Objective To investigate the treatment of moed high anal fistula operation.Methods 110 cases of high anal fistula patients were randomly divided into the incision line selective suture group(treatment group 55 cases) and incision group(55 cases in the control group),on two groups of treatment time,the cure rate,the anal function were analyzed.Results The cure rate of the treatment group and control group were 98 ％,86％,respectively,the cure rates of two groups have no significant difference (x2 =1.557,P ＞ 0.05),the healing time and postoperative anal function evaluation in treatment group was superior than those in control group (t =3.440,4.671,all P ＜ 0.01).Conclusion Incisionunder selective suture in the treatment of high anal fistula operation is a better way.

Objective To observe and evaluate the efficacy of the preventing antibiotic-associated diarrhea in infant with bacterial pneumonia using the live Clostridium butyricum and Bifidobacterium combined Powders. Methods 103 infants with bacterial pneumonia were randomly divided into the two groups,53 infants as the trial group,another 50 infants as the control group with normal antibacterial therapy,two or three hours afterword the live Clostridium butyricum and Bifidobacterium combined Powders was administered at dose of 0.5g ti-daily in the trial group,After diarrhea taken place,the live Clostridium butyricum and Bifidobacterium combined Powders was adminis-tered at dose of 0.5g ti-daily in the control group,to contrast the rate of secondary diarrhea and clinical efficacy in the two groups.Results The incidence of antibiotic-associated diarrhea was 13.2%( 7/53 ) in the trial group and 56.0%(28/50) in the control group (χ2 =21.00,P<0.01).There were significant differences between the two groups.Duration of diarrhea and period of treatment in the trial group was obviously shorter than that of the control group,the rate of dehydration in the trial group was lighter than that in the control group(χ2 =6.64,P<0.01). Conclusion The live Clostridium butyricum and Bifidobacterium combined powders with antibacterial therapy at reg-ular intervals can prevent antibiotic-associated diarrhea.It is worthy of preventive application.

Objective To report the clinical and pathological features of the sensory neuropathy caused by a combined therapy of telbivudine and pegylated interferon α-2a in 2 patients with hepatitis B virus infection Methods Two male patients aged 48(case 1)and 20(case 2),who suffered from hepatitis B virus infection.were given telbivudine and pegylated interferon α-2a.After 4 months treatment,both patients developed numbness and pain in the lower limbs.The physical examination showed decreased pain sensation in distal extremities.Hypahidrosis appeared in distal extremities.The nails were pale changed in fingers and toes in cage 1.Case 2 presented mild weakness in the proximal muscle of lower limbs and the tendon reflex was decreased in both lower limbs.His 8erunl creatine kinase level was mild elevated.The electromyography examination and sural nerve biopsies were performed on both patients.Results Electromyography examination showed significant decrease of amplitude of sensory nerve action potentials and mild decrease of sensory nerve conduction velocities in both patients.The amplitude of motor nerve action potentials was also decreased in case 2.Light microscope examination revealed middle reduction of myelinated fibers,wallerian degeneration of myelinated fibers and small clusbers of regenerated fibers in sural nerve.Electro microscopy examination revealed the loss of unmyehnated nerve fibers.After the combined therapy was stopped and vitamin B,CoQ10 and L-camitine were administered,the patients recovered gradually.Conclusions Combined therapy of telbivudine and pegylated interferon α-2a may cause sensory neuropathy with electrophsiological and pathological abnormalities of axonal lesions.The sensory neuropathy induced by the combined therapy may be reversible.

[Objective]To modify posterior lumbar interbody fusion for improvement of convenient manipulation and safety in the operation,and solid fusion. [Methods]After total decompression of the spinal nerve through posterior medline approach,discectomy of the slipping segment was performed with a circular saw with diameter of 1.0 centmeter.Under direct visualization through the hole of the circular saw,the disc tissue including cartilage of upper and lower end plates was removed with a long handle curette.After pedicle screw and rod system was placed,a bone block harvested from the posterosuperior iliac with a circular saw with diameter of 1.2 centmeter was implanted into the intervertebral space.Then compression of the intervertebral space to catch the bone lock firmly was conducted by regulating and fixing the the pedicle screw and rod system.[Results]Forty-eight patients in this report were followed up from 6 to 24 months.Based on JOA low back pain score,there were 36 patients was in excellent result,8 in good and 4 in fair,the satisfactory rate was 91.67% and effective rate was 100%.[Conclusion]Using circular saws in posterior lumbar interbody fusion has advantagas of good visualization profit removing disc tissue,preventing neurovascular injuries,and making good bone grafting bed.Convenient and secure bone harvesting decrease blood loss,time consume during the operation and prevent donor site complication.Futhermore,follow up results of the patients in this report demonstrate that posterior interbody fusion with circular saw for treatment of lumbar spondylolisthesis have satisfactory outcome and high fusion rate.

