ObjectiveTo investigate the safety and feasibility of enhanced recovery after surgery (ERAS) in radical gastrectomy. MethodsThe Cochrane library, PubMed, EMBASE, and Chinese biomedical literature databases were searched to identify randomized controlled trails including patients undergoing radical gastrectomy surgery who were treated by ERAS or traditional methods.The five outcome variables were the time to passage of first flatus and first defecation, the length of postoperative hospital stay, medical cost, and postoperative complications. ResultsFifteen published reports involving 1 533 participants met the inclusion criteria.Compared with traditional methods, ERAS had better outcomes with shorter time to the passage of flatus (WMD=-26.557 hours, 95%CI:-34.097～-19.018, P < 0.05), shorter time to the passage of defecation (WMD=-34.071 hours, 95%CI:-53.449～-14.693, P < 0.05), shorter postoperative hospital stay (WMD=-2.824 days, 95%CI:-3.638～-2.010, P < 0.05), less medical cost (WMD=-0.342 ten thousand yuan, 95%CI:-0.501～-0.184, P < 0.05), and lower postoperative complication rate (RR=0.597, 95%CI: 0.435-0.820, P < 0.05).Especially, ERAS had a significant lower rate of postoperative digestive tract complications (RR=0.492, 95%CI: 0.350-0.693, P < 0.05).However, there were no significant differences between two methods in the incidence of complications including postoperative pulmonary infection, infection or liquefaction of incision, fistula of anastomosis, and postoperative readmission rate (P > 0.05). ConclusionsThe application of ERAS in the perioperated period of radical gastrectomy surgery shortens the time to passage of first flatus and first defecation, the postoperative hospital stay, as well as lowers the medical cost, and the postoperative complication rate.The results suggest that ERAS is safe and effective in perioperated period of radical gastrectomy and it is very promising in clinical application.
Objective To observe the differentiation effect of rabbit amnion-derived stem cells (ADSC) induced into neural cells.Methods ADSC of New Zealand female rabbits were isolated and cultured. Its mRNA level of Fibronectin, Nestin and Vimentin were detected by real-time quantitative polymerase chain reaction. The selfreplication ability of ADSC was confirmed by monoclonal formation experiments. These ADSC were further induced into neural cells in vitro. Five days after induced differentiation, the expression of -tubulin and glial fibrillary acidic protein (GFAP) were detected by immunofluorescent staining. Results ADSC were separated from amnion tissue gradually after 24 hours. There were polygonal cells gathered around the amnion tissue at 72 hours, and were distributed compactly around the amnion at 120 hours. The morphology of cleavage daughter cells was basically the same as parent cells. ADSC has the ability of self-replication. The Nestin, Vimentin, Fibronectin mRNA expressions in ADSC were 15.79, 1.91, 7.65 times those in spleen cells. The differences were statistically significant(Z=-5.243, -3.972, -2.524; P＜0.05). The beta;-tubulin expression was found in cytoplasm of most cells. The GFAP expression was found in cytoplasm in some cells. Conclusions ADSC has self-replication ability. It can be induced into neurons and neuroglial cells under the right conditions.
Objective To learn the impact of health education on schistosomiasis among high school students in Wanzhou area of Three Gorges Reservoir, and to evaluate its effects. Methods The stratified multi-level cluster randomized sampling was used to survey 566 high school students in Wanzhou and Yunyang areas, and the questionnaire was used to investigate their recognition of schistosomiasis. Results After one-year health education on schistosomiasis, the passing rate of the knowledge about schistosomiasis prevention among high school students in demonstration area raised from 9.43% to 98.87% (χ2=463.46, P=0.000), which was higher than that of the inside and outside control areas (χ2=312.92, P=0.000); the passing rate of the attitude and belief of schistosomiasis prevention were 98.12%, which was higher than that of the inside and outside control areas (χ2=109.49, P=0.000); 56.02% of high school students in demonstration area had no susceptible behavior of schistosomiasis, which was higher than that of the inside and outside control areas (χ2=237.53, P=0.000). Conclusion Health education on schistosomiasis can efficiently improve the awareness of schistosomiasis prevention among high school students, and has important meanings for controlling potential epidemics and spread of schistosomiasis in Wanzhou area of Three Gorges Reservoir.
With the continuous development of China's aging society and the prevalence of unhealthy lifestyles, the incidence of cardiovascular disease in China has been increasing in recent years. Among them, atrial fibrillation (AF) is the most common arrhythmia disease. In recent years, pulsed field ablation ( PFA ) has been continuously applied to AF treatment as a novel treatment. This paper first introduces the principle of PFA applied to AF treatment, and introduces the research progress of PFA in different directions, such as the comparison of different ablation methods, the study of physical parameters, the study of ablation area, the study of tissue specificity and clinical research. Then, the clinical priori research of PFA is discussed, including the use of simulation software to obtain the simulation effect of different parameters, the evaluation of ablation effect during animal research, and finally the current AF treatment. Various priori studies and clinical studies are summarized, and suggestions are made for the shortcomings found in the study of AF treatment and the future research direction is prospected.
