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Objective: To examine the outcomes of Slide tracheoplasty for the children with severe congenital tracheal stenosis received previous repeated balloon dilatation or metal stent placement under endoscopy. Methods: A retrospective study was conducted in 9 children with congenital tracheal stenosis undergoing previous interventional therapy under tracheoscopy and later received Slide tracheoplasty due to obvious respiratory symptoms at Department of Cardiac Surgery, Qilu Children's Hospital of Shandong University between February 2017 and July 2021. There were 7 males and 2 females with a median age at operation of 72.4 months (range: 13.3 to 98.9 months), and the median weight was 19.0 kg (range: 9.0 to 33.0 kg). Among the 9 patients, 2 patients began to receive repeated balloon dilatation (more than 3 times) 17.8 and 51.8 months ago respectively. One patient received metal stents placement into the trachea for 4 days and the other 6 children for median 56.8 months (range: 21.6 to 74.2 months). Complete tracheal cartilage rings and long segmental stenosis were present. in all 9 children. Operative details and outcome measures, including the need for endoscopic airway intervention and mortality, were collected. Results: Slide tracheoplasty was performed in all cases. Two patients with repeated balloon dilatation had different thickness of tracheal wall, local scar hyperplasia and irregular lumen. Among them, 1 case had obvious local calcification of tracheal wall, which was difficult to suture. The metal stent in one patient with short time of placement was completely removed. However, only part of the metal stents could be removed due to the long placement time in the other 6 cases. There was no operative death in the 9 children. The median postoperative tracheal intubation time was 25.3 hours (range: 17.4 to 74.5 hours). A silicone stent was placed in the trachea of 1 child due to obvious respiratory symptoms. Follow-up of median 11 months (range: 1 to 23 months) showed that no death occurred after discharge and all children had basically normal activity tolerance with no obvious respiratory symptoms. Conclusions: Slide tracheoplasty is feasible for children undergoing prior balloon dilatation or metal stents placement. Previously repeated balloon dilatation or metal stent placement under endoscopy increased the difficulty of slide tracheoplasty, the metal stent could not be completely removed after a long time.
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Child , Female , Humans , Infant , Male , Constriction, Pathologic , Dilatation , Endoscopy , Plastic Surgery Procedures , Retrospective Studies , Stents , Trachea/surgery , Tracheal Stenosis/surgery , Treatment OutcomeABSTRACT
ObjectiveTo observe the efficacy and safety of Fuzheng Huayu tablets （FHT） for treating pulmonary inflammation in patients with coronavirus disease 2019 （COVID-19）. MethodA total of 70（4 cases were lost to follow-up, and 66 cases were finally completed） COVID-19 patients were recruited from February 1 to April 15 in 2020. They were assigned to a control group （35 patients） and a FHT group （31 patients）. The patients in the control group received routine treatment alone and those in the FHT group received FHT in addition to routine treatment. The primary outcome was the ratio of patients showing improvement in chest computed tomographic manifestations after 14 days. The secondary outcome measures included remission rate or progression rate of critical illness， clinical remission rate of respiratory symptoms， routine blood examination， C-reactive protein （CPR） level， procalcitonin （PCT） level， and blood oxygen saturation （SPO2）. The safety was assessed based on liver and kidney functions and adverse events. ResultAfter the 14-day treatment， the ratio of patients showing improvement in the FHT group （100%） was higher than that in the control group （77.1%） （χ2=8.063，P<0.01）. The ratio of disease stages after treatment showed no significant difference between two groups. In the FHT group， the symptoms including cough， dyspnea， and fatigue were alleviated after treatment （P<0.01）. In the control group， the symptoms including fever， cough， and dyspnea were alleviated （P<0.01）， while the fatigue was not relieved after treatment. No significant difference was observed in the clinical symptoms between the two groups after treatment. After treatment， the FHT group showed decreased white blood cell （WBC） count and neutrophil-to-lymphocyte ratio （NLR） （P<0.01）， elevated platelet （PLT） level （P<0.05）， lowered CRP level （P<0.05）， and no significant difference in lymphocyte （LYM）， hemoglobin （Hb）， SPO2 or PCT level. The control group showed decreased NLR （P<0.05） and WBC count （P<0.01）， elevated PCT level （P<0.05）， and no significant change in LYM， Hb， PLT， SPO2 or CRP level after treatment. Furthermore， the FHT group had higher PLT level than the control group （P<0.05） after treatment， and other indicators had no significant differences between the two groups. The liver and kidney functions had no significant difference between the two groups after treatment. ConclusionFHT can safely promote the absorption of acute pulmonary inflammation in COVID-19 patients.
