BACKGROUND:Cervical rotatory manipulation is widely used in the treatment of neck-related diseases with a clear curative effect,but it also has some risks in clinical practice.The previous study of our group found that cervical rotatory manipulation can reduce the tensile mechanical properties of the atherosclerotic carotid artery,but it is not clear about the effects of different cervical rotatory manipulations(positioning/non-positioning)and different degrees(mild/moderate/severe)of atherosclerosis on the tensile mechanical properties of the carotid artery. OBJECTIVE:To explore the effects of different cervical rotatory manipulations and different degrees of atherosclerosis on the tensile mechanical properties of the internal carotid artery. METHODS:The 120 male New Zealand rabbits were randomly divided into eight experimental groups with different degrees of atherosclerosis and different cervical rotatory manipulations:severe atherosclerosis + positioning/non-positioning cervical rotatory manipulation,moderate atherosclerosis + positioning/non-positioning cervical rotatory manipulation,mild atherosclerosis + positioning/non-positioning cervical rotatory manipulation,and normal rabbit + positioning/non-positioning cervical rotatory manipulation,as well as three model control groups:mild/moderate/severe atherosclerosis + non-cervical rotatory manipulation,and the blank control group.Two-factor analysis of variance was used to explore the main effects and interactive effects of different cervical rotatory manipulations and different degrees of atherosclerosis on the tensile mechanical properties of the internal carotid artery.One-way analysis of variance was applied to explore the influence of different cervical rotatory manipulations on the tensile mechanical properties of the internal carotid artery under the same degree of atherosclerosis. RESULTS AND CONCLUSION:(1)Both different cervical rotatory manipulations and different degrees of atherosclerosis were the main effect factors affecting the tensile mechanical properties of the internal carotid artery.(2)For both mild and severe atherosclerosis,both positioning and non-positioning cervical rotatory manipulations reduced the maximum stress of the internal carotid artery(P<0.05)and also increased the physiological elastic modulus of the internal carotid artery(P<0.05).(3)For moderate atherosclerosis,positioning and non-positioning cervical rotatory manipulations also increased the physiological elastic modulus of the internal carotid artery(P<0.05).Non-positioning cervical rotatory manipulation reduced the maximum strain of the internal carotid artery(P<0.05),and its maximum strain was also less than the internal carotid artery of the positioning cervical rotatory manipulations(P<0.05).(4)For the normal internal carotid artery,in addition to the maximum strain,both positioning and non-positioning cervical rotatory manipulations had no statistically significant effects on other tensile mechanical indicators of the internal carotid artery(P>0.05).(5)The results suggest that both positioning and non-positioning cervical rotatory manipulations may increase the stiffness of the atherosclerotic internal carotid artery,reducing its elasticity and brittleness.Therefore,both positioning and non-positioning cervical rotatory manipulations may increase the risk of cardiovascular events in mild/moderate/severe atherosclerotic internal carotid artery,and the more severe the atherosclerosis is,the greater the risk of positioning/non-positioning cervical rotatory manipulation treatment,but the risk of positioning cervical rotatory manipulation is not lower than that of non-positioning cervical rotatory manipulation.

Alzheimer's disease (AD) is a chronic central neurodegenerative disease. The pathological features of AD are the extracellular deposition of senile plaques formed by amyloid-β oligomers (AβOs) and the intracellular accumulation of neurofibrillary tangles formed by hyperphosphorylated tau protein. In this paper, an in vitro pathological model of AD based on neuronal network chip and its real-time dynamic analysis were presented. The hippocampal neuronal network was cultured on the microelectrode array (MEA) chip and induced by AβOs as an AD model to simultaneously record two firing patterns from the interneurons and pyramidal neurons. The spatial firing patterns mapping and cross-correlation between channels were performed to validate the degeneration of neuronal network connectivity. This biosensor enabled the detection of the AβOs toxicity responses, and the identification of connectivity and interactions between neuronal networks, which can be a novel technique in the research of AD pathological model .
Alzheimer Disease ; Amyloid beta-Peptides ; Humans ; Neurofibrillary Tangles ; tau Proteins

