Objective To discuss the way of animal model building of hepaticocholedochostomy(HC) and hepaticojejunostomy(HJ) and to compare the short-term effect. Metheds Twenty-nine dogs were divided randomly into control group(n=5) and the experimental group (stenosis of left hepatic duct, n=24). After 7 weeksof stenosis of left hepatic duct,24 dogs in the experimental group were divided randomly into HC subgroup (n=12) and HJ subgroup (n=12) .The operation time and the blood loss during operation were recorded and the hepatic function was detected.Results The diameter of left hepatic duct was significantly expended after 7 week’s stenosis. Hepaticocholedochostomy took shorter time and lost less blood than hepaticojejunostomy. The dogs in HC subgroup lost less weight than thosein HJ subgroup. In HC and HJ subgroups, the mortality rates were 1/12 and 3/12;the infectious rates of incision were 3/12and 5/12 respectively. Serum levels of total bilirubin and transaminase increased significantly in the 7th week after stenosis of left hepatic duct compared with before stenosis of left hepatic duct. However, Serum levels of total bilirubin and transaminase restored to normallevels after 1 month of HC or HJ.Conclusion It is feasible to establish animal model of bile duct reconstruction on the basis of stricture of bile duct. The dogs undergoing hepaticocholedochostomy have less trauma, better results than the dogs undergoing hepaticojejunostomy. Both hepaticocholedochostomy and hepaticojejunostomy are able to relieve the obstruction of bile duct.
Objective To evaluate the effect of mindfulness therapy on sleep problems in adolescents. Methods We searched PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, Chongqing VIP and SinoMed for relevant randomized controlled trials on mindfulness intervention to improve adolescents’ sleep. The retrieval time was from the establishment of the databases to October 21, 2022. The results were meta-analysed with RevMan 5.4 software. Results A total of 11 randomized controlled trials were included, with a total sample size of 870 cases. The types of mindfulness therapy include mindfulness-based stress reduction, mindfulness-based cognitive therapy, mindfulness meditation, group mindfulness sleep intervention, body scanning and other mindfulness technologies. The duration of single intervention was different. The included studies showed that the mindfulness intervention can effectively improve the sleep problems of adolescents and the accompanying daytime sleepiness, anxiety, depression and other negative emotions compared with the control intervention. Meta-analysis of six studies showed that the sleep quality of adolescents in the mindfulness intervention group was improved [mean difference=−1.21, 95% confidence interval (−1.58, −0.83), P<0.00001]. Conclusion Mindfulness therapy has a good effect on improving adolescents’ sleep problems, but whether it can achieve long-term benefits still needs to be further evaluated by high-quality, multicenter long-term follow-up trials.
This paper introduced the fundamental theory, method advantages, application scenario and R software implementation method of the covariate-adjusted receiver operating characteristic (ROC) curve. Compared with the traditional univariate ROC curve, the covariate-adjusted ROC curve has distinct methodological advantages and wider application scenarios, which can help to evaluate the ability of markers to predict the targeted outcome more scientifically. It merits more widespread and prior adoption in practical research.
ObjectiveTo summarize the research progress of the regulation effect of hypoxia inducible factor (HIF) on intervertebral disc. MethodsThe domestic and foreign related literature about the regulation effect of HIF on intervertebral disc was reviewed, summarized, and analyzed. ResultsHIF is a key transcription factor that is in response to hypoxia by cells, which is widely distributed in tissues and organs, including intervertebral disc. Hypoxia inducible factor is expressed highest in the nucleus pulposus which has the lowest oxygen concentration in the intervertebral disc. The effects of HIF include the regulation of nucleus pulposus differentiation and development, maintenance of the survival, energy metabolism, and anabolism of nucleus pulposus cells, and maintenance of the stability of extracellular matrix. ConclusionHIF plays a vital role in the development and differentiation of intervertebral disc and maintenance of physiological function, which may become a target for the research of the mechanism and the treatment of intervertebral disc degeneration.
