed as having at least one mental disorder episode,in comparison with only 3.8％ among the controls.It was found that mental disorder was the most important risk factor for the Chinese young suicide cases in the rural areas.Conclusion As seen in the Western countries,mental disorder had also been the number one correlate on suicidal cases in China,with the difference as other social and psychological factors might have played relatively more important roles in China.

OBJECTIVETo observe the effect and safety of plastering Chinese Compound Shenhuang Ointment (CSO) at Shenque (RN8) in promoting the rehabilitation of postoperative gastrointestinal dysfunction patients of qi stagnation blood stasis syndrome (QSBSS).

METHODSA prospective, multi-centered, randomized, double-blinded, controlled trial was conducted in 220 postoperative gastrointestinal dysfunction patients of QSBSS. They were randomly assigned to two groups, the CSO group (110 cases) and the placebo group (110 cases). CSO was plastered at Shenque (RN8) for 5 days after operation. The time of exhaustion, defecation, the recovery of intestinal peristalsis, integrals of TCM syndrome, and serum levels of motilin (MOT)and somatostatin (SS) were observed.

RESULTSCompared with the placebo group, the condition of exhaustion and defecation, the recovery of intestinal peristalsis on the 3rd day after operation was all improved (P < 0.05). The integrals of TCM syndrome at day 2, 3, and 4 were more significantly lowered in the CSO group than in the placebo group (P < 0.01, P < 0.05). The total effective rate of TCM syndrome was 95.3% in the CSO group, better than that in the placebo group (91.8%, P < 0.05). Compared with the placebo group, the serum MOT level increased and the serum SS level decreased at day 5 after operation in the CSO group (P < 0.05).

CONCLUSIONSThe plastering of CSO at Shenque (RN8) could advance the time of exhaustion and defecation, and improve patients' clinical symptoms. And patients could tolerate well.

Aged ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gastrointestinal Diseases ; drug therapy ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Ointments ; Postoperative Period ; Prospective Studies

Objective:Investigating the chemical constituents in the root of Rumex patientia.Method:Compounds were separated by rechromatography on silica gel. Their structures were determined by spectral analysis and chemical evidence.Result:Eight compounds were isolated and identified as 5-methoxy-7-hydroxy-1(3H)-benzofuranone (Ⅰ), 5,7-dihydroxy-1(3H)-benzofuranone(Ⅱ),nonadecanoic acid-2,3-dihydroxypropyl ester(Ⅲ), torachrysone-8-O-β-D-glucopyranoside(Ⅳ),gallic acid(Ⅴ),β-sitosterol(Ⅵ),β-sitosterol-3-O-β-D-glucopyranoside(Ⅶ) and catechin(Ⅷ).Conclusion:Compound Ⅲ is a new natural products,and compounds Ⅰ and Ⅱwere obtained from this plant for the first time.

Objective To explore the secular trend of incidence for nasopharyngeal carcinoma (NPC) in urban Shanghai during 1973-2005. Methods The incidence data from the population-based cancer registries in Shanghai was used in our analysis. We calculated the crude incidence rates, age-adjusted incidence rates, trucated rates and cumulative rates of NPC. The annual percentage change (APC) was used as an estimate of the secular trend. Results Over 33 years, a total of 7889 incident NPC cases in urban Shanghai were registered for 5555 males and 2334 females, respectively. The incidence of NPC had remained stable in males during the period (APC=-0.250%, P= 0.340), but a decreasing trend was observed in females with an average reduction of -1.577% (P=0.000) per year. During the period of 1973-1976 to 2001-2005, the crude incidence rates changed from 4.56 to 6.18 and from 3.96 to 2.41 per 100 000 in males and females, and the age-adjusted rates from 4.12 to 3.96 and from 2.18 to 3.42 per 100 000 in males and females, respectively. Conclusion From 1973 to 2005, the incidence of NPC was stable in males while having a decline in females, indicating that further epidemioiogical study and prevention for NPC should be addressed.

OBJECTIVETo assess the effect of Bryan cervical disc replacement on the function of the cervical spine.

METHODSBryan cervical artificial disc replacement was performed in 164 cases from Dec 2003 to Aug 2007, and all the cases were retrospectively followed up. Among them, 1 disc replacement was done in 132 cases, 2 discs in 28 cases and 3 discs in 4 cases with a total number of 200 artificial discs. There were 102 male patients and 62 female patients. Their age ranged from 25 to 70 years old (with an average of 47 years old). All the cases were operated according to the standard procedure for Bryan artificial disc replacement, and immobilized in a cervical collar for 2 weeks after operation. Motion of the replaced disc in sagittal direction, JOA score and satisfaction rate of the patients were followed up and evaluated.

