Objective:To evaluate the clinical efficacy of C-type endoscopic submucosal dissection (C-ESD) for rectal neuroendocrine tumors (NEN).Methods:The retrospective analysis was performed on data of 55 patients who underwent ESD for rectal NEN at the Department of Endoscopy in Quanzhou First Hospital from January 2018 to July 2021. Patients were divided into the C-ESD group ( n=28) and the conventional ESD group ( n=27). The dissection time, the dissection speed, the number of submucosal injections, the enbloc resection rate, the curative resection rate and the rate of postoperative complications of the two groups were compared. Results:There were no statistically significant differences in basic information between the two groups ( P>0.05). The dissection time was 13.8±4.2 min in the C-ESD group and 19.9±3.9 min in the conventional ESD group with statistically significant difference ( t=5.649, P<0.001). The dissection speed in the C-ESD group was 0.08±0.04 cm 2/min, which was faster than 0.06±0.04 cm 2/min in the conventional ESD group ( t=2.218, P=0.031). The number of submucosal injections in the C-ESD group was less than that in the conventional ESD group [2 (1, 2) VS 3 (2, 3), Z=-8.701, P<0.001]. The lesions were enbloc resected in both groups. The curative resection rate in the C-ESD group was 100.0% (28/28) and 88.9% (24/27) in the conventional ESD group with statistically significant difference ( P=0.011). There were 7 cases of postoperative complications in the conventional ESD group, including 1 delayed bleeding, 5 delayed perforation and 1 muscularis propria injury, while no postoperative complications occurred in the C-ESD group ( P=0.004). Conclusion:C-ESD is a safe and effective treatment strategy for colorectal NEN, which can shorten the dissection time, improve the dissection speed, reduce the number of submucosal injections, improve the curative resection rate, and reduce complications.

Humans ; Aripiprazole/therapeutic use* ; Schizophrenia/drug therapy* ; Antipsychotic Agents/therapeutic use* ; Risperidone ; China ; Treatment Outcome

Objective:To explore the surgical technique and clinical effect of pressure boost in repairing soft tissue defects of limbs with thinned anterolateral thigh perforator flap (ALTP) .Methods:From January, 2015 to December, 2018, 18 cases with soft tissue defects of limbs with various damages of blood vessels and nerves with explosure of tendon and bone. There were 13 males and 5 females aged between 18 to 56 (averaged of 36.3) years, which were 6 defects in shank, 4 in foot and ankle, 5 in forearm, and 3 in hand. The soft tissue defect area was 7 cm ×12 cm to 13 cm ×30 cm. Thinned ALTP was used to repair the wound surface. The perforating vessels of the distal flap were anastomosed with one branch of the internal vessel pedicle flap to increase the pressure hence the blood supply of the distal region. The donor sites were sutured directly or covered by skin graft. Followed-up was conducted by 1-2 monthly clinic visits and telephone or on-line review to check the flap survival and recovery of functions.Results:All flaps survived without arterial or venous crisis. One flap had partial necrosis at the distal end, and healed after dressing change. One case had a swelling flap due to a congestion beneath the flap. The wound achieved primary healing after removal of sutures, ligation of subcutaneous vessels and drainage of hematoma. All patients were followed-up for 6 to 18 (average, 9.5) months. All flaps had good appearance and texture. After rehabilitation treatment, most of the joint activity had been recovered: extension and flexion of wrists joints ranged 60°-80°, 70°-80° for metacarpophalangeal joints and 40°-60° for ankle joints. One patient underwent ankle joint dorsiflexion function reconstruction and flap thinning at 6 months after operation due to the defects of most of the extensor tendon.Conclusion:During the use of free ALTP to repair soft tissue defect of limbs, application of the technique of pressure boost is able to increase blood supply to the distal region of flap. It helps to reduce the incidence of infection and necrosis at the edge of the flap.

Objective: To explore the effectiveness of collaborative care model-based continuous nursing on the postpartum posttraumatic stress disorder(PPTSD), to provide reference for postpartum clinical nursing. Methods: A total of 100 cases of postpartum puerpera in Beijing Luhe Hospital of Capital Medical University were assigned to the intervention group and the control group according to the random number table method with 50 cases each. In the control group, patients received continuous nursing, however, collaboration care model-based continuous nursing care was carried out in the intervention group. The PPTSD status and psychological resilience between the two groups was assessed by Posttraumatic stress Checklist-Civilian version (PCL-C) and Connor-Davidson Resilience Scale (CD-RISC), respevtively. Results: Before intervention, symptoms scores and total scores of PCL-C and CD-RISC between the two group was no statistical difference (P>0.05). After intervention, the scores of increased arousal symptoms (7.22±1.09), avoidance/numbing (9.77±2.41), re-experiencing symptoms (5.66±1.17) and PCL-C total scores (22.64±3.02) were significantly decreased in the intervention group compared to the control group (8.32 ± 1.05), (11.46 ± 2.87), (6.36 ± 1.25), (26.14 ± 3.27), and there were significant differences between the two groups (t=2.899-5.559, all P<0.01). However, the scores of tenacity (24.90 ± 4.83), strength (14.91 ± 2.25), optimism (7.18 ± 1.61) symptoms and CD-RISC total scores (46.99 ± 6.30) were remakedly increased in the intervention group compared to the control group (23.22 ± 2.69), (13.61 ± 1.75), (6.14 ± 0.91), (42.97 ± 3.30), there were significant differences between the two groups (t=2.154-4.011, P<0.05 or 0.01). Conclusions Collaboration care model-based continuous nursing care can promote the psychological resilience and alliviate PPTSD.