ObjectiveTo research the biological characteristics of different generations of rabbit nucleus pulposus cells (NPCs) that were cultured with natural culture and subculture method.MethodsThe thoracolumbar segments of New Zealand white rabbits (6-8 weeks old and weighing 1.5-2.5 kg) were obtained and nucleus pulposus were isolated from disc regions. And NPCs were harvested by enzymatic digestion from nucleus pulposus. Primary NPCs were counted as P0 generation. Then, NPCs were passaged by trypsin and counted as P1, P2, P3 with a totle of 4 generations. P0 to P3 generations NPCs were separately examined by observation of cell morphology and proliferation time, detection of apoptosis rates of cells by flow cytometry, and detection of hypoxia-inducible factor 1α (HIF-1α), matrix metalloproteinases 2 (MMP-2), Aggrecan, and collagen type Ⅱ proteins by immunofluorescence and Western blot.ResultsThe morphology of NPCs transformed from triangular or polygonal in P0 generation to spindle in P3 generation; the characteristic vacuolated cells gradually disappeared; and the cell volume and cell proliferation time increased. The cell apoptosis rates were 5.47%±0.91%, 13.77%±2.42%, 33.46%±1.82%, and 38.76%±1.50% from P0 to P3 generations, with the increase of culture time, and there were significant differences between 4 generations (P<0.05). Immunofluorescence staining showed that with the increase of cells generation, the fluorescence intensity of HIF-1α, collagen type Ⅱ, and Aggrecan decreased, and the fluorescence intensity of MMP-2 increased. Western blot results showed that the relative expression of HIF-1α protein was high in P0 generation, the P1 generation has a rising trend, and then gradually decreased; the differences between generations were significant (P<0.05). The relative expression of collagen type Ⅱ protein decreased from P0 to P3 generations and there were significant differences between generations (P<0.05). The relative expression of Aggrecan protein decreased from P0 to P2 generations and there were significant differences between generations (P<0.05); but no significant difference was found between P2 and P3 generations (P>0.05). The relative expression of MMP-2 protein increased significantly in P3 generation; except that the difference between P0 and P2 generations was not significant (P>0.05), the significant differences were found between the other generations (P<0.05).ConclusionRabbit NPCs degeneration model was successfully established by the natural culture and subculture method. Transforming of NPCs morphology, increasing of cell apoptosis rates, decreasing of anabolism, and increasing of catabolism were presented in NPCs degeneration model.
ObjectiveTo evaluate the usefulness of estimation of physiologic ability and surgical stress (E-PASS) for predicting postoperative complications in patients undergoing elective colorectal cancer surgery. MethodsPatients underwent colorectal cancer surgery between August 2009 and October 2010 were analyzed retrospectively. E-PASS equations were applied to those patients for estimation of operative risk. The preoperative risk score (PRS), surgical stress score (SSS), and comprehensive risk score (CRS) of the E-PASS were compared with actual postoperative complications. The relationship between E-PASS variables and morbidity after colorectal cancer surgery was identified. ResultsOf the 313 patients, 22 (7.0%) had postoperative complications. Of all the E-PASS variables between complicative group and noncomplicative group, the morbidity was significantly correlated to age (P=0.003), weight (P=0.019), tumor histologic types (P=0.033), Dukes stage (P=0.001), severe heart disease (P=0.019), severe pulmonary disease (P=0.000), performance status (P=0.000), loss of blood volume/body weight (P=0.007), loss of blood volume (P=0.001) and operation time (P=0.001). Differentiation degree of tumor (P=0.503), diabetes (P=0.745), ASA grade (P=0.085), and size of surgical incision (P=0.726) were not significantly associated with postoperative complications. The PRS and CRS were higher in complicative group than those in noncomplicative group (Plt;0.001). But the difference of SSS between the two groups was not statistically significant (P=0.059). ConclusionThe E-PASS scoring system is a relatively simple, fast, and operable tool that can be used to predict short-term postoperative morbidity accurately for clinical decision-making in colorectal cancer surgery.