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To detect the methylation level of genome-wide DNA and total RNA in the process of heart failure, we established the method of ultra-high performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) to observe the change and synchronization of methylation rate of myocardial infarction (MI) tissue and peripheral blood. Animal welfare and experimental process were in accordance with the regulations of the Animal Ethics Committee of Guangzhou Medical University. The rats with myocardial infarction were divided into three groups: 1st, 4th, and 8th week to simulate different levels of cardiac function. And they were euthanized at the same time to keep the same age. DNA and RNA were extracted from infarct marginal tissues and peripheral blood lymphocytes, and then decomposed into single nucleosides by enzymolysis. The methylation rate of DNA and RNA was measured and calculated quantitatively. The results showed a concordant methylation changes in tissue and blood, and the methylation level of genome-wide DNA and total RNA was increased after myocardial infarction in rats. In this study, we obtained the preliminary data of DNA and RNA methylation during the occurrence and development of heart failure, further indicating that epigenetic changes can be used as biomarkers for early diagnosis of heart failure.
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<p><b>BACKGROUND</b>Nucleolin (NCL) is the most abundant RNA-binding protein in the cell nucleolus and plays an important role in chromatin stability, ribosome assembly, ribosomal RNA maturation, ribosomal DNA transcription, nucleocytoplasmic transport, and regulation of RNA stability and translation efficiency. In addition to its anti-apoptotic properties, the underlying mechanisms associated with NCL-related roles in different cellular processes remain unclear. In this study, the effect of NCL on microRNA (miRNA) expression was evaluated by generating transgenic mice with myocardial overexpression of NCL and by analyzing microarrays of mature and precursor miRNAs from mice.</p><p><b>METHODS</b>Using microinjection of alpha-MyHc clone 26-NCL plasmids, we generated transgenic mice with myocardial overexpression of NCL firstly, and then mature and precursor miRNAs expression profiles were analyzed in NCL transgenic mice (n = 3) and wild-type (WT) mice (n = 3) by miRNA microarrays. Statistical Package for the Social Sciences version 16.0 software (SPSS, Inc., Chicago, IL, USA) was used to perform Student's t-test, and statistical significance was determined at P < 0.05.</p><p><b>RESULTS</b>Several miRNAs were found to be differentially expressed, of which 11 were upregulated and 4 were downregulated in transgenic mice with myocardial overexpression of NCL compared to those in WT mice. Several differentially expressed miRNAs were subsequently confirmed and quantified by real-time quantitative reverse transcription-polymerase chain reaction. Bioinformatics analysis was used for the prediction of miRNA targets. Furthermore, in vitro experiments showed that NCL regulated miR-21 expression following hydrogen peroxide preconditioning.</p><p><b>CONCLUSIONS</b>Myocardial-protection mechanisms exerted by NCL might be mediated by the miRNAs identified in this study.</p>
