Seven cases of pathologically proven duplication of the rectum are presented. Three of these were cystiform in shape, others were tubular duolication. The most common presenting signs were perianal fistula and obstruction by the rectal mass. Four cases had associated spinal and vertebral anomalies. Rectal duplication was extremely rare, our prior experience and literature review are given.
Objective To study the effect of perioperative nutritional support on protein metabolism and immunity in patients underwent liver transplantation. Methods A total of 80 patients who underwent liver transplantation in our hospital from March 2015 to March 2016 were collected retrospectively, and then the 80 patients were divided into control group (n=40) and observation group (n=40) according to the type of perioperative nutritional support. Patients of control group didn’t receive preoperatively nutritional support, and received total parenteral nutrition support before postoperative exhaust, then received enteral nutrition support after anal exhaust. Patients of observation group receive preoperatively nutritional support before surgery, and received parenteral nutrition and enteral nutrition support before postoperative exhaust. The several parameters about nutritional status and immune function were observed on 7 days and 14 days after liver transplantation, and comparison of the 2 group in these parameters was performed. Results On the protein metabolism, the levels of serum transferrin, prealbumin, and nitrogen balance on 14 days after liver transplantation were higher than those of other time points (before liver transplantation and 7 days after liver transplantation),P<0.05, both in control group and observation group. There was no significant difference in the levels of serum transferrin, prealbumin, and value of nitrogen balance between the 2 groups before liver transplantation (P>0.05). But on 7 days and 14 days after liver transplantation, the levels of serum transferrin, prealbumin, and value of nitrogen balance of the observation group were higher than those of control group (P<0.05). On the immunity, the total number of lymphocytes, value of IgG and CD4/CD8 on 14 days after liver transplantation, were superior to other time points (before liver transplantation and 7 days after liver transplantation),P<0.05, both in control group and observation group. There was no significant difference in the total number of lymphocytes, value of IgG and CD4/CD8 between the 2 groups before liver transplantation (P>0.05). But on 7 days and 14 days after liver transplantation, the levels of the total number of lymphocytes, value of IgG and CD4/CD8 in the observation group were superior to those of control group (P<0.05). Conclusion Perioperative nutritional support can improve the nutritional status and immune function in patients underwent liver transplantation.
Objective To evaluate the effectiveness and safety of different injection sites for collagenase chemonucleolysis for lumbar intervertebral disc protrusion (LIDP). Methods We searched for randomized controlled trials (RCTs) and quasi-RCTs in the following electronic databases: Pubmed (1966 to May 2006), EMBASE(1966 to May 2006), The Cochrane library (Issue 2, 2006), CRD(Center for Reviews and Dissemination),York University, CBM (1978 to May 2006 ), CNKI(1994-2006)and VIP(1989-2006). Quality assessment and data extraction were conducted by two reviewers independently. Disagreement was resolved through discussion. Results Eight studies involving a total of 1035 participants met the inclusion criteria. Meta-analysis was not carried out because of apparent heterogeneity. Four studies made comparisons among intradisc, extradisc, and combined intra- and extra-disc injection. One study (62 participants) showed that intradisc injection was superior to extradisc injection (RR 3.71, 95% CI 1.19 to 11.58, Plt;0.05). Another study (240 participants) showed that intradisc injection was superior to combined intra- and extra-disc injection after 3 months and 6 months of follow-up (RR 0.88, 95% CI 0.80 to 0.98, Plt;0.05). The other two studies showed no significant difference among intradisc, extradisc, and combined intra- and extra-disc injection. Four studies (436 participants in total) showed that amongst three extradisc injections, both anterior epidural space injection and lateral epidural space injection were superior to posterior epidural space injection (Plt;0.05). Although one study indicated that anterior epidural space injection was superior to lateral epidural space injection (RR 1.24, 95% CI 1.03 to 1.51, Plt;0.05), no statistical significance was found between anterior epidural space injection and lateral epidural space injection in two other studies (Pgt;0.05). Conclusions There is insufficient evidence to identify which injection site for collagenase is the most effective for lumbar intervertebral disc protrusion. The included studies showed that both anterior and lateral epidural space injection were superior to posterior epidural space injection. However, these studies are too small and poor quality, and have different diagnostic criteria, follow-up time points, outcome measures and efficacy parameters. Thus, more high quality and large-scale RCTs are needed.