RESULTSIn this group, no acute complications happened during the operation. All patients returned to work 4 to 6 weeks after operation. The postoperative ameliorate rate of JOA score was 56%. Range of motion in sagittal direction of the operated disc was 14.4 degrees before operation, decreased to 5.7 degrees at 1 week after operation , but improved to 14.7 degrees at the time of final follow-up and was not significantly different from preoperative range. Motion in the upper adjacent disc to the replacement level was 10.9 degrees before operation, decreased to 5.5 degrees at 1 week after operation , and improved to 8.2 degrees at the time of final follow-up but was significantly smaller than preoperative range. The satisfaction rate of the patients was 94%. Loosening of the prosthesis happened in 1 case 6 months after operation but remained stable afterwards. Subsidence up to 1 mm occurred in another case 7 months after operation but also remained stable afterwards. Automatic posterior union occurred in 3 cases in which relative small size artificial discs were implanted.

CONCLUSIONSThe clinical outcome of Bryan artificial disc replacement was quite good. Pre-operative range of motion of the cervical spine can be maintained.

Adult ; Aged ; Arthroplasty, Replacement ; methods ; Cervical Vertebrae ; physiopathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc ; surgery ; Joint Prosthesis ; Male ; Middle Aged ; Range of Motion, Articular ; Retrospective Studies ; Spinal Osteophytosis ; surgery

Objective To explore whether straight guiding catheter exchange assisted by double guidewire can slove the difficult problem of the guiding catheter being unable to enter the right carotid artery in patients with carotid stenosis via circuitous approach.Methods Fifteen patients with severe carotid stenosis,admitted to our hospital from August 2005 to January 2013,were chosen in our study; they were performed straight guiding catheter exchange assisted by double guidewire.Secondary carotid sinus syndrome,puncture wound,acute coronary syndrome,cerebral infarction and cerebral hemorrhage in the postprocedural period were observed; National Institutes of Health Stroke Scale (NIHSS) scores 3 and 30 days after the surgery were recorded and compared; meanwhile,modified Rankin Scale (mRS) scores 3 months after the surgery were compared.Results With the techniques of straight guiding catheter exchange assisted by double guidewire,13 patients were successfully implanted carotid artery stent among the 15 patients.Two patients had secondary carotid sinus syndrome,3 had femoral sheath around postoperative bleeding and 1 had femoral artery fistula during the 13 patients.The NIHSS scores in 1 patient decreased after the operation,but new infarction lesion was not found in the head CT.The NIHSS scores 30 days after the surgery [11 (8-13)] were significantly lower than the preoperative NIHSS scores [14(9-17)] (Z=-10.153,P-0.000).The mRS scores 3 months after the surgery was significantly improved as compared with those before surgery (U=2.079,P=-0.045).Conclusion The application of straight guiding catheter exchange assisted by double guidewire is safe and effective in the carotid-artery stenting via circuitous approach.

Aim: To put forward criteria for the pressure assessment in the operation of intercavemous embedding of bulboperineal urethra for the treatment of urinary incontinence after prostatic operation. Methods: A Fl4 urethral catheter is inserted during the operation and upon suturing the corpora cavemosa centrally, the catheter is slowly pushed in and pulled out in order that the operator feels a certain degree of close-fit resistance. The degree of tightness of the stitches,which regulate the compression pressure, is adjusted in accordance with this close-fit sensation. To further ascertain the adequacy of the force of compression, the bladder is filled with 300 ml physiological saline and observe the appropriateness (size and continuity) of the outflow stream when the lower abdomen is depressed with a pressure of 80-90 cm H2O. The operation was given to six patients suffered from urinary incontinence for 20 or more months after prostatic operation. Results: Five cases achieved complete recovery, while the therapeutic effect of the 6th one was not satisfactory. A second stage operation was carried out 3 months later with the addition of one more stitch both proximally and distally to reinforce the compression force. The condition was improved dramatically. The follow-up period averaged 3.5 years. Conclusion: The adequacy of the compression pressure exerted by the juxtaposed corpora cavernosa is the key point determining the outcome of the operation. The measures for assessing the compression pressure suggested by the authors are helpful in obtaining the good results of the present paper (6/6 success) as compared with 25/34success in the previous report.

BACKGROUNDThe ideal post-gastrectomy reconstruction procedure should maintain the normal digestive function and restore intestinal transit to improve the patient quality of life. The aim of this study was to evaluate the effects of integral continual jejunal interposition after subtotal gastrectomy on the nutritional status, glucose levels, and gastric-intestinal motility.