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AIM:To observe the expression of microRNA-126-5p during myocardial injury and its role in myo-cardial cell injury induced by adriamycin(also called doxorubicin, DOX).METHODS: The BALB/c mouse model of DOX-induced acute and chronic myocardial injury was established via intraperitoneal injection of DOX.HE staining was applied to observe the morphological changes of myocardial tissues.Lactate dehydrogenase(LDH)in serum was detected and PowerLab system was used to detect the influence of DOX on the changes of ±dp/dtmax.The expression of microRNA-126-5p in injured myocardial tissues and the H 9c2 cells exposed to DOX was detected by real-time PCR.Gain-and loss-of-function experiments were conducted to detect the role of microRNA-126-5p in H9c2 cells treated with DOX on LDH release and caspase-3 activation.RESULTS:In acute and chronic DOX myocardial damage models in mice,HE staining showed disarranged myocardial fibers, dissolved myofibril and inflammatory cell infiltration.Higher serum LDH level and lower ±dp/dtmaxin DOX-treated mice than those in normal mice were found.Compared with the normal mice, the expression level of microRNA-126-5p was significant increased in the myocardium with DOX-induced injury.Similarly,the expression level of microRNA-126-5p was significant increased in the H9c2 cells treated with DOX.In addition, over-expression of microRNA-126-5p decreased cell viability and promoted apoptosis,while microRNA-126-5p ablation promoted the viability and inhibited the apoptosis of H9c2 cells.CONCLUSION:The microRNA-126-5p expression is up-regulated in myocar-dial injury induced by DOX,and microRNA-126-5p inhibits cell viability and promotes apoptosis induced by DOX.
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With the development of whole genome and transcrip-tome sequencing technologies, a growing body of long noncoding RNAs (lncRNAs) and circular RNAs (circRNAs) has been i-dentified and is receiving increasing attention. LncRNAs and circRNAs are non-protein encoding transcripts whose functions are crucial for advancing our comprehensive understanding of bi-ological processes in human health and diseases, specifically tumor. And there is a close relationship between circRNAs and lncRNAs in their origin and function. In this paper, we have re-viewed the recent advances of lncRNAs and circRNAs in tumor by focusing on their relationships, which may help to distinguish them and identify tumor biomarkers further.
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Application of a combination of various chromatographic techniques including column chromatography over silica gel, Sephadex LH-20, macroporous adsorbent resin, and reversed-phase HPLC, led to the isolation of 173 compounds including irdidoids, monoterpenes, sesquiterpenes, triterpenes, lignans, flavonoids, and simple aromatic derivatives from the ethyl acetate-soluble fraction of the whole plants of Valeriana jatamansi(Valerianaceae), and their structures were elucidated by spectroscopic methods including 1D, 2D NMR UV, IR, and MS techniques. Among them, 77 compounds were new. In previous reports, we have described the isolation, structure elucidation, and bioactivities of 68 new and 25 known compounds. As a consequence, we herein reported the isolation and structure elucidation of the remaining 9 new and 71 known compounds, the structure revision of valeriotriate A(8a), as well as cytotoxicity of some compounds.
