Objective To discuss the clinical efficacy of stent treatment for the benign or malignant colorectal obstruction. Methods Under fluoroscopic and / or endoscopic guidance stent implantation was performed in 30 patients with colonic or rectal obstruction. The obstruction sites were located at rectum (n = 20), recto-sigmoid juncture (n = 2), sigmoid colon (n = 3), descending colon (n = 3) and transverse colon (n = 2). Results Thirty-one colorectal stents were implanted in total 30 patients, the technical success rate was 92% by once-through operation. The patients were immediately relieved of the symptoms of intestinal obstruction. No complications related to stent implantation occurred. The average survival time in patients with malignant obstruction was 271 days. Conclusion For colorectal obstruction, stent implantation through anus is a minimally-invasive, safe and effective treatment with few complications. The procedure can effectively relieve the patients of the intestinal obstruction symptoms and, thus, improve their living quality.

Adult ; Branchial Region ; abnormalities ; Branchioma ; congenital ; diagnosis ; Diagnostic Errors ; Female ; Fistula ; congenital ; diagnosis ; Humans

Objective To evaluate the effectiveness and predictive value of high-resolution manometry(HRM) for POEM in treating achalasia. Methods A total of 84 achalasia patients categorized into subtypes by HRM, who also underwent POEM, were enrolled in our study. Eckardt score, Barium esophagogram and HRM were performed before, 6 months and 1 year after POEM. Results POEM was successfully performed in all 84 patients. No perforation occurred in any patient. The Eckardt scores and esophageal diameter after POEM significantly reduced compared with those before(P<0. 05). The 4s-IRP decreased from 33. 4±9. 0 mmHg (1 mmHg =0. 133 kPa) to 14. 6±3. 8 mmHg six months after POEM (P<0. 05) and to 16. 4±3. 9 mmHg one year after POEM (VS preoperate, P<0. 05). The LESP before treatment was 41. 8±15. 4 mmHg, decreasing to 18. 4±7. 1 mmHg six months after POEM (P<0. 05) and 20. 7±7. 6 mmHg one year after POEM (VS preoperate, P <0. 05) . When categorizing patients into 3 subtypes by HRM, 4s-IRP of type II showed the most dramatic decrease six months after POEM(62. 8%), followed by typeⅠ(53. 5%), while type III had the least decrease(41. 8%). The mean decreasing rate of LESP in type III was 42. 3% six months after POEM, followed by typeⅠ(55. 3%) , while type II showed the highest rate(57. 8%). Conclusion POEM is a safe treatment for achalasia and has significant short-term efficacy with Type II responding best to POEM. HRM plays a vital role in typing AC and predicting the effectiveness of POEM and can be useful in selecting an appropriate treatment.

Objective To investigate the value of obli que coronal MR images in visualization of the anterior cruciafe ligment(ACL).Methods Conventional axial,oblique sagittal and coronal MR images were performed in 30 normal knees.Then oblique coronal T 2-weighted i mages,which was parallel to ACL,based on oblique sagittal T 2 -weighted images ,were acquired.The visualization of ACL on oblique coronal,oblique sagital and coronal T 2-weighted images was analysed.Results The visualization of the whole ACL was 100%(30/30 ) on one image of the oblique coronal T 2-weighted images, 83.3%(25/30) on on e image of the oblique sagaital T 2-weighted image. On the coronal T 2-weighte d images,the ACL appeared as segmental bundle.The whole ACL could not be visua lized on one image of coronal T 2-weighted images.Conclusion The whole ACL can be showed on one image of ob lique coronal T 2-weighted image,which is helpful in evaluation of the injure o f ACL.