Objective To investigate the effects of 3 methods (suture removal, suture removal with epineurium neurolysis, and l igated femoral nerve resection with end-end suture) in repairing femoral nerve injury after l igation in different periods so as to provide a reference for cl inical use of repairing iatrogenic l igation injury of the peri pheral nerve. Methods A total of 120 adult female Sprague Dawley rats, weighing (200 ± 20) g, were used to prepare the animal models of left femoralnerve l igation, and were divided into groups A (n=40), B (n=40), and C (n=40) according different repairing methods. Atimmediate, 1, 3, and 5 months (10 rats each time point) after l igation, suture removal was performed in group A, suture removal with epineurium neurolysis in group B, and l igated femoral nerve resection with end-end suture in group C. At 3 months after operation, the foot-base angle (FBA) and the heels-tail angle (HTA), action potential and conduction velocity of femoral nerve, and wet weight of quadriceps femoris muscle (QFM) were measured; the samples of quadriceps femoris and femoral nerve were harvested for histological observation, muscle fiber count, and nerve fiber passing rate measuring. Results The FBA in group A was significant smaller than that in group C at immediate, 1, 3, and 5 months (P lt; 0.05), but there was no significant difference between groups A and B (P gt; 0.05). The HTA in group A was significantly smaller than that in group C at immediate, 1, 3, and 5 months (P lt; 0.05), and the THA in group B was significantly smaller than that in group C at 1, 3, and 5 months (P lt; 0.05). The wet weight of QFM in group B was significantly higher than that in group C at immediate, 3, and 5 months (P lt; 0.05), and the wet weight of QFM in group A was significantly higher than that in group C at immediate and 3 months (P lt; 0.05), but no significant difference was found between groups A and B at immediate, 1, and 3 months (P gt; 0.05). There was significant difference in the action potential of femoral nerve between group A and groups B and C at immediate and 1 month (P lt; 0.05), but there was no significant difference between other groups at 3 and 5 months (P gt; 0.05) except between groups A and C at 5 months (P lt; 0.05). The conduction velocity of femoral nerve in group A was significantly faster than that in group C at immediate, 1, and 5 months (P lt; 0.05), and it was significantly faster in group A than in group B at immediate and 1 month (P lt; 0.05), but no significant difference was found between groups A and B at 3 and 5 months (P gt; 0.05), between groups B and C at other time points (P gt; 0.05) except at immediate (P lt; 0.05). The count of muscle fibre of the quadriceps femoris was significantly more in groups A and B than in group C at immediate (P lt; 0.05); it was significantly more in group A than in group B at 5 months (P lt; 0.05). The passing rate of the femoral nerve fiber was significantly higher in group A than in groups B and C at 3 months (P lt; 0.05), but no significant difference was found between the other groups (P gt; 0.05). Conclusion After femoral nerve l igation, suture removal method has the best effect at early term, the next is epineurium neurolysis method, and the worst is the l igation femoral nerve resection with end-end suture repair.
ObjectiveTo study and compare the effects of inhaled preparations with open airway and conventional inhaled preparation on asthma patients.MethodsThe patients diagnosed with asthma and treated with the same inhaled preparation only who visited the outpatient department of West China Hospital of Sichuan University, were selected as the study subjects from April to September, 2019. The subjects were divided into the test group and the control group according to random ratio 1∶1. The conventional inhaled preparations were used in the control group. The inhaled preparations with open airway were used in the test group. Asthma control, life quality and treatment satisfaction rate were compared between the two groups after 3 months.ResultsA total of 150 subjects were included and one case dropped-off, then 149 effective subjects were obtained in which 75 cases in the test group and 74 cases in the control group. After 3 months’ treatment of inhaled preparations, the proportion of effective asthma control patients in the test group was higher than that in the control group, and the number of patients satisfied with the treatment of inhaled preparations was higher than that in the control group, with statistically significant differences (all P<0.05). The life quality of patients in both groups was improved compared with baseline, and the difference was statistically significant (P<0.05). However, the increase of scores in the test group was more than that in the control group, and the difference was also statistically significant (P<0.05). ConclusionInhaed preparations with open airway is superior to conventional inhaled preparation on asthma patients in asthma control, life quality and treatment satisfaction rate.