Subject(s)
Acetates , Chromatography, High Pressure Liquid , Flavonoids , Iridoids , Lignans , Molecular Structure , Monoterpenes , Phytochemicals , Plant Extracts , Chemistry , Sesquiterpenes , Triterpenes , Valerian , ChemistryABSTRACT
<p><b>OBJECTIVE</b>To explore the therapeutic effects of distal humeral lateral closing wedge osteotomy followed by modified pinning combined with external tension band fixation in the treatment of cubitus varus deformity in children.</p><p><b>METHODS</b>Total 26 adult patients with cubitus varus deformity were treated by operation from March 2011 to June 2015, 15 patients were boys and the other 11 patients were girls, ranging in age from 4 to 13 years, with an average of 7.8 years. The cubitus varus angel ranged from 11 degrees to 24 degrees, with a mean(17.50±6.73) degrees, 3 patients complicated more than 10 degrees constriction of flexion. Lateral closing wedge osteotomy retaining the medial 3 to 4 mm intact cortex by lateral elbow approach was applied in these 26 patients. The wedge defect were closed and fixed by crossing pinning. The lateral column compression was achieved with external tension band(the crossing pins were bended laterally and the pin ends were hooked mutually). The pre-operative, post-oparetive and contralateral carrying angles were compared and Laupattarakasem criteria was used to evaluate the results at follow-up.</p><p><b>RESULTS</b>All the patients got bony union 2 months after operation and there was no infection or nerve palsy. The average follow-up period was 18.8 months (ranged, 13 to 29 months). The carrying angle was restored to(11.50±3.17) degrees(ranged, 8 to 14 degrees). According to the Laupattarakasem evaluation criteria, 14 patients got an excellent result, 13 good and 1 fair.</p><p><b>CONCLUSIONS</b>Normal carrying angle and elbow flexion could be restored by lateral closing wedge osteotomy, and stable fixation could be achieved with crossing pinning and external tension band, which is available for early mobilization.</p>
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Objective To investigate the effect and safety of Gukang capsule combined with sodium hyaluronate injection on the treatment of the patients with osteoarthritis. Methods 94 osteoarthritis patients selected from December 2015 to March 2017 were randomly divided into study group (n=47) and control group (n=47). The control group were given sodium hyaluronate injection, the study group were received local injection of sodium hyaluronate combined with Gukang capsule. The changes of knee joint function (HSS scale score) and adverse reaction rate were recorded and compared before and after treatment in the two groups. Results Before treatment, there was no significant difference in HSS scores between the two groups. After treatment, the HSS score in the study group was significantly better than that in the control group (P<0.05). There were no significant differences in the adverse reactions between the 2 groups during the treatment. Conclusion Local injection of sodium hyaluronate combined with Gukang capsule on the treatment of osteoarthritis, which can significantly improve the clinical efficacy, the security is higher. .
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Objective·To investigate the effectiveness of nerve transfer in repairing defecation function after spinal cord injury by the pseudorabies virus (PRV) retrograde tracing. Methods·The spinal cords were transected between L6 and S1 nerve root in 20 rats. The nerve transferring surgery was then conducted in 10 rats (Group B) and the remaining rats were control (Group A). After six months, all rats were injected with 6 μL PRV, sacrificed after 3 d and perfused with paraformaldehyde. Spinal cords were then harvested and frozen sections were prepared for observation. Results·There was no detectable infection of PRV proximal to the injury level in Group A, while infected neurons proximal to the injury level were widely observed in Group B.Conclusion·Nerve transfer has potent effect on defecation reconstruction after spinal cord injury in rats. PRV retrograde tracing can prove the existence of new neuron pathway.
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Objective To investigate the effect and safety of Gukang capsule combined with sodium hyaluronate injection on the treatment of the patients with osteoarthritis. Methods 94 osteoarthritis patients selected from December 2015 to March 2017 were randomly divided into study group (n=47) and control group (n=47). The control group were given sodium hyaluronate injection, the study group were received local injection of sodium hyaluronate combined with Gukang capsule. The changes of knee joint function (HSS scale score) and adverse reaction rate were recorded and compared before and after treatment in the two groups. Results Before treatment, there was no significant difference in HSS scores between the two groups. After treatment, the HSS score in the study group was significantly better than that in the control group (P<0.05). There were no significant differences in the adverse reactions between the 2 groups during the treatment. Conclusion Local injection of sodium hyaluronate combined with Gukang capsule on the treatment of osteoarthritis, which can significantly improve the clinical efficacy, the security is higher. .
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Objective·To investigate the effectiveness of nerve transfer in repairing defecation function after spinal cord injury by the pseudorabies virus (PRV) retrograde tracing. Methods·The spinal cords were transected between L6 and S1 nerve root in 20 rats. The nerve transferring surgery was then conducted in 10 rats (Group B) and the remaining rats were control (Group A). After six months, all rats were injected with 6 μL PRV, sacrificed after 3 d and perfused with paraformaldehyde. Spinal cords were then harvested and frozen sections were prepared for observation. Results·There was no detectable infection of PRV proximal to the injury level in Group A, while infected neurons proximal to the injury level were widely observed in Group B.Conclusion·Nerve transfer has potent effect on defecation reconstruction after spinal cord injury in rats. PRV retrograde tracing can prove the existence of new neuron pathway.