Objective To analyze the prognostic factors of nasopharyngeal carcinoma treated with radiotherapy.Methods 135 preliminary diagnosed patients were selected and treated with radiotherapy to a total dose of 68～80 Gy in 7～8 weeks. In order to analyze the factors affecting prognosis of NPC,SPSS analysis and Cox regression analysis were used to identify the prognostic factors.Results The overall 10-year survival rate was 48 9%; Univariate analysis suggested that 8 out of 13 items were significant factors for prognosis (P

China ; Oral Medicine ; education

Objective To evaluate the characteristics and safety of capsule endoscopy for elderly patients.Methods The clinical data of 376 patients who underwent capsule endoscopy between May 2002 and September 2007 were retrospectively analyzed,and patients were divided into geriatric group(≥60 years old,n=134)and control group(

Objective To detect the effects of bifidobacterium or bifidobacterium cultured supernatant on the mRNA expression of tumor necrosis factor receptor-associated factor 6 (TRAF6),glycogen synthase kinase-3β (GSK-3β) and the miRNA-146a in rat small intestinal epithelial cell(IEC-6) induced by lipopolysaccharide (LPS).Methods IEC-6 in logarithmic phase were randomly divided into LPS group,cultured supernatant group and inactivated bacteria group.All the 3 groups were exposed to 5 mg/L LPS for 5 hours,and then 1 mL sterile saline was added in LPS group and culturing continued for 24 hours ; 1 mL bifidobacterium cultured supernatant was added in cultured supernatant group and culturing continued for 24 hours;1 mL inactivated bifidobacterium 1 x 1010 CFU/L added in inactivated bacteria group and continued culturing for 24 hours.The mRNA expressions of TRAF6,GSK-3 β and miRNA-146a were detected by reverse transcription-polymerase chain reaction (RT-PCR).Results The level of TRAF6,GSK-3 β of culture supematant group (0.72 ± 0.05,0.46 ± 0.14) were all lower than LPS group (1.01 ± 0.14,1.02 ± 0.25),but the level of miRNA-146a(3.05 ± 0.40) was higher than that in LPS group(1.01 ± 0.12),and there were significant differences between them (t =5.278,6.316,13.218,P =0.000).The level of GSK-3 β of inactivated bacteria group(0.59 ±0.13) was significantly lower than that in LPS group(t =4.837,P =0.000).The levels of TRAF6 and miRNA-146a of inactivated bacteria group(1.05 ±0.11,0.78 ±0.22) had no significant differences with LPS group (t =0.732,1.463,P ＞ 0.05).The level of TRAF6 of cultured supernatant group was lower than that in inactivated bacteria group,and the level of miRNA-146a was higher than that in inactivated bacteria group,and there were significant differences between 2 groups (t =6.009,14.687,P =0.000).Conclusions Bifidobacterium cultured supernatant and inactivated bacteria both have certain protective effect on the IEC-6 induced by LPS.One of the protective mechanisms of bifidobacterium cultured supernatant may be achieved by elevating the expression of miRNA-146a,and decreasing the levels of inflammation related factor TRAF6 and damage related factor GSK-3β.The protective effects of inactivated bifidobacterium may be achieved by decreasing the level of damage related factor GSK-3β.

To establish a convenient and rapid method for identification of Pseudostellariae Radix by molecular identification, the rDNA-ITS sequences of Pseudostella riaheterophylla and its adulterants had been aligned to find out specific fragment. The specific primers against the fragment were designed and the PCR amplification conditions were optimized. The fluorescence reaction of the PCR products colored by 100 x SYBR Green I was observed under UV. The concentration of reaction buffer included 5.5 μL DNA Taq polymerase premix, 10 pmol Tzs-2F and 10 pmol Tzs-2R, 20-80 ng template DNA, and plus double sterile distilled water to 25 μL. The PCR thermal profile was as follows: predenaturation at 95 degrees C for 1 min, followed by 30 cycles of denaturation at 95 degrees C for 5 seconds, primer annealing and extension at 56 degrees C for 15 seconds, then it was extension at 72 degrees C for 30 seconds. The fluorescence reaction of Pseudostellariae Radix showed green fluorescence, while adulterants had not. Extraction, amplification DNA and all steps of molecular identification could be completed successfully in 40 minutes. The approach could amplify DNA template of Pseudostellariae Radix specificity, and its product with 1 μL 100 x SYBR Green I could engender green fluorescence under UV. The method was simple and accurate, so it could be used for identification of Chinese traditional medicine.
Caryophyllaceae ; classification ; genetics ; DNA Primers ; genetics ; Drug Contamination ; prevention & control ; Plant Roots ; classification ; genetics ; Polymerase Chain Reaction ; methods

Objective Investigate the reasonable surgical approach combined with frozen sections pathological features of papillary thyroid microcarcinoma.Methods Clinical data of 96 cases papillary thyroid microcarcinoma nearly 5 years of follow-up in our clinic referral was retrospectively analyzed.Metastasis and recurrence rate were compared between group of ipsilateral lobe plus isthmus resection (unilateral group) and group of ipsilateral lobe plus isthmus resection and contralateral lobe subtotal (bilateral group).Metastasis and recurrence rate were compared between group of central lymph node dissection (dissection group) and non-dissection group (non-dissection group),and the injury rate of the recurrent laryngeal nerve was also compared between the two groups.Results The diagnosis of cancer by intraoperative frozen pathology were 53 cases (55％).Whether in high or low risk populations,the metastasis and recurrence between unilateral and bilateral groups showed no significant difference (P ＞ 0.05).Whether in high or low risk populations,the metastasis and recurrence between dissection group and non-dissection groups showed no significant difference (P ＞0.05).The temporary injury rate of recurrent laryngeal nerve in dissection group were higher than thatin non-dissection group both in high-risk populations (P =0.040,P ＜ 0.05) and low risk populations(P =0.037,P ＜ 0.05).Conclusions Intraoperative frozen pathological diagnosis of papillary thyroid microcarcinoma is difficult.The reasonable surgical approach for the first time is ipsilateral lobe plus isthmus resection.Preventive cervical dissections operation should not be carried out if the exploratory of lymph node showed no metastasis.