Alzheimer's disease (AD) is a chronic central neurodegenerative disease. The pathological features of AD are the extracellular deposition of senile plaques formed by amyloid-β oligomers (AβOs) and the intracellular accumulation of neurofibrillary tangles formed by hyperphosphorylated tau protein. In this paper, an in vitro pathological model of AD based on neuronal network chip and its real-time dynamic analysis were presented. The hippocampal neuronal network was cultured on the microelectrode array (MEA) chip and induced by AβOs as an AD model in vitro to simultaneously record two firing patterns from the interneurons and pyramidal neurons. The spatial firing patterns mapping and cross-correlation between channels were performed to validate the degeneration of neuronal network connectivity. This biosensor enabled the detection of the AβOs toxicity responses, and the identification of connectivity and interactions between neuronal networks, which can be a novel technique in the research of AD pathological model in vitro.
Alzheimer Disease ; Amyloid beta-Peptides ; Humans ; Neurofibrillary Tangles ; tau Proteins

OBJECTIVE: To explore the feasibility, safety and the economical efficiency of double-pouch anastomosis in laparoscopic radical rectal cancer assisted by small incisions. METHODS: Clinical data of 224 patients undergoing gastrointestinal surgery at Taizhou People's Hospital of Jiangsu Province from January 2011 to December 2017 were retrospectively analyzed. Indusion criteria: patients were diagnosed as primary rectal adenocarcinoma by preoperative enteroscopy pathology, the distance of the tumor to anal margin was from 4 to 15 cm, and patients were treated with laparoscopic total mesorectal excision(TME) through small incision. Patients were divided into two groups according to different anastomosis method, double-pouch group(108 cases) and single-pouch group (116 cases). The surgical indexes, tumor safety indexes, short-term efficacy and economic indexes were compared between the two groups. RESULTS: There was no significant difference between two groups in baseline data, operative time, blood loss, number of lymph nodes dissection, average length of proximal and distal bowel, or incidence of urination and sexual dysfunction (all P>0.05). Compared with the single-pouch group, the double-pouch group presented lower anastomotic secondary bleeding rate [0.9%(1/108) vs. 6.0% (7/116), χ²=4.238, P=0.040], lower incidence of anastomotic leakage[1.9%(2/108) vs. 7.8%(9/116), χ²=4.179, P=0.041], lower incidence of anastomotic stricture [1.9% (2/108) vs. 8.6% (10/116), χ²=5.054, P=0.025], shorter hospital stay [(13.4±3.9) days vs. (15.9±9.8) days, t=2.524, P=0.013] and less average hospitalization costs [(34 000±7 000) yuan vs. (46 000±23 000) yuan, t=5.047,P<0.001]. There was no significant difference in local recurrence, distant metastasis or overall survival between the two groups during mean follow-up of 33 months (all P>0.05). CONCLUSION Laparoscopic TME assisted by small incision with double-pouch anastomosis is a safe, feasible and economical method.
Anastomosis, Surgical ; standards ; Humans ; Laparoscopy ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo evaluate the clinical significance of No.12 lymph node dissection for advanced gastric cancer with D2 lymphadenectomy.

METHODSClinicopathologic data and No.12 lymph node dissection of 256 advanced gastric cancer patients undergoing radical operation in our department between January 2005 and December 2010 were retrospectively summarized and the influence factors of metastasis in No.12 lymph nodes were analyzed.