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Objective To analyze the epidemiological characteristics of malaria prevalence in Danyang City from 2004 to 2015,so as to provide the evidence for formulating the strategy of prevention and control of malaria. Methods The data of ma-laria serum tests,the reported malaria cases from the Internet Reporting System,and the epidemiological case survey from 2004 to 2015 as well as the mosquito monitoring data from 2008 to 2015 were collected and analyzed. Results From 2004 to 2015, 58 malaria cases were reported in Danyang City,with an average annual incidence rate of 0.6/105. Among the cases reported, vivax malaria accounted for 65.52％(38/58),falciparum malaria accounted for 5.17％(3/58),oval malaria accounted for 1.72％(1/58),and unclassified subtype accounted for 27.59％(16/58). The local infection cases accounted for 31.03％(18/58),and the imported cases accounted for 68.97％(40/58). There were no local infections since 2011. Anopheles sinensis,the only malaria vector in Danyang City,was still prevalent,but its density was low. Conclusion Imported malaria poses a serious threat to the malaria elimination achievements in Danyang City,and the surveillance and disposal of imported malaria need to be strengthened.
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Objective To detect the expression and the role of the long non -coding RNA AK046999 in the development of mouse cerebral cortex.Methods 1) The AK046999 locus was obtained from the UCSC genome browser ,and the coding ability of protein was predicted by Coding Potential Calculator ; 2) The expression profile of AK046999 in the development of mouse cerebral cortex was analyzed by immunofluorescence and in situ hybridization;3)The AK046999 knockout mouse was constructed by TALEN technique and identified at the level of DNA and RNA; 4)The phenotype of knockout mouse cerebral cortex was analyzed by immunofluorescence and TUNEL assay.Results 1)AK046999 had weak coding ability and could be considered as non -coding RNA; 2)AK046999 was highly expressed in VZ /SVZ of the development of mouse cerebral cortex; 3)The AK046999 knockout mouse was successfully constructed; 4) Immunofluorescence results showed that there were no obvious changes in the markers of PAX6, TBR2 and NEUROD2 compared with the control, and apoptotic cells also had no obvious change.Conclusions The AK046999 is expressed in the cerebral cortex of developing mouse and AK046999 knockout has no effect on proliferation, differentiation and apoptosis of neural progenitor cells in the cerebral cortex .
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BACKGROUND:In recent years,the incidence of skeletal muscle injury becomes higher and higher,but the skeletal muscle repair ability is limited;therefore,studies on the molecular mechanism of skeletal muscle repair play a positive role in the treatment of skeletal muscle injury.OBJECTIVE:To explore the role of microRNA in skeletal muscle regeneration.METHODS:C2C12 myoblasts were cyclic stretched in vitro by the Flexercell-5000 flexible device,and the appropriate stretch condition which could induce myogenesis was selected.The microRNA expression alteration during mechanical stretch-induced myoblast myogenesis was explored using high-throughout sequencing,and the differentially expressed microRNAs were further studied by the bioinformatics analysis.RESULTS AND CONCLUSION:10％ deformation,0.125 Hz cyclic mechanical stretch could promote myoblast proliferation and increase MyoD and Myogenin expressions in C2C12 myoblasts.MicroRNA expression profile alteration,including the downregulated miR-500-3p/1934-5p/31-3p/378a-5p/3473b/331-3p/5097 and upregulated miR-340-5p/449c-Sp/1941-3p,were all involved in the stretch-mediated myoblast myogenesis,and the MAPK signal pathway seemed to participate in this process.These results suggest that the low frequency of the cyclic mechanical stretch can upregulate the expression levels of myogenic regulatory factors through the alteration of MicroRNA expression,further inducing myogenesis,which the MAPK signal pathway may be involved in.