Objective To explore the clinical value of measuring angle alpha ( α) in the descending limb of maximum expiratory flow-volumem ( MEFV) curve in chronic obstructive pulmonary disease ( COPD) and bronchial asthma. Methods From MEFV curves, angle αand other parameters were measured in 157 individuals with COPD and 149 patients with asthma who received pulmonary function test in Zhongshan Hospital, from November 2008 until December 2009. The results were grouped and analyzed.The area under ROC curve of the angle αwas measured in the patients with COPD and compared with asthma. Results The angle αlessened with the increasing degree of airway obstruction in the patients with COPD and asthma( P lt;0. 01, P gt;0. 05) . Tangent( 180 - α) and FEV1. 0 were correlated either in the COPD group or in the asthma group( r = - 0. 640, P =0. 000; r = - 0. 206, P = 0. 012) . There was no statistical difference in the angle α between the COPD group and the asthma group when the patients had mild obstructive ventilation disorders( P =0. 177) . The angle αin the COPD group was smaller than that in the asthma group when the patients had moderate and severe obstructive ventilation disorders( P =0. 000, P =0. 000) . Area under ROC curves of the angle αin the patients with COPD who had mild, moderate and severe obstructive ventilation disorders were 0. 431, 0. 846 and 0. 928 respectively. In moderate obstructive ventilation disorders, the optimal diagnostic cutoff point was 135. 5 degree which was capable of differentiating COPD and asthma with a sensitivity of 81. 7% , a specificity of 74. 2% , a positive predictivevalue of 75. 4% , and a negative predictive value of 80. 7% . In severe obstructive ventilation disorders, the optimal diagnostic cutoff point was 129. 5 degree with a sensitivity of 87. 5% , a specificity of 84. 0% , a positive predictive value of 94. 3% , and a negative predictive value of 77. 8% . Conclusions Angle αin the descending limb of MEFV curve can assess the degree of airway obstruction in COPD, whereas it just reflect the presence of airway obstruction in asthma. Differences in Angle αare associated with pathological and pathophysiological differences between COPD and asthma, which will help for deffirentiating diagnosis.
Objective To summarize the experience of sequentially minimally invasive treatment for aged and high risk symptomatic pancreatic pseudocyst under ultrasound guided percutaneous catheter drainage combined with endoscopic technique. Methods The clinical data of 30 patients with aged and high risk pancreatic pseudocyst treated from January 2009 to January 2012 in this hospital were analyzed retrospectively. Results Percutaneous tubes were successfully placed in 30 patients， cystic liquid was sufficiently drained， and the compression symptom of cyst was relieved immediately. After stable disease， 12 patients with communicating cysts were diagnosed by using endoscopic retrograde cholangiopancreatography. Pancreatic duct stents were inserted in 12 patients with communicating cysts for 60-90d （with an average 70d） after endoscopic sphincterectomy and endoscopic pancreatic sphincterectomy. Cysts disappeared in the other 18 cases receiving external drainage with external drainage tubes， the drainage time was 15-90 d with an average 30d. Neither recurrence nor complications were found in all the cases during 12-21 months （with an average 18 months） follow-up. Conclusion Interventional ultrasound combined with endoscopic technique sequentially minimally invasive treatment for aged and high risk symptomatic pancreatic pseudocyst has superiorities in little trauma， fewer complications， and exact effect.
Objective To explore the effectiveness of maintaining the stability between the fourth and the fifth metacarple base during the treatment in the hamate-metacarpal joint injury. Methods Between September 2015 and June 2017, 13 cases of hamate-metacarpal joint injury were treated, including 12 males and 1 female, aged from 17 to 55 years (mean, 30.8 years). The injury causes included heavy boxing in 10 cases and falling in 3 cases. There were 2 cases of simple fourth metacarpal basal fracture, 1 basal fracture of the fourth metacarpal bone combined with intermetacarpal ligament fracture, 7 fractures of the fourth and fifth metacarpal base, 2 fourth metacarpal basal fractures combined with the fifth metacarpal basal fracture dislocation, and 1 base fracture of fourth and fifth metacarpal bone combined with hamate bone fracture. The time from injury to operation was 5-11 days (mean, 7.2 days). According to different damage degree and stability change between the fourth and the fifth metacarple base, a preliminary classification was made for different degrees of injury: 2 cases of type Ⅰ, 1 case of type Ⅱ, 7 cases of type Ⅲ, 2 cases of type Ⅳ, and 1 case of type Ⅴ. The patients were treated with corresponding internal fixation methods under the principle of stability recovery between the fourth and fifth metacarple base. Results All the incisions healed by first intention without infection or skin necrosis. All the 13 patients were followed up 6-18 months with an average of 9.4 months. All fractures healed clinically, and the healing time was 5.5-8.0 weeks with an average of 6.3 weeks. No complication such as plate breakage, fracture dislocation, fracture malunion, and bone nonunion occurred. Hand function was evaluated according to the total active motion (TAM) functional evaluation standard of hand surgery at 6 months after operation, and the results was excellent in 9 cases, good in 3 cases, and fair in 1 case, with an excellent and good rate of 92.3%. Conclusion Stability between the fourth and fifth metacarple base is of great significance to the classification and the treatment of the hamate-metacarpal joint injury.