RESULTSOf 256 patients, 179 were male and 77 were female with the average age of 59.2 years. Tumor located in the upper of stomach in 24 cases, middle of stomach in 41 cases, lower of stomach in 174 cases, multi-focus or diffuse distribution of stomach in 17 cases. Tumor diameter was <3 cm in 39 cases, 3 to 5 cm in 100 cases, >5 cm in 117 cases. Serum carcinoembryonic antigen (CEA) level increased in 61 cases, serum carbohydrate antigens (CA)72-4 increased in 56 cases and CA19-9 increased in 61 cases. The number of No.12 lymph nodes resected from all the patients was 1 152, and the average number was 4.5±1.9. The metastasis rate of No.12 lymph nodes was 9.4%(24/256) after hematoxylin eosin staining (positive group). All the patients received effective follow-up to December 2015, and the average follow-up time was 101.2 months. The median survival time of positive No.12 group (24 cases) was 29.8 months and of negative No.12 group (232 cases) was 78.2 months, whose difference was statistically significant (χ=21.715, P=0.000). Univariate analysis found that No.12 lymph node metastasis was not associated with age, gender, tumor differentiation (all P>0.05), but was associated with tumor location, tumor diameter, invasive depth (all P<0.05), and was closely associated with Borrmann type, outside metastatic lymph nodes of No.12 and high levels of serum CEA, CA72-4 and CA19-9 (all P=0.000). Multivariate regression analysis found that tumor location (RR=2.452, 95%CI:1.537 to 3.267, P=0.000), Borrmann type (RR=1.864, 95%CI:1.121 to 3.099, P=0.016) and number of outside metastatic lymph nodes of No.12 (RR=2.979, 95%CI: 2.463 to 3.603, P=0.000) were the independent risk factors of the No.12 metastasis (P<0.05).

CONCLUSIONSMetastasis in No.12 lymph nodes indicates poorer prognosis. The No.12 lymph nodes of advanced gastric cancer patients with curative resection, especially those with the tumor located in the lower part, Borrmann type IIII(, outside metastatic lymph nodes of No.12, should be regularly cleaned.

Antigens, Tumor-Associated, Carbohydrate ; blood ; CA-19-9 Antigen ; blood ; Carcinoembryonic Antigen ; blood ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; methods ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; diagnosis ; pathology ; physiopathology ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Grading ; statistics & numerical data ; Neoplasm Invasiveness ; Neoplasm Staging ; statistics & numerical data ; Prognosis ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; blood ; mortality ; pathology ; Survival Rate

OBJECTIVETo evaluate the feasibility, safety, radicality and short-term outcome of preserving left colic artery (LCA) during laparoscopic total mesorectal excision (TME) for the treatment of rectal cancer.

METHODSFrom January 2013 to December 2016,136 patients with mid-lower rectal cancer received laparoscopic TME in the Gastrointestinal Surgery Department of Taizhou People's Hospital of Jiangsu Province. Patients with rectal tumor within 10 cm to the anal verge were enrolled into the study. All the enrolled patients had complete data of pathology and follow-up. Those receiving neoadjuvant chemoradiotherapy, with severe base diseases, multifocal tumor, tumor invasion of surrounding tissues, fixation of tumor, recurrent tumor, complications such as acute ileus, bleeding, perforation were excluded. In this study, 72 patients did not undergo preservation of LCA (high ligation group) and 64 patients underwent preservation of LCA (low ligation group). Operative parameters, clinicopathological data and short-term outcome were collected and compared between two groups.

RESULTSThe baseline data including gender, age, body mass index, tumor stage, and distance of tumor from anal verge of two groups were comparable (P>0.05). The differences between two groups about the mean time of operation and the operative blood loss were not significant [(164.0±12.6) min vs. (167.3±9.4) min, (30.0±3.6) ml vs. (30.1±3.0) ml, all P>0.05]. There was no operative death in both groups. Differences in the lymph node dissection (13.7±2.6 vs. 13.3±2.1) and the specimen length of proximal resection margin [(16.4±1.9) cm vs. (16.7±2.1) cm] or distal resection margins [(3.9±0.6) cm vs. (4.1±0.9) cm] between high and low ligation groups were not significant (all P>0.05). Compared with high ligation group, the low ligation group had higher rate of sphincter preservation [92.2% (59/64) vs. 79.2% (57/72), χ=4.580, P=0.032], lower rate of anastomotic leakage [1.6% (1/64) vs. 9.7% (7/72), χ=4.075, P=0.044], anastomotic stenosis [3.1% (2/64) vs. 12.5%(9/72), χ=4.006, P=0.045], and voiding and sexual dysfunction [6.3%(4/64) vs. 18.1%(13/72), χ=4.317, P=0.038]. Mean time of follow-up was 19 months. In high ligation group, the local recurrent rate was 5.56%, distant metastasis rate was 13.89%, overall survival rate was 90.28%, disease-free survival rate was 80.56%, while in low ligation group, the local recurrence rate was 4.69%, distant metastasis rate was 12.50%, overall survival rate was 90.63%, disease-free survival rate was 82.81%, whose differences between two groups were not significant (all P>0.05).