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To evaluate the feasibility of Pegaspargase instead of L-asparaginase to treat children with advanced-stage lymphoblastic lymphoma [LBL] on the Berlin-Frankfurt-Munster [BFM]-95 protocol. Fifty-four newly diagnosed patients with stage III or IV LBL and without any treatment were enrolled in this study. Pegaspargase took place of L-asparaginase in BFM-95. The complications and treatment responses of patients treated on the BFM-95 protocol and modified BFM-95 protocol were then evaluated respectively. For LBL patients treated with BFM-95 protocol or modified BFM-95 protocol, the complete response, event-free survival, overall survival were similar. Stage 4 myelosuppression was the most common complication in both groups. Besides that, among 31 patients receiving modified BFM-95 protocol, coagulation defects were the most common complication. In contrast, anaphylactic reaction was the most common complication in the other 23 patients receiving BFM-95 protocol. Modified BFM-95 protocol is available to children with advanced-stage LBL with an equal outcome and enhances its compliance and decreases the incidence of anaphylactic reaction, compared to BFM-95 protocol. Coagulation defects are the major complication and tolerable in modified one
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<p><b>OBJECTIVE</b>To discuss the effect of electric coagulation through bronchoscopy in diagnosis and treatment of congenital vallecular cyst in children.</p><p><b>METHOD</b>Ten cases of congenital vallecular cyst in the study with age ranged from 21 days to 4 years and 10 months were treated with electric coagulation through bronchoscopy. The therapeutic effect was evaluated by endoscopic and clinical manifestation. And all the patients were followed-up for 6-12 months.</p><p><b>RESULT</b>All the patients obtained 3-5 times electric coagulation. After the operation, the cyst decreased in size, epiglottis softening was subsided, uplift uncompression, dyspnea and laryngeal stridor were improved obviously. After follow-up periods of 6-12 months, no capsule wall were left, and the activity of the epiglottis resumed.No severe complication was found in any patient.</p><p><b>CONCLUSION</b>Electric coagulation through bronchoscopy is a simple, effective and safe method to treat congenital vallecular cyst in children.</p>
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Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Bronchoscopy , Methods , Cysts , Diagnosis , General Surgery , Dyspnea , Electrocoagulation , Epiglottis , Pathology , General Surgery , Follow-Up Studies , Laryngeal Diseases , Diagnosis , General Surgery , Respiratory Sounds , Retrospective Studies , Treatment OutcomeABSTRACT
<p><b>BACKGROUND</b>The association between IGF2BP2 and type 2 diabetes mellitus (T2DM) has been repeatedly confirmed among different ethnic populations. However, in several genome-wide association studies (GWAS) from the Chinese Han population, the gene IGF2BP2 has not been replicated. The results of relevant studies for the association between IGF2BP2 and T2DM showed controversy in Chinese Han population. It is necessary to systematically evaluate the contribution of common variants in IGF2BP2 to T2DM in Chinese Han population.</p><p><b>METHODS</b>Two single-nucleotide polymorphisms (SNPs, rs4402960 and rs1470579) in IGF2BP2 were genotyped in Chinese Han population (3807 controls/4531 T2DM cases) by Illumina GoldenGate Indexing assay. The association between SNPs and T2DM was evaluated by multiple Logistic Regression analysis. A meta-analysis was used to estimate the effects of IGF2BP2 in 20854 Chinese Han individuals.</p><p><b>RESULTS</b>rs1470579 and rs4402960 were confirmed to have strong association with T2DM in the Chinese Han population (rs1470579 P = 1.80×10(-7), OR (95% CI) = 1.22 (1.14-1.32), rs4402960 P = 7.46×10(-9), OR (95% CI) = 1.26 (1.17-1.37), respectively). Moreover, 11 studies for rs4402960 were included in the meta-analysis and 7 studies for rs1470579. The meta-analysis also showed the association between T2DM and IGF2BP2 (rs1470579 OR of 1.15 (95% CI = 1.10-1.19), P < 0.0001 under an additive model and rs4402960 OR of 1.14 (95% CI = 1.10-1.18), P < 0.0001 under an additive model).</p><p><b>CONCLUSION</b>IGF2BP2 was strongly associated with the risk of T2DM in Chinese Han population.</p>