METHODSThe study investigated the effects of the integral continual jejunal interposition, the Billroth I and Billroth II operations, and the isolated jejunal interposition following subtotal distal gastrectomy on the blood glucose, insulin, routine blood parameters, liver function, and myoelectrical activity in Beagle dogs.

RESULTSThe weights of the dogs decreased during the first post-operative weeks. Dogs in the integral continual jejunal interposition, Billroth I, and Billroth II groups gained significantly more weight by 8 weeks. The prognosis nutrition index of the dogs decreased in the first 2 post-operative weeks and increased significantly by 4 weeks in the integral continual jejunal interposition and Billroth I groups. The group with duodenal exclusion (Billroth II) had significantly higher glucose levels compared to the normal control group. The insulin curve was much higher in dogs that underwent the Billroth I, continual jejunal interposition, and isolated jejunal interposition than the Billroth II and normal groups. The frequencies of fasting and postprandial jejunal pacesetter potentials (PPs) were greater in the continual jejunal interposition and Billroth I groups than that in the isolated jejunal interposition and Billroth II groups. The percentage of aboral propagation of PPs was greater in the continual jejunal interposition group than the Billroth I, isolated jejunal interposition, and Billroth II groups.

CONCLUSIONContinual jejunal interposition after subtotal gastrectomy avoids jejunal transection, maintains the duodenal passage and food storage bags, and reduces the influence of blood glucose and insulin.

Animals ; Dogs ; Gastrectomy ; methods ; Gastroenterostomy ; methods ; Jejunum ; pathology ; surgery ; Reconstructive Surgical Procedures ; methods

OBJECTIVETo evaluate the impact of reconstruction techniques after subtotal gastrectomy on postoperative glucose and insulin levels after oral glucose tolerance test (OGTT).

METHODSDistal gastrectomy was performed in 38 Beagle dogs. Reconstruction techniques used included integral continual jejunal interposition (n=9), Billroth I( (n=6), Billroth II( (n=7), and isolated jejunal interposition (n=8). Eight controls were used. OGTT was conducted to examine the changes in glucose and insulin levels.

RESULTSCompared to controls, glucose significantly increased in all the 4 operative groups and peaked at 60 min. Billroth II( was associated with the most significant increase. Insulin level significantly increased in all the experimental groups in response to food stimulus and peaked at 60 min. However, the increase of insulin in Billroth II( group was not as prominent as in other groups.

CONCLUSIONSFluctuation of blood glucose after gastrectomy may be mitigated and insulin elevated if duodenal passage is preserved. Continual jejunal interposition should be given priority when Billroth I( reconstruction is not feasible.

Animals ; Blood Glucose ; metabolism ; Digestive System Surgical Procedures ; methods ; Dogs ; Female ; Gastrectomy ; methods ; Glucose Tolerance Test ; Insulin ; blood ; Male

OBJECTIVETo evaluate nutritional status, myoelectrical activity, and gastrointestinal tract emptying capacity after integral continuous jejunal interposition following subtotal gastrectomy.

METHODSAccording to different re-construction techniques, 30 Beagle dogs were divided into four groups after subtotal distal gastrectomy: group 1(n=9, integral continuous jejunal interposition), group 2(n=6, Billroth I(), group 3(n=7, Billroth II(), group 4(n=8, isolated jejunal interposition). Blood cell counts, liver function, myoelectrical activity and the rate of gastrointestinal tract emptying were compared among the four groups.

RESULTSAt week 12 after operation, the body weight in group 1 [(9.65±1.54) kg] was significantly higher than that in group 2[(9.25±1.76)kg], group 3[(9.31±1.54)kg] and group 4[(7.77±1.46)kg]. At week 4, the prognostic nutritional index in group 1(2671.9±49.9) was significantly higher than that in group 3(2555.9±54.7) and group 4(2440.9±54.3), but similar to that in group 2(2791.8±54.3). At week 6, the fasting and postprandial frequency of jejunal pacesetter potentials in group 1 were higher than those in group 3 and group 4(P<0.05) but comparable with those in group 2. The emptying rate of food in the four groups were 95.4%, 91.3%, 93.1% and 94.2%, respectively and there were no significant differences(P>0.05). However, as compared with group 2 and group 3, group 1 had longer operative time and later regular diet resumption, more severe abdominal adhesion(P<0.05).

CONCLUSIONContinuous jejunal interposition should be considered when Billroth I( is not feasible after subtotal gastrectomy.

Anastomosis, Surgical ; methods ; Animals ; Digestive System Surgical Procedures ; methods ; Dogs ; Female ; Gastrectomy ; methods ; Gastric Emptying ; physiology ; Gastroenterostomy ; Male ; Myoelectric Complex, Migrating ; physiology ; Nutritional Status ; Postoperative Period