OBJECTIVE: To compare the differences in the clinical therapeutic effects on perimenopausal syndrome (PMS) between the combined treatment with the transcutaneous electrostimulation at Shuitu (ST 10) and the seed-pressure therapy at the auricular points and the hormone replacement therapy. METHODS: A total of 64 PMS patients were divided into an observation group (30 cases) and a control group (34 cases) according to patient's willingness. In the observation group, the transcutaneous electrostimulation at Shuitu (ST 10) was combined with the seed-pressure therapy at the auricular points. The stimulation intensity at Shuitu (ST 10) was ranged from 15 to 20 mA, for 20 min in each treatment, twice a week. The 8 treatments made one course and 3 courses were required. Additionally, the seed-pressure therapy was used at neifenmi (CO), Shenmen (TF), luanchao, zigong, gan (CO), shen (CO), once a week, retained for 5 days. The 4-week treatment was as one course and a total of 3 courses were required. In the control group, the hormone replacement therapy was applied. On Day 5 of menstruation, progynova was prescribed for oral administration, 1 mg, once a day, continuously for 21 days. On Day 12 in the oral administration of progynova, dydrogesterone was used, 20 mg, once every day, continuously for 10 days. Totally, 3 courses were required. Separately, before treatment and in 1 and 3 months after treatment, Kuppermann score, the sexual hormone levels [follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E)] and the adverse reactions were observed in the patients of the two groups. RESULTS: In 1 and 3 months after treatment, Kuppermann scores were reduced significantly as compared with those before treatment in the two groups (all <0.05). The levels of serum FSH and LH were reduced remarkably as compared with those before treatment in the two groups (all <0.05) and the level of serum E was increased remarkably as compared with that before treatment in the two groups (all <0.05). After treatment, the differences in the above indexes were not significant between the two groups (all >0.05). In the control group, the incidences of the adverse reactions such as vaginal bleeding, bread distending pain and endometrial thickening were higher than those in the observation group [17.6% (6/34) vs 0% (0/30), 20.6% (7/34) vs 3.3% (1/30), 8.8% (3/34) vs 0% (0/30), all <0.05]. CONCLUSION The combined treatment with the transcutaneous electrostimulation at Shuitu (ST 10) and the seed-pressure therapy at the auricular points achieves the similar therapeutic effects on PMS as compared with the hormone replacement therapy. This combined therapy effectively relieves the clinical symptoms and improves the sexual hormone levels. The adverse reactions and the complications are less obviously as compared with the hormone replacement therapy.
Acupuncture Points ; Acupuncture, Ear ; Female ; Follicle Stimulating Hormone ; Humans ; Luteinizing Hormone ; Perimenopause

Objective To explore the value of the molecular probe USPIO-PEG-sLeX on nasopharyngeal carcinoma xenograft in nude mice.Methods The USPIO nanoparticles was synthesized by physical deposition method,and which was modified by PEG to synthesize USPIO-PEG-sLeX .The nude mice of nasopharyngeal carcinoma xenograft were divided into experimental and control groups.USPIO-PEG-sLeX and USPIO-PEG were injected into nude mice of experimental and control groups by caudal vein,respectively.MR T2 mapping imaging was scanned before and after the injection,and analyzed the changes of T2 values between experimental and control groups. Results USPIO-PEG-sLeX had a good representation.The non-enhanced T2 values between control and experimental group had no statistical significance (P >0.05).However,T2 values of the mice in two groups before and after injections were statistically significant (P <0.05);and T2 values of experimental group were much lower than that of the control group after the injection,additionally,the difference of enhanced rate between the two groups was statistically significant (P <0.05).Conclusion USPIO-PEG-sLeX magnetic nanoparticles is potential to be a targeted contrast agent to ELAM-1 expression of nasopharyngeal carcinoma,and can be valuable in non-invasive dynamic monitoring the expression of ELAM-1.

Objective : To establish an animal model that clinically conforms to the characteristics of severe alveolar ridge atrophy. Methods : Beagle dogs were used as experimental subjects. Bilateral fourth premolars and first molars in mandible were extracted. A horizontal groove was made on alveolar ridge which was 8 mm from the cemento-enamal junction of mandible third premolar and second molar. Rongeur was used to remove the alveolar bone above this groove and bone chisel was used to level the bone-free area. A box-shaped defect cavity of the size 25 mm × 8 mm was formed with sterile silicone prosthesis implanted. After careful suture we waited for the subjects to heal naturally. Eight weeks after operation, CBCT examination was performed. Results : Eight weeks after bone remodeling the top of alveolar ridge of operation area appeared to be a circular arc. The average distance from the bottom of the ridge to inferior alveolar nerve canal was 2.5 mm. Conclusion This study successfully established the Beagle dog animal model for severe alveolar ridge atrophy and laid the foundation for experiments on vertical bone augmentation.