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Female , Humans , Male , Middle Aged , Asian People , Genetics , Diabetes Mellitus, Type 2 , Genetics , Genetic Predisposition to Disease , Genetics , Genome-Wide Association Study , Genotype , Linkage Disequilibrium , Genetics , Polymorphism, Single Nucleotide , Genetics , RNA-Binding Proteins , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To investigate the risk factors and the prevention management of anastomotic leak in patients with Crohn disease undergoing bowel resections.</p><p><b>METHODS</b>Clinical data of 91 patients with Crohn disease undergoing intestinal resection from 1990 to 2010 were analyzed retrospectively. Logistic regression analysis was used to assess the risk factors of anastomotic leak.</p><p><b>RESULTS</b>A total of 120 intestinal anastomosis were performed in 91 patients, and anastomosis leak occurred in 14 patients (11.7%). Univariate analysis showed that operative timing (emergency or elective surgery), anastomosis type (side-to-side or end to end and end-to-side), operative time (≥3 h or <3 h), methods of anastomosis (handsewn or stapled) were the risk factors for anastomotic leak (P<0.05). Multivariate analysis revealed that emergency surgery (OR=3.891, 95%CI:1.332-13.692), end to end and end-to-side anastomosis (OR=3.236, 95%CI:1.165-11.950), handsewn anastomosis (OR=5.715, 95%CI:1.454-17.328) were independent risk factors of anastomotic leak.</p><p><b>CONCLUSION</b>Avoiding emergency operation, use of side to side anastomosis, and application of stapling may lower the incidence of postoperative anastomotic leak in patients with Crohn disease undergoing bowel resections.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Anastomotic Leak , Colectomy , Crohn Disease , General Surgery , Logistic Models , Retrospective Studies , Risk FactorsABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical effects of modified Nirschl surgical techniique in treating refractory lateral epicondylitis.</p><p><b>METHODS</b>From March 2009 to January 2011,21 patients (21 elbows) with refractory lateral epicondylitis were treated in our hospital. There were 8 males and 13 females,ranged in age from 25 to 59 years with an average of (48.3+/-13.4) years and the duration time from 8 to 33 months with an average of (17.1+/-7.7) months;affected position in dominant sides of 16 cases and non-dominant sides of 5 cases. The patients had already received multiple non-operative treatments. Modified Nirschl surgical technique was performed,and operative origination from origin of musculus extensor carpi radialis brevis to discard process with small incision, the process place of extensor digitorum communis would be removed. The incisions were nursed by ice compress for 2 days after operation. Range of motion (ROM) and strengthening exercise of elbow joints started at the 1 week after plaster slab fixation; ROM and strengthening exercise of wrist joints also started at the 2 week after fixation. The pain, power of gripping and patient staisfaction were recorded after operation. Verhaar scaling were used to estimate the recovery.</p><p><b>RESULTS</b>Seventeen patients were followed up from 13 to 22 months with an average of 16.3 months. According to Verhaar standard, 15 cases obtained excellent results and 2 good. No postoperative complication such as instability was found.</p><p><b>CONCLUSION</b>Modified Nirschl surgical technique is an effective method in treating refractory lateral epicondylitis but correct to diagnosis and exclusion the coexisting diseases,accurate removal the process are important guarantee.</p>