Objective To detecte the expression of COX-2,VEGF-C and lymphatic vessel density (LVD)in pancreatic cancerous and paracancerous tissues,and investigate their correlation.Methods The expression of COX-2.VEGF-C and LVD in 40 cases of pancreatic cancer tissues and paracancerous tissues and 12 cases of normal pancreas was detected by tissue chip and immunohistochemical assays,and the relationship between them and the cljnicopathological parameters was analyzed. Results The expression of COX-2,VEGF-C in pancreatic cancer tissues were 70.0%(28/40)and 67.5%(27/40),respectively,which were significantly higher than that in paracancerous tissues(42.5%,17/40)and(35.0%,14/40),and that in normal pancreas(8.3%,1/12)and(25.0%,3/12).The LVD in pancreatic cancerous,paracancerous and normal pancreatic tissues were 4.75±2.77,15.2 ±4.70 and 1.67±1.15,respectively.The expression of COX-2 in cancerous tissues and LVD in paracancerous tissues was correlated with tumor differentiation and lymph metastasis;the expression of VEGF-C Was correlated with lymph metastasis.LVD in paracancerous tissues was correlated with the expression of COX-2 and VEGF-C.Conclusions Pancreatic cancer lymphangiogenesis mainly existed in paracancerous tissues,COX-2 and VEGF-C may play an important role in the lymphangiogenesis.

Objective To investigate the serum C-reactive protein (CRP) level in patients with acute cerebral infarction and acute massive cerebral infarction with multiple organ dysfunction syndrome (MODS),and analyze the clinical value of CRP. Methods The serum CRP level of 50 patients of control group and 50 patients of cerebral infarction admitted to hospital within 7 days (30 patients were admitted into acute cerebral infarction group and 20 patients into acute massive cerebral infarction with MODS group) were determined by immune scatter turbidimetry. Results (1)In cerebral infarction patients,serum CRP level in 48 cases(96%) was equal and over 5 mg/L.In control group,serum CRP level in 3 cases(6%) was equal and over 5 mg/L(P＜0.0 5).(2)The level of serum CRP acute in cerebral infarction group and in acute massive cerebral infarction with MODS group increased significantly than that in control group (P＜0.01).The level of serum CRP in acute massive cerebral infarction with MODS group increased significantly than that in acute cerebral infarction group.(3)When the level of CRP＜25 mg/L,the incidence of MODS in patients with acute cerebral infarction was zero.When the level of CRP≥25 mg/L,the incidence of MODS increased gradually with the rise of CRP. Conclusions There is positive correlation between the serum level of CRP and the severity of acute cerebral infarction and the incidence of MODS.CRP is a useful marker in predicting the prognosis of acute massive cerebral infarction with MODS.

Objective To summarize the etiology and clinical features of recurrent acute pancreatitis (RAP) in the recent l0 years in China.Methods Pubmed,Medline,EMbase,CNKI,Wan fang and VIP database were searched for relevant articles published from January 2001 to December 2016 using Pancreatitis,Recurrence and Etiology as term index words.Meta analysis was conducted by RevManS.3 software.Results A total of 16 studies involving 3 980 patients (RAP n =1 231,AP n =2 749) were included.The age and sex were not correlated with AP recurrence.Biliary diseases,alcohol,inappropriate diets were associated with AP recurrence,but these were not the factors influencing RAP.Hyperlipidemia was responsible for the occurrence of pancreatitis in 17.00％ of RAP and 10.20％ of AP,with statistically significant difference (P =0.002).Hyperlipidemia was an important risk factor influencing AP relapse.The percentage of SAP in AP and RAP patients was 16.83％ and 24.13％,respectively,and the complication rate was 11.43％ and 15.13％,and the percentage of jaundice was 28.20％ and 32.53％.Those in RAP were higher than those in AP,and the differences were statistically significant (all P ＜ 0.05).Conclusions Hyperlipidemia was the predominant risk factor for RAP in China,and the patients with RAP tend to progress into SAP,and have jaundice and complications.