Objective To evaluate the effectiveness of induced membrane technique in the treatment of infectious bone defect. Methods Thirty-six patients (37 bone lesions) with infectious bone defects were treated with induced membrane technique between January 2011 and June 2014. There were 28 males and 8 females with an average age of 36 years (range, 20-68 years). All bone defects were post-traumatic infectious bone defect. The bone defect was located at the tibia and fibula in 24 cases (25 bone lesions), at femurs in 6 cases (6 bone lesions), at ulnas and radii in 2 cases (2 bone lesions), at calcanei in 3 cases (3 bone lesions), and at clavicle in 1 case (1 bone lesion). The average time between onset and the treatment of induced membrane technique was 6.2 months (range, 0.5-36.0 months); 15 patients were acute infections (disease duration was less than 3 months). At the first stage, after the removal of internal fixator (applicable for the patients who had internal fixation), complete debridement of infection necrotic bone tissue and surrounding soft tissue was performed and the bone defects were filled with antibiotic-impregnated cement spacers. If the bone was unstable after debridement, external fixator or plaster could be used for stabilization. Patients received sensitive antibiotics postoperatively. At the second stage (usually 6-8 weeks later), the cement spacer were removed, with preservation of the induced membrane formed by the spacer, and filled the bone defect with autologous iliac bone graft within the membrane. Results The hospitalization time after debridement was 17-30 days (mean, 22.2 days), and the hospitalization time after the second stage was 7-14 days (mean, 10 days). All the flaps healed uneventfully in 16 cases treated with local flap transposition or free flap grafting after debridement. One patient of femur fracture received Ilizarov treatment after recurrence of infection at 11 months after operation; 1 patient of distal femoral fracture received amputation after recurrence of infection at 1 month after operation; 1 patient of distal end of tibia and fibula fractures received ankle arthrodesis after repeated debridements due to the recurrence of infection; 1 patient of tibia and fibula fractures lost to follow-up. The other 32 patients (33 bone lesions) were followed up 1-5 years (mean, 2 years) without infection recurrence, and the infection control rate was 91.7% (33/36). All the patients had bony union, and the healing time was 4-12 months (mean, 7.5 months); no refracture occurred. One patient of femur bone defect had a lateral angulation of 15° and leg discrepancy of 1.5 cm. Superficial pin infection was observed in 7 cases and healed after intensive wound care and oral antibiotics. Adjacent joint function restriction were observed in 6 cases at last follow-up. Conclusion Induced membrane technique is a simple and reliable technique for the treatment of infectious bone defect. The technique is not limited to the size of the bone defect and the effectiveness is satisfactory.
Objective To learn and evaluate the effect of health education of schistosomiasis in the Three Gorges Reservoir Area, so as to provide scientific basis for establishing the comprehensive prevention and control model in potential epidemic area of schistosomiasis. Methods Through adopting the multi-stage stratified cluster sampling method, the questionnaires were distributed to residents selected randomly from the demonstration, inside and outside control areas. The survey data were input with EpiData 3.0 software by two reviewers, and the differences among groups were analyzed by using SPSS 18.0 software to further evaluate the effect of health education of schistosomiasis. Results All the questionnaires distributed to 1 420 residents were retrieved (100%). The results of analysis showed that for the residents in the demonstration area, the average score of being aware of schistosomiasis prevention was (7.51±2.89), which was markedly higher than those in the inside (2.52±2.97) and the outside (3.13±3.51) control areas, with significant differences (Plt;0.05); and the passing rates were 78.15%, which was also obviously higher than those in the inside (17.26%) and the outside control areas (32.16%), with significant differences (Plt;0.05). Conclusion The health education of schistosomiasis can improve residents’ knowledge about schistosomiasis prevention, and it is very important to prevent and control the potential prevalence of schistosomiasis in the Three Gorges Area.
Objective To learn the status and compare the effect of improving drinking water and lavatories in potential endemic areas of schistosomiasis in the Three Gorges Reservoir Area. Methods A cluster random sampling method was adopted and a questionnaire survey was conducted to four selected villages and towns before and after organized and large scale drinking water and lavatories improvement in the potential endemic areas of schistosomiasis in the Three Gorges Reservoir Area. Results A total of 807 households in four demonstrate villages and towns were investigated for the baseline survey, while 856 households in the same four villages and towns were investigated for the terminal survey. The popularity rate of using tap water from waterworks went up from 33.58% to 66.12% (P=0.000); the summation of popularity rate of using tap water from both waterworks and water tower made by local residents went up from 76.33% to 96.38% (P=0.000); and the popularity rate of using decontaminated lavatories went up from 53.68% to 78.85% (P=0.000). According to Chi-square test, there were significant differences compared with the popularity rate before improvement (Plt;0.05). Conclusion The condition of intervention villages and towns gets greatly improved through the organized and large scale project of improving water quality and lavatories decontamination, and the potential danger of schistosomiasis is obviously reduced in the Three Gorges Reservoir Area.