Objective To explore the application of plastic pancreatic stents and/or nasal biliary drainage for choledocholithiasis patients having DSBC during Endoscopic Retrograde Cholangiopancreatography (ERCP).Methods Retrospective analysis on clinical data of 57 ERCP cases aiming at choledocholithiasis patients having DSBC from January 2010 to December 2015 has been carried out. According to the guide wire cannulation in an operation, patients are divided into three groups, i.e. plastic pancreatic stents group, nasal biliary drainage group, and plastic pancreatic stents + nasal biliary drainage group, so as to observe the success rate of operation and the occurrence rate of postoperative complications, such as pancreatitis or hyperamylasemia, as well as to compare the differences between the three groups.Results Out of the 57 patients receiving ERCP, 13 patients are in the plastic pancreatic stents group, with two successful operations (15.4%), one case of hyperamylasemia (7.7%), two cases of postoperative pancreatitis (15.4%), one case of fever (7.7%) and one case of hemorrhage (7.7%); 20 patients are in the nasal biliary drainage group, with 20 successful operations (100.0%), no occurrence of hyperamylasemia or postoperative pancreatitis or other complications including hemorrhage and fever; 24 patients are in the plastic pancreatic stents + nasal biliary drainage group, with 19 ERCP operations succeeded at the first attempt (79.2%) and 5 ERCP operations succeeded at the second try (20.8%), as well as 4 cases of hyperamylasemia (16.7%), 2 cases of hemorrhage (8.3%) , no occurrence of fever cases and postoperative pancreatitis. In comparison between the three groups, the occurrence of postoperative pancreatitis and successful rate of operation show a significant difference.Conclusion By adopting plastic pancreatic stents and/or nasal biliary drainage for patients having a dififcult selective biliary cannulation during ERCP, the success rate of operation can be improved, and the occurrence of pancreatitis can also be reduced.

Objective To investigate the clinical applicative of short 5 Fr pancreatic duct (PD) stents in difficult biliary cannulation of ERCP. Methods 131 patients who underwent difficult biliary cannulation during routine ERCP were randomized to receive prophylactic short 5 Fr PD stents (stent group, 66 patients) and not (control group, 65 patients) from January 2012 to October 2015. The success rate of biliary cannulation for the first ERCP, scores of abdominal pain, the incidence of post-ERCP pancreatitis (PEP) and hyperamylasemia and severe post-ERCP pancreatitis were analyzed. Results The success rate of biliary cannulation for the first ERCP was significantly higher with the stent group than the control group. The scores of abdominal pain of the stent group was significantly lower than the control group. The postoperative serum amylase value at 3 h and 24 h were obviously lower in PD stents group than those in control group. The incidence of hyperamylasemia, post-ERCP pancreatitis, severe post-ERCP pancreatitis were also significantly lower with PD stents group than the control group. 3 cm long 5 Fr PD stents has high success rate of placement, high spontaneous migration rate, low complications, decreases the need for endoscopic removal. Conclusion In difficult biliary cannulation during ERCP, placement of short 5 Fr PD stent is safe and effective, enhance the success rate of biliary cannulation, relieve the abdominal pain, reduces the rate of post-ERCP pancreatitis efficiently.

Objective To explore the effect of different factors on strengthening the tissue culture seedlings and roots of Dendranthema morifolium ( Ramat) Tzvel. cv. Gongju, so as to provide experimental basis for establishing an in-vitro rapid propagation system of Dendranthema morifolium. Methods The experiment took Dendranthema morifolium ( Ramat) Tzvel. cv. Gongju tissue culture seedling as the studying object. By using tissue culture technology, different additives were added into the MS medium. Results In the seedling-strengthening culture medium, 150 mL/L of macro-element was beneficial to the growth of tissue culture seedlings of Dendranthema morifolium ( Ramat) Tzvel. cv. Gongju. The culture medium with 100 g/L of coconut milk added could obviously promote the growth of Dendranthema morifolium ( Ramat) Tzvel. cv. Gongju tissue culture seedlings. And activated carbon added to the rooting culture medium could induce the formation of tissue culture root system of Dendranthema morifolium ( Ramat) Tzvel. cv. The addition of α-naphthaleneacetic acid ( NAA) and indolebutyric acid ( IBA) at certain concentrations could promote the amount and the growth of the roots. Conclusion The tissue culture seedlings of Dendranthema morifolium ( Ramat) Tzvel. cv. Gongju are boosted by increasing the amount of macro-element, reducing the concentration of agar in the culture medium and adding coconut milk and growth hormones to the culture medium. The optimal rooting culture medium is a compound of 1/2MS, NAA 0.05 mg/L and IBA 0.05 mg/L.