CONCLUSIONPreservation of LCA during laparoscopic TME for the treatment of rectal cancer is safe and feasible, which can reduce the incidence of anastomotic leakage and stenosis, and voiding and sexual dysfunction.

The clinical data of 42 patients undergoing laparoscopic transabdomical preperitoneal ( TAPP) hernia repair in Taizhou People′s Hospital from January 2015 to June 2016 were retrospectively analyzed.In this series, 22 patients used VicrylTM polyglactin suture (group A) and 20 patients used the unidirectional barbed suture (group B).The clinical efficacy and postoperative complications were compared between the two groups.There were no significant differences in volume of intraoperative blood loss [(7.3 ± 3.2) vs.(7.9 ±3.2)ml],length of postoperative hospital stay [(14.6 ±1.2) vs.(4.8 ±1.1)d], pain scores [visual analogue scale (VAS),1.9 ±0.9 vs.2.1 ±1.0] at the first-day after operation,body discomfort(1 vs.0 case),and incidence of chronic pain and recurrence between the two groups (P>0.05). The time of operation and peritoneum suturation in group B was markedly shorter than that in group A [(34.3 ±7.1) vs.(40.4 ±9.9) min, (9.8 ±1.8) vs.(13.1 ±4.8) min, both P <0.05].Both unidirectional barbed suture and VicrylTM polyglactin suture are safe ,effective in peritoneum suturation for inguinal hernia repair; however , the unidirectional barbed suture has advantages of shorter operation time and less difficulty of surgical procedure .

OBJECTIVETo explore the feasibility, safety and efficacy of intraoperative regional infusion chemotherapy by celiac trunk in advanced gastric cancer patients.

METHODSOne hundred and twenty-six patients with advanced gastric cancer(stageII(-III() were screened from database of Gastrointestinal Surgery Department of Taizhou People's Hospital between January 2008 and December 2010 who underwent R0 resection and D2 lymphadenectomy, received postoperative chemotherapy(XELOX or FOLFOX), and had complete follow-up data. They were divided into infusion chemotherapy group (65 cases) and control group (61 cases) according to regional infusion chemotherapy or not (fluorine 1 000 mg and cisplatin 60 mg). The side effects of chemotherapy, parameters related to the operation, long-term survival and relapse rate were compared between the two groups.

RESULTSThe baseline data between the two groups were comparable(all P>0.05). Postoperative III( and IIII( adverse reaction of chemotherapy was not significantly different between the two groups (P>0.05). The time of postoperative intestinal function recovery [(67.9±14.8) hours vs. (68.9±15.0) hours, t=-0.380, P=0.705), volume of postoperative 1-week drainage [(66.1±17.1) ml vs.(61.9±18.2) ml, t=1.478, P=0.142], recent morbidity of complications[55.4%(36/65) vs. 49.2%(30/61), χ=0.256, P=0.613], and the long-term morbidity of complications [16.9% (11/65) vs. 14.8% (9/61), χ=0.111, P=0.739] were all not significantly different between the two groups. The 3-year survival rate and 3-year relapse-free survival rate in infusion chemotherapy group were significantly higher than those in control group(58.4% vs. 37.7%, χ=5.382, P=0.020; 58.4% vs. 34.4%, χ=6.636, P=0.010).