Objective To investigate the apoptosis-inducing effect and anti-proliferative effect of epigallocatechin-3-gallate (EGCG) on human pancreatic cancer cell SW1990 in vitro. Methods The effect of proliferation was evaluated by MTT after the SW1990 cells in vitro were incubated with different concentrations of EGCG (6.25, 12.5, 25, 50, 100 μg/ml). The apoptosis-inducing effect was determined by flow cytometry after the cells were treated with 25 μg/ml of EGCG. The cell cycle of SW1990 cells was detected by flow cytometry after the cells incubated with different concentrations of EGCG (0, 10, 20, 30, 40, 50 μg/ml).Results After SW1990 cell were treated with different concentrations of EGCG (0, 25, 50 μg/ml), the values of A492 were 0.46 ±0.04,0.42 ±0.04,0.27 ±0.03 at 24 h; 0.48 ±0.02, 0.31 ±0.03,0.16 ±0.02at 48 h; 0.51 ±0.01,0.24 ±0.04,0. 14 ±0.04 at 72 h. EGCG inhibited the proliferation of SW1990 in a doseand time-dependant manner(P ＜0.01 ). The apoptotic rates at 24, 48, 72 h were (8.33 ± 1.15 )%, (19.77 ±0.81 )%, (29.17 ± 0.75 )% in the EGCG treatment group; while the corresponding values were (2.77 ±0.45 ) %, (3.20 ± 0.26 ) %, (3.67 ± 0.35 ) % in the control group; and the difference was statistically significant (P ＜0.01 ). After 0, 20, 50 μg/ml of EGCG treatment for 24 h, the percentages of SW1990 cellsin G0/G1 stage were (57.59 ±0.97)%, (62.99 ± 1.91 )%, (68.87 ± 1.88)%, and the percentages of SW1990 cells in G0/G1 stage increased with the increase of concentrations of EGCG, while the percentages of SW1990 cells in G2/M stage decreased with the increase of concentrations of EGCG (P ＜0.01 ). Conclusions EGCG can significantly inhibit the proliferation of SW1990 cells. The mechanism may be related to the apoptosis-inducing effect and the regulation of the cell cycle of the SW1990 cells.

Objective To evaluate the applicability of activated charcoal in treatment of oral poisoning. Methods The feasibility of clinical manipulation and tastiness of 4 forms of activated charcoal were investigated, with different dosage forms in 35 nurses and 50 volunteers, respectively. The feasibility of the clinical manipulation was assessed by gastrelavage time and block numbers of stomach duet,and the tastiness by volunteers' taking orally. Results The gastrolavage time (151.8±17.8) s for powder, (96.9±24.80) s for suspension, (319.0±82.4) s for tablet and (314.3±93.3) s for suspension(P <0.001). Conclusion There are significant differences in the applicability of activated charcoal in different dosage forms. The suspension is the best form in feasibility. Capsule and tablet are better than powder and suspension in tastiness. Suspension and powder are the worst to accept.

Objective To explore the effect of support with total parenteral nutrition(TPN)or early enteral and parenteral nutrition(EN+PN)on immune function of critically ill neurosurgical patients.Methods In this prospective control study,patients were divided inte TPN group and EN+PN group based on the timing of admission.The changes of immunological indicators including CD3,CD4,CD8,CD4/CD8,CD3/CD25,IgA,IgG,IgM,and serum protein before and after nutritional support were compared.Results The percentage of T lymphocyte subsets CD3,CD4,and CD8,the ratio of CD3+/CD25+,the plasma leveh of IgA,IgM,and IgG,and the serum protein were significantly increased after nutrifional supports(P<0.05,P<0.01).However,compared with the TPN group,the percentages of T lymphocyte subsets(CD3,CD4,and CD8),the ratio of CD4+/CD8+,the plasma levels of IgA,IgM,and IgG,and the serum protein were significantly higher in EN+PN group(P<0.05,P<0.01).Conclusions Both TPN and EN+PN can promote the recovery of immune function,while EN+PN is superior to TPN.Early nutritional support should be provided to critically ill neurosurgical patients.