ObjectiveTo assess the effects of nursing grading management for nurses in emergency department. MethodsAll nurses of the employment system in Department of Emergency were classified into different groups in 2011. Based on the combination of the duties of nurses, technical requirements and nursing grading management, nurses of different levels were given the right tasks, so that nurses in the emergency department could make use of their special skills. ResultsAs the result of nursing grading management, the rates of satisfaction of patients and survival of critically-ill patients were increased, and the rates of pressure ulcer, nursing adverse events and wrong nursing documents were reduced. ConclusionNursing grading management not only saves nursing resources and improves nursing efficiency, but also ensures quality and safety of nursing.
ObjectiveTo compare the clinical recovery and immune response between laparoscopic-assisted and open D2 gastrectomy for advanced gastric cancer. MethodsThe clinical data of 53 patients with advanced gastric cancer from January 2012 to October 2013 were studied prospectively. According to random number table, patients were randomly divided into laparoscopic-assisted group(LA group, n=27) and open operation group(OO group, n=26). Operative time, blood loss, time to passage of flatus, time to resume soft diet, after bed time, postoperative hospital stay, and number of retrieved lymph nodes were compared respectively between the two groups. The changes in CD3, CD4+, CD8+, IgG, IgA, IgM, and CRP were examined respectively by using flow cytometry and immunoturbidimetric assays on the preoperative day 1, and on the postoperative day 1 and 7. ResultsThe operative time was longer significantly in LA group than that in OO group(P < 0.05). The mean blood loss, the first flatus time, after bed time, and postoperative hospital stay in the two groups were all different statistically(P < 0.05), and all were better in LA group. However, the mean number of retrieved lymph nodes and the time to resume soft diet were not significantly different in the two groups(P > 0.05). On the day 1 and 7 after operation, the CD3, CD4+, and CD8+ significantly decreased as compared with those preoperatively in two groups(P < 0.01, P < 0.05). On the day 1 after operation, the levels of IgG, IgA, and IgM significantly decreased as compared with those preoperatively in two groups(P < 0.05). Those immunoglobulin in LA group recovered to close to the level before surgery, but in OO group sustained lower level(P < 0.05). On the day 1 and 7 after operation, CRP level significantly increased as compared with those preoperatively in two groups(P < 0.01, P < 0.05). Those changes of above index were not significantly different between the LA group and OO group on the day 1 after operation(P > 0.05). All index recovered gradually in the two groups on the day 7 after operation and were better in LA group(P < 0.05, except IgA). ConclusionLaparoscopic radical gastrectomy for advanced gastric cancer resulted in a quicker clinical recovery and a lesser depression to the perioperative cellular and humoral immune function.
ObjectiveTo investigate whether liquid-based cytology (LBC) can improve diagnostic value of cytological assessment of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). MethodsA cohort of 600 cases who underwent EBUS-TBNA from June 2012 to September 2013 was enrolled in this prospective study in West China Hospital. EBUS-TBNA was carried out under local anesthesia and moderate sedation. The procedure was performed with echobronchoscopes. Histological tissues were stained with hematoxylin and eosin for further study. Additional immunohistological analysis was performed for establishing a reliable diagnosis as necessary. Aspirates were smeared on glass slides and separate aspirates were processed by the monolayer SurePath method. ResultsIn total, 480 cases of malignant tumors and 120 cases of benign lesions were confirmed by histological examination. The sensitivity of SurePath liquid-based preparations and conventional smears was 82.1% and 56.0%, and the specificity was 87.5% and 82.5%, respectively. The combined specificity was 100.0%. The positive predictive value of two methods combined was 96.3% and 92.8%, whereas the negative predictive value was 54.9% and 31.9%, respectively. The difference between the two methods was significant (P < 0.05). ConclusionsLBC preparation can improve cytological assessment of EBUS-TBNA. Histological study is necessary when the cytological diagnosis is obscure.