CONCLUSIONRegional infusion chemotherapy by celiac trunk during operation for advanced gastric cancer patients is safe and feasible, and can reduce the risk of local recurrence and improve survival rate.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Celiac Artery ; Chemotherapy, Cancer, Regional Perfusion ; adverse effects ; methods ; mortality ; Cisplatin ; administration & dosage ; adverse effects ; therapeutic use ; Deoxycytidine ; analogs & derivatives ; therapeutic use ; Disease-Free Survival ; Fluorine ; administration & dosage ; adverse effects ; therapeutic use ; Fluorouracil ; analogs & derivatives ; therapeutic use ; Gastrectomy ; Humans ; Leucovorin ; therapeutic use ; Lymph Node Excision ; Neoplasm Recurrence, Local ; prevention & control ; Organoplatinum Compounds ; therapeutic use ; Postoperative Complications ; Recovery of Function ; Stomach Neoplasms ; drug therapy ; mortality ; surgery ; Survival Rate

Objective To establish an HPLC method for concentration determination of emodin in plasma and colon tissues after gavage withHuchang Qingdu Pellets;To explore pharmacokinetic properties and colon tissue distribution ofHuchang Qingdu Pellets in rats.Methods Wistar rats were randomly divided into Pellets group and ordinary capsule group. Blood was taken after gavage withHuchang QingduPellets or capsule content in given time points (1, 2, 3, 4, 5, 6, 8, 12, 24 h) from rat venous sinus and analyzed. Rats were put to death, and gastric and colon tissues were isolated and extracted for analysis. Chromatographic conditions:Phenomenex C18 column (4.6 mm × 150 mm, 10μm), the mobile phase of methanol-0.1% acetic acid solution (80∶20), flow rate of 1 mL/min, the detection wavelength of 254 nm.Results Emodin was in good linear range of 0.102-20.40μg/mL. The regression equations were:plasma solutionA=76 825C + 3567.8,r=0.999 4 (n=6);intestinal tissue solutionA=75 931C + 3384.2,r=0.999 0 (n=6). Day-to-day precision and within-day precision were less than 4%. The recovery rate was more than 90%. Pharmacokinetic parameters of T1/2 and Tmax of emodin in rat blood and intestinal tissues increased compared with the ordinary capsule group;Cmax and AUC0-24 were obviously improved compared with the ordinary capsule group.ConclusionHuchang Qingdu Pellets do have controlled release and colon targeting effect.

BACKGROUND:Internal fixation is commonly used in an early stage of intertrochanteric fractures of the aged worldwide, and can apparently reduce complications and fatality rate. The commonly used internal fixators contain proximal femoral nail anti-rotation and dynamic hip screw, whose comparison is current research hotspot.
OBJECTIVE: To evaluate the hip function and stability after internal fixation with proximal femoral nail anti-rotation and dynamic hip screw in repair of intertrochanteric fractures of the aged.
METHODS:A total of 64 aged patients with intertrochanteric fractures were enroled in this study, and assigned to dynamic hip screw group (n=30) and proximal femoral nail anti-rotation group (n=34). The fracture reduction and healing were evaluated using anterioposterior and lateral X-ray films. Operation time, intraoperative blood loss, complication rate, healing time and postoperative hip function were compared and analyzed between the two groups, and then assessed in accordance with Sander’s scoring system.
RESULTS AND CONCLUSION:Compared with dynamic hip screw group, operation time, intraoperative blood loss, healing time and complication rate after treating unstable intertrochanteric fracture (Tronzo-Evans III, IV and V types) showed significant advantages in the proximal femoral nail anti-rotation group (P < 0.05). Hip function restored better, and the complication rate of stable intertrochanteric fracture (Tronzo-Evans I and II types) was lower after treatment in both groups (P > 0.05). These data show that the effects of proximal femoral nail anti-rotation were better than that of dynamic hip screw for treatment of intertrochanteric fractures, and hip function recovered better. Moreover, proximal femoral nail anti-rotation had biomechanical stability, especialy